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Agarwal T, Bhojraj SY, Nagad PB, Kashikar AD, Borde M, Powal G, Harikrishnan A. Spontaneous Lumbar Interbody Fusion Following Posterolateral Fusion Surgery: A Retrospective Analysis of 5-Year Data. Indian J Orthop 2024; 58:598-605. [PMID: 38694687 PMCID: PMC11058144 DOI: 10.1007/s43465-024-01148-w] [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: 10/16/2023] [Accepted: 03/31/2024] [Indexed: 05/04/2024]
Abstract
Background Posterolateral fusion (PLF) surgery is frequently performed for a range of spinal disorders. However, spontaneous lumbar interbody fusion (SLIF) following PLF surgery is yet to be reported. Thus, we evaluated the incidence and characteristics of SLIF among patients that underwent PLF surgery. Methods This retrospective study involved review of electronic medical records of 121 adult patients who underwent primary lumbar decompression with instrumented PLF between 2006 and 2011. The available radiographs of L2-S1 region were assessed for SLIF and PLF. At 1 year, modified Lee's and Lenke's criteria were used to assess SLIF and PLF, respectively. Differences between the patients in the fusion and non-fusion groups were evaluated. Results At 1-year follow-up, 28.93 and 87.61% patients had SLIF and PLF, respectively. Moreover, 27.27% patients had both SLIF and PLF. L4-L5 (n = 13) was the most common segment involved in SLIF. SLIF rate was significantly greater among young adults (p value = 0.001), and those with no pre-operative instability (p value = 0.003) as well as who underwent pedicular fixation instrumented PLF surgery (p value < 0.0001). While, PLF was significantly greater in patients who did not undergo discectomy (p value = 0.049). SLIF was not significantly associated with sex, age groups, discectomy status, and level of PLF surgery (all p values > 0.05). PLF was not significantly associated with sex, age groups, pre-operative instability, type of instrumentation, and level of PLF surgery (all p values > 0.05). There was no significant association between patients with SLIF and PLF (p value = 0.155). Conclusions More than a quarter of patients developed SLIF and majority of them had PLF. SLIF was significantly associated with younger age at surgery and use of pedicular fixation instruments.Level of Evidence III; retrospective cohort study.
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Affiliation(s)
- Tejasvi Agarwal
- Department of Spine Surgery, Lilavati Hospital and Research Center, Bandra Reclamation Rd, General Arunkumar Vaidya Nagar, Bandra West, Mumbai, Maharashtra 400050 India
| | - Shekhar Y. Bhojraj
- Department of Spine Surgery, Lilavati Hospital and Research Center, Bandra Reclamation Rd, General Arunkumar Vaidya Nagar, Bandra West, Mumbai, Maharashtra 400050 India
| | - Premik B. Nagad
- Department of Spine Surgery, Lilavati Hospital and Research Center, Bandra Reclamation Rd, General Arunkumar Vaidya Nagar, Bandra West, Mumbai, Maharashtra 400050 India
| | - Aaditya D. Kashikar
- Department of Spine Surgery, Lilavati Hospital and Research Center, Bandra Reclamation Rd, General Arunkumar Vaidya Nagar, Bandra West, Mumbai, Maharashtra 400050 India
| | - Mandar Borde
- Department of Spine Surgery, Lilavati Hospital and Research Center, Bandra Reclamation Rd, General Arunkumar Vaidya Nagar, Bandra West, Mumbai, Maharashtra 400050 India
| | - Gajendra Powal
- Department of Spine Surgery, Lilavati Hospital and Research Center, Bandra Reclamation Rd, General Arunkumar Vaidya Nagar, Bandra West, Mumbai, Maharashtra 400050 India
| | - A. Harikrishnan
- Department of Spine Surgery, Lilavati Hospital and Research Center, Bandra Reclamation Rd, General Arunkumar Vaidya Nagar, Bandra West, Mumbai, Maharashtra 400050 India
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Davies J, Cheetham M, Branagan G, Eardley N, Tiernan J, Harikrishnan A, Spinelli A, Wheeler J, Moran B, Jenkins JT, Maxwell-Armstrong C. Response to: Boyle J M, et al. 'What is the impact of hospital and surgeon volumes on outcomes in rectal cancer surgery?' Colorectal Disease 2023; 25: 1981-1993. Colorectal Dis 2024; 26:381-382. [PMID: 38131634 DOI: 10.1111/codi.16843] [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: 11/23/2023] [Accepted: 11/24/2023] [Indexed: 12/23/2023]
Affiliation(s)
- Justin Davies
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
- University of Cambridge, Cambridge, UK
| | - Mark Cheetham
