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Kaushik JJ, Kaushik A, Mebrahtu D, Bereket E, Eyob E, Kelifa H, Weldemichael K, Andebrhan R. Evaluation of larvicidal potential of Eritrean medicinal plants against Aedes aegypti. J Parasit Dis 2024; 48:150-156. [PMID: 38440761 PMCID: PMC10908879 DOI: 10.1007/s12639-024-01653-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 01/29/2024] [Indexed: 03/06/2024] Open
Abstract
Larvicidal activity of three Eritrean medicinal plants was evaluated against Aedes aegypti by conducting the bioassay using WHO methods. Efficacy of the plant extracts of O. hadiense, R. officinalis and C. spinarum was evaluated against 3rd instar Aedes aegypti larvae and mortality was recorded. LC50 and LC90 of the various plant extracts were also calculated using probit analysis. The morphological analysis of treated larvae was also performed. Extracts of O. hadiense, C. spinarium and R. officinalis were prepared using different solvents viz chloroform, 70% ethanol and water. Of the screened extracts, the chloroform extracts of O. hadiense exhibited the highest larvicidal activities and has the minimum LC50 and LC90 (24 mg/ml and 198.411 mg/ml respectively). Chloroform extract of C. spinarium exhibited the least larvicidal activity with maximum LC50 and LC90 (736.883 mg/ml and 1188.699 mg/ml respectively). Microscopic analysis confirmed the changes in the Aedes aegypti larvae caused by various plants extracts. An accumulation of dark pigmentation was observed in abdominal region and in the anal papillae after contact and also showed major structural damage such as destruction of the gut.
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Affiliation(s)
- Jeevan Jyoti Kaushik
- Department of Microbiology, School of Basic and Applied Sciences, Shri Guru Ram Rai University, Dehradun, Uttarakhand India
| | - Atul Kaushik
- Unit of Pharmacy, Department of Medical Sciences, Orotta College of Medicine & Health Sciences, Asmara, Eritrea
| | - Dawit Mebrahtu
- Department of Clinical Laboratory Sciences, School of Allied Health Professions, Asmara College of Health Sciences, Asmara, Eritrea
| | - Efrem Bereket
- Department of Clinical Laboratory Sciences, School of Allied Health Professions, Asmara College of Health Sciences, Asmara, Eritrea
| | - Elen Eyob
- Department of Clinical Laboratory Sciences, School of Allied Health Professions, Asmara College of Health Sciences, Asmara, Eritrea
| | - Hana Kelifa
- Department of Clinical Laboratory Sciences, School of Allied Health Professions, Asmara College of Health Sciences, Asmara, Eritrea
| | - Kokob Weldemichael
- Department of Clinical Laboratory Sciences, School of Allied Health Professions, Asmara College of Health Sciences, Asmara, Eritrea
| | - Rahwa Andebrhan
- Department of Clinical Laboratory Sciences, School of Allied Health Professions, Asmara College of Health Sciences, Asmara, Eritrea
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Goswami S, Choudhary R, Deora S, Kaushik A. The diagnostic accuracy of two-dimensional strain imaging echocardiography to detect the severity of coronary artery disease in non-ST segment elevation acute coronary syndrome. Indian Heart J 2023; 75:409-415. [PMID: 37774948 PMCID: PMC10774580 DOI: 10.1016/j.ihj.2023.09.003] [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: 02/20/2023] [Revised: 08/11/2023] [Accepted: 09/23/2023] [Indexed: 10/01/2023] Open
Abstract
OBJECTIVE Strain imaging by two-dimensional speckle tracking echocardiography can detect severe coronary artery disease (CAD). This study aims to assess the diagnostic accuracy of various strain parameters in patients with non-ST segment acute coronary syndrome to detect the angiographic severity of CAD and also to compare among them. METHODS This hospital-based observational study was conducted on 178 patients with NSTEACS and preserved left ventricular ejection fraction who presented in emergency or outdoor from July 2021 to December 2022. We excluded patients with prior coronary revascularization, heart failure, arrhythmia, more than trivial valvular heart disease, or poor acoustic window. Global longitudinal strain (GLS), peak systolic strain (SS), post systolic index (PSI), and systolic strain rate (SR) were calculated by speckle tracking with automated function imaging. Coronary angiography was done in all patients, and the syntax score was calculated. RESULTS The strain parameters showed a significant correlation with the syntax score. There was a statistically significant difference in strain parameters between patients with left main (LM) or triple vessel disease (TVD) and others. Receiver operating characteristic (ROC) curve analysis showed that GLS had a better diagnostic accuracy for detecting LM or TVD than other strain parameters. GLS with a cut-off value of -11.2% had a sensitivity of 85.7% and specificity of 53.5% for detecting LM or TVD. CONCLUSION Strain imaging can be a helpful bedside adjunct to conventional investigations for detecting severe CAD in patients with NSTEACS.
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Affiliation(s)
- Sourabh Goswami
- Department of Cardiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.
| | - Rahul Choudhary
- Department of Cardiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Surender Deora
- Department of Cardiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Atul Kaushik
- Department of Cardiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
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Kaushik A. Virome. Br Dent J 2023; 235:361. [PMID: 37737381 DOI: 10.1038/s41415-023-6344-1] [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] [Received: 07/25/2023] [Accepted: 08/02/2023] [Indexed: 09/23/2023]
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Kaushik A. STRINGS. Br Dent J 2023; 235:296. [PMID: 37684442 DOI: 10.1038/s41415-023-6285-8] [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] [Received: 07/27/2023] [Accepted: 08/02/2023] [Indexed: 09/10/2023]
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Kaushik A. Correction to: Citation context. Br Dent J 2023; 235:234. [PMID: 37620499 DOI: 10.1038/s41415-023-6226-6] [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: 08/26/2023]
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Deora S, Choudhary R, Kaushik A, Singh S, Singh B, Kumar B. Noninvasive assessment of pulmonary congestion in heart failure: Need of the hour. Indian Heart J 2023; 75:224-228. [PMID: 37207829 PMCID: PMC10421985 DOI: 10.1016/j.ihj.2023.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 04/25/2023] [Accepted: 05/15/2023] [Indexed: 05/21/2023] Open
Abstract
Early pulmonary congestion detection and surveillance in acute heart failure patients can prevent decompensation, minimize hospitalizations, and improve prognosis. In India, the warm and wet types of HF are still the most common types and residual congestion at discharge is still a significant concern. Thus, there is an urgent need for a reliable and sensitive means of identifying residual and subclinical congestion. Two such monitoring systems are available and approved by US FDA. These include CardioMEMS HF System (Abbott, Sylmar, California) and ReDS System (Sensible Medical Innovations, Ltd., Nanya, Israel). CardioMEMS is a wireless pressure-sensitive implantable device, while ReDS is a wearable noninvasive device for measurement of the lung fluid and hence direct detection of PC. This review discusses the role of noninvasive assessment in PC monitoring in patients with heart failure and its implications from an Indian perspective.
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Affiliation(s)
- Surender Deora
- All India Institute of Medical Sciences, Jodhpur, India.
| | | | - Atul Kaushik
- All India Institute of Medical Sciences, Jodhpur, India
| | | | | | - Barun Kumar
- All India Institute of Medical Sciences, Rishikesh, India
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Kaushik A. Citation context. Br Dent J 2023; 235:77. [PMID: 37500834 DOI: 10.1038/s41415-023-6141-x] [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] [Received: 06/04/2023] [Accepted: 06/08/2023] [Indexed: 07/29/2023]
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Rathod DK, Sharma A, Sharma N, Kaushik A, Karmakar S. Takotsubo cardiomyopathy following head and neck surgery: Can the fear of disfigurement be blamed? Saudi J Anaesth 2023; 17:419-422. [PMID: 37601518 PMCID: PMC10435813 DOI: 10.4103/sja.sja_906_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 01/07/2023] [Accepted: 01/07/2023] [Indexed: 08/22/2023] Open
Abstract
Takotsubo cardiomyopathy is accompanied by transitory left ventricular dysfunction without substantial coronary artery disease. A history of acute physical or mental stress typically precedes such a presentation. We want to highlight a case of Takotsubo cardiomyopathy in the early postoperative period in a young female patient who underwent extensive surgery for buccal mucosal carcinoma. The onset of this cardiomyopathy can be ascribed to a fear of disfigurement and prolonged surgical stress.
