1
|
Bansal N, Khajuria K, Kaur Cheema R, Sharma A, Singh Bajwa B. Implementation of Indian National plasma policy at blood bank of a tertiary care hospital: A step towards strengthening of blood transfusion services. Transfus Clin Biol 2024; 31:3-6. [PMID: 37865157 DOI: 10.1016/j.tracli.2023.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 10/10/2023] [Accepted: 10/16/2023] [Indexed: 10/23/2023]
Abstract
INTRODUCTION The World Health Organization has advocated that every country should make its own policy for ensuring safe and adequate supply of plasma derived medicinal products through mobilization and usage of locally collected plasma. The National Plasma Policy (NPP) of India was published in 2014 with a dual objective to achieve self sufficiency in the production of plasma derived medicinal products and at the same time to augment the component preparation facilities in India and overall upliftment of blood transfusion services in the country. Thus the present study was done to access the impact of implementation of NPP in our blood bank on the blood transfusion services in our hospital. MATERIALS AND METHODS The present study was a retrospective observational study conducted in the department of transfusion medicine of a tertiary care hospital in India involving analysis of data from 1st January 2019 till 31st December 2022. For the purpose of data analysis the time period was divided into 2 periods: (i) Pre-NPP implementation period from 1st January 2019 till 31st December 2020; (ii) Post-NPP period from 1st January 2021 till 31st December 2022. The following parameters were compared for the two periods: (i) component preparation rate; (ii) percentage of component therapy; (iii) total number of FFP transferred to plasma fractionation centers; (iv) total amount of exchange amount generated in lieu of transferred FFP to plasma fractionation centers. RESULTS The component preparation rate after NPP implementation was significantly higher as compared to the pre NPP implementation period (93.81% vs 56.70%; p = 0.007). The percentage of component therapy in the patients was also significantly higher as compared to the pre-NPP implementation period (97.9% vs 73.6%; p = 0.005). The total amount of exchange amount generation in Indian rupee (INR) after NPP implementation was INR 1419462 (15835€) while it was INR 636898 (7105€) in the pre NPP implementation period. This amount was utilized for procurement of various blood bank equipment, in addition 2 lab technicians were also hired for the blood bank. CONCLUSIONS The implementation of NPP resulted in upliftment of blood transfusion services in our hospital. Other low and middle income countries can benefit from implementation of similar plasma policy in their countries.
Collapse
Affiliation(s)
- Naveen Bansal
- Department of Transfusion Medicine, MM Institute of Medical Sciences and Research, Mullana, Ambala, Haryana, India.
| | - Kajal Khajuria
- Department of Transfusion Medicine, MM Institute of Medical Sciences and Research, Mullana, Ambala, Haryana, India
| | - Rajbir Kaur Cheema
- Department of Transfusion Medicine, MM College of Medical Sciences and Research, Sadopur, Ambala, Haryana, India
| | - Ashish Sharma
- Department of Transfusion Medicine, MM Institute of Medical Sciences and Research, Mullana, Ambala, Haryana, India
| | - Baltaran Singh Bajwa
- MBBS Student, MM Institute of Medical Sciences and Research, Mullana, Ambala, Haryana, India
| |
Collapse
|
2
|
Bansal N, Paul Saluja G, Raturi M. Need for standardization of technical manpower norms for Indian blood centres. Transfus Clin Biol 2023; 30:456-457. [PMID: 37739335 DOI: 10.1016/j.tracli.2023.09.002] [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: 09/03/2023] [Revised: 09/06/2023] [Accepted: 09/15/2023] [Indexed: 09/24/2023]
Affiliation(s)
- Naveen Bansal
- Department of Transfusion Medicine, Homi Bhabha Cancer Hospital and Research Centre, Punjab, India.
| | - Gulshan Paul Saluja
- Department of Transfusion Medicine, Alchemist Hospital, Panchkula, Haryana, India
| | - Manish Raturi
- Department of Immunohematology and Blood Transfusion, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Jolly Grant, Dehradun, Uttarakhand, India
| |
Collapse
|
3
|
Bansal N, Bansal Y, Singh C, Gulia A. Blood inventory management strategies to ensure adequacy of packed red blood cell stock. Transfus Clin Biol 2023; 30:455-456. [PMID: 37567361 DOI: 10.1016/j.tracli.2023.08.002] [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: 07/16/2023] [Accepted: 08/03/2023] [Indexed: 08/13/2023]
Affiliation(s)
- Naveen Bansal
- Department of Transfusion Medicine, Homi Bhabha Cancer Hospital and Research Centre, Punjab, India.
| | - Yashik Bansal
- Department of Microbiology, ESIC Medical College and Hospital, Alwar, Rajasthan, India
| | - Charu Singh
- Department of Microbiology, Homi Bhabha Cancer Hospital and Research Centre, Punjab, India
| | - Ashish Gulia
- Department of Orthopedic Oncology, Homi Bhabha Cancer Hospital and Research Centre, Punjab, India
| |
Collapse
|
4
|
Bansal N, Tiwari P, Dev P. Wide-awake local anesthesia and no tourniquet (WALANT) in upper limb fractures. Acta Orthop Belg 2023; 89:547-550. [PMID: 37935241 DOI: 10.52628/89.3.11357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2023]
Abstract
Wide-awake local anesthesia and no tourniquet (WALANT), first used for hand surgery, has been sparingly described for use in fracture fixation of the upper limb. We present our experience using this technique. 26 patients with upper limb fractures (3 distal radius, 6 radial shaft, 11 ulnar shaft, and 6 olecranon fractures) were operated on using WALANT by three orthopedic surgeons. We used 35-40ml of 2% Lignocaine with 1:80000 Adrenaline(7mg/kg) diluted with normal saline. Numeric Pain Rating (NPR) scoring was done during injection and per-operatively, and the Likert scale was used for the surgeon's satisfaction. The average NPR score was reported as 0.65 (1-3) during injection and 0.15 (0-2) preoperatively. All three surgeons reported excellent satisfaction in all the cases operated on. No complication occurred due to anesthesia. WALANT is a much simpler option and can be safely used in place of general anesthesia or regional blocks for fixation of fractures of the upper limb, with added advantages of no need for a tourniquet and better intraoperative assessment of fracture fixation.
Collapse
|
5
|
Spinner J, D'Souza N, Duganiero T, Stark S, Lorts A, Almond C, Simpson K, Wright L, Nandi D, Wilkens S, Bansal N, Conway J, Broda K, Lal A, Lytrivi I, Hunter T, Gralia N, Parent J, Butts R. A Pediatric Heart Failure Registry is Needed: A Time for ACTION. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1626] [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: 04/05/2023] Open
|
6
|
Nandi D, Wright L, Sublett-Smith J, Brax A, Almond C, Bansal N, Azeka E, Butts R, Conway J, Chen C, Cunningham C, Fisher L, Hall E, Hunter T, Kobayashi R, Patterson D, Peng D, Simpson K, Ryan T, Spinner J, Wisotzkey B, Zangwill S, Gajarski R, O'Connor M. Suboptimal Titration of Heart Failure Medications in Pediatric Patients: Baseline Data from the ACTION Network. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1627] [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: 04/05/2023] Open
|
7
|
Varma M, Zuckerman W, Sutcliffe D, Mokshagundam D, Magnetta D, Laks J, Spinner J, Bansal N, Butto A, Rosenthal D, Singh R. Training and Early Career Experience in Pediatric Heart Failure and Transplantation. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1341] [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: 04/05/2023] Open
|
8
|
Sharma H, Khajuria K, Bansal N, Thakur K, Sharma A. Plateletpheresis donor deferral patterns at a tertiary care hospital in North India: A need for rethink of haemoglobin cutoff. Transfus Clin Biol 2023; 30:268-271. [PMID: 36893913 DOI: 10.1016/j.tracli.2023.02.006] [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: 01/22/2023] [Revised: 02/26/2023] [Accepted: 02/28/2023] [Indexed: 03/09/2023]
Abstract
INTRODUCTION The donor deferral criteria for blood or apheresis donations are established for two main reasons: (i) to ensure the safety of the blood donor (non-maleficence); (ii) to obtain safe blood of standard quality that has therapeutic benefit for the patient (beneficence). This study was planned to assess the various causes and patterns of plateletpheresis donor deferral in our hospital and to subsequently assess whether any evidence based changes can be done in the current plateletpheresis donor deferral criteria in India to maximize the platelet donor pool without compromising donor safety. MATERIAL AND METHODS The present study was conducted from May 2021 till June 2022 in the department of transfusion medicine of a tertiary care hospital in North India. The first part of the study was conducted from May 2021 till March 2022 to assess the various causes of donor deferral by analysing the plateletpheresis donor deferral data during the corresponding period. The second part of the study was conducted from April 2022 till June 2022, to assess: (i) average decrease in haemoglobin after plateletpheresis procedure; (ii) red blood cell loss during plateletpheresis procedure; (iii) to determine whether any correlation exists between donor haemoglobin and platelet yield. RESULTS During the study period, a total of 260 donors were screened for plateletpheresis, out of which 221 (85%) donors were accepted and 39 (15%) donors were deferred for various reasons. Out of the 39 deferred donors, 33 (84.6%) were temporary deferrals, while 6 (15.4%) were permanent deferrals. Low haemoglobin (Hb < 12.5 g/dl) was a cause of deferral in 12.8% (n = 5) of the deferred donors. 192 (73.9%) out of the 260 donors were replacement donors. The calculated mean decrease in haemoglobin as a result of plateletpheresis procedure was 0.4 g/dl. No correlation was seen between donor pre-donation haemoglobin and platelet yield (p = 0.86, r = 0.06, R2 = 0.003). The calculated mean red cell loss as a result of plateletpheresis procedure was 28 ml. CONCLUSION Low haemoglobin (<12.5 g/dl) is a significant cause of temporary plateletpheresis donor deferral in India. In view of the advancement in plateletpheresis technology, which has resulted in minimal red cell loss with the current generation apheresis devices, haemoglobin cutoff of 12.5 g/dl needs to be reconsidered. Perhaps, after performing a multi-centric trial, a consenscus can be reached for revision of haemoglobin cutoff for plateletpheresis donations.