- Shrewsbury and Telford Hospital NHS Trust, Shrewsbury, UK
| | | | | | - Jim Tiernan
- Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | | | - Antonino Spinelli
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
- IRCCS Humanitas research Hospital, Rozzano, Milan, Italy
| | - James Wheeler
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Brendan Moran
- Basingstoke and North Hampshire Hospital, Basingstoke, UK
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Harji D, Sarmah P, Gwyther B, Lyons MK, Boereboom CL, Siddiqi S, Arnott R, Harikrishnan A, Maxwell-Armstrong C, Cuming T. Bridging that gap: a qualitative study of perceptions of equality, diversity and inclusivity in colorectal surgery in the UK and Ireland. BMJ Open 2023; 13:e069297. [PMID: 37429683 DOI: 10.1136/bmjopen-2022-069297] [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] [Indexed: 07/12/2023] Open
Abstract
BACKGROUND There is a growing recognition on the importance of equality, diversity and inclusion (EDI) within surgery and the need to diversify the surgical community and its various organisations, in a bidto reflect the diverse populations they serve. To create, sustain and encourage a diverse surgical workforce requires an in-depth understanding of the current makeup of key surgical institutions, relevant issues pertaining to EDI and appropriate solutions and strategies to ensure tangible change. OBJECTIVES Following on from the recent Kennedy Review into Diversity and Inclusion commissioned by the Royal College of Surgeons of England, the aim of this qualitative study was to understand the EDI issues which affected the membership of the Association of Coloproctology of Great Britain and Ireland, while seeking appropriate solutions to address them. DESIGN Dedicated, online and qualitative focus groups. PARTICIPANTS Colorectal surgeons, trainees and nurse specialists were recruited using a volunteer sampling strategy. METHODS A series of online, dedicated, qualitative focus groups across the 20 chapter regions were held. Each focus group was run informed by a structured topic guide. All participants who were given the opportunity to remain anonymous were offered a debriefing at the end. This study has been reported in keeping with the Standards for Reporting Qualitative Research. RESULTS Between April and May 2021, a total number of 20 focus groups were conducted, with a total of 260 participants across 19 chapter regions. Seven themes and one standalone code pertaining to EDI were identified: support, unconscious behaviours, psychological consequences, bystander behaviour, preconceptions, inclusivity and meritocracy and the one standalone code was institutional accountability. Five themes were identified pertaining to potential strategies and solutions: education, affirmative action, transparency, professional support and mentorship. CONCLUSION The evidence presented here is of a range of EDI issues which affect the working lives of those within colorectal surgery in the UK and Ireland, and of potential strategies and solutions which can help build a more inclusive, equitable and diverse colorectal community.
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Affiliation(s)
- Deena Harji
- Department of Surgery, Manchester University Foundation Trust, Northern Surgical Trainees Research Association, Newcastle, UK
| | - Panchali Sarmah
- Robert Kilpatrick Clinical Sciences Building, University Hospitals of Leicester NHS Trust, Leicester, UK
- Leicester Cancer Research Centre, University of Leicester, Leicester, UK
| | - Bethany Gwyther
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - M K Lyons
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | | | - S Siddiqi
- Department of Surgery, Mid and South Essex NHS Foundation Trust, Basildon, UK
| | - R Arnott
- Institute for Energy Studies, University of Oxford, Oxford, UK
| | - Athur Harikrishnan
- Department of Surgery, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | | | - Tamzin Cuming
- Deparment of Surgery, Homerton University Hospital NHS Foundation Trust, London, UK
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Maxwell-Armstrong C, Cheetham M, Branagan G, Davies J, Davies M, Eardley N, Hancock L, Harikrishnan A, McArthur D, Siddiqui S, Tiernan J, Torkington J. Rectal cancer services - is it time for specialization within units? Colorectal Dis 2023. [PMID: 37082786 DOI: 10.1111/codi.16572] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 02/24/2023] [Indexed: 04/22/2023]
