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Chaudhary S, Weigt SS, Ribeiro Neto ML, Benn BS, Pugashetti JV, Keith R, Chand A, Oh S, Kheir F, Ramalingam V, Solomon JJ, Harper R, Lasky JA, Oldham JM. Interstitial lung disease progression after genomic usual interstitial pneumonia testing. Eur Respir J 2023; 61:2201245. [PMID: 36549706 PMCID: PMC10288658 DOI: 10.1183/13993003.01245-2022] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 11/23/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND A genomic classifier for usual interstitial pneumonia (gUIP) has been shown to predict histological UIP with high specificity, increasing diagnostic confidence for idiopathic pulmonary fibrosis (IPF). Whether those with positive gUIP classification exhibit a progressive, IPF-like phenotype remains unknown. METHODS A pooled, retrospective analysis of patients who underwent clinically indicated diagnostic bronchoscopy with gUIP testing at seven academic medical centres across the USA was performed. We assessed the association between gUIP classification and 18-month progression-free survival (PFS) using Cox proportional hazards regression. PFS was defined as the time from gUIP testing to death from any cause, lung transplant, ≥10% relative decline in forced vital capacity (FVC) or censoring at the time of last available FVC measure. Longitudinal change in FVC was then compared between gUIP classification groups using a joint regression model. RESULTS Of 238 consecutive patients who underwent gUIP testing, 192 had available follow-up data and were included in the analysis, including 104 with positive gUIP classification and 88 with negative classification. In multivariable analysis, positive gUIP classification was associated with reduced PFS (hazard ratio 1.58, 95% CI 0.86-2.92; p=0.14), but this did not reach statistical significance. Mean annual change in FVC was -101.8 mL (95% CI -142.7- -60.9 mL; p<0.001) for those with positive gUIP classification and -73.2 mL (95% CI -115.2- -31.1 mL; p<0.001) for those with negative classification (difference 28.7 mL, 95% CI -83.2-25.9 mL; p=0.30). CONCLUSIONS gUIP classification was not associated with differential rates of PFS or longitudinal FVC decline in a multicentre interstitial lung disease cohort undergoing bronchoscopy as part of the diagnostic evaluation.
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Affiliation(s)
- Sachin Chaudhary
- Division of Pulmonary and Critical Care Medicine, University of Arizona, Tucson, AZ, USA
| | - S Sam Weigt
- Division of Pulmonary and Critical Care Medicine, University of California at Los Angeles, Los Angeles, CA, USA
| | | | - Bryan S Benn
- Division of Pulmonary and Critical Care Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Janelle Vu Pugashetti
- Division of Pulmonary, Critical Care and Sleep Medicine, University of California at Davis, Sacramento, CA, USA
| | - Rebecca Keith
- Division of Pulmonary and Critical Care and Sleep Medicine, National Jewish Health, Denver, CO, USA
| | - Arista Chand
- Division of Pulmonary and Critical Care Medicine, University of Arizona, Tucson, AZ, USA
| | - Scott Oh
- Division of Pulmonary and Critical Care Medicine, University of California at Los Angeles, Los Angeles, CA, USA
| | - Fayez Kheir
- Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Vijaya Ramalingam
- Division of Pulmonary and Critical Care Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
- Northeast Georgia Physicians Group
| | - Joshua J Solomon
- Division of Pulmonary and Critical Care and Sleep Medicine, National Jewish Health, Denver, CO, USA
| | - Richart Harper
- Division of Pulmonary, Critical Care and Sleep Medicine, University of California at Davis, Sacramento, CA, USA
| | - Joseph A Lasky
- Division of Pulmonary and Critical Care Medicine, Tulane University, New Orleans, LA, USA
| | - Justin M Oldham
- Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, MI, USA
- Department of Epidemiology, University of Michigan, Ann Arbor, MI, USA
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Malo J, Natt B, Chaudhary S, Knox KS. Prophylaxis in Lung Transplant Recipients. Clin Infect Dis 2023; 76:368-369. [PMID: 36037080 DOI: 10.1093/cid/ciac706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 08/25/2022] [Indexed: 01/18/2023] Open
Affiliation(s)
- Joshua Malo
- Department of Medicine, University of Arizona College of Medicine-Tucson, Tucson, Arizona, USA
| | - Bhupinder Natt
- Department of Medicine, University of Arizona College of Medicine-Tucson, Tucson, Arizona, USA
| | - Sachin Chaudhary
- Department of Medicine, University of Arizona College of Medicine-Tucson, Tucson, Arizona, USA
| | - Kenneth S Knox
- Department of Medicine, University of Arizona College of Medicine-Phoenix, Phoenix, Arizona, USA
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Barik S, Garg V, Sinha SK, Chaudhary S, Kandwal P, Singh V. A Meta-Analysis on Comparison of Open vs Closed Reduction of Gartland Type 3 Supracondylar Humerus Fractures in Children. Acta Chir Orthop Traumatol Cech 2023; 90:198-205. [PMID: 37395427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 07/04/2023]
Abstract
PURPOSE OF THE STUDY Although there are numerous studies on outcomes and comparison of open and closed reduction but there is no clarity on relationship between outcomes and complications with type of surgical intervention done for Type 3 Gartland supracondylar humerus fracture. The aim of this study is to compare the outcomes and complications of closed vs open reduction in Type 3 Gartland supracondylar humerus fractures. MATERIAL AND METHODS Electronic literature searches of Embase, MEDLINE and the Cochrane Library was conducted in February 2022 using the terms "supracondylar", "humerus", "fracture", "Gartland type 3" and synonymous. The data extracted included the study details, demographic data, procedure performed, final functional and cosmetic outcome according to Flynn criteria and complications of included studies. RESULTS Pooled data analysis revealed no significant difference in mean satisfactory outcome rate according to Flynn cosmetic criteria in open group (97%, 95% CI 95.5%-98.5%), as compared to closed group (97.5%, 95% CI 96.3%-98.7%), although a statistically significant difference in mean satisfactory rate according to Flynn functional criteria in open group (93.4%, 95% CI 90.8%- 96.1%) as compared to closed group (98.5%, 95% CI 97.5%-99.4%) was noted. On separate comparison of the two-arm studies, closed reduction favoured better functional outcomes (RR 0.92, 95% CI 0.86-0.99). CONCLUSIONS Closed reduction and percutaneous fixation have better functional outcome than open reduction with K-wire fixation. But there was no significant difference in cosmetic outcomes, overall complication rate and nerve injury with either open or closed reduction. The threshold of converting a closed reduction to an open reduction in supracondylar humerus fractures of children should be high. Key words: supracondylar humerus, open reduction, percutaneous pinning, Flynn criteria.