Collapse
Affiliation(s)
- Himani Sharma
- Department of Pathology, MM Institute of Medical Sciences and Research, Mullana, Ambala, Haryana, India
| | - Kajal Khajuria
- Department of Transfusion Medicine, MM Institute of Medical Sciences and Research, Mullana, Ambala, Haryana, India
| | - Naveen Bansal
- Department of Transfusion Medicine, MM Institute of Medical Sciences and Research, Mullana, Ambala, Haryana, India.
| | - Kusum Thakur
- Department of Transfusion Medicine, MM Institute of Medical Sciences and Research, Mullana, Ambala, Haryana, India
| | - Ashish Sharma
- Department of Transfusion Medicine, MM Institute of Medical Sciences and Research, Mullana, Ambala, Haryana, India
| |
Collapse
|
9
|
Bansal N, Bansal Y, Singh C, Gulia A, Thakur K. Red cell alloimmunization in thalassaemia patients in India: Causes and mitigation strategies. Transfus Clin Biol 2023; 30:187-188. [PMID: 36806792 DOI: 10.1016/j.tracli.2023.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Accepted: 02/13/2023] [Indexed: 02/19/2023]
Affiliation(s)
- Naveen Bansal
- Department of Transfusion Medicine, Homi Bhabha Cancer Hospital and Research Centre, Punjab, India.
| | - Yashik Bansal
- Department of Microbiology, ESIC Medical College and Hospital, Alwar, Rajasthan, India
| | - Charu Singh
- Department of Microbiology, Homi Bhabha Cancer Hospital and Research Centre, Punjab, India
| | - Ashish Gulia
- Homi Bhabha Cancer Hospital and Research Centre, Punjab, India
| | - Kusum Thakur
- Department of Transfusion Medicine, Shrimann Super Specialty Hospital, Jalandhar, Punjab, India
| |
Collapse
|
10
|
Bansal N, Bansal Y, Raturi M, Thakur K, Sood A, Kumar S. Blood Inventory Management During COVID-19 Pandemic Using a Simple Mathematical Tool: A Two-Year Study from a Tertiary Care Hospital in North India. Indian J Hematol Blood Transfus 2023; 39:1-7. [PMID: 36741877 PMCID: PMC9889947 DOI: 10.1007/s12288-023-01631-8] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Accepted: 01/20/2023] [Indexed: 02/04/2023] Open
Abstract
Multiple recurrent waves of the coronavirus disease 2019 (COVID-19) resulted in major fluctuations in blood supply and demand, which presented a major challenge for the blood centres to maintain adequate blood inventory. Hence, the primary aim of the present study was to determine whether safety stock as a simple mathematical tool can be used to maintain optimum blood inventory to meet all blood demands. The secondary aim of the study was to test whether daily blood stock index (DBSI), which was a novel index developed by the authors and derived from the calculated safety stock, can be used to minimize blood wastage due to the outdating of packed red blood cells (PRBC)/whole blood (WB) units. The present study was a descriptive, cross-sectional study conducted from 1st October 2019 to 31st December 2021 at a blood centre of a tertiary care hospital. For the purpose of data analysis, the time period of study was divided into 7 periods signifying different phases during the COVID-19 outbreak. Data of PRBC/WB (referred to as red cell) collection, red cell issue and the daily red cell stock were collected for these 7 time periods. Safety stock, percentage of out-dated whole blood/packed red blood cell units (OB) and DBSI were calculated based on the data extracted. Red cell collection as well as red cell utilization decreased during the 1st as well as the 2nd wave of the COVID-19 outbreak. The blood centre was able to meet the blood demand of the hospital at all times, as the daily average red cell stock remained above the calculated safety stock during all periods. OB (12.4%) and DBSI (2.3) were highest during the lockdown period of second wave of COVID-19 outbreak (period E). A strong direct relationship was seen between OB (dependent variable) and DBSI (predictor variable) [R = 0.79; p = 0.03]. Firstly, safety stock is a simple, user-friendly mathematic tool which can be used for efficient blood inventory management not only at times of a pandemic/disaster but also during routine times. Secondly, DBSI is a logical and empirical tool to reduce OB units and consequently reduce blood wastage.
Collapse
Affiliation(s)
- Naveen Bansal
- Department of Transfusion Medicine, VCSG Government Institute of Medical Science and Research, Srinagar, Uttarakhand India
| | - Yashik Bansal
- Department of Microbiology, VCSG Government Institute of Medical Science and Research, Srinagar, Uttarakhand India
| | - Manish Raturi
- Department of Immunohematology and Blood Transfusion, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Jolly Grant, Dehradun, Uttarakhand India
| | - Kusum Thakur
- Department of Transfusion Medicine, MM Institute of Medical Sciences and Research, Mullana, Ambala, Haryana India
| | - Ashwani Sood
- Department of Hospital Administration, MM Institute of Medical Sciences and Research, Mullana, Ambala, Haryana India
| | - Satish Kumar
- Department of Transfusion Medicine, VCSG Government Institute of Medical Science and Research, Srinagar, Uttarakhand India
| |
Collapse
|
11
|
Raturi M, Dhiman Y, Bansal N, Kala M, Tyagi S. Upholding routine hours blood collections against the night-shift timings. Transfus Clin Biol 2022; 30:185-187. [PMID: 36496164 DOI: 10.1016/j.tracli.2022.11.006] [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: 11/28/2022] [Accepted: 11/28/2022] [Indexed: 12/12/2022]
Affiliation(s)
- Manish Raturi
- Department of Immunohematology and Blood Transfusion, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Swami Ram Nagar, Jolly Grant Dehradun, 248016 Uttarakhand, India.
| | - Yashaswi Dhiman
- Department of Immunohematology and Blood Transfusion, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Swami Ram Nagar, Jolly Grant Dehradun, 248016 Uttarakhand, India
| | - Naveen Bansal
- Department of Transfusion Medicine, Homi Bhabha Cancer Hospital, Tata Memorial Centre, Sangrur, Punjab, India
| | - Mansi Kala
- Department of Pathology, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Swami Ram Nagar, Jolly Grant Dehradun, 248016 Uttarakhand, India
| | - Siddhartha Tyagi
- Department of Pathology, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Swami Ram Nagar, Jolly Grant Dehradun, 248016 Uttarakhand, India
| |
Collapse
|
12
|
Mitra S, Simson D, Khurana H, Tandon S, Ahlawat P, Bansal N, Barik S, Sethi J, Chufal K, Gairola M. Impact of Radiation Treatment Delay Due to COVID-19 Pandemic. Int J Radiat Oncol Biol Phys 2022. [PMCID: PMC9595463 DOI: 10.1016/j.ijrobp.2022.07.1410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Purpose/Objective(s) To study the effect of radiation treatment delay due to COVID-19 infection. Materials/Methods This study is a descriptive analysis. We studied all patients who were COVID-19 positive while undergoing radiation treatment. In addition, those COVID-19 positive patients before the start of radiation during their neoadjuvant treatment period or surgery were also analyzed. However, patients detected with COVID-19 infection after the radiation treatment course were excluded. The study period was from June 2020 to May 2021. A radiation treatment delay was defined as a delay in starting the treatment, a break in therapy during their scheduled radiation course, or treatment discontinuation. Patients who had a radiation treatment delay were followed-up till December 2021. Results Ninety-four patients who met the criteria were identified for the analysis. Seventy-seven of them had a mild infection, while 17 had a moderate or severe infection. Of the 94 patients identified, 83 patients had a treatment delay. The median treatment delay (MTD) was 18 (6 to 47) days and the median follow-up period was 13 months. In this cohort, 66 patients were treated with a curative intent, of which 51 are on follow-up {34 patients are disease-free (MTD – 18.5, 10 to 43), seven had either a residual disease or locoregional recurrence (MTD – 22, 10 to 32), seven had distant metastasis (MTD – 18, 15 to 47), and three patients died (MTD – 20, 8 to 27)}. Amongst the three patients who died, only one died of COVID-19 infection or sequel (Case Fatality Rate, CFR – 1.06%). Conclusion The CFR due to COVID-19 infection amongst those who underwent radiotherapy was low. At the same time, higher MTD might have been the reason for residual or locoregional recurrences. However, a longer follow-up is required to confirm this. Till then, it will remain debatable whether it was worth delaying radiotherapy for mild to moderate COVID-19 infection for a significant time to cause a potential cancer treatment failure.
Collapse
|
13
|
Kamper D, Barry A, Bansal N, Stoykov ME, Triandafilou K, Vidakovic L, Seo N, Roth E. Use of cyproheptadine hydrochloride (HCl) to reduce neuromuscular hypertonicity in stroke survivors: A Randomized Trial: Reducing Hypertonicity in Stroke. J Stroke Cerebrovasc Dis 2022; 31:106724. [PMID: 36054974 PMCID: PMC9533231 DOI: 10.1016/j.jstrokecerebrovasdis.2022.106724] [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: 06/27/2022] [Revised: 08/09/2022] [Accepted: 08/11/2022] [Indexed: 10/14/2022] Open
Abstract
OBJECTIVES The goal of this study was to examine how the administration and dosing of the anti-serotonergic medication cyproheptadine hydrochloride (HCl) affects involuntary muscle hypertonicity of the spastic and paretic hands of stroke survivors. MATERIALS AND METHODS A randomized, double-blinded, placebo-controlled longitudinal intervention study was performed as a component of a larger clinical trial. 94 stroke survivors with chronic, severe hand impairment, rated as levels 2 or 3 on the Chedoke-McMaster Stroke Assessment Stage of Hand (CMSA-H), were block randomized to groups receiving doses of cyproheptadine HCl or matched doses of placebo. Doses were increased from 4 mg BID to 8 mg TID over 3 weeks. Outcomes were assessed at baseline and after each of the three weeks of intervention. Primary outcome measure was grip termination time; other measures included muscle strength, spasticity, coactivation of the long finger flexors, and recording of potential adverse effects such as sleepiness and depression. RESULTS 89 participants (receiving cyproheptadine HCl: 44, receiving placebo: 45) completed the study. The Cyproheptadine group displayed significant reduction in grip termination time, in comparison with the Placebo group (p<0.05). Significant change in the Cyproheptadine group (45% time reduction) was observed after only one week at the 4mg BID dosage. The effect was pronounced for those participants in the Cyproheptadine group with more severe hand impairment (CMSA-H level 2) at baseline. Conversely, no significant effect of Group * Session interaction was observed for spasticity (p=0.6) or coactivation (p=0.53). There were no significant changes in strength (p=0.234) or depression (p=0.441) during the trial. CONCLUSIONS Use of cyproheptadine HCl was associated with a significant reduction in relaxation time of finger flexor muscles, without adversely affecting voluntary strength, although spasticity and coactivation were unchanged. Decreasing the duration of involuntary flexor activity can facilitate object release and repeated prehensile task performance. REGISTRATION Clinical Trial number: NCT02418949.