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Affiliation(s)
| | - Ankur Sharma
- Department of Trauma and Emergency (Anesthesiology), AIIMS, Jodhpur, Rajasthan, India
| | - Nivedita Sharma
- Department of Surgical Oncology, AIIMS, Jodhpur, Rajasthan, India
| | - Atul Kaushik
- Department of Cardiology, AIIMS, Jodhpur, Rajasthan, India
| | - Shilpi Karmakar
- Department of Burns and Plastic Surgery, AIIMS, Jodhpur, Rajasthan, India
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Parsons ES, Liu F, Kaushik A, Lee A, Schuetz J, Dunham D, Seastedt H, Ogulur I, Heider A, Tan G, Shah A, Cao S, Smith E, Kost L, Acharya S, Prunicki M, Rothenberg M, Sindher S, Leib R, Akdis CA, Nadeau K, Lejeune S. Detection of gut and mucosal peptides through TOMAHAQ in healthy individuals. Allergy 2023. [PMID: 36872560 DOI: 10.1111/all.15698] [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] [Received: 11/09/2022] [Revised: 02/13/2023] [Accepted: 02/28/2023] [Indexed: 03/07/2023]
Affiliation(s)
- E S Parsons
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University School of Medicine, Palo Alto, California, USA
| | - F Liu
- Mass Spectrometry Center, Stanford University, Palo Alto, California, USA
| | - A Kaushik
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University School of Medicine, Palo Alto, California, USA
| | - A Lee
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University School of Medicine, Palo Alto, California, USA
| | - J Schuetz
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University School of Medicine, Palo Alto, California, USA
| | - D Dunham
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University School of Medicine, Palo Alto, California, USA
| | - H Seastedt
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University School of Medicine, Palo Alto, California, USA
| | - I Ogulur
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - A Heider
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - G Tan
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - A Shah
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University School of Medicine, Palo Alto, California, USA
| | - S Cao
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University School of Medicine, Palo Alto, California, USA
| | - E Smith
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University School of Medicine, Palo Alto, California, USA
| | - L Kost
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University School of Medicine, Palo Alto, California, USA
| | - S Acharya
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University School of Medicine, Palo Alto, California, USA
| | - M Prunicki
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University School of Medicine, Palo Alto, California, USA
| | - M Rothenberg
- Department of Pediatrics, Department of Allergy and Immunology, Cincinnati Children's Hospital, Cincinnati, Ohio, USA
| | - S Sindher
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University School of Medicine, Palo Alto, California, USA.,Division of Pulmonary, Allergy, and Critical Care Medicine, Stanford University, Stanford, California, USA
| | - R Leib
- Mass Spectrometry Center, Stanford University, Palo Alto, California, USA
| | - C A Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - K Nadeau
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University School of Medicine, Palo Alto, California, USA.,Department of Environmental Health Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - S Lejeune
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University School of Medicine, Palo Alto, California, USA.,INSERM U1019, CNRS UMR 9017, Center for infection and immunity of Lille (CIIL), Univ. Lille, CHU Lille, Institut Pasteur de Lille, Lille, France
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Kaushik A. International collaboration impact. Br Dent J 2023; 234:293-294. [PMID: 36899217 DOI: 10.1038/s41415-023-5632-0] [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] [Received: 02/14/2023] [Accepted: 02/21/2023] [Indexed: 03/12/2023]
Affiliation(s)
- A Kaushik
- Panjab University, Chandigarh, India.
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Kaushik A. Preprint Citation Index. Br Dent J 2023; 234:359. [PMID: 36964338 PMCID: PMC10037373 DOI: 10.1038/s41415-023-5695-y] [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] [Received: 02/19/2023] [Accepted: 02/28/2023] [Indexed: 03/26/2023]
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Kaushik A, Chawla S. Vieussens' arterial ring in a 65-year-old man. J Indian Acad Echocardiogr Cardiovasc Imaging 2023. [DOI: 10.4103/jiae.jiae_41_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
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Deora S, Sharma JB, Kaushik A, Choudhary R. Origin of all Three Coronaries from Single Ostium: A Rare Case Report. Heart Views 2023; 24:59-62. [PMID: 37124435 PMCID: PMC10144412 DOI: 10.4103/heartviews.heartviews_81_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Accepted: 01/22/2023] [Indexed: 02/24/2023] Open
Abstract
Origin of coronary arteries from the opposite sinus of Valsalva is rare and origin from a single ostium is extremely rare. Patients with these anomalies may have myocardial ischemia because of altered ostial configuration, exit angulation from the aorta, the course between great arteries, and atherosclerosis. Usually, these anomalies are diagnosed during coronary angiography either by computed tomography or catheter-based. Management depends upon the coronary anomaly and associated clinical condition.
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Affiliation(s)
- Surender Deora
- Department of Cardiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Jai Bharat Sharma
- Department of Cardiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Atul Kaushik
- Department of Cardiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Rahul Choudhary
- Department of Cardiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
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Mohanty V, Sharma S, Goswami S, Kaushik A, Choudhary R, Yadav D, Deora S, Singh K. Association of Novel Hematological Indices with Severity of Coronary Artery Disease using SYNTAX Score in Patients with Acute Coronary Syndrome. Cardiovasc Hematol Disord Drug Targets 2023; 23:202-211. [PMID: 37953615 DOI: 10.2174/011871529x269740231102045028] [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: 07/30/2023] [Revised: 10/06/2023] [Accepted: 10/18/2023] [Indexed: 11/14/2023]
Abstract
INTRODUCTION Recent evidence suggests that systemic inflammation not only plays an important role in the pathogenesis of Acute Coronary Syndrome but also correlates with disease severity. Monocyte-to-high-density lipoprotein cholesterol ratio (MHR), Neutrophil-Lymphocyte Ratio (NLR), and Monocyte-Lymphocyte Ratio (MLR) are novel systemic inflammation markers used for predicting the burden of coronary artery disease (CAD) based on SYNTAX Score. This single-center, cross-sectional, observational study compared the association of these novel hematological indices with CAD severity using the SYNTAX Score in ACS patients and aimed to determine the best predictor of the severity of CAD. METHODS A total of 403 consecutive patients with ACS who underwent coronary angiography were enrolled. On the basis of the SYNTAX Score, patients were divided into three groups: Low: <22, Moderate 22 - 32 and High ≥ 32. MHR, MLR, and NLR were calculated and correlated with SYNTAX Score. RESULTS All three indices: MHR (r=0.511; p <0.001), MLR (r=0.373; p <0.001), and NLR (r=0.292; p =0.001) showed significant correlation with SYNTAX Score. The MHR ROC was significantly higher than that of MLR (difference between area: 0.158; 95% CI: 0.079-0.259) and NLR (difference between area: 0.279; 95% CI: 0.172-0.419) for the SYNTAX Score. Analysis showed a strong correlation between these indices with SYNTAX Score >22 compared to low scores <22 and that these also related to the LAD as an infarct artery. Multiple regression analysis showed that diabetes mellitus, eGFR, Infarct-related artery left anterior descending (IRALAD), MHR, MLR, and NLR were predictors of the severity of CAD in ACS patients based on SYNTAX Score. CONCLUSION In ACS patients MHR, MLR, and NLR showed significant correlation with SYNTAX score >22 which may be indicative of severity of disease. MHR is a better predictor of the severity of CAD than MLR and NLR in ACS patients.
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Affiliation(s)
- Vivek Mohanty
- Senior Resident of Cardiology, All India Institute of Medical Sciences, Jodhpur, India
| | - Shubham Sharma
- Senior Resident of Cardiology, All India Institute of Medical Sciences, Jodhpur, India
| | - Sourabh Goswami
- Senior Resident of Cardiology, All India Institute of Medical Sciences, Jodhpur, India
| | - Atul Kaushik
- Associate Professor of Cardiology, All India Institute of Medical Sciences, Jodhpur, India
| | - Rahul Choudhary
- Associate Professor of Cardiology, All India Institute of Medical Sciences, Jodhpur, India
| | - Dharamveer Yadav
- Additional Professor of Biochemistry, All India Institute of Medical Sciences, Jodhpur, India
| | - Surender Deora
- Additional Professor of Cardiology, All India Institute of Medical Sciences, Jodhpur, India
| | - Kuldeep Singh
- Professor of Paediatrics and Genetic Medicine, All India Institute of Medical Sciences, Jodhpur, India
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Mohan-Goyal B, Kant-Yadav V, Jhanwar S, Patel S, Kaushik A. Severe primary hypothyroidism presenting as polymorphic ventricular tachycardia. RCCAR 2022. [DOI: 10.24875/rccar.m22000191] [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: 12/24/2022] Open
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Kurri N, Tyagi B, Kaushik A, Gupta N, Agarwal AK, Singh BM. Role of Itolizumab in the Treatment of COVID-19 Patients, Admitted to ICU at a Tertiary Care Hospital. J Assoc Physicians India 2022; 70:11-12. [PMID: 37355865 DOI: 10.5005/japi-11001-0114] [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] [Subscribe] [Scholar Register] [Indexed: 06/26/2023]
Abstract
BACKGROUND Clinical studies have correlated severe deterioration of COVID-19 patients due to excessive and uncontrolled production of cytokines. There is a pressing need to explore therapies, which could prevent the cytokine storm rather than terminating it. AIMS AND OBJECTIVES The aim of the study is to evaluate the effect of itolizumab on clinical outcomes of patients with moderate-severe COVID-19 disease admitted to ICU. The primary aim of the current study is to find out any mortality benefit in 14 days. The secondary aim is to assess the morbidity outcomes in terms of reduction in inflammatory markers and also the duration of hospital stays to assess the prognostication. MATERIALS AND METHODS It is a retrospective case-control study in which laboratory-confirmed COVID-19 patients admitted to ICU were taken. A total of 62 patients were recruited, 31 patients received itolizumab (cases/treatment group) and 31 patients didn't receive itolizumab (designated as controls). RESULTS Among the total patients recruited, 68% of the study population was male and 32% were female. A total of 12 patients expired among cases and 13 expired among controls. Overall mortality in both groups was noted to be almost similar. The control group showed mortality at lower computed tomography (CT) scores compared to the cases. There is a significant reduction in inflammatory markers, like interleukins-6 (IL-6) and D-dimer in cases compared to the control group. CONCLUSION In conclusion, treating patients with cytokine storms before they require intubation/mechanical ventilation is crucial to preventing deaths. Itolizumab has shown no clinical benefit in critically ill COVID-19 patients, however, timely initiation of itolizumab therapy may serve as a key therapeutic option in preventing the mortality and morbidity outcomes in moderate-severe COVID-19 patients.