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Affiliation(s)
- S Barik
- Department of Orthopedics, All India Institute of Medical Sciences, Deoghar, Jharkhand, India
| | - V Garg
- Department of Orthopaedics All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - S K Sinha
- Department of Orthopaedics All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - S Chaudhary
- Department of Orthopaedics All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - P Kandwal
- Department of Orthopaedics All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - V Singh
- Department of Orthopaedics All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
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Chaudhary S, Das L, Sharma N, Sachdeva N, Bhansali A, Dutta P. Utility of myxedema score as a predictor of mortality in myxedema coma. J Endocrinol Invest 2023; 46:59-65. [PMID: 35945394 DOI: 10.1007/s40618-022-01884-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 07/26/2022] [Indexed: 01/12/2023]
Abstract
OBJECTIVE Myxedema crisis (MC) is a rare condition. There is a dearth of data regarding the predictors of mortality in MC. Predictive scores for mortality specific to the clinical and biochemical profile of MC are still lacking. DESIGN AND METHODS All consecutive patients presenting with MC from September 2006 to December 2020 comprised the new cohort. Patients managed between January 1999 and August 2006 comprised the old cohort. Both cohorts were compared for the determination of secular trends. Combined analysis of both the cohorts was done for clinico-demographic profile and predictors of mortality. Myxedema score (MS) and qSOFA (Quick Sequential Organ Failure Assessment) score were evaluated in all the patients. RESULTS A total of forty-one patients (new cohort; n = 18 and old cohort; n = 23) were enrolled into the study. There was a female predominance (80.5%). Nearly half (51.2%) of the patients were newly diagnosed with hypothyroidism on admission. Overall mortality was 60.9%. On comparative analysis among survivors and non-survivors, female gender (OR 20.4, p value 0.018), need for mechanical ventilation (OR16.4, p value 0.009), in-hospital hypotension (OR 9.1, p value 0.020), and high qSOFA score (OR 7.1, p value 0.023) predicted mortality. MS of > 90 had significantly higher mortality (OR-11.8, p value - 0.026) while MS of > 110 had 100% mortality. There was no change in secular trends over last 20 years. There was no difference in outcome of patients receiving oral or IV levothyroxine. CONCLUSION Myxedema crisis is associated with high mortality despite improvement in health care services. The current study is first to elucidate the role of the MS in predicting mortality in patients with MC.
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Affiliation(s)
- S Chaudhary
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research (PGIMER), Nehru Extension Block, 1012, Chandigarh, 160012, India
| | - L Das
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research (PGIMER), Nehru Extension Block, 1012, Chandigarh, 160012, India
| | - N Sharma
- Department of Internal Medicine, PGIMER, Chandigarh, India
| | - N Sachdeva
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research (PGIMER), Nehru Extension Block, 1012, Chandigarh, 160012, India
| | - A Bhansali
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research (PGIMER), Nehru Extension Block, 1012, Chandigarh, 160012, India
| | - P Dutta
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research (PGIMER), Nehru Extension Block, 1012, Chandigarh, 160012, India.
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Ratan S, Nigam S, Midha T, Chaudhary S. A comparative study on treatment seeking behaviour of geriatric population in rural and urban areas of district Kanpur, Uttar Pradesh. Indian J Community Health 2022. [DOI: 10.47203/ijch.2022.v34i04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Background: Aging is a complex and universal life process. Treatment seeking behaviour in elderly is affected by socio-economic factors and by affordability, availability and accessibility of healthcare. Objectives: To study treatment-seeking behaviour of the study subjects. To compare treatment seeking behaviour among rural and urban study subjects. Methods: This was a cross-sectional study conducted in the Kanpur district. Selection of villages in rural and mohallas in urban areas was done using a multistage random sampling technique. A total of 600 subjects were studied, including 400 from urban areas and 200 from rural areas. Elderly persons>60 years of age, both males and females were included in the study. Results: Overall, out of 600 study subjects, 59.8% were taking treatment in rural areas and in urban areas 77.6% were taking treatment. In urban areas, more females availed treatment compared to rural areas. Majority of study subjects (56.5%) sought treatment from a government hospital. Only 36% subjects had health insurance. Conclusion: In Urban areas more subjects availed treatment as compared to rural areas. Majority of subjects sought treatment from government health facilities. Lack of financial support and long waiting time were major reasons for not availing health care.
