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Dziadula J, Sabbaj S, Gupta K, Cutter G, Yu H, Brunham RC, Geisler WM. Interferon-Gamma Responses to Chlamydia trachomatis Vaccine Candidate Proteins in Chlamydia-Infected Women with Different Chlamydia Outcomes. J Infect Dis 2024:jiae092. [PMID: 38394609 DOI: 10.1093/infdis/jiae092] [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: 10/27/2023] [Revised: 01/31/2024] [Accepted: 02/20/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Chlamydia trachomatis (CT) testing and treatment strategies have not decreased infection rates, justifying need for a CT vaccine. A murine study showed that a vaccine consisting of MOMP and 4 polymorphic membrane proteins (Pmps E, F, G, H) elicited protective immunity; studies on human cellular immune responses to Pmps are sparse. METHODS Interferon gamma (IFN-γ) responses to these 5 CT proteins were measured by ELISPOT in PBMCs from women returning for treatment of a positive CT screening test. Responses were compared in those with spontaneous CT clearance vs. persisting infection at baseline and no reinfection vs. reinfection at a 3-month follow-up visit. RESULTS IFN-γ response to one or more proteins was detected in 39% at baseline and 51.5% at follow-up; PmpE and MOMP most often elicited positive responses. IFN-γ responses to MOMP were detected less often at follow-up vs. baseline in women with reinfection, but were maintained in those without reinfection. Women with spontaneous clearance had a higher magnitude of IFN-γ response to PmpE and MOMP. CONCLUSIONS IFN-γ responses to these 5 CT vaccine candidate proteins were heterogenous and primarily directed against MOMP and PmpE. Spontaneous clearance of infection and absence of reinfection may be clinical correlates of protection.
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Affiliation(s)
- Jacob Dziadula
- Departments of Medicine and Biostatistics, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Steffanie Sabbaj
- Departments of Medicine and Biostatistics, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Kanupriya Gupta
- Departments of Medicine and Biostatistics, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Gary Cutter
- Biostatistics, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Hong Yu
- British Columbia Centre for Disease Control, University of British Columbia, Vancouver, BC, Canada
| | - Robert C Brunham
- British Columbia Centre for Disease Control, University of British Columbia, Vancouver, BC, Canada
| | - William M Geisler
- Departments of Medicine and Biostatistics, University of Alabama at Birmingham, Birmingham, AL, USA
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Yu H, Geisler WM, Dai C, Gupta K, Cutter G, Brunham RC. Antibody responses to Chlamydia trachomatis vaccine candidate antigens in Chlamydia-infected women and correlation with antibody-mediated phagocytosis of elementary bodies. Front Cell Infect Microbiol 2024; 14:1342621. [PMID: 38371301 PMCID: PMC10869445 DOI: 10.3389/fcimb.2024.1342621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 01/16/2024] [Indexed: 02/20/2024] Open
Abstract
Murine research has revealed a significant role for antibody responses in protection against Chlamydia reinfection. To explore potential humoral immune markers of protection elicited by Chlamydia trachomatis (CT) antigens in humans in the context of presumed clinical correlates of protection, we used both an IgG1-based ELISA and a conventional total IgG ELISA to evaluate antibody responses. We evaluated responses to five CT outer membrane proteins (PmpE, PmpF, PmpG, PmpH, and MOMP), along with other promising CT antigens (Pgp3 and HSP60), negative control antigens (RecO and AtpE), and CT elementary bodies (EBs) in sera from a well-characterized cohort of 60 women with different CT infection outcomes, including two outcomes that are likely clinical correlates of protective immunity: spontaneous resolution of infection and absence of reinfection after treatment. Furthermore, we used a flow cytometry-based assay to measure antibody-mediated phagocytosis by neutrophils in these sera. Results demonstrated that IgG1 ELISA displayed higher sensitivity than conventional total IgG ELISA in assessing antibody responses to CT EBs and antigens. Pgp3 IgG1 ELISA exhibited the highest sensitivity compared to IgG1 ELISA incorporating CT EBs or other antigens, confirming Pgp3 IgG1 ELISA as an ideal assay for CT antibody detection. Most (95%) sera from women with CT infection outcomes exhibited antibody-mediated phagocytosis of CT EBs, which was significantly correlated with IgG1 antibody responses to MOMP, Pgp3, HSP60, and PmpF. However, neither IgG1 responses to CT antigens and EBs nor antibody-mediated phagocytosis were associated with clinical correlates of protection. These findings suggest that neither CT IgG1 antibody detection nor antibody-mediated phagocytosis will be useful as immune correlates of protection against CT infection in humans.
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Affiliation(s)
- Hong Yu
- Department of Medicine, British Columbia Centre for Disease Control, University of British Columbia, Vancouver, BC, Canada
| | - William M. Geisler
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Chuanbin Dai
- Department of Medicine, British Columbia Centre for Disease Control, University of British Columbia, Vancouver, BC, Canada
| | - Kanupriya Gupta
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Gary Cutter
- Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Robert C. Brunham
- Department of Medicine, British Columbia Centre for Disease Control, University of British Columbia, Vancouver, BC, Canada
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D’Amico M, Mbah JCE, Gupta K, Dionne JA, Akoachere JF, Nguedia JCA, Van Der Pol B, Geisler WM. Chlamydia trachomatis -Specific Antibody Responses in Women in Cameroon With Secondary Infertility. Sex Transm Dis 2023; 50:e30-e33. [PMID: 37732834 PMCID: PMC10592028 DOI: 10.1097/olq.0000000000001866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/22/2023]
Abstract
ABSTRACT The contribution of chlamydia to secondary infertility in women is poorly understood. Among 404 female participants enrolled in a previous study in Cameroon, 142 had secondary infertility (cases) and 262 were pregnant with no history of infertility (controls) , Chlamydia trachomatis seropositivity was 92%. Seropositivity did not significantly differ by case/control status.
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Affiliation(s)
- Madison D’Amico
- Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL, USA
| | - J Clarisse Engowei Mbah
- Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
- Institute of Medical Research and Medicinal Plants Studies, Center for Research on Health and Priority Pathologies, Yaoundé, Cameroon
| | - Kanupriya Gupta
- Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Jodie A. Dionne
- Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL, USA
| | | | - Jules Clement Assob Nguedia
- Department of Laboratory Medicines, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | - Barbara Van Der Pol
- Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL, USA
| | - William M. Geisler
- Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL, USA
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Gupta K, Wiener HW, Tiwari HK, Geisler WM. HLA-DQB1*06 and Select Neighboring HLA Variants Predict Chlamydia Reinfection Risk. Int J Mol Sci 2023; 24:15803. [PMID: 37958786 PMCID: PMC10647357 DOI: 10.3390/ijms242115803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 10/25/2023] [Accepted: 10/27/2023] [Indexed: 11/15/2023] Open
Abstract
Associations of HLA class II alleles with genital chlamydial infection outcomes have been reported, especially HLA DQB1*06. However, the potential role of DQB1*06 in influencing reinfection risk has still not been established. The purpose of this study was to determine whether the association of DQB1*06 with chlamydia reinfection was impacted by any other nearby HLA class II variants that were also associated with reinfection. We used next-generation sequencing to map HLA class II variants spanning the HLA-DQ and -DR loci. DQB1*06 as well as DQB1*04 were confirmed as significant predictors of chlamydia reinfection, when controlling for age and percent African ancestry. SKAT analysis revealed one region each in DRB1, DRB5, DQA2, and three intergenic regions that had variants associated with reinfection. Further analyses of these variants revealed that rs112651494 within DRB5 and an intergenic SNP rs617058 in DRB1:DQA1 were significantly associated with reinfection, but this did not impact the significance of the association of DQB1*06 or DQB1*04 with reinfection.
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Affiliation(s)
- Kanupriya Gupta
- Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL 35294, USA;
| | - Howard W. Wiener
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL 35294, USA;
| | - Hemant K. Tiwari
- Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL 35294, USA;
| | - William M. Geisler
- Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL 35294, USA;
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL 35294, USA;
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Jordan SJ, Wilson L, Ren J, Gupta K, Barnes S, Geisler WM. Natural Clearance of Chlamydia trachomatis Infection Is Associated With Distinct Differences in Cervicovaginal Metabolites. J Infect Dis 2023; 228:1119-1126. [PMID: 37163744 PMCID: PMC10582912 DOI: 10.1093/infdis/jiad155] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 04/25/2023] [Accepted: 05/09/2023] [Indexed: 05/12/2023] Open
Abstract
BACKGROUND Natural clearance of Chlamydia trachomatis in women occurs in the interval between screening and treatment. In vitro, interferon-γ (IFN-γ)-mediated tryptophan depletion results in C. trachomatis clearance, but whether this mechanism occurs in vivo remains unclear. We previously found that women who naturally cleared C. trachomatis had lower cervicovaginal levels of tryptophan and IFN-γ compared to women with persisting infection, suggesting IFN-γ-independent pathways may promote C. trachomatis clearance. METHODS Cervicovaginal lavages from 34 women who did (n = 17) or did not (n = 17) naturally clear C. trachomatis were subjected to untargeted high-performance liquid chromatography mass-spectrometry to identify metabolites and metabolic pathways associated with natural clearance. RESULTS In total, 375 positively charged metabolites and 149 negatively charged metabolites were annotated. Compared to women with persisting infection, C. trachomatis natural clearance was associated with increased levels of oligosaccharides trehalose, sucrose, melezitose, and maltotriose, and lower levels of indoline and various amino acids. Metabolites were associated with valine, leucine, and isoleucine biosynthesis pathways. CONCLUSIONS The cervicovaginal metabolome in women who did or did not naturally clear C. trachomatis is distinct. In women who cleared C. trachomatis, depletion of various amino acids, especially valine, leucine, and isoleucine, suggests that amino acids other than tryptophan impact C. trachomatis survival in vivo.