Collapse
Affiliation(s)
- Derek Kamper
- UNC/NC State Joint Department of Biomedical Engineering, North Carolina State University, Raleigh, North Carolina, USA, Closed-Loop Engineering for Advanced Rehabilitation Research Core, North Carolina State University, Raleigh, North Carolina, USA, Department of Physical Medicine & Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Alexander Barry
- Shirley Ryan AbilityLab, Arms + Hands Lab, Chicago, IL, USA.
| | - Naveen Bansal
- Marquette University, Department of Mathematical and Statistical Sciences, Milwaukee, WI, USA
| | - Mary Ellen Stoykov
- Shirley Ryan AbilityLab, Arms + Hands Lab, Chicago, IL, USA, Department of Physical Medicine & Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | | | - Lynn Vidakovic
- Shirley Ryan AbilityLab, Chicago, IL, USA, Department of Physical Medicine & Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - NaJin Seo
- Medical University of South Carolina, Rehabilitation Sciences, Charleston, SC, USA
| | - Elliot Roth
- Medical University of South Carolina, Rehabilitation Sciences, Charleston, SC, USA
| |
Collapse
|
14
|
Bansal N, Raturi M, Dhiman Y, Adhikari B, Thakur K. The Indian “blood storage centre” model for the provision of safe blood towards obstetric care in the remote regions of Uttarakhand. Transfus Clin Biol 2022; 30:183-184. [PMID: 36273774 DOI: 10.1016/j.tracli.2022.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Accepted: 10/15/2022] [Indexed: 11/06/2022]
|
15
|
Bansal N, Raturi M, Bansal Y. SARS-CoV-2 variants in immunocompromised COVID-19 patients: The underlying causes and the way forward. Transfus Clin Biol 2022; 29:161-163. [PMID: 34973463 PMCID: PMC8714679 DOI: 10.1016/j.tracli.2021.12.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Revised: 12/20/2021] [Accepted: 12/26/2021] [Indexed: 01/25/2023]
Affiliation(s)
- N. Bansal
- Department of Transfusion Medicine, VCSG Government Institute of Medical Science and Research, Srinagar, Uttarakhand, India,Corresponding author
| | - M. Raturi
- Department of Immunohematology and Blood Transfusion, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Jolly Grant, Dehradun, Uttarakhand, India
| | - Y. Bansal
- Department of Microbiology, VCSG Government Institute of Medical Science and Research, Srinagar, Uttarakhand, India
| |
Collapse
|
16
|
Bansal N, Jeewa A, Richmond M, Watanabe K, Lorts A, Rosenthal D, Taylor K, O'Shea C, Smyth L, Koehl D, Zhao H, Hollander S. Reducing Donor Acceptance Practice Variation- Learnings from a Discussion Forum. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1288] [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: 11/27/2022] Open
|
17
|
Gupta D, Cantor R, Zhao H, Clifford S, Bansal N, Hope K, Albers E, Prada-Ruiz A, Reinhardt Z, Sorabella R, Kirklin J, Ramakrishnan K. Use of Donor Hearts with Low Ejection Fraction in Pediatric Heart Transplantation: A PHTS Analysis. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
|
18
|
Dykes J, Zafar F, Almond C, Sofilos M, Lytrivi I, Szugye N, Plasencia J, Edelson J, Ghosh R, Shah J, Shugh S, Bansal N, Choueiter N, Romanowicz J, Zhang Y, Moore R, Rosenthal D, Zangwill S. Inter-Rater Reliability of Total Cardiac Volume Measurement for Heart Transplantation: An ACTION Collaborative Study. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1289] [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: 11/27/2022] Open
|
19
|
Bansal N, Raturi M, Dhiman Y, Kala M, Kusum A. Assessing the impetus and impediments to donate coronavirus disease-2019 convalescent plasma: A survey study from a tertiary care Indian blood center. Iraqi J Hematol 2022. [DOI: 10.4103/ijh.ijh_34_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
|
20
|
Bansal N, Bansal Y, Chand P, Singh P. Vaccine hesitancy after taking the first dose of COVID-19 vaccine: A challenge for the COVID-19 vaccination program in India. J Family Med Prim Care 2022; 11:2201-2206. [PMID: 35800545 PMCID: PMC9254787 DOI: 10.4103/jfmpc.jfmpc_2103_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 02/05/2022] [Accepted: 02/07/2022] [Indexed: 11/23/2022] Open
Abstract
Background: Coronavirus disease 2019 (COVID-19) vaccination campaigns are trying to curb the pandemic by vaccinating as many individuals and as quickly as possible. The speed of immunization depends upon the availability of the vaccine and vaccine uptake by the communities, which in turn is related to vaccine hesitancy, the safety/efficacy profile of the vaccines, and adverse events following immunization (AEFI) Objectives: (i) To study the AEFI experienced by vaccine recipients and (ii) to assess the subjective effect of these AEFI on the vaccine recipients, that is, perceived disability and opinion regarding taking the vaccine’s second dose Methods: This was a cross-sectional study conducted at a tertiary care hospital where a questionnaire was distributed to the medical students who had taken at least one dose of a COVID-19 vaccine Results: Out of 208 participants, more than three-quarters (n = 169, 81.2%) experienced AEFI symptoms within 12 hours of vaccination. The commonest symptoms were pain at the injection site (n = 173, 83.2%), body aches (n = 91, 43.8%), fever (n = 88, 42.3%), weakness (n = 86, 41.3%), and headache (n = 72, 34.6%). A majority of the participants reported complete recovery within 13–24 hours. Complete recovery was seen in all the study participants, and no serious event was seen. Twenty (10%) participants reported that they were not confident in taking the second dose of the vaccine Conclusions: The disability perceived by the vaccine recipients should be taken into consideration in a vaccine with a multi-dose schedule. Pitfalls in alleviating the immunization-related anxiety should be identified and addressed.
Collapse
|
21
|
Raturi M, Nambiyar R, Kala M, Bansal N. U is dissimilar to u for human immunodeficiency virus transmission through the infected whole blood unit. Glob J Transfus Med 2022. [DOI: 10.4103/gjtm.gjtm_103_21] [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: 11/04/2022] Open
|
22
|
Bansal N, Raturi M, Bansal Y. Seroprevalence of SARS-CoV-2 among blood donors: A practical serosurveillance tool for COVID-19. Transfus Clin Biol 2021; 29:182-183. [PMID: 34961672 PMCID: PMC8673919 DOI: 10.1016/j.tracli.2021.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 11/10/2021] [Indexed: 11/19/2022]
Affiliation(s)
- N Bansal
- Department of Transfusion Medicine, VCSG Government Institute of Medical Science and Research, Srinagar, Uttarakhand, India.
| | - M Raturi
- Department of Immunohematology and Blood Transfusion, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Jolly Grant, Dehradun, Uttarakhand, India
| | - Y Bansal
- Department of Microbiology, VCSG Government Institute of Medical Science and Research, Srinagar, Uttarakhand, India
| |
Collapse
|
23
|
Bansal N, Raturi M, Bansal Y. COVID-19convalescent plasma use in the oncology and geriatric patients: Ethical aspects in transfusion medicine. Transfus Clin Biol 2021; 29:184-185. [PMID: 34961671 PMCID: PMC8665838 DOI: 10.1016/j.tracli.2021.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 12/09/2021] [Indexed: 11/30/2022]
Affiliation(s)
- N Bansal
- Department of Transfusion Medicine, VCSG Government Institute of Medical Science and Research, Srinagar, Uttarakhand, India.
| | - M Raturi
- Department of Immunohematology and Blood Transfusion, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Jolly Grant, Dehradun, Uttarakhand, India
| | - Y Bansal
- Department of Microbiology, VCSG Government Institute of Medical Science and Research, Srinagar, Uttarakhand, India
| |
Collapse
|
24
|
Michels S, Bansal N, Greene C. Impact of Follow-Up Visit Timing Recommendations After Dental Rehabilitation Under General Anesthesia. Pediatr Dent 2021; 43:470-474. [PMID: 34937618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Purpose: Dental rehabilitation under general anesthesia (DRGA) is performed increasingly by pediatric dentists. Follow-up visits and ongoing recall attendance are shown to be low post-DRGA. There is currently no guideline or published study on optimal DRGA follow-up timing recommendations. A quality improvement initiative was performed at Children's Dental Center of Children's Wisconsin to increase the rate of follow-up post-DRGA. The purpose of this study was to evaluate changes in follow-up compliance after implementing a two-week visit recommendation instead of a six-week interval for dental rehabilitation under general anesthesia follow-up. Methods: The DRGA follow-up visit recommendation was changed from six weeks to two weeks postsurgery. Attendance rates for recall exams were evaluated before and after implementation with 17 months follow-up (n equals 544). Attendance was then compared by age, special health care needs, foster care status, and caries recurrence. Results: The intervention improved compliance with DRGA follow-up for all ages (P<0.001) and six-month recall visits for ages zero to five (83.3 percent of cases, P=0.001). Patients were more likely to return for any visit within 17 months in the two-week follow-up group compared to the six-week group (P=0.002). There was no difference in caries recurrence requiring treatment between the two follow-up timing groups (P=0.86). Conclusion: Changing the dental rehabilitation under general anesthesia follow-up from six weeks to two weeks improved compliance through six months and decreased the overall number of patients lost to follow-up.
Collapse
Affiliation(s)
- Stacy Michels
- Dr. Michels is a pediatric dentist in private practice, Oconomowoc, Wisconsin, USA
| | - Naveen Bansal
- Dr. Bansal is a professor at Marquette University, Milwaukee, Wisconsin, USA
| | - Colleen Greene
- Dr. Greene is a pediatric dentist at Children's Wisconsin, Milwaukee, Wisconsin, USA; greene.colleen@gmail. com
| |
Collapse
|
25
|
Rabbani M, Haque MM, Das Dipal D, Zarif MII, Iqbal A, Schwichtenberg A, Bansal N, Soron TR, Ahmed SI, Ahamed SI. An mCARE study on patterns of risk and resilience for children with ASD in Bangladesh. Sci Rep 2021; 11:21342. [PMID: 34725409 PMCID: PMC8560902 DOI: 10.1038/s41598-021-00793-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 10/15/2021] [Indexed: 11/28/2022] Open
Abstract
Community-wide lockdowns in response to COVID-19 influenced many families, but the developmental cascade for children with autism spectrum disorder (ASD) may be especially detrimental. Our objective was to evaluate behavioral patterns of risk and resilience for children with ASD across parent-report assessments before (from November 2019 to February 2020), during (March 2020 to May 2020), and after (June 2020 to November 2020) an extended COVID-19 lockdown. In 2020, our study Mobile-based care for children with ASD using remote experience sampling method (mCARE) was inactive data collection before COVID-19 emerged as a health crisis in Bangladesh. Here we deployed "Cohort Studies", where we had in total 300 children with ASD (150 test group and 150 control group) to collect behavioral data. Our data collection continued through an extended COVID-19 lockdown and captured parent reports of 30 different behavioral parameters (e.g., self-injurious behaviors, aggression, sleep problems, daily living skills, and communication) across 150 children with ASD (test group). Based on the children's condition, 4-6 behavioral parameters were assessed through the study. A total of 56,290 behavioral data points was collected (an average of 152.19 per week) from parent cell phones using the mCARE platform. Children and their families were exposed to an extended COVID-19 lockdown. The main outcomes used for this study were generated from parent reports child behaviors within the mCARE platform. Behaviors included of child social skills, communication use, problematic behaviors, sensory sensitivities, daily living, and play. COVID-19 lockdowns for children with autism and their families are not universally negative but supports in the areas of "Problematic Behavior" could serve to mitigate future risk.