Affiliation(s)
| | - Mark Cheetham
- Shrewsbury and Telford Hospital NHS Trust, Shrewsbury, UK
| | | | - Justin Davies
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Mike Davies
- Cardiff and Vale University Health Board, Cardiff, UK
| | | | - Laura Hancock
- Manchester University NHS Foundation Trust (Wythenshawe), Manchester, UK
| | | | - David McArthur
- University Hospitals Birmingham NHS Foundation Trust (Heartlands), Birmingham, UK
| | - Shahab Siddiqui
- Mid and South Essex Foundation Trust (Broomfield), Essex, UK
| | - Jim Tiernan
- Leeds Teaching Hospitals NHS Trust, Leeds, UK
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Alagarasan D, Harikrishnan A, Surendiran M, Indira K, Khalifa AS, Elesawy BH. RETRACTED ARTICLE: Synthesis and characterization of CuO nanoparticles and evaluation of their bactericidal and fungicidal activities in cotton fabrics. Appl Nanosci 2023; 13:1797. [PMID: 34540519 PMCID: PMC8435145 DOI: 10.1007/s13204-021-02054-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 08/28/2021] [Indexed: 02/06/2023]
Affiliation(s)
| | - A. Harikrishnan
- Department of Chemistry, School of Arts and Sciences, Vinayaka Mission’s Research Foundation, Aarupadai Veedu (VMRF-AV) Campus, Paiyanoor, Chennai, Tamil Nadu 603104 India
| | - M. Surendiran
- Department of Chemistry, School of Arts and Sciences, Vinayaka Mission’s Research Foundation, Aarupadai Veedu (VMRF-AV) Campus, Paiyanoor, Chennai, Tamil Nadu 603104 India
| | - Karuppusamy Indira
- Department of Chemistry, M. Kumarasamy College of Engineering, Karur, Tamil Nadu 639113 India
| | - Amany Salah Khalifa
- Department of Clinical Pathology and Pharmaceutics, College of Pharmacy, Taif University, P.O. Box 11099, Taif, 21944 Saudi Arabia
| | - Basem H. Elesawy
- Department of Pathology, College of Medicine, Taif University, P.O. Box 11099, Taif, 21944 Saudi Arabia
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Yiasemidou M, Howitt A, Long J, Sedman P, Garcia-Olmo D, Guadalajara H, Van Cleynenbreugel B, Sharma D, Biyani SC, Patel B, Lam W, Harikrishnan A, Gómez Rivas J, Robinson J, Manuel Ribeiro de Oliveira T, Escalona Vivas G, Sanchez-Salas R, Tourinho-Barbosa R, Chetter I. An international consensus for mitigation of the detrimental effects of the COVID-19 pandemic on laparoscopic training. PLoS One 2022; 17:e0272446. [PMID: 36137091 PMCID: PMC9499280 DOI: 10.1371/journal.pone.0272446] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 07/20/2022] [Indexed: 11/19/2022] Open
Abstract
Aim Achieve an international consensus on how to recover lost training opportunities. The results of this study will help inform future EAES guidelines about the recovery of surgical training before and after the pandemic. Background A global survey conducted by our team demonstrated significant disruption in surgical training during the COVID-19 pandemic. This was wide-spread and affected all healthcare systems (whether insurance based or funded by public funds) in all participating countries. Thematic analysis revealed the factors perceived by trainees as barriers to training and gave birth to four-point framework of recovery. These are recommendations that can be easily achieved in any country, with minimal resources. Their implementation, however, relies heavily on the active participation and leadership by trainers. Based on the results of the global trainee survey, the authors would like to conduct a Delphi-style survey, addressed to trainers on this occasion, to establish a pragmatic step-by-step approach to improve training during and after the pandemic. Methods This will be a mixed qualitative and quantitative study. Semi-structured interviews will be performed with laparoscopic trainers. These will be transcribed and thematic analysis will be applied. A questionnaire will then be proposed; this will be based on both the results of the semi structured interviews and of the global trainee survey. The questionnaire will then be validated by the steering committee of this group (achieve consensus of >80%). After validation, the questionnaire will be disseminated to trainers across the globe. Participants will be asked to consent to participate in further cycles of the Delphi process until more than 80% agreement is achieved. Results This study will result in a pragmatic framework for continuation of surgical training during and after the pandemic (with special focus on minimally invasive surgery training).
