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Rao AR, Noronha V, Ramaswamy A, Kumar A, Pillai A, Gattani S, Sehgal A, Kumar S, Castelino R, Dhekale R, Krishnamurthy J, Mahajan S, Daptardar A, Sonkusare L, Deodhar J, Ansari N, Vagal M, Mahajan P, Timmanpyati S, Nookala M, Chitre A, Kapoor A, Gota V, Banavali S, Badwe RA, Prabhash K. Correlation of the Geriatric Assessment with Overall Survival in Older Patients with Cancer. Clin Oncol (R Coll Radiol) 2024; 36:e61-e71. [PMID: 37953073 DOI: 10.1016/j.clon.2023.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 10/09/2023] [Accepted: 11/02/2023] [Indexed: 11/14/2023]
Abstract
AIMS Global guidelines recommend that all older patients with cancer receiving chemotherapy should undergo a geriatric assessment. However, utilisation of the geriatric assessment is often constrained by its time-intensive nature, which limits its adoption in settings with limited resources and high demand. There is a lack of evidence correlating the results of the geriatric assessment with survival from the Indian subcontinent. Therefore, the aims of the present study were to assess the impact of the geriatric assessment on survival in older Indian patients with cancer and to identify the factors associated with survival in these older patients. MATERIALS AND METHODS This was an observational study, conducted in the geriatric oncology clinic of the Tata Memorial Hospital (Mumbai, India). Patients aged 60 years and older with cancer who underwent a geriatric assessment were enrolled. We assessed the non-oncological geriatric domains of function and falls, nutrition, comorbidities, cognition, psychology, social support and medications. Patients exhibiting impairment in two or more domains were classified as frail. RESULTS Between June 2018 and January 2022, we enrolled 897 patients. The median age was 69 (interquartile range 65-73) years. The common malignancies were lung (40.5%), oesophagus (31.9%) and genitourinary (12.1%); 54.6% had metastatic disease. Based on the results of the geriatric assessment, 767 (85.4%) patients were frail. The estimated median overall survival in fit patients was 24.3 (95% confidence interval 18.2-not reached) months, compared with 11.2 (10.1-12.8) months in frail patients (hazard ratio 0.54; 95% confidence interval 0.41-0.72, P < 0.001). This difference in overall survival remained significant after adjusting for age, sex, primary tumour and metastatic status (hazard ratio 0.56; 95% confidence interval 0.41-0.74, P < 0.001). In the patients with a performance status of 0 or 1 (n = 454), 365 (80.4%) were frail; the median overall survival in the performance status 0-1 group was 33.0 months (95% confidence interval 24.31-not reached) in the fit group versus 14.4 months (95% confidence interval 12.25-18.73) in the frail patients (hazard ratio 0.50; 95% confidence interval 0.34-0.74, P = 0.001). In the multivariate analysis, the geriatric assessment domains that were predictive of survival were function (hazard ratio 0.68; 95% confidence interval 0.52-0.88; P = 0.003), nutrition (hazard ratio 0.64; 95% confidence interval 0.48-0.85, P = 0.002) and cognition (hazard ratio 0.67; 95% confidence interval 0.49-0.91, P = 0.011). DISCUSSION The geriatric assessment is a powerful prognostic tool for survival among older Indian patients with cancer. The geriatric assessment is prognostic even in the cohort of patients thought to be the fittest, i.e. performance status 0 and 1. Our study re-emphasises the critical importance of the geriatric assessment in all older patients planned for cancer-directed therapy.
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Affiliation(s)
- A R Rao
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, India
| | - V Noronha
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, India
| | - A Ramaswamy
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, India
| | - A Kumar
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, India
| | - A Pillai
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, India
| | - S Gattani
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, India
| | - A Sehgal
- Department of Clinical Pharmacology, Advanced Centre for Treatment Research and Education in Cancer, Mumbai, India
| | - S Kumar
- Department of Clinical Pharmacology, Advanced Centre for Treatment Research and Education in Cancer, Mumbai, India
| | - R Castelino
- Department of Clinical Pharmacology, Advanced Centre for Treatment Research and Education in Cancer, Mumbai, India
| | - R Dhekale
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, India
| | - J Krishnamurthy
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, India
| | - S Mahajan
- Department of Physiotherapy, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - A Daptardar
- Department of Physiotherapy, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - L Sonkusare
- Department of Psycho-oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - J Deodhar
- Department of Psycho-oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - N Ansari
- Department of Occupational Therapy, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - M Vagal
- Department of Occupational Therapy, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - P Mahajan
- Department of Digestive Diseases and Clinical Nutrition, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - S Timmanpyati
- Department of Digestive Diseases and Clinical Nutrition, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - M Nookala
- Department of Clinical Pharmacology, Advanced Centre for Treatment Research and Education in Cancer, Mumbai, India
| | - A Chitre
- Department of Physiotherapy, Mahamana Pandit Madan Mohan Malviya Cancer Center & Homi Bhabha Cancer Hospital, Varanasi, India
| | - A Kapoor
- Department of Medical Oncology, Mahamana Pandit Madan Mohan Malviya Cancer Center & Homi Bhabha Cancer Hospital, Varanasi, India
| | - V Gota
- Department of Clinical Pharmacology, Advanced Centre for Treatment Research and Education in Cancer, Mumbai, India
| | - S Banavali
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, India
| | - R A Badwe
- Department of Surgical Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - K Prabhash
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, India.
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Sharma A, Mahajan P, Garg R. End-of-life solar photovoltaic panel waste management in India: forecasting and environmental impact assessment. Int J Environ Sci Technol (Tehran) 2023:1-20. [PMID: 37360560 PMCID: PMC10164243 DOI: 10.1007/s13762-023-04953-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 01/30/2023] [Accepted: 04/18/2023] [Indexed: 06/28/2023]
Abstract
Presently, India is in the stage of installation of solar photovoltaic panels and no focus is being given towards the impending problem of handling solar waste. The absence of adequate regulations, guidelines and operational infrastructure for photovoltaic waste in the country may lead to waste being inappropriately landfilled or incinerated in a manner that may be detrimental to human health and the environment. Business as usual projection estimates 6.64 million tonnes and 5.48 million tonnes of waste generation due to the early and regular losses using the Weibull distribution function, respectively by 2040 in India. The current study also systematically investigates various policies and legislation developments on the end-of-life of photovoltaic modules in various regions of the world, to identify gaps for further assessment. Using life cycle assessment methodology, this paper compares the environmental impacts of landfilling end-of-life crystalline silicon panels with avoided burden approach due to the recycling of materials. It has been demonstrated that solar photovoltaic recycling and reusing the recovered materials will result in impact reduction in the forthcoming production phase by as high as 70%. Further, the outcomes of carbon footprint, single score indicator with the application of Intergovernmental Panel on Climate Change also predicts lower values for avoided burden approach due to recycling (15,393.96 kgCO2 eq) in comparison to landfill approach (19,844.054 kg CO2 eq). The outcomes of this study aim to illuminate the importance of the sustainable management of photovoltaic panels at end-of-life.
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Affiliation(s)
- A. Sharma
- Department of Electrical Engineering, Delhi Technological University, Shahbad Daulatpur, Main Bawana Road, 110042 Delhi, India
| | - P. Mahajan
- Department of Electrical Engineering, Delhi Technological University, Shahbad Daulatpur, Main Bawana Road, 110042 Delhi, India
| | - R. Garg
- Department of Electrical Engineering, Delhi Technological University, Shahbad Daulatpur, Main Bawana Road, 110042 Delhi, India
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Rain M, Puri GD, Bhalla A, Avti P, Subramaniam B, Kaushal V, Srivastava V, Mahajan P, Singh M, Pandey N, Malhotra P, Goel S, Kumar K, Sachdeva N, Maity K, Verma P, Dixit N, Gupta SJ, Mehra P, Nadholta P, Khosla R, Ahuja S, Anand A. Effect of breathing intervention in patients with COVID and healthcare workers. Front Public Health 2022; 10:945988. [PMID: 36249235 PMCID: PMC9561424 DOI: 10.3389/fpubh.2022.945988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 08/29/2022] [Indexed: 01/21/2023] Open
Abstract
Background Regulated breathing facilitates ventilation and reduces breathlessness. However, the effect of Yogic breathing on patients with COVID remains unclear. We aimed to evaluate the efficacy of two breathing protocols, i.e., short breathing technique (SBT) and long duration breathing technique (LBDT). Methods Three groups including COVID-positive patients, COVID-recovered patients, and healthcare workers (HCWs) were included in the study and segregated into Yoga and control groups. SBT was administered to COVID-positive patients. Both SBT and LBDT were administered to COVID-recovered patients and HCWs. A total of 18 biochemical parameters, a 6-min walk test (6MWT), and a 1-min sit-stand test (1MSST) were assessed on 0th, 7th, and 15th days, where biochemical parameters were the primary outcome. Pre-post estimation of neuropsychological parameters (nine questionnaires) and heart rate variability (HRV) were carried out. The paired t-test or Wilcoxon rank test was applied for pre-post comparison and the Student's t-test or Mann-Whitney U test was used for group comparison. Repeated measures test was applied for data recorded at three time points. Results A significant elevation in white blood cell (WBC) count was observed in COVID-positive intervention (p < 0.001) and control groups (p = 0.003), indicating no role of intervention on change in WBC number. WBC count (p = 0.002) and D-dimer (p = 0.002) significantly decreased in the COVID-recovered intervention group. D-dimer was also reduced in HCWs practicing Yogic breathing as compared to controls (p = 0.01). D-dimer was the primary outcome, which remained below 0.50 μg/ml (a cutoff value to define severity) in the COVID-positive yoga group (CYG) and decreased in the COVID-recovered yoga group (RYG) and the HCW yoga group (HYG) after intervention. A 6-min walk test (6MWT) showed an increase in distance covered among the COVID-positive patients (p = 0.01) and HCWs (p = 0.002) after intervention. The high-frequency power (p = 0.01) was found to be reduced in the COVID-positive intervention group. No significant change in neuropsychological parameters was observed. Conclusion Yogic breathing lowered D-dimer, which is helpful in reducing thrombosis and venous thromboembolism in patients with COVID-19 besides lowering the chances of vaccine-induced thrombotic thrombocytopenia in vaccinated individuals. The breathing intervention improved exercise capacity in mild to moderate cases of COVID-19. Further studies can show if such breathing techniques can influence immunity-related genes, as reported recently in a study. We suggest that Yogic breathing may be considered an integrative approach for the management of patients with COVID. Trial registration http://ctri.nic.in/Clinicaltrials/login.php, identifier: CTRI/2020/10/028195.