Collapse
Affiliation(s)
- Masud Rabbani
- Ubicomp Lab, Department of Computer Science, Marquette University, Milwaukee, WI, 53233, USA.
| | - Munirul M Haque
- R.B. Annis School of Engineering, University of Indianapolis, Indianapolis, IN, 46227, USA
| | - Dipranjan Das Dipal
- Ubicomp Lab, Department of Computer Science, Marquette University, Milwaukee, WI, 53233, USA
| | - Md Ishrak Islam Zarif
- Ubicomp Lab, Department of Computer Science, Marquette University, Milwaukee, WI, 53233, USA
| | - Anik Iqbal
- Ubicomp Lab, Department of Computer Science, Marquette University, Milwaukee, WI, 53233, USA
| | - Amy Schwichtenberg
- College of Health and Human Sciences, Purdue University, West Lafayette, IN, USA
| | - Naveen Bansal
- Department of Mathematical and Statistical Sciences, Marquette University, Milwaukee, WI, USA
| | | | - Syed Ishtiaque Ahmed
- Department of Computer Science, University of Toronto, Toronto, ON, M5S 2E4, Canada
| | - Sheikh Iqbal Ahamed
- Ubicomp Lab, Department of Computer Science, Marquette University, Milwaukee, WI, 53233, USA
| |
Collapse
|
26
|
Bansal N, Raturi M, Bansal Y, Singh P. A novel scoring system for selecting the target patients of COVID-19 convalescent plasma therapy: A hypothesis. Transfus Clin Biol 2021; 29:89-91. [PMID: 34175469 PMCID: PMC8225297 DOI: 10.1016/j.tracli.2021.06.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Revised: 06/17/2021] [Accepted: 06/17/2021] [Indexed: 12/28/2022]
Abstract
The primary cause of mortality in patients of coronavirus disease 2019 (COVID-19) is the cytokine storm and not directly due to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus. Therefore, it is being stressed by transfusion medicine specialists to use COVID-19 convalescent plasma (CCP) therapy early in the course of the disease, preferably within 72 h of diagnosis. The authors herein, propose a scoring system for the rapid assessment of the patients who have tested positive for SARS-CoV-2. Therefore, a systematic approach may be followed where the patients are categorised into two groups, namely, the low-risk group [LRG; score < 5] and the high-risk group [HRG; score ≥ 5] based on this scoring system. Those classified as an HRG should be administered CCP therapy within 72 h of a confirmed diagnosis of COVID-19 to neutralise the SARS-CoV-2 virus and prevent the occurrence of the cytokine storm. This in turn could help reduce the overall mortality in the recipients.
Collapse
Affiliation(s)
- Naveen Bansal
- Department of Transfusion Medicine, VCSG Government Institute of Medical Science and Research, Srinagar, Uttarakhand, India
| | - Manish Raturi
- Department of Immunohematology and Blood Transfusion, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Jolly Grant, Dehradun, Uttarakhand, India.
| | - Yashik Bansal
- Department of Microbiology and Immunology, VCSG Government Institute of Medical Science and Research, Srinagar, Uttarakhand, India
| | - Pushpendra Singh
- Department of Forensic Medicine and Toxicology, VCSG Government Institute of Medical Science and Research, Srinagar, Uttarakhand, India
| |
Collapse
|
27
|
Haque MM, Rabbani M, Dipal DD, Zarif MII, Iqbal A, Schwichtenberg A, Bansal N, Soron TR, Ahmed SI, Ahamed SI. Informing Developmental Milestone Achievement for Children With Autism: Machine Learning Approach. JMIR Med Inform 2021; 9:e29242. [PMID: 33984830 PMCID: PMC8262602 DOI: 10.2196/29242] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 05/10/2021] [Accepted: 05/12/2021] [Indexed: 01/09/2023] Open
Abstract
Background Care for children with autism spectrum disorder (ASD) can be challenging for families and medical care systems. This is especially true in low- and- middle-income countries such as Bangladesh. To improve family–practitioner communication and developmental monitoring of children with ASD, mCARE (Mobile-Based Care for Children with Autism Spectrum Disorder Using Remote Experience Sampling Method) was developed. Within this study, mCARE was used to track child milestone achievement and family sociodemographic assets to inform mCARE feasibility/scalability and family asset–informed practitioner recommendations. Objective The objectives of this paper are threefold. First, it documents how mCARE can be used to monitor child milestone achievement. Second, it demonstrates how advanced machine learning models can inform our understanding of milestone achievement in children with ASD. Third, it describes family/child sociodemographic factors that are associated with earlier milestone achievement in children with ASD (across 5 machine learning models). Methods Using mCARE-collected data, this study assessed milestone achievement in 300 children with ASD from Bangladesh. In this study, we used 4 supervised machine learning algorithms (decision tree, logistic regression, K-nearest neighbor [KNN], and artificial neural network [ANN]) and 1 unsupervised machine learning algorithm (K-means clustering) to build models of milestone achievement based on family/child sociodemographic details. For analyses, the sample was randomly divided in half to train the machine learning models and then their accuracy was estimated based on the other half of the sample. Each model was specified for the following milestones: Brushes teeth, Asks to use the toilet, Urinates in the toilet or potty, and Buttons large buttons. Results This study aimed to find a suitable machine learning algorithm for milestone prediction/achievement for children with ASD using family/child sociodemographic characteristics. For Brushes teeth, the 3 supervised machine learning models met or exceeded an accuracy of 95% with logistic regression, KNN, and ANN as the most robust sociodemographic predictors. For Asks to use toilet, 84.00% accuracy was achieved with the KNN and ANN models. For these models, the family sociodemographic predictors of “family expenditure” and “parents’ age” accounted for most of the model variability. The last 2 parameters, Urinates in toilet or potty and Buttons large buttons, had an accuracy of 91.00% and 76.00%, respectively, in ANN. Overall, the ANN had a higher accuracy (above ~80% on average) among the other algorithms for all the parameters. Across the models and milestones, “family expenditure,” “family size/type,” “living places,” and “parent’s age and occupation” were the most influential family/child sociodemographic factors. Conclusions mCARE was successfully deployed in a low- and middle-income country (ie, Bangladesh), providing parents and care practitioners a mechanism to share detailed information on child milestones achievement. Using advanced modeling techniques this study demonstrates how family/child sociodemographic elements can inform child milestone achievement. Specifically, families with fewer sociodemographic resources reported later milestone attainment. Developmental science theories highlight how family/systems can directly influence child development and this study provides a clear link between family resources and child developmental progress. Clinical implications for this work could include supporting the larger family system to improve child milestone achievement.
Collapse
Affiliation(s)
- Munirul M Haque
- R.B. Annis School of Engineering, University of Indianapolis, Indianapolis, IN, United States
| | - Masud Rabbani
- Ubicomp Lab, Department of Computer Science, Marquette University, Milwaukee, WI, United States
| | - Dipranjan Das Dipal
- Ubicomp Lab, Department of Computer Science, Marquette University, Milwaukee, WI, United States
| | - Md Ishrak Islam Zarif
- Ubicomp Lab, Department of Computer Science, Marquette University, Milwaukee, WI, United States
| | - Anik Iqbal
- Ubicomp Lab, Department of Computer Science, Marquette University, Milwaukee, WI, United States
| | - Amy Schwichtenberg
- College of Health and Human Sciences, Purdue University, West Lafayette, IN, United States
| | - Naveen Bansal
- Department of Mathematical and Statistical Sciences, Marquette University, Milwaukee, WI, United States
| | | | | | - Sheikh Iqbal Ahamed
- Ubicomp Lab, Department of Computer Science, Marquette University, Milwaukee, WI, United States
| |
Collapse
|
28
|
Bansal N, Raturi M, Bansal Y. Covid-19 convalescent plasma therapy: Analyzing the factors that led to its failure in India. Transfus Clin Biol 2021; 28:296-298. [PMID: 34102319 PMCID: PMC8178955 DOI: 10.1016/j.tracli.2021.05.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Accepted: 05/27/2021] [Indexed: 11/20/2022]
Affiliation(s)
- Naveen Bansal
- Department of Transfusion Medicine, VCSG Government Institute of Medical Science and Research, Srinagar, Uttarakhand, India
| | - Manish Raturi
- Department of Immunohematology and Blood Transfusion, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Jolly Grant, 248016 Dehradun, Uttarakhand, India.