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Affiliation(s)
- Stephen J Jordan
- Department of Medicine, Indiana University, Indianapolis, Indiana, USA
| | - Landon Wilson
- Targeted Metabolomics and Proteomics Laboratory, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Jie Ren
- Department of Biostatics and Health Data Science, Indiana University, Indianapolis, Indiana, USA
| | - Kanupriya Gupta
- Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Stephen Barnes
- Targeted Metabolomics and Proteomics Laboratory, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Department of Pharmacology and Toxicology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - William M Geisler
- Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
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Flammini D, Chaudhary A, Colangeli A, Fonnesu N, Guirao J, Gupta K, Kalwale S, Mariano G, Moro F, Previti A, Quatrevaux M, Shigin P, Udintsev V, Villari R. Neutronic analyses for the equatorial diagnostic port plug #12 in ITER. Fusion Engineering and Design 2023. [DOI: 10.1016/j.fusengdes.2023.113639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/07/2023]
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Gupta R, Gupta P, Gupta K, Chandra D, Singh MK, Arora N, Rahman K. Nodular lymphocyte predominant Hodgkin lymphoma: An unusual case with peripheral blood atypical T-cell lymphocytosis. Int J Lab Hematol 2023; 45:586-588. [PMID: 36710455 DOI: 10.1111/ijlh.14027] [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: 07/06/2022] [Accepted: 01/13/2023] [Indexed: 01/31/2023]
Affiliation(s)
- R Gupta
- Department of Hematology, Sanjay Gandhi Post Graduate Institute of Medical Sciences (SGPGIMS), Lucknow, Uttar Pradesh, India
| | - P Gupta
- Department of Hematology, Sanjay Gandhi Post Graduate Institute of Medical Sciences (SGPGIMS), Lucknow, Uttar Pradesh, India
| | - K Gupta
- Department of Hematology, Sanjay Gandhi Post Graduate Institute of Medical Sciences (SGPGIMS), Lucknow, Uttar Pradesh, India
| | - D Chandra
- Department of Hematology, Sanjay Gandhi Post Graduate Institute of Medical Sciences (SGPGIMS), Lucknow, Uttar Pradesh, India
| | - M K Singh
- Department of Hematology, Sanjay Gandhi Post Graduate Institute of Medical Sciences (SGPGIMS), Lucknow, Uttar Pradesh, India
| | - N Arora
- Unipath Specialty Laboratory, Ahmedabad, India
| | - K Rahman
- Department of Hematology, Sanjay Gandhi Post Graduate Institute of Medical Sciences (SGPGIMS), Lucknow, Uttar Pradesh, India
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Patel M G, Nidhi , Gupta K, Gupta M, Gupta S, Krupa S. THE IMPACT OF CLIMATE CHANGE ON INFECTIOUS DISEASES: A COMPREHENSIVE ANALYSIS OF VECTOR-BORNE DISEASES, WATER-BORNE DISEASES, AND PUBLIC HEALTH STRATEGIES. Georgian Med News 2023:136-142. [PMID: 37805887] [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: 10/09/2023]
Abstract
Climate change is long-term modifications to weather patterns and a rise in extreme weather events. It might modify the hazard to human health and exacerbate current problems. The article explores the scientific data in a description of the effects of Infectious diseases in humans and climate change. It identifies scientific advancements and gaps in potential responses from human civilization and how it might prepare for the changes that come with it by adjusting to them. The impact reflects three aspects, such as climate variables, selected infectious diseases, and infectious disease components. This study demonstrates how vulnerable people are to any ill consequences that climate change may have on their health. Humans can actively influence controllable correlated health impacts by taking proactive measures, such as increasing our understanding of the detrimental effects associated with specific diseases and the patterns in climate change. We can also carefully distribute technology and resources, encouraging exercise and public awareness. It is advised to take the following adaption measures: Considering how infectious diseases and climate change are not the only things that science has discovered and create locally efficient early warning systems for those effects to produce more scientific justifications and go beyond scientific reports. Improve prediction of the spatiotemporal processes behind climate change and changes in infectious illnesses connected at different temporal and spatial scales.
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Affiliation(s)
- G Patel M
- 1Department of Community Medicine, Parul University, PO Limda, Tal.Waghodia, District Vadodara, Gujarat, India
| | - - Nidhi
- 2Department of Nursing, IIMT University, Meerut, Uttar Pradesh, India
| | - K Gupta
- 3Department of Ayurveda, Sanskriti University, Mathura, Uttar Pradesh, India
| | - M Gupta
- 4Department of Pharmacy, Vivekananda Global University, Jaipur, India
| | - S Gupta
- 5Department of Community Medicine, TeerthankerMahaveer University, Moradabad, Uttar Pradesh, India
| | - S Krupa
- 6Department of Chemistry & Biochemistry, School of Sciences, JAIN (Deemed-to-be University), Karnataka, India
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Morsy MA, Gupta S, Dora CP, Jhawat V, Dhanawat M, Mehta D, Gupta K, Nair AB, El-Daly M. Venoms classification and therapeutic uses: a narrative review. Eur Rev Med Pharmacol Sci 2023; 27:1633-1653. [PMID: 36876699 DOI: 10.26355/eurrev_202302_31408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
Abstract
The mere glimpse of venomous animals has always terrified humans because of the devastating effects of their venoms. However, researchers across the globe have isolated therapeutically active ingredients from these venoms and continue to explore them for drug leads. These efforts lead to the discovery of therapeutic molecules that the US-FDA has approved to treat different diseases, such as hypertension (Captopril), chronic pain (Ziconotide), and diabetes (Exenatide). The main active constituents of most venoms are proteins and peptides, which gained more attention because of advancements in biotechnology and drug delivery. The utilization of newer screening approaches improved our understanding of the pharmacological complexity of venom constituents and facilitated the development of novel therapeutics. Currently, with many venom-derived peptides undergoing different phases of clinical trials, more are in pre-clinical drug development phases. This review highlights the various sources of venoms, their pharmacological actions, and the current developments in venom-based therapeutics.
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Affiliation(s)
- M A Morsy
- Department of Pharmaceutical Sciences, College of Clinical Pharmacy, King Faisal University, Al-Ahsa, Saudi Arabia.
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Hu M, Souder JP, Subramaniam A, Van Der Pol B, Xiao L, Gupta K, Dionne-Odom J, Geisler WM. Prevalence of Mycoplasma genitalium infection and macrolide resistance in pregnant women receiving prenatal care. Int J Gynaecol Obstet 2023; 160:341-344. [PMID: 36074058 PMCID: PMC10439771 DOI: 10.1002/ijgo.14443] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 08/01/2022] [Accepted: 08/30/2022] [Indexed: 12/15/2022]
Affiliation(s)
- Muhan Hu
- Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Jaclyn Paige Souder
- Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Akila Subramaniam
- Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Center for Women’s Reproductive Health, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Barbara Van Der Pol
- Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Center for Women’s Reproductive Health, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Li Xiao
- Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Kanupriya Gupta
- Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Jodie Dionne-Odom
- Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Center for Women’s Reproductive Health, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - William M. Geisler
- Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Center for Women’s Reproductive Health, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
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Sharma M, Marodia Y, Singh AK, Kurdia K, Gupta K, Sandhu MS. Gastrointestinal: An unusual cause of biliary obstruction in a case of Peutz-Jeghers syndrome. J Gastroenterol Hepatol 2023; 38:8. [PMID: 35643980 DOI: 10.1111/jgh.15890] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 05/07/2022] [Indexed: 01/19/2023]
Affiliation(s)
- M Sharma
- Department of Radiodiagnosis, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Y Marodia
- Department of Radiodiagnosis, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - A K Singh
- Department of Gastroenterology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - K Kurdia
- Department of General Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - K Gupta
- Department of Histopathology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - M S Sandhu
- Department of Radiodiagnosis, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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Chaturvedi TP, Gupta K, Agrawal R, Naveen Kumar PG, Gupta J. Immunohistochemical expression of Ki-67 and Glypican-3 to distinguish aggressive from nonaggressive benign odontogenic tumors. J Cancer Res Ther 2022; 18:S205-S209. [PMID: 36510965 DOI: 10.4103/jcrt.jcrt_223_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Background The benign neoplasms are normally slow growing, indolent with no invasive potential. However, there exist a few locally aggressive benign odontogenic tumors that have a tendency to invade and deform the surrounding structures. The exact reason for the aggressiveness of these benign neoplasms remained an enigma. Their biology and clinical expression can often be destructive and ominous. An appropriate treatment protocol needs to be followed to combat the high recurrence rate and aggressiveness of these entities. Aggressive and noniaggressive epithelial odontogenic tumors were analyzed immunohistochemically with Ki-67 and glypican 3 (GPC3). Materials and Methods Fifty-nine cases of tumors were divided into aggressive odontogenic tumors (20 solid ameloblastomas, four unicystic ameloblastoma, and 28 keratocystic odontogenic tumors) and nonaggressive odontogenic tumors (five adenomatoid odontogenic tumors and two calcifying cystic odontogenic itumors). Results Statistical analysis using Pearson correlation showed Ki-67 to be a better marker for differentiating aggressive from nonaggressive odontogenic tumor as compared to GPC3 (P < 0.001, highly significant), whereas among aggressive tumors, GPC3 turned out to be more useful as compared to Ki-67 (P < 0.001, highly significant). Conclusion The present study provides an insight into the different biological behavior of odontogenic tumors, which can thus be helpful in determining the therapy strategies for more aggressive odontogenic tumors.
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Affiliation(s)
- T P Chaturvedi
- Faculty of Dental Sciences, IMS, BHU, Varanasi, Uttar Pradesh, India
| | - Kanupriya Gupta
- Faculty of Dental Sciences, IMS, BHU, Varanasi, Uttar Pradesh, India
| | - Rahul Agrawal
- Faculty of Dental Sciences, IMS, BHU, Varanasi, Uttar Pradesh, India
| | - P G Naveen Kumar
- Faculty of Dental Sciences, IMS, BHU, Varanasi, Uttar Pradesh, India
| | - Jatin Gupta
- Faculty of Dental Sciences, IMS, BHU, Varanasi, Uttar Pradesh, India
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Gupta K, Zahedi S, Kakar TS, Zweig B. Independent prognostic value of ventricular premature complexes during exercise and recovery in asymptomatic patients: a meta-analysis of observational studies. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Ventricular premature contractions (VPCs) are a common finding during a cardiac stress test. The independent prognostic value of these findings in asymptomatic participants is not clear.
Purpose
To investigate the cumulative independent prognostic value of VPC for adverse outcomes.
Methods
We conducted a systematic review and meta-analysis of observational studies in the following databases: MEDLINE, Embase®, and Cochrane Central from inception till January 28, 2022. The primary outcome was the cumulative hazard of all-cause mortality with VPCs during exercise or recovery in asymptomatic participants. The secondary outcome was cardiovascular mortality. We stratified results based on VPC during exercise or recovery.
We included studies with participants with no known CV disease and known CV disease. If there was known CV disease at baseline, the study should have adjusted for at least ≥1 known confounder. If a study reported low risk or higher risk VPCs, we included outcomes with higher risk VPCs to make the data comparable across literature. Random effect meta-analyses were used to predict cumulative hazard ratios. The review was registered with PROSPERO (registration number CRD42022297028)
Results
We found 10 studies with 47,497 participants that met our inclusion criteria (8 studies with all-cause and CV mortality, 2 studies with CV mortality only). Three studies included patients with baseline CV disease (proportion 12–33%). Follow-up duration ranged from 5.3 to 20.3 years. Definition of VPCs differed in the individual studies.
Both VPCs during exercise and recovery were associated with a higher hazard of all-cause mortality (HR 1.21, 95% confidence interval [CI] 1.07, 1.34 and 1.32, 95% CI 1.06, 1.58, p<0.001 and low heterogeneity for both, respectively, Figure 1A). There was no small study treatment effect bias.
Similarly, both VPCs during exercise and recovery were associated with a higher hazard of CV mortality (HR 1.63, 95% CI 1.30, 1.96 and 1.68, 95% CI 1.00, 2.35, p<0.001, and low heterogeneity for both, respectively, Figure 1B).
The presence of VPC had a numerically stronger association with CV mortality than all-cause mortality. VPCs during recovery seem to have more prognostic value than VPC during rest.