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Affiliation(s)
- Marina Yiasemidou
- NIHR Academic Clinical Lecturer, University of Hull, Hull, United Kingdom
- ST8 Colorectal Surgery, Bradford Teaching Hospitals, Bradford, United Kingdom
- * E-mail:
| | - Annabel Howitt
- General Surgery, Bradford Teaching Hospitals, Bradford, United Kingdom
| | - Judith Long
- Hull University Teaching Hospitals, Hull, United Kingdom
| | - Peter Sedman
- Hull University Teaching Hospitals, Hull, United Kingdom
| | - Damian Garcia-Olmo
- Chief of Surgery Department at Fundacion Jimenez Díaz University Hospital (Universidad Autonoma de Madrid), Madrid, Spain
| | - Hector Guadalajara
- University Hospital Fundación Jimenez Díaz and Associate Professor at “Universidad Autonoma de Madrid”, Madrid, Spain
| | - Ben Van Cleynenbreugel
- University Hospitals of Leuven and a Guest Lecturer at the Catholic University of Leuven, Leuven, Belgium
| | | | - Shekhar Chandra Biyani
- Leeds Teaching Hospitals and Honorary Senior Clinical Lecturer, University of Leeds, Leeds, United Kingdom
| | - Bijendra Patel
- Barts Health NHS Trust and University College London Hospitals NHS Foundation Trust and Professor of Surgery, University of London, London, United Kingdom
| | - Wayne Lam
- Department of Surgery, Faculty of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong, China
| | | | | | | | | | - Gabriel Escalona Vivas
- Hospital Sótero del Río and researcher at the Simulation and Experimental Surgery Center at the Pontificia Universidad Católica in Santiago, Santiago, Chile
| | - Rafael Sanchez-Salas
- Department of Urology L’Institut Mutualiste Montsouris Université, Paris Descartes, Paris, France
| | - Rafael Tourinho-Barbosa
- Department of Urology Hospital Cardio Pulmonar–Oncologia D’Or and Núcleo de Oncologia da Bahia, Faculdade de Medicina do ABC, Salvador, Bahia, Brazil
| | - Ian Chetter
- Hull University Teaching Hospitals, Hull, United Kingdom
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Khan K, Bhettani MK, Harikrishnan A, Fawole A, Shiwani MH, Sedman P, Siddique K. Johan Forceps As a Knot Pusher for Extracorporeal Roeder Knot: An Inexpensive Alternative to an Endoloop Ligature in Laparoscopic Appendicectomy. J Laparoendosc Adv Surg Tech A 2021; 32:395-400. [PMID: 34097473 DOI: 10.1089/lap.2021.0223] [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: 11/12/2022] Open
Abstract
Background: Securing of the appendix stump is one of the key steps in performing laparoscopic appendicectomy (LA). This can be achieved by a variety of methods including endoloops, stapler, and clips. An alternative technique, previously described by authors, is the use of Johan forceps as a knot pusher, to deploy an extracorporeal Roeder knot at the base of appendix. We aimed to evaluate the safety and cost-effectiveness of our technique. Patients and Methods: A single surgeon's, prospective cohort, and multicenter study was undertaken at three different hospitals in the United Kingdom. We collected data of all patients, who underwent LA by this technique between 2014 and 2019. Demographics, operative findings, postoperative complications and readmissions were recorded and analyzed. Results: In total, 227 appendicectomies were performed. Median age was 24 years (interquartile range [IQR]: 16-58) with 58% male preponderance. Operative findings were 57% (n = 130) acutely inflammatory appendicitis, 16.74% (n = 38) were complicated appendicitis (perforated, gangrenous). Rest of the operative findings were macroscopically normal appendix (with no other pathology in 18.06% (n = 41), and macroscopically normal appendix but with gynecological pathologies in 7.9% (n = 18). Postoperatively, there were no cases to report complication of blow out stumps neither clinically nor radiologically. Surgical site infections rate has been 3.5% (n = 8). One patient had small intra-abdominal abscess (0.4%), treated by IV antibiotics. Mean hospital stay was 1.89 days (standard deviation [SD] 1-5 days). Thirty days readmissions rate was 4.8%. None of the complications or readmissions was related to the surgical technique. There were no deaths recorded in this series. Cost of handmade endoloop was $0.69. Conclusion: Use of Johan forceps as knot pusher for extracorporeal Roeder knot is a safe, feasible, cost-effective, and easily reproducible technique for carrying out LA.