| | - Yashik Bansal
- Department of Microbiology and Immunology, VCSG Government Institute of Medical Science and Research, Srinagar, Uttarakhand, India
| |
Collapse
|
29
|
Ezeanuna M, Prince D, Alexander SA, Richards JS, Kerr G, Jala D, Bansal N, Liew J, Singh N. POS0487 ASSOCIATION OF RHEUMATOID ARTHRITIS WITH MORTALITY IN A COHORT OF CHRONIC KIDNEY DISEASE PATIENTS. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.3222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Rheumatoid Arthritis (RA) is associated with an increased risk of cardiovascular disease. RA is also associated with increased risk of chronic kidney disease (CKD) (1, 2), which is a known cardiovascular risk factor (3). We hypothesized that RA (compared with no RA) would be associated with increased risk of mortality among a cohort of patients with CKD.Objectives:To determine the risk of mortality in RA patients with CKD.Methods:This study was conducted using participants from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) prospective Chronic Renal Insufficiency Cohort (CRIC) study. Approximately 3600 participants were enrolled from seven US clinical centers. Patients aged 21 – 74 years with mild to moderate CKD were eligible for enrollment. The primary outcome of interest was all-cause mortality. Secondary outcomes of interest included: kidney event defined as end stage renal disease (ESRD) or 50% decline in estimated glomerular filtration rate (eGFR), myocardial infarction (MI), cerebrovascular accident (CVA), heart failure and a composite cardiovascular endpoint. The association of RA mortality over time was examined using Cox multivariate proportional hazards regression, adjusting for potential covariates (age, sex, race/ethnicity, BMI, current smoker, education).Results:The study cohort included 492 participants with self-reported RA with a mean follow up of 9.5 years. Compared to the non-RA group, RA patients tended to be older, female, Black. Hypertension, diabetes, use of prednisone was more prevalent among the RA cohort. The unadjusted hazards ratio (HR) for mortality based on RA status was 1.45 (1.26, 1.67) but this association was attenuated after adjusting for the confounding factors [aHR 1.09 (0.94, 1.27)] (Table 1). Participants with RA had a significantly higher risk for heart failure than those without RA [aHR 1.17 (1.02, 1.34)]. We did not observe a statistically significant association between RA status and other secondary outcomes.Conclusion:RA was not associated with higher mortality among participants with CKD. However, RA was associated with higher rates of heart failure. Further studies evaluating the mechanisms behind this association are needed.References:[1]Kochi M, Kohagura K, Shiohira Y, Iseki K, Ohya Y. Chronic kidney disease, inflammation, and cardiovascular disease risk in rheumatoid arthritis. J Cardiol. 2018;71(3):277-83.[2]Sumida K, Molnar MZ, Potukuchi PK, Hassan F, Thomas F, Yamagata K, et al. Treatment of rheumatoid arthritis with biologic agents lowers the risk of incident chronic kidney disease. Kidney Int. 2018;93(5):1207-16.[3]Chiu HY, Huang HL, Li CH, Chen HA, Yeh CL, Chiu SH, et al. Increased Risk of Chronic Kidney Disease in Rheumatoid Arthritis Associated with Cardiovascular Complications - A National Population-Based Cohort Study. PLoS One. 2015;10(9):e0136508.[4]Muthukumar P, Dhanapriya J, Gopalakrishnan N, Dineshkumar T, Sakthirajan R, Balasubramaniyan T. Evaluation of renal lesions and clinicopathologic correlation in rheumatoid arthritis. Saudi J Kidney Dis Transpl. 2017;28(1):44-50.Table 1.Estimated hazard ratios (HR) for various outcomes from Cox proportional hazards regression for RA statusUnadjustedModel 1Model 2HR (95% CI)HR (95% CI)HR (95% CI)Death1.45 (1.26, 1.67)1.09 (0.94, 1.27)1.13 (0.97, 1.32)MI or death1.43 (1.25, 1.63)1.09 (0.95, 1.26)1.15 (0.99, 1.33)CVA or death1.42 (1.24, 1.63)1.07 (0.92, 1.24)1.11 (0.95, 1.29)CHF or death1.54 (1.35, 1.75)1.17 (1.02, 1.34)1.22 (1.06, 1.40)Composite1.49 (1.31, 1.69)1.13 (0.99, 1.30)1.18 (1.03, 1.35)Kidney event1.09 (0.94, 1.27)0.91 (0.78, 1.07)1.01 (0.85, 1.20)Model 1 adjusted for: age, sex, race/ethnicity, BMI, current smoker, educationModel 2 adjusted for: model 1 + cardiovascular risk factors (urine albumin creatinine ratio, systolic blood pressure, estimated glomerular filtration rate)Disclosure of Interests:None declared
Collapse
|
30
|
Bansal N, Raturi M, Bansal Y. COVID-19 vaccination: The impact on the selection criteria of the convalescent plasma donors. Transfus Clin Biol 2021; 28:308-309. [PMID: 33971319 PMCID: PMC8103736 DOI: 10.1016/j.tracli.2021.05.002] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Accepted: 05/04/2021] [Indexed: 11/16/2022]
Abstract
Clinical management protocols for COVID-19 are evolving rapidly as more information about the epidemiology and pathophysiological changes in COVID-19 become available. However, no definite treatment of COVID-19 has been found till date. The COVID-19 convalescent plasma (CCP) therapy has emerged as an important investigational therapy in the management of COVID-19 patients. Additionally, the regulatory agencies, in particular, the Indian blood transfusion council must release some interim recommendations for the blood centres on the CCP blood donor eligibility criteria after COVID-19 vaccination. More clinical trials are needed to know the efficacy of the CCP harvested from COVID-19 recovered individuals who have been vaccinated against those COVID-19 recovered individuals who are not vaccinated to understand the vaccine impact on the IgG titres of anti-SARS-CoV-2 antibodies.
Collapse
Affiliation(s)
- N Bansal
- Department of Transfusion Medicine, VCSG Government Institute of Medical Sciences and Research, Srinagar, Uttarakhand, India
| | - M Raturi
- Department of Immunohematology and Blood Transfusion, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Jolly Grant, Dehradun-248016, Uttarakhand, India.
| | - Y Bansal
- Department of Microbiology and Immunology, VCSG Government Institute of Medical Science and Research, Srinagar, Uttarakhand, India
| |
Collapse
|
31
|
Raturi M, Kusum A, Kala M, Mittal G, Sharma A, Bansal N. Locally harvested Covid-19 convalescent plasma could probably help combat the geographically determined SARS-CoV-2 viral variants. Transfus Clin Biol 2021; 28:300-302. [PMID: 33971318 PMCID: PMC8103771 DOI: 10.1016/j.tracli.2021.05.003] [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] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 04/21/2021] [Accepted: 05/04/2021] [Indexed: 01/28/2023]
Abstract
The only effective way to provide individuals with herd immunity against the novel coronavirus [SARS-CoV-2] is to administer an effective vaccine that will help check the current pandemic status. In India, the central drugs standard control organization (CDSCO) has granted the emergency-use authorization [EUA] to three vaccines namely, Covishield (live vaccine, Oxford AstraZeneca, United Kingdom being manufactured by the Serum Institute of India), Covaxin (inactivated vaccine, Bharat Biotech, India) and Sputnik V (live vaccine, Gamaleya, Russia). However, there is a rising need for the efficacy of the vaccines to be proven against the "SARS-CoV-2 viral variants." Also, human plasma is polyclonal in nature with an inherent propensity to identify multiple epitopes of either an antigen or pathogen. With this context in mind, the researchers hypothesize that using COVID-19 convalescent plasma [CCP] harvested from the locally recovered individuals [i.e. potential CCP donors] may be particularly beneficial in combating not only the founder SARS-CoV-2 virus but also the geographically determined SARS-CoV-2 variants among the regionally affected COVID-19 patients.
Collapse
Affiliation(s)
- Manish Raturi
- Department of Immunohematology and Blood Transfusion, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Swami Ram Nagar, Jolly Grant, 248016 Dehradun, Uttarakhand, India.
| | - Anuradha Kusum
- Department of Pathology, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Swami Ram Nagar, Jolly Grant, 248016 Dehradun, Uttarakhand, India
| | - Mansi Kala
- Department of Pathology, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Swami Ram Nagar, Jolly Grant, 248016 Dehradun, Uttarakhand, India
| | - Garima Mittal
- Department of Microbiology, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Swami Ram Nagar, Jolly Grant, 248016 Dehradun, Uttarakhand, India
| | - Anita Sharma
- Department of Biochemistry, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Swami Ram Nagar, Jolly Grant, 248016 Dehradun, Uttarakhand, India
| | - Naveen Bansal
- Department of Transfusion Medicine, VCSG Government Institute of Medical Science and Research, Srinagar, Uttarakhand, India
| |
Collapse
|
32
|
Bansal N, Raturi M. COVID-19 vaccination in the Indian blood donors: Adjudging the impact on the deferral period. Transfus Clin Biol 2021; 28:310-312. [PMID: 33857620 PMCID: PMC8040337 DOI: 10.1016/j.tracli.2021.04.002] [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] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Accepted: 04/05/2021] [Indexed: 01/28/2023]
Abstract
The only efficacious way to provide people with herd immunity against the novel corona virus [nCoV] is to administer an appropriate vaccine and help check the current pandemic. With the genetic sequence data of the nCoV already available since January 10, 2020, leading pharmaceutical companies, world over, in turn, have started working on the clinical trials to produce vaccines against this nCoV. In fact, many vaccines under the Phase III trial have claimed to demonstrate their efficacy to be as high as 95% against the nCoV. In January, the central drugs standard control organization, India had granted the emergency-use authorization [EUA] to two vaccines namely, Covishield (live vaccine, Oxford-AstraZeneca, United Kingdom being manufactured by the Serum Institute of India, Pune) and Covaxin (inactivated vaccine, Bharat Biotech, India). Although, most of the countries offer no deferral period for the donors who have been administered an inactivated vaccine against this nCoV. However, the national blood transfusion council of India has recently recommended a donor deferral period of 28 days from the last dose of vaccination. This could essentially lead to a massive loss of eligible blood donors and jeopardize the already disrupted blood supply management due to the COVID-19 outbreak. The authors, herein, propose a thorough redefining of this deferral period post-vaccination amongst the Indian blood donors.
Collapse
Affiliation(s)
- N Bansal
- Department of transfusion medicine, VCSG government institute of medical science and research, Srinagar, Uttarakhand, India
| | - M Raturi
- Department of immunohematology and blood transfusion, Himalayan institute of medical sciences, Swami Rama Himalayan University, Swami Ram Nagar, Jolly Grant Dehradun, 248016 Uttarakhand, India.
| |
Collapse
|
33
|
Nandi D, Auerbach S, Bansal N, Kaufman B, Lal A, Law S, Lorts A, May L, Mehegan M, Mokshagundam D, O'connor M, Rosenthal D, Shezad M, Simpson K, Sutcliffe D, VanderPluym C, Wittlieb-Weber C, Zafar F, Cripe L, Villa C. Ventricular Assist Device Outcomes in Children and Young Adults with Muscular Dystrophy: An ACTION Analysis. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.514] [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: 11/27/2022] Open
|
34
|
Lal A, Bansal N, Cantor R, Koehl D, Urschel S, Asante-Korang A, Carlo W, Conway J, Deal N, Kirklin J, Kleinmahon J, Everitt M. Impact of Insurance and Race on Pediatric Heart Transplant Outcomes- An Analysis of the Pediatric Heart Transplant Society (PHTS) Registry. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
|
35
|
Pokorney S, Garonzik S, Chertow G, Washam J, Mussina K, Bansal N, Gadegbeku C, Garcia D, Lopes R, Mahaffey K, Middleton J, Thadhani R, Thomas K, Winkelmayer W, Granger C. Pharmacokinetics of apixaban in patients with end stage renal disease on hemodialysis and atrial fibrillation: results from the RENAL-AF trial. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3373] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background/Introduction
Apixaban use is increasing for stroke prevention in patients with atrial fibrillation (AF) and end stage renal disease (ESRD) on hemodialysis. There is uncertainty as to the optimal dose in this population in part related to the limited available pharmacokinetic (PK) data.
Purpose
We comprehensively evaluated the PK of apixaban collected over 1 month of apixaban dosing in 63 patients with AF and ESRD on hemodialysis.
Methods
Patients with AF and ESRD on hemodialysis were randomized to warfarin versus apixaban within the RENAL-AF trial with 5 mg BID dosing, except for 2.5 mg BID in those age ≥80 years or weight ≤60 kg. The 5 mg BID dose could be reduced to 2.5mg BID for minor bleeding. Day 1 PK data was collected on all patients pre- and post-hemodialysis. Day 3 and 1 month pre- and post-hemodialysis PK samples were collected in 49 patients. The timing of apixaban dosing and hemodialysis relative to PK samples was recorded. Dosing history, hemodialysis, and PK samples were chronologically integrated with patient specific data such as body size, age, race and gender. This dataset was combined with the ARISTOTLE dataset, and the published PK model from ARISTOTLE describing exposures in the AF population was updated to incorporate an additional clearance term for hemodialysis. The model estimated apixaban exposures (AUC) in RENAL-AF were compared to ARISTOLTE AUC values.