Conclusion
After adjusting for known confounders, VPCs during exercise and recovery predict a higher risk of all-cause and CV mortality. The risk is higher with VPCs during recovery.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- K Gupta
- Henry Ford Hospital , Detroit , United States of America
| | - S Zahedi
- Henry Ford Hospital , Detroit , United States of America
| | - T S Kakar
- Henry Ford Hospital , Detroit , United States of America
| | - B Zweig
- Henry Ford Hospital , Detroit , United States of America
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Gupta K, Van Der Pol B, Press CG, Geisler WM. Chlamydia trachomatis Infection and Seropositivity in Women Reporting Sexual Contact to a Chlamydia-Infected Partner. Sex Transm Dis 2022; 49:e97-e99. [PMID: 35728006 PMCID: PMC9357228 DOI: 10.1097/olq.0000000000001613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT Among 73 women presenting to a sexually transmitted infection (STI) clinic in Birmingham, Alabama for reported sexual contact to a chlamydia-infected partner, Chlamydia trachomatis was detected in genital specimens in 24 (32.8%), less often in women reporting prior chlamydial infection ( P = 0.001). Most women (93.2%) were C. trachomatis seropositive.
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Affiliation(s)
- Kanupriya Gupta
- Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Barbara Van Der Pol
- Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Christen G. Press
- Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - William M. Geisler
- Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
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Beine A, Albano Y, Deischter J, Gupta K, Palkovits R. Flexible conversion of sorbitol to the diols ethylene/propylene glycol and isosorbide – Catalysis over solid acids and bases. CHEM-ING-TECH 2022. [DOI: 10.1002/cite.202255379] [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]
Affiliation(s)
- A. K. Beine
- RWTH Aachen University ITMC Worringerweg 2 52074 Aachen Germany
| | - Y. Albano
- RWTH Aachen University ITMC Worringerweg 2 52074 Aachen Germany
| | - J. Deischter
- RWTH Aachen University ITMC Worringerweg 2 52074 Aachen Germany
| | - K. Gupta
- RWTH Aachen University ITMC Worringerweg 2 52074 Aachen Germany
| | - R. Palkovits
- RWTH Aachen University ITMC Worringerweg 2 52074 Aachen Germany
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Strickland G, Qu R, Gupta K, Jiang Y, Dong D, Saez C, Weng P, Taketo M, Klugar Y, Myung P. 704 Decomposing a deterministic path to hair follicle dermal niche formation: The intersection of two morphogen gradients. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Gupta K, Chopra R, Kulkarni P. Use of pulse oximetry during nitrous oxide- oxygen inhalation sedation: mandatory or recommended? Eur Arch Paediatr Dent 2022; 23:647-652. [PMID: 35655051 DOI: 10.1007/s40368-022-00717-7] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 04/28/2022] [Indexed: 11/30/2022]
Abstract
AIM There is skepticism amongst many dentists about the interference of nitrous oxide with the physiological parameters. This commentary attempts to make clear recommendations on the use of pulse oximeter during nitrous oxide inhalation sedation. BACKGROUND Nitrous oxide is used commonly in dentistry as a tool to reduce fear/ anxiety and build a positive dental attitude. Dentists use pulse oximeter to monitor oxygen saturation during the period of administration of nitrous oxide. There is no consensus amongst various guidelines across the world on the necessity of using pulse oximeter during the period of administration of nitrous oxide CONCLUSION: Pulse oximetry may not be considered mandatory when nitrous oxide gas is being administered for minimal sedation to a healthy patient having no pre- existing diseases/illness.
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Affiliation(s)
- K Gupta
- Children's Dental Center, 8, FF, MGF Megacity Mall, MG Road, Gurugram, 122002, India.
- Sharad Pawar Dental College, Wardha, India.
- Peoples College of Dental Sciences, Bhopal, India.
| | - R Chopra
- Children's Neurology and Dentistry, Ghaziabad, India
| | - P Kulkarni
- Peoples College of Dental Sciences, Bhopal, India
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Hoang K, Win S, Gupta K. Abstract No. 147 Comparison of Celect inferior vena cava filter thrombus incidence based on filter position at time of filter retrieval. J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.228] [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: 11/24/2022] Open
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Singla A, Madan R, Kumar N, Goyal S, Tripathi M, Gupta K, Gupta D, Kapoor R. PO-1149 Clinico-pathological and prognostic factors of Medulloblastoma - Tertiary care centre in India. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03113-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Sharma J, Gupta K, Schwebke JR, Geisler WM, Muzny CA. Association of Bacterial Vaginosis With Higher Vaginal Indole Levels. Sex Transm Dis 2022; 49:e53-e55. [PMID: 34561371 DOI: 10.1097/olq.0000000000001564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT We adapted a simple hydroxylamine-based indole assay to detect indole from stored vaginal swab specimens from women with and without bacterial vaginosis (BV). Women with BV had significantly higher vaginal indole levels compared with women without BV (6451.5 vs 5632.4 μM; P = 0.01), suggesting that indole-producing bacteria are a component of BV.
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Affiliation(s)
- Jyoti Sharma
- From the Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL
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21
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Sharma J, Gupta K, Geisler W, Muzny C. Association of Bacterial Vaginosis with Higher Vaginal Indole Levels. Am J Obstet Gynecol 2022. [DOI: 10.1016/j.ajog.2021.11.1336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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22
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Gupta K, Thapa B, Gupta S, Sharma S. Lung Function Tests in Hairdressers of Gangtok: A Cross-Sectional Study. Indian J Occup Environ Med 2022; 26:91-94. [PMID: 35991197 PMCID: PMC9384880 DOI: 10.4103/ijoem.ijoem_264_21] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 11/18/2021] [Accepted: 12/06/2021] [Indexed: 01/09/2023] Open
Abstract
Background Hairdressers undergo extensive and prolonged exposure to a variety of chemical substances present in the air in their salons. Although in low concentrations, the various products used for hair care are harmful as most of these products generate chemical aerosols during different procedures. These aerosols which have irritant or sensitizing effects on respiratory mucosa have been found to enter into the airways. Aim The aim of this study is to assess the impairment of lung function in hairdressers in Gangtok. Method This is a cross-sectional, comparative study conducted on 50 hairdressers and 50 age- and sex-matched non-hairdresser comparison group. The sampling technique used was simple random sampling. Permission from Institutional Ethical Committee was obtained before beginning the study. A standard questionnaire was used to record the respiratory symptoms. The pulmonary function parameters of the subjects were measured using portable spirometer HELIOS 720. Results All the parameters were decreased in hairdressers and almost all the differences were statistically significant. FEV1 (P = 0.023) and FEV1/FVC ratio (P < 0.05) were reduced significantly. FEF25-75% and PEFR were also significantly reduced (P < 0.05 in both parameters). FVC was also reduced in hairdressers, but it was not statistically significant (P = 0.342). Conclusion Hairdressers undergo exposure to different chemicals in their workplace and carry the risk of decreased pulmonary function.
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Affiliation(s)
- K. Gupta
- Department of Physiology, Sikkim Manipal Institute of Medical Sciences, Sikkim Manipal University, Tadong, Gangtok, Sikkim, India
| | - B. Thapa
- Department of Physiology, Sikkim Manipal Institute of Medical Sciences, Sikkim Manipal University, Tadong, Gangtok, Sikkim, India,Address for correspondence: Dr. B. Thapa, Department of Physiology, Sikkim Manipal Institute of Medical Sciences, 5th Mile, Tadong, Gangtok, Sikkim, India. E-mail:
| | - S. Gupta
- Sikkim Manipal College of Physiotherapy, Sikkim Manipal University, Tadong, Gangtok, Sikkim, India
| | - S. Sharma
- Department of Physiology, Sikkim Manipal Institute of Medical Sciences, Sikkim Manipal University, Tadong, Gangtok, Sikkim, India
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23
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Joshi R, Medhi B, Prakash A, Chandy S, Ranjalkar J, Bright HR, Basker J, Govindraj L, Chugh PK, Tripathi CD, Badyal DK, Balakrishnan S, Jhaj R, Shukla AK, Atal S, Najmi A, Banerjee A, Kamat S, Tripathi RK, Shetty YC, Parmar U, Rege N, Dikshit H, Mishra H, Roy SS, Chatterjee S, Hazra A, Bhattacharya M, Das D, Trivedi N, Shah P, Chauhan J, Desai C, Gandhi AM, Patel PP, Shah S, Sheth S, Raveendran R, Mathaiyan J, Manikandan S, Jeevitha G, Gupta P, Sarangi SC, Yadav HN, Singh S, Kaushal S, Arora S, Gupta K, Jain S, Cherian JJ, Chatterjee NS, Kaul R, Kshirsagar NA. Assessment of prescribing pattern of drugs and completeness of prescriptions as per the World Health Organization prescribing indicators in various Indian tertiary care centers: A multicentric study by Rational Use of Medicines Centers-Indian Council of Medical Research network under National Virtual Centre Clinical Pharmacology activity. Indian J Pharmacol 2022; 54:321-328. [PMID: 36537400 PMCID: PMC9846909 DOI: 10.4103/ijp.ijp_976_21] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVE The rational use of medicines as per the World Health Organization (WHO) should be practiced globally. However, data regarding the completeness of the prescriptions and their rational use is lacking from developing countries like India. Thus, the aim of this study was to assess the prescribing patterns of drugs and completeness of prescriptions as per WHO core drug use and complementary indicators to provide real-life examples for the Indian Council of Medical Research (ICMR) online prescribing skill course for medical graduates. METHODS Prescriptions of the patients, fulfilling inclusion criteria, attending Outpatient Departments of various specialties of tertiary care hospitals, were collected by thirteen ICMR Rational use of medicines centers located in tertiary care hospitals, throughout India. Prescriptions were evaluated for rational use of medicines according to the WHO guidelines and for appropriateness as per standard treatment guidelines using a common protocol approved by local Ethics committees. RESULTS Among 4838 prescriptions, an average of about three drugs (3.34) was prescribed to the patients per prescription. Polypharmacy was noted in 83.05% of prescriptions. Generic drugs were prescribed in 47.58% of the prescriptions. Further, antimicrobials were prescribed in 17.63% of the prescriptions and only 4.98% of prescriptions were with injectables. During the prescription evaluation, 38.65% of the prescriptions were incomplete due to multiple omissions such as dose, duration, and formulation. CONCLUSION Most of the parameters in the present study were out of the range of WHO-recommended prescribing indicators. Therefore, effective intervention program, like training, for the promotion of rational drug use practice was recommended to improve the prescribing pattern of drugs and the quality of prescriptions all over the country.