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Affiliation(s)
- Khalid Khan
- Department of General and Upper GI Surgery, Barnsley District General Hospital NHS Trust, South Yorkshire, United Kingdom
| | - Mehreen Khan Bhettani
- Department of General and Colorectal Surgery, Royal Oldham Hospital, Lancashire, United Kingdom
| | - Athur Harikrishnan
- Department of Colorectal Surgery, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, South Yorkshire, United Kingdom
| | - Adeshina Fawole
- Department of General and Colorectal Surgery, Mid Yorkshire Hospitals NHS Trust, Wakefield, West Yorkshire, United Kingdom
| | - Muhammad H Shiwani
- Department of General and Upper GI Surgery, Barnsley District General Hospital NHS Trust, South Yorkshire, United Kingdom
| | - Peter Sedman
- Department of General Surgery, Hull University Teaching Hospitals NHS Trust, East Yorkshire, United Kingdom
| | - Khurram Siddique
- Department of General and Upper GI Surgery, Barnsley District General Hospital NHS Trust, South Yorkshire, United Kingdom.,Department of General and Colorectal Surgery, Royal Oldham Hospital, Lancashire, United Kingdom.,Department of Colorectal Surgery, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, South Yorkshire, United Kingdom.,Department of General and Colorectal Surgery, Mid Yorkshire Hospitals NHS Trust, Wakefield, West Yorkshire, United Kingdom
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Harikrishnan A, Khanna S, Veena V. Design of New Improved Curcumin Derivatives to Multi-targets of Cancer and Inflammation. Curr Drug Targets 2021; 22:573-589. [PMID: 32753008 DOI: 10.2174/1389450121666200804113745] [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] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 05/11/2020] [Accepted: 05/11/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Curcumin is a major active principle of Curcuma longa. There are more than 1700 citations in the Medline, reflecting various biological effects of curcumin. Most of these biological activities are associated with the antioxidant, anti-inflammatory and antitumor activity of the molecule. Several reports suggest various targets of natural curcumin that include growth factors, growth factor receptor, cytokines, enzymes and gene regulators of apoptosis. This review focuses on the improved curcumin derivatives that target the cancer and inflammation. METHODOLOGY In this present review, we explored the anticancer drugs with curcumin-based drugs under pre-clinical and clinical studies with critical examination. Based on the strong scientific reports of patentable and non-patented literature survey, we have investigated the mode of the interactions of curcumin-based molecules with the target molecules. RESULTS Advanced studies have added new dimensions of the molecular response of cancer cells to curcumin at the genomic level. However, poor bioavailability of the molecule seems to be the major limitation of the curcumin. Several researchers have been involved to improve the curcumin derivatives to overcome this limitation. Sufficient data of clinical trials to various cancers that include multiple myeloma, pancreatic cancer and colon cancer, have also been discussed. CONCLUSION The detailed analysis of the structure-activity relationship (SAR) and common synthesis of curcumin-based derivatives have been discussed in the review. Utilising the predictions of in silico coupled with validation reports of in vitro and in vivo studies have concluded many targets for curcumin. Among them, cancer-related inflammation genes regulating curcumin-based molecules are a very promising target to overcome hurdles in the multimodality therapy of cancer.
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Affiliation(s)
- A Harikrishnan
- Department of Chemistry, School of Arts and Sciences, Vinayaka Mission Research Foundation-Aarupadai Veedu (VMRF-AV) campus, Paiyanoor, Chennai-603104, Tamil Nadu, India
| | - Sunali Khanna
- Nair Hospital Dental College, Municipal Corporation of Greater Mumbai, Mumbai, 400 008, India
| | - V Veena
- Department of Biotechnology, School of Applied Sciences, REVA University, Rukmini knowledge park, Kattigenahalli, Yelahanka, Bengaluru - 5600 064. Karnataka State, India
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Sakshi C, Harikrishnan A, Jayaraman S, Choudhury AR, Veena V. Predictive medicinal metabolites from Momordica dioica against comorbidity related proteins of SARS-CoV-2 infections. J Biomol Struct Dyn 2021; 40:5175-5188. [PMID: 33427588 PMCID: PMC7814569 DOI: 10.1080/07391102.2020.1868340] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Momordica dioica have proven medicinal potential of antidiabetic, antiviral and immune stimulating properties. Flavonoids and triterpenoids from M. dioica were more extensively investigated for antiviral, antidiabetic and immunomodulatory activities. In this present study, we have predicted the reported bioactive flavonoids and triterpenoids of the plant against the SARS-CoV-2 main protease, RNA-dependent RNA polymerase (RdRp), spike protein, angiotensin converting enzyme (ACE-2) receptor and dipeptidyl peptidase (DPP4) receptor through molecular docking and in silico ADME predictions methods. According to