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Affiliation(s)
| | | | | | | | | | - B M Singh
- Professor, SMS & R Sharda Hospital, Greater Noida, Uttar Pradesh, India
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Upadhyay A, Kaushik A. DORA challenges. Br Dent J 2022; 233:439-440. [PMID: 36151147 DOI: 10.1038/s41415-022-5047-3] [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: 11/09/2022]
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Patra S, Kaliyappan A, Kaushik A, Roy A. Impending myocardial ischaemia during thyroid storm diagnosed through Wellens’ syndrome. BMJ Case Rep 2022; 15:15/8/e250488. [DOI: 10.1136/bcr-2022-250488] [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: 11/04/2022] Open
Abstract
We present a case of thyroid storm precipitated by discontinuation of antithyroid drugs. The patient developed a concurrent acute coronary event during the resolution period of the thyroid storm. After 48 hours of prudent management of thyroid storm, the patient’s sensorium and haemodynamics were stabilised but he had persistent mild chest discomfort and developed new-onset jaw pain. On admission, ECG showed sinus tachycardia. In consideration of persistent mild chest discomfort and new-onset jaw pain, serial ECGs were performed which revealed biphasic T waves in V2–V3 suggestive of Wellens’ syndrome type A. This indicated a critical stenosis of the left anterior descending (LAD) coronary artery and impending myocardial ischaemia. The patient underwent urgent coronary catheterisation, which revealed 80% stenosis of proximal LAD and was subsequently revascularised resolving his symptoms. This case underscores the significance of serial ECG monitoring even after the acute phase of thyroid crisis, which helped in timely identification of Wellens’ syndrome.
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Deora S, Sharma SK, Choudhary R, Kaushik A, Garg PK, Khera PS, Singh K, Shah S, Patel TM. Assessment and comparison of distal radial artery diameter in anatomical snuff box with conventional radial artery before coronary catheterization. Indian Heart J 2022; 74:322-326. [PMID: 35728657 PMCID: PMC9453060 DOI: 10.1016/j.ihj.2022.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 06/03/2022] [Accepted: 06/16/2022] [Indexed: 11/28/2022] Open
Abstract
Background The distal radial artery (dRA) approach at anatomical snuff box has gained attention of the interventional cardiologist in last few years. The procedural success rate by this novel approach depends on size of the radial artery and therefore the study was planned to study the size of distal radial artery. Methods Total of 1004 patients of >18 years of age undergoing coronary catheterization were included in the study. The vessel diameter was measured from media to media in the anatomical snuff box a day prior to coronary catheterization. Results The mean diameter of right radial artery at conventional access site was 2.56 ± 0.35 mm and at distal access site 2.23 ± 0.39 mm (p < 0.001). Females had significantly smaller radial artery diameter as compared to males at right conventional access site (2.42 ± 0.36 mm vs 2.60 ± 0.34 mm; p < 0.001) and distal access site (2.09 ± 0.38 mm vs 2.27 ± 0.39 mm; p < 0.001). The diameter of the right dRA was not significantly correlated with age (r2 linear = 0.002, p = 0.0475) but was positively correlated with height and weight (r2 linear = 0.076, p = <0.001 and r2 linear = 0.005, p = <0.001) and negatively correlated with BMI (r2 linear = 0.076, p = 0.519). Conclusions This study has shown the size of right dRA 2.27 + 0.39 mm in males and 2.09 + 0.38 mm in females. Diabetes, hypertension, height and weight are important predictors of dRA diameter.
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Affiliation(s)
- Surender Deora
- Department of Cardiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.
| | - Shubham Kumar Sharma
- Department of Cardiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Rahul Choudhary
- Department of Cardiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Atul Kaushik
- Department of Cardiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Pawan Kumar Garg
- Department of Diagnostic and Interventional Radiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Pushpinder Singh Khera
- Department of Diagnostic and Interventional Radiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Kuldeep Singh
- Department of Cardiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Sanjay Shah
- Department of Cardiology, Smt NHL Medical College & Apex Heart Institute, Ahmedabad, Gujarat, India
| | - Tejas M Patel
- Department of Cardiology, Smt NHL Medical College & Apex Heart Institute, Ahmedabad, Gujarat, India
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Kaushik A, Singh K, Patel S, Bharat-Sharma J, Deora S, Choudhary R, Dhanesh-Goel A. Telemedicine during coronavirus disease-19 pandemic: a paradigm shift in cardiovascular care. RCCAR 2022. [DOI: 10.24875/rccar.m21000061] [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: 11/17/2022] Open
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Do E, Dunham D, Kaushik A, Manohar M, Chinthrajah S, Nadeau K. A010 MASS CYTOMETRY ANALYSIS REVEALS DAMPENING OF TH2 PHENOTYPE AMONG PEANUT-REACTIVE CD4+ T CELLS FOLLOWING PEANUT-OIT. Ann Allergy Asthma Immunol 2021. [DOI: 10.1016/j.anai.2021.08.020] [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: 10/19/2022]
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Deora S, Choudhary R, Kaushik A. Comment: Comparison of radial versus femoral access using hemostatic devices following percutaneous coronary intervention. Indian Heart J 2021; 73:525-526. [PMID: 34474774 PMCID: PMC8424269 DOI: 10.1016/j.ihj.2021.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 06/27/2021] [Indexed: 11/29/2022] Open
Affiliation(s)
- Surender Deora
- Department of Cardiology All India Institute of Medical Sciences, Jodhpur, Raj, India.
| | - Rahul Choudhary
- Department of Trauma and Emergency (Cardiology), All India Institute of Medical Sciences, Jodhpur, Raj, India
| | - Atul Kaushik
- Department of Cardiology, All India Institute of Medical Sciences, Jodhpur, Raj, India.