Results
There were 285 PK concentrations collected among 63 patients in the RENAL-AF trial. Patients had median age 69 years with 41% women (N=26) and a median weight of 84 kg (49, 157). The median AUCs for patients with ESRD on hemodialysis were 5,452 and 2,990 for patients treated with 5mg BID and 2.5mg BID doses, respectively. The median AUCs for patients treated with 5mg BID from ARISTOTLE increased from 2,802 for patients with class 1 CKD to 5,863 for class 4 CKD, while they increased from 2,392 for class 1 CKD to 2,881 for class 4 CKD in patients treated with 2.5mg BID. The median AUC for patients with ESRD on hemodialysis were within 50% of the exposure of patients from ARISTOTLE for all classes of CKD for the 2.5mg BID dose and for classes 2, 3A, 3B, and 4 CKD for the 5mg BID dose (Figure).
Conclusions
The steady state apixaban exposure data in patients with AF and ESRD on hemodialysis were modestly higher but consistent with the results of non-ESRD patients from ARISTOTLE, using 5 mg BID unless patients had age ≥80 years or weight ≤60 kg. Additional clinical outcomes data on the use of apixaban in patients with AF and ESRD on hemodialysis are needed.
Funding Acknowledgement
Type of funding source: Private grant(s) and/or Sponsorship. Main funding source(s): Investigator sponsored grant from Bristol-Myers Squibb and Pfizer
Collapse
Affiliation(s)
- S Pokorney
- Duke University, Durham, United States of America
| | - S Garonzik
- Bristol Myers Squibb, Princeton, United States of America
| | - G.M Chertow
- Stanford University, Palo Alto, United States of America
| | - J.B Washam
- Duke University, Durham, United States of America
| | - K Mussina
- Frenova Renal Research, Waltham, United States of America
| | - N Bansal
- University of Washington, Seattle, United States of America
| | - C Gadegbeku
- Temple University School of Medicine, Philadelphia, United States of America
| | - D Garcia
- University of Washington, Seattle, United States of America
| | - R.D Lopes
- Duke University, Durham, United States of America
| | - K.W Mahaffey
- Stanford University, Palo Alto, United States of America
| | - J Middleton
- Duke University, Durham, United States of America
| | - R Thadhani
- Cedars-Sinai Medical Center, Los Angeles, United States of America
| | - K.L Thomas
- Duke University, Durham, United States of America
| | - W Winkelmayer
- Baylor College of Medicine, Houston, United States of America
| | - C.B Granger
- Duke University, Durham, United States of America
| |
Collapse
|
36
|
Batra U, Sharma M, Jain P, Soni S, Nathany S, Bansal N. 330P COVID and cancer: Choosing between hammer and anvil. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.10.324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
|
37
|
Bansal N, Kaur G, Garg S, Gombar S. Acute normovolemic hemodilution in major orthopedic surgery. J Clin Orthop Trauma 2020; 11:S844-S848. [PMID: 32999566 PMCID: PMC7503082 DOI: 10.1016/j.jcot.2020.06.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 06/05/2020] [Accepted: 06/08/2020] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND With increasing concerns regarding the newer emerging pathogens, alternatives to allogeneic blood transfusion are being explored and acute normovolemic hemodilution (ANH) is one of them. METHODS A prospective study was conducted in patients aged 18-65 years with preoperative hemoglobin >12 g/dl undergoing total knee replacement or total hip replacement. Patients in whom hemodilution was performed were included in the ANH group whereas patients undergoing treatment as per the routine hospital protocol were included in the control group. RESULTS Preoperative hemoglobin was similar in both ANH and control groups (12.7 ± 0.7 vs 12.6 ± 0.6, p = 0.56). Allogeneic blood requirement was significantly less in the ANH group as compared to the control group (4 vs 15, p = 0.001). Postoperative complications were significantly lower in ANH group as compared to control group (7 vs 16, p = 0.01). CONCLUSIONS ANH can be an alternative approach to meet the need of safe blood especially in resource constrained countries, like India where risk of transfusion transmitted infections are still high and where there is high demand of blood and acute shortage of blood in hospitals.
Collapse
Affiliation(s)
- Naveen Bansal
- Department of Transfusion Medicine, Government Medical College Hospital, Chandigarh, India
- Corresponding author. Department of Lab Medicine, ESIC Model Hospital, Baddi, Himachal Pradesh, 173205, India.
| | - Gagandeep Kaur
- Department of Transfusion Medicine, Government Medical College Hospital, Chandigarh, India
| | - Sudhir Garg
- Department of Orthopedics, Government Medical College Hospital, Chandigarh, India
| | - Satinder Gombar
- Department of Anesthesiology, Government Medical College Hospital, Chandigarh, India
| |
Collapse
|
38
|
Bansal N, Bansal Y, Ralta A. Thrombocytopenia in COVID-19 patients in Himachal Pradesh (India) and the absence of dengue false-positive tests: Insights for patient management. J Med Virol 2020; 93:606-607. [PMID: 32729946 DOI: 10.1002/jmv.26373] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 07/28/2020] [Indexed: 12/15/2022]
Affiliation(s)
- Naveen Bansal
- Department of Laboratory Medicine, ESIC Hospital, Baddi, Himachal Pradesh, India
| | - Yashik Bansal
- Department of Microbiology, VCSG Govt. Institute of Medical Science and Research, Srinagar Garhwal, Uttarakhand, India
| | - Arti Ralta
- Department of Laboratory Medicine, ESIC Hospital, Baddi, Himachal Pradesh, India
| |
Collapse
|
39
|
Barry AJ, Triandafilou KM, Stoykov ME, Bansal N, Roth EJ, Kamper DG. Survivors of Chronic Stroke Experience Continued Impairment of Dexterity But Not Strength in the Nonparetic Upper Limb. Arch Phys Med Rehabil 2020; 101:1170-1175. [PMID: 32113974 DOI: 10.1016/j.apmr.2020.01.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 07/10/2019] [Revised: 01/13/2020] [Accepted: 01/15/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To investigate the performance of the less affected upper limb in people with stroke compared with normative values. To examine less affected upper limb function in those whose prestroke dominant limb became paretic and those whose prestroke nondominant limb became paretic. DESIGN Cohort study of survivors of chronic stroke (7.2±6.7y post incident). SETTING The study was performed at a freestanding academic rehabilitation hospital. PARTICIPANTS Survivors of chronic stroke (N=40) with severe hand impairment (Chedoke-McMaster Stroke Assessment rating of 2-3 on Stage of Hand) participated in the study. In 20 participants the prestroke dominant hand (DH) was tested (nondominant hand [NH] affected by stroke), and in 20 participants the prestroke NH was tested (DH affected by stroke). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURE Jebsen-Taylor Hand Function Test. Data from survivors of stroke were compared with normative age- and sex-matched data from neurologically intact individuals. RESULTS When combined, DH and NH groups performed significantly worse on fine motor tasks with their nonparetic hand relative to normative data (P<.007 for all measures). Even the participants who continued to use their prestroke DH as their primary hand after the stroke demonstrated reduced fine motor skills compared with normative data. In contrast, grip strength was not significantly affected in either group of survivors of stroke (P>.140). CONCLUSIONS Survivors of stroke with severe impairment of the paretic limb continue to present significant upper extremity impairment in their nominally nonparetic limb even years after stroke. This phenomenon was observed regardless of whether the DH or NH hand was primarily affected. Because this group of survivors of stroke is especially dependent on the nonparetic limb for performing functional tasks, our results suggest that the nonparetic upper limb should be targeted for rehabilitation.
Collapse
Affiliation(s)
| | | | | | - Naveen Bansal
- Department of Mathematical and Statistical Sciences, Marquette University, Milwaukee, Wisconsin
| | - Elliot J Roth
- Shirley Ryan AbilityLab, Chicago, Illinois; Department of Physical Medicine & Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Derek G Kamper
- Department of Physical Medicine & Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, Illinois; UNC/NC State Joint Department of Biomedical Engineering, North Carolina State University, Raleigh, North Carolina; Closed-Loop Engineering for Advanced Rehabilitation Research Core, North Carolina State University, Raleigh, North Carolina
| |
Collapse
|
40
|
Gupta A, Singh G, Patil V, Bansal N. Balloon Mitral Valvotomy in Patients with Mitral Stenosis and Left Atrial Thrombus. Indian Heart J 2019. [DOI: 10.1016/j.ihj.2019.11.059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
|
41
|
Barry A, Roth E, Triandafilou K, Bansal N, Stoykov ME, Kamper D. Deficits of the Nonparetic Upper Limb in Chronic Stroke Survivors. Arch Phys Med Rehabil 2019. [DOI: 10.1016/j.apmr.2019.08.168] [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: 10/26/2022]
|
42
|
Bhatnagar S, Patek B, Khan-Ansari Y, Bansal N, Buckingham H, Hacein-Bey L. MENTAL IMAGERY PRACTICE AS A THERAPY FOR NAMING IMPAIRMENTS: A PRELIMINARY STUDY. Acta Neuropsychologica 2019. [DOI: 10.5604/01.3001.0013.6197] [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: 11/13/2022]
Abstract
Anomia remains one of the most recalcitrant linguistic disruptions in aphasia to treat. Developing successful interventions to address the word-finding deficits are complicated by the post-stroke symptom variability and inconsistent recovery patterns associated with anomia. Most of the current treatment methods, with a focus on specific compensating techniques and the repetitive practice of a limited set of items, have had variable success in naming treatment. However, it has not been possible to predict the gains in generalizing the learning beyond the stimuli used in practice or the controlled clinical setting. In this preliminary case study, we explore the value of a novel treatment concept, grounded in centuries of cognitive-perceptual exercises in mindfulness training. It incorporates the practice of mental imagery and focused attention to remedy the broken phonological assembly patterns found in word finding deficits. The aim of this study was to evaluate the potential effectiveness of practicing the repeated activation of mental imagery of concrete objects as a therapeutic tool for repairing disorders of lexical retrieval in a subject with chronic moderate to severe word-finding deficits.
This trial treatment was used to assist a right-handed, 68-year old educated male with a two-and-a-half years post-onset chronic severe aphasia (anomic type) secondary to a left hemispheric infarct. Two five-week long training protocols involving common (typical) and uncommon (less typical) categories of pictured objects were used for treating anomia. The first trial involved the blocked presentation of stimuli; the second trial, undertaken a year after, included a random presentation of stimuli.