the binding affinities, the two triterpenoids, hederagenin and oleanolic acid exhibited the best docking scores with these proteins than the catechin and quercetin with compared to standard remdesivir, favipiravir and hydroxychloroquine. The in vitro protein-drug studies have also showed significant interaction of catechin and quercetin compounds than standard drugs. The in silico binding studies correlated with the in silico binding studies. Further, M. dioica being used as antidiabetic and its metabolite had significant interaction with DDP4, a comorbidity protein involved in aiding the viral entry. Out of all the natural ligands, quercetin was reported relatively good and safe for humans with high gastrointestinal tract permeability and poor blood brain barrier crossing abilities. Hence, M. dioica phytocompounds reflects promising therapeutic properties against SARS-CoV-2 infections under comorbid conditions such as diabetes, cardiovascular disease and kidney disorders. Communicated by Ramaswamy H. Sarma
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Affiliation(s)
- Chavan Sakshi
- Department of Bioanalytical Sciences, Ramnarain Ruia Autonomous College, Mumbai, Maharashtra, India
| | - A Harikrishnan
- Department of Chemistry, School of Arts and Sciences, Vinayaka Mission Research Foundation-Aarupadai Veedu (VMRF-AV) Campus, Chennai, Tamil Nadu, India
| | | | - Ahana Roy Choudhury
- Centre for Bioinformatics, School of Life Science, Pondicherry University, Puducherry, India
| | - V Veena
- Department of Biotechnology, School of Applied Sciences, REVA University, Bengaluru, Karnataka, India
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10
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Fearnhead NS, Acheson AG, Brown SR, Hancock L, Harikrishnan A, Kelly SB, Maxwell‐Armstrong CA, Sagar PM, Siddiqi S, Walsh CJ, Wheeler JMD, Abercrombie JF. The ACPGBI recommends pause for reflection on transanal total mesorectal excision. Colorectal Dis 2020; 22:745-748. [PMID: 32705791 PMCID: PMC7497088 DOI: 10.1111/codi.15143] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 03/05/2020] [Indexed: 12/26/2022]
Affiliation(s)
- N. S. Fearnhead
- Cambridge University Hospitals NHS Foundation TrustCambridgeUK
| | - A. G. Acheson
- Nottingham University Hospitals NHS TrustNottinghamUK
| | - S. R. Brown
- Sheffield Teaching Hospitals NHS Foundation TrustSheffieldUK
| | - L. Hancock
- Wythenshawe HospitalManchester University NHS Foundation TrustManchesterUK
| | - A. Harikrishnan
- Sheffield Teaching Hospitals NHS Foundation TrustSheffieldUK
| | - S. B. Kelly
- Northumbria Healthcare NHS Foundation TrustNewcastle upon TyneUK
| | | | - P. M. Sagar
- Leeds Teaching Hospitals NHS TrustLeedsWest YorkshireUK
| | - S. Siddiqi
- Broomfield HospitalMid Essex Hospital NHS TrustChelmsfordEssexUK
| | - C. J. Walsh
- Arrowe Park HospitalWirral University Teaching Hospital NHS Foundation TrustWirralMerseysideUK
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11
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Amarnani R, Harikrishnan A. Aneurysmal benign fibrous histiocytoma of the anal canal: a rare differential diagnosis. Int J Colorectal Dis 2020; 35:347-349. [PMID: 31845025 DOI: 10.1007/s00384-019-03472-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/22/2019] [Indexed: 02/04/2023]
Abstract
BACKGROUND To our knowledge, we report the first case of an aneurysmal benign fibrous histiocytoma occurring in the anal canal. METHODS Clinical, histological, radiological and surgical data pertaining to this patient were analysed. Additionally, a literature review on aneurysmal benign fibrous histiocytoma was conducted. RESULTS We describe a 48-year-old Caucasian male presenting with a 2-week history of a painful anus, fresh rectal bleeding and tenesmus. Digital rectal examination identified a tender firm mass in the anal verge. Magnetic resonance imaging revealed high signal in the anal canal. Flexible sigmoidoscopy revealed an ulcerated 3-cm indurated lesion at the four o'clock position. Biopsies taken of the mass confirmed the diagnosis of an aneurysmal benign fibrous histiocytoma (BFH). Following a discussion in the colorectal multi-disciplinary team, the patient was counselled for an excision of the lesion. Diathermy dissection was performed to completely excise the tumour with a margin involving the fibres of the anal sphincter. The patient made a full recovery and had no residual symptoms. Histology of the excised specimen confirmed clear margins of the BFH. CONCLUSIONS This paper aims to highlight a rare differential diagnosis for an anal mass. An aneurysmal BFH most often presents as a painless mass within the dermis and subcutaneous tissue. As such, this case presents a diagnostic challenge to both colorectal surgeon and histopathologist due to its low incidence and unusual location. We further present the clinical and radiographic evidence to confirm the diagnosis. Additionally, we discuss the literature pertaining to this condition and its optimal management.
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Affiliation(s)
- Raj Amarnani
- University College London Hospitals NHS Foundation Trust, London, UK. .,Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, London, UK.