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Choudhary R, Singh K, Choudhary D, Kumar Gautam D, Mathur R, Deora S, Kaushik A, Bharat Sharma J. Patterns of care and mortality outcomes in patients admitted with acute coronary syndrome during coronavirus disease 2019 pandemic in India. Coron Artery Dis 2021; 32:590-592. [PMID: 33471481 DOI: 10.1097/mca.0000000000001011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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] [Indexed: 11/27/2022]
Affiliation(s)
- Rahul Choudhary
- Department of Cardiology, All India Institute of Medical Sciences
| | - Kuldeep Singh
- Department of Pediatric, Dean Academics, All India Institute of Medical Sciences, Jodhpur
| | | | | | - Rohit Mathur
- Department of Cardiology, Dr S N Medical College, Jodhpur, Rajasthan, India
| | - Surender Deora
- Department of Cardiology, All India Institute of Medical Sciences
| | - Atul Kaushik
- Department of Cardiology, All India Institute of Medical Sciences
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Narang T, Ashraf R, Kaushik A, Dogra S. Apremilast in multibacillary leprosy patients with chronic and recurrent erythema nodosum leprosum: a prospective single-centre pilot study. J Eur Acad Dermatol Venereol 2021; 35:e917-e919. [PMID: 34365679 DOI: 10.1111/jdv.17585] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 07/29/2021] [Indexed: 01/23/2023]
Affiliation(s)
- T Narang
- Department of Dermatology, Venereology, and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - R Ashraf
- Department of Dermatology, Venereology, and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - A Kaushik
- Department of Dermatology, Venereology, and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - S Dogra
- Department of Dermatology, Venereology, and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Deora S, Sharma JB, Sharma SK, Chaudhary N, Kaushik A, Choudhary R, Charan J, Kumar D, Bohra GK, Singh K. Clinical characteristic, red blood cell indices, iron profile and prognosis of heart failure in females. Glob Cardiol Sci Pract 2021; 2021:e202113. [PMID: 34285904 PMCID: PMC8272410 DOI: 10.21542/gcsp.2021.13] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 03/19/2021] [Accepted: 05/31/2021] [Indexed: 12/28/2022] Open
Abstract
Background: Heart failure is a leading killer worldwide, with concurrent anaemia and iron deficiency portending sepulchral prognosis. Anaemia is rampant, with 53% prevalence in Indian females, but iron deficiency can be present even without anaemia. Therefore, this study was planned to determine the clinical profile, red blood cell indices, and effects of iron deficiency, on the course and prognosis of heart failure in Indian females. Materials and methods: This was a hospital-based observational study, conducted at a tertiary care teaching institute in India. Data from 147 females enrolled in the study between September 2017 to March 2020 was collected out of all patients enrolled in ongoing heart failure registry at the institute. Clinical characteristics at presentation, iron profile, red blood cell indices, treatment and mortality data was collected. Results: Mean age of the subjects (n = 147) was 53.31 ± 17.1 years with 55% non-rheumatic and 45% with rheumatic heart disease. The patients with rheumatic heart disease were younger, with a higher prevalence of atrial fibrillation. Non-rheumatic patients had a higher prevalence of CV risk factors like diabetes, hypertension, renal failure, more patients in NYHA IV, and 83% patients had LVEF ≤40%. Anaemia was present in 49%, however iron deficiency was present in 89% (absolute iron deficiency in 80% and functional iron deficiency in 9%) with no significant difference between rheumatic and non-rheumatic group. Red blood cell indices showed no significant difference across the spectrum of iron deficiency and anaemia, except lower mean corpuscular volume in patients with both iron deficiency and anaemia. The mean survival time was 840 days, with no significant difference between groups. There was significantly higher mortality in patients with iron deficiency (log rank 0.045). Conclusion: Iron deficiency–with or without anaemia–is very high in Indian females, worsening survival in heart failure. Proper diagnosis with iron supplementation will improve the prognosis.
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Affiliation(s)
- Surender Deora
- Department of Cardiology, All India Institute of Medical Sciences, Jodhpur, Raj, India
| | - Jai Bharat Sharma
- Department of Cardiology, All India Institute of Medical Sciences, Jodhpur, Raj, India
| | - Shubham Kumar Sharma
- Department of Cardiology, All India Institute of Medical Sciences, Jodhpur, Raj, India
| | - Nikhil Chaudhary
- Department of Cardiology, All India Institute of Medical Sciences, Jodhpur, Raj, India
| | - Atul Kaushik
- Department of Cardiology, All India Institute of Medical Sciences, Jodhpur, Raj, India
| | - Rahul Choudhary
- Department of Cardiology, All India Institute of Medical Sciences, Jodhpur, Raj, India
| | - Jaykaran Charan
- Department of Pharmacology, All India Institute of Medical Sciences, Jodhpur, Raj, India
| | - Deepak Kumar
- Department of General Medicine, All India Institute of Medical Sciences, Jodhpur, Raj, India
| | - Gopal Krishna Bohra
- Department of General Medicine, All India Institute of Medical Sciences, Jodhpur, Raj, India
| | - Kuldeep Singh
- Professor & Dean Academics, All India Institute of Medical Sciences, Jodhpur, Raj, India
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Sharma VC, Kaushik A, Dey YN, Srivastava B, Wanjari M, Pawar S, Chougule S. Nephroprotective potential of Anogeissus latifolia Roxb. (Dhava) against gentamicin-induced nephrotoxicity in rats. J Ethnopharmacol 2021; 273:114001. [PMID: 33705920 DOI: 10.1016/j.jep.2021.114001] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2018] [Revised: 01/13/2021] [Accepted: 03/03/2021] [Indexed: 06/12/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Stem bark of Anogeissus latifolia Roxb. (Family: Combretaceae) is used traditionally and ethnomedicinally for correction of kidney disorders. AIM OF THE STUDY The present study demonstrates the nephroprotective potential of stem bark of A. latifolia Roxb. MATERIALS AND METHODS The HPTLC fingerprint and HPLC analysis were carried out to standardize the ethanolic extract of stem bark of A. latifolia (ALEE) using ellagic acid as a marker. Nephrotoxicity was induced in adult Wistar albino rats by gentamicin (100 mg/kg, intraperitoneally for 8 days) and they were treated with ALEE (100, 200 and 400 mg/kg, orally for 8 days), ellagic acid (10 mg/kg, orally for 8 days) and cystone syrup (5 ml/kg, orally), a standard reference a polyherbal formulation. Urine volume, serum and urine levels of creatinine, urea and uric acid, oxidative stress parameters (lipid peroxidation, catalase, superoxide dismutase and reduced glutathione), inflammatory markers (TNF-α and IL-6) and kidney weight along with its histological changes were studied in experimental animals. RESULTS HPTLC, HPLC and LC-MS analysis of ALEE revealed the presence of ellagic acid and other various phytoconstituents. Administration of gentamicin caused significant increase in urine output and kidney weight, elevated biochemical, inflammatory and oxidative stress parameters as well as caused histological damage in the kidney tissue. These parameters were attenuated by the concurrent treatment with ALEE and ellagic acid. The effects were comparable to cystone. CONCLUSION Present investigations concluded that ALEE exhibited nephroprotective potential and validated the traditional use of stem bark of A. latifolia in kidney disorders. The nephroprotective effect may be attributed to the antioxidant and anti-inflammatory phytoconstituents in ALEE.
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Affiliation(s)
- Vikas Chandra Sharma
- Department of Pharmaceutical Sciences, IFTM University, Moradabad, Uttar Pradesh, India; IPS College of Pharmacy, Gwalior, Madhya Pradesh, India.
| | - Atul Kaushik
- IPS College of Pharmacy, Gwalior, Madhya Pradesh, India.
| | - Yadu Nandan Dey
- School of Pharmaceutical Technology, Adamas University, Barasat, Kolkata, India; Regional Ayurveda Research Institute for Drug Development, Gwalior, Madhya Pradesh, India.
| | - Bhavana Srivastava
- Regional Ayurveda Research Institute for Drug Development, Gwalior, Madhya Pradesh, India.
| | - Manish Wanjari
- Regional Ayurveda Research Institute for Drug Development, Gwalior, Madhya Pradesh, India.
| | - Sharad Pawar
- Regional Ayurveda Institute for Fundamental Research, Pune, Maharashtra, India.
| | - Shridhar Chougule
- Regional Ayurveda Institute for Fundamental Research, Pune, Maharashtra, India.
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Kaushik A, Kapoor A, Agarwal SK, Pande S, Tewari P, Majumdar G, Sinha A, Kashyap S, Khanna R, Kumar S, Garg N, Tewari S, Goel P. Statin reload before off-pump coronary artery bypass graft: Effect on biomarker release kinetics. Ann Card Anaesth 2021; 23:27-33. [PMID: 31929243 PMCID: PMC7034209 DOI: 10.4103/aca.aca_133_18] [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: 01/02/2023] Open
Abstract
Objectives Statins confer protection from ischemia/reperfusion through various pathways including pleiotropic mechanisms. Following chronic administration, activation of intrinsic cellular mechanisms causes attenuation of these pleiotropic effects. Methods Since coronary artery bypass surgery (CABG) represents a reversible ischemia-reperfusion sequence, we assessed if statin reload is effective in patients undergoing off-pump CABG (n = 100) in limiting myocardial injury. Patients received loading dose of rosuvastatin (40 mg initiated 7 days before surgery) while nonloaded patients continued whatever statin dose they were receiving and served as controls. Cardiac biomarkers (Troponin-I, creatine kinase muscle/brain [CK-MB], and B-type natriuretic peptide [BNP]) were measured at 8, 24, and 48 h postoperatively. The primary end-point was the extent of perioperative myocardial injury (area under the curve [AUC]: AUC of each biomarker). Results Despite similar baseline levels, all biomarkers at 8, 24, and 48 h were significantly lower in the loaded group. The AUC for each biomarker was also significantly lower in the loaded group (cTnI 37.96 vs. 70.12 ng. hr/ml, CK-MB 229.64 vs. 347.04 ng. hr/ml, and BNP 5257.56 vs. 15606.68 pg. hr/ml, all P < 0.001). Delta cTnI (change from baseline to peak level) (1.00 ± 1.34 vs. 2.25 ± 2.59), delta CK-MB (4.54 ± 5.89 vs. 10.68 ± 9.95), and delta BNP (120.41 ± 172.48 vs. 449.23 ± 790.95) all P < 0.001 were also significantly lower in the loaded group. Those loaded with rosuvastatin had lower inotrope duration (22.9 ± 23.33 vs. 31.26 ± 25.39 h, P = 0.04) and ventilator support time (16.94 ± 6.78 vs. 23.8 ± 20.53 h, P = 0.03). Conclusion In patients undergoing off-pump CABG, statin reload can "recapture" cardioprotection in patients already on statins with favorable effect on release kinetics of biomarkers and postoperative outcomes.