It was found that the impact was manifested in three ways: (1) an improved verbal naming of the treated objects; (2) retention of therapeutic gains by a successful generalization to untreated similar lexical items; and (3) importantly, serendipitous gains in the ability to concurrently write the names of the pictured objects. The post-treatment data on all blocked lexical trials, and some random lexical trials, were found to be significant on the Fisher’s exact test.
The use of the visual mental imagery-based therapy had a positive impact on the partial restoration of the subject’s naming.
Collapse
Affiliation(s)
- Subhash Bhatnagar
- Department of Speech Pathology and Audiology, Marquette University, Milwaukee WI
| | - Bridget Patek
- Advocate Aurora Health-St. Luke’s Medical Center, Milwaukee, WI
| | | | - Naveen Bansal
- Department of Mathematics, Statistics, & Computer Science, Marquette University, Milwaukee, WI
| | - Hugh Buckingham
- Department of Communication Sciences and Disorders, University of Oklahoma Health Sciences Center, Oklahoma City, OK
| | - Lotfi Hacein-Bey
- Radiology Department, University of California Davis School of Medicine, Sacramento, CA 95817
| |
Collapse
|
43
|
Kaur H, Bansal N, Abraham R. A randomized, single-blind, placebo-controlled trial to evaluate the effectiveness of verbal behavior modification and acetaminophen on orthodontic pain. Angle Orthod 2019; 89:617-623. [PMID: 30753091 DOI: 10.2319/080518-570.1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVES To evaluate the effectiveness of verbal behavior modification, acetaminophen, and the combined effectiveness of verbal behavior modification along with acetaminophen on orthodontic pain. MATERIALS AND METHODS One hundred and forty orthodontic fixed appliance patients were randomly assigned to four groups. Group A was administered acetaminophen, group B was given verbal behavior modification, group C was administered acetaminophen as well as verbal behavior modification, and group D was placebo-controlled. A visual analog scale was used to assess pain intensity after 1 week of separator placement. RESULTS Group A had less mean pain intensity when compared to group B at 6 hours (P < .001) and at 1 (P < .001) and 2 (P = .002) days. Group C patients encountered less mean pain intensity when compared to group B patients at 6 hours (P < .001) and at 1 (P < .001), 2 (P < .001), and 4 (P = .001) days. There was a statistically significant difference between groups A and C (group C experienced less pain intensity) after 6 hours (P = .004) and at day 4 (P = .009) after separator placement. CONCLUSIONS Acetaminophen is the main agent of orthodontic pain reduction after separator placement, with verbal behavior serving as an adjunct to it.
Collapse
|
44
|
Sweeney EL, Al-Shehri SS, Cowley DM, Liley HG, Bansal N, Charles BG, Shaw PN, Duley JA, Knox CL. The effect of breastmilk and saliva combinations on the in vitro growth of oral pathogenic and commensal microorganisms. Sci Rep 2018; 8:15112. [PMID: 30310099 PMCID: PMC6181944 DOI: 10.1038/s41598-018-33519-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Accepted: 09/24/2018] [Indexed: 01/12/2023] Open
Abstract
Neonates are exposed to microbes in utero and at birth, thereby establishing their microbiota (healthy microbial colonisers). Previously, we reported significant differences in the neonatal oral microbiota of breast-fed and formula-fed babies after first discovering a primal metabolic mechanism that occurs when breastmilk (containing the enzyme xanthine oxidase) and neonatal saliva (containing highly elevated concentrations of the substrates for xanthine oxidase: xanthine and hypoxanthine). The interaction of neonatal saliva and breast milk releases antibacterial compounds including hydrogen peroxide, and regulates the growth of bacteria. Using a novel in vitro experimental approach, the current study compared the effects of this unique metabolic pathway on a range of bacterial species and determined the period of time that microbial growth was affected. We demonstrated that microbial growth was inhibited predominately, immediately and for up to 24 hr following breastmilk and saliva mixing; however, some microorganisms were able to recover and continue to grow following exposure to these micromolar amounts of hydrogen peroxide. Interestingly, growth inhibition was independent of whether the organisms possessed a catalase enzyme. This study further confirms that this is one mechanism that contributes to the significant differences in the neonatal oral microbiota of breast-fed and formula-fed babies.
Collapse
Affiliation(s)
- E L Sweeney
- The Institute of Health and Biomedical Innovation, Faculty of Health, School of Biomedical Sciences, Queensland University of Technology, Brisbane, 4059, Australia.
| | - S S Al-Shehri
- School of Applied Medical Science, Taif University, Taif, 21974, Saudi Arabia
| | - D M Cowley
- Mater Research Institute, The University of Queensland, Woolloongabba, 4102, Australia
| | - H G Liley
- Mater Research Institute, The University of Queensland, Woolloongabba, 4102, Australia
| | - N Bansal
- School of Pharmacy, PACE, The University of Queensland, St Lucia, 4072, Australia.,School of Agriculture and Food Science, The University of Queensland, St Lucia, 4072, Australia
| | - B G Charles
- School of Pharmacy, PACE, The University of Queensland, St Lucia, 4072, Australia
| | - P N Shaw
- School of Pharmacy, PACE, The University of Queensland, St Lucia, 4072, Australia
| | - J A Duley
- School of Pharmacy, PACE, The University of Queensland, St Lucia, 4072, Australia.,Mater Research Institute, The University of Queensland, Woolloongabba, 4102, Australia
| | - C L Knox
- The Institute of Health and Biomedical Innovation, Faculty of Health, School of Biomedical Sciences, Queensland University of Technology, Brisbane, 4059, Australia
| |
Collapse
|
45
|
Ghosh I, Hamedani GG, Bansal N, Maadooliat M. On the mixtures of Weibull and Pareto (IV) distribution: An alternative to Pareto distribution. COMMUN STAT-THEOR M 2018. [DOI: 10.1080/03610926.2016.1171353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- I. Ghosh
- Department of Mathematics and Statistics, University of North Carolina, Wilmington, USA
| | - G. G. Hamedani
- Department of Mathematics, Statistics and Computer Science, Marquette University, Milwaukee, USA
| | - N. Bansal
- Department of Mathematics, Statistics and Computer Science, Marquette University, Milwaukee, USA
| | - M. Maadooliat
- Department of Mathematics, Statistics and Computer Science, Marquette University, Milwaukee, USA
| |
Collapse
|
46
|
Jhorawat R, Bansal N, Beniwal P, Agarwal D, Malhotra V. Factors Affecting Insulin Resistance and Its Relation to Vitamin D Status and Clinical Nutritional Parameters in Dialysis Patients: A Single-center Indian Study. Indian J Nephrol 2018; 28:41-45. [PMID: 29515300 PMCID: PMC5830808 DOI: 10.4103/ijn.ijn_361_16] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
The aim of this study was to measure insulin resistance (IR) in dialysis patients and its relation to Vitamin D status and nutritional parameters. We included patients on maintenance dialysis, both hemodialysis and peritoneal dialysis (HD and PD). IR was measured by homeostatic model assessment (HOMA)-IR index defined as fasting serum insulin (μU/L) × fasting blood sugar (mmol/L)/22.5. Baseline Vitamin D levels were measured by chemiluminescence immunoassay (CLIA) method. HOMA-IR index correlated with nutritional parameters such as 7-point subjective global assessment (SGA) and anthropometric measures, for example, body fat percentage, lean body weight (LBW), mid-arm circumference (MAC), and mid-arm muscle circumference (MAMC). A total of 55 patients were studied, of them 74.55% were male with mean age of the study population being 37.44 ± 14.96 years. The prevalence values of Vitamin D deficiency <30 ngm/ml, <20 ngm/ml, and <10 ngm/ml levels were 96.36%, 70.91%, and 23.64%, respectively. Mean HOMA-IR index was 3.14 ± 3.86. The correlation of HOMA-IR with Vitamin D was negative (r = -0.140, 95% confidence interval [CI] = -0.397-0.138 and P = 0.309); however, in subgroup analysis, patients with Vitamin D level <20 ng/ml had significantly high IR compared to those with Vitamin D >20 ng/ml, i.e., 3.74 ± 4.37 and 1.67 ± 1.47, respectively (P = 0.018). The other measured parameter which had a significant positive correlation with IR was serum uric acid (r = 0.303, 95% CI = 0.021-0.534, and P = 0.025). In nutritional assessment, body mass index, MAC, and MAMC had statistically significant positive correlation with HOMA-IR index (P ≤ 0.001, 0.004, and 0.004, respectively) unlike SGA (P = 0.480). The mode of dialysis did not have a significant effect on IR (HD vs. PD, P = 0.227). The majority of the patients on maintenance dialysis are Vitamin D deficient. Low Vitamin D level, especially <20 ng/ml, muscle mass, and high serum uric acid level are likely to have more IR in dialysis-dependent patients.
Collapse
Affiliation(s)
- R. Jhorawat
- Department of Nephrology, SMS Medical College and Hospital, Jaipur, Rajasthan, India
| | - N. Bansal
- Department of Nephrology, SMS Medical College and Hospital, Jaipur, Rajasthan, India
| | - P. Beniwal
- Department of Nephrology, SMS Medical College and Hospital, Jaipur, Rajasthan, India
| | - D. Agarwal
- Department of Nephrology, SMS Medical College and Hospital, Jaipur, Rajasthan, India
| | - V. Malhotra
- Department of Nephrology, SMS Medical College and Hospital, Jaipur, Rajasthan, India
| |
Collapse
|
47
|
Park M, Katz R, Shlipak MG, Weiner D, Tracy R, Jotwani V, Hughes-Austin J, Gabbai F, Hsu CY, Pfeffer M, Bansal N, Bostom A, Gutierrez O, Sarnak M, Levey A, Ix JH. Urinary Markers of Fibrosis and Risk of Cardiovascular Events and Death in Kidney Transplant Recipients: The FAVORIT Trial. Am J Transplant 2017; 17:2640-2649. [PMID: 28371433 PMCID: PMC5620109 DOI: 10.1111/ajt.14284] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2016] [Revised: 03/13/2017] [Accepted: 03/18/2017] [Indexed: 01/25/2023]
Abstract
Cardiovascular risk remains high in kidney transplant recipients (KTRs) despite improved kidney function after transplant. Urinary markers of kidney fibrosis and injury may help to reveal mechanisms of this risk. In a case-cohort study among stable KTRs who participated in the FAVORIT trial, we measured four urinary proteins known to correlate with kidney tubulointerstitial fibrosis on biopsy (urine alpha 1 microglobulin [α1m], monocyte chemoattractant protein-1 [MCP-1], procollagen type I [PINP] and type III [PIIINP] N-terminal amino peptide) and evaluated associations with cardiovascular disease (CVD) events (n = 300) and death (n = 371). In adjusted models, higher urine α1m (hazard ratio [HR] per doubling of biomarker 1.40 [95% confidence interval [CI] 1.21, 1.62]), MCP-1 (HR 1.18 [1.03, 1.36]), and PINP (HR 1.13 [95% CI 1.03, 1.23]) were associated with CVD events. These three markers were also associated with death (HR per doubling α1m 1.51 [95% CI 1.32, 1.72]; MCP-1 1.31 [95% CI 1.13, 1.51]; PINP 1.11 [95% CI 1.03, 1.20]). Higher concentrations of urine α1m, MCP-1, and PINP may identify KTRs at higher risk for CVD events and death. These markers may identify a systemic process of fibrosis involving both the kidney and cardiovascular system, and give new insights into mechanisms linking the kidney with CVD.