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Affiliation(s)
- Manjari Rain
- Department of Neurology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Goverdhan Dutt Puri
- Department of Anesthesia, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Aashish Bhalla
- Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Pramod Avti
- Department of Biophysics, Post Graduate Institute of Medical Education and Research, Chandigarh, India,Pramod Avti
| | | | - Vipin Kaushal
- Department of Hospital Administration, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Vinod Srivastava
- College of Health and Behavioral Sciences, Fort Hays State University, Hays, KS, United States
| | - Pranay Mahajan
- Department of Hospital Administration, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Mini Singh
- Department of Virology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Navin Pandey
- Department of Hospital Administration, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Pankaj Malhotra
- Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Sonu Goel
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Krishan Kumar
- Department of Psychiatry, Post Graduate 30 Institute of Medical Education and Research, Chandigarh, India
| | - Naresh Sachdeva
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Kalyan Maity
- Department of Neurology, Post Graduate Institute of Medical Education and Research, Chandigarh, India,Swami Vivekananda Yoga Anusandhana Samsthana, Bengaluru, India
| | - Prashant Verma
- Department of Neurology, Post Graduate Institute of Medical Education and Research, Chandigarh, India,Interdisciplinary Centre for Swami Vivekananda Studies, Panjab University, Chandigarh, India
| | - Nishant Dixit
- Department of Psychology, Panjab University, Chandigarh, India
| | - Sheetal Jindal Gupta
- Department of Neurology, Post Graduate Institute of Medical Education and Research, Chandigarh, India,Swami Vivekananda Yoga Anusandhana Samsthana, Bengaluru, India
| | - Priya Mehra
- Department of Neurology, Post Graduate Institute of Medical Education and Research, Chandigarh, India,Department of Biotechnology, Panjab University, Chandigarh, India
| | - Pooja Nadholta
- Department of Neurology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Radhika Khosla
- Department of Neurology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | | | - Akshay Anand
- Department of Neurology, Post Graduate Institute of Medical Education and Research, Chandigarh, India,Centre of Phenomenology and Cognitive Sciences, Panjab University, Chandigarh, India,CCRYN-Collaborative Center for Mind Body Intervention Through Yoga, Post Graduate Institute of Medical Education and Research, Chandigarh, India,*Correspondence: Akshay Anand
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Aedma S, Gupta R, Mahajan S, Mahajan P, Patel M, Malik A, Naik A, Mehta S, Patel NC. Transcatheter aortic valve implantation outcomes compared between bicuspid aortic and tricuspid aortic valve stenosis: an updated systematic review and meta-analysis. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
TAVI has emerged as an attractive treatment modality based on promising recent trial data. Patients with BAV, a commonly encountered clinical condition have largely been excluded from a majority of trials.
Purpose
Elderly patients with BAV and severe AS are increasingly encountered in clinical practice. This meta-analysis compares clinical outcomes between bicuspid and tricuspid AV patients to address the current knowledge-gap and identify optimal management strategies of these patients.
Methods
A comprehensive literature search was performed in PubMed, Embase, and Cochrane to identify the available observational studies comparing outcomes of TAVI in BAV and TAV patients. Summary effects were calculated using a DerSimonian and Laird random-effects model as odds ratio with 95% confidence intervals for all the clinical endpoints.
Results
16 Observational studies met inclusion criteria, comprising 10,053 patients with BAV and 173,307 patients with TAV that underwent TAVI. No significant differences in 30-day and long-term mortality rates were observed. Patients with BAV had an increased risk of stroke (OR 1.23; 95% CI [1.06–1.44], p=0.007), re-intervention (OR 1.90; 95% CI [1.15–3.15], p=0.01), paravalvular leak (OR 1.42; 95% CI [1.25–1.61], p<0.ehab724.22251), conversion to open surgery (OR 1.93; 95% CI [1.21–3.07], p=0.006), and new pacemaker implantation (1.57; 95% CI (1.06 - 2.33, p=0.02). Adverse event rates are lower with the use of newer generation of valves. No significant difference in major vascular complications, major bleeding, or incidence of AKI was noted.
Conclusions
Complication rates for BAV TAVI are higher, but mortality is similar to TAV TAVI indicating TAVI is an appropriate alternative for intermediate-high risk patients with BAV. A better understanding of valve anatomy, physician expertise, the use of newer-generation valves can help reduce these complications.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- S Aedma
- Carle Foundation Hospital, Internal medicine, Urbana, United States of America
| | - R Gupta
- Lehigh Valley Health Network, Cardiology, Allentown, United States of America
| | - S Mahajan
- Carle Foundation Hospital, Internal medicine, Urbana, United States of America
| | - P Mahajan
- Carle Foundation Hospital, Internal medicine, Urbana, United States of America
| | - M Patel
- Sumandeep Vidyapeeth, Vadodara, India
| | - A Malik
- New York Medical College, cardiology, Valhalla, United States of America
| | - A Naik
- Carle Foundation Hospital, Internal medicine, Urbana, United States of America
| | - S Mehta
- Carle Foundation Hospital, Internal medicine, Urbana, United States of America
| | - N C Patel
- Lehigh Valley Health Network, Cardiology, Allentown, United States of America
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Mahajan P, Mahajan S, Gupta R, Aedma S, Samala V, Malik A, Mehta S. Outcomes of permanent pacemaker insertion after TAVR: a systematic review and meta-analysis. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background/Introduction
Conduction abnormalities are frequently encountered after transcatheter aortic valve replacement (TAVR) performed for severe aortic stenosis, leading to post-procedure permanent pacemaker (PPM) insertion. Although the predictors of- and factors leading to post-TAVR PPM have been studied extensively, its short-term and long-term outcomes have not been established.
Purpose
PPM placement can lead to significant changes in outcomes in post-TAVR patients, which remain unclear. With this analysis, we aim to evaluate the differences between outcomes of patients requiring PPM and those not requiring PPM post-TAVR.
Methods
A comprehensive literature search was performed in PubMed, EMBASE, and Cochrane to identify relevant trials. Outcomes were compared between the two groups of patients- those requiring post-TAVR PPM and those not requiring post-TAVR PPM. Summary effects were calculated using a DerSimonian and Laird random-effects model as odds ratio (OD) with 95% confidence intervals (CI) for all the clinical endpoints.
Results
34 studies, including observational and prospective studies, met our inclusion criteria, with a total of 76,402 patients undergoing TAVR and 10,381 requiring post-TAVR PPM. There were no significant differences between 30-days (OR 1.04; 95% CI 0.96–1.13) and 1-year (OR 1.09; 95% CI 0.72–1.03) all-cause mortality rates, and 30-days (OR 0.86; 95% CI 0.72–1.03) and 1-year (OR 0.85; 95% CI 0.70–1.04) cardiovascular deaths among the two groups. Incidence of heart failure was higher in the post-TAVR PPM group at 30 days (OR 1.26; 95% CI 1.05–1.51) but not at 1 year (OR 1.21; 95% CI 0.93–1.57). No significant difference was noted between the two groups in 30-days or 1-year stroke, 30-days or 1-year myocardial infarction, 30-days or 1-year atrial fibrillation, 30-days or 1-year major bleeding, or 30-days and 1-year readmission rate. Other outcomes, including post-procedure aortic regurgitation, major vascular complications, minor bleeding, valve migration, and device success, also did not have any statistically significant difference in the two patient groups (Figure 1). Of all the patients who received post-TAVR PPM, an average of 46.4% and 58.5% patients had >40% ventricular pacing, and 48.9% and 41.4% had <40% ventricular pacing at 1-month, and 1-year follow up respectively.
Conclusions
Although there were no differences in the outcomes between the two groups at 30-days and 1-year follow-ups (except the higher incidence of heart failure at 30 days in the post-TAVR PPM group), long-term follow-up studies would be needed to identify any possible adverse events after one year. Also, a significant number of patients requiring post-TAVR PPM had <40% ventricular pacing at 1-month and even at 1-year intervals, which might suggest adopting an alternate approach of closely monitoring any conduction disturbances and avoiding early PPM implantation in post-TAVR patients, if possible.
Funding Acknowledgement
Type of funding sources: None. Forest plot of differences in outcomes
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Affiliation(s)
- P Mahajan
- Carle Foundation Hospital, Internal Medicine, Urbana, United States of America
| | - S Mahajan
- Carle Foundation Hospital, Internal Medicine, Urbana, United States of America
| | - R Gupta
- Lehigh Valley Hospital, Allentown, United States of America
| | - S Aedma
- Carle Foundation Hospital, Internal Medicine, Urbana, United States of America
| | - V Samala
- Cheshire Medical Center/Dartmouth-Hitchcock, Keene, United States of America
| | - A Malik
- New York Medical College, Cardiology, Valhalla, United States of America
| | - S Mehta
- Carle Foundation Hospital, Cardiology, Urbana, United States of America
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Rain M, Subramaniam B, Avti P, Mahajan P, Anand A. Can Yogic Breathing Techniques Like Simha Kriya and Isha Kriya Regulate COVID-19-Related Stress? Front Psychol 2021; 12:635816. [PMID: 33935886 PMCID: PMC8081973 DOI: 10.3389/fpsyg.2021.635816] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 03/23/2021] [Indexed: 12/19/2022] Open
Abstract
The global impact of Coronavirus Disease 2019 (COVID-19) is tremendous on human life, not only affecting the physical and mental health of population but also impacting the economic system of countries and individual itself. The present situation demands prompt response toward COVID-19 by equipping the humans with strategies to overcome the infection and stress associated with it. These strategies must not only be limited to preventive and therapeutic measures, but also aim at improving immunity and mental health. This can be achieved by yogic breathing techniques. In this perspective, we emphasize the importance of yogic breathing, Simha Kriya and Isha kriya, the simple yet effective breathing techniques.