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Lakshmanan D, Harikrishnan A, Jyoti K, Idul Ali M, Jeevaratnam K. A compound isolated from Alpinia officinarum Hance. inhibits swarming motility of Pseudomonas aeruginosa and down regulates virulence genes. J Appl Microbiol 2020; 128:1355-1365. [PMID: 31869477 DOI: 10.1111/jam.14563] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 06/25/2019] [Revised: 12/18/2019] [Accepted: 12/18/2019] [Indexed: 12/16/2022]
Abstract
AIM The study was aimed at purifying the active principle from Alpinia officinarum rhizomes responsible for inhibition of swarming motility of Pseudomonas aeruginosa and analysing the mechanism of action. METHODS AND RESULTS The active compound from methanol extract of A. officinarum was purified by silica gel column chromatography followed by elution from Amberlite resin. The compound 1-(3,5-dihydroxyphenyl)-2-(methylamino)ethan-1-one, inhibited swarming motility at 12·5 µg ml-1 . This inhibition was independent of rhamnolipid production. Real-time PCR analysis showed significant down-regulation of virulence-associated genes including T3SS exoS, exoT and flagella master regulator fleQ. CONCLUSIONS The compound from A. officinarum inhibited swarming motility and significantly down-regulated the expression of type III secretory system effector genes exoS and exoT and flagellar master regulator fleQ genes. SIGNIFICANCE AND IMPACT OF THE STUDY The study identifies a potent swarming inhibitory compound from the common medicinal plant A. officinarum and reinstates the potential of plant-derived compounds in tackling virulence properties of pathogenic bacteria.
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Affiliation(s)
- D Lakshmanan
- Department of Biochemistry and Molecular Biology, Pondicherry University, Kalapet, Pondicherry, India
| | - A Harikrishnan
- Department of Chemistry, Pondicherry University, Kalapet, Pondicherry, India
| | - K Jyoti
- Department of Biochemistry and Molecular Biology, Pondicherry University, Kalapet, Pondicherry, India
| | - M Idul Ali
- Department of Biochemistry and Molecular Biology, Pondicherry University, Kalapet, Pondicherry, India
| | - K Jeevaratnam
- Department of Biochemistry and Molecular Biology, Pondicherry University, Kalapet, Pondicherry, India
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Parton S, Lee M, Harikrishnan A. What happens to the follow-up of patients who undergo incision and drainage for perianal abscess? Int J Surg 2016. [DOI: 10.1016/j.ijsu.2016.08.154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Rae A, Lee M, Harikrishnan A. What happens to pilonidal abscesses after emergency incision and drainage? Int J Surg 2015. [DOI: 10.1016/j.ijsu.2015.07.647] [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: 12/01/2022]
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Findlay JM, Tilson RC, Harikrishnan A, Sgromo B, Marshall REK, Maynard ND, Gillies RS, Middleton MR. Attempted validation of the NUn score and inflammatory markers as predictors of esophageal anastomotic leak and major complications. Dis Esophagus 2015; 28:626-33. [PMID: 24894195 DOI: 10.1111/dote.12244] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [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] [Indexed: 12/11/2022]
Abstract
The ability to predict complications following esophagectomy/extended total gastrectomy would be of great clinical value. A recent study demonstrated significant correlations between anastomotic leak (AL) and numerical values of C-reactive protein (CRP), white cell count (WCC) and albumin measured on postoperative day (POD) 4. A predictive model comprising all three (NUn score >10) was found to be highly sensitive and discriminant in predicting AL and complications. We attempted a retrospective validation in our center. Data were collected on all resections performed during a 5-year period (April 2008-2013) using prospectively maintained databases. Our biochemistry laboratory uses a maximum CRP value (156 mg/L), unlike that of the original study; otherwise all variables and outcome measures were comparable. Analysis was performed for all patients with complete blood results on POD4. Three hundred twenty-six patients underwent resection, of which 248 had POD4 bloods. There were 21 AL overall (6.44%); 16 among those with complete POD4 blood results (6.45%). There were 8 (2.45%) in-hospital deaths; 7 (2.82%) in those with POD4 results. No parameters were associated with AL or complication severity on univariate analysis. WCC was associated with AL in multivariate binary logistic regression with albumin and CRP (OR 1.23 [95% CI 1.03-1.47]; P = 0.021). When a binary variable of CRP ≥ 156 mg/L was used rather than an absolute value, no factors were significant. Mean NUn was 8.30 for AL, compared with 8.40 for non-AL (P = 0.710 independent t-test). NUn > 10 predicted 0 of 16 leaks (sensitivity 0.00%, specificity 94.4%, receiver operator curve [ROC] area under the curve [AUC] 0.485; P = 0.843). NUn > 7.65 was 93% sensitive and 21.6% specific. ROC for WCC alone was comparable with NUn (AUC 0.641 [0.504-0.779]; P = 0.059; WCC > 6.89 93.8% sensitive, 20.7% specific; WCC > 15 6.3% sensitive and 97% specific). There were no associations between any parameters and other complications. In a comparable cohort with the original study, we demonstrated a similar multivariate association between WCC alone on POD4 and subsequent demonstration of AL, but not albumin or CRP (measured up to 156 mg/L). The NUn score overall (calculated with this caveat) and a threshold of 10 was not found to have clinical utility in predicting AL or complications.