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Affiliation(s)
- Atul Kaushik
- Department of Cardiology, Sanjay Gandhi PGIMS, Lucknow, Uttar Pradesh, India
| | - Aditya Kapoor
- Department of Cardiology, Sanjay Gandhi PGIMS, Lucknow, Uttar Pradesh, India
| | - Surendra K Agarwal
- Department of Cardiovascular and Thoracic Surgery, Sanjay Gandhi PGIMS, Lucknow, Uttar Pradesh, India
| | - Shantanu Pande
- Department of Cardiovascular and Thoracic Surgery, Sanjay Gandhi PGIMS, Lucknow, Uttar Pradesh, India
| | - Prabhat Tewari
- Department of Cardiac Anesthesia, Sanjay Gandhi PGIMS, Lucknow, Uttar Pradesh, India
| | - Gauranga Majumdar
- Department of Cardiovascular and Thoracic Surgery, Sanjay Gandhi PGIMS, Lucknow, Uttar Pradesh, India
| | - Archana Sinha
- Department of Cardiology, Sanjay Gandhi PGIMS, Lucknow, Uttar Pradesh, India
| | - Shiridhar Kashyap
- Department of Cardiology, Sanjay Gandhi PGIMS, Lucknow, Uttar Pradesh, India
| | - Roopali Khanna
- Department of Cardiology, Sanjay Gandhi PGIMS, Lucknow, Uttar Pradesh, India
| | - Sudeep Kumar
- Department of Cardiology, Sanjay Gandhi PGIMS, Lucknow, Uttar Pradesh, India
| | - Naveen Garg
- Department of Cardiology, Sanjay Gandhi PGIMS, Lucknow, Uttar Pradesh, India
| | - Satyendra Tewari
- Department of Cardiovascular and Thoracic Surgery, Sanjay Gandhi PGIMS, Lucknow, Uttar Pradesh, India
| | - Pravin Goel
- Department of Cardiac Anesthesia, Sanjay Gandhi PGIMS, Lucknow, Uttar Pradesh, India
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De D, Kaushik A, Handa S, Mahajan R, Schmidt E. Omalizumab: an underutilized treatment option in bullous pemphigoid patients with co-morbidities. J Eur Acad Dermatol Venereol 2021; 35:e469-e472. [PMID: 33725360 DOI: 10.1111/jdv.17229] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 03/10/2021] [Indexed: 11/30/2022]
Affiliation(s)
- D De
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - A Kaushik
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - S Handa
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - R Mahajan
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - E Schmidt
- Department of Dermatology, University of Lübeck, Lübeck, Germany.,Lübeck Institute of Experimental Dermatology (LIED), University of Lübeck, Lübeck, Germany
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Kaushik A, Kapoor A, Dabadghao P, Khanna R, Kumar S, Garg N, Tewari S, Goel PK, Sinha A. Use of strain, strain rate, tissue velocity imaging, and endothelial function for early detection of cardiovascular involvement in young diabetics. Ann Pediatr Cardiol 2021; 14:1-9. [PMID: 33679055 PMCID: PMC7918008 DOI: 10.4103/apc.apc_158_19] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 01/31/2020] [Accepted: 09/17/2020] [Indexed: 11/22/2022] Open
Abstract
Background: Subtle structural and functional changes may precede the onset of overt global left ventricular (LV) dysfunction. Data pertaining to tissue velocity imaging (TVI)and strain imaging to assess regional myocardial function and flow mediated vasodilatation are limited in young patients with diabetes. Materials: Conventional echocardiography, TVI parameters along with strain (S), and strain rate (SR) were measured in 50 young diabetics (15.16 ± 2.95 years, mean HBA1c 8.15 ± 1.37 g %) and 25 controls (15.60 ± 2.51 years). Flow-mediated dilation (FMD), nitrate--mediated dilatation (NMD), and carotid intima–media thickness were also assessed. Results: Conventional echocardiography parameters were similar in patients and controls; however, deceleration time of the mitral inflow velocity (early deceleration time) was significantly shorter in patients when compared with controls (149.06 ± 31.66 vs. 184.56 ± 19.27 ms, P =0.001). Patients had lower strain values at the basal lateral LV (21.39 ± 4.12 vs. 23.78 ± 2.02; P =0.001), mid-lateral LV (21.43 ± 4.27 vs. 23.17 ± 1.92 P =0.02), basal septum (20.59 ± 5.28 vs. 22.91 ± 2.00; P = 0.01), and midseptum (22.06 ± 4.75 vs. 24.10 ± 1.99; P = 0.01) as compared to controls. SR at the basal and midsegments of the lateral LV wall and at the basal septum was also significantly lower in diabetic patients. Diabetic children also had endothelial dysfunction with significantly lower FMD (8.36 ± 4.27 vs. 10.57 ± 4.12, P = 0.04). Conclusions: LV strain indices and flow--mediated dilatation are impaired in asymptomatic children and adolescents with type 1 diabetes mellitus despite absence of overt heart failure and normal ejection fraction. Early detection of subclinical regional myocardial dysfunction by deformation analysis including strain and strain rate may be useful in the asymptomatic diabetic population.
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Affiliation(s)
- Atul Kaushik
- Department of Cardiology, AIIMS, Jodhpur, Rajasthan, India
| | - Aditya Kapoor
- Department of Cardiology, SGPGIMS, Lucknow, Uttar Pradesh, India
| | - Preeti Dabadghao
- Department of Endocrinology, SGPGIMS, Lucknow, Uttar Pradesh, India
| | - Roopali Khanna
- Department of Cardiology, SGPGIMS, Lucknow, Uttar Pradesh, India
| | - Sudeep Kumar
- Department of Cardiology, SGPGIMS, Lucknow, Uttar Pradesh, India
| | - Naveen Garg
- Department of Cardiology, SGPGIMS, Lucknow, Uttar Pradesh, India
| | - Satyendra Tewari
- Department of Cardiology, SGPGIMS, Lucknow, Uttar Pradesh, India
| | - Pravin K Goel
- Department of Cardiology, SGPGIMS, Lucknow, Uttar Pradesh, India
| | - Archana Sinha
- Department of Dietetics, SGPGIMS, Lucknow, Uttar Pradesh, India
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Kaushik A, Garg A, Singh BM, Agarwal AK, Wani SN. Hypokalaemic Paralysis Associated with COVID-19 Infection. J Assoc Physicians India 2021; 69:78-79. [PMID: 34227783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
INTRODUCTION COVID-19 is a pandemic affecting mainly respiratory and gastrointestinal system. Severe acute respiratory syndrome coronavirus-2 (SARS-COV-2) binds angiotensin converting enzyme 2 (ACE-2) of renin-angiotensin system (RAS) resulting in hypokalaemia. We hereby report the a of hypokalaemic paralysis induced by COVID-19. CASE A 56 years old male with no co-morbidities presented with fever (2days), weakness in bilateral lower limbs (1 day). His had severe hypokalaemia with serum potassium of 2.05 mEq/L. RT-PCR of nasopharyngeal swab for SARS-CoV- 19 was positive. He was diagnosed as a case of hypokalaemic paralysis induced by COVID-19 infection. CONCLUSION We suggest that during this pandemic era if a COVID-19 patient presents with paralysis, hypokalaemia induced paralysis should be kept in the differential diagnosis. WHAT IS KNOWN COVID-19 infection leads to hypokalemia. WHAT IS NEW Hypokalaemic paralysis as a manifestation of COVID-19.