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Chaudhary S, Walia R, Bhansali A, Dayal D, Sachdeva N, Singh T, Bhadada SK. Unravelling a novel, promising and convenient tool for differential diagnosis of delayed puberty: GnRHa-stimulated inhibin B (GnRH-iB). J Endocrinol Invest 2022; 45:2265-2273. [PMID: 35841519 DOI: 10.1007/s40618-022-01858-8] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Accepted: 06/29/2022] [Indexed: 10/17/2022]
Abstract
BACKGROUND Etiological diagnosis of delayed puberty is difficult. Despite availability of various basal and stimulation tests differentiation between constitutional delay in puberty and hypogonadotropic hypogonadism is still challenging. OBJECTIVE To elucidate the role of GnRH agonist-stimulated inhibin B (GnRH-iB) for the differential diagnosis of delayed puberty. STUDY DESIGN Participants were recruited into "exploratory cohort" (n = 39) and "validation cohort" (n = 16). "Exploratory cohort" included children with spontaneous puberty and patients with hypogonadotropic hypogonadism. "Validation cohort" constituted children who presented with delayed puberty. INTERVENTION AND OUTCOME GnRHa (Triptorelin) stimulation test along with measurement of inhibin B level at 24 h after GnRHa injection was performed in all the study participants. Cut-offs for GnRH-iB were derived from the "exploratory cohort". These cut-offs were applied to the "validation cohort". Basal LH, basal inhibin B(INH-B), GnRHa-stimulated LH at 4 h (GnRH-LH) and GnRH-iB were evaluated for the prediction of onset of puberty on prospective follow-up. RESULTS GnRH-iB at a cut-off value of 113.5 pg/ml in boys and 72.6 pg/ml in girls had 100% sensitivity and specificity for the documentation of puberty. In the "validation cohort" basal LH, basal INH-B, GnRH-LH, and GnRH-iB had a diagnostic accuracy of 68.75%, 81.25%, 68.75% and 93.75% respectively, for the prediction of onset of puberty. Basal LH, basal INH-B and GnRH-LH used alone or in combination were inferior to GnRH-iB used alone. CONCLUSION GnRHa-stimulated inhibin B (GnRH-iB) is a convenient and easily employable test for the differentiation of constitutional delay in puberty from hypogonadotropic hypogonadism. CTRI REGISTRATION NO CTRI/2019/10/021570.
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Affiliation(s)
- S Chaudhary
- Department of Endocrinology, PGIMER, Chandigarh, 160012, India
| | - R Walia
- Department of Endocrinology, PGIMER, Chandigarh, 160012, India.
| | - A Bhansali
- Department of Endocrinology, PGIMER, Chandigarh, 160012, India
| | - D Dayal
- Department of Paediatrics, PGIMER, Chandigarh, 160012, India
| | - N Sachdeva
- Department of Endocrinology, PGIMER, Chandigarh, 160012, India
| | - T Singh
- Department of Radiology, PGIMER, Chandigarh, 160012, India
| | - S K Bhadada
- Department of Endocrinology, PGIMER, Chandigarh, 160012, India
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Chaudhary S, Kędziera D, Rafiński Z, Dobrzańska L. Polymorphism in a series of dipodal N-donor ligands containing a biphenyl core. Acta Cryst Sect A 2022. [DOI: 10.1107/s2053273322090921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/19/2023]
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Brahmbhatt N, Mishra V, Aggrawal R, Chaudhary S, Shah K, Priya P, Solanki S, Sheth H, Patel K, Suthar A, Patel K, Repswal P, Dongare A. P-059 Effect of outcome of microfluidic sperm sorter and conventional swim-up technique on DNA integrity of the sperm. Hum Reprod 2022. [DOI: 10.1093/humrep/deac107.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Study question
Does the approach of sperm preparation technique plays any role in sperm DNA Integrity
Summary answer
Outcome of the semen sample is directly proportional to the choice of preparation technique. Microfluidics improves sperm selection and results in better sperm DNA integrity
What is known already
Microfluidic systems are promising tools for fluid manipulation that can noninvasively separate motile sperm with higher hydrodynamics profile from the lower ones. It also enables to manipulate micro swimmers as compared to the traditional methods that to without centrifugation .As it is already known that Semen analysis and preparation is one of the most important aspects in andrology and microfluidics can improve sperm analysis and selection, therefore increasing the ART success rates
Study design, size, duration
Comparative study from July 2019 to Dec 2021 in IVF unit of IKDRC Hospital .A total number of 900 patients were enrolled in the study and were randomized by using computer generated list then divided into two groups, Group A contains 460 samples and Group B having 440 samples.
Participants/materials, setting, methods
Group A (n = 460) sample was prepared by using Microfluidic sperm Sorting technique and Group B (n = 440) sample was prepared by conventional Swim up technique. Samples were analyzed according to WHO 2010 laboratory manual for examination and processing of human sperm, including all normozoospermic samples. Primary outcomes of the study was DNA Fragmentation index (DFI) and it was evaluated by using sperm chromatin dispersion (SCD) test and secondary outcomes was Progressive motility .