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Affiliation(s)
- Manjari Rain
- Department of Neurology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Balachundhar Subramaniam
- Center for Anesthesia Research Excellence, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
| | - Pramod Avti
- Department of Biophysics, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Pranay Mahajan
- Department of Hospital Administration, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Akshay Anand
- Department of Neurology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.,Centre for Mind Body Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India.,Centre of Phenomenology and Cognitive Sciences, Panjab University, Chandigarh, India
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7
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Dutta U, Sachan A, Premkumar M, Gupta T, Sahoo S, Grover S, Sharma S, Lakshmi PVM, Talati S, Biswal M, Suri V, Singh MP, Ghai B, Chhabra R, Bharti B, Samanta J, Arora P, Mohindra R, Malhotra S, Singh G, Guru RR, Pandey N, Koushal V, Kumar A, Bhogal RS, Aggarwal AK, Goel K, Malhotra P, Yaddanapudi N, Mahajan P, Thakur JS, Sehgal R, Ghosh A, Sehgal IS, Agarwal R, Jayashree M, Bhalla A, Jain S, Kochhar R, Chakrabarti A, Puri GD, Ram J. Multidimensional dynamic healthcare personnel (HCP)-centric model from a low-income and middle-income country to support and protect COVID-19 warriors: a large prospective cohort study. BMJ Open 2021; 11:e043837. [PMID: 33619195 PMCID: PMC7902325 DOI: 10.1136/bmjopen-2020-043837] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVES Healthcare personnel (HCP) are at an increased risk of acquiring COVID-19 infection especially in resource-restricted healthcare settings, and return to homes unfit for self-isolation, making them apprehensive about COVID-19 duty and transmission risk to their families. We aimed at implementing a novel multidimensional HCP-centric evidence-based, dynamic policy with the objectives to reduce risk of HCP infection, ensure welfare and safety of the HCP and to improve willingness to accept and return to duty. SETTING Our tertiary care university hospital, with 12 600 HCP, was divided into high-risk, medium-risk and low-risk zones. In the high-risk and medium-risk zones, we organised training, logistic support, postduty HCP welfare and collected feedback, and sent them home after they tested negative for COVID-19. We supervised use of appropriate personal protective equipment (PPE) and kept communication paperless. PARTICIPANTS We recruited willing low-risk HCP, aged <50 years, with no comorbidities to work in COVID-19 zones. Social distancing, hand hygiene and universal masking were advocated in the low-risk zone. RESULTS Between 31 March and 20 July 2020, we clinically screened 5553 outpatients, of whom 3012 (54.2%) were COVID-19 suspects managed in the medium-risk zone. Among them, 346 (11.4%) tested COVID-19 positive (57.2% male) and were managed in the high-risk zone with 19 (5.4%) deaths. One (0.08%) of the 1224 HCP in high-risk zone, 6 (0.62%) of 960 HCP in medium-risk zone and 23 (0.18%) of the 12 600 HCP in the low-risk zone tested positive at the end of shift. All the 30 COVID-19-positive HCP have since recovered. This HCP-centric policy resulted in low transmission rates (<1%), ensured satisfaction with training (92%), PPE (90.8%), medical and psychosocial support (79%) and improved acceptance of COVID-19 duty with 54.7% volunteering for re-deployment. CONCLUSION A multidimensional HCP-centric policy was effective in ensuring safety, satisfaction and welfare of HCP in a resource-poor setting and resulted in a willing workforce to fight the pandemic.
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Affiliation(s)
- Usha Dutta
- Department of Gastroenterology, PGIMER, Chandigarh, India
| | - Anurag Sachan
- Department of Gastroenterology, PGIMER, Chandigarh, India
| | - Madhumita Premkumar
- Department of Gastroenterology, PGIMER, Chandigarh, India
- Department of Hepatology, PGIMER, Chandigarh, India
| | - Tulika Gupta
- Department of Anatomy, PGIMER, Chandigarh, India
| | | | | | - Sugandhi Sharma
- Department of Community Medicine and School of Public Health, PGIMER, Chandigarh, India
| | - P V M Lakshmi
- Department of Community Medicine and School of Public Health, PGIMER, Chandigarh, India
| | - Shweta Talati
- Department of Hospital Administration, PGIMER, Chandigarh, India
| | | | - Vikas Suri
- Department of Internal Medicine, PGIMER, Chandigarh, India
| | - Mini P Singh
- Department of Virology, PGIMER, Chandigarh, India
| | - Babita Ghai
- Department of Anesthesia, PGIMER, Chandigarh, India
| | | | | | | | - Pankaj Arora
- Department of Hospital Administration, PGIMER, Chandigarh, India
- Department of Internal Medicine, PGIMER, Chandigarh, India
| | - Ritin Mohindra
- Department of Internal Medicine, PGIMER, Chandigarh, India
| | | | - Gurmeet Singh
- Department of Community Medicine and School of Public Health, PGIMER, Chandigarh, India
| | | | - Navin Pandey
- Department of Hospital Administration, PGIMER, Chandigarh, India
| | - Vipin Koushal
- Department of Hospital Administration, PGIMER, Chandigarh, India
| | - Ashok Kumar
- Department of Hospital Administration, PGIMER, Chandigarh, India
| | | | - Arun K Aggarwal
- Department of Community Medicine and School of Public Health, PGIMER, Chandigarh, India
| | - Kapil Goel
- Department of Community Medicine and School of Public Health, PGIMER, Chandigarh, India
| | | | | | - Pranay Mahajan
- Department of Hospital Administration, PGIMER, Chandigarh, India
| | - J S Thakur
- Department of Community Medicine and School of Public Health, PGIMER, Chandigarh, India
| | - Rakesh Sehgal
- Department of Parasitology, PGIMER, Chandigarh, India
| | - Arnab Ghosh
- Department of Virology, PGIMER, Chandigarh, India
| | | | | | | | - Ashish Bhalla
- Department of Internal Medicine, PGIMER, Chandigarh, India
| | - Sanjay Jain
- Department of Internal Medicine, PGIMER, Chandigarh, India
| | - Rakesh Kochhar
- Department of Gastroenterology, PGIMER, Chandigarh, India
| | | | | | - Jagat Ram
- Department of Ophthalmology, PGIMER, Chandigarh, India
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Dhandapani M, Kaur S, Das K, Guru RR, Biswal M, Mahajan P, Koushal V, Puri GD. Enhancing the safety of frontline healthcare workers during coronavirus disease: a novel real-time remote audiovisual aided doffing approach. Infect Dis (Lond) 2020; 53:145-147. [PMID: 33131375 DOI: 10.1080/23744235.2020.1836390] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Affiliation(s)
- Manju Dhandapani
- National Institute of Nursing Education, PGIMER, Chandigarh, India
| | - Sukhpal Kaur
- National Institute of Nursing Education, PGIMER, Chandigarh, India
| | - Karobi Das
- National Institute of Nursing Education, PGIMER, Chandigarh, India
| | | | | | - Pranay Mahajan
- Department of Hospital Administration, PGIMER, Chandigarh, India
| | - Vipin Koushal
- Department of Hospital Administration, PGIMER, Chandigarh, India
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9
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Kumar P, Mahajan P, Kaur R, Gautam S. Nanotechnology and its challenges in the food sector: a review. Mater Today Chem 2020; 17:100332. [PMID: 32835156 PMCID: PMC7386856 DOI: 10.1016/j.mtchem.2020.100332] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 06/29/2020] [Accepted: 07/01/2020] [Indexed: 05/05/2023]
Abstract
Antibacterial activity of nanoparticles has received significant attention worldwide because of their great physical and chemical stability, excellent magnetic properties, and large lattice constant values. These properties are predominate in the food science for enhancing the overall quality, shelf life, taste, flavor, process-ability, etc., of the food. Nanoparticles exhibit attractive antibacterial activity due to their increased specific surface area leading to enhanced surface reactivity. When nanoparticles are suspended in the biological culture, they encounter various biological interfaces, resulting from the presence of cellular moieties like DNA, proteins, lipids, polysaccharides, etc., which helps antibacterial properties in many ways. This paper reviews different methods used for the synthesis of nanoparticles but is specially focusing on the green synthesis methods owing to its non-toxic nature towards the environment. This review highlights their antibacterial application mainly in the food sector in the form of food-nanosensors, food-packaging, and food-additives. The possible mechanism of nanoparticles for their antibacterial behavior underlying the interaction of nano-particles with bacteria, (i) excessive ROS generation including hydrogen peroxide (H2O2), OH- (hydroxyl radicals), and O- 2 2 (peroxide); and (ii) precipitation of nano-particles on the bacterial exterior; which, disrupts the cellular activities, resulting in membranes disturbance. All these phenomena results in the inhibition of bacterial growth. Along with this, their current application and future perspectives in the food sector are also discussed. Nanoparticles help in destroying not only pathogens but also deadly fungi and viruses. Most importantly it is required to focus more on the crop processing and its containment to stop the post-harvesting loss. So, nanoparticles can act as a smart weapon towards the sustainable move.
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Affiliation(s)
- P Kumar
- Advanced Functional Materials Lab., Dr. S.S. Bhatnagar University Institute of Chemical Engineering & Technology, Panjab University, Chandigarh, 160 014, India
| | - P Mahajan
- Advanced Functional Materials Lab., Dr. S.S. Bhatnagar University Institute of Chemical Engineering & Technology, Panjab University, Chandigarh, 160 014, India
| | - R Kaur
- Advanced Functional Materials Lab., Dr. S.S. Bhatnagar University Institute of Chemical Engineering & Technology, Panjab University, Chandigarh, 160 014, India
| | - S Gautam
- Advanced Functional Materials Lab., Dr. S.S. Bhatnagar University Institute of Chemical Engineering & Technology, Panjab University, Chandigarh, 160 014, India
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10
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Pandey N, Kaushal V, Puri GD, Taneja S, Biswal M, Mahajan P, Guru RR, Malhotra P, Sehgal IS, Dhooria S, Muthu V, Agarwal R. Transforming a General Hospital to an Infectious Disease Hospital for COVID-19 Over 2 Weeks. Front Public Health 2020; 8:382. [PMID: 32850601 PMCID: PMC7399037 DOI: 10.3389/fpubh.2020.00382] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 07/01/2020] [Indexed: 12/21/2022] Open
Abstract
Pandemics like the coronavirus disease (COVID)-19 can cause a significant strain on the healthcare system. Healthcare organizations must be ready with their contingency plans for managing many patients with contagious infectious disease. Ideally, every large hospital should have a facility that can function as a high-level isolation unit. An isolation unit ensures that the healthcare staff and the hospital are equipped to deal with infectious disease outbreaks. Unfortunately, such facilities do not exist in several hospitals, especially in resource-limited settings. In such a scenario, healthcare setups need to convert their existing general structure into an infectious disease facility. Herein, we describe our experience in transforming a general hospital into a functional infectious disease isolation unit.