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Affiliation(s)
- J M Findlay
- Oxford OesophagoGastric Centre, Churchill Hospital, Oxford, UK
| | - R C Tilson
- Oxford OesophagoGastric Centre, Churchill Hospital, Oxford, UK
| | - A Harikrishnan
- Oxford OesophagoGastric Centre, Churchill Hospital, Oxford, UK
| | - B Sgromo
- Oxford OesophagoGastric Centre, Churchill Hospital, Oxford, UK
| | - R E K Marshall
- Oxford OesophagoGastric Centre, Churchill Hospital, Oxford, UK
| | - N D Maynard
- Oxford OesophagoGastric Centre, Churchill Hospital, Oxford, UK
| | - R S Gillies
- Oxford OesophagoGastric Centre, Churchill Hospital, Oxford, UK
| | - M R Middleton
- NIHR Biomedical Research Centre, Churchill Hospital, Oxford, UK
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Gupta A, Habib K, Harikrishnan A, Khetan N. Laparoscopic Surgery in Luminal Gastrointestinal Emergencies-a Review of Current Status. Indian J Surg 2015; 76:436-43. [PMID: 25614718 DOI: 10.1007/s12262-014-1081-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2014] [Accepted: 04/23/2014] [Indexed: 11/28/2022] Open
Abstract
Laparoscopy has already established itself as the preferred surgical approach in a variety of elective surgical conditions. Along with its usual advantages of less tissue trauma and faster recovery, its diagnostic as well as therapeutic role is making it an attractive option in emergency surgery. In this paper, we have reviewed the current status of laparoscopic surgery in luminal gastrointestinal emergencies. Relevant papers were selected using Medline database from 2007 to the present. These were reviewed, and outcomes were stated under the headings of appendicitis, perforated peptic ulcer, colorectal emergencies and small bowel obstruction. The laparoscopic intervention was found to be of clear benefit in most of the patients with appendicitis. Its role, however, is not absolutely clear in managing perforated peptic ulcers. Laparoscopic lavage and drainage have been recommended in diverticular perforation with limited contamination. Small case series and studies have shown benefits of laparoscopic surgery in iatrogenic colonic perforations, colonic obstruction, emergency colectomy and small bowel obstruction. Laparoscopic surgery can be recommended in appendicitis and low-risk cases of perforated peptic ulcers. Its definitive role in other conditions needs more evidence. The surgeon's experience and careful patient selection are very important to improve the outcome.
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Affiliation(s)
- Ajay Gupta
- General Surgery, Doncaster Royal Infirmary, Doncaster, South Yorkshire UK
| | - Khalid Habib
- Colorectal and Laparoscopic Surgery, Doncaster Royal Infirmary, Doncaster, South Yorkshire UK
| | - Athur Harikrishnan
- Colorectal and Laparoscopic Surgery, Doncaster Royal Infirmary, Doncaster, South Yorkshire UK
| | - Niraj Khetan
- Colorectal and Laparoscopic Surgery, Doncaster Royal Infirmary, Doncaster, South Yorkshire UK
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Harikrishnan A, Anderson K, Patra S. Severe visual loss secondary to central serous chorioretinopathy following prolonged immune suppression with oral prednisolone. JRSM Short Rep 2010; 1:31. [PMID: 21103123 PMCID: PMC2984357 DOI: 10.1258/shorts.2010.090424] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Amarawickrama H, Harikrishnan A, Krijgsman B. Superior mesenteric artery syndrome in a young girl following spinal surgery for scoliosis. Br J Hosp Med (Lond) 2006; 66:700-1. [PMID: 16417118 DOI: 10.12968/hmed.2005.66.12.20212] [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] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- H Amarawickrama
- Department of General Surgery, Peterborough District Hospital
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Affiliation(s)
- H Amarawickrama
- Department of General Surgery, Peterborough District Hospital, Peterborough PE3 6DA
| | - A Harikrishnan
- Department of General Surgery, Peterborough District Hospital, Peterborough PE3 6DA
| | - B Krijgsman
- Department of General Surgery, Peterborough District Hospital, Peterborough PE3 6DA
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