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Affiliation(s)
- R Joshi
- Department of Pharmacology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - B Medhi
- Department of Pharmacology, Post Graduate Institute of Medical Education and Research, Chandigarh, India,Address for correspondence: Dr. Medhi B, Department of Pharmacology, Post Graduate Institute of Medical Education and Research, Chandigarh, India. E-mail:
| | - A Prakash
- Department of Pharmacology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - S Chandy
- Department of Pharmacology and Clinical Pharmacology, Christian Medical College, Vellore, Tamil Nadu, India
| | - J Ranjalkar
- Department of Pharmacology and Clinical Pharmacology, Christian Medical College, Vellore, Tamil Nadu, India
| | - HR Bright
- Department of Pharmacology and Clinical Pharmacology, Christian Medical College, Vellore, Tamil Nadu, India
| | - J Basker
- Department of Pharmacology and Clinical Pharmacology, Christian Medical College, Vellore, Tamil Nadu, India
| | - L Govindraj
- Department of Pharmacology and Clinical Pharmacology, Christian Medical College, Vellore, Tamil Nadu, India
| | - PK Chugh
- Vardhman Mahavir Medical College, New Delhi, India
| | - CD Tripathi
- Vardhman Mahavir Medical College, New Delhi, India
| | - DK Badyal
- Department of Pharmacology, Christian Medical College, Ludhiana, Punjab, India
| | - S Balakrishnan
- Department of Pharmacology, All India Institute of Medical Sciences, Bhopal, India
| | - R Jhaj
- Department of Pharmacology, All India Institute of Medical Sciences, Bhopal, India
| | - AK Shukla
- Department of Pharmacology, All India Institute of Medical Sciences, Bhopal, India
| | - S Atal
- Department of Pharmacology, All India Institute of Medical Sciences, Bhopal, India
| | - A Najmi
- Department of Pharmacology, All India Institute of Medical Sciences, Bhopal, India
| | - A Banerjee
- Department of Pharmacology, All India Institute of Medical Sciences, Bhopal, India
| | - S Kamat
- Department of Pharmacology and Therapeutics, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India
| | - RK Tripathi
- Department of Pharmacology and Therapeutics, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India
| | - YC Shetty
- Department of Pharmacology and Therapeutics, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India
| | - U Parmar
- Department of Pharmacology and Therapeutics, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India
| | - N Rege
- Department of Pharmacology and Therapeutics, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India
| | - H Dikshit
- Department of Pharmacology, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India
| | - H Mishra
- Department of Pharmacology, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India
| | - SS Roy
- Department of Pharmacology, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India
| | - S Chatterjee
- Department of Pharmacology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
| | - A Hazra
- Department of Pharmacology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
| | - M Bhattacharya
- Department of Pharmacology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
| | - D Das
- Department of Pharmacology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
| | - N Trivedi
- Department of Pharmacology, Government Medical College, Baroda, Gujarat, India
| | - P Shah
- Department of Pharmacology, Government Medical College, Baroda, Gujarat, India
| | - J Chauhan
- Department of Pharmacology, Government Medical College, Baroda, Gujarat, India
| | - C Desai
- Department of Pharmacology, B.J. Medical College, Ahmedabad, Gujarat, India
| | - AM Gandhi
- Department of Pharmacology, B.J. Medical College, Ahmedabad, Gujarat, India
| | - PP Patel
- Department of Pharmacology, B.J. Medical College, Ahmedabad, Gujarat, India
| | - S Shah
- Department of Pharmacology, B.J. Medical College, Ahmedabad, Gujarat, India
| | - S Sheth
- Department of Pharmacology, B.J. Medical College, Ahmedabad, Gujarat, India
| | - R Raveendran
- Department of Pharmacology, Jawaharlal Institute of Post Medical Education and Research, Puducherry, India
| | - J Mathaiyan
- Department of Pharmacology, Jawaharlal Institute of Post Medical Education and Research, Puducherry, India
| | - S Manikandan
- Department of Pharmacology, Jawaharlal Institute of Post Medical Education and Research, Puducherry, India
| | - G Jeevitha
- Department of Pharmacology, Jawaharlal Institute of Post Medical Education and Research, Puducherry, India
| | - P Gupta
- Department of Pharmacology, All India Institute of Medical Sciences, New Delhi, India
| | - SC Sarangi
- Department of Pharmacology, All India Institute of Medical Sciences, New Delhi, India
| | - HN Yadav
- Department of Pharmacology, All India Institute of Medical Sciences, New Delhi, India
| | - S Singh
- Department of Pharmacology, All India Institute of Medical Sciences, New Delhi, India
| | - S Kaushal
- Department of Pharmacology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - S Arora
- Department of Pharmacology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - K Gupta
- Department of Pharmacology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - S Jain
- Department of Pharmacology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - JJ Cherian
- Indian Council of Medical Research, New Delhi, India
| | - NS Chatterjee
- Indian Council of Medical Research, New Delhi, India
| | - R Kaul
- Indian Council of Medical Research, New Delhi, India
| | - NA Kshirsagar
- Indian Council of Medical Research, New Delhi, India
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Kumar S, Akif S, Parmar K, Singh P, Thummala Y, Panda I, Gupta K. Metachronous isolated inferior vena cava tumour thrombus in renal cell cancer: a rare aftermath. Ann R Coll Surg Engl 2021; 104:e139-e142. [PMID: 34941460 DOI: 10.1308/rcsann.2021.0230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Renal cell cancer (RCC) accounts for 3% of all solid malignancies. Synchronous tumour thrombus in the renal vein or inferior vena cava is reported in 4-10% cases and is a surgical challenge. Contemporary imaging modalities that are used to define the presence and extent of venous thrombus include colour Doppler, contrast-enhanced computed tomography and magnetic resonance venography. Surgical management depends upon the degree of tumour thrombus. We report isolated recurrence of RCC in the inferior vena cava 2 years after radical nephrectomy, and discuss its pathophysiology and management.
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Affiliation(s)
- S Kumar
- Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - S Akif
- Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - K Parmar
- Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - P Singh
- Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Y Thummala
- Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - I Panda
- Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - K Gupta
- Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
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Mamidanna S, Neibart S, Chundury A, Sayan M, Alexander H, August D, Berim L, Boland P, Grandhi M, Gulhati P, Gupta K, Hochster H, Kennedy T, Langan R, Minacapelli C, Spencer K, Nosher J, Jabbour S. Survival Outcomes of Patients With Unresectable Hepatocellular Carcinoma Secondary to Viral vs. Non-Viral Etiologies Treated with Definitive Radiotherapy. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Olson KM, Geisler WM, Bakshi RK, Gupta K, Tiwari HK. Predicting the Probability of Chlamydia Reinfection in African American Women Using Immunologic and Genetic Determinants in a Bayesian Model. Sex Transm Dis 2021; 48:813-818. [PMID: 33993163 PMCID: PMC8550879 DOI: 10.1097/olq.0000000000001468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND African Americans have the highest rates of Chlamydia trachomatis (CT) infection in the United States and also high reinfection rates. The primary objective of this study was to develop a Bayesian model to predict the probability of CT reinfection in African American women using immunogenetic data. METHODS We analyzed data from a cohort of CT-infected African American women enrolled at the time they returned to a clinic in Birmingham, AL, for the treatment of a positive routine CT test result. We modeled the probability of CT reinfection within 6 months after treatment using logistic regression in a Bayesian framework. Predictors of interest were presence or absence of an HLA-DQB1*06 allele and CT-specific CD4+ IFN-γ response, both of which we had previously reported were independently associated with CT reinfection risk. RESULTS Among 99 participants evaluated, the probability of reinfection for those with a CT-specific CD4+ IFN-γ response and no HLA-DQB1*06 alleles was 14.1% (95% credible interval [CI], 3.0%-45.0%), whereas the probability of reinfection for those without a CT-specific CD4+ IFN-γ response and at least one HLA-DQB1*06 allele was 61.5% (95% CI, 23.1%-89.7%). CONCLUSIONS Our model demonstrated that presence or absence of an HLA-DQB1*06 allele and CT-specific CD4+ IFN-γ response can have an impact on the predictive probability of CT reinfection in African American women.
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Affiliation(s)
- Kristin M. Olson
- School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - William M. Geisler
- School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Rakesh K. Bakshi
- School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Kanupriya Gupta
- School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Hemant K. Tiwari
- Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL, USA
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27
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Mamidanna S, Neibart S, Chundury A, Sayan M, Alexander H, August D, Berim L, Boland P, Grandhi M, Gulhati P, Gupta K, Hochster H, Kennedy T, Langan R, Minacapelli C, Spencer K, Nosher J, Jabbour S. Comparing Acute Toxicities of Patients With Unresectable Hepatocellular Carcinoma Treated With Definitive Proton vs. Photon-Based Radiotherapy. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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28
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Avolio E, Carrabba M, Kavanagh Williamson M, Milligan R, Gupta K, Gamez M, Foster R, Berger I, Caputo M, Davidson A, Hill D, Madeddu P. The SARS-CoV-2 Spike protein alters human cardiac pericyte function and interaction with endothelial cells through a non-infective mechanism involving activation of CD147 receptor signalling. Eur Heart J 2021. [PMCID: PMC8524576 DOI: 10.1093/eurheartj/ehab724.3383] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Human cardiac pericytes (PC) were proposed as the main cellular target for SARS-CoV-2 in the heart due to high transcriptional levels of the angiotensin-converting enzyme 2 (ACE2) receptor. Emerging reports indicate CD147/Basigin (BSG), highly expressed in endothelial cells (EC), is an alternative SARS-CoV-2 receptor. To date, the mechanism by which the virus infects and disrupts the heart vascular cells was not identified yet. Moreover, cleaved Spike (S) protein molecules could be released into the bloodstream from the leaking pulmonary epithelial-endothelial barrier in patients with severe COVID-19, opening to the possibility of non-infective diseases in organs distant from the primary site of infection.
Purposes
(1) to confirm that human primary cardiac PC express ACE2 and CD147; (2) to verify if PC are permissible to SARS-CoV-2 infection; (3) to investigate if the recombinant SARS-CoV-2 S protein alone, without the other viral elements, can trigger molecular signalling and induce functional alterations in PC; (4) to explore which viral receptor is responsible for the observed events.
Methods and results
Cardiac PC express both the ACE2 and CD147 receptors at mRNA and protein level. Incubation of PC for up to 5 days with SARS-CoV-2 expressing the green fluorescent protein (GFP) did not show any evidence of cell infection or viral replication. Next, we exposed the PC to the recombinant S protein (5.8 nM) and confirmed that the protein engaged with cellular receptors (western blot analysis of S protein in treated and control PC). Incubation with the S protein increased PC migration (wound closure assay, P<0.01 vs ctrl) and reduced the formation of tubular structures between PC and EC in a Matrigel assay (P<0.01 vs ctrl). Moreover, the S protein promoted the production of pro-inflammatory factors typical of the cytokine storm in PC (ELISA measurement of MCP1, IL-6, IL-1β, TNFα, P<0.05 vs ctrl), and induced the secretion of pro-apoptotic factors responsible for EC death (Caspase 3/7 assay, P<0.05 vs ctrl). Signalling studies revealed that the S protein triggers the phosphorylation/activation of the extracellular signal-regulated kinase 1/2 (ERK1/2) through the CD147 receptor, but not ACE2, in cardiac PC. The neutralization of CD147, using a blocking antibody, prevented ERK1/2 activation in PC, and was reflected into a partial rescue of the cell functional behaviour (migration and pro-angiogenic capacity). In contrast, blockage of CD147 failed to prevent the pro-inflammatory response in PC.
Conclusions
We propose the novel hypothesis that COVID-19 associated heart's microvascular dysfunction is prompted by circulating S protein molecules rather than by the direct coronavirus infection of PC. Besides, we propose CD147, and not ACE2, as the leading receptor mediating S protein signalling in cardiac PC.