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Affiliation(s)
- Navin Pandey
- Department of Hospital Administration, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Vipin Kaushal
- Department of Hospital Administration, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Goverdhan Dutt Puri
- Department of Anesthesia and Critical Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Sunil Taneja
- Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Manisha Biswal
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Pranay Mahajan
- Department of Hospital Administration, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Rashmi Ranjan Guru
- Department of Hospital Administration, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Pankaj Malhotra
- Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Inderpaul Singh Sehgal
- Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Sahajal Dhooria
- Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Valliappan Muthu
- Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Ritesh Agarwal
- Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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11
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Mahajan P, Koushal V, Chhabra R, Dhaliwal N, Pandey N, Kaur R. Effectiveness of Interventional Strategies in Modulating Knowledge and Attitude of Health Care Professionals for Promoting Organ Donation: A Study in Tertiary Care Public Hospital of North India. Ann Neurosci 2020; 27:242-256. [PMID: 34556965 PMCID: PMC8455009 DOI: 10.1177/0972753121990238] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Objective: To evaluate the impact of interventional “educational module” on knowledge and attitude regarding organ donation amongst resident doctors and nurses in the Institute of National Importance. Study Design: Interventional and prospective. Methods: We devised an interactive educational module covering various aspects of organ donation through a series of audiovisual lectures and information booklets. Resident doctors and nurses posted in those areas of the 1948-bedded Postgraduate Institute of Medical Education and Research (PGIMER), where head injury patients were treated and were subject to intervention using this module. The pre and postinterventional scores of their knowledge and attitude regarding organ donation were compared to find out impact of the intervention. Results: A total of 242 nurses and 87 resident doctors participated in this research. Higher knowledge score was observed preintervention amongst doctors as compared to nurses. Significant improvement was seen in total knowledge scores of both groups postintervention. Doctors had better scores for the “concept of organ donation,” while nurses were more familiar with “procedures and protocols.” Both had low knowledge about “clinical criteria for brain death” and “legal issues” preintervention which improved significantly postintervention. The positive impact of intervention was also observed on attitude in both categories. A significant impact of intervention was observed on overall propensity of doctors and nurses to promote organ donation, for pledging their own organs and for counseling of the patient/attendants on this cause. Conclusion: Scientifically designed educational modules have a promising role in improving awareness and attitude of health care professionals regarding organ donation and their propensity to be prospective donors, effective counselors, and advocates of organ donation.
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Affiliation(s)
- Pranay Mahajan
- Department of Hospital Administration, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - V Koushal
- Department of Hospital Administration, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - R Chhabra
- Department of Neurosurgery, PGIMER, Chandigarh, India
| | - N Dhaliwal
- Department of Hospital Administration, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - N Pandey
- Department of Hospital Administration, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - R Kaur
- Transplant Coordinator, PGIMER, Chandigarh, India
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12
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Bulbrook D, Brazier H, Mahajan P, Kliszczak M, Fedorov O, Marchese FP, Aubareda A, Chalk R, Picaud S, Strain-Damerell C, Filippakopoulos P, Gileadi O, Clark AR, Yue WW, Burgess-Brown NA, Dean JLE. Tryptophan-Mediated Interactions between Tristetraprolin and the CNOT9 Subunit Are Required for CCR4-NOT Deadenylase Complex Recruitment. J Mol Biol 2017; 430:722-736. [PMID: 29291391 DOI: 10.1016/j.jmb.2017.12.018] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [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: 07/26/2017] [Revised: 12/19/2017] [Accepted: 12/20/2017] [Indexed: 12/27/2022]
Abstract
The zinc-finger protein tristetraprolin (TTP) binds to AU-rich elements present in the 3' untranslated regions of transcripts that mainly encode proteins of the inflammatory response. TTP-bound mRNAs are targeted for destruction via recruitment of the eight-subunit deadenylase complex "carbon catabolite repressor protein 4 (CCR4)-negative on TATA-less (NOT)," which catalyzes the removal of mRNA poly-(A) tails, the first obligatory step in mRNA decay. Here we show that a novel interaction between TTP and the CCR4-NOT subunit, CNOT9, is required for recruitment of the deadenylase complex. In addition to CNOT1, CNOT9 is now included in the identified CCR4-NOT subunits shown to interact with TTP. We find that both the N- and C-terminal domains of TTP are involved in an interaction with CNOT9. Through a combination of SPOT peptide array, site-directed mutagenesis, and bio-layer interferometry, we identified several conserved tryptophan residues in TTP that serve as major sites of interaction with two tryptophan-binding pockets of CNOT9, previously found to interact with another modulator GW182. We further demonstrate that these interactions are also required for recruitment of the CCR4-NOT complex and TTP-directed decay of an mRNA containing an AU-rich element in its 3'-untranslated region. Together the results reveal new molecular details for the TTP-CNOT interaction that shape an emerging mechanism whereby TTP targets inflammatory mRNAs for deadenylation and decay.
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Affiliation(s)
- D Bulbrook
- Kennedy Institute of Rheumatology, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Roosevelt Drive, Headington, Oxford, OX3 7FY, United Kingdom
| | - H Brazier
- Kennedy Institute of Rheumatology, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Roosevelt Drive, Headington, Oxford, OX3 7FY, United Kingdom; Structural Genomics Consortium, Nuffield Department of Clinical Medicine, University of Oxford, Old Road Campus Research Building, Roosevelt Drive, Headington, Oxford, OX3 7DQ, United Kingdom
| | - P Mahajan
- Structural Genomics Consortium, Nuffield Department of Clinical Medicine, University of Oxford, Old Road Campus Research Building, Roosevelt Drive, Headington, Oxford, OX3 7DQ, United Kingdom
| | - M Kliszczak
- Structural Genomics Consortium, Nuffield Department of Clinical Medicine, University of Oxford, Old Road Campus Research Building, Roosevelt Drive, Headington, Oxford, OX3 7DQ, United Kingdom
| | - O Fedorov
- Structural Genomics Consortium, Nuffield Department of Clinical Medicine, University of Oxford, Old Road Campus Research Building, Roosevelt Drive, Headington, Oxford, OX3 7DQ, United Kingdom
| | - F P Marchese
- Kennedy Institute of Rheumatology, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Roosevelt Drive, Headington, Oxford, OX3 7FY, United Kingdom
| | - A Aubareda
- Kennedy Institute of Rheumatology, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Roosevelt Drive, Headington, Oxford, OX3 7FY, United Kingdom
| | - R Chalk
- Structural Genomics Consortium, Nuffield Department of Clinical Medicine, University of Oxford, Old Road Campus Research Building, Roosevelt Drive, Headington, Oxford, OX3 7DQ, United Kingdom
| | - S Picaud
- Structural Genomics Consortium, Nuffield Department of Clinical Medicine, University of Oxford, Old Road Campus Research Building, Roosevelt Drive, Headington, Oxford, OX3 7DQ, United Kingdom
| | - C Strain-Damerell
- Structural Genomics Consortium, Nuffield Department of Clinical Medicine, University of Oxford, Old Road Campus Research Building, Roosevelt Drive, Headington, Oxford, OX3 7DQ, United Kingdom
| | - P Filippakopoulos
- Structural Genomics Consortium, Nuffield Department of Clinical Medicine, University of Oxford, Old Road Campus Research Building, Roosevelt Drive, Headington, Oxford, OX3 7DQ, United Kingdom; Ludwig Institute for Cancer Research, Old Road Campus Research Building, Roosevelt Drive, Oxford, OX3 7DQ, United Kingdom
| | - O Gileadi
- Structural Genomics Consortium, Nuffield Department of Clinical Medicine, University of Oxford, Old Road Campus Research Building, Roosevelt Drive, Headington, Oxford, OX3 7DQ, United Kingdom
| | - A R Clark
- Institute of Inflammation and Ageing, University of Birmingham, Edgbaston, B15 2TT, United Kingdom
| | - W W Yue
- Structural Genomics Consortium, Nuffield Department of Clinical Medicine, University of Oxford, Old Road Campus Research Building, Roosevelt Drive, Headington, Oxford, OX3 7DQ, United Kingdom.
| | - N A Burgess-Brown
- Structural Genomics Consortium, Nuffield Department of Clinical Medicine, University of Oxford, Old Road Campus Research Building, Roosevelt Drive, Headington, Oxford, OX3 7DQ, United Kingdom.
| | - J L E Dean
- Kennedy Institute of Rheumatology, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Roosevelt Drive, Headington, Oxford, OX3 7FY, United Kingdom.
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Rasool RU, Nayak D, Chakraborty S, Faheem MM, Rah B, Mahajan P, Gopinath V, Katoch A, Iqra Z, Yousuf SK, Mukherjee D, Kumar LD, Nargotra A, Goswami A. AKT is indispensable for coordinating Par-4/JNK cross talk in p21 downmodulation during ER stress. Oncogenesis 2017; 6:e341. [PMID: 28530706 PMCID: PMC5523074 DOI: 10.1038/oncsis.2017.41] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [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: 12/15/2016] [Revised: 03/22/2017] [Accepted: 04/17/2017] [Indexed: 12/25/2022] Open
Abstract
The double-edged role of p21 to command survival and apoptosis is emerging. The current investigation highlights ER stress-mediated JNK activation that plausibly triggers cell death by attenuating endogenous p21 level. Here, we demonstrated that ER stress activator 3-AWA diminishes the p21 levels in cancer cells by averting the senescent phenotype to commence G2/M arrest. In essence, the deceleration in p21 level occurs through ER stress/JNK/Caspase-3 axis via activation/induction of proapoptotic Par-4 and inhibition of AKT. The molecular dynamics studies identified important interactions, which may be responsible for the AKT inhibition and efficacy of 3-AWA towards AKT binding pocket. Interestingly, the p21 deceleration was rescued by incubating the cells with 3-AWA in the presence of an ER stress inhibitor, Salubrinal. Furthermore, we demonstrated that p21 expression decreases solitarily in Par-4+/+ MEFs; albeit, ER stress-induced JNK activation was observed in both Par-4+/+ and Par-4−/− MEFs. Par-4 knockdown or overexpression studies established that ectopic Par-4 along with ER stress are not sufficient to downregulate p21 in PC-3 cells but are adequate for DU-145 cells and that the ER stress inflicted activation of JNK, inhibition of AKT and Par-4 induction are all crucial to p21 downmodulation by 3-AWA. By using isogenic cell lines, such as HCT-116 p53+/+ and HCT-116 p53−/−, we found that deceleration in p21 expression due to ER stress is p53 independent. Moreover, in orthotopic carcinogen-induced rat colorectal carcinoma model, we found that 3-AWA inhibits colorectal tumor growth and formation of colorectal polyps at a tolerable dose, similar to the first-line drug for colorectal cancer-5-fluorouracil.