Main results and the role of chance
DNA fragmentation index is significantly lower in group A where Microfluidic Sperm Sorting technique (MFSS )is used than in group B where conventional swim up technique is use (10.06% vs 34.2%, p<0.0001) significant values implies that DNA integrity is better in group A than in group B and progressive motility was also found to be significantly higher in group A as compared to group B (57.6%vs16.9%, p <0.001).
Limitations, reasons for caution
As sample size was smaller, larger randomized control studies are needed to strengthen these results and all normal samples were used for the analysis and preparation , abnormal parameters were not involved .
Wider implications of the findings
According to our study the samples prepared by Microfluidic technique have higher DNA integrity than samples prepared by Swim up technique. Lower DNA Fragmentation index in microfluidics outcome indicates lower DNA damage. Choice of technique for the preparation of semen sample also plays a key role in better sperm selection.
Trial registration number
N/A
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Affiliation(s)
- N Brahmbhatt
- IVF Unit -Department of obs and gynae , Embryology, ahemdabad, India
| | - V Mishra
- IVF Unit -Department of obs and gynae, obstetrics and gynaecology , ahemdabad, India
| | - R Aggrawal
- IVF Unit -Department of obs and gynae, obstetrics and gynaecology , ahemdabad, India
| | - S Chaudhary
- IVF Unit -Department of obs and gynae, obstetrics and gynaecology , ahemdabad, India
| | - K Shah
- IVF Unit -Department of obs and gynae, obstetrics and gynaecology , ahemdabad, India
| | - P Priya
- IVF Unit -Department of obs and gynae, obstetrics and gynaecology , ahemdabad, India
| | - S Solanki
- IVF Unit -Department of obs and gynae, obstetrics and gynaecology , ahemdabad, India
| | - H Sheth
- IVF Unit -Department of obs and gynae , Embryology, ahemdabad, India
| | - K Patel
- IVF Unit -Department of obs and gynae , Embryology, ahemdabad, India
| | - A Suthar
- IVF Unit -Department of obs and gynae , Embryology, ahemdabad, India
| | - K Patel
- IVF Unit -Department of obs and gynae , Embryology, ahemdabad, India
| | - P Repswal
- IVF Unit -Department of obs and gynae , Embryology, ahemdabad, India
| | - A Dongare
- IVF Unit -Department of obs and gynae, obstetrics and gynaecology , ahemdabad, India
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Shrestha K, Sharma P, Shah S, Thomas M, Franco PM, Guru P, Chaudhary S. Hyperammonemia Refractory to Continuous Renal Replacement Therapy, a Fatal Complication Post-Lung Transplant. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Abstract
Background- During the COVID- 19 pandemic in the first wave, infected patients age was range from 4 weeks to 90 years and those who have more age and with comorbidities are more susceptible to develop serious illness and have high mortality rates. Objective-To study the association between survivor vs non survivor on the basis of demographic profile and high risk factors. Material & methods: This study was done in the Government Medical College, Kannauj on the COVID-19 patients who were admitted in the isolation wards, from 1st September 2020 to December 31st 2020. Statistical Analysis- Analysis was done using SPSS- 23 trial version software. Results: case fatality rate was 2.7% in this study. Most common symptoms was cough (61.0%) and among these admitted patients the most common comorbidities was hypertension (26.7%), followed by diabetes (20.7%), and COPD (14.0%) respectively. Platelets (< 0.02), post prandial blood sugar (PPBS) (< 0.01) have significant role in survivability of COVID- 19 patients. Conclusion: This study concludes that those patients who were older in age and with comorbidity especially (hypertension, COPD, high PPBS, High platelets) have poorer prognosis as compare to those without.
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Soni KC, Verma P, Arya P, Tiwari B, Midha T, Chaudhary S. Clinico-immunological Study of HIV Infected Children Attending ART CenterA Prospective Longitudinal Study. J Clin Diagn Res 2022. [DOI: 10.7860/jcdr/2022/52417.15948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Introduction: Human Immunodeficiency Virus (HIV) infection is a growing concern in paediatric population and large number of children are registered and treated at Antiretroviral Treatment (ART) centres across the country. Children with HIV progress more rapidly, develop more bacterial infections, suffer from neurologic developmental problems and have higher mortality than adults. So the screening and counselling of HIV positive parents and their children must be done timely. This helps the physician for starting the treatment timely. Aim: To determine the clinico-immunological profile of paediatric patients registered in ART, and to compare the immunological profile and clinical staging of paediatric patients receiving ART. Materials and Methods: This prospective longitudinal study was conducted in the ART centre of Sarojini Naidu Medical College, Agra, Uttar Pradesh, India, from October 2017 to October 2018. Total 51 children, upto the age group of 18 years, suffering from HIV/Acquired immunodeficiency syndrome (AIDS) were enrolled in the study. Diagnosis of HIV was confirmed using EnzymeLinked Immunosorbent Assay (ELISA) method (using two different antigens Comb HIV test, TRI-DOT) in children more than 18 months of age. In children less than 18 months age, diagnosis was confirmed using Deoxyribonucleic Acid (DNA) Polymerase Chain Reaction (PCR) (repeated twice with cessation of breast feeding for minimum of six weeks). Statistical analysis was done by using Statistical Package for the Social Sciences (SPSS) trial version 23.0 and simple frequency and Chi-square test was used for analysis. Results: Majority of the children (20, 39.26%) were in the age group of 5-10 years, and male: female ratio was 2.4:1. Most common presenting complaint was cough (52.94%), followed by fever (47.05%), chronic diarrhea (37.25%). Most common clinical signs seen were hepatosplenomegaly (41.17%), pneumonia (33.33%) and lymphadenopathy (31.37%). Initially the mean CD4 count was 370.31±231.5 cell/mm3 , and after starting ART mean CD4 count was 524.6±260.4 cell/mm3 . Significant improvement in CD4 count was observed in age group of 5-10 years (p-value=0.009), and 10-15 years (p-value=0.001) after six months of starting the ART. In the beginning, maximum (56.7%) children belonged to World Health Organization (WHO) clinical staging III and after starting ART maximum 40% belonged to stage II. Conclusion: ART improves symptomatology and immunological status HIV infected children, so there is need to screen the children of HIV affected parents and identify the children suffering with HIV in order to initiate ART at the earliest indication in order to improve their general health, freedom from illness and better immunological status.