Collapse
Affiliation(s)
- M Park
- Division of Nephrology, Department of Medicine, University of California San Francisco, San Francisco, California,Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California
| | - R Katz
- Kidney Research Institute, Division of Nephrology, University of Washington, Seattle, Washington
| | - M G Shlipak
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California,General Internal Medicine Section, San Francisco Veterans Affairs Hospital, San Francisco, California,Division of General Internal Medicine, Department of Medicine, University of California San Francisco, San Francisco, California
| | - D Weiner
- Division of Nephrology, Department of Medicine, Tufts Medical Center, Boston, Massachusetts
| | - R Tracy
- Department of Pathology, University of Vermont, Burlington, Vermont
| | - V Jotwani
- Division of Nephrology, Department of Medicine, University of California San Francisco, San Francisco, California
| | - J Hughes-Austin
- Division of Preventive Medicine, Department of Preventive Medicine and Public Health, University of California San Diego, San Diego, California
| | - F Gabbai
- Division of Nephrology-Hypertension, Department of Medicine, University of California San Diego, San Diego, California,Nephrology Section, Veterans Affairs San Diego Healthcare System, San Diego, California
| | - CY Hsu
- Division of Nephrology, Department of Medicine, University of California San Francisco, San Francisco, California
| | - M Pfeffer
- Division of Cardiology, Brigham and Women's Hospital, Boston, Massachusetts
| | - N Bansal
- Kidney Research Institute, Division of Nephrology, University of Washington, Seattle, Washington
| | - A Bostom
- Rhode Island Hospital, Providence, Rhode Island
| | - O Gutierrez
- Departments of Medicine and Epidemiology, University of Alabama at Birmingham, Birmingham, AL
| | - M Sarnak
- Division of Nephrology, Department of Medicine, Tufts Medical Center, Boston, Massachusetts
| | - A Levey
- Division of Nephrology, Department of Medicine, Tufts Medical Center, Boston, Massachusetts
| | - J H Ix
- Division of Preventive Medicine, Department of Preventive Medicine and Public Health, University of California San Diego, San Diego, California,Division of Nephrology-Hypertension, Department of Medicine, University of California San Diego, San Diego, California,Nephrology Section, Veterans Affairs San Diego Healthcare System, San Diego, California
| |
Collapse
|
48
|
Bansal N, Hampe CS, Rodriguez L, Smith EO, Kushner J, Balasubramanyam A, Redondo MJ. DPD epitope-specific glutamic acid decarboxylase (GAD)65 autoantibodies in children with Type 1 diabetes. Diabet Med 2017; 34:641-646. [PMID: 26802570 PMCID: PMC4958605 DOI: 10.1111/dme.13077] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/19/2016] [Indexed: 12/18/2022]
Abstract
AIM To study whether DPD epitope-specific glutamate decarboxylase autoantibodies are found more frequently in children with milder forms of Type 1 diabetes. METHODS We prospectively evaluated 75 children with new-onset autoimmune Type 1 diabetes, in whom we collected demographic, anthropometric and clinical data and measured islet autoantibodies. Glutamate decarboxylase 65 autoantibody-positive samples were analysed for epitope specificities using recombinant Fab against the DPD-defined epitope of glutamate decarboxylase 65. RESULTS After adjustment for age, positive DPD epitope recognition was significantly associated with higher C-peptide levels at onset (P = 0.02, r2 =0.21, n = 35), and high DPD recognition in the highest quartile tended to be associated with HbA1c ≤ 53 mmol/mol (7%) at the last follow-up [mean (sd) follow-up 1.3 (0.4) years; P = 0.07; for the model, P = 0.044, n = 30)]. Age- and sex-adjusted BMI percentile was significantly correlated with recognition of the DPD-defined epitope (P < 0.03, r2 =0.14, n = 34), but this correlation was driven by the older age group (age ≥ 10 years; P = 0.016, r2 =0.27, n = 21) and was not significant in younger children (P = 0.93, n = 13). There were no independent associations with sex, race/ethnicity, diabetic ketoacidosis, HbA1c , HLA DR3-DQ2/DR4-DQ8 or autoantibody number. CONCLUSIONS Our findings suggest that recognition of the DPD-defined glutamate decarboxylase 65 autoantibody epitope at Type 1 diabetes onset is directly associated with β-cell function, BMI and age, which supports the hypothesis that immunological factors contribute to the clinical heterogeneity of Type 1 diabetes. Larger studies relating epitope-specific glutamate decarboxylase 65 autoantibody to clinical phenotype in children with Type 1 diabetes are warranted.
Collapse
Affiliation(s)
- N. Bansal
- Department of Pediatrics, Section of Diabetes and Endocrinology, Texas Children’s Hospital, Baylor College of Medicine, Houston, TX
| | - C. S. Hampe
- Department of Medicine, University of Washington, Seattle, WA
| | - L. Rodriguez
- Department of Pediatrics, Section of Pediatric Endocrinology, Children’s Hospital of San Antonio, Baylor College of Medicine, San Antonio, TX
| | - E. O’Brian Smith
- Children’s Nutrition Research Center, Baylor College of Medicine, Houston, TX
| | - J. Kushner
- Department of Pediatrics, Section of Diabetes and Endocrinology, Texas Children’s Hospital, Baylor College of Medicine, Houston, TX
| | - A. Balasubramanyam
- Translational Metabolism Unit, Diabetes Research Center, Division of Diabetes, Endocrinology and Metabolism, Baylor College of Medicine, Houston, TX, USA
| | - M. J. Redondo
- Department of Pediatrics, Section of Diabetes and Endocrinology, Texas Children’s Hospital, Baylor College of Medicine, Houston, TX
| |
Collapse
|
49
|
Prasad S, Bansal N. Predoctoral Dental Students’ Perceptions of Dental Implant Training: Effect of Preclinical Simulation and Clinical Experience. J Dent Educ 2017; 81:395-403. [DOI: 10.21815/jde.016.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Accepted: 09/02/2016] [Indexed: 11/20/2022]
Affiliation(s)
- Soni Prasad
- Department of General Dental Science; Marquette University School of Dentistry
| | - Naveen Bansal
- Department of Mathematics, Statistics, and Computer Science; Marquette University
| |
Collapse
|
50
|
Maan S, Kumar A, Gupta AK, Dalal A, Chaudhary D, Gupta TK, Bansal N, Kumar V, Batra K, Sindhu N, Kumar A, Mahajan NK, Maan NS, Mertens PPC. Concurrent infection of Bluetongue and Peste-des-petits-ruminants virus in small ruminants in Haryana State of India. Transbound Emerg Dis 2017; 65:235-239. [PMID: 28116836 DOI: 10.1111/tbed.12610] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Indexed: 11/27/2022]
Abstract
Bluetongue (BT) and peste-des-petits-ruminants (PPR) are major transboundary diseases of small ruminant, which are endemic in India. Testing of bluetongue virus (BTV) and peste-des-petits-ruminants virus (PPRV) from recent outbreaks (2015-2016) in different regions of Haryana State of India revealed that 27.5% of the samples showed the presence of dual infection of BTV and PPRV. Analysis of Seg-2 of BTV (the serotype-determining protein) showed the presence of BTV-12w in several isolates. However, analysis of N gene fragment amplicons showed that viruses belong to lineage IV were most closely related to a pathogenic strain of PPRV from Delhi. This is the first report of co-circulation of PPRV lineage IV and bluetongue virus serotype 12 in the state.
Collapse
Affiliation(s)
- S Maan
- Department of Animal Biotechnology, College of Veterinary Sciences, Lala Lajpat Rai University of Veterinary and Animal Sciences, Hisar, Haryana, India
| | - Aman Kumar
- Department of Animal Biotechnology, College of Veterinary Sciences, Lala Lajpat Rai University of Veterinary and Animal Sciences, Hisar, Haryana, India
| | - A K Gupta
- Department of Veterinary Microbiology, College of Veterinary Sciences, Lala Lajpat Rai University of Veterinary and Animal Sciences, Hisar, Haryana, India
| | - A Dalal
- Department of Animal Biotechnology, College of Veterinary Sciences, Lala Lajpat Rai University of Veterinary and Animal Sciences, Hisar, Haryana, India.,Department of Veterinary Microbiology, College of Veterinary Sciences, Lala Lajpat Rai University of Veterinary and Animal Sciences, Hisar, Haryana, India
| | - D Chaudhary
- Department of Animal Biotechnology, College of Veterinary Sciences, Lala Lajpat Rai University of Veterinary and Animal Sciences, Hisar, Haryana, India
| | - T K Gupta
- Teaching Veterinary Clinical Complex, College of Veterinary Sciences, Lala Lajpat Rai University of Veterinary and Animal Sciences, Hisar, Haryana, India
| | - N Bansal
- Department of Animal Biotechnology, College of Veterinary Sciences, Lala Lajpat Rai University of Veterinary and Animal Sciences, Hisar, Haryana, India
| | - V Kumar
- Department of Animal Biotechnology, College of Veterinary Sciences, Lala Lajpat Rai University of Veterinary and Animal Sciences, Hisar, Haryana, India
| | - K Batra
- Department of Animal Biotechnology, College of Veterinary Sciences, Lala Lajpat Rai University of Veterinary and Animal Sciences, Hisar, Haryana, India
| | - N Sindhu
- Teaching Veterinary Clinical Complex, College of Veterinary Sciences, Lala Lajpat Rai University of Veterinary and Animal Sciences, Hisar, Haryana, India
| | - Ankit Kumar
- TVCC Regional Centre, Uchani (Karnal), College of Veterinary Sciences, Lala Lajpat Rai University of Veterinary and Animal Sciences, Hisar, Haryana, India
| | - N K Mahajan
- Veterinary Public Health & Epidemiology, College of Veterinary Sciences, Lala Lajpat Rai University of Veterinary and Animal Sciences, Hisar, Haryana, India
| | - N S Maan
- Department of Animal Nutrition and Resource faculty, Department of Animal Biotechnology, College of Veterinary Sciences, Lala Lajpat Rai University of Veterinary and Animal Sciences, Hisar, Haryana, India
| | - P P C Mertens
- The Pirbright Institute, Pirbright, Surrey, UK.,School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington Campus, Leicestershire, UK
| |
Collapse
|