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Kuerec AH, Wang W, Yi L, Tao R, Lin Z, Vaidya A, Pendse S, Thasma S, Andhalkar N, Avhad G, Kumbhar V, Maier AB. Towards personalized nicotinamide mononucleotide (NMN) supplementation: Nicotinamide adenine dinucleotide (NAD) concentration. Mech Ageing Dev 2024; 218:111917. [PMID: 38430946 DOI: 10.1016/j.mad.2024.111917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 02/07/2024] [Accepted: 02/19/2024] [Indexed: 03/05/2024]
Abstract
Nicotinamide mononucleotide (NMN) is a precursor of nicotinamide adenine dinucleotide (NAD), which declines with age. Supplementation of NMN has been shown to improve blood NAD concentration. However, the optimal NMN dose remains unclear. This is a post-hoc analysis of a double-blinded clinical trial involving 80 generally healthy adults aged 40-65 years. The participants received a placebo or daily 300 mg, 600 mg, or 900 mg NMN for 60 days. Blood NAD concentration, blood biological age, homeostatic model assessment for insulin resistance, 6-minute walk test, and 36-item short-form survey (SF-36) were measured at baseline and after supplement. A significant dose-dependent increase in NAD concentration change (NADΔ) was observed following NMN supplementation, with a large coefficient of variation (29.2-113.3%) within group. The increase in NADΔ was associated with an improvement in the walking distance of 6-minute walk test and the SF-36 score. The median effect dose of NADΔ for the 6-minute walk test and SF-36 score was 15.7 nmol/L (95% CI: 10.9-20.5 nmol/L) and 13.5 nmol/L (95% CI; 10.5-16.5 nmol/L), respectively. Because of the high interindividual variability of the NADΔ after NMN supplementation, monitoring NAD concentration can provide valuable insights for tailoring personalized dosage regimens and optimizing NMN utilization.
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Affiliation(s)
- Ajla Hodzic Kuerec
- Healthy Longevity Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore; Centre for Healthy Longevity, @AgeSingapore, National University Health System, 10 Medical Drive, Singapore 117597, Singapore
| | - Weilan Wang
- Healthy Longevity Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore; Centre for Healthy Longevity, @AgeSingapore, National University Health System, 10 Medical Drive, Singapore 117597, Singapore
| | - Lin Yi
- Abinopharm, Inc, 3 Enterprise Drive, Suite 407, Shelton, CT 06484, USA
| | - Rongsheng Tao
- Huzhou Yihui Biotechnology Co., Ltd, 1366 Hong Feng Road, Huzhou, Zhejiang 313000, People's Republic of China
| | - Zhigang Lin
- ABA Chemicals Corporation, 67 Libing Road, Building 4, Zhangjian Hi-Tech Park, Shanghai 201203, People's Republic of China
| | - Aditi Vaidya
- ProRelix Services LLP, 102 A/B, Park Plaza, Karve Road, Karve Nagar, Pune, Maharashtra 411052, India
| | - Sohal Pendse
- ProRelix Services LLP, 102 A/B, Park Plaza, Karve Road, Karve Nagar, Pune, Maharashtra 411052, India
| | - Sornaraja Thasma
- ProRelix Services LLP, 102 A/B, Park Plaza, Karve Road, Karve Nagar, Pune, Maharashtra 411052, India
| | - Niranjan Andhalkar
- ProRelix Services LLP, 102 A/B, Park Plaza, Karve Road, Karve Nagar, Pune, Maharashtra 411052, India
| | - Ganesh Avhad
- Lotus Healthcare & Aesthetics Clinic, 5 Bramha Chambers, 2010 Sadashivpeth, Tilak Road, Pune, Maharashtra, India
| | - Vidyadhar Kumbhar
- Sunad Ayurved, Siddhivinayak Apart, Jeevan Nagar, Chinchwad, Pune, Maharashtra 411033, India
| | - Andrea B Maier
- Healthy Longevity Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore; Centre for Healthy Longevity, @AgeSingapore, National University Health System, 10 Medical Drive, Singapore 117597, Singapore; Vrije Universiteit Amsterdam, Department of Human Movement Sciences, @AgeAmsterdam, Amsterdam Movement Sciences, Van der Boechorststraat 7, Amsterdam 1081 BT, the Netherlands.
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Yi L, Maier AB, Tao R, Lin Z, Vaidya A, Pendse S, Thasma S, Andhalkar N, Avhad G, Kumbhar V. The efficacy and safety of β-nicotinamide mononucleotide (NMN) supplementation in healthy middle-aged adults: a randomized, multicenter, double-blind, placebo-controlled, parallel-group, dose-dependent clinical trial. GeroScience 2022; 45:29-43. [PMID: 36482258 PMCID: PMC9735188 DOI: 10.1007/s11357-022-00705-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 11/29/2022] [Indexed: 12/13/2022] Open
Abstract
In animal studies, β-nicotinamide mononucleotide (NMN) supplementation increases nicotinamide adenine dinucleotide (NAD) concentrations and improves healthspan and lifespan with great safety. However, it is unclear if these effects can be transferred to humans. This randomized, multicenter, double-blind, placebo-controlled, parallel-group, dose-dependent clinical trial included 80 middle-aged healthy adults being randomized for a 60-day clinical trial with once daily oral dosing of placebo, 300 mg, 600 mg, or 900 mg NMN. The primary objective was to evaluate blood NAD concentration with dose-dependent regimens. The secondary objectives were to assess the safety and tolerability of NMN supplementation, next to the evaluation of clinical efficacy by measuring physical performance (six-minute walking test), blood biological age (Aging.Ai 3.0 calculator), Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), and subjective general health assessment [36-Item Short Form Survey Instrument (SF-36)]. Statistical analysis was performed using the Per Protocol analysis with significant level set at p = 0.05. All 80 participants completed the trial without trial protocol violation. Blood NAD concentrations were statistically significantly increased among all NMN-treated groups at day 30 and day 60 when compared to both placebo and baseline (all p ≤ 0.001). Blood NAD concentrations were highest in the groups taking 600 mg and 900 mg NMN. No safety issues, based on monitoring adverse events (AEs), laboratory and clinical measures, were found, and NMN supplementation was well tolerated. Walking distance increase during the six-minute walking test was statistically significantly higher in the 300 mg, 600 mg, and 900 mg groups compared to placebo at both days 30 and 60 (all p < 0.01), with longest walking distances measured in the 600 mg and 900 mg groups. The blood biological age increased significantly in the placebo group and stayed unchanged in all NMN-treated groups at day 60, which resulted in a significant difference between the treated groups and placebo (all p < 0.05). The HOMA-IR showed no statistically significant differences for all NMN-treated groups as compared to placebo at day 60. The change of SF-36 scores at day 30 and day 60 indicated statistically significantly better health of all three treated groups when compared to the placebo group (p < 0.05), except for the SF-36 score change in the 300 mg group at day 30. NMN supplementation increases blood NAD concentrations and is safe and well tolerated with oral dosing up to 900 mg NMN daily. Clinical efficacy expressed by blood NAD concentration and physical performance reaches highest at a dose of 600 mg daily oral intake. This trial was registered with ClinicalTrials.gov, NCT04823260, and Clinical Trial Registry - India, CTRI/2021/03/032421.
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Affiliation(s)
- Lin Yi
- Abinopharm, Inc, 3 Enterprise Drive, Suite 407, Shelton, CT, 06484, USA.
| | - Andrea B. Maier
- grid.12380.380000 0004 1754 9227Department of Human Movement Sciences, @AgeAmsterdam, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands ,grid.4280.e0000 0001 2180 6431Healthy Longevity Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 119228 Singapore ,grid.410759.e0000 0004 0451 6143Centre for Healthy Longevity, @AgeSingapore, National University Health System, 28 Medical Drive, Singapore, 117456 Singapore
| | - Rongsheng Tao
- Huzhou Yihui Biotechnology Co., Ltd, 1366 Hong Feng Road, Huzhou, Zhejiang 313000 People’s Republic of China
| | - Zhigang Lin
- ABA Chemicals Corporation, 67 Libing Road, Building 4, Zhangjian Hi-Tech Park, Shanghai, 201203 People’s Republic of China
| | - Aditi Vaidya
- grid.513192.dProRelix Services LLP, 102 A/B, Park Plaza, Karve Road, Karve Nagar, Pune, Maharashtra 411052 India
| | - Sohal Pendse
- grid.513192.dProRelix Services LLP, 102 A/B, Park Plaza, Karve Road, Karve Nagar, Pune, Maharashtra 411052 India
| | - Sornaraja Thasma
- grid.513192.dProRelix Services LLP, 102 A/B, Park Plaza, Karve Road, Karve Nagar, Pune, Maharashtra 411052 India
| | - Niranjan Andhalkar
- grid.513192.dProRelix Services LLP, 102 A/B, Park Plaza, Karve Road, Karve Nagar, Pune, Maharashtra 411052 India
| | - Ganesh Avhad
- Lotus Healthcare & Aesthetics Clinic, 5 Bramha Chambers, 2010 Sadashivpeth, Tilak Road, Pune, Maharashtra India
| | - Vidyadhar Kumbhar
- Sunad Ayurved, Siddhivinayak Apart, Jeevan Nagar, Maharashtra 411033 Chinchwad, Pune, India
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Avhad G. Treatment of resistant alopecia areata with tofacitinib. Int J Trichology 2022; 14:60-61. [PMID: 35531489 PMCID: PMC9069910 DOI: 10.4103/ijt.ijt_128_21] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 03/22/2022] [Accepted: 03/25/2022] [Indexed: 11/12/2022] Open
Abstract
The activity of tofacitinib for Alopecia areata (AA) has been reported but mainly from the western countries. We report the case of a young female Indian patient with AA unresponsive to therapy. Improvements in terms of hair regrowth were observed within 2 months of treatment with oral tofacitinib 5 mg BID tablets. The effectiveness of tofacitinib in hair regrowth was maintained till 5-month follow-up period. There were no side effects reported and the treatment with tofacitinib was well-tolerated.
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Affiliation(s)
- Ganesh Avhad
- Department of Dermatology, L. T. M. Medical College and General Hospital, Sion, Mumbai, Maharashtra, India
| | - Hemangi Jerajani
- Department of Dermatology, L. T. M. Medical College and General Hospital, Sion, Mumbai, Maharashtra, India
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Sannananja B, Shah H, Avhad G, Agrawal A. Unusual case of an anomalous congenital band causing acute small bowel obstruction in a case of abdominal tuberculosis. J Mahatma Gandhi Inst Med Sci 2016. [DOI: 10.4103/0971-9903.178130] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Abstract
Eruptive syringoma is a very rare variant of syringoma. It is a benign adnexal tumor of the intraepidermal portion of eccrine sweat ducts. Here we report a 32-year-old female presented with classical asymptomatic eruptive syringomas involving her face and extremities.
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Affiliation(s)
- Ganesh Avhad
- Department of Dermatology, L.T.M. Medical College and General Hospital, Sion, Mumbai, India
| | - Priyanka Ghuge
- Department of Dermatology, Jaslok Hospital, Mumbai, India
| | - H R Jerajani
- Department of Dermatology, L.T.M. Medical College and General Hospital, Sion, Mumbai, India
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Affiliation(s)
- Ganesh Avhad
- Consultant Dermatologist, Microcare Hospital, Sion, Mumbai, Maharashtra, India
| | - Priyanka Ghuge
- Department of Dermatology, Jaslok Hospital and Research Centre, Mumbai, Maharashtra, India
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Affiliation(s)
- Ganesh Avhad
- Department of Dermatology, L.T.M. Medical College and General Hospital, Sion, Mumbai, Maharashtra, India
| | - Priyanka Ghuge
- Department of Dermatology, Jaslok Hospital and Research Centre, Pedder Road, Mumbai, Maharashtra, India
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Affiliation(s)
- Ganesh Avhad
- Departments of Dermatology, L. T. M. Medical College and General Hospital, Sion, Mumbai, India
| | - Smita Ghate
- Departments of Dermatology, L. T. M. Medical College and General Hospital, Sion, Mumbai, India
| | - Rachita Dhurat
- Departments of Dermatology, L. T. M. Medical College and General Hospital, Sion, Mumbai, India
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Affiliation(s)
- Ganesh Avhad
- Department of Dermatology, Lokmanya Tilak Municipal Medical College and General Hospital, Sion, Mumbai, Maharashtra, India
| | - Priyanka Ghuge
- Department of Dermatology, Lokmanya Tilak Municipal Medical College and General Hospital, Sion, Mumbai, Maharashtra, India
| | - Hemangi Jerajani
- Department of Dermatology, Lokmanya Tilak Municipal Medical College and General Hospital, Sion, Mumbai, Maharashtra, India
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Avhad G, Ghuge P, Jerajani H. Acute hemorrhagic edema of infancy. Indian Dermatol Online J 2014; 5:356-7. [PMID: 25165670 PMCID: PMC4144238 DOI: 10.4103/2229-5178.137809] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Ganesh Avhad
- Department of Dermatology, L.T.M. Medical College and General Hospital, Sion, Mumbai, India
| | - Priyanka Ghuge
- Jaslok Hospital & Research Centre Pedder Road, Mumbai, India
| | - Hemangi Jerajani
- Department of Dermatology, L.T.M. Medical College and General Hospital, Sion, Mumbai, India
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Affiliation(s)
- Ganesh Avhad
- Department of Dermatology, L.T.M. Medical College and General Hospital, Sion, Mumbai, India
| | - H R Jerajani
- Department of Dermatology, L.T.M. Medical College and General Hospital, Sion, Mumbai, India
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Affiliation(s)
- Ganesh Avhad
- Department of Dermatology, Microcare Hospital, Sion, Maharashtra, India
| | - Priyanka Ghuge
- Department of Dermatology, Jaslok Hospital and Research Centre, Mumbai, Maharashtra, India
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Avhad G, Jerajani HR. Plexiform neurofibromatosis. Indian Dermatol Online J 2014; 5:362-3. [PMID: 25165674 PMCID: PMC4144242 DOI: 10.4103/2229-5178.137815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Affiliation(s)
- Ganesh Avhad
- Department of Dermatology, L.T.M. Medical College and General Hospital, Mumbai, Maharashtra, India
| | - Hemangi Jerajani
- Department of Dermatology, L.T.M. Medical College and General Hospital, Mumbai, Maharashtra, India
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Avhad G, Ghuge P, Jerajani H. Cerebriform nevus sebaceous of Jadassohn. Indian Pediatr 2013; 50:1072. [PMID: 24382915] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Affiliation(s)
- Ganesh Avhad
- Department of Dermatology, LTM Medical College and General Hospital, Sion, Mumbai 400 022, India.
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Avhad G, Ghuge P. Median canaliform dystrophy of Heller. Indian Pediatr 2013; 50:1073. [PMID: 24382916] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Affiliation(s)
- Ganesh Avhad
- Department of Dermatology, L.T.M.Medical College and General Hospital, Sion, Mumbai, 400 022, India.
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Affiliation(s)
- Ganesh Avhad
- Department of Dermatology, L. T. M. Medical College and General Hospital, Mumbai, Maharashtra, India
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Dhurat R, Sukesh M, Avhad G, Dandale A, Pal A, Pund P. A randomized evaluator blinded study of effect of microneedling in androgenetic alopecia: a pilot study. Int J Trichology 2013; 5:6-11. [PMID: 23960389 PMCID: PMC3746236 DOI: 10.4103/0974-7753.114700] [Citation(s) in RCA: 116] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Introduction: Dermal papilla (DP) is the site of expression of various hair growth related genes. Various researches have demonstrated the underlying importance of Wnt proteins and wound growth factors in stimulating DP associated stem cells. Microneedling works by stimulation of stem cells and inducing activation of growth factors. Materials and Methods: Hundred cases of mild to moderate (III vertex or IV) androgenetic alopecia (AGA) were recruited into 2 groups. After randomization one group was offered weekly microneedling treatment with twice daily 5% minoxidil lotion (Microneedling group); other group was given only 5% minoxidil lotion. After baseline global photographs, the scalp were shaved off to ensure equal length of hair shaft in all. Hair count was done in 1 cm2 targeted fixed area (marked with tattoo) at baseline and at end of therapy (week 12). The 3 primary efficacy parameters assessed were: Change from baseline hair count at 12 weeks, patient assessment of hair growth at 12 weeks, and investigator assessment of hair growth at 12 weeks. A blinded investigators evaluated global photographic response. The response was assessed by 7- point scale. Results: (1) Hair counts – The mean change in hair count at week 12 was significantly greater for the Microneedling group compared to the Minoxidil group (91.4 vs 22.2 respectively). (2) Investigator evaluation – Forty patients in Microneedling group had +2 to +3 response on 7-point visual analogue scale, while none showed the same response in the Minoxidil group. (3) Patient evaluation – In the Microneedling group, 41 (82%) patients reported more than 50% improvement versus only 2 (4.5%) patients in the Minoxidil group. Unsatisfied patients to conventional therapy for AGA got good response with Microneedling treatment. Conclusion: Dermaroller along with Minoxidil treated group was statistically superior to Minoxidil treated group in promoting hair growth in men with AGA for all 3 primary efficacy measures of hair growth. Microneedling is a safe and a promising tool in hair stimulation and also is useful to treat hair loss refractory to Minoxidil therapy.
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Affiliation(s)
- Rachita Dhurat
- Department of Dermatology, L.T.M. Medical College and General Hospital, Sion, Mumbai, Maharashtra, India
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Abstract
Keratoacanthoma (KA) is a rapidly evolving tumor, composed of keratinizing squamous cells originating in pilosebaceous follicles and resolving spontaneously if left untreated. It is relatively uncommon in dark-skinned and occurs in middle aged individuals. Males are three times more affected than females. It presents as firm, rounded, flesh-colored or reddish papule; with a rapid growth phase followed by spontaneous healing over three months. Two types of KA exist i.e., solitary and multiple. There are three rare clinical variants of solitary KA, namely giant KA, keratoacanthoma centrifugum marginatum (KCM) and subungual KA. In KCM, lesions are large, reaching upto 20cms. There is peripheral extension with raised, rolled border and atrophy in the center. There is no tendency toward spontaneous involution. The most common locations are dorsa of hands and legs, lesions on scalp being rare. A rare case of KCM occurring on scalp which is an unusual site is reported.
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Affiliation(s)
- Meghana M Phiske
- Department of Dermatogology, L.T.M. Medical College and General Hospital, Sion, Mumbai, India
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Affiliation(s)
- Ganesh Avhad
- Department of Dermatology, L. T. M. Medical College and General Hospital, Sion, Mumbai, India
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Avhad G, Dandale A, Ghate S, Dhurat R. Unknown: Multiple painful nodules - what is the diagnosis? Chronic tophaceous gout. Dermatol Online J 2011; 17:9. [PMID: 22233745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023] Open
Abstract
Gout is a common rheumatologic condition of recurrent polyarticular involvement. Tophi may be the first sign of the disease. We report a 55-year-old hypertensive, chronic alcoholic and diabetic male with a three-year history of multiple painful skin-colored nodules on the forearms, elbows, feet, posterior thighs, and popliteal fossa associated with discharging sinuses. Serum uric acid was 8.1 mg/dL (normal: 2-7.4 mg/dL). Fine needle aspiration cytology showed monosodium urate crystals, which are pathognomonic for gout, confirmed histopathalogically.
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Avhad G, Dandale A, Ghate S, Dhurat R. Multiple painful nodules - What is the diagnosis? Dermatol Online J 2011. [DOI: 10.5070/d335w130t1] [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: 11/08/2022] Open
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Rathod K, Deshmukh H, Bhatia S, Popat B, Shukla A, Avhad G. Abstract No. 312: Endovascular management of Budd Chiari syndrome-KEM experience. J Vasc Interv Radiol 2010. [DOI: 10.1016/j.jvir.2009.12.100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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