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Affiliation(s)
- Atul Kaushik
- Post Graduate Resident, SMS and R, Sharda Hospital, Sharda University, Greater Noida, Uttar Pradesh
| | - Anish Garg
- Post Graduate Resident, SMS and R, Sharda Hospital, Sharda University, Greater Noida, Uttar Pradesh
| | - Brinder Mohan Singh
- Professor, SMS and R, Sharda Hospital, Sharda University, Greater Noida, Uttar Pradesh
| | - Ashok Kumar Agarwal
- Professor and HOD, SMS and R, Sharda Hospital, Sharda University, Greater Noida, Uttar Pradesh
| | - Showkat Nazir Wani
- Senior Resident, SMS and R, Sharda Hospital, Sharda University, Greater Noida, Uttar Pradesh
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Kaushik A, Patel S, Dubey K. COVID-19 and nuclear cardiology: Introducing the "forward" virtual visit. J Card Surg 2020; 36:783. [PMID: 33284490 DOI: 10.1111/jocs.15236] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 11/19/2020] [Indexed: 12/11/2022]
Affiliation(s)
- Atul Kaushik
- Department of Cardiology, All India Institute of Medical Sciences, Jodhpur, India
| | - Surendra Patel
- Department of Trauma and Emergency Cardiothoracic Surgery, All India Institute of Medical Sciences, Jodhpur, India
| | - Kalika Dubey
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, Jodhpur, India
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Sharma JB, Deora S, Choudhary R, Kaushik A. Diagnostic utility of mitral annular displacement by speckle tracking echocardiography in predicting significant coronary artery disease in suspected chronic stable angina pectoris. Echocardiography 2020; 37:2010-2017. [DOI: 10.1111/echo.14900] [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] [Received: 08/08/2020] [Revised: 10/01/2020] [Accepted: 10/01/2020] [Indexed: 11/26/2022] Open
Affiliation(s)
| | | | | | - Atul Kaushik
- Department of Cardiology AIIMS Jodhpur Jodhpur India
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Kaushik A, Kapoor A, Agarwal SK, Pande S, Kashyap S, Sinha A, Khanna R, Kumar S, Garg N, Tewari S, Goel PK. Effect of statin on perioperative myocardial injury in isolated valve surgery. Asian Cardiovasc Thorac Ann 2020; 29:369-375. [PMID: 33197319 DOI: 10.1177/0218492320974514] [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] [Indexed: 11/16/2022]
Abstract
BACKGROUND Statins have known pleiotropic effects that confer protection from ischemia-reperfusion injury. Because cardiopulmonary bypass is a potentially reversible ischemia-reperfusion sequence, we aimed to assess whether statin loading could help to limit myocardial injury in patients undergoing isolated heart valve replacement under cardiopulmonary bypass. METHODS One hundred patients with rheumatic valvular heart disease undergoing valve replacement received either a loading dose of rosuvastatin (40 mg initiated 7 days before surgery; loaded group) or no statins (non-loaded group). Cardiac troponin I, creatine kinase MB, and brain natriuretic peptide were measured at 8, 24, and 48 hours postoperatively. The primary endpoint was the extent of perioperative myocardial injury measured by the area under the curve for each biomarker. RESULTS Despite similar baseline levels, all biomarkers at 8, 24, and 48 h were significantly lower in the loaded group. The area under the curve of each biomarker was significantly lower in the loaded group than in the non-loaded group (troponin I: 31.43 vs. 77.21 ng·h·mL-1, creatine kinase MB 309.31 vs. 429.12 ng·h·mL-1, brain natriuretic peptide 5176.11 vs. 16119.31 pg·h·mL-1, all p < 0.001). The mean changes from baseline to peak levels were also significantly lower in the loaded group. The loaded group had a shorter hospital stay but no significant difference was seen in ventilator time, inotrope time, aortic crossclamp time, cardiopulmonary bypass time, or intensive care unit stay. CONCLUSION In patients undergoing valve replacement, high-dose statin loading before surgery had a favorable impact on the release kinetics of various cardiac biomarkers.
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Affiliation(s)
- Atul Kaushik
- Department of Cardiology, AIIMS, Jodhpur, Rajasthan, India
| | - Aditya Kapoor
- Department of Cardiology, SGPGIMS, Lucknow, Uttar Pradesh, India
| | - Surendra Kumar Agarwal
- Department of Cardiovascular and Thoracic Surgery, SGPGIMS, Lucknow, Uttar Pradesh, India
| | - Shantanu Pande
- Department of Cardiovascular and Thoracic Surgery, SGPGIMS, Lucknow, Uttar Pradesh, India
| | | | | | - Roopali Khanna
- Department of Cardiology, SGPGIMS, Lucknow, Uttar Pradesh, India
| | - Sudeep Kumar
- Department of Cardiology, SGPGIMS, Lucknow, Uttar Pradesh, India
| | - Naveen Garg
- Department of Cardiology, SGPGIMS, Lucknow, Uttar Pradesh, India
| | - Satyendra Tewari
- Department of Cardiology, SGPGIMS, Lucknow, Uttar Pradesh, India
| | - Pravin K Goel
- Department of Cardiology, SGPGIMS, Lucknow, Uttar Pradesh, India
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Affiliation(s)
- Atul Kaushik
- All India Institute of Medical Sciences, Jodhpur, India
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Choudhary R, Mathur R, Sharma JB, Sanghvi S, Deora S, Kaushik A. Impact of Covid-19 outbreak on clinical presentation of patients admitted for acute heart failure in India. Am J Emerg Med 2020; 39:S0735-6757(20)30911-6. [PMID: 34756390 PMCID: PMC7563576 DOI: 10.1016/j.ajem.2020.10.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 09/23/2020] [Accepted: 10/08/2020] [Indexed: 12/14/2022] Open
Affiliation(s)
- Rahul Choudhary
- Department of Cardiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.
| | - Rohit Mathur
- Department of Cardiology, Dr S N Medical College, Jodhpur, India
| | - Jai Bharat Sharma
- Department of Cardiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Sanjeev Sanghvi
- Department of Cardiology, Dr S N Medical College, Jodhpur, India
| | - Surender Deora
- Department of Cardiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Atul Kaushik
- Department of Cardiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
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Kaushik A, Patel S, Dubey K. Digital cardiovascular care in COVID-19 pandemic: A potential alternative? J Card Surg 2020; 35:3545-3550. [PMID: 33040399 PMCID: PMC7675673 DOI: 10.1111/jocs.15094] [Citation(s) in RCA: 12] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Revised: 09/06/2020] [Accepted: 09/13/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND Cardiovascular patients are at increased risk of acquiring coronavirus disease 2019 (COVID-19) infection while their visit to healthcare facilities. There is a need for alternative tools for optimal monitoring and management of cardiovascular patients in the present pandemic situation. Digital health care may prove to be a new revolutionary tool to protect cardiovascular patients from coronavirus disease by avoiding routine visits to health care facilities that are already overwhelmed with COVID-19 patients. METHODS To evaluate the role of digital health care in the present era of the COVID-19 pandemic, we have reviewed the published literature on digital health services providing cardiovascular care. RESULTS AND CONCLUSION Digital health including telemedicine services, robotic telemedicine carts, use of artificial intelligence and machine learning, use of digital gadgets like smartwatches and web-based applications may be a safe alternative for the management of cardiovascular patients in the present pandemic situation.
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Affiliation(s)
- Atul Kaushik
- Department of Cardiology, All India Institute of Medical Sciences (AIIMS), Jodhpur, India
| | - Surendra Patel
- Department of Trauma and Emergency Cardiothoracic Surgery, All India Institute of Medical Sciences (AIIMS), Jodhpur, India
| | - Kalika Dubey
- Department of Maternal and Reproductive Health, Sanjay Gandhi Post Graduate Institute of Medical Sciences (SGPGIMS), Lucknow, India
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Kaushik A, Singh A. Metal removal and recovery using bioelectrochemical technology: The major determinants and opportunities for synchronic wastewater treatment and energy production. J Environ Manage 2020; 270:110826. [PMID: 32721300 DOI: 10.1016/j.jenvman.2020.110826] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [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: 02/04/2020] [Revised: 05/10/2020] [Accepted: 05/22/2020] [Indexed: 06/11/2023]
Abstract
Microbial fuel cell (MFC) technology has emerged as a new and attractive bioelectrochemical approach in the last one and a half decade that offers an alternative to conventional treatment methods to remove and recover heavy metals and organics from wastewaters with simultaneous energy production. This technique has advantage over the conventional wastewater treatment techniques, which are energy intensive, sludge producing and with little effectivity at high concentrations. Significant work has been done in the recent years on MFC principle, electrode configuration, biofilm composition, application of MFC in wastewater treatment, metal removal or recovery and energy production. Basically, metal in the cathode chamber acts as acceptor of the electrons released from the oxidation of organic matter in the anode chamber by electrogenic microbes. Literature shows that efficacy of MFCs in removal and recovery of metals and power production is significantly influenced by redox potential of the metal, initial concentration, mix metal systems, carbon source in substrate, pH, biocathode, biofilm composition, gaseous environment in cathode, electrode modification and external resistance, which have been critically reviewed for the first time in the present paper to understand the role of the determinant factors that may be explored for improvement of the MFC performance. The paper provides further insights into the techno-economic aspects of MFC technology and suggests research needs for enhanced performance and reduced costs to increase its feasibility for application at commercial level.
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Affiliation(s)
- A Kaushik
- University School of Environment Management, Guru Gobind Singh Indraprastha University New Delhi, 110078, India.
| | - Aradhana Singh
- University School of Environment Management, Guru Gobind Singh Indraprastha University New Delhi, 110078, India.
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Yadav SK, Shukla P, Joshi M, Khan A, Kaushik A, Jha AK, Sapra BK, Singh RS. Emission characteristics of ultrafine particles from bare and Al 2O 3 coated graphite for high temperature applications. Sci Rep 2020; 10:14595. [PMID: 32884029 PMCID: PMC7471292 DOI: 10.1038/s41598-020-71424-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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 08/16/2020] [Indexed: 11/09/2022] Open
Abstract
Owing to its exceptional properties at high temperature, graphite is used in several applications such as structural material and fuel block in high temperature nuclear reactors. Air ingress is one of the serious safety concerns in these reactors. Oxidation of graphite leading to increased porosity affects its mechanical strength and may lead to core collapse resulting in a severe accident. During such a scenario, generation of graphite particles could be the main hazard. Once generated, these particles often in fine and ultrafine sizes, may carry radioactivity to large distances and/or for long times. These particles owing to their higher surface to volume ratio possess an additional inhalation hazard. Ultrafine particles have the potential to enter into respiratory tract and cause damage to body organs. Coating of graphite components is preferred to reduce the oxidation induced damages at high temperatures. In the present work, effect of alumina (Al2O3) coating on the emission characteristics of particles from graphite under high temperature conditions has been investigated. Bare and Al2O3 coated graphite specimens were heated within a closed chamber at varying temperatures during these experiments. Temporal evolution of concentrations of gases (CO and CO2) and particles were measured. The results reveal that Al2O3 coating on the graphite delayed the oxidation behavior and the structure of graphite remained largely intact at high temperatures. A significant reduction in aerosol formation and CO emission was also noticed for the coated specimens.
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Affiliation(s)
- S K Yadav
- Department of Mechanical Engineering, Indian Institute of Technology (BHU), Varanasi, 221005, India
| | - P Shukla
- Department of Mechanical Engineering, Indian Institute of Technology (BHU), Varanasi, 221005, India.
| | - Manish Joshi
- Radiological Physics and Advisory Division, Bhabha Atomic Research Center, Mumbai, India
| | - Arshad Khan
- Radiological Physics and Advisory Division, Bhabha Atomic Research Center, Mumbai, India
| | - A Kaushik
- High Temperature Reactor Section, Bhabha Atomic Research Center, Mumbai, India
| | - Ajit Kumar Jha
- Department of Mechanical Engineering, Indian Institute of Technology (BHU), Varanasi, 221005, India
| | - B K Sapra
- Radiological Physics and Advisory Division, Bhabha Atomic Research Center, Mumbai, India
| | - R S Singh
- Department of Chemical Engineering, Indian Institute of Technology (BHU), Varanasi, India
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Mujawar MA, Gohel H, Bhardwaj SK, Srinivasan S, Hickman N, Kaushik A. Nano-enabled biosensing systems for intelligent healthcare: towards COVID-19 management. Mater Today Chem 2020; 17:100306. [PMID: 32835155 PMCID: PMC7274574 DOI: 10.1016/j.mtchem.2020.100306] [Citation(s) in RCA: 77] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 05/28/2020] [Accepted: 05/30/2020] [Indexed: 05/18/2023]
Abstract
Biosensors are emerging as efficient (sensitive and selective) and affordable analytical diagnostic tools for early-stage disease detection, as required for personalized health wellness management. Low-level detection of a targeted disease biomarker (pM level) has emerged extremely useful to evaluate the progression of disease under therapy. Such collected bioinformatics and its multi-aspects-oriented analytics is in demand to explore the effectiveness of a prescribed treatment, optimize therapy, and correlate biomarker level with disease pathogenesis. Owing to nanotechnology-enabled advancements in sensing unit fabrication, device integration, interfacing, packaging, and sensing performance at point-of-care (POC) has rendered diagnostics according to the requirements of disease management and patient disease profile i.e. in a personalized manner. Efforts are continuously being made to promote the state of art biosensing technology as a next-generation non-invasive disease diagnostics methodology. Keeping this in view, this progressive opinion article describes personalized health care management related analytical tools which can provide access to better health for everyone, with overreaching aim to manage healthy tomorrow timely. Considering accomplishments and predictions, such affordable intelligent diagnostics tools are urgently required to manage COVID-19 pandemic, a life-threatening respiratory infectious disease, where a rapid, selective and sensitive detection of human beta severe acute respiratory system coronavirus (SARS-COoV-2) protein is the key factor.
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Affiliation(s)
- M A Mujawar
- Department of Electrical and Computer Engineering, College of Engineering and Computing, Florida International University, Miami, FL, 33174, USA
| | - H Gohel
- Department of Computer Science, School of Art and Sciences, University of Houston, Victoria, TX, USA
| | - S K Bhardwaj
- Van't Hoff Institute for Molecular Sciences, University of Amsterdam, Science Park 904, 1098 XH, Amsterdam, the Netherlands
| | - S Srinivasan
- NnaoBioTech Laboratory, Department of Natural Sciences, Division of Sciences, Art, & Mathematics, Florida Polytechnic University, Lakeland, FL, 33805, USA
| | - N Hickman
- NnaoBioTech Laboratory, Department of Natural Sciences, Division of Sciences, Art, & Mathematics, Florida Polytechnic University, Lakeland, FL, 33805, USA
| | - A Kaushik
- NnaoBioTech Laboratory, Department of Natural Sciences, Division of Sciences, Art, & Mathematics, Florida Polytechnic University, Lakeland, FL, 33805, USA
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Kaushik A, Wani SN, Baba MA, Agarwal AK. Prevalence of Abnormal Liver Function Tests in COVID-19 Patients at a Tertiary Care Centre. J Assoc Physicians India 2020; 68:73-75. [PMID: 32738845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
BACKGROUND AND AIM Coronavirus disease 2019 (COVID 2019) outbreak caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is observed to cause liver dysfunction. We aimed to observe abnormal liver function tests (LFTs) in COVID-19 patients admitted in our hospital. METHODS It was a cross- sectional study involving 105 COVID-19 patients who were admitted in our Hospital from 03-04-2020 to 02-05-2020. The COVID-19 positivity was defined on basis of real-time PCR. Thorough clinical examination and laboratory investigations including Complete Blood Count, Renal function Tests, Liver Function Tests, Chest X-ray, ECG, etc. were done. RESULTS The total number of male and female patients were 64 and 41. Out of total 105 patients, 62 i.e. 59.04% had abnormal LFTs at time of admission. Out of these 62 patients, 44(70.9%) were Male and 18(29.03%) were female. Only 5(4.76%) patients had abnormal LFTs on repeat testing. Median Age of patients was 33years. Average stay of patients with Abnormal LFTs was 15 days (10-16 days) as compared to 10 days (7-11days) for patients with normal LFTs. CONCLUSION The prevalence of Abnormal Liver function tests in patients of COVID-19 is 59.04%. Abnormal liver functions were more in males. The average stay in hospital for COVID-19 patients with abnormal LFTs was longer than those with normal LFTs.
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Affiliation(s)
- Atul Kaushik
- Post Graduate Resident, SMS and R, Sharda University, Greater Noida, Uttar Pradesh
| | | | | | - A K Agarwal
- Sr. Professor and HOD, SMS and R, Sharda University, Greater Noida, Uttar Pradesh
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Choudhary R, Kaushik A, Sharma JB. COVID-19 pandemic and stent thrombosis in a post percutaneous coronary intervention patient-a case report highlighting the selection of P2Y12 inhibitor. Cardiovasc Diagn Ther 2020; 10:898-901. [PMID: 32968646 DOI: 10.21037/cdt-20-485] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
The current pandemic of novel coronavirus disease 2019 (COVID-19) has posed a great threat to people's health worldwide, with specific implications on patients with underlying heart diseases. During this challenging period, nearly all major societies have recommended for conservative approach, even for patients with relatively stable acute cardiovascular diseases. Selection of specific antiplatelet therapy in an uncomplicated post percutaneous coronary intervention (PCI) patient can, at times, be crucial issue in such strained circumstances. We report a case of 64-year-old male, who was taken for urgent coronary angiogram (CAG) in view of non ST elevation acute coronary syndrome. Successful PCI with implantation of drug eluting stent was done for right coronary artery (RCA) and left anterior descending (LAD) artery lesions. On day 5th post-PCI, he developed acute inferior wall STEMI due to subacute stent thrombosis (ST), and despite all efforts, patient could not be saved as he didn't receive timely intervention. Increased travel time to emergency department due to lockdown because of COVID-19 and along with extra time required for donning of personal protection equipment (PPE) and other COVID-19 related safety measures prolonged the ischemic time. Potent P2Y12 inhibitor based dual antiplatelet therapy might have prevented this subacute ST, and thus mortality, as the patient was discharged on clopidogrel after PCI. While selecting specific P2Y12 inhibitor in a post PCI patient, apart from clinical condition of patient and complexity of procedure, we should also consider current COVID-19 pandemic. Current circumstances may favour ticagrelor over other P2Y12 inhibitors in view of its potent, rapid, and reversible antiplatelet action along with its optimistic effect in pneumonia.