Funding Acknowledgement
Type of funding sources: Foundation. Main funding source(s): BHF project grant “Targeting the SARS-CoV-2 S-protein binding to the ACE2 receptor to preserve human cardiac pericytes function in COVID-19” BHF Centre for Vascular Regeneration II
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Affiliation(s)
- E Avolio
- University of Bristol, Bristol Medical School, Bristol, United Kingdom
| | - M Carrabba
- University of Bristol, Bristol Medical School, Bristol, United Kingdom
| | - M Kavanagh Williamson
- University of Bristol, School of Cellular and Molecular Medicine, Bristol, United Kingdom
| | - R Milligan
- University of Bristol, School of Cellular and Molecular Medicine, Bristol, United Kingdom
| | - K Gupta
- University of Bristol, School of Biochemistry, Bristol, United Kingdom
| | - M Gamez
- University of Bristol, Bristol Medical School, Bristol, United Kingdom
| | - R Foster
- University of Bristol, Bristol Medical School, Bristol, United Kingdom
| | - I Berger
- University of Bristol, School of Biochemistry, Bristol, United Kingdom
| | - M Caputo
- University of Bristol, Bristol Medical School, Bristol, United Kingdom
| | - A Davidson
- University of Bristol, School of Cellular and Molecular Medicine, Bristol, United Kingdom
| | - D Hill
- University of Bristol, School of Cellular and Molecular Medicine, Bristol, United Kingdom
| | - P Madeddu
- University of Bristol, Bristol Medical School, Bristol, United Kingdom
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Singh N, Gupta K, Khan T, Rahman E, Singh-Ranger D. 516 Does the Use of Adjuvant Chemotherapy Increase Incisional Hernia Rates in Colorectal Cancer Patients – A Retrospective Single Centre Cohort Study. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Aim
Incisional hernias (IH) are a known complication of any major abdominal surgery. It is known that chemotherapy impairs healing processes via delayed inflammation, impaired collagen synthesis and reduced fibrin deposition and wound contraction. There are currently, to our knowledge, no trials examining the effect of adjuvant chemotherapy on incidence of IH in patients with colorectal cancer. This study aims to assess the same by comparing IH rates between chemotherapy and non-chemotherapy patient groups.
Method
All the patients who had major surgery for colorectal cancer between January 2009 and January 2014 were divided into two groups of chemotherapy (A) and non-chemotherapy (B). Records of first 160 patients from each group were retrospectively analysed.
Results
There were non-significant differences between groups for sex, tumour location, primary operation, and type of procedure (emergency or elective). Significant differences were observed for age (more elder patients in group B, p = 0.000011), method of access (more open procedures in group B and more laparoscopic procedures in group A, p = 0.0007) and Charlson co-morbidity scores (more advanced score in group B, p = 0.029). We found that 21/120 (21.21%) patients in the chemotherapy group and 12/99 (13.79%) patients in non-chemotherapy group developed Incisional hernias. Although there was a higher rate of IH in the chemotherapy group, this was not statistically significant (p = 0.27).
Conclusions
Although this study fails to demonstrate any statistically significant difference in IH incidence between two groups, but this study can act as a pilot in order to fuel further high-quality research to draw more valid conclusions.
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Affiliation(s)
- N Singh
- Royal Wolverhampton NHS Trust, Wolverhampton, United Kingdom
| | - K Gupta
- Royal Wolverhampton NHS Trust, Wolverhampton, United Kingdom
| | - T Khan
- Royal Wolverhampton NHS Trust, Wolverhampton, United Kingdom
| | - E Rahman
- Royal Wolverhampton NHS Trust, Wolverhampton, United Kingdom
| | - D Singh-Ranger
- Royal Wolverhampton NHS Trust, Wolverhampton, United Kingdom
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Balai E, Bhamra N, Gupta K, Jolly K, Barraclough J. Implementation of an acute tonsillitis management protocol within a clinical decisions unit. Ann R Coll Surg Engl 2021; 103:690-693. [PMID: 34436947 DOI: 10.1308/rcsann.2021.0060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION With tonsillectomy surgery subject to increasingly strict commissioning criteria over the past 20 years in the UK, the total number of admissions for acute tonsillitis has been rising steadily. Multiple single-centre studies have demonstrated how introduction of a standardised management protocol can be effective in improving the delivery of treatment for acute tonsillitis in the emergency department. METHODS Using a novel approach, we aimed to implement an acute tonsillitis management protocol within a formal clinical decisions unit (CDU) pathway. Following a retrospective baseline audit, we carried out two post-intervention cycles of data collection to assess safety and efficacy. RESULTS The median number of initial treatments increased significantly from two of five at baseline, to three of five in both the first (U = 86, p = 0.004) and second (z = 2.959, p = 0.003) audit cycles. Admission rate was reduced from 0.79 to 0.44 in the first cycle, representing a 44.6% relative risk reduction [95% confidence interval (CI) 0.304-1.012; p = 0.0547]. Admission rate remained reduced at 0.48 in the second cycle, with a relative risk reduction of 39.2% compared with baseline (95% CI 0.380-0.972; p = 0.038). CONCLUSIONS Utilisation of the CDU led to an improvement in the delivery of initial treatment, an extended period of observation and subsequently a greater percentage of patients being discharged. An acute tonsillitis management protocol within a CDU appears to be a safe and effective model and is now standard practice in our hospital.
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Affiliation(s)
- E Balai
- The Royal Wolverhampton NHS Trust, UK
| | - N Bhamra
- The Royal Wolverhampton NHS Trust, UK
| | - K Gupta
- The Royal Wolverhampton NHS Trust, UK
| | - K Jolly
- The Royal Wolverhampton NHS Trust, UK
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Gupta K, Harrison SA, Davis NA, Culp ML, Hand SC, Simpson T, Van Der Pol B, Galbraith JW, Van Wagoner NJ, Morrison SG, Morrison RP, Geisler WM. Prevalence of Chlamydia trachomatis Infection in Young Women and Associated Predictors. Sex Transm Dis 2021; 48:529-535. [PMID: 34110759 PMCID: PMC8847232 DOI: 10.1097/olq.0000000000001372] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Chlamydia trachomatis (CT) infection remains highly prevalent, and young women are disproportionately affected. Most CT-infected women are asymptomatic, and their infection often goes unrecognized and untreated. We hypothesized that testing for active CT infection with molecular diagnostics and obtaining a reported history of CT infection underestimate the prevalence of current and past CT infection, and incorporating serum CT antibody testing in addition to these other prevalence measures would generate more accurate estimates of the prevalence of CT infection in asymptomatic young women. METHODS We enrolled 362 asymptomatic women aged 16 to 29 years at 4 different clinical settings in Birmingham, AL, between August 2016 and January 2020 and determined the prevalence of CT infection based on having 1 or more of the following prevalence measures: an active urogenital CT infection based on molecular testing, reported prior CT infection, and/or being CT seropositive. Multivariable regression analysis was used to determine predictors of the prevalence of CT infection after adjustment for participant characteristics. RESULTS The prevalence of CT infection was 67.7% (95% confidence interval, 62.6%-72.5%). Addition of CT antibody testing to the other individual prevalence measures more than doubled the CT infection prevalence. Non-Hispanic Black race, reported prior gonorrhea, and reported prior trichomoniasis predicted a higher prevalence of CT infection. CONCLUSIONS More than half of women were unaware of ever having CT infection, suggesting many were at risk for CT-associated reproductive complications. These data reinforce the need to adhere to chlamydia screening guidelines and to increase screening coverage in those at risk.
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Affiliation(s)
- Kanupriya Gupta
- School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Sally A. Harrison
- School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Nkele A. Davis
- School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Matilda L. Culp
- School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Samuel C. Hand
- School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Tina Simpson
- School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
- Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Barbara Van Der Pol
- School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - James W. Galbraith
- School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
- Department of Emergency Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Nicholas J. Van Wagoner
- School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Sandra G. Morrison
- Department of Microbiology and Immunology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Richard P. Morrison
- Department of Microbiology and Immunology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - William M. Geisler
- School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
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32
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Olson E, Gupta K, Van Der Pol B, Galbraith JW, Geisler WM. Mycoplasma genitalium infection in women reporting dysuria: A pilot study and review of the literature. Int J STD AIDS 2021; 32:1196-1203. [PMID: 34229513 DOI: 10.1177/09564624211030040] [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: 11/17/2022]
Abstract
Mycoplasma genitalium (MG) infection, a sexually transmitted infection (STI), causes cervicitis and may cause reproductive sequelae and adverse pregnancy outcomes. Some MG-infected women report dysuria, a symptom frequently attributed to urinary tract infection (UTI). Given potential MG-associated morbidity and the likelihood that UTI treatment would be ineffective in eradicating MG, an improved understanding of MG infection frequency and clinical significance in young women reporting dysuria is needed. We conducted MG testing on stored urogenital specimens collected in a pilot study on frequency of STIs in young women presenting to an emergency department for dysuria evaluation and performed a literature review on MG infection frequency in women reporting dysuria. Among 25 women presenting for dysuria evaluation in our pilot study, 6 (24.0%) had MG detected and one-third had co-infection with chlamydia and one-third with trichomoniasis; half with MG detected did not receive an antibiotic with known efficacy against MG, while the other half received azithromycin. In five studies identified in the literature review, dysuria was reported by 7%-19% of women and MG detected in 5%-22%. MG infection is common in young women with dysuria and empiric UTI treatment may not be effective against MG. Studies evaluating the clinical significance of MG infection in women reporting dysuria are needed.
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Affiliation(s)
- Elizabeth Olson
- School of Medicine, 9967University of Alabama at Birmingham, Birmingham, AL, USA
| | - Kanupriya Gupta
- School of Medicine, 9967University of Alabama at Birmingham, Birmingham, AL, USA.,Department of Medicine, 9967University of Alabama at Birmingham, Birmingham, AL, USA
| | - Barbara Van Der Pol
- School of Medicine, 9967University of Alabama at Birmingham, Birmingham, AL, USA.,Department of Medicine, 9967University of Alabama at Birmingham, Birmingham, AL, USA
| | - James W Galbraith
- School of Medicine, 9967University of Alabama at Birmingham, Birmingham, AL, USA.,Department of Emergency Medicine, 9967University of Alabama at Birmingham, Birmingham, AL, USA
| | - William M Geisler
- School of Medicine, 9967University of Alabama at Birmingham, Birmingham, AL, USA.,Department of Medicine, 9967University of Alabama at Birmingham, Birmingham, AL, USA
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Remick M, McDowell MM, Gupta K, Felker J, Abel TJ. Emerging indications for stereotactic laser interstitial thermal therapy in pediatric neurosurgery. Int J Hyperthermia 2021; 37:84-93. [PMID: 32672117 DOI: 10.1080/02656736.2020.1769868] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
Surgical treatment of deep or difficult to access lesions represents a unique and significant challenge for pediatric neurosurgeons. The introduction of stereotactic magnetic resonance-guided laser interstitial thermal therapy (LITT) over the last decade has had a dramatic impact on the landscape of pediatric neurosurgery. LITT provides a safe and effective option for children with epilepsy from hypothalamic hamartoma that represents a ground-breaking new therapy for a condition which was historically very difficult to treat with previous neurosurgical techniques. LITT has also been used as an alternative surgical technique for mesial temporal sclerosis, focal cortical dysplasia, MR-negative epilepsy, cavernoma-related epilepsy, insular epilepsy, and corpus callosotomy among other epilepsy etiologies. In some cases, LITT has been associated with improved cognitive outcomes compared to standard techniques, as in mesial temporal lobe epilepsy. Initial experiences with LITT for neuro-oncologic processes are also promising. LITT is often attractive to patients and providers as a minimally invasive approach, but the differences in safety and clinical outcome between LITT and traditional approaches are still being studied. In this review, we examine the emerging indications and clinical evidence for LITT in pediatric neurosurgery.