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Chaudhary S, Chaudhary S, Kumar M, Salhotra R. Fentanyl versus nalbuphine for intubating conditions during awake fiberoptic bronchoscopy: A randomized double-blind comparative study. J Anaesthesiol Clin Pharmacol 2021; 37:378-382. [PMID: 34759547 PMCID: PMC8562462 DOI: 10.4103/joacp.joacp_359_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 12/20/2019] [Accepted: 02/24/2020] [Indexed: 11/10/2022] Open
Abstract
Background and Aims: Patient cooperation, sedation, anxiolysis, and topicalization are important prerequisites for the successful and safe conduct of awake intubation. Because of the pharmacological properties, opioids can facilitate this process. Fentanyl is an opioid agonist and nalbuphine is an agonist-antagonist. This study aims to compare these two opioids for their effect on sedation and intubating conditions during awake fiberoptic intubation. Material and Methods: This randomized double-blind controlled study was conducted on 62 ASA I/II patients of either sex between the age of 20 and 60 years, weight between 40 and 80 kg, with MP class I/II airways requiring general anesthesia with endotracheal intubation. All patients received standard airway topicalization and nebulization. Patients were randomly allocated to one of the two groups according to a computer-generated random number table. Group F (n = 31) received fentanyl 2 μg/kg i.v. and group N (n = 31) received nalbuphine 0.2 mg/kg i.v. over 10 min before intubation. Fiberoptic intubation was attempted and lignocaine spray and propofol boluses were administered as and when required. Hemodynamic responses and intubating conditions were recorded. Repeated measure ANOVA, McNemar test, and Chi-square test or Fischer's exact test were used for data analysis. A P < 0.05 was considered significant. Results: Cough score (P = 0.458), post-intubation score (P = 1.000), and sedation score (P = 1.000) were comparable among the two groups. Hemodynamic responses and propofol and lignocaine requirements were also comparable. Conclusion: Both fentanyl and nalbuphine provide comparable intubating conditions when used before awake fiberoptic intubation with minimal adverse effects on hemodynamic profile.
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Affiliation(s)
- Sujata Chaudhary
- Department of Anesthesiology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Dilshad Garden, Delhi, India
| | - Sachin Chaudhary
- Department of Anesthesiology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Dilshad Garden, Delhi, India
| | - Mahendra Kumar
- Department of Anesthesiology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Dilshad Garden, Delhi, India
| | - Rashmi Salhotra
- Department of Anesthesiology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Dilshad Garden, Delhi, India
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Chaudhary S, Ranamagar R, Shrestha L, Pun DB, Karmacharya P, Mahotra NB. The Postural Effects on Electrical Activities of Heart in Apparently Healthy Young Adults. Kathmandu Univ Med J (KUMJ) 2021; 19:499-502. [PMID: 36259195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Background The electrical activities of heart recorded as electrocardiogram (ECG) are mostly done in supine postures. The body postural changes have effects in these electrical activities in heart which needs to be properly recognized. Objective To find the variations in electrocardiogram during postural changes from supine to upright i.e. sitting and standing postures among apparently healthy young adults. Method A cross sectional study was carried out in Manipal College of Medical Sciences after the institutional ethical clearance. The apparently healthy 30 Nepalese male medical students between 18-25 years of age were enrolled. The electrocardiography was elicited in supine, sitting and standing postures in the participants after 5 minutes' interval between each procedure in each participant. Result The highest mean amplitudes of Q wave were seen in sitting postures (0.12±0.04 mm), R wave in standing postures (1.46±0.55 mm) and S wave also in standing postures (0.23±0.2 mm). The mean amplitudes of Q and S waves showed statistically significant difference when compared between supine and upright postures. The maximum QRS duration was found while sitting (0.08±0.01 ms)and maximum heart rate in standing posture (82.43±10.59/min). The mean comparison of heart rate was statistically highly significant when compared between supine and standing postures. The mean QRS frontal axis was comparatively increased while standing (64.30±39.29). Conclusion The electrical activities of heart vary during postural changes among apparently healthy young adults. These changes are most prominent when compared between supine and standing postures which urges for careful interpretation of electrocardiogram if it is done in upright postures.
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Affiliation(s)
- S Chaudhary
- Department of Clinical Physiology, Maharajgunj Medical Campus, Institute of Medicine, Kathmandu, Nepal
| | - R Ranamagar
- Department of Physiology, Manipal College of Medical Sciences, Pokhara, Nepal
| | - L Shrestha
- Department of Clinical Physiology, Maharajgunj Medical Campus, Institute of Medicine, Kathmandu, Nepal
| | - D B Pun
- Department of Physiology, Karnali Academy of Health Sciences, Karnali, Nepal
| | - P Karmacharya
- Department of Physiology, Manipal College of Medical Sciences, Pokhara, Nepal
| | - N B Mahotra
- Department of Clinical Physiology, Maharajgunj Medical Campus, Institute of Medicine, Kathmandu, Nepal
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15
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Stahl C, Frederick K, Chaudhary S, Morton CJ, Loy D, Muralidharan K, Sorooshian A, Parthasarathy S. Comparison of the Filtration Efficiency of Different Face Masks Against Aerosols. Front Med (Lausanne) 2021; 8:654317. [PMID: 34277652 PMCID: PMC8282900 DOI: 10.3389/fmed.2021.654317] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 05/31/2021] [Indexed: 11/22/2022] Open
Abstract
Background: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic can spread through virus-containing aerosols ( ≤ 5 μm) and larger airborne droplets. Quantifying filtration efficiency of different kinds of masks and linings for aerosols that fall within the most penetrating particle size (80-400 nm) is critical to limiting viral transmission. The objective of our experiment was to compare the “real-world” filtering efficiency of different face masks for fine aerosols (350 nm) in laboratory simulations. Methods: We performed a simulated bench test that measured the filtering efficiency of N95 vs. N99 masks with elastomeric lining in relation to baseline (“background”) aerosol generation. A mannequin head was placed within a chamber and was attached to an artificial lung simulator. Particles of known size (350 ± 6 nm aerodynamic diameter) were aerosolized into the chamber while simulating breathing at physiological settings of tidal volume, respiratory rate, and airflow. Particle counts were measured between the mannequin head and the lung simulator at the tracheal airway location. Results: Baseline particle counts without a filter (background) were 2,935 ± 555 (SD) cm−3, while the N95 (1348 ± 92 cm−3) and N99 mask with elastomeric lining (279 ± 164 cm−3; p <0.0001) exhibit lower counts due to filtration. Conclusion: The filtration efficiency of the N95 (54.1%) and N99 (90.5%) masks were lower than the filtration efficiency rating. N99 masks with elastomeric lining exhibit greater filtration efficiency than N95 masks without elastomeric lining and may be preferred to contain the spread of SARS-CoV-2 infection.
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Affiliation(s)
- Connor Stahl
- Department of Chemical and Environmental Engineering, University of Arizona, Tucson, AZ, United States
| | - Kevin Frederick
- Department of Materials Science and Engineering, University of Arizona, Tucson, AZ, United States
| | - Sachin Chaudhary
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, University of Arizona, Tucson, AZ, United States
| | - Christopher J Morton
- University of Arizona Health Sciences Center for Sleep and Circadian Sciences, University of Arizona, Tucson, AZ, United States
| | - Douglas Loy
- Department of Materials Science and Engineering, University of Arizona, Tucson, AZ, United States
| | - Krishna Muralidharan
- Department of Materials Science and Engineering, University of Arizona, Tucson, AZ, United States
| | - Armin Sorooshian
- Department of Chemical and Environmental Engineering, University of Arizona, Tucson, AZ, United States.,Department of Hydrology and Atmospheric Sciences, University of Arizona, Tucson, AZ, United States
| | - Sairam Parthasarathy
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, University of Arizona, Tucson, AZ, United States.,University of Arizona Health Sciences Center for Sleep and Circadian Sciences, University of Arizona, Tucson, AZ, United States
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16
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Harris DT, Badowski M, Jernigan B, Sprissler R, Edwards T, Cohen R, Paul S, Merchant N, Weinkauf CC, Bime C, Erickson HE, Bixby B, Parthasarathy S, Chaudhary S, Natt B, Cristan E, El Aini T, Rischard F, Campion J, Chopra M, Insel M, Sam A, Knepler JL, Knox K, Mosier J, Spier C, Dake MD. SARS-CoV-2 Rapid Antigen Testing of Symptomatic and Asymptomatic Individuals on the University of Arizona Campus. Biomedicines 2021; 9:539. [PMID: 34066047 PMCID: PMC8150898 DOI: 10.3390/biomedicines9050539] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 04/29/2021] [Accepted: 05/05/2021] [Indexed: 01/29/2023] Open
Abstract
SARS-CoV-2, the cause of COVID19, has caused a pandemic that has infected more than 80 M and killed more than 1.6 M persons worldwide. In the US as of December 2020, it has infected more than 32 M people while causing more than 570,000 deaths. As the pandemic persists, there has been a public demand to reopen schools and university campuses. To consider these demands, it is necessary to rapidly identify those individuals infected with the virus and isolate them so that disease transmission can be stopped. In the present study, we examined the sensitivity of the Quidel Rapid Antigen test for use in screening both symptomatic and asymptomatic individuals at the University of Arizona from June to August 2020. A total of 885 symptomatic and 1551 asymptomatic subjects were assessed by antigen testing and real-time PCR testing. The sensitivity of the test for both symptomatic and asymptomatic persons was between 82 and 90%, with some caveats.
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Affiliation(s)
- David T. Harris
- Biorepository, College of Medicine-Tucson, University of Arizona Health Sciences, University of Arizona, Tucson, AZ 85724, USA; (M.B.); (B.J.)
- Department of Immunobiology & Medicine, College of Medicine-Tucson, University of Arizona Health Sciences, University of Arizona, Tucson, AZ 85724, USA
| | - Michael Badowski
- Biorepository, College of Medicine-Tucson, University of Arizona Health Sciences, University of Arizona, Tucson, AZ 85724, USA; (M.B.); (B.J.)
| | - Brandon Jernigan
- Biorepository, College of Medicine-Tucson, University of Arizona Health Sciences, University of Arizona, Tucson, AZ 85724, USA; (M.B.); (B.J.)
| | - Ryan Sprissler
- College of Medicine-Tucson, University of Arizona Genetics Core, University of Arizona, Tucson, AZ 85724, USA; (R.S.); (T.E.)
| | - Taylor Edwards
- College of Medicine-Tucson, University of Arizona Genetics Core, University of Arizona, Tucson, AZ 85724, USA; (R.S.); (T.E.)
| | - Randall Cohen
- Department of Athletic, University of Arizona, Tucson, AZ 85724, USA; (R.C.); (S.P.)
| | - Stephen Paul
- Department of Athletic, University of Arizona, Tucson, AZ 85724, USA; (R.C.); (S.P.)
| | - Nirav Merchant
- Data Science Institute, University of Arizona, Tucson, AZ 85724, USA;
| | - Craig C. Weinkauf
- Department of Surgery, College of Medicine-Tucson, University of Arizona, Tucson, AZ 85724, USA;
| | - Christian Bime
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, College of Medicine-Tucson, University of Arizona, Tucson, AZ 85724, USA; (C.B.); (H.E.E.); (B.B.); (S.P.); (S.C.); (B.N.); (E.C.); (T.E.A.); (F.R.); (J.C.); (M.C.); (M.I.); (A.S.); (J.L.K.)
| | - Heidi E. Erickson
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, College of Medicine-Tucson, University of Arizona, Tucson, AZ 85724, USA; (C.B.); (H.E.E.); (B.B.); (S.P.); (S.C.); (B.N.); (E.C.); (T.E.A.); (F.R.); (J.C.); (M.C.); (M.I.); (A.S.); (J.L.K.)
| | - Billie Bixby
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, College of Medicine-Tucson, University of Arizona, Tucson, AZ 85724, USA; (C.B.); (H.E.E.); (B.B.); (S.P.); (S.C.); (B.N.); (E.C.); (T.E.A.); (F.R.); (J.C.); (M.C.); (M.I.); (A.S.); (J.L.K.)
| | - Sairam Parthasarathy
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, College of Medicine-Tucson, University of Arizona, Tucson, AZ 85724, USA; (C.B.); (H.E.E.); (B.B.); (S.P.); (S.C.); (B.N.); (E.C.); (T.E.A.); (F.R.); (J.C.); (M.C.); (M.I.); (A.S.); (J.L.K.)
| | - Sachin Chaudhary
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, College of Medicine-Tucson, University of Arizona, Tucson, AZ 85724, USA; (C.B.); (H.E.E.); (B.B.); (S.P.); (S.C.); (B.N.); (E.C.); (T.E.A.); (F.R.); (J.C.); (M.C.); (M.I.); (A.S.); (J.L.K.)
| | - Bhupinder Natt
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, College of Medicine-Tucson, University of Arizona, Tucson, AZ 85724, USA; (C.B.); (H.E.E.); (B.B.); (S.P.); (S.C.); (B.N.); (E.C.); (T.E.A.); (F.R.); (J.C.); (M.C.); (M.I.); (A.S.); (J.L.K.)
| | - Elaine Cristan
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, College of Medicine-Tucson, University of Arizona, Tucson, AZ 85724, USA; (C.B.); (H.E.E.); (B.B.); (S.P.); (S.C.); (B.N.); (E.C.); (T.E.A.); (F.R.); (J.C.); (M.C.); (M.I.); (A.S.); (J.L.K.)
| | - Tammer El Aini
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, College of Medicine-Tucson, University of Arizona, Tucson, AZ 85724, USA; (C.B.); (H.E.E.); (B.B.); (S.P.); (S.C.); (B.N.); (E.C.); (T.E.A.); (F.R.); (J.C.); (M.C.); (M.I.); (A.S.); (J.L.K.)
| | - Franz Rischard
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, College of Medicine-Tucson, University of Arizona, Tucson, AZ 85724, USA; (C.B.); (H.E.E.); (B.B.); (S.P.); (S.C.); (B.N.); (E.C.); (T.E.A.); (F.R.); (J.C.); (M.C.); (M.I.); (A.S.); (J.L.K.)
| | - Janet Campion
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, College of Medicine-Tucson, University of Arizona, Tucson, AZ 85724, USA; (C.B.); (H.E.E.); (B.B.); (S.P.); (S.C.); (B.N.); (E.C.); (T.E.A.); (F.R.); (J.C.); (M.C.); (M.I.); (A.S.); (J.L.K.)
| | - Madhav Chopra
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, College of Medicine-Tucson, University of Arizona, Tucson, AZ 85724, USA; (C.B.); (H.E.E.); (B.B.); (S.P.); (S.C.); (B.N.); (E.C.); (T.E.A.); (F.R.); (J.C.); (M.C.); (M.I.); (A.S.); (J.L.K.)
| | - Michael Insel
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, College of Medicine-Tucson, University of Arizona, Tucson, AZ 85724, USA; (C.B.); (H.E.E.); (B.B.); (S.P.); (S.C.); (B.N.); (E.C.); (T.E.A.); (F.R.); (J.C.); (M.C.); (M.I.); (A.S.); (J.L.K.)
| | - Afshin Sam
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, College of Medicine-Tucson, University of Arizona, Tucson, AZ 85724, USA; (C.B.); (H.E.E.); (B.B.); (S.P.); (S.C.); (B.N.); (E.C.); (T.E.A.); (F.R.); (J.C.); (M.C.); (M.I.); (A.S.); (J.L.K.)
| | - James L. Knepler
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, College of Medicine-Tucson, University of Arizona, Tucson, AZ 85724, USA; (C.B.); (H.E.E.); (B.B.); (S.P.); (S.C.); (B.N.); (E.C.); (T.E.A.); (F.R.); (J.C.); (M.C.); (M.I.); (A.S.); (J.L.K.)
| | - Kenneth Knox
- Department of Medicine, University of Arizona-Phoenix, Phoenix, AZ 85724, USA;
| | - Jarrod Mosier
- Department of Emergency Medicine, College of Medicine-Tucson, Tucson, AZ 85724, USA;
| | - Catherine Spier
- Department of Pathology, University of Arizona College of Medicine-Tucson, University of Arizona, Tucson, AZ 85724, USA;
| | - Michael D. Dake
- Office of the Senior Vice-President for Health Sciences, University of Arizona, Tucson, AZ 85724, USA;
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17
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Chaudhary S, Natt B, Bime C, Knox KS, Glassberg MK. Corrigendum: Antifibrotics in COVID-19 Lung Disease: Let Us Stay Focused. Front Med (Lausanne) 2021; 7:604640. [PMID: 33777966 PMCID: PMC7992361 DOI: 10.3389/fmed.2020.604640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 09/11/2020] [Indexed: 11/28/2022] Open
Affiliation(s)
- Sachin Chaudhary
- Interstitial Lung Disease Program, University of Arizona Colleges of Medicine, Tucson, AZ, United States
| | - Bhupinder Natt
- Interstitial Lung Disease Program, University of Arizona Colleges of Medicine, Tucson, AZ, United States
| | - Christian Bime
- Interstitial Lung Disease Program, University of Arizona Colleges of Medicine, Tucson, AZ, United States
| | - Kenneth S Knox
- Banner-University Medicine Division, Phoenix, AZ, United States
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18
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Casanova NG, Gonzalez-Garay ML, Sun B, Bime C, Sun X, Knox KS, Crouser ED, Sammani N, Gonzales T, Natt B, Chaudhary S, Lussier Y, Garcia JGN. Differential transcriptomics in sarcoidosis lung and lymph node granulomas with comparisons to pathogen-specific granulomas. Respir Res 2020; 21:321. [PMID: 33276795 PMCID: PMC7716494 DOI: 10.1186/s12931-020-01537-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 10/06/2020] [Indexed: 12/15/2022] Open
Abstract
Rationale Despite the availability of multi-“omics” strategies, insights into the etiology and pathogenesis of sarcoidosis have been elusive. This is partly due to the lack of reliable preclinical models and a paucity of validated biomarkers. As granulomas are a key feature of sarcoidosis, we speculate that direct genomic interrogation of sarcoid tissues, may lead to identification of dysregulated gene pathways or biomarker signatures. Objective To facilitate the development sarcoidosis genomic biomarkers by gene expression profiling of sarcoidosis granulomas in lung and lymph node tissues (most commonly affected organs) and comparison to infectious granulomas (coccidiodomycosis and tuberculosis). Methods Transcriptomic profiles of immune-related gene from micro-dissected sarcoidosis granulomas within lung and mediastinal lymph node tissues and compared to infectious granulomas from paraffin-embedded blocks. Differentially-expressed genes (DEGs) were profiled, compared among the three granulomatous diseases and analyzed for functional enrichment pathways. Results Despite histologic similarities, DEGs and pathway enrichment markedly differed in sarcoidosis granulomas from lymph nodes and lung. Lymph nodes showed a clear immunological response, whereas a structural regenerative response was observed in lung. Sarcoidosis granuloma gene expression data corroborated previously reported genomic biomarkers (STAB1, HBEGF, and NOTCH4), excluded others and identified new genomic markers present in lung and lymph nodes, ADAMTS1, NPR1 and CXCL2. Comparisons between sarcoidosis and pathogen granulomas identified pathway divergences and commonalities at gene expression level. Conclusion These findings suggest the importance of tissue and disease-specificity evaluation when exploring sarcoidosis genomic markers. This relevant translational information in sarcoidosis and other two histopathological similar infections provides meaningful specific genomic-derived biomarkers for sarcoidosis diagnosis and prognosis.
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Affiliation(s)
- Nancy G Casanova
- Department of Medicine, College of Medicine, University of Arizona Health Sciences, Tucson, AZ, USA
| | - Manuel L Gonzalez-Garay
- Department of Medicine, College of Medicine, University of Arizona Health Sciