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Singh PP, Behera MD, Rai R, Shankar U, Upadhaya K, Nonghuloo IM, Mir AH, Barua S, Naseem M, Srivastava PK, Tiwary R, Gupta A, Gupta V, Nand S, Adhikari D, Barik SK. Morpho-physiological and demographic responses of three threatened Ilex species to changing climate aligned with species distribution models in future climate scenarios. Environ Monit Assess 2022; 195:139. [PMID: 36416991 DOI: 10.1007/s10661-022-10594-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Accepted: 10/07/2022] [Indexed: 06/16/2023]
Abstract
The success of a species in future climate change scenarios depends on its morphological, physiological, and demographic adaptive responses to changing climate. The existence of threatened species against climate adversaries is constrained due to their small population size, narrow genetic base, and narrow niche breadth. We examined if ecological niche model (ENM)-based distribution predictions of species align with their morpho-physiological and demographic responses to future climate change scenarios. We studied three threatened Ilex species, viz., Ilex khasiana Purkay., I. venulosa Hook. f., and I. embelioides Hook. F, with restricted distribution in Indo-Burma biodiversity hotspot. Demographic analysis of the natural populations of each species in Meghalaya, India revealed an upright pyramid suggesting a stable population under the present climate scenario. I. khasiana was confined to higher elevations only while I. venulosa and I. embelioides had wider altitudinal distribution ranges. The bio-climatic niche of I. khasiana was narrow, while the other two species had relatively broader niches. The ENM-predicted potential distribution areas under the current (2022) and future (2050) climatic scenarios (General Circulation Models (GCMs): IPSL-CM5A-LR and NIMR-HADGEM2-AO) revealed that the distribution of highly suitable areas for the most climate-sensitive I. khasiana got drastically reduced. In I. venulosa and I. embelioides, there was an increase in highly suitable areas under the future scenarios. The eco-physiological studies showed marked variation among the species, sites, and treatments (p < 0.05), indicating the differential responses of the three species to varied climate scenarios, but followed a similar trend in species performance aligning with the model predictions.
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Affiliation(s)
- Prem Prakash Singh
- Department of Botany, North-Eastern Hill University, Shillong, 793022, India
| | - Mukunda Dev Behera
- Indian Institute of Technology Kharagpur, Kharagpur, West Bengal, 721302, India
| | - Richa Rai
- CSIR-National Botanical Research Institute, Lucknow, 226001, India
| | - Uma Shankar
- Department of Botany, North-Eastern Hill University, Shillong, 793022, India
| | - Krishna Upadhaya
- Department of Basic Sciences and Social Sciences, North-Eastern Hill University, Shillong, 793022, India
| | | | - Aabid Hussain Mir
- Centre of Research for Development, University of Kashmir, Hazratbal Srinagar, Srinagar, 190006, India
| | - Sushmita Barua
- Department of Botany, North-Eastern Hill University, Shillong, 793022, India
| | - Mariya Naseem
- CSIR-National Botanical Research Institute, Lucknow, 226001, India
| | | | - Raghuvar Tiwary
- CSIR-National Botanical Research Institute, Lucknow, 226001, India
| | - Anita Gupta
- CSIR-National Botanical Research Institute, Lucknow, 226001, India
| | - Vartika Gupta
- CSIR-National Botanical Research Institute, Lucknow, 226001, India
| | - Sampurna Nand
- CSIR-National Botanical Research Institute, Lucknow, 226001, India
| | | | - Saroj Kanta Barik
- Department of Botany, North-Eastern Hill University, Shillong, 793022, India.
- CSIR-National Botanical Research Institute, Lucknow, 226001, India.
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Lasushe KU, Mir AH, Singh PP, Chaudhary KL, Choudhury H, Deori C, Roy DK, Singh B, Upadhaya K. A comprehensive checklist of threatened plants of Meghalaya, Northeast India. Journal of Asia-Pacific Biodiversity 2022. [DOI: 10.1016/j.japb.2022.03.008] [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: 11/28/2022] Open
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Srivastava S, Mahor A, Singh G, Bansal K, Singh PP, Gupta R, Dutt R, Alanazi AM, Khan AA, Kesharwani P. Formulation Development, In Vitro and In Vivo Evaluation of Topical Hydrogel Formulation of Econazole Nitrate-Loaded β-Cyclodextrin Nanosponges. J Pharm Sci 2021; 110:3702-3714. [PMID: 34293406 DOI: 10.1016/j.xphs.2021.07.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 07/14/2021] [Accepted: 07/15/2021] [Indexed: 12/17/2022]
Abstract
Econazole nitrate, an antifungal drug used in the handling of skin ailments, is commercially not efficient as these ailments typically require a more elevated concentration of the drug to offer an effective pharmacological retort. Like so, it is proposed to assess the effectiveness of the topical hydrogel of econazole-loaded nanosponge in the management of skin ailment(s). Econazole nitrate-laden β-cyclodextrin nanosponges were developed by employing the melt method using β-cyclodextrin as the organic polymer and N,N-carbonyldiimidazole as the crosslinker. The critical factors disturbing the quality of the formulation were uniquely identified by the Ishikawa diagram, and they were optimized by the statistical experiment design concept. β-cyclodextrin loaded nanosponges were uniquely designed using the Placket-Burman approach and optimized utilizing the Box-Behnken method. The optimized nanosponges (EN-CDN) were 421.37 ± 6.19 nm in size with an entrapment efficiency of 70.13% ± 5.73%. The topical hydrogel of nanosponges (EN-TG) was prepared using carbopol 934 and pyrrolidone as permeation enhancers. In vitro skin permeation studies affirmed the improved transport crosswise the goatskin for topical hydrogel in comparison to the marketed product. EN-TG was able to control the fungal infection in the selected animal model in comparison to the marketed preparation. Stability studies reported favorably that nanogel remained stable under normal and accelerated settings.
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Affiliation(s)
| | - Alok Mahor
- Institute of Pharmacy, Bundelkhand University, Jhansi, India 284128.
| | - Gyanendra Singh
- Department of Pharmaceutical Engineering & Technology, Indian Institute of Technology, Banaras Hindu University, (IIT-BHU), Varanasi, India 221005
| | - Kuldeep Bansal
- Pharmaceutical Science Laboratory, Faculty of Science and Engineering, Abo Akademi University, Turku, Finland 20520
| | | | - Rishikesh Gupta
- Institute of Pharmacy, Bundelkhand University, Jhansi, India 284128
| | - Rohit Dutt
- School of Medical and Allied Sciences, G.D. Goenka University, Gurgaon Sohna Road, Gurgaon, India 122103
| | - Amer M Alanazi
- Pharmaceutical Chemistry Department, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia
| | - Azmat Ali Khan
- Pharmaceutical Chemistry Department, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia
| | - Prashant Kesharwani
- Department of Pharmaceutics, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi, 110062, India.
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Sinha S, Gupta G, Biswas S, Gupta K, Singh PP, Jain R, Sharma SK, Das B. Coronin-1 levels in patients with tuberculosis. Indian J Med Res 2021; 154:866-870. [PMID: 35662092 PMCID: PMC9347245 DOI: 10.4103/ijmr.ijmr_4343_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Background & objectives: Despite advances in diagnostics and therapeutics, tuberculosis (TB) is widely prevalent and contributes to a significant burden of illness in both developing and developed nations. The present study was aimed to assess the role of coronin in TB patients and healthy controls. Coronin is a leucocyte-specific protein that is actively recruited in mycobacterial phagolysosomes, where it inhibits lysosomal delivery of Mycobacterium by activating a calcium-dependent phosphatase-calcineurin. Methods: In the study, 100 newly diagnosed cases of TB (pulmonary and extra-pulmonary) and healthy controls were prospectively enrolled over one year and the levels of coronin-1a in these patients and controls were measured by quantitative PCR (qPCR). Results: A total of 100 TB patients and 100 healthy individuals as controls were assessed. There were 59 patients with extra-pulmonary TB (EPTB) and 41 of pulmonary TB (PTB). In 47 per cent of patients, corroborative histopathological evidence of TB was also available. Significantly higher values of coronin-1a were observed in TB patients (19.94±2.61) than in healthy controls (16.09±1.91) (P<0.001). Interpretation & conclusions: Coronin 1a appears to play an important role in the TB disease pathophysiology and agents developed against coronin may have a role in the treatment of TB. Further studies are required to assess if coronin-1a levels are elevated in non-tubercular infective a etiologies and whether these can be a potential drug target in patients with TB.
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Singh PP, Goyal M. Our Experience with Intraoral Submandibular Gland Excision. Indian J Otolaryngol Head Neck Surg 2020; 72:297-301. [PMID: 32728538 DOI: 10.1007/s12070-019-01784-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Accepted: 12/26/2019] [Indexed: 11/29/2022] Open
Abstract
The aim of this paper is to present our experience with intraoral approach for submandibular gland excision in terms of effectiveness and safety in patients with chronic sialadenitis. This is a prospective study carried out from November, 2016 to April, 2018 analyzing 13 patients of chronic sialadenitis. The indication of intraoral approach was either failed attempt to remove the stone endoscopically, chronic sialadenitis or benign tumor. The surgical triangle was used as the landmark for hilar area and gland was dissected close to the capsule and removed via intraoral incision and preserving the sublingual gland. We were successfully able to remove the submandibular gland via intraoral approach in 10 cases. Two patients had to undergo transcervical gland excision and one patient refused for transcervical approach. Intraoral excision of submandibular gland is a safe and viable approach to be utilized in carefully selected patients. The major advantages being avoidance of transcervical scar and of injury to marginal mandibular branch of facial nerve.
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Affiliation(s)
- P P Singh
- Department of Otorhinolaryngology and Head and Neck Surgery, Guru Teg Bahadur Hospital, University College of Medical Sciences, New Delhi, Delhi 110095 India
| | - M Goyal
- Department of Otorhinolaryngology and Head and Neck Surgery, Guru Teg Bahadur Hospital, University College of Medical Sciences, New Delhi, Delhi 110095 India.,B-160, Nirman Vihar, New Delhi, Delhi 110092 India
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Rapalli VK, Gorantla S, Waghule T, Mahmood A, Singh PP, Dubey SK, Saha RN, Singhvi G. Nanotherapies for the Treatment of Age-Related Macular Degeneration (AMD) Disease: Recent Advancements and Challenges. ACTA ACUST UNITED AC 2020; 13:283-290. [DOI: 10.2174/1872211314666200117095917] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 11/14/2019] [Accepted: 12/11/2019] [Indexed: 12/17/2022]
Abstract
Age-related Macular Degeneration (AMD) is one of the common diseases affecting the posterior
part of the eye, of a large population above 45 years old. Anti-Vascular Endothelial Growth Factor-
A (Anti-VEGF-A) agents have been considered and approved as therapeutic agents for the treatment
of AMD. Due to the large molecular weight and poor permeability through various eye membranes,
VEGF-A inhibitors are given through an intravitreal injection, even though the delivery of small therapeutic
molecules by topical application to the posterior part of the eye exhibits challenges in the treatment.
To overcome these limitations, nanocarrier based delivery systems have been utilized to a large
extent for the delivery of therapeutics. Nanocarriers system offers prodigious benefits for the delivery of
therapeutics to the posterior part of the eye in both invasive and non-invasive techniques. The nano size
can improve the permeation of therapeutic agent across the biological membranes. They provide protection
from enzymes present at the site, targeted delivery or binding with the disease site and extend the
release of therapeutic agents with prolonged retention. This leads to improved therapeutic efficacy, patient
compliance, and cost effectiveness of therapy with minimum dose associated side-effects. This
review has summarized various nanocarriers explored for the treatment of AMD and challenges in
translation.
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Affiliation(s)
- Vamshi Krishna Rapalli
- Department of Pharmacy, Birla Institute of Technology and Science (BITS), Pilani, Pilani Campus, Rajasthan 333031, India
| | - Srividya Gorantla
- Department of Pharmacy, Birla Institute of Technology and Science (BITS), Pilani, Pilani Campus, Rajasthan 333031, India
| | - Tejashree Waghule
- Department of Pharmacy, Birla Institute of Technology and Science (BITS), Pilani, Pilani Campus, Rajasthan 333031, India
| | - Arisha Mahmood
- Department of Pharmacy, Birla Institute of Technology and Science (BITS), Pilani, Pilani Campus, Rajasthan 333031, India
| | - Prem Prakash Singh
- Formulation development, Slayback Pharma India LLP, Hyderabad 500072, Telangana, India
| | - Sunil Kumar Dubey
- Department of Pharmacy, Birla Institute of Technology and Science (BITS), Pilani, Pilani Campus, Rajasthan 333031, India
| | - Ranendra Narayan Saha
- Department of Pharmacy, Birla Institute of Technology and Science (BITS), Pilani, Pilani Campus, Rajasthan 333031, India
| | - Gautam Singhvi
- Department of Pharmacy, Birla Institute of Technology and Science (BITS), Pilani, Pilani Campus, Rajasthan 333031, India
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Gorantla S, Waghule T, Rapalli VK, Singh PP, Dubey SK, Saha RN, Singhvi G. Advanced Hydrogels Based Drug Delivery Systems for Ophthalmic Delivery. ACTA ACUST UNITED AC 2020; 13:291-300. [DOI: 10.2174/1872211314666200108094851] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 11/19/2019] [Accepted: 12/09/2019] [Indexed: 02/06/2023]
Abstract
Hydrogels are aqueous gels composed of cross-linked networks of hydrophilic polymers. Stimuli-responsive based hydrogels have gained focus over the past 20 years for treating ophthalmic diseases. Different stimuli-responsive mechanisms are involved in forming polymer hydrogel networks, including change in temperature, pH, ions, and others including light, thrombin, pressure, antigen, and glucose-responsive. Incorporation of nanocarriers with these smart stimuli-responsive drug delivery systems that can extend the duration of action by increasing ocular bioavailability and reducing the dosing frequency. This review will focus on the hydrogel drug delivery systems highlighting the gelling mechanisms and emerging stimuli-responsive hydrogels from preformed gels, nanogels, and the role of advanced 3D printed hydrogels in vision-threatening diseases like age-related macular degeneration and retinitis pigmentosa. It also provides insight into the limitations of hydrogels along with the safety and biocompatibility of the hydrogel drug delivery systems.
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Affiliation(s)
- Srividya Gorantla
- Department of Pharmacy, Birla Institute of Technology & Science (BITS), Pilani, Pilani Campus, Rajasthan 333031, India
| | - Tejashree Waghule
- Department of Pharmacy, Birla Institute of Technology & Science (BITS), Pilani, Pilani Campus, Rajasthan 333031, India
| | - Vamshi Krishna Rapalli
- Department of Pharmacy, Birla Institute of Technology & Science (BITS), Pilani, Pilani Campus, Rajasthan 333031, India
| | - Prem Prakash Singh
- Formulation development, Slayback Pharma India LLP, Hyderabad, Telangana-500072, India
| | - Sunil Kumar Dubey
- Department of Pharmacy, Birla Institute of Technology & Science (BITS), Pilani, Pilani Campus, Rajasthan 333031, India
| | - Ranendra Narayan Saha
- Birla Institute of Technology & Science (BITS) - Pilani, Dubai Campus, United Arab Emirates
| | - Gautam Singhvi
- Department of Pharmacy, Birla Institute of Technology & Science (BITS), Pilani, Pilani Campus, Rajasthan 333031, India
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Gorantla S, Rapalli VK, Waghule T, Singh PP, Dubey SK, Saha RN, Singhvi G. Nanocarriers for ocular drug delivery: current status and translational opportunity. RSC Adv 2020; 10:27835-27855. [PMID: 35516960 PMCID: PMC9055630 DOI: 10.1039/d0ra04971a] [Citation(s) in RCA: 102] [Impact Index Per Article: 25.5] [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: 06/05/2020] [Accepted: 07/07/2020] [Indexed: 12/13/2022] Open
Abstract
Ocular diseases have a significant effect on vision and quality of life. Drug delivery to ocular tissues is a challenge to formulation scientists. The major barriers to delivering drugs to the anterior and posterior segments include physiological barriers (nasolacrimal drainage, blinking), anatomical barriers (static and dynamic), efflux pumps and metabolic barriers. The static barriers comprise the different layers of the cornea, sclera, and blood–aqueous barriers whereas dynamic barriers involve conjunctival blood flow, lymphatic clearance and tear drainage. The tight junctions of the blood–retinal barrier (BRB) restrict systemically administered drugs from entering the retina. Nanocarriers have been found to be effective at overcoming the issues associated with conventional ophthalmic dosage forms. Various nanocarriers, including nanodispersion systems, nanomicelles, lipidic nanocarriers, polymeric nanoparticles, liposomes, niosomes, and dendrimers, have been investigated for improved permeation and effective targeted drug delivery to various ophthalmic sites. In this review, various nanomedicines and their application for ophthalmic delivery of therapeutics are discussed. Additionally, scale-up and clinical status are also addressed to understand the current scenario for ophthalmic drug delivery. Ocular diseases have a significant effect on vision and quality of life.![]()
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Affiliation(s)
- Srividya Gorantla
- Industrial Research Laboratory
- Department of Pharmacy
- Birla Institute of Technology and Science (BITS)
- India
| | - Vamshi Krishna Rapalli
- Industrial Research Laboratory
- Department of Pharmacy
- Birla Institute of Technology and Science (BITS)
- India
| | - Tejashree Waghule
- Industrial Research Laboratory
- Department of Pharmacy
- Birla Institute of Technology and Science (BITS)
- India
| | | | - Sunil Kumar Dubey
- Industrial Research Laboratory
- Department of Pharmacy
- Birla Institute of Technology and Science (BITS)
- India
| | - Ranendra N. Saha
- Industrial Research Laboratory
- Department of Pharmacy
- Birla Institute of Technology and Science (BITS)
- India
- Birla Institute of Technology & Science (BITS)
| | - Gautam Singhvi
- Industrial Research Laboratory
- Department of Pharmacy
- Birla Institute of Technology and Science (BITS)
- India
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Adhikari D, Tiwary R, Singh PP, Upadhaya K, Singh B, Haridasan KE, Bhatt BB, Chettri A, Barik SK. Ecological niche modeling as a cumulative environmental impact assessment tool for biodiversity assessment and conservation planning: A case study of critically endangered plant Lagerstroemia minuticarpa in the Indian Eastern Himalaya. J Environ Manage 2019; 243:299-307. [PMID: 31102897 DOI: 10.1016/j.jenvman.2019.05.036] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 03/12/2019] [Accepted: 05/07/2019] [Indexed: 06/09/2023]
Abstract
Cumulative environmental impact assessment (CEIA) at river basin level for hydroelectric projects is an evolving concept and has proved to be a useful tool to assess the cumulative impact of developmental projects on the natural ecosystems. However, the generality of CEIA studies is often contested because of methodological limitations, especially in the domain of biodiversity conservation and conservation planning. Ecological niche modeling (ENM) can be a useful tool in CEIA studies for conservation planning of threatened plants in hydroelectric project (HEP) areas. We elucidate this hypothesis taking the example of Lagerstroemia minuticarpa Debberm. ex P.C. Kanjilal, a critically endangered tree species in the Indian Eastern Himalaya. Standard ecological methods were employed to document occurrence records, estimate population size, and characterize habitats. ENM was used to estimate the species potential environmental niche and distribution areas. The possible impacts of HEPs on the potential habitats were predicted by overlaying the HEPs on the potential area map as well as using the conceptual network diagram. The study revealed that the species occupies an environmental niche characterized by humid to per-humid conditions, and is distributed mostly in the Lohit and Teesta basins. Potential areas of the species with high environmental suitability coincide with 19 HEPs, which point to a potential threat to the survival of the species. Network diagram indicated that project activities might deteriorate the habitats thereby affecting the population and regeneration of the species. Our study provides a framework for developing appropriate measures for species conservation and reintroduction at basin level using ENM.
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Affiliation(s)
- Dibyendu Adhikari
- Department of Botany, North-Eastern Hill University, Shillong, 793022, India.
| | - Raghuvar Tiwary
- Department of Botany, North-Eastern Hill University, Shillong, 793022, India.
| | - Prem Prakash Singh
- Department of Botany, North-Eastern Hill University, Shillong, 793022, India.
| | - Krishna Upadhaya
- Department of Basic Science and Social Science, North-Eastern Hill University, Shillong, 793022, India.
| | - Bikarma Singh
- Indian Institute of Integrative Medicine, Jammu, 180001, India.
| | | | - Bharat Bhushan Bhatt
- Department of Environment and Forest, Government of Arunachal Pradesh, Itanagar, 791111, India.
| | - Arun Chettri
- Department of Botany, Sikkim University, Tadong, 737102, Gangtok, India.
| | - Saroj Kanta Barik
- Department of Botany, North-Eastern Hill University, Shillong, 793022, India; CSIR-National Botanical Research Institute, Lucknow, 226001, India.
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Strode AE, Singh PP, Slack CM, Wassenaar DR. Research ethics committees in a tight spot: Approving consent strategies for child research that are prima facie illegal but are ethical in terms of national guidelines. S Afr Med J 2018; 108:828-832. [PMID: 30421709 PMCID: PMC6237194 DOI: 10.7196/samj.2018.v108i10.13203] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Indexed: 11/27/2022] Open
Abstract
It is an internationally accepted principle that ethics norms should be applied and enforced in research with humans through ethics review by research ethics committees (RECs). This places RECs at the very heart of the system for protecting participants and enforcing their rights. In the South African ethical-legal framework for child research, there are divergent approaches to consent. That is, section 71 of the National Health Act (No. 61 of 2003) (NHA) requires mandatory parental consent for child research, and limits the authority for proxy consent to parents and legal guardians. However, national ethics guidelines authorised by section 72 of the NHA and issued by the National Health Research Ethics Council (NHREC) acting in terms of its mandate (National Department of Health, 2015) allow a more nuanced approach - i.e. self-consent by older adolescents, provided certain conditions are met, and consent by a range of parental substitutes where there are no available parents or legal guardians. We have argued elsewhere that the consent approach in section 71 is inappropriately restrictive and are of the view that the consent approach endorsed in national ethics guidelines is more defensible. An REC that elects to approve a consent strategy allowable in ethics guidelines is effectively electing to not follow section 71, which raises the question of what the consequences might be for that REC. This article examines the legal liability of RECs through three 'threads' of accountability: the NHREC, the institutions hosting RECs, and the courts. We conclude that: (i) if an REC approves a child protocol with consent strategies allowable in terms of national ethics guidelinesbut not in terms of section 71, it is unlikely that the NHREC would discipline the REC in the face of a complaint - provided the REC acted within national ethics guidelines issued by the NHREC in terms of the latter's section 72 mandate to set national norms and standards; (ii) if an REC approves a consent approach allowed for in ethics guidance, it is also unlikely that the host institution would discipline the REC in the face of a complaint - especially if the institution is aware of the REC's explicit decision to follow national ethics guidelines that are authorised by section 72 of the NHA; and (iii) an REC could only be sued by a participant in terms of the law of delict (and be liable for damages) if several demanding components are proven, such as that the harm suffered by the participant resulted directly from the REC's actions in approving a particular consent strategy for that research. Furthermore, the court may well look to national ethics guidelines in making determinations about whether an REC's conduct was wrongful for the purposes of liability in civil law. RECs are protected from being collectively liable by insurance taken out by their host institutions. We make a series of recommendations to address this issue.
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Affiliation(s)
- A E Strode
- School of Law, College of Law and Management Studies, University of KwaZulu-Natal, Pietermaritzburg, South Africa; HIV/AIDS Vaccines Ethics Group, School of Applied Human Sciences, College of Humanities, University of KwaZulu-Natal, Pietermaritzburg, South Africa.
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Singh PP, Goyal M, Goyal A. Sialendoscopic Approach in Management of Juvenile Recurrent Parotitis. Indian J Otolaryngol Head Neck Surg 2017; 69:453-458. [PMID: 29238673 DOI: 10.1007/s12070-017-1223-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [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: 07/31/2016] [Accepted: 10/06/2017] [Indexed: 11/29/2022] Open
Abstract
To assess the role of sialendoscopy as a diagnostic and therapeutic modality in juvenile recurrent parotitis. Juvenile recurrent parotitis (JRP) is the second most frequent salivary gland disease in childhood and is characterized by recurrent non suppurative and non obstructive parotid inflammation. These attacks influence the quality of life and can even lead to gland destruction, and there are no definitive treatment to avoid them. Sialendoscopic dilatation is emerging as the new treatment modality in this aspect. STUDY DESIGN retrospective study. STUDY SETTING Department of Otorhinolaryngology in tertiary care hospital. 17 cases of juvenile recurrent parotitis (i.e. children of age group 3-11 years presenting with complaints of recurrent parotid region swelling and pain, sometimes associated with fever) were included in the study during October 2012-September 2015. All cases underwent sialendoscopy under general anaesthesia. Diagnostic (classifying the ductal lesion) and interventional sialendoscopic procedure (dilatation with instillation of steroid) were carried out in single sitting. Follow up was done for a minimum of 6 months (range 6-36 months). 17 patients with mean age of 5.6 years and gender distribution of 47:53 (boys:girls) underwent sialendoscopy for JRP. 8 patients presented with unilateral parotitis and 9 with bilateral. The mean number of attacks in previous 1 year were 9.2. Average time for procedure was 20 min. All cases had ductal stenosis and ductal mucosa was pale in 15 cases on endoscopy. 1 patient underwent repeat endoscopy after 2 years. 50% had complete resolution of symptoms and 6 patients had one mild (swelling not associated with fever which subsided on its own) attack after treatment. Follow up period ranged from 6 months to 3 years. No complications were observed. Sialendoscopy has emerged as a viable option for assessment and treatment of JRP. Dilatation of the parotid duct and steroid instillation has significantly reduced the morbidity of this condition.
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Affiliation(s)
- P P Singh
- Department of Otorhinolaryngology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
| | - M Goyal
- Department of Otorhinolaryngology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
| | - A Goyal
- Department of Otorhinolaryngology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
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Sharma RK, Singh MP, Saha KB, Bharti PK, Jain V, Singh PP, Silawat N, Patel R, Hussain M, Chand SK, Pandey A, Singh N. Socio-economic & household risk factors of malaria in tribal areas of Madhya Pradesh, central India. Indian J Med Res 2016; 141:567-75. [PMID: 26139773 PMCID: PMC4510754 DOI: 10.4103/0971-5916.159515] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background & objectives: Malaria is a major public health problem in many States of the country, particularly, in Madhya Pradesh where both Plasmodium vivax and P. falciparum are endemic. Although many studies have been conducted to investigate risk factors for malaria, but only a few have examined household and socio-economic risk factors. The present study was, therefore, undertaken to explore the relationship of different socio-demographic, socio-economic and behavioural risk factors with malaria prevalence in tribal areas of Madhya Pradesh, India. Methods: This study was undertaken in all 62 villages of Bargi Primary Health Centre from May 2005 to June 2008. These villages comprised 7117 households with an average family size of five members. Fortnightly fever surveys were conducted in all villages to assess prevalence of malaria infection in the community. The distinct univariate and multivariate logistic regression models were fitted on the data set. Results: The important socio-demographic risk factors like age of household head, social group, occupation and family size; socio-economic factors like type of walls of house, place of drinking water source, irrigated land, cash crop; and behavioural variables like place of sleeping, use of bed nets, etc. were found significantly associated with malaria in univariate analyses. In multivariate analyses only social groups, family size, type of walls of house, and place of sleeping had strong significant association with prevalence of malaria. Interpretation & conclusions: The study shows that in tribal areas where people are living in poor quality of houses with no proper use of preventive measures, malaria is firmly established. We conclude that community based interventions which bring improvement in standard of living, access to healthcare facilities and health awareness, will have a significant impact on malaria prevention in these areas.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - Neeru Singh
- National Institue for Research in Tribal Health (ICMR); National Institute of Malaria Research (Field Station) (ICMR), Jabalpur, Madhya Pradesh, India
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Abstract
ABSTRACT
Neurofibroma is a benign neoplasm derived from peripheral nerves. Most of these are associated with neurofibromatosis but may also occur as solitary lesions. When found in the neck, they are often located in the soft tissues. They are slow-growing masses, often asymptomatic and have been found most commonly in the oral cavity. We report a case of neurofibroma involving two separate and unusual sites of face, which are subcutaneous tissues of the cheek and dorsum of nose, and present a brief review of literature.
How to cite this article
Gupta N, Kaur R, Rai A, Wadhwa N, Singh PP. Neurofibroma of the Cheek and Nasal Dorsum: A Case Report and a Mini Review. Int J Otorhinolaryngol Clin 2016;8(2):62-64.
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Nagamma T, Baxi J, Singh PP. Status of oxidative stress and antioxidant levels in smokers with breast cancer from western Nepal. Asian Pac J Cancer Prev 2015; 15:9467-70. [PMID: 25422256 DOI: 10.7314/apjcp.2014.15.21.9467] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Research indicates that oxidative stress induced by smoking plays a role in breast cancer. In view of these reports, we aimed to study th relationship between smoking and oxidative stress in breast cancer patients from the western region of Nepal. MATERIALS AND METHODS The study included a control group of 42 females (non-smoking healthy women) and a test group sudivided into Group I consisting of 46 female breast cancer patients who were smokers and Group II consisting of 42 non-smoking breast cancer patients. Detailed history of the patients was collected with the help of pre-test proforma. Plasma levels of malondialdehyde (MDA), total antioxidant activity (TAA) which represents total dietary antioxidants, vitamin C and α- tocopherol were estimated by standard methods. Statistical analysis was done using SPSS version 16. RESULTS The plasma MDA, TAA, vitamin C and α- tocopherol were 1±1.4nmol/ml, 918±207μmol/L, 1±0.24mg/dL and 0.94±0.31mg/dL in controls, 5±1.2nmol/ml, 458±166 μmol/L, 0.64±0.32mg/dL and 0.5±0.3mg/dL in Group-I and 2.56±1.2nmol/ml, 663±178 μmol/L, 0.78±0.2mg/dL and 0.77±0.2mg/dL in Group- II, respectively. Vitamin C, α- tocopherol and TAA (p=0.001) were significantly reduced whereas MDA (p=0.001) was significantly raised in Group-I when compared to controls and Group-II. CONCLUSIONS We observed a significant rise in oxidative stress and low levels of antioxidants in breast cancer patients with smoking habit. It is well known that free radicals facilitate the progression of breast cancer, possibly increasing the risk of progression to the next stage.
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Affiliation(s)
- T Nagamma
- Department of Biochemistry, Faculty of Medical Sciences, Manipal University, Manipal, India E-mail :
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Yadav A, Kumar P, Raghav A, Shuaib M, Sharma VR, Singh DP, Singh PP, Gupta S, Gupta U, Sharma MK, Bala I, Kumar R, Muralithar S, Singh RP, Singh BP, Prasad R. Low energy incomplete fusion and its relevance to the synthesis of super heavy elements. EPJ Web of Conferences 2015. [DOI: 10.1051/epjconf/20158600064] [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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Lemanu DP, Singh PP, Stowers MDJ, Hill AG. A systematic review to assess cost effectiveness of enhanced recovery after surgery programmes in colorectal surgery. Colorectal Dis 2014; 16:338-46. [PMID: 24283942 DOI: 10.1111/codi.12505] [Citation(s) in RCA: 89] [Impact Index Per Article: 8.9] [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: 05/30/2013] [Accepted: 09/20/2013] [Indexed: 12/18/2022]
Abstract
AIM Enhanced recovery after surgery (ERAS) programmes have been shown to reduce length of stay and peri-operative morbidity. However, there are comparatively few data on their cost effectiveness. The object of this systematic review was to appraise the current literature to determine the cost effectiveness of ERAS and to characterize how cost is reported and evaluated. METHOD An electronic database search identified studies comparing ERAS with standard peri-operative care in colorectal surgery where an evaluation of cost effectiveness was a primary or secondary outcome. Cost data were converted to euros to enable a more standardized comparison of the studies. There were no limits on study design. RESULTS Seven articles were included in the analysis. The reporting and evaluation of cost data were inconsistent. Reported cost for ERAS ranged from €1989 to €12,805 per patient. Although not all statistically significant, all studies demonstrated cost reductions with ERAS compared with non-ERAS although they were highly variable, ranging from €153 to €6537 per patient. CONCLUSION Although the review has shown ERAS to be cost effective, there are some important inconsistencies and deficiencies regarding the reporting of data. Authors should therefore be encouraged to report cost data to supplement the literature detailing clinical efficacy.
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Affiliation(s)
- D P Lemanu
- Department of Surgery, South Auckland Clinical School, University of Auckland, Auckland, New Zealand
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Gonsalves WI, Rajkumar SV, Gupta V, Morice WG, Timm MM, Singh PP, Dispenzieri A, Buadi FK, Lacy MQ, Kapoor P, Gertz MA, Kumar SK. Quantification of clonal circulating plasma cells in newly diagnosed multiple myeloma: implications for redefining high-risk myeloma. Leukemia 2014; 28:2060-5. [PMID: 24618735 DOI: 10.1038/leu.2014.98] [Citation(s) in RCA: 91] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Accepted: 02/21/2014] [Indexed: 12/22/2022]
Abstract
The presence of clonal circulating plasma cells (cPCs) is a marker of high-risk disease in all stages of monoclonal gammopathies. However, the prognostic utility of quantitating cPCs using multiparametric flow cytometry in multiple myeloma (MM) patients with current treatments is unknown. There were 157 consecutive patients with newly diagnosed MM seen at the Mayo Clinic, Rochester from 2009 to 2011 that had their peripheral blood evaluated for cPCs by multiparameter flow cytometry. Survival analysis was performed by the Kaplan-Meier method and differences assessed using the log-rank test. Using a receiver operating characteristics (ROC) analysis, ⩾400 cPCs were considered as the optimal cutoff for defining high-risk disease. The presence of ⩾400 cPCs was associated with higher plasma cell (PC) proliferation and adverse cytogenetics. The median time-to-next-treatment and overall survival (OS) in patients with ⩾400 cPCs (N=37, 24%) was 14 months and 32 months compared with 26 months and not reached for the rest (P<0.001). In a multivariable model, the presence of ⩾400 cPCs and older age adversely affected OS. Flow cytometry to quantify cPCs is a valuable test for risk stratifying newly diagnosed MM patients in the era of novel agents. Future studies are needed to determine its role in developing a risk-adapted treatment approach.
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Affiliation(s)
- W I Gonsalves
- 1] Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA [2] Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - S V Rajkumar
- 1] Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA [2] Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - V Gupta
- 1] Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA [2] Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - W G Morice
- 1] Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA [2] Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - M M Timm
- 1] Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA [2] Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - P P Singh
- 1] Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA [2] Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - A Dispenzieri
- 1] Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA [2] Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - F K Buadi
- 1] Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA [2] Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - M Q Lacy
- 1] Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA [2] Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - P Kapoor
- 1] Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA [2] Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - M A Gertz
- 1] Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA [2] Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - S K Kumar
- 1] Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA [2] Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
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Singh PP, Lemanu DP, Taylor MHG, Hill AG. Association between preoperative glucocorticoids and long-term survival and cancer recurrence after colectomy: follow-up analysis of a previous randomized controlled trial. Br J Anaesth 2014; 113 Suppl 1:i68-73. [PMID: 24583820 DOI: 10.1093/bja/aet577] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The effect of anaesthetic drugs on long-term oncological outcomes after cancer surgery is an area of current interest. Dexamethasone is widely used in anaesthetic practice; however, its effect on long-term survival and cancer outcomes is not known. This study presents the results of a 5-yr follow-up of patients receiving dexamethasone before elective colectomy as part of a previous randomized clinical trial. METHODS Sixty patients who underwent elective open colonic resection for any indication between June 2006 and March 2008 were randomized to receive either 8 mg i.v. dexamethasone or placebo before surgery. A 5-yr follow-up analysis was conducted to evaluate overall survival, disease-free survival and recurrence specifically for patients undergoing resection for Stage I-III colon cancer. Kaplan-Meier analysis was performed and log-rank test was used to evaluate difference in survival between groups. RESULTS Forty-three of the 60 subjects had Stage I-III colon cancer and were included in the follow-up analysis. Twenty received preoperative dexamethasone and 23 received placebo. There were no significant differences between groups in baseline or disease characteristics. No differences were found between groups for overall or disease-free survival. In the dexamethasone group, there was a significantly higher rate of distant recurrence (6 compared with 1, P=0.04). CONCLUSIONS Preoperative dexamethasone was associated with a higher rate of distant recurrence in patients undergoing colectomy for colon cancer. Given the small sample size, this finding should be interpreted with caution, but warrants further investigation in a prospective study.
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Affiliation(s)
- P P Singh
- Faculty of Medical and Health Sciences, Department of Surgery, South Auckland Clinical School, University of Auckland, Auckland, New Zealand
| | - D P Lemanu
- Faculty of Medical and Health Sciences, Department of Surgery, South Auckland Clinical School, University of Auckland, Auckland, New Zealand
| | - M H G Taylor
- Department of Anaesthesia, Middlemore Hospital, Counties Manukau District Health Board, Auckland, New Zealand
| | - A G Hill
- Faculty of Medical and Health Sciences, Department of Surgery, South Auckland Clinical School, University of Auckland, Auckland, New Zealand
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Srinivasa S, Lemanu DP, Singh PP, Taylor MHG, Hill AG. Systematic review and meta-analysis of oesophageal Doppler-guided fluid management in colorectal surgery. Br J Surg 2014; 100:1701-8. [PMID: 24227354 DOI: 10.1002/bjs.9294] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2013] [Indexed: 11/07/2022]
Abstract
BACKGROUND Oesophageal Doppler monitor (ODM)-guided fluid therapy has been recommended for routine use in patients undergoing colorectal surgery. However, recent trials have suggested either equivalent or inferior results for patients randomized to ODM-guided fluid management, especially when compared with fluid restriction or within the context of optimized perioperative care. Hence, an updated systematic review and meta-analysis was conducted. METHODS A systematic review and meta-analysis was conducted of all randomized trials exploring ODM-guided fluid management in major colorectal surgery with the endpoints total complications and length of hospital stay (LOS). Subset analyses were planned a priori specifically to investigate the role of the ODM in the context of fluid restriction or optimized perioperative care. RESULTS Six high-quality trials comprising a total of 691 patients were included in the final analysis. ODM-guided fluid therapy did not influence the incidence of complications (odds ratio 0·74, 95 per cent confidence interval (c.i.) 0·50 to 1·11; P = 0·15), with moderate heterogeneity in the results (I(2) = 33 per cent; P = 0·19). There was no difference in mean LOS between patients receiving ODM-guided fluid therapy and controls: mean difference -0·88 (95 per cent c.i. -2·89 to 1·13) days (P = 0·39). There was no difference in complications or LOS when ODM-guided fluid therapy was compared with fluid restriction or used within an otherwise optimized perioperative environment. CONCLUSION ODM-guided fluid therapy did not influence LOS or complications in patients undergoing colorectal surgery. Results favouring the ODM were seen only in early studies, whereas newer trials did not show any benefit from such monitoring.
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Affiliation(s)
- S Srinivasa
- Department of Surgery, South Auckland Clinical School, Middlemore Hospital, University of Auckland, Auckland, New Zealand
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Thakur V, Talwar M, Singh PP. Low free to total PSA ratio is not a good discriminator of chronic prostatitis and prostate cancer: An Indian experience. Indian J Cancer 2014; 51:335-337. [PMID: 25494133 DOI: 10.4103/0019-509x.146790] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Aims: To find out the utility of free to total PSA ratio in discriminating chronic prostatitis and prostate cancer. Setting and design: The patients visited urology clinics at Batra Hospital and Medical Research Center, New Delhi. Background: The use of serum free to total PSA as a diagnostic tool for prostate cancer has led to early detection of prostate cancer; however, the effect of inflammation on f/t PSA ratio restricts its use in early detection of cancer. Materials and Methods: The study was conducted in age related 101 patients which include 27 carcinoma patients (group I), 34 BPH patients (group II) and 40 chronic prostatitis patients (group III). Serum total PSA (tPSA) and free PSA (fPSA) were analyzed on Elecsys 2010. These were compared with histological reports of biopsy specimen. Other biochemistry tests were done on Randox Imola. P Value was calculated using one way ANOVA with posthoc Bonferroni analysis. Results: Serum total PSA levels were comparable in group I and III and were higher than group II (P < 0.049). Serum fPSA in group I was not significantly different from group II and III, However, group II has higher levels than group III (P < 0.035). Difference was significant for f/t PSA ratio in group I and II (P < 0.00) and group II and III (P < 0.000).Group I and III were with comparable levels (P < 0.807). Conclusions: f/t PSA ratio is not a good discriminator for malignancy and chronic prostatitis. This limitation of f/t PSA ratio must be taken into consideration while interpreting the results clinically.
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Affiliation(s)
- V Thakur
- Department of Laboratory Medicine, Clinical Biochemistry Lab, New Delhi, India
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Nagamma T, Ahmed S, Pai A, Mohan S, Chathuvedi A, Singh PP. Evaluation of oxidative stress and antioxidant activity in pre and post hemodialysis in chronic renal failure patients from Western region of Nepal. Bangladesh J Med Sci 2013. [DOI: 10.3329/bjms.v13i1.14741] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Objective: To evaluate the oxidative stress and antioxidant activity in pre and post hemodialysis in chronic renal failure patients using a diacetate cellulose membrane. Background: Chronic Renal Failure is a gradual, progressive and irreversible loss of normal functioning of kidneys. This is associated with increased formation of reactive oxygen species and increased oxidative stress. No studies have been undertaken in this area in Nepal. Method: The study groups were devided into chronic renal failure patients undergoing hemodialysis (n=52) and healthy controls (n=52). Diacetate cellulose was used as dialyzer membrane for chronic renal failure patients. Blood samples were collected in EDTAbottles and plasma was used for the estimation of oxidative stress marker, total antioxidant activity, vitamin C, ?-tocopherol, urea and creatinine. Results: There was significant reduction in the levels of vitamin C,? -tocopherol and total antioxidant activity in post dialysis patients compared to predialysis and control groups (p<0.001). Plasma urea and creatinine levels were high in predialysis patients compared to controls and was significantly reduced after dialysis. Significantly elevated malondialdehyde levels were found in chronic renal failure patients before and after dialysis when compared with controls. Conclusion: The results of our study indicate that there are reduced levels antioxidants in chronic renal patients in pre and post dialysis condition and also more loss of antioxidants after dialysis. All these condition leads to increased oxidative stress in these patients. DOI: http://dx.doi.org/10.3329/bjms.v13i1.14741 Bangladesh Journal of Medical Science Vol. 13 No. 01 January2014: 40-44
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Singh PP, Zeng ISL, Srinivasa S, Lemanu DP, Connolly AB, Hill AG. Systematic review and meta-analysis of use of serum C-reactive protein levels to predict anastomotic leak after colorectal surgery. Br J Surg 2013; 101:339-46. [PMID: 24311257 DOI: 10.1002/bjs.9354] [Citation(s) in RCA: 227] [Impact Index Per Article: 20.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/25/2013] [Indexed: 12/13/2022]
Abstract
BACKGROUND Several recent studies have investigated the role of C-reactive protein (CRP) as an early marker of anastomotic leakage following colorectal surgery. The aim of this systematic review and meta-analysis was to evaluate the predictive value of CRP in this setting. METHODS A systematic literature search was performed using MEDLINE, Embase and PubMed to identify studies evaluating the diagnostic accuracy of postoperative CRP for anastomotic leakage following colorectal surgery. A meta-analysis was carried out using a random-effects model and pooled predictive parameters were determined along with a CRP cut-off value at each postoperative day (POD). RESULTS Seven studies, with a total of 2483 patients, were included. The pooled prevalence of leakage was 9·6 per cent and the median day on which leakage was diagnosed ranged from POD 6 to 9. The serum CRP level on POD 3, 4 and 5 had comparable diagnostic accuracy for the development of an anastomotic leak with a pooled area under the curve of 0·81 (95 per cent confidence interval 0·75 to 0·86), 0·80 (0·74 to 0·86) and 0·80 (0·73 to 0·87) respectively. The derived CRP cut-off values were 172 mg/l on POD 3, 124 mg/l on POD 4 and 144 mg/l on POD 5; these corresponded to a negative predictive value of 97 per cent and a negative likelihood ratio of 0·26-0·33. All three time points had a low positive predictive value for leakage, ranging between 21 and 23 per cent. CONCLUSION CRP is a useful negative predictive test for the development of anastomotic leakage following colorectal surgery.
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Affiliation(s)
- P P Singh
- Department of Surgery, South Auckland Clinical School, Middlemore Hospital, University of Auckland, Auckland, New Zealand
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Greenberg AJ, Rajkumar SV, Therneau TM, Singh PP, Dispenzieri A, Kumar SK. Relationship between initial clinical presentation and the molecular cytogenetic classification of myeloma. Leukemia 2013; 28:398-403. [PMID: 24005246 PMCID: PMC3924716 DOI: 10.1038/leu.2013.258] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2013] [Revised: 07/19/2013] [Accepted: 08/02/2013] [Indexed: 11/09/2022]
Abstract
Multiple myeloma (MM) consists of several distinct cytogenetic subtypes, and we hypothesized that each subtype may have a unique mode of initial presentation and end-organ damage. We studied 484 patients with newly diagnosed MM to determine the relationship between specific myeloma-defining event (MDE) and the cytogenetic subtype. Patients were divided into four non-overlapping groups based on the MDE at diagnosis: isolated renal failure, isolated anemia, isolated lytic bone disease or a combination (mixed). MM with translocations without trisomies accounted for 30% of all patients, but accounted for 50% of patients with renal failure. Specifically, the t(14;16) translocation accounted for only 5% of all MM patients, but was present in 13.5% of patients with renal failure as MDE. Among patients with t(14;16), 25% presented with renal failure only as MDE. Patients with isolated renal failure as MDE had significantly poorer survival compared with all other groups, whereas patients with bone disease as MDE had the best outcome (P<0.001). Our findings support the hypothesis that in addition to prognostic differences, there is significant heterogeneity in clinical presentation associated with the cytogenetic subtype, suggesting that MM encompasses a group of cytogenetically and phenotypically distinct disorders rather than a single entity.
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Affiliation(s)
- A J Greenberg
- 1] Center for Translational Science Activities, Rochester, MN, USA [2] Division of Epidemiology, Department of Health Sciences Research, Rochester, MN, USA
| | - S V Rajkumar
- Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - T M Therneau
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Rochester, MN, USA
| | - P P Singh
- Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - A Dispenzieri
- Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - S K Kumar
- Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
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Singh R, Jain V, Singh PP, Bharti PK, Thomas T, Basak S, Singh N. First report of detection and molecular confirmation of Plasmodium ovale from severe malaria cases in central India. Trop Med Int Health 2013; 18:1416-20. [PMID: 24001284 DOI: 10.1111/tmi.12184] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE We report for the first-time detection of Plasmodium ovale in central India. METHODS From 2010, all hospitalised suspected malaria cases at the malaria clinic of the Regional Medical Research Centre for Tribals in Bastar district, central India, were screened. Plasmodium species were identified by microscopy and species-specific nested PCR of 18s rRNA. RESULTS Of 256 enrolled cases of confirmed P. falciparum malaria by microscopy, P. ovale infection was detected in three cases (1.2%) by PCR and sequencing. Of these three cases, one had cerebral malaria and another had severe malaria anaemia. In both of these cases, P. ovale infection was mixed with P. falciparum, while in third case the infection was mixed with both P. falciparum and P. vivax. Phylogenetic analysis revealed that these isolates showed closed homology with West African genotypes. CONCLUSION All three hospitalised patients were originally residents of remote inaccessible forest villages and never moved out of their residence. This finding also has implications in malaria control and elimination as P. ovale causes relapses. This study highlights the need of molecular diagnosis of malaria species for appropriate treatment and control.
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Affiliation(s)
- R Singh
- Regional Medical Research Center for Tribals, Jabalpur, India
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Singh PP, Gupta V. Sialendoscopy: introduction, indications and technique. Indian J Otolaryngol Head Neck Surg 2013; 66:74-8. [PMID: 24605306 DOI: 10.1007/s12070-013-0675-1] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2013] [Accepted: 07/25/2013] [Indexed: 11/28/2022] Open
Affiliation(s)
- P P Singh
- Department of ENT, University College of Medical Sciences & GTB Hospital, Delhi, 110095 India
| | - Vikas Gupta
- Department of ENT and Head & Neck Surgery, All India Institute of Medical Sciences, Room No 16, Ist Floor OPD Block, Saket Nagar, Bhopal, 462024 India
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Gupta N, Sharma A, Singh PP, Goyal A, Sao R. Assessment of knowledge of harmful effects and exposure to recreational music in college students of delhi: a cross sectional exploratory study. Indian J Otolaryngol Head Neck Surg 2013; 66:254-9. [PMID: 25032110 DOI: 10.1007/s12070-013-0671-5] [Citation(s) in RCA: 11] [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: 06/05/2013] [Accepted: 06/28/2013] [Indexed: 11/30/2022] Open
Abstract
Exposure to loud sounds results in a mild to profound degree of temporary or permanent hearing loss. Though occupational noise exposure remains the most commonly identified cause of noise-induced hearing loss, potentially hazardous noise can be encountered during recreational activities. Unfortunately not much attention is being given to the increasing trend of prolonged exposure to noisy environment, in the younger generation of Indians. The purpose of our study was to know the knowledge of college students about the harmful effects of loud music, prevailing practices with regard to exposure to recreational music and the subjective effects that this exposure is causing if any. Cross Sectional survey of College Students (n = 940), from randomly selected colleges of Delhi University. Majority of students listened to music using music-enabled phones; earphones were preferred and 56.6 % participants listened to music on a loud volume. Effects experienced due to loud sound were headache (58 %), inability to concentrate (48 %), and ringing sensation in the ear (41.8 %). Only 2.7 % respondents used ear protection device in loud volume settings. Twenty-three percent respondents complained of transient decreased hearing and other effects after exposure to loud music. 83.8 % knew that loud sound has harmful effect on hearing but still only 2.7 % used protection device. The survey indicates that we need to generate more such epidemiological data and follow up studies on the high risk group; so as to be able to convincingly sensitize the Indian young generation to take care of their hearing and the policy makers to have more information and education campaigns for this preventable cause of deafness.
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Affiliation(s)
- Neelima Gupta
- Department of Otorhinolaryngology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India ; A-304, Abhyant Apartments 2, Vasundhara Enclave, Delhi, 110096 India
| | - Arun Sharma
- Department of Preventive and Social Medicine, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
| | - P P Singh
- Department of Otorhinolaryngology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
| | - Abhishek Goyal
- University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
| | - Rahul Sao
- University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
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Abstract
BACKGROUND Several observational studies have shown that statins may modify the risk of gastric cancer (GC). We carried out a systematic review and meta-analysis of studies evaluating the effect of statins on GC risk. PATIENTS AND METHODS We conducted a systematic search of multiple databases up to December 2012. Studies that evaluated exposure to statins, reported GC outcomes and odds ratio (OR) or provided data for their estimation were included in the meta-analysis. Pooled OR estimates with 95% confidence intervals (CIs) were calculated using the random-effects model. RESULTS Eleven studies (eight observational, three post-hoc analyses of 26 clinical trials) reporting 5581 cases of GC were included. Meta-analysis showed a significant 32% reduction in GC risk with statin use (adjusted OR, 0.68; 95% CI, 0.51-0.91). After exclusion of one study which was contributing to considerable heterogeneity, a significant 16% reduction in GC risk was a more conservative, consistent estimate (adjusted OR, 0.84; 95% CI, 0.78-0.90). This chemopreventive association was present in both Asian (adjusted OR, 0.68; 95% CI, 0.53-0.87) and Western population (adjusted OR, 0.86; 95% CI, 0.79-0.93). CONCLUSIONS Meta-analysis of studies supports a protective association between statin use and GC risk, in both Asian and Western population, in a dose-dependent manner.
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Affiliation(s)
| | - S Singh
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Mayo Clinic, Rochester, USA
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Lemanu DP, Singh PP, Berridge K, Burr M, Birch C, Babor R, MacCormick AD, Arroll B, Hill AG. Randomized clinical trial of enhanced recovery versus standard care after laparoscopic sleeve gastrectomy. Br J Surg 2013; 100:482-9. [PMID: 23339040 DOI: 10.1002/bjs.9026] [Citation(s) in RCA: 159] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/01/2012] [Indexed: 12/20/2022]
Abstract
BACKGROUND Optimized perioperative care within an enhanced recovery after surgery (ERAS) protocol is designed to reduce morbidity after surgery, resulting in a shorter hospital stay. The present study evaluated this approach in the context of sleeve gastrectomy for patients with morbid obesity. METHODS Patients were allocated to perioperative care according to a bariatric ERAS protocol or a control group that received standard care. These groups were also compared with a historical group of patients who underwent laparoscopic sleeve gastrectomy at the same institution between 2006 and 2010, selected using matched propensity scores. The primary outcome was median length of hospital stay. Secondary outcomes included readmission rates, postoperative morbidity, postoperative fatigue and mean cost per patient. RESULTS Of 116 patients included in the analysis, 78 were allocated to the ERAS (40) or control (38) group and there were 38 in the historical group. There were no differences in baseline characteristics between groups. Median hospital stay was significantly shorter in the ERAS group (1 day) than in the control (2 days; P < 0·001) and historical (3 days; P < 0·001) groups. It was also shorter in the control group than in the historical group (P = 0·010). There was no difference in readmission rates, postoperative complications or postoperative fatigue. The mean cost per patient was significantly higher in the historical group than in the ERAS (P = 0·010) and control (P = 0·018) groups. CONCLUSION The ERAS protocol in the setting of bariatric surgery shortened hospital stay and was cost-effective. There was no increase in perioperative morbidity. REGISTRATION NUMBER NCT01303809 (http://www.clinicaltrials.gov).
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Affiliation(s)
- D P Lemanu
- Department of Surgery, South Auckland Clinical School, Auckland, New Zealand.
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29
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Abstract
Aneurysmal bone cysts have been described as pseudocysts in view of their lack of an epithelial lining. These cysts are uncommon, but when they do occur they typically involve the long bones of the extremities, the membranous bones of the thorax and pelvis, and the vertebrae. Skull involvement is uncommon. We present the case of a 14-year-old girl who presented with nasal obstruction and a swelling of the right cheek. Contrast-enhanced computed tomography detected a heterogeneous cystic mass involving the sphenoid and ethmoid bones. The mass was excised via a lateral rhinotomy approach, and it was identified as an aneurysmal bone cyst on histologic examination. The patient experienced a recurrence in the right sphenoid sinus within 3 months, and the lesion was removed via transnasal endoscopy.
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Affiliation(s)
- Arun Goyal
- Department of Otorhinolaryngology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India.
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30
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Srinivasa S, Taylor MHG, Singh PP, Yu TC, Soop M, Hill AG. Randomized clinical trial of goal-directed fluid therapy within an enhanced recovery protocol for elective colectomy. Br J Surg 2012; 100:66-74. [PMID: 23132508 DOI: 10.1002/bjs.8940] [Citation(s) in RCA: 112] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/16/2012] [Indexed: 01/09/2023]
Abstract
BACKGROUND Goal-directed fluid therapy (GDFT) has been compared with liberal fluid administration in non-optimized perioperative settings. It is not known whether GDFT is of value within an enhanced recovery protocol incorporating fluid restriction. This study evaluated GDFT under these circumstances in patients undergoing elective colectomy. METHODS Patients undergoing elective laparoscopic or open colectomy within an established enhanced recovery protocol (including fluid restriction) were randomized to GDFT or no GDFT. Bowel preparation was permitted for left colonic operations at the surgeon's discretion. Exclusion criteria included rectal tumours and stoma formation. The primary outcome was a patient-reported surgical recovery score (SRS). Secondary endpoints included clinical outcomes and physiological measures of recovery. RESULTS Eighty-five patients were randomized, and there were 37 patients in each group for analysis. Nine patients in the GDFT and four in the fluid restriction group received oral bowel preparation for either anterior resection (12) or subtotal colectomy (1). Patients in the GDFT group received more colloid during surgery (mean 591 versus 297 ml; P = 0·012) and had superior cardiac indices (mean corrected flow time 374 versus 355 ms; P = 0·018). However, no differences were observed between the GDFT and fluid restriction groups with regard to surgical recovery (mean SRS after 7 days 47 versus 46 respectively; P = 0·853), other secondary outcomes (mean aldosterone/renin ratio 9 versus 8; P = 0·898), total postoperative fluid (median 3750 versus 2400 ml; P = 0·604), length of hospital stay (median 6 versus 5 days; P = 0·570) or number of patients with complications (26 versus 27; P = 1·000). CONCLUSION GDFT did not provide clinical benefit in patients undergoing elective colectomy within a protocol incorporating fluid restriction. REGISTRATION NUMBER NCT00911391 (http://www.clinicaltrials.gov).
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Affiliation(s)
- S Srinivasa
- Department of Surgery, South Auckland Clinical School, Middlemore Hospital, University of Auckland, New Zealand.
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31
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Kaushal A, Vaid L, Singh PP. Antrochoanal polyp - Validating its origin and management by endonasal endoscopic sinus surgery (eess). Indian J Otolaryngol Head Neck Surg 2012; 56:273-9. [PMID: 23120095 DOI: 10.1007/bf02974386] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
AIM AND OBJECTIVES 20 fresh cases of Antrochoanal Polyps were subjected to EESS for studying the site of origin and to validate its efficacy. STUDY DESIGN This was a prospective study in which the cases were subjected to surgery and were followed; up for evaluation of results. METHODS The surgery performed was an endoscopic endonasal sinus surgery preceded and followed by transcanne sinuscopy. Results/Findigs: The age at the time of presentation ranged from 7-35 years. Male to female ratio was 1:1:5. Occurrence Antrochoanal Polyp was 1.5 times more common on the left side. The mean duration of symptoms was 3 years. The main presenting symptom was unilateral nasal obstruction in 100% of cases. Allergic symtomps.were noticed in 10%. Vasmotor symptom were present in 15% of the patients. Antroscopy revealed the antral part.to be cytic in 100% of the cases. The site of origin of the polyp could be ascertained in only 12 out of 20 cases; in 7 of them it acrose from the infrolateral wall of maxillary sinus, in 2 from the infromedial wall und in 2 it appeared to arise from the supromedial wall while in 1 from margin of the ostium. Post-surgery intra-natral remnants were found in 3 out of 20 cases i.e. in 15% of them. In two cases it was removed through maxillary ostia but in one case removed through transcanine route. CONCLUSIONS Endoscopic Sinus Surgery is the best modality of treating Antrochoanal Polyps. We report a success rate of 95% in our series.
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Affiliation(s)
- Anuj Kaushal
- Department of ENT, University College of Medical Sciences & GTB Hospital, 110095 Delhi
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32
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Abstract
Serum antioxidant status and peroxidative stress was estimated in 30 pregnant women, their newborn infants and 25 non-pregnant women. Serum Ascorbic acid, α-tocopherol, retinol & β-carotene levels were found to be significantly reduced and peroxidative stress was significantly higher in mothers as compared to matched non-pregnant women. Newborn had significantly higher levels of ascorbic acid as compared to their mother but had significantly lower levels of lipid soluble vitamins. The peroxidative stress in newborn was found to be significantly less as compared to their mothers. A positive correlation of ascorbic acid and α-tocopherol levels between mother and newborn reflects that their status in mother does influence the newborn status.
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Affiliation(s)
- Chitra Upadhyaya
- Department of Biochemistry, S.M.S. Medical College, 302004 Jaipur, (India)
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33
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Abstract
Background: Vascular proliferation in the papillary dermis is considered to be an important and probably an early feature of psoriasis. Few morphometric studies have attempted to analyze the vascular changes. However, no study was found in the available literature comparing vascular changes between psoriasis and psoriasiform dermatitis. Materials and Methods: Skin biopsies from 25 cases each of psoriasis and psoriasiform lesions were immunohistochemically stained for CD34 (endothelial marker). Microvessel density (MVD), microvessel length density and ratio of microvessel area to papillary dermal area were calculated using image analysis software. Results: Skin biopsies from psoriasis showed higher staining for CD34 on light microscopy. Using morphometric techniques, microvessel length density was significantly higher in psoriasis compared to psoriasiform lesions (P value <0.05). MVD was also higher in psoriasis, though the difference was not significant. The ratio of microvessel area to dermal area was almost similar in both the groups. Conclusion: Our results indicate that vascular tortuousity and dilatation is significant only in psoriatic lesions. These results may assist in automated diagnosis of skin biopsies.
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Affiliation(s)
- Shilpa Gupta
- Department of Pathology, Hindu Rao Hospital, Delhi, India
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34
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Dhabbe KI, Kumari A, Manoj V, Singh PP, Bhattacharya B. Development of an eco-friendly method to convert life expired composite propellant into liquid fertilizer. J Hazard Mater 2012; 205-206:89-93. [PMID: 22265654 DOI: 10.1016/j.jhazmat.2011.12.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2011] [Revised: 12/02/2011] [Accepted: 12/07/2011] [Indexed: 05/31/2023]
Abstract
Large quantity of composite propellants is produced as waste due to life expiry of missiles/rejection of propellant lots during manufacturing. The environmental protection agency does not allow the hazardous materials for open burning/open detonation. Therefore, a systematic study has been carried out to develop a method for the disposal of composite propellant into liquid fertilizer without affecting the environment. In this study, propellant compositions were digested in dilute nitric acid followed by neutralization with 5M KOH solution to get precipitated out aluminium as aluminium hydroxide and finally the obtained liquid was treated with orthophosphoric acid for further neutralization. The liquid fertilizer, thus, obtained was characterized for nitrate and phosphate content using ion chromatography while ICP-AES was used for the estimation of potassium, aluminium and other noxious metallic elements such as Pb, Cd, As, Cr, Cu, Ni and Zn. The analyses data indicate that liquid fertilizer is free from aluminium and noxious metallic elements while ratio of nitrogen, phosphorous and potassium are close to the Indian NPK value.
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35
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Priya SR, Singh PP, Upreti L, Vaid L. High resolution computed tomography in stapedial otosclerosis. Indian J Otolaryngol Head Neck Surg 2011; 65:505-11. [PMID: 24427705 DOI: 10.1007/s12070-011-0412-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2010] [Accepted: 11/24/2011] [Indexed: 12/01/2022] Open
Abstract
The value of high-resolution CT scanning in diagnosing stapedial otosclerosis and in influencing surgical planning was studied. 40 cases, consisting of patients of both genders, above the age of 14 years, with a clinical diagnosis of otosclerosis underwent HRCT of the temporal bones. Images were acquired in axial plane, with a bone algorithm, keeping slice thickness at 0.5 mm and intervals of 0.5 mm. Reconstruction of the volume data set was done to obtain overlapping slices in various planes, so as to obtain the best possible images of the footplate of stapes. The thickness of the footplate was measured and the site of lesion was noted in these images. On exploratory tympanotomy, the footplate was assessed and graded according to a visual scale. HRCT was able to diagnose stapedial otosclerosis in 85% ears. It was able to identify the presence of a thickened footplate correctly with a sensitivity of 85.3% (P value 0.16). It was able to correctly localize the site of otosclerotic focus in 85% cases (P value <0.01). Thus, an estimate of the thickness of the footplate likely to be encountered and thus the amount of drilling likely to be required to create a fenestra; and the likely site of maximum thickness could be made pre-operatively. This study also established the value of multislice CT on the acquisition of such data. This method obviates the requirement of difficult patient positioning, reduces scanning time; while greatly improving the sensitivity of the scanning.
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Affiliation(s)
- S R Priya
- Department of ENT, Guru Teg Bahadur Hospital, Dilshad Garden, Delhi, 110092 India
| | - P P Singh
- Department of ENT, Guru Teg Bahadur Hospital, Dilshad Garden, Delhi, 110092 India
| | - Lalendra Upreti
- Department of Radiology, Govind Ballabh Pant Hospital, Delhi, India
| | - Lakshmi Vaid
- Department of ENT, Guru Teg Bahadur Hospital, Dilshad Garden, Delhi, 110092 India
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36
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Singh PP, Gupta N, Goyal A, Tomar S. Interventional sialendoscopy for parotid ductal calculi: our preliminary experience. Indian J Otolaryngol Head Neck Surg 2011; 64:252-6. [PMID: 23998030 DOI: 10.1007/s12070-011-0361-0] [Citation(s) in RCA: 13] [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: 06/06/2011] [Accepted: 11/10/2011] [Indexed: 11/26/2022] Open
Abstract
With this article we present our initial experience with interventional sialendoscopy of the parotid duct for the parotid calculi. We carried out a prospective study of patients of parotid calculi in a tertiary referral centre. Diagnostic and interventional sialendoscopy was performed in five cases of parotid calculi. The outcome was classified on the basis of clearance of the lumen of the duct and resolution of symptoms. Diagnostic sialendoscopy was able to diagnose the calculus in all cases. Interventional sialendoscopy was done under general anesthesia in all cases and calculus was successfully removed. The average size of sialolith was 8.2 mm. No complications occurred in any of the cases. Check sialendoscopy was done in all cases after a minimum follow up of 6 months, which showed the duct lumen to be free of stone with no stricture of the duct. Sialendoscopy is an optimal technique for removal of intraductal parotid calculi and avoids removal of the gland. In our series there was no associated morbidity and complication.
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Affiliation(s)
- P P Singh
- Department of Otorhinolaryngology, University College of Medical Sciences and GTB Hospital, A-304, Abhyant Apartments, 2, Vasundhara Enclave, Delhi 110096 India
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37
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Abstract
Carcinoid tumors are low-grade malignant tumors that arise from neuroendocrine cells. Primary renal carcinoid is extremely rare. We present a case of 57-year-old male with primary renal carcinoid tumor. Presently, the patient is on regular follow up and is doing well.
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Affiliation(s)
- P P Singh
- Batra Hospital and Medical Research Centre, 1, Tughlakabad institutional area, M.B. Road, New Delhi -110 062, India
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38
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Gupta N, Goyal A, Singh PP, Sharma S. Isolated laryngeal lymphangioma: a rarity. Indian J Otolaryngol Head Neck Surg 2011; 63:90-2. [PMID: 22754851 DOI: 10.1007/s12070-011-0210-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2008] [Accepted: 03/28/2009] [Indexed: 11/27/2022] Open
Abstract
Lymphangiomas are uncommon congenital lesions of the lymphatic system, most often located in the head and neck. Most of these lesions manifest in children less than 2 years of age. Involvement of the larynx in isolation is rare and only a few cases have been reported so far. We report the case of a thirteen-year-old girl who presented with a swelling in the supraglottis. Excision of the mass was done after tracheotomy. Histopathological diagnosis was lymphangioma of the larynx. After a follow up of 15 months the patient is free of recurrence with all functions of larynx being normal.
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Affiliation(s)
- Neelima Gupta
- University College of Medical Sciences and GTB Hospital, Delhi, India
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39
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Vaid L, Gupta M, Gupta N, Singh PP. Bleomycin sclerotherapy in a rare case of adult-onset cervical lymphangioma. Ear Nose Throat J 2010; 89:E23-E26. [PMID: 20155685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
Abstract
Cervical lymphangioma in adults is a rare, benign tumor. Traditionally, the most accepted treatment has been surgical excision. However, when lymphangioma infiltrates vital neurovascular structures, excision is difficult and recurrence rates are high. The most common alternate treatment is intralesional injection of sclerosing agents, which has resulted in good outcomes in children. However, until now, no report of such treatment in adults has been published. We describe the case of a 60-year-old woman who presented with two lymphangiomas in the cervical area-one in the upper cervical area just below the angle of the mandible and the other in the submental area. She was treated with an intralesional injection of 1 mg/kg of bleomycin at both sites. Fifteen days later, the submental swelling had remitted completely and the other swelling had been reduced by 50%; 2 weeks later, a second injection was administered to the remaining swelling. At 6 months of follow-up, both lymphangiomas were in complete remission.
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Affiliation(s)
- Lakshmi Vaid
- Department of Otorhinolaryngology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India.
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40
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Abstract
Abstract
Extranasopharyngeal angiofibromas are rare tumors with only 65 cases being reported in the world literature. The most common sites involved are maxillary sinus, ethmoid sinus, sphenoid sinus, nasal septum, middle turbinate, inferior turbinate, cheek, conjunctiva, pterygomaxillary fissure, infratemporal fossa and laryngotracheal tree. We report on a case of 18 years old male patient of extranasopharyngeal angiofibroma of nasal septum.
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41
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Singh PP, Mahadi F, Roy A, Sharma P. Reactive oxygen species, reactive nitrogen species and antioxidants in etiopathogenesis of diabetes mellitus type-2. Indian J Clin Biochem 2009; 24:324-42. [PMID: 23105858 DOI: 10.1007/s12291-009-0062-6] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Diabetes mellitus type-2 (DMT-2) is a hyperglycemic syndrome with several characteristic features. It continues to rise unabatedly in all pockets of the world, parallels with affluence and can be controlled but not cured. It has a definite involvement of genetic component but environmental factors play overwhelmingly dominant role in etiopathogenesis. Insulin resistance (IR) and obesity are singular instigators of DMT-2. The various events cause critical defects in insulin signaling cascade followed by beta-cell dysfunction. Over a period of time, numerous other metabolic aberrations develop, resulting in diabetic complications which could be both vascular (cardiovascular complications, nephropathy, neuropathy, retinopathy and embryopathy) or a-vascular (cataract and glaucoma etc). It has been proposed that all these abnormal events are initiated or activated by a common mechanism of superoxide anion, which is accompanied with generation of a variety of reactive oxygen species (ROS), reactive nitrogen specie (RNS) and resultant heightened oxidative stress (OS). Provoked OS causes IR and altered gene expressions. Hyperglycemia induces OS through multiple routes: a)stimulated polyol pathway where in ≤ 30% glucose can be diverted to sorbitol and fructose, b)increased transcription of genes for proinflammatory cytokines and plasminogen activator inhibitor-1 (PAI-1) c) activation of protein kinase-C (PKC) leading to several molecular changes d)increased synthesis of Advanced Glycation End Products (AGEs) e)changes in a receptor far AGEs and f) autooxidation of glucose with formation of ketoimines and AGEs. All these processes are accompanied with alteration in redox status, ROS, RNS and OS which trigger DMT-2 and its complications. Initial hurriedly planned and executed experimental and clinical studies showed promising results of antioxidant therapies, but recent studies indicate that excess intake/supplement may have adverse outcomes including increased mortality. It is advocated that antioxidants should be given only if preexisting deficiency is present. Selection of antioxidant is another important aspect. Lastly but most importantly the impact of OS is not obligatory but facultative. As such only those diabetic patients will be benefited by antioxidant therapies that have impelling punch of prooxidants.
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Affiliation(s)
- P P Singh
- Department of Biochemistry, Era's Lucknow Medical College, Sarfarazganj, Lucknow, Uttar Pradesh India ; Department of Biochemistry, Era's Lucknow Medical College, Sarfarazganj, Lucknow, 226003 India
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42
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Abstract
BACKGROUND The APOE gene and its protein product is associated with a number of plasma proteins like very-low density lipoprotein (VLDL), high density lipoprotein (HDL) chylomicrons, chylomicron remnants, and plays a crucial role in lipid metabolism. The APOE gene is polymorphic and common alleles (*E2, *E3 and *E4) have been associated with a number of common and complex diseases in different populations. Due to their crucial role in metabolism and clinical significance, it is imperative that allelic variation in different populations is analysed to evaluate the usage of APOE in an evolutionary and clinical context. AIM We report allelic variation at the APOE locus in three European and four Indian populations and evaluate global patterns of genetic variation at this locus. The large, intricate and unexpected heterogeneity of this locus in its global perspective may have insightful consequences, which we have explored in this paper. SUBJECT AND METHODS Apolipoprotein E genotypes were determined in four population groups (Punjabi Sikhs, Punjabi Hindus, Maria Gonds and Koch, total individuals = 497) of India and three regionally sub-divided British populations (Nottinghamshire, East Midlands and West Midlands, total individuals = 621). The extent and distribution of APOE allele frequencies were compared with 292 populations of the world using a variety of multivariate methods. RESULTS Three alleles, APOE*E2, APOE*E3 and APOE*E4, were observed with contrasting variation, although *E4 was absent in the tribal population of Koch. Higher heterozygosities (>43%) in British populations reflected their greater genetic diversity at this locus. The overall pattern of allelic diversity among these populations is comparable to many European and Indian populations. At a global level, higher frequencies of the *E2 allele were observed in Africa and Oceania (0.099 +/- 0.083 and 0.111 +/- 0.052, respectively). Similarly, *E4 allele averages were higher in Oceania (0.221 +/- 0.149) and Africa (0.209 +/- 0.090), while Indian and Asian populations showed the highest frequencies of *E3 allele. The coefficient of gene differentiation was found to be highest in South America (9.6%), although the highest genetic diversity was observed in Oceania (48.7%) and Africa (46.3%). APOE*E2 revealed a statistically significant decreasing cline towards the north in Asia (r = -0.407, d.f. = 70, p < 0.05), which is not compatible with the coronary heart disease statistics in this continent. APOE*E4 showed a significant increasing cline in North European populations. Spatial autocorrelation analysis shows that the variation at this locus is influenced by 'isolation by distance' with a strong positive correlation for lower distances up to 1313 km. CONCLUSION Overall APOE allelic variation in UK and Indian populations is comparable to previous studies but in tribal populations *E4 allele frequency was very low or absent. At a global level allelic variation shows that geography, isolation by distance, genetic drift and possibly pre-historical selection are responsible for shaping the spectrum of genetic variation at the APOE gene. Overall, APOE is a good anthropogenetic and clinical diagnostic marker.
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Affiliation(s)
- P P Singh
- Department of Human Biology, Punjabi University, Patiala, India
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Singh PP, Singh M, Bhatnagar DP, Kaur TP, Gaur SK. Apolipoprotein E polymorphism and its relation to plasma lipids in coronary heart disease. ACTA ACUST UNITED AC 2009. [PMID: 18376083 DOI: 10.4103/0019-5359.39613] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND The present investigation is aimed at examining the Apolipoprotein E (APOE) genotypic influence on coronary heart disease (CHD) risk in northwest India (Punjab), where this disease is emerging as a major threat to public-health care system. MATERIALS AND METHODS The present study comprised of angiographically diagnosed coronary heart disease patients (n = 193) and controls (n = 150) of Punjab. Genetic polymorphism of APOE gene was investigated by polymerase chain reaction (PCR), and its association with lipid levels was evaluated. RESULTS The allele frequencies of epsilon2, epsilon3, and epsilon4 were 0.054, 0.795, 0.151; and 0.077, 0.856, 0.067 in patients and controls respectively. The bearers of E3/E4 genotype had threefold higher propensity of developing CHD in this population (OR, 3.04; CI, 1.55-6.25; P < 0.001), which exacerbated (OR, 4.18; CI, 2.03-9.27; P < 0.001) after correcting for age, sex, BMI, and lipid-lowering drugs. Lower HDL-C levels and higher LDL-C levels were found to be correlated with E3/E4 genotype (P < 0.01). Other concomitants like body mass index (BMI), total cholesterol (TC), and triglyceride (TG) levels did not show up as genetic determinants in this part of the region. CONCLUSIONS A significant association (P = 0.016) of epsilon4 allele, especially E3/E4 genotype, with CHD was observed, along with HDL-C and LDL-C concentrations, in the population of northwest India.