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Affiliation(s)
- Madison Remick
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA, USA
| | - Michael M McDowell
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA, USA
| | - Kanupriya Gupta
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - James Felker
- Department of Pediatric Neuro-Oncology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Taylor J Abel
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA, USA.,University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.,Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA
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34
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Datta SS, Basu S, Reddy M, Gupta K, Sinha S. Comparative evaluation of the conventional tube test and column agglutination technology for ABO antibody titration in healthy individuals: a report from India. Immunohematology 2021; 37:25-32. [PMID: 33962486 DOI: 10.21307/immunohematology-2021-006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Determination of accurate anti-A/-B titers is important for treatment selection in ABO-incompatible stem cell and solid-organ transplants. The standard method for ABO antibody titration is the conventional tube test (CTT). Dithiothreitol (DTT) is commonly used to inactivate the IgM antibody component. The aim of this study was to compare six different methods for ABO antibody titration and to observe the effectiveness of DTT on antibody estimation. A total of 90 healthy voluntary blood donors were enrolled in this study, including 30 each for blood groups A, B, and O. Antibody titrations were performed and tested using the CTT-immediate spin (IS), CTT-antihuman globulin (AHG) with and without DTT, column agglutination technology (CAT)-IS, and CAT-AHG with and without DTT methods. Bead-CAT was used, and the positive cutoff value was set to 1+ for each method to determine the endpoint of the titer. The median values of anti-A/-B titers by IS were found to be higher than those values by AHG in CTT and CAT among group B and A individuals, whereas no statistically significant differences were observed in values from group O individuals for IS and AHG anti-A/-B titers, estimated by each method. Although there was positive correlation between the anti-A/-B titer results obtained using the CTT and CAT in all blood groups, testing using AHG showed poor agreement with and without DTT pretreatment (kappa value of 0.11 and 0.20, respectively). Moderate agreement was observed between CTT-IS and CAT-IS (kappa value of 0.46). Median anti-A/-B AHG titers were reduced by the use of DTT in all blood group samples. Significant differences in the interpretability of anti-A/-B titers were observed among different methods. A uniform approach for selecting the method for ABO antibody titration is highly recommended, and DTT pretreatment of plasma to neutralize IgM activity should be considered to obtain precise values of IgG anti-A/-B titers. Immunohematology 2021;37:25-32 . Determination of accurate anti-A/-B titers is important for treatment selection in ABO-incompatible stem cell and solid-organ transplants. The standard method for ABO antibody titration is the conventional tube test (CTT). Dithiothreitol (DTT) is commonly used to inactivate the IgM antibody component. The aim of this study was to compare six different methods for ABO antibody titration and to observe the effectiveness of DTT on antibody estimation. A total of 90 healthy voluntary blood donors were enrolled in this study, including 30 each for blood groups A, B, and O. Antibody titrations were performed and tested using the CTT-immediate spin (IS), CTT-antihuman globulin (AHG) with and without DTT, column agglutination technology (CAT)-IS, and CAT-AHG with and without DTT methods. Bead-CAT was used, and the positive cutoff value was set to 1+ for each method to determine the endpoint of the titer. The median values of anti-A/-B titers by IS were found to be higher than those values by AHG in CTT and CAT among group B and A individuals, whereas no statistically significant differences were observed in values from group O individuals for IS and AHG anti-A/-B titers, estimated by each method. Although there was positive correlation between the anti-A/-B titer results obtained using the CTT and CAT in all blood groups, testing using AHG showed poor agreement with and without DTT pretreatment (kappa value of 0.11 and 0.20, respectively). Moderate agreement was observed between CTT-IS and CAT-IS (kappa value of 0.46). Median anti-A/-B AHG titers were reduced by the use of DTT in all blood group samples. Significant differences in the interpretability of anti-A/-B titers were observed among different methods. A uniform approach for selecting the method for ABO antibody titration is highly recommended, and DTT pretreatment of plasma to neutralize IgM activity should be considered to obtain precise values of IgG anti-A/-B titers. Immunohematology 2021;37:25–32 .
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Affiliation(s)
- S S Datta
- Transfusion Medicine, Tata Medical Center , 14 Middle Arterial Road (EW), Rajarhat, New Town, Kolkata 700160 , India
| | - S Basu
- Transfusion Medicine, Tata Medical Center , Kolkata , India
| | - M Reddy
- Transfusion Medicine, Tata Medical Center , Kolkata , India
| | - K Gupta
- Transfusion Medicine, Tata Medical Center , Kolkata , India
| | - S Sinha
- Tata Medical Center , Kolkata , India
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Al-Hity S, Bhamra N, Kumar R, Gupta K, Howard J, Jolly K, Darr A. 908 Personal Protective Equipment (PPE) Guidance During A Global Pandemic: A Statistical Analysis of National Perceived Confidence, Knowledge, And Educational Deficits Amongst U.K. Based Doctors. Br J Surg 2021. [PMCID: PMC8135915 DOI: 10.1093/bjs/znab134.174] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Introduction March 11th, 2020 saw the World Health Organisation declare a global pandemic following the eruption of the novel coronavirus disease 2019. Unprecedented global demand for personal protective equipment (PPE) was complicated by limited availability and conflicting guidance from healthcare bodies. This study aimed to assess perceived confidence and knowledge of Public Health England’s PPE guidance amongst doctors of varying specialties and grades. Method A nationwide 11-point survey comprising of multiple-choice questions (MCQs) and a Likert scale assessing perceived confidence (1=not confident, 5=very confident) was disseminated to U.K. based doctors using multiple platforms. Results Data collated from 697 respondents revealed average perceived confidence was low. Notably, 59% felt they had received insufficient education regarding up-to-date guidance, with 81% advocating further training. Anaesthetics and ophthalmology were the highest and lowest scoring specialties in knowledge based MCQs, achieving 59% and 31% respectively. Subsequent statistical analysis revealed significant differences between specialties." Conclusions Ensuring consistency in published PPE guidance and education can develop doctor’s confidence and knowledge of appropriate PPE use. The absence of a unified consensus and global education regarding the use of PPE poses significant ramifications for patient and healthcare professional (HCP) safety whilst risking further depletion of already sparse resources.
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Affiliation(s)
- S Al-Hity
- The Royal Wolverhampton NHS Trust, Wolverhampton, United Kingdom
| | - N Bhamra
- The Royal Wolverhampton NHS Trust, Wolverhampton, United Kingdom
| | - R Kumar
- The Royal Wolverhampton NHS Trust, Wolverhampton, United Kingdom
| | - K Gupta
- The Royal Wolverhampton NHS Trust, Wolverhampton, United Kingdom
| | - J Howard
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - K Jolly
- The Royal Wolverhampton NHS Trust, Wolverhampton, United Kingdom
| | - A Darr
- The Royal Wolverhampton NHS Trust, Wolverhampton, United Kingdom
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Mahajan R, Gulati S, Gupta K, Jain K, Bloria S, JItendra M. Ultrasound-guided sacral multifidus plane block for analgesia following excision of sacrococcygeal teratoma in two neonates. Anaesth Rep 2021; 9:81-84. [PMID: 33937779 DOI: 10.1002/anr3.12116] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/29/2021] [Indexed: 11/07/2022] Open
Abstract
Peri-operative pain management in the neonate with a sacrococcygeal teratoma poses significant challenges to the anaesthetist. Involvement of the sacrococcygeal area by the tumour often prevents the use of conventional regional anaesthetic techniques such as caudal or epidural analgesia, with a subsequent reliance on intravenous opioids and paracetamol. Since opioids are associated with respiratory depression, constipation and urinary retention, there is high incidence of opiophobia with consequent inappropriate dosage prescription, particularly in the paediatric population. We describe the use of an ultrasound-guided sacral multifidus plane block in two neonates undergoing surgical excision of sacrococcygeal teratoma. The block is technically easy to perform and also avoids traversing critical structures. Hence, it may be regarded as a promising analgesic technique for painful interventions in the sacrococcygeal area.
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Affiliation(s)
- R Mahajan
- Department of Anesthesia, ICU and Pain Medicine Government Medical College Jammu India
| | - S Gulati
- Department of Anesthesia, ICU and Pain Medicine Government Medical College Jammu India
| | - K Gupta
- Department of Radiodiagnosis and Imaging Government Medical College Jammu India
| | - K Jain
- Department of Anesthesia and ICU Postgraduate Institution of Medical Education and Research Chandigarh India
| | - S Bloria
- Department of Anesthesia, ICU and Pain Medicine Government Medical College Jammu India
| | - M JItendra
- Department of Anesthesia, ICU and Pain Medicine Government Medical College Jammu India
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Maheshwari A, Varshney M, Gupta K, Bajpai M. Psychological assessment and lived experiences of recovered COVID-19 patients who presented for convalescent plasma donation. Transfus Clin Biol 2021; 28:254-257. [PMID: 33895379 PMCID: PMC8061783 DOI: 10.1016/j.tracli.2021.04.008] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 04/07/2021] [Accepted: 04/16/2021] [Indexed: 12/28/2022]
Abstract
Background Increasingly, it has been seen that patients recovering from COVID-19 may face a second battle of coping with its mental health ramifications. These psychological issues can even be experienced by patients who were asymptomatic or had mild to moderate symptoms, potentially impacting their quality of life. Methodology This was a prospective observational study to analyse the psychological impact of COVID-19 in recovered patients who presented as prospective convalescent plasma (CP) donors. An interview for the psychological assessment of the prospective donors was carried out. Depression and anxiety in the participants were assessed by HAM-A, and HAM-D scores and Quality of Life were assessed using the WHOQOL-BREF scale. Results A total of 51 prospective donors were assessed, with a mean age of 34.37 (±9.08) years, with the majority being males (46). No clinically significant depression and anxiety were found on the basis of HAM-D and HAM-A scores. The worst affected quality of life parameter, based on the WHOQOL-BREF scale, was physical quality of life followed by environmental, psychological, and social relationships. Moreover, due to infection, social stigma was experienced by 49.02% of the donors, while 21.97% had anxiety related to convalescent plasma donation as a common livid experience. Conclusion Poor quality of life and social stigma during the recovery phase is prevalent in COVID-19 recovered patients, for which formulation of holistic support strategies are the need of the hour.
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Affiliation(s)
- A Maheshwari
- Department of Transfusion Medicine, Institute of Liver and Biliary Sciences, New Delhi, India
| | - M Varshney
- Department of Psychiatry, Institute of Liver and Biliary Sciences, New Delhi, India
| | - K Gupta
- Department of Transfusion Medicine, Institute of Liver and Biliary Sciences, New Delhi, India
| | - M Bajpai
- Department of Transfusion Medicine, Institute of Liver and Biliary Sciences, New Delhi, India.