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Affiliation(s)
- R U Rasool
- Academy of Scientific and Innovative Research (AcSIR), CSIR-Indian Institute of Integrative Medicine, Jammu, India.,Cancer Pharmacology Division, CSIR-Indian Institute of Integrative Medicine, Jammu, India
| | - D Nayak
- Academy of Scientific and Innovative Research (AcSIR), CSIR-Indian Institute of Integrative Medicine, Jammu, India.,Cancer Pharmacology Division, CSIR-Indian Institute of Integrative Medicine, Jammu, India
| | - S Chakraborty
- Academy of Scientific and Innovative Research (AcSIR), CSIR-Indian Institute of Integrative Medicine, Jammu, India.,Cancer Pharmacology Division, CSIR-Indian Institute of Integrative Medicine, Jammu, India
| | - M M Faheem
- Cancer Pharmacology Division, CSIR-Indian Institute of Integrative Medicine, Jammu, India
| | - B Rah
- Department of Biochemistry and Molecular Biology, University of Nebraska Medical Center (UNMC), Omaha, NE, USA
| | - P Mahajan
- Discovery Informatics Division, CSIR-Indian Institute of Integrative Medicine, Jammu, India
| | - V Gopinath
- Cancer Biology Division, CSIR-Centre for Cellular and Molecular Biology, Hyderabad, India
| | - A Katoch
- Academy of Scientific and Innovative Research (AcSIR), CSIR-Indian Institute of Integrative Medicine, Jammu, India.,Cancer Pharmacology Division, CSIR-Indian Institute of Integrative Medicine, Jammu, India
| | - Z Iqra
- Cancer Pharmacology Division, CSIR-Indian Institute of Integrative Medicine, Jammu, India
| | - S K Yousuf
- Natural Product Chemistry Division, CSIR-Indian Institute of Integrative Medicine, Jammu, India
| | - D Mukherjee
- Natural Product Chemistry Division, CSIR-Indian Institute of Integrative Medicine, Jammu, India
| | - L D Kumar
- Cancer Biology Division, CSIR-Centre for Cellular and Molecular Biology, Hyderabad, India
| | - A Nargotra
- Discovery Informatics Division, CSIR-Indian Institute of Integrative Medicine, Jammu, India
| | - A Goswami
- Academy of Scientific and Innovative Research (AcSIR), CSIR-Indian Institute of Integrative Medicine, Jammu, India.,Cancer Pharmacology Division, CSIR-Indian Institute of Integrative Medicine, Jammu, India
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Shukla R, Singh M, Jain RK, Mahajan P, Kumar R. Functional Outcome of Bipolar Prosthesis versus Total Hip Replacement in the Treatment of Femoral Neck Fracture in Elderly Patients. Malays Orthop J 2017; 11:1-5. [PMID: 28435566 PMCID: PMC5393106 DOI: 10.5704/moj.1703.002] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Introduction The present study was performed to compare cemented total hip replacement (THR) with cemented bipolar prosthesis in the treatment of displaced fracture neck of femur in elderly patients. Materials and Methods This prospective study included 47 patients of greater than 60 years of age and having fracture of neck of femur, out of which 25 patients were managed by cemented bipolar prosthesis and remaining 22 were managed by cemented THR between June 2011 and June 2013. These patients were followed up post-operatively for two years, at 6, 12 and 24 months, for functional analysis using Modified Harris Hip Score. Results Modified Harris Hip Score was significantly higher in the THR group as compared to the bipolar prosthesis group at 6, 12 and 24 months post-operatively. Pain was almost similar in both the groups at all follow-up periods. Gait and range of motion was significantly higher in THR group as compared to bipolar prosthesis group at all-time point intervals. Conclusion Cemented THR is a better option as compared to cemented bipolar prosthesis based on our short term functional outcome for the management of fracture of neck of femur in elderly patients.
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Affiliation(s)
- R Shukla
- Department of Orthopaedics, Sri Aurobindo Institute Medical Science, Indore, India
| | - M Singh
- Department of Orthopaedics, Sri Aurobindo Institute Medical Science, Indore, India
| | - R K Jain
- Department of Orthopaedics, Sri Aurobindo Institute Medical Science, Indore, India
| | - P Mahajan
- Department of Orthopaedics, Sri Aurobindo Institute Medical Science, Indore, India
| | - R Kumar
- Department of Orthopaedics, Sri Aurobindo Institute Medical Science, Indore, India
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15
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Shishodia BS, Sanghi S, Mahajan P. Redesigning of Motorcycle Helmet for Improved Air Ventilation Using Numerical Simulations. Fluid Mechanics and Fluid Power – Contemporary Research 2017. [DOI: 10.1007/978-81-322-2743-4_60] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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16
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Mahajan P, Czabanowska K, Tripathy PR, Pakhare A, Pawar R, Salelkar S, Lucero-Prisno DE. European Public Health Leadership Competency Framework: What does it say about Indian public health professionals? Eur J Public Health 2016. [DOI: 10.1093/eurpub/ckw166.017] [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: 11/14/2022] Open
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17
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Mahajan P, Rux G, Caleb O, Linke M, Herppich W, Geyer M. Mathematical model for transpiration rate at 100% humidity for designing modified humidity packaging. ACTA ACUST UNITED AC 2016. [DOI: 10.17660/actahortic.2016.1141.33] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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18
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Tunik MG, Powell EC, Mahajan P, Schunk JE, Jacobs E, Miskin M, Zuspan SJ, Wootton-Gorges S, Atabaki SM, Hoyle JD, Holmes JF, Dayan PS, Kuppermann N, Gerardi M, Tunik M, Tsung J, Melville K, Lee L, Mahajan P, Dayan P, Nadel F, Powell E, Atabaki S, Brown K, Glass T, Hoyle J, Cooper A, Jacobs E, Monroe D, Borgialli D, Gorelick M, Bandyopadhyay S, Bachman M, Schamban N, Callahan J, Kuppermann N, Holmes J, Lichenstein R, Stanley R, Badawy M, Babcock-Cimpello L, Schunk J, Quayle K, Jaffe D, Lillis K, Kuppermann N, Alpern E, Chamberlain J, Dean J, Gerardi M, Goepp J, Gorelick M, Hoyle J, Jaffe D, Johns C, Levick N, Mahajan P, Maio R, Melville K, Miller S, Monroe D, Ruddy R, Stanley R, Treloar D, Tunik M, Walker A, Kavanaugh D, Park H, Dean M, Holubkov R, Knight S, Donaldson A, Chamberlain J, Brown M, Corneli H, Goepp J, Holubkov R, Mahajan P, Melville K, Stremski E, Tunik M, Gorelick M, Alpern E, Dean J, Foltin G, Joseph J, Miller S, Moler F, Stanley R, Teach S, Jaffe D, Brown K, Cooper A, Dean J, Johns C, Maio R, Mann N, Monroe D, Shaw K, Teitelbaum D, Treloar D, Stanley R, Alexander D, Brown J, Gerardi M, Gregor M, Holubkov R, Lillis K, Nordberg B, Ruddy R, Shults M, Walker A, Levick N, Brennan J, Brown J, Dean J, Hoyle J, Maio R, Ruddy R, Schalick W, Singh T, Wright J. Clinical Presentations and Outcomes of Children With Basilar Skull Fractures After Blunt Head Trauma. Ann Emerg Med 2016; 68:431-440.e1. [DOI: 10.1016/j.annemergmed.2016.04.058] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Revised: 04/18/2016] [Accepted: 04/27/2016] [Indexed: 12/17/2022]
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19
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Rao PB, Mangaraj M, Mahajan P, Tripathy S. Abstract PR400. Anesth Analg 2016. [DOI: 10.1213/01.ane.0000492789.60802.5b] [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]
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20
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Strand V, Chen C, Mahajan P, Kosinski M, Mangan E, van Hoogstraten H, Graham N, Lin Y, Keystone E, Braun J. AB0251 Early Onset of Benefit by Patient-Reported Outcomes (PROs) with Sarilumab Treatment in RA. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.4214] [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: 11/03/2022]
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21
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Chastek B, Curtis J, Becker L, Mahajan P, Chen C. FRI0550 Real-World Treatment Patterns among Rheumatoid Arthritis Patients Who Switch from A Tumor Necrosis Factor Inhibitor To Another Medication. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.1245] [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: 11/03/2022]
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Bonafede M, Curtis J, McMorrow D, Mahajan P, Chen C. AB0359 Treatment Effectiveness for Rheumatoid Arthritis after Switching from A Tumor Necrosis Factor Inhibitor to Another Agent:. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.1183] [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: 11/03/2022]
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Strand V, Mahajan P, Chen C, van Hoogstraten H, Mangan E, Hagino O, Graham N, Pinheiro GR, Kivitz A. AB0252 Benefit of Sarilumab with csDMARDs on Patient Productivity in Work, Household Work and Family, Social, Leisure Activities in TNF-IR RA Patients. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.4295] [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: 11/03/2022]
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Abstract
Introduction: An increased number of screen failure patients in a clinical trial increases time and cost required for the recruitment. Assessment of reasons for screen failure can help reduce screen failure rates and improve recruitment. Materials and Methods: We collected retrospective data of human epidermal growth factor receptor (HER2) positive Indian breast cancer patients, who failed screening for phase 3 clinical trials and ascertained their reasons for screen failure from screening logs. Statistical comparison was done to ascertain if there are any differences between private and public sites. Results: Of 727 patients screened at 14 sites, 408 (56.1%) failed screening. The data on the specific reasons for screen failures was not available at one of the public sites (38 screen failures out of 83 screened patients). Hence, after excluding that site, further analysis is based on 644 patients, of which 370 failed screening. Of these, 296 (80%) screen failure patients did not meet selection criteria. The majority -266 were HER2 negative. Among logistical issues, 39 patients had inadequate breast tissue sample. Sixteen patients withdrew their consent at private sites as compared to six at public sites. The difference between private and public sites for the above three reasons was statistically significant. Conclusion: Use of prescreening logs to reduce the number of patients not meeting selection criteria and protocol logistics, and patient counseling to reduce consent withdrawals could be used to reduce screen failure rate.