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Affiliation(s)
| | - Atul Kaushik
- All India Institute of Medical Sciences, Jodhpur, India
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Patel S, Kaushik A, Sharma AK. Prioritizing cardiovascular surgical care in COVID-19 pandemic: Shall we operate or defer? J Card Surg 2020; 35:2768-2772. [PMID: 32668048 PMCID: PMC7404879 DOI: 10.1111/jocs.14864] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 06/28/2020] [Accepted: 07/03/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND The coronavirus disease (COVID-19) has affected a large population across the world. Patients with cardiovascular disease have increased morbidity and mortality due to coronavirus disease. The burden over the health care system has to be reduced in this global pandemic to provide optimal care of patients with COVID-19, as well not compromising those who are in need of emergent cardiovascular care. METHODS There is a very limited data published defining which cardiovascular procedures are to be performed or to be deferred in the COVID-19 pandemic. In this article, we have reviewed a few published guidelines regarding cardiovascular surgery in COVID-19 pandemics. CONCLUSION After reviewing a few available guidelines regarding cardiovascular surgery in COVID-19, we conclude to perform only those surgeries which cannot be deferred to a certain period of time, to reduce the burden of the health care system of the country, provide optimal care to patients with COVID-19, and to protect health care workers and cardiovascular patients from COVID-19.
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Affiliation(s)
- Surendra Patel
- Department of Trauma and Emergency Cardiothoracic Surgery, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Atul Kaushik
- Department of Cardiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Alok Kumar Sharma
- Department of Cardiothoracic and Vascular Surgery, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
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Kaushik A, Mahajan R, De D, Handa S. Paediatric morphoea: a holistic review. Part 1: epidemiology, aetiopathogenesis and clinical classification. Clin Exp Dermatol 2020; 45:673-678. [PMID: 32472964 DOI: 10.1111/ced.14234] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/21/2020] [Indexed: 12/29/2022]
Abstract
Morphoea, also known as localized scleroderma, is a debilitating fibrosing disorder of uncertain aetiology, affecting the skin and subcutaneous tissues. Paediatric-onset disease is not uncommon and is associated with frequent relapses. The disease has complex pathogenetic mechanisms and multiple clinical subtypes, and affects children of all ages. Recent research has focused on elucidating the disease pathophysiology and identifying measures of disease activity. We performed a literature search on PubMed, MEDLINE and Google Scholar, using keywords such as 'pediatric morphea', 'juvenile localised scleroderma' and 'juvenile systemic sclerosis'. Relevant studies, including randomized trials, reviews of standard current guidelines and original research articles, were selected, and results were analysed before being summarized. In the first of this two-part review, we provide a bird's-eye view of the current literature concerning the epidemiology, aetiopathogenesis and clinical classification of paediatric morphoea; in Part 2, we review the diagnosis, markers of disease activity, management and natural history.
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Affiliation(s)
- A Kaushik
- Department of Dermatology, Venereology, and Leprology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - R Mahajan
- Department of Dermatology, Venereology, and Leprology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - D De
- Department of Dermatology, Venereology, and Leprology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - S Handa
- Department of Dermatology, Venereology, and Leprology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
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Kaushik A, Mahajan R, De D, Handa S. Paediatric morphoea: a holistic review. Part 2: diagnosis, measures of disease activity, management and natural history. Clin Exp Dermatol 2020; 45:679-684. [PMID: 32449205 DOI: 10.1111/ced.14236] [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] [Accepted: 02/21/2020] [Indexed: 12/01/2022]
Abstract
Paediatric morphoea is a debilitating fibrosing disorder of uncertain aetiology, affecting the skin and subcutaneous tissues. Defining optimum management strategies in paediatric morphoea remains an ongoing challenge, owing to the varied presentations and a relative paucity of paediatric-specific studies. We performed a literature search on PubMed, MEDLINE and Google Scholar, using keywords such as 'pediatric morphea', 'juvenile localised scleroderma' and 'juvenile systemic sclerosis'. Relevant studies, including randomized trials, reviews of standard current guidelines and original research articles, were selected and results analysed before summarizing them. In Part 1 of this review, we described the epidemiology, aetiopathogenesis and clinical classification; in this part, we discuss the diagnosis, markers of disease activity, management and natural history in paediatric morphoea.
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Affiliation(s)
- A Kaushik
- Department of Dermatology, Venereology, and Leprology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - R Mahajan
- Department of Dermatology, Venereology, and Leprology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - D De
- Department of Dermatology, Venereology, and Leprology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - S Handa
- Department of Dermatology, Venereology, and Leprology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
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Sharma JB, Deora S, Choudhary R, Kaushik A. Diagnosing anomalous circumflex origin by 3D echocardiography. J Echocardiogr 2020; 19:185-186. [PMID: 32415588 DOI: 10.1007/s12574-020-00472-y] [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] [Received: 10/28/2019] [Revised: 04/06/2020] [Accepted: 04/27/2020] [Indexed: 10/24/2022]
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Sharma VC, Kaushik A, Dey YN, Srivastava B, Wanjari M, Jaiswal B. Analgesic, anti-inflammatory and antipyretic activities of ethanolic extract of stem bark of Anogeissus latifolia Roxb. Clin Phytosci 2020. [DOI: 10.1186/s40816-020-00171-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Stem bark of Anogeissus latifolia Roxb (family: Combretaceae) is used traditionally and ethnomedicinally to alleviate pain, inflammation and fever conditions. The current study investigates the analgesic, anti-inflammatory and antipyretic activities of ethanolic extract of stem bark of Anogeissus latifolia Roxb.
Method
The HPLC studies were carried out to standardize the stem bark ethanolic extract of Anogeissus latifolia (ALEE) using ellagic acid as a marker. ALEE was screened for analgesic (formalin-induced pain and acetic acid induced writhing) and anti-inflammatory (formalin and carrageenan-induced paw oedema) activities in Wistar rats. Before 1 h of acetic acid or formalin or carrageenan injection, rats were orally fed with ALEE (100, 200 and 400 mg/kg), Aspirin (100 mg/kg) or Indomethacin (10 mg/kg). Antipyretic effect was studied in brewer’s yeast-induced pyrexia model in rats using Paracetamol (100 mg/kg) as a standard drug.
Results
HPLC analysis of ALEE revealed the presence of ellagic acid. ALEE treatment (200 and 400 mg/kg) significantly inhibited pain response in both models. ALEE treatments prevented the raise of paw volume in both in-vivo models with percent inhibition of 44.40 and 46.21, respectively at 5 h. ALEE also showed a significant reduction of yeast-induced pyrexia till 4 h of treatment.
Conclusion
ALEE exhibited analgesic, anti-inflammatory and antipyretic property in experimental models and validates traditional use of ALEE in pain, inflammation and fever.
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Kaushik A, Papachristou E, Dima D, Fewings S, Kostaki E, Ploubidis G, Kyriakopoulos M. Measuring stigma in children receiving mental health treatment: Validation of the Paediatric Self-Stigmatization Scale (PaedS). Eur Psychiatry 2020; 43:1-8. [DOI: 10.1016/j.eurpsy.2017.01.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Revised: 01/17/2017] [Accepted: 01/17/2017] [Indexed: 10/20/2022] Open
Abstract
AbstractBackground:Research on the impact of stigma associated with mental illness in children is scarce. Considering the known negative effects of stigma associated with mental illness in adults, it is crucial to explore the stigma experienced by children who access mental health treatment. However, no scale measuring self-stigmatization in younger children is available to date. This study aimed to develop and validate such a scale, the Paediatric Self-Stigmatization Scale (PaedS).Methods:A total of 156 children (119 receiving outpatient and 37 receiving inpatient treatment), aged 8–12 years, completed the PaedS, the Self-Perception Profile for Children and the Pediatric Quality of Life Inventory (PedsQL – Child Report, ages 8–12). In addition, parents completed the PedsQL (Parent Report for Children, ages 8–12), the Strengths and Difficulties Questionnaire (SDQ) and a modified subscale of the PaedS measuring the children's rejection by others due to their mental health difficulties.Results:A confirmatory factor analysis showed that a four-factor structure, comprising Societal Devaluation, Personal Rejection, Self-Stigma and Secrecy scales, had excellent fit to the data (CFI = 0.95; TLI = 0.95; RMSEA = 0.05). Child-reported PaedS scores were positively correlated with parental-reported PaedS scores and negatively with PedsQL, the SDQ, and 5 out of 6 subscales of the Self-Perception Profile for Children, suggesting adequate convergent validity (all P-values < 0.05).Conclusions:The PaedS is a valid instrument, which is hoped to advance the understanding of self-stigmatization in children with mental health difficulties and contribute to its prevention.
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