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Gupta K, Omil-Lima D, Mahran A, Callegari M, Muncey W, Thirumavalavan N. 062 Comparison of Patient Demographics and Surgical Trends in Peyronie's Disease: A NSQIP Study. J Sex Med 2021. [DOI: 10.1016/j.jsxm.2021.01.032] [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: 10/21/2022]
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Callegari M, Jella T, Mahran A, Muncey W, Gupta K, Omil-Lima D, Loeb A, Thirumavalavan N. 033 Trends in Testosterone Prescription Modalities Amongst Medical Specialties: A 5-year CMS Data Analysis (2013-2017). J Sex Med 2021. [DOI: 10.1016/j.jsxm.2021.01.102] [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: 10/21/2022]
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Gupta K, Shivabalan, Kumar V, Vyas S, Pandey RM, Jagannathan NR, Sinha S. Cognitive Performance and Neuro-Metabolites in HIV Using 3T Magnetic Resonance Spectroscopy: A Cross-Sectional Study from India. Curr HIV Res 2021; 19:147-153. [PMID: 33106144 DOI: 10.2174/1570162x18666201026141729] [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: 06/19/2020] [Revised: 09/08/2020] [Accepted: 09/22/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Cognitive impairment in patients with human immunodeficiency virus (HIV) is associated with higher morbidity. The prevalence of the metabolite changes in the brain associated with cognitive impairment in anti-retroviral therapy naïve patients with HIV is unknown. OBJECTIVE To estimate the prevalence of the neurometabolites associated with cognitive impairment in antiretroviral therapy (ART) naïve patients with HIV. METHODS We conducted a cross-sectional study among ART naïve patients with HIV aged 18-50 years in a tertiary care center in India. Cognition was tested using the Post Graduate Institute battery of brain dysfunction across five domains; memory, attention-information processing, abstraction executive, complex perceptual, and simple motor skills. We assessed the total N-acetyl aspartyl (tNAA), creatine (tCr) and glutamate + glutamine (Glx) using 3T magnetic resonance spectroscopy. Cognitive impairment was defined as an impairment in ≥2 domains. RESULTS Among 43 patients eligible for this study, the median age was 32 years (IQR 29, 40) and 30% were women. Median CD4 count and viral load were 317 cells/μL (IQR 157, 456) and 9.3 copies/ μL (IQR 1.4, 38), respectively. Impairment in at least one cognitive domain was present in 32 patients (74.4%). Impairment in simple motor skills and memory was present in 46.5% and 44% of patients, respectively. Cognitive impairment, defined by impairment in ≥2 domains, was found in 22 (51.2%) patients. There was a trend towards higher concentration of tNAA (7.3 vs. 7.0 mmol/kg), tGlx (9.1 vs. 8.2 mmol/kg), and tCr (5.5 vs. 5.2 mmol/kg) in the frontal lobe of patients with cognitive impairment vs. without cognitive impairment but it did not reach statistical significance (p>0.05 for all). There was no difference in the concentration of these metabolites in the two groups in the basal ganglia. CONCLUSION There is a high prevalence of cognitive impairment in ART naïve patients with HIV. There is no difference in metabolites in patients with or without cognitive impairment. Further studies, with longitudinal follow-up are required to understand the underlying pathophysiological mechanisms.
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Affiliation(s)
- K Gupta
- Department of Internal Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Shivabalan
- Department of Nuclear Magnetic Resonance and Magnetic Resonance Imaging Facility, All India Institute of Medical Sciences, New Delhi, India
| | - V Kumar
- Department of Nuclear Magnetic Resonance and Magnetic Resonance Imaging Facility, All India Institute of Medical Sciences, New Delhi, India
| | - S Vyas
- Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India
| | - R M Pandey
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - N R Jagannathan
- Department of Nuclear Magnetic Resonance and Magnetic Resonance Imaging Facility, All India Institute of Medical Sciences, New Delhi, India
| | - S Sinha
- Department of Internal Medicine, All India Institute of Medical Sciences, New Delhi, India
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Kumar N, Madan R, Gupta K, Chatterjee D, Uppal DK, Goyal S, Ballari N, Khosla D, Sahoo SK, Ahuja CK. Embryonal tumors with multilayered rosettes: A tertiary care centre experience. Clin Neurol Neurosurg 2021; 202:106508. [PMID: 33556852 DOI: 10.1016/j.clineuro.2021.106508] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 01/15/2021] [Accepted: 01/16/2021] [Indexed: 11/15/2022]
Abstract
BACKGROUND Embryonal tumors with multilayered rosettes (ETMR) is an extremely rare and highly aggressive tumor. It includes three distinct entities i.e, embryonal tumor with abundant neuropil and true rosettes (ETANTR), ependymoblastoma (EBL) and medulloepithelioma (MEPL). Here, we present our institutional experience of seven ETMR cases treated over a period of five years. MATERIALS AND METHODS Patients' records from 2015 to 2019 were reviewed manually and electronically to retrieve the data. Clinicopathological and outcome details of ETMR cases were entered in a predesigned proforma. RESULTS A total of seven cases of ETMR were registered from 2015 to 2019 with a median age at presentation of four years (range 3-7 years). All patients underwent surgery. However, only three patients completed the planned adjuvant treatment, comprising of focal radiotherapy (RT) alone, craniospinal irradiation (CSI) alone and CSI followed by six cycles of chemotherapy in one patient each respectively. Two patients commenced CSI but deteriorated during RT and thereafter needed best supportive care. Two patients could not be started on any adjuvant treatment. Unfortunately, six patients succumbed to their disease within one year of their diagnosis. Only one patient who received both CSI and adjuvant chemotherapy is alive at 15 months of diagnosis. CONCLUSION ETMR is a rare and aggressive entity. Majority of the patients die within one year of the diagnosis despite multimodality treatment.
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MESH Headings
- Brain Neoplasms/diagnostic imaging
- Brain Neoplasms/mortality
- Brain Neoplasms/pathology
- Brain Neoplasms/therapy
- Chemoradiotherapy, Adjuvant
- Child
- Child, Preschool
- Female
- Humans
- Male
- Neoplasms, Germ Cell and Embryonal/diagnostic imaging
- Neoplasms, Germ Cell and Embryonal/mortality
- Neoplasms, Germ Cell and Embryonal/pathology
- Neoplasms, Germ Cell and Embryonal/therapy
- Neuroectodermal Tumors, Primitive/diagnostic imaging
- Neuroectodermal Tumors, Primitive/mortality
- Neuroectodermal Tumors, Primitive/pathology
- Neuroectodermal Tumors, Primitive/therapy
- Neurosurgical Procedures
- Radiotherapy, Adjuvant
- Tertiary Care Centers
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Affiliation(s)
- N Kumar
- Department of Radiotherapy and Oncology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - R Madan
- Department of Radiotherapy and Oncology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
| | - K Gupta
- Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - D Chatterjee
- Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - D K Uppal
- Department of Radiotherapy and Oncology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - S Goyal
- Department of Radiotherapy and Oncology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - N Ballari
- Department of Radiotherapy and Oncology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - D Khosla
- Department of Radiotherapy and Oncology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - S K Sahoo
- Department of Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - C K Ahuja
- Department of Radiodiagnosis, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Thakare M, Sarma H, Datar S, Roy A, Pawar P, Gupta K, Pandit S, Prasad R. Understanding the holistic approach to plant-microbe remediation technologies for removing heavy metals and radionuclides from soil. Current Research in Biotechnology 2021. [DOI: 10.1016/j.crbiot.2021.02.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
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43
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Gupta K, Grover P, Abel TJ. Current Conceptual Understanding of the Epileptogenic Network From Stereoelectroencephalography-Based Connectivity Inferences. Front Neurol 2020; 11:569699. [PMID: 33324320 PMCID: PMC7724044 DOI: 10.3389/fneur.2020.569699] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 10/13/2020] [Indexed: 11/13/2022] Open
Abstract
Localization of the epileptogenic zone (EZ) is crucial in the surgical treatment of focal epilepsy. Recently, EEG studies have revealed that the EZ exhibits abnormal connectivity, which has led investigators to now consider connectivity as a biomarker to localize the EZ. Further, abnormal connectivity of the EZ may provide an explanation for the impact of focal epilepsy on more widespread brain networks involved in typical cognition and development. Stereo-electroencephalography (sEEG) is a well-established method for localizing the EZ that has recently been applied to examine altered brain connectivity in epilepsy. In this manuscript, we review recent computational methods for identifying the EZ using sEEG connectivity. Findings from previous sEEG studies indicate that during interictal periods, the EZ is prone to seizure generation but concurrently receives inward connectivity preventing seizures. At seizure onset, this control is lost, allowing seizure activity to spread from the EZ. Regulatory areas within the EZ may be important for subsequently ending the seizure. After the seizure, the EZ appears to regain its influence on the network, which may be how it is able to regenerate epileptiform activity. However, more research is needed on the dynamic connectivity of the EZ in order to build a biomarker for EZ localization. Such a biomarker would allow for patients undergoing sEEG to have electrode implantation, localization of the EZ, and resection in a fraction of the time currently needed, preventing patients from having to endure long hospital stays and induced seizures.
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Affiliation(s)
- Kanupriya Gupta
- University of Pittsburgh School of Medicine, Pittsburgh, PA, United States.,Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA, United States
| | - Pulkit Grover
- Center for the Neural Basis of Cognition, Carnegie Mellon University/University of Pittsburgh, Pittsburgh, PA, United States.,Department of Electrical and Computer Engineering, Carnegie Mellon University, Pittsburgh, PA, United States
| | - Taylor J Abel
- University of Pittsburgh School of Medicine, Pittsburgh, PA, United States.,Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA, United States.,Center for the Neural Basis of Cognition, Carnegie Mellon University/University of Pittsburgh, Pittsburgh, PA, United States.,Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, United States
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44
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Goodale SE, González HFJ, Johnson GW, Gupta K, Rodriguez WJ, Shults R, Rogers BP, Rolston JD, Dawant BM, Morgan VL, Englot DJ. Resting-State SEEG May Help Localize Epileptogenic Brain Regions. Neurosurgery 2020; 86:792-801. [PMID: 31814011 DOI: 10.1093/neuros/nyz351] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 06/18/2019] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Stereotactic electroencephalography (SEEG) is a minimally invasive neurosurgical method to localize epileptogenic brain regions in epilepsy but requires days in the hospital with interventions to trigger several seizures. OBJECTIVE To make initial progress in the development of network analysis methods to identify epileptogenic brain regions using brief, resting-state SEEG data segments, without requiring seizure recordings. METHODS In a cohort of 15 adult focal epilepsy patients undergoing SEEG, we evaluated functional connectivity (alpha-band imaginary coherence) across sampled regions using brief (2 min) resting-state data segments. Bootstrapped logistic regression was used to generate a model to predict epileptogenicity of individual regions. RESULTS Compared to nonepileptogenic structures, we found increased functional connectivity within epileptogenic regions (P < .05) and between epileptogenic areas and other structures (P < .01, paired t-tests, corrected). Epileptogenic areas also demonstrated higher clustering coefficient (P < .01) and betweenness centrality (P < .01), and greater decay of functional connectivity with distance (P < .05, paired t-tests, corrected). Our functional connectivity model to predict epileptogenicity of individual regions demonstrated an area under the curve of 0.78 and accuracy of 80.4%. CONCLUSION Our study represents a preliminary step towards defining resting-state SEEG functional connectivity patterns to help localize epileptogenic brain regions ahead of neurosurgical treatment without requiring seizure recordings.