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Affiliation(s)
- P P Singh
- Department of Human Biology, Punjabi University, Patiala, India.
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Agrawal A, Singh PP, Bottazzi B, Garlanda C, Mantovani A. Pattern Recognition by Pentraxins. Advances in Experimental Medicine and Biology 2009; 653:98-116. [DOI: 10.1007/978-1-4419-0901-5_7] [Citation(s) in RCA: 116] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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45
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Satyanarayana K, Sharma A, Parikh P, Vijayan VK, Sahu DK, Nayak BK, Gulati RK, Parikh MN, Singh PP, Bavdekar SB, Sreehari U, Sahni P. Statement on publishing clinical trials in Indian biomedical journals. Indian J Cancer 2008; 45:39-40. [PMID: 18626145 DOI: 10.4103/0019-509x.41767] [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: 11/04/2022]
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Maharjan BR, Jha JC, Adhikari D, Risal S, Alurkar VM, Singh PP. Oxidative stress, antioxidant status and lipid profile in ischemic heart disease patients from western region of Nepal. Nepal Med Coll J 2008; 10:20-24. [PMID: 18700625] [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
Disturbed lipid profile is one of the most important and potent risk factors in ischemic heart disease (IHD). In recent years, it has been demonstrated that raised oxidative stress promotes several undesirable pathways including the formation of oxidised LDL (O-LDL) and oxidized cholesterol which encourages cholesterol accumulation in arterial tissues. We, therefore, aimed to ascertain the redox balance by measuring oxidative stress (OS) and total antioxidant activity (TAA) along with lipid profile to determine their possible association with IHD. Our study group comprised of 28 confirmed cases of IHD. The inclusion criterion was history of chest pain, ischemic changes in the ECG and good left ventricular (LV) function. Patients with diabetes mellitus, poor LV function, previous infarct and valvular heart disease were excluded. Lipid profile, plasma thiobarbituric acid reactive substances (TBARS), plasma total antioxidant activity (TAA) and urinary TBARS were estimated in these patients by standard procedures and the values were compared with 30 age, sex and socioeconomically matched normal healthy control subjects. Body mass index (BMI) and waist/hip ratio (W/H ratio) was also noted in both the groups. Lipid profile and OS (TBARS levels) were significantly raised in IHD patients. Though statistically not significant but TAA tended to be lower and urinary TBARS levels tended to be higher in patients. BMI, W/H ratio, smoking and alcohol did not show discernible association with lipid profile, OS or TAA. OS is significantly raised in majority of IHD patients. The non association of BMI, W/H ratio, smoking and alcohol with lipid profile, OS and TAA suggest that there are other risk factors which primarily contribute to the initiation and progression of IHD.
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Affiliation(s)
- B R Maharjan
- Department of Biochemistry, Kathmandu University of Medical Sciences, Chaukot, Kavre, Nepal.
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Maharjan BR, Jha JC, Adhikari D, Vishwanath P, Baxi J, Alurkar VM, Singh PP. A study of oxidative stress, antioxidant status and lipid profile in diabetic patient in the western region of Nepal. Kathmandu Univ Med J (KUMJ) 2008; 6:16-22. [PMID: 18604109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
AIMS AND OBJECTIVES Diabetes mellitus (DM) is often termed as a disease of premature aging. Several studies have indicated lopsided redox balance due to pro oxidant environment as one of the important etiological factors. Some recent researches also indicate a causal relationship with oxidative stress (OS). So far, no study has been undertaken on this aspect in Nepali populations. We, therefore, aimed this maiden study in Nepali population to examine redox balance by measuring OS and antioxidant status along with lipid profile in 37 patients of DM type- 2 and 30 matched normal subjects. METHODOLOGY Thirty seven patients of DM type-2 without any complications (mean age= 57.6+/- 10.6 years) and 30 normal subjects (mean age= 55.8 +/- 14.8 years) were included in this study. Body Mass Index (BMI) and Waist/Hip (W/H) ratio were measured. Fasting blood sample was collected for the analysis of total antioxidant activity (TAA), plasma and urinary thiobarbituric acid reactive substances (TBARS) and lipid profile by standard procedures in both the groups. The statistical analysis was done with SPSS 10 version. RESULTS Total cholesterol, triglyceride, VLDL-cholesterol, LDL-cholesterol, plasma and urinary TBARS were significantly raised whereas, plasma TAA was significantly reduced in DM type-2 patients as compared to controls. The comparison of old and fresh cases revealed that though TAA was lower and PTBARS and UTBARS were higher in patients but did not attain the level of significance. W/H ratio is significantly higher in patients compared to normal subjects. But, no significant correlation of BMI and W/H with lipid profile is observed in both control and patients. CONCLUSION Oxidative stress is raised in type 2 DM patients. This along with deranged lipid profile and decreased antioxidant status could be the risk factors in the development of complications associated with DM.
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Affiliation(s)
- B R Maharjan
- Department of Biochemistry, Kathmandu University of Medical Sciences, Kavre, Nepal.
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Jha JC, Maharjan BR, Adhikari D, Vishwanath P, Nagamma T, Azhari S, Singh PP. Cigarette smoke induced oxidative insult in local population of Pokhara. Kathmandu Univ Med J (KUMJ) 2007; 5:511-517. [PMID: 18604085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
OBJECTIVES To assess the effect of cigarette smoking on lipid peroxidation induced oxidative stress, antioxidants, uric acid and blood sugar in normal subjects. METHODS The study included 61 normal subjects with regular smoking habit and 57 never-smokers normal subjects matched in respect to socio-economic status, age and BMI. Information regarding smoking habit and other personal details were collected by oral questionnaire. Total antioxidant activity (TAA), reduced glutathione (GSH), alpha-tocopherol (alpha-T), ascorbic acid (AA), uric acid (UA), plasma and urinary thiobarbituric acid reactive substances (TBARS), fasting blood sugar (FBS) and urinary creatinine (Cr) were estimated by standard procedures in both the groups. Ferric Reducing Antioxidant Power (FRAP) procedure is used to estimate TAA which measures total dietary antioxidants. Statistical analysis was done with SPSS version 10. RESULTS The mean pack years smoked by smokers was 14.4 +/- 15.8. The plasma TBARS level in smokers and never-smokers was 2.6 +/- 0.8 and 2.5 +/- 0.6 micromol/L respectively. The respective figure for urinary TBARS level was 4.6 +/- 2.7 and 3.7 +/- 1.4 micromol/gmCr. Smokers did not show any significant difference from never-smokers with respect to GSH, alpha-T, AA, plasma TBARS and FBS. However, the smokers had significantly lower levels of TAA (p<0.05) and raised level of urinary TBARS (p<0.05) and uric acid (p<0.01) as compared to never-smokers. CONCLUSION Our study suggests that smoking induces mild lipid peroxidation but the body is able to compensate for it by removing its adducts. Importantly it also indicates enhanced oxidation of purines which are essential components of both DNA and RNA. Dietary antioxidants are consumed to scavenge free radicals (FR) and other reactive species (RS) in smoke. Female smokers are more prone to oxidative insult than male smokers. In summary RS present in smoke induce mild lipid peroxidation but are not the major contributors of redox imbalance in smoke induced toxicity in the selected subjects.
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Affiliation(s)
- J C Jha
- Department of Biochemistry, Manipal College of Medical Sciences, Pokhara, Nepal.
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Singh PP, Voleti B, Agrawal A. A novel RBP-J kappa-dependent switch from C/EBP beta to C/EBP zeta at the C/EBP binding site on the C-reactive protein promoter. J Immunol 2007; 178:7302-9. [PMID: 17513780 PMCID: PMC3831876 DOI: 10.4049/jimmunol.178.11.7302] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Regulation of basal and cytokine (IL-6 and IL-1beta)-induced expression of C-reactive protein (CRP) in human hepatoma Hep3B cells occurs during transcription. A critical transcriptional regulatory element on the CRP promoter is a C/EBP binding site overlapping a NF-kappaB p50 binding site. In response to IL-6, C/EBPbeta and p50 occupy the C/EBP-p50 site on the CRP promoter. The aim of this study was to identify the transcription factors occupying the C/EBP-p50 site in the absence of C/EBPbeta. Accordingly, we treated Hep3B nuclear extract with a C/EBP-binding consensus oligonucleotide to generate an extract lacking active C/EBPbeta. Such treated nuclei contain only C/EBPzeta (also known as CHOP10 and GADD153) because the C/EBP-binding consensus oligonucleotide binds to all C/EBP family proteins except C/EBPzeta. EMSA using this extract revealed formation of a C/EBPzeta-containing complex at the C/EBP-p50 site on the CRP promoter. This complex also contained RBP-Jkappa, a transcription factor known to interact with kappaB sites. RBP-Jkappa was required for the formation of C/EBPzeta-containing complex. The RBP-Jkappa-dependent C/EBPzeta-containing complexes were formed at the C/EBP-p50 site on the CRP promoter in the nuclei of primary human hepatocytes also. In luciferase transactivation assays, overexpressed C/EBPzeta abolished both C/EBPbeta-induced and (IL-6 + IL-1beta)-induced CRP promoter-driven luciferase expression. These results indicate that under basal conditions, C/EBPzeta occupies the C/EBP site, an action that requires RBP-Jkappa. Under induced conditions, C/EBPzeta is replaced by C/EBPbeta and p50. We conclude that the switch between C/EBPbeta and C/EBPzeta participates in regulating CRP transcription. This process uses a novel phenomenon, that is, the incorporation of RBP-Jkappa into C/EBPzeta complexes solely to support the binding of C/EBPzeta to the C/EBP site.
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Affiliation(s)
| | | | - Alok Agrawal
- Address correspondence and reprint requests to: Dr. Alok Agrawal, Department of Pharmacology, P.O. Box 70577, East Tennessee State University, Johnson City, TN 37614.
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Voleti B, Singh PP, Agrawal A. Transcription factor OCT‐1 represses C‐reactive protein expression. FASEB J 2007. [DOI: 10.1096/fasebj.21.5.a284-d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Bhavya Voleti
- PharmacologyEast Tennessee State UniversityP.O.Box 70577Johnson cityTN37614
| | - Prem Prakash Singh
- PharmacologyEast Tennessee State UniversityP.O.Box 70577Johnson cityTN37614
| | - Alok Agrawal
- PharmacologyEast Tennessee State UniversityP.O.Box 70577Johnson cityTN37614
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