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Affiliation(s)
- P Mahajan
- Department of Clinical Operations, Clininvent Research Pvt. Ltd, Mumbai, India
| | - A Kulkarni
- Department of Medical and Regulatory Affairs, Clininvent Research Pvt. Ltd, Mumbai, India
| | - S Narayanswamy
- Department of Clinical Operations, Clininvent Research Pvt. Ltd, Mumbai, India
| | - J Dalal
- Department of Clinical Operations, Glaxosmithkline Pharmaceuticals Ltd, Mumbai, India
| | - V Halbe
- Department of Clinical Operations, Glaxosmithkline Pharmaceuticals Ltd, Mumbai, India
| | - S Patkar
- Department of Clinical Operations, Glaxosmithkline Pharmaceuticals Ltd, Mumbai, India
| | - A Bhatt
- President, Clininvent Research Pvt. Ltd, India
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Arya V, Mahajan P, Saraf A, Mohanty A, Sawhney JPS, Bhargava M. Association of CYP2C19, CYP3A5 and GPIIb/IIIa gene polymorphisms with Aspirin and Clopidogrel Resistance in a cohort of Indian patients with Coronary Artery Disease. Int J Lab Hematol 2015; 37:809-18. [PMID: 26264906 DOI: 10.1111/ijlh.12416] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2015] [Accepted: 07/13/2015] [Indexed: 12/27/2022]
Abstract
INTRODUCTION Dual antiplatelet therapy with clopidogrel and aspirin is the current standard of care in the management of patients with coronary artery disease (CAD) and acute coronary syndrome (ACS). The variability in response to these antiplatelet agents may be due to the underlying genetic diversity. This study was designed to determine the resistance to aspirin and clopidogrel in Indian patients and to look for correlation, if any, with selected polymorphisms. METHODS Platelet function testing by light transmission aggregometry was performed on 72 patients with CAD/ACS who were stable on dual antiplatelet therapy (clopidogrel 75 mg OD and aspirin 150 mg OD) along with 72 controls. Aspirin resistance was considered as mean platelet aggregation ≥ 70% with 10 μm ADP and ≥ 20% with 0.75 mm arachidonic acid. Clopidogrel resistance was defined as <10% decrease from the baseline in platelet aggregation in response to ADP 10 μm and semi-response as <30% decrease from the baseline. Polymorphisms CYP2C19*2, *3, CYP3A5*3 and PLA1/A2 were genotyped. RESULTS We found 51.4% patients with inadequate response to clopidogrel (1.4% resistant and 50% semi-responders) and 5.5% patients semi-responders to aspirin, none being completely resistant. The genotype and allele frequencies of CYP2C19*2 and PLA1/A2 gene polymorphisms were significantly different between clopidogrel semi-responders and responders. Carriers of CYP2C19*2 and CYP3A5*3 showed diminished inhibition of platelet aggregation. No significant correlation was found between coronary events, type of coronary intervention with clopidogrel nonresponsiveness. CONCLUSION Unlike aspirin, a high proportion of partial responders to clopidogrel were identified. In an interim analysis on 72 Indian patients, a significant association was found between CYP2C19*2 and PLA1/A2 in clopidogrel semi-responders.
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Affiliation(s)
- V Arya
- Department of Haematology, Sir Ganga Ram Hospital, New Delhi, India
| | - P Mahajan
- Department of Cardiology, Sir Ganga Ram Hospital, New Delhi, India
| | - A Saraf
- Department of Haematology, Sir Ganga Ram Hospital, New Delhi, India
| | - A Mohanty
- Department of Cardiology, Sir Ganga Ram Hospital, New Delhi, India
| | - J P S Sawhney
- Department of Cardiology, Sir Ganga Ram Hospital, New Delhi, India
| | - M Bhargava
- Department of Haematology, Sir Ganga Ram Hospital, New Delhi, India
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Ellison AM, Quayle KS, Bonsu B, Garcia M, Blumberg S, Rogers A, Wootton-Gorges SL, Kerrey BT, Cook LJ, Cooper A, Kuppermann N, Holmes JF, Kuppermann N, Alpern E, Borgialli D, Callahan J, Chamberlain J, Dayan P, Dean J, Gerardi M, Gorelick M, Hoyle J, Jacobs E, Jaffe D, Lichenstein R, Lillis K, Mahajan P, Maio R, Monroe D, Ruddy R, Stanley R, Tunik M, Walker A, Kavanaugh D, Park H. Use of Oral Contrast for Abdominal Computed Tomography in Children With Blunt Torso Trauma. Ann Emerg Med 2015; 66:107-114.e4. [DOI: 10.1016/j.annemergmed.2015.01.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2014] [Revised: 01/08/2015] [Accepted: 01/13/2015] [Indexed: 10/23/2022]
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Sharma R, Mahajan P, Mittal RK. X-Ray Tomography Based Observations on Interfacial Behavior of 3D Carbon/Carbon Composite. Proceedings of the Indian National Science Academy 2013. [DOI: 10.16943/ptinsa/2013/v79i4/48009] [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: 11/13/2022]
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Sharma P, Singh M, Mahajan P. Plasticity: A Journey from Uniaxial Stress to Uniaxial Strain. Proceedings of the Indian National Science Academy 2013. [DOI: 10.16943/ptinsa/2013/v79i4/47983] [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: 11/13/2022]
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Patel SD, Ahmad S, Mahajan P. Probabilistic Failure Analysis of Composite Plate Due to Low Velocity Impact. Proceedings of the Indian National Science Academy 2013. [DOI: 10.16943/ptinsa/2013/v79i4/48015] [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: 11/13/2022]
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Mahajan A, Bharadwaj A, Mahajan P. Comparison of periosteal pedicle graft and subepithelial connective tissue graft for the treatment of gingival recession defects. Aust Dent J 2012; 57:51-7. [PMID: 22369558 DOI: 10.1111/j.1834-7819.2011.01648.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND The use of periosteum as a pedicle graft in the treatment of gingival recession defects is a recent advancement. The subepithelial connective tissue graft (SCTG) is considered the gold standard for the treatment of gingival recession defects. The present randomized controlled trial was done to compare periosteal pedicle graft (PPG) with SCTG for the treatment of gingival recession defects. METHODS 10 males and 10 females between the ages of 16 and 40 years (mean age 25.2 years) with Miller's Class I and II recessions ≥3 mm participated in this one-year clinical study. They were assigned randomly to test group (PPG) and control group (SCTG). Results were evaluated based on parameters measuring patient satisfaction and clinical outcomes associated with two treatment procedures. Significance was set at p < 0.05. RESULTS At the end of the study, the defect coverage was 3.1 ± 0.13 mm or 92.6% in the test group compared to the control group in which the defect coverage was 2.70 ± 0.11 mm or 88.5%. The difference between the two groups was statistically significant (p < 0.0001). The average residual defect was comparable between the two groups, i.e. 0.3 ± 0.67 and 0.5 ± 0.84 in the PPG and SCTG group respectively. The test group was rated higher in terms of overall patient satisfaction (p < 0.02) and comfort during and after the procedure (p < 0.001). CONCLUSIONS PPG and SCTG have comparable clinical effectiveness, but PPG is superior to SCTG in terms of patient-centred outcomes, reflecting improved patient comfort and overall patient satisfaction.
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Affiliation(s)
- A Mahajan
- Department of Periodontics, Himachal Pradesh Government Dental College and Hospital, Shimla, India.
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Kalia NP, Mahajan P, Mehra R, Nargotra A, Sharma JP, Koul S, Khan IA. Capsaicin, a novel inhibitor of the NorA efflux pump, reduces the intracellular invasion of Staphylococcus aureus. J Antimicrob Chemother 2012; 67:2401-8. [DOI: 10.1093/jac/dks232] [Citation(s) in RCA: 127] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Srikanth S, Thirunaaukarasu, Behera B, Mahajan P. Modular teaching: an alternative to routine teaching method for undergraduate medical students. Indian J Community Med 2011; 36:237-8. [PMID: 22090682 PMCID: PMC3214453 DOI: 10.4103/0970-0218.86529] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2010] [Accepted: 08/31/2011] [Indexed: 11/16/2022] Open
Affiliation(s)
- S Srikanth
- Department of Community Medicine, Sri Venkateshwaraa Medical College Hospital and Research Centre, Ariyur, Puducherry, India E-mail: srikanthlatha2003@ yahoo.co.in
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Natale J, Joseph J, Rogers A, Mahajan P, Wisner D, Miskin M, Hoyle J, Atabaki S, Dayan P, Holmes J, Kuppermann N. 14 Cranial CT Use for Minor Head Trauma in Children Is Associated With Race/Ethnicity. Ann Emerg Med 2011. [DOI: 10.1016/j.annemergmed.2011.06.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Purty AJ, Mahajan P, Singh Z, Meenakshi A, Murugan N, Cherian J, Senthilvel A, Gurumurthy D. P2-537 Tracking progress towards elimination of iodine deficiency disorders in Puducherry (India), a school based study. Br J Soc Med 2011. [DOI: 10.1136/jech.2011.142976m.64] [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]
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Bhattacharya SK, Rathi N, Mahajan P, Tripathi AK, Paudel KR, Rauniar GP, Das BP. Effect of Ocimum sanctum, ascorbic acid, and verapamil on macrophage function and oxidative stress in mice exposed to cocaine. Indian J Pharmacol 2011; 41:134-9. [PMID: 20442822 PMCID: PMC2861815 DOI: 10.4103/0253-7613.55210] [Citation(s) in RCA: 3] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2007] [Revised: 04/19/2008] [Accepted: 06/06/2009] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To investigate the effect of Ocimum sanctum, ascorbic acid, and verapamil on macrophage function and oxidative stress in experimental animals exposed to cocaine. MATERIALS AND METHODS Mice were used in this study and were divided randomly into different groups of six animals each. They were either treated with intraperitoneal injection of saline or cocaine hydrochloride or an oral feeding of oil of Ocimum sanctum, ascorbic acid or verapamil, or both (ascorbic acid and verapamil), and were evaluated for a respiratory burst of macrophages, superoxide and nitric oxide (NO) production, estimation of TNF-alpha in the serum and supernatant of cultured macrophages, estimation of lipid peroxidation (malondialdehyde- MDA) in the serum, and superoxide dismutase activity in the erythrocytes. RESULTS Unstimulated respiratory burst as well as superoxide production was enhanced on treatment with cocaine and all the three drugs were found to attenuate this enhancement. The bactericidal capacity of macrophages decreased significantly on chronic cocaine exposure, as it was associated with decreased respiratory burst and superoxide production. There was a significant decrease in NO production by macrophages on chronic cocaine exposure and all the test drugs were found to restore nitrite formation to a normal level. There was an increase in the malonylodialdehyde (MDA) level and decrease in the superoxide dismutase level on chronic cocaine exposure, and all the three drugs effectively decreased the MDA level and increased superoxide dismutase level. There was an increase in serum TNF-alpha on chronic cocaine exposure, which was decreased significantly by ascorbic acid and verapamil. CONCLUSION O. sanctum, ascorbic acid, and verapamil were equally effective in improving the macrophage function and reducing oxidative stress. These findings suggested that O. sanctum, ascorbic acid, and verapamil attenuated acute and chronic cocaine-mediated effects.
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Affiliation(s)
- S K Bhattacharya
- Department of Pharmacology, B. P. Koirala Institute of Health Sciences, Dharan, Nepal, India
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Gupta SK, Singh Z, Purty AJ, Kar M, Vedapriya D, Mahajan P, Cherian J. Diabetes prevalence and its risk factors in rural area of Tamil Nadu. Indian J Community Med 2011; 35:396-9. [PMID: 21031104 PMCID: PMC2963877 DOI: 10.4103/0970-0218.69262] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2009] [Accepted: 03/25/2010] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To estimate the usefulness of the Indian diabetes risk score for detecting undiagnosed diabetes in the rural area of Tamil Nadu. MATERIALS AND METHODS The present study was conducted in the field practice area of rural health centers (Chunampett and Annechikuppam, Tamil Nadu), covering a population of 35000 from February to March 2008 by using a predesigned and pretested protocol to find out the prevalence and the risk of diabetes mellitus in general population by using Indian diabetes risk score. RESULTS 1936 respondents comprising 1167 (60.27%) females and 769 (39.73%) males were studied. Majority 1203 (62.50%) were Hindus. 1220 (63.%) had studied up to higher secondary. 1200 (62%) belonged to lower and lower-middle socio-economic class. A large number of the subjects 948 (50%) were below 35 years of age. Most of the respondents 1411 (73%) indulged in mild to moderate physical activity. 1715 (87.91%) had no family history of diabetes mellitus. 750 (39.64%) individuals were in the overweight category (>25 BMI). Out of these overweight persons, 64% had high diabetic risk score. It is observed that chances of high diabetic score increase with the increase in BMI. Prevalence of diabetes in studied population was 5.99%; out of these, 56% known cases of diabetes mellitus had high (>60) IDRS. Co-relation between BMI and IDRS shows that, if BMI increases from less than 18.50 to more than 30, chances of high risk for developing diabetes mellitus also significantly increase. CONCLUSIONS This study estimates the usefulness of simplified Indian diabetes risk score for identifying undiagnosed high risk diabetic subjects in India. This simplified diabetes risk score has categorized the risk factors based on their severity. Use of the IDRS can make mass screening for undiagnosed diabetes in India more cost effective.
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Affiliation(s)
- Sanjay Kumar Gupta
- Department of Community Medicine, Pondicherry Institute of Medical Sciences, Kalapet, Pondicherry - 605 014, India
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Ford CA, Mahajan P, Tabrizchi R. Characterization of β-adrenoceptor-mediated relaxation signals in isolated pulmonary artery of Dahl salt-sensitive hypertensive and normotensive rats. ACTA ACUST UNITED AC 2010; 31:1-12. [DOI: 10.1111/j.1474-8673.2010.00460.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Campbell J, Seitz J, Mahajan P, Wong O, Manczuk J, Given K, Fink-Bennett D, Nagle C. SU-GG-I-76: Reduction of CT Field on SPECT-CT Scans: Impact on Patient Dose and Diagnostic Information. Med Phys 2010. [DOI: 10.1118/1.3468109] [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: 11/07/2022] Open
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Abstract
We report the clinicopathological features, treatment and outcome of 54 Indian children (14 boys) with biopsy-proven lupus nephritis followed over a 10-year period. The mean age (SD) at onset of disease was 9.6 ± 2.6 (range 2.5–14.4) years. Twenty-six (48.1%) patients had class IV nephritis, 7 (13.0%) had class V, whereas class I, II and III nephritis were present in 3 (5.6%), 10 (18.5%) and 6 (11.1%) patients, respectively. Hypertension, haematuria and nephrotic range proteinuria were present in 30 (55.6%), 31 (57.4%) and 28 (51.8%) patients, respectively. Compared with all the other classes combined, there were more boys among patients with class IV nephritis, and hypertension, haematuria, nephrotic syndrome and decreased glomerular filtration rate at presentation were more common. The mean duration of follow-up was 3.1 ± 2.9 years (median 2.5, range 0.2–10.3 years). Of the 39 patients who were followed-up for at least 1 year, 33 (84.6%) were in complete or partial remission, whereas six (15.4%) had no response to therapy. The incidence of serious infection was 1.5 episodes per 10 patient-years. Nine patients died, of whom four had serious infections or septicaemia, and three developed end-stage renal failure (ESRF). The patient survival rate at 3 years and at last follow-up visit was 88% and 83.3%, respectively, whereas the renal survival rates (without ESRF) were 92% and 94.4% respectively. Cox regression analysis showed no relation of gender, age of onset, presence of hypertension, haematuria and proteinuria, estimated glomerular filtration rate, renal histology and response to therapy to the outcome of death or ESRF. We found lower patient survival rate as compared with data from the developed countries but similar to that seen in developing countries. Serious infections were an important cause of mortality besides renal failure.
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Affiliation(s)
- P Hari
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - A Bagga
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - P Mahajan
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - A Dinda
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
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Bapat S, Kashyapi B, Padhye A, Yadav P, Mahajan P, Bhave A, Sovani Y, Kshirsagar Y. MP-1.13: Sub-epididymal Orchidectomy for Metastatic Carcinoma Prostate: A Point of Technique. Urology 2008. [DOI: 10.1016/j.urology.2008.08.213] [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]
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Bhattacharya SK, Madan M, Mahajan P, Paudel KR, Rauniar GP, Das BP, Roy RK. Relationship between plasma leptin and plasma insulin levels in type-2 diabetic patients before and after treatment with glibenclamide and glimepiride. Indian J Physiol Pharmacol 2008; 52:43-52. [PMID: 18831351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Type 2 diabetes affects 100 million people throughout the world. Among the various factors implicated in the causation of this disease, the role of leptin, an obesity gene product, is increasingly being investigated. This especially assumes importance in the light of knowledge that obesity confers a minimum of 3-10 fold higher risk of diabetes. This study was planned to investigate the relationship between leptin and insulin levels in type 2 diabetic patients before and after treatment with glibenclamide or glimepiride. 60 type 2 diabetic patients were recruited for the study and were divided into 2 groups-one receiving glimepiride and the other group receiving glibenclamide for duration of 10 weeks. This study demonstrated a highly positive correlation of plasma leptin levels with BMI, plasma insulin and insulin resistance. No gender specific differences were observed in leptin concentrations. The study, however, failed to demonstrate any possible relationship between glycemic control as assessed by blood sugars/ glycosylated hemoglobin (HbAlc) and plasma leptin. The administration of glibenclamide or glimepiride significantly lowered blood glucose levels coupled with a decrease in (HbAlc). Both the drugs increased insulin concentrations. Glibenclamide increased leptin levels but they remained unaltered with glimepiride. Glibenclamide and glimepiride were found to be equally effective in their glucose lowering action. However, the patients receiving glibenclamide experienced higher episode of hypoglycaemic spells than those receiving glimepiride.
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Affiliation(s)
- S K Bhattacharya
- Department of Pharmacology, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
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Bapat S, Yadav P, Padhye A, Mahajan P, Bhave A. MP-21.14: Dorsal onlay urethroplasty: our experience in 73 patients. Urology 2007. [DOI: 10.1016/j.urology.2007.06.132] [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: 10/22/2022]
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Bapat S, Padhye A, Yadav P, Bhave A, Mahajan P, Purnapatre S, Pai K. POS-03.30: Is pre-op stenting routinely required prior to retrograde intrarenal surgery (RIRS)? Urology 2007. [DOI: 10.1016/j.urology.2007.06.1019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Sethuraman U, Kannikeswaran N, Mahajan P, Saidinejad M, Duffy E, Compton S, Yu S, Knazik S. Effect of Rapid Assessment Times on Length of Stay in a Pediatric Emergency Department. Acad Emerg Med 2007. [DOI: 10.1197/j.aem.2007.03.969] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Sharma KK, Mediratta PK, Reeta KH, Mahajan P. Effect of ?-arginine on restraint stress induced modulation of immune responses in rats and mice. Pharmacol Res 2004; 49:455-60. [PMID: 14998555 DOI: 10.1016/j.phrs.2003.11.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/17/2003] [Indexed: 11/24/2022]
Abstract
The present study investigates the role of nitric oxide (NO) on restraint stress (RS)-induced modulation of humoral and cell-mediated immune responses in rats and mice. RS produced suppression of humoral immune response, i.e., anti-SRBC antibody titre ( 7.38 +/- 0.32 versus 4.13 +/- 0.30; mean +/- S.E.M., P < 0.001). In case of cell-mediated immunity, in delayed type hypersensitivity (DTH) response the change in paw volume decreased from 0.069 +/- 0.003 mm (mean +/- S.E.M.) in control non-stressed group to 0.038 +/- 0.002 mm in the stressed group (P < 0.001) while percentage leucocyte migration inhibition (% LMI) decreased from 39.7 +/- 1.95 in control non-stressed animals to 15.2 +/- 1.07 in animals subjected to stress (P < 0.01). Pretreating the animals with an NO precursor, L-arginine (1000 mg kg-1, i.p.) antagonized the effect of RS on humoral (anti-SRBC antibody titre 6.50 +/- 0.27 versus 4.13 +/- 0.30, P < 0.001 ) and cell-mediated (DTH response 0.066 +/- 0.002 mm versus 0.038 +/- 0.002 mm, P < 0.001; % LMI 41.5 +/- 1.46 versus 15.2 +/- 1.07, P < 0.01) immune responses. Administration of 7-nitroindazole (7-NI, 50 mg kg-1, i.p.), an inhibitor of neuronal NO synthase, alone further enhanced the immunosuppressive effect of RS (anti-SRBC antibody titre 2.75 +/- 0.25 versus 4.13 +/- 0.30, P < 0.001; DTH response 0.019 +/- 0.002 mm versus 0.038 +/- 0.002 mm, P < 0.001; % LMI 5.0 +/- 1.08 versus 15.2 +/- 1.07, P < 0.01). However, when given before L-arginine treatment, 7-NI reversed the effect of the latter drug on stress-induced immunomodulation (anti-SRBC antibody titre 3.00 +/- 0.27 versus 6.5 +/- 0.27, P < 0.001; DTH response 0.043 +/- 0.003 mm versus 0.066 +/- 0.002 mm, P < 0.001; % LMI 12.0 +/- 0.93 versus 41.5 +/- 1.46, P < 0.01). Unlike its effect on RS-induced immune responsiveness, L-arginine (250, 500, 1000 mg kg-1) when given for 5-7 days to naive non-stressed animals produced dose dependent suppression of both humoral (anti-SRBC antibody titre 6.4 +/- 0.32 versus 5.4 +/- 0.32, 4.0 +/- 0.27, 3.1 +/- 0.30, respectively) and cell-mediated (DTH 0.065 +/- 0.003 mm versus 0.064 +/- 0.004 mm, 0.039 +/- 0.003 mm, 0.020 +/- 0.002 mm, respectively and % LMI 37.52 +/- 1.58 versus 30.48 +/- 1.07, 28.18 +/- 1.22, 19.76 +/- 0.83, respectively) immune responses. 7-NI significantly blocked these immunosuppressive effects of L-arginine (anti-SRBC antibody titre 6.0 +/- 0.38 versus 3.1 +/- 0.030, P < 0.01; DTH response 0.056 +/- 0.004 mm versus 0.020 +/- 0.002 mm, P < 0.001; % LMI 34.76 +/- 1.31 versus 19.76 +/- 0.83, P < 0.01). However, 7-NI when given to non-stressed animals failed to modulate immune responsiveness. Thus, NO appears to play an important role in RS-induced immunomodulation and these effects are different from its effect on immune responsiveness in non-stressed animals.
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MESH Headings
- Animals
- Antibody Formation/drug effects
- Antibody Formation/immunology
- Arginine/administration & dosage
- Arginine/metabolism
- Arginine/pharmacokinetics
- Cell Migration Inhibition
- Dose-Response Relationship, Immunologic
- Drug Administration Schedule
- Erythrocytes/immunology
- Hypersensitivity, Delayed/diagnosis
- Hypersensitivity, Delayed/immunology
- Immunity, Cellular/drug effects
- Immunity, Cellular/immunology
- Indazoles/administration & dosage
- Indazoles/pharmacokinetics
- Injections, Intraperitoneal
- Male
- Mice
- Nerve Tissue Proteins/antagonists & inhibitors
- Nerve Tissue Proteins/pharmacokinetics
- Nitric Oxide Synthase/antagonists & inhibitors
- Nitric Oxide Synthase/pharmacokinetics
- Nitric Oxide Synthase Type I
- Rats
- Rats, Wistar
- Restraint, Physical/methods
- Sheep/blood
- Sheep/immunology
- Stress, Physiological/immunology
- Stress, Physiological/metabolism
- Stress, Physiological/physiopathology
- Time Factors
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Affiliation(s)
- K K Sharma
- Department of Pharmacology, University College of Medical Sciences and GTB Hospital, New Delhi 110095, India.
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47
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McDonald CP, Roy A, Mahajan P, Smith R, Charlett A, Barbara JAJ. ORIGINAL PAPER. Relative values of the interventions of diversion and improved donor-arm disinfection to reduce the bacterial risk from blood transfusion. Vox Sang 2004; 86:178-82. [PMID: 15078252 DOI: 10.1111/j.0042-9007.2004.00404.x] [Citation(s) in RCA: 90] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND AND OBJECTIVES The aim of this study was to demonstrate the efficiency of diverting the initial 20-ml donation from the collection bag and of an improved donor-arm disinfection procedure in reducing bacterial contamination in blood. MATERIALS AND METHODS Donations were collected in bags specially manufactured for the study. These bags incorporated two satellite pouches into each of which 20 ml of blood was collected. Blood initially flowed into sample pouch P1, representing a diversion pouch. Pouch P2 was then filled with 20 ml of blood, which allowed us to sample the collection bag after diversion was complete. Blood then flowed into the standard collection bag. The contents of the pouches were aerobically and anaerobically cultured on the BacT/ALERT automated culture system for 7 days. Two procedures were investigated in the study (each involving 1409 blood donations): one analysed the current disinfection procedure; and the other analysed an improved donor-arm disinfection procedure. RESULTS The use of diversion alone resulted in a 47% reduction in contamination, and improved donor-arm disinfection alone resulted in a 57% reduction in contamination. Diversion plus improved donor-arm disinfection produced a predicted 77% reduction in contamination. CONCLUSIONS The study validates diversion and an improved donor-arm disinfection procedure. In combination, these two interventions produced a substantial reduction in contamination. These procedures are to be introduced by the English National Blood Service to enhance the safety of the blood supply.
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Affiliation(s)
- C P McDonald
- National Blood Service, North London, Colindale, London, UK.
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Ray M, Mediratta PK, Mahajan P, Sharma KK. Evaluation of the role of melatonin in formalin-induced pain response in mice. Indian J Med Sci 2004; 58:122-30. [PMID: 15051907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
BACKGROUND Melatonin, the major secretory product of pineal gland has been suggested to play a regulatory role in the circadian rhythm of body activities including the pain sensitivity. Three subtypes of melatonin receptors, i.e. ML1, ML2 and ML3 have been identified. AIM To investigate the antinociceptive activity of melatonin and to unravel the underlying receptor mechanisms involved in this action. MATERIAL AND METHODS Effect of melatonin (25-100 mg/kg, ip) and its interaction with putative melatonin receptor antagonists and opioidergic and serotoninergic agents have been studied in formalin test, a model of tonic continuous pain. Formalin (0.1 ml of 1% solution) was injected under the plantar surface of right hind paw of mice and the time an animal spent in licking the injected paw was measured. STATISTICAL ANALYSIS The data were analysed by one-way ANOVA followed by Tukey's test for multiple comparisons. RESULTS Injection of formalin produced two phases of intense licking, an early phase (0-5 min) and a late phase (20-25 min). Melatonin dose-dependently decreased the licking response in both the phases, effect being more marked in the late phase. Luzindole, a ML1 receptor antagonist did not block but rather enhanced the antinociceptive activity of melatonin. However, prazosin, a ML2 receptor antagonist in the low dose (0.5 mg/kg) significantly attenuated but in higher dose (1 mg/kg) enhanced the analgesic effect of melatonin. Naloxone, an opioid receptor antagonist did not reverse but morphine, an opioid agonist enhanced the antinociceptive activity of melatonin. Both mianserin and ondansetron the 5HT2 and 5HT3 receptor antagonists, respectively increased the analgesic effect of melatonin. CONCLUSION The present results suggest the involvement of ML2 receptors in mediating the antinociceptive activity of melatonin in formalin-induced pain response. Further an interplay between melatonin, alpha-1 adrenergic and 5HT2 and 5HT3 serotoninergic receptors may also be participating in this action.
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Affiliation(s)
- M Ray
- Department of Pharmacology, University College of Medical Sciences, Delhi--110 095, India
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Ray M, Mediratta PK, Reeta K, Mahajan P, Sharma KK. Receptor mechanisms involved in the anticonvulsant effect of melatonin in maximal electroshock seizures. ACTA ACUST UNITED AC 2004; 26:177-81. [PMID: 15148522 DOI: 10.1358/mf.2004.26.3.809723] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The present study investigates the mechanisms involved in the anticonvulsant effect of melatonin in maximum electroshock (MES) seizures. Melatonin (25-100 mg/kg) dose-dependently decreased the duration of tonic hindlimb extension (THLE). The anticonvulsant effect of melatonin was blocked by bicuculline, a GABA(A) receptor antagonist, and luzindole, an ML(1) receptor antagonist, while prazosin, an ML(2) receptor antagonist, enhanced the anticonvulsant actions of melatonin in this seizure model. Administration of serotonergic agents, mianserin and ondansetron, along with melatonin, increased the antiseizurogenic activity of melatonin, while buspirone had no effect. Pretreating the animals with diazepam, carbamazepine or lamotrigine enhanced the anticonvulsant effect of melatonin. Melatonin thus appears to be an effective anticonvulsant, and melatonin ML(1) receptors, GABAergic and serotonergic mechanisms may play an important role in mediating the anticonvulsant activity of melatonin in electroshock seizures.
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Affiliation(s)
- M Ray
- Department of Pharmacology, University College of Medical Sciences and GTB Hospital, Delhi, India
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Reeta K, Mediratta PK, Mahajan P, Sharma KK. Differential effect of cyclooxygenase-2 preferring [correction of prefering] inhibitors on electrically- and chemically-induced seizures in mice. Indian J Physiol Pharmacol 2003; 47:471-5. [PMID: 15266962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
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