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Affiliation(s)
- Sarah E Goodale
- Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee
| | - Hernán F J González
- Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee
| | - Graham W Johnson
- Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee
| | - Kanupriya Gupta
- Department of Electrical Engineering and Computer Science, Vanderbilt University, Nashville, Tennessee
| | - William J Rodriguez
- Department of Electrical Engineering and Computer Science, Vanderbilt University, Nashville, Tennessee
| | - Robert Shults
- Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Baxter P Rogers
- Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee.,Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tennessee
| | - John D Rolston
- Department of Neurosurgery, University of Utah, Salt Lake City, Utah
| | - Benoit M Dawant
- Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee.,Department of Electrical Engineering and Computer Science, Vanderbilt University, Nashville, Tennessee
| | - Victoria L Morgan
- Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee.,Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee.,Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Dario J Englot
- Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee.,Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tennessee
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45
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Ashwath R, Rauthan A, Patil P, Gupta K. 416P A single institute study evaluating the additional benefit of blood NGS testing over conventional molecular testing in metastatic adenocarcinoma lung. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.10.410] [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: 11/26/2022] Open
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46
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Nahid R, Bansal M, Gupta K, Pandey S, Tiwari P, Agarwal R. Exophytic gingival growth of the maxillary canine region in a young individual: Extremely rare case report of peripheral dentinogenic ghost cell tumor. J Cancer Res Ther 2020; 16:661-664. [PMID: 32719286 DOI: 10.4103/jcrt.jcrt_180_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
The present case report is a case of peripheral dentinogenic ghost cell tumor (PDGCT), an extremely rare solid benign neoplastic variant of calcifying cystic odontogenic tumor of the gingiva mimicking clinically as pyogenic granuloma, fibroma, peripheral ossifying fibroma, and peripheral giant-cell granuloma. A 24-year-old male reported with painless, firm, solitary, sessile, smooth-surfaced, nonulcerative, nonpulsatile, well-defined swelling measuring ≈12 mm × 9 mm in the interdental gingiva of the teeth #13 and #14 extending to the mucogingival junction. Intraoral periapical radiographic showed a normal trabecular pattern with mild radiolucency without bony expansion, periapical lesion, and resorption of the adjacent teeth. The diagnosis was established by histopathologic examination. Very few cases of this entity have been documented in the literature. The present case report aims to document this rare entity and emphasizes on the fact that histopathological examination of every localized gingival growth should be included in the treatment planning to differentiate with other commonly found lesions.
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Affiliation(s)
- Rakhshinda Nahid
- Department of Periodontics, Faculty of Dental Sciences, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Monika Bansal
- Department of Periodontics, Faculty of Dental Sciences, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Kanupriya Gupta
- Department of Oral Pathology, Faculty of Dental Sciences, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Samidha Pandey
- Department of Periodontics, Faculty of Dental Sciences, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Preeti Tiwari
- Department of Oral Surgery, Faculty of Dental Sciences, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Rahul Agarwal
- Department of Oral Pathology, Faculty of Dental Sciences, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
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47
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Narasimhan S, Kundassery KB, Gupta K, Johnson GW, Wills KE, Goodale SE, Haas K, Rolston JD, Naftel RP, Morgan VL, Dawant BM, González HFJ, Englot DJ. Seizure-onset regions demonstrate high inward directed connectivity during resting-state: An SEEG study in focal epilepsy. Epilepsia 2020; 61:2534-2544. [PMID: 32944945 DOI: 10.1111/epi.16686] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 08/15/2020] [Accepted: 08/17/2020] [Indexed: 01/06/2023]
Abstract
OBJECTIVE In patients with medically refractory focal epilepsy, stereotactic-electroencephalography (SEEG) can aid in localizing epileptogenic regions for surgical treatment. SEEG, however, requires long hospitalizations to record seizures, and ictal interpretation can be incomplete or inaccurate. Our recent work showed that non-directed resting-state analyses may identify brain regions as epileptogenic or uninvolved. Our present objective is to map epileptogenic networks in greater detail and more accurately identify seizure-onset regions using directed resting-state SEEG connectivity. METHODS In 25 patients with focal epilepsy who underwent SEEG, 2 minutes of resting-state, artifact-free, SEEG data were selected and functional connectivity was estimated. Using standard clinical interpretation, brain regions were classified into four categories: ictogenic, early propagation, irritative, or uninvolved. Three non-directed connectivity measures (mutual information [MI] strength, and imaginary coherence between and within regions) and four directed measures (partial directed coherence [PDC] and directed transfer function [DTF], inward and outward strength) were calculated. Logistic regression was used to generate a predictive model of ictogenicity. RESULTS Ictogenic regions had the highest and uninvolved regions had the lowest MI strength. Although both PDC and DTF inward strengths were highest in ictogenic regions, outward strengths did not differ among categories. A model incorporating directed and nondirected connectivity measures demonstrated an area under the receiver-operating characteristic (ROC) curve (AUC) of 0.88 in predicting ictogenicity of individual regions. The AUC of this model was 0.93 when restricted to patients with favorable postsurgical seizure outcomes. SIGNIFICANCE Directed connectivity measures may help identify epileptogenic networks without requiring ictal recordings. Greater inward but not outward connectivity in ictogenic regions at rest may represent broad inhibitory input to prevent seizure generation.
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Affiliation(s)
- Saramati Narasimhan
- Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.,Department of Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, Tennessee, USA.,Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee, USA
| | - Keshav B Kundassery
- Department of Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Kanupriya Gupta
- Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.,Department of Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Graham W Johnson
- Department of Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, Tennessee, USA.,Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee, USA
| | - Kristin E Wills
- Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.,Department of Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Sarah E Goodale
- Department of Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, Tennessee, USA.,Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee, USA
| | - Kevin Haas
- Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - John D Rolston
- Department of Neurosurgery, University of Utah, Salt Lake City, Utah, USA
| | - Robert P Naftel
- Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Victoria L Morgan
- Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.,Department of Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, Tennessee, USA.,Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee, USA.,Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Benoit M Dawant
- Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee, USA.,Department of Electrical Engineering and Computer Science, Vanderbilt University, Nashville, Tennessee, USA
| | - Hernán F J González
- Department of Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, Tennessee, USA.,Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee, USA
| | - Dario J Englot
- Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.,Department of Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, Tennessee, USA.,Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee, USA.,Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA.,Department of Electrical Engineering and Computer Science, Vanderbilt University, Nashville, Tennessee, USA
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48
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Abstract
Plant genetic resources (PGR) are the foundation of agriculture as well as food and nutritional security.
The ICAR-NBPGR is the nodal institution at national level for management of PGR in India under the umbrella
of Indian Council of Agricultural Research (ICAR), New Delhi. India being one of the gene-rich countries faces a
unique challenge of protecting its natural heritage while evolving mutually beneficial strategies for germplasm
exchange with other countries. The Bureaus activities include PGR exploration, collection, exchange, characterization,
evaluation, conservation and documentation. It also has the responsibility to carry out quarantine of
all imported PGR including transgenics meant for research purposes. The multifarious activities are carried out
from ICAR-NBPGR headquarters and its 10 regional stations located in different agro-climatic zones of India. It
has linkages with international organizations of the Consultative Group on International Agricultural Research
(CGIAR) and national crop-based institutes to accomplish its mandated activities. NBPGR collects and acquires
germplasm from various sources, conserves it in the Genebank, characterizes and evaluates it for different traits
and provides ready material for breeders to develop varieties for farmers. ICAR-NBPGR encompasses the National
Genebank Network and at present, the National Genebank conserves more than 0.40 million accessions. NBPGR
works in service-mode for effective utilization of PGR in crop improvement programmes which depends mainly
on its systematic characterization and evaluation, and identification of potentially useful germplasm. NBPGR is
responsible for identifying trait-specific pre-adapted climate resilient genotypes, promising material with disease
resistance and quality traits which the breeders use for various crop improvement programmes. The system has
contributed immensely towards safeguarding the indigenous and introducing useful exotic PGR for enhancing
the agricultural production. Presently, our focus is on characterization of ex situ conserved germplasm and
detailed evaluation of prioritized crops for enhanced utilization; assessment of impact of on-farm conservation
practices on genetic diversity; genome-wide association mapping for identification of novel genes and alleles for
enhanced utilization of PGR; identification and deployment of germplasm/landraces using climate analog data;
validation of trait-specific introduced germplasm for enhanced utilization.
Key words: plant genetic resources; gene banks; wild relatives; biotic and abiotic stresses; marker-assisted
selection.
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Affiliation(s)
- K Singh
- ICAR-National Bureau of Plant Genetic Resources, Pusa Campus, New Delhi, India
| | - K Gupta
- ICAR-National Bureau of Plant Genetic Resources, Pusa Campus, New Delhi, India
| | - V Tyagi
- ICAR-National Bureau of Plant Genetic Resources, Pusa Campus, New Delhi, India
| | - S Rajkumar
- ICAR-National Bureau of Plant Genetic Resources, Pusa Campus, New Delhi, India
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49
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Madan R, Kumar N, Gupta A, Gupta K, Salunke P, Khosla D, Yadav BS, Kapoor R. Effect of prophylactic granulocyte-colony stimulating factor (G-CSF) on acute hematological toxicity in medulloblastoma patients during craniospinal irradiation (CSI). Clin Neurol Neurosurg 2020; 196:105975. [PMID: 32505868 DOI: 10.1016/j.clineuro.2020.105975] [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: 01/29/2020] [Revised: 02/24/2020] [Accepted: 05/26/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Haematological toxicity and treatment breaks are common during cranio-spinal irradiation (CSI) due to irradiation of large volume of bone marrow. We conducted this study to see the effect of prophylactic granulocyte colony stimulating factor (GCSF) in reducing treatment breaks. PATIENTS AND METHODS The study was conducted over a period of 15 months from August 2017 to November 2018. Histopathologically proven Medulloblastoma patients received prophylactic GCSF during CSI. Acute hematological toxicities and treatment breaks were noted and effect of age and pretreatment blood counts were analyzed by SPSS (Statistical Package for Social Sciences) version 23. RESULTS A total of 28 patients were included in the study. During CSI, hematological toxicity leading to treatment breaks was observed in 11 (39.3 %) patients, of which grade 3 and 2 toxicities were seen in ten and one patients respectively. Younger age (<10 years) at diagnosis was significantly associated with the development of hematological toxicity (p = 0.028, Chi-Square). No correlation was found with pre-treatment blood counts. CONCLUSION Prophylactic use of GCSF may be effective in preventing radiation induced hematological toxicity and treatment breaks.
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Affiliation(s)
- R Madan
- Department of Radiotherapy and Oncology, PGIMER, Chandigarh, India
| | - N Kumar
- Department of Radiotherapy and Oncology, PGIMER, Chandigarh, India.
| | - A Gupta
- Department of Radiotherapy and Oncology, PGIMER, Chandigarh, India
| | - K Gupta
- Department of Pathology, PGIMER, Chandigarh, India
| | - P Salunke
- Department of Neurosurgery, PGIMER, Chandigarh, India
| | - D Khosla
- Department of Radiotherapy and Oncology, PGIMER, Chandigarh, India
| | - B S Yadav
- Department of Radiotherapy and Oncology, PGIMER, Chandigarh, India
| | - R Kapoor
- Department of Radiotherapy and Oncology, PGIMER, Chandigarh, India
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50
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Chattopadhyay A, Mittal S, Gupta K, Dhir V, Jain S. Intestinal leishmaniasis. Clin Microbiol Infect 2020; 26:1345-1346. [PMID: 32439594 DOI: 10.1016/j.cmi.2020.05.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 04/27/2020] [Accepted: 05/03/2020] [Indexed: 10/24/2022]
Affiliation(s)
- A Chattopadhyay
- Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - S Mittal
- Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - K Gupta
- Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - V Dhir
- Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - S Jain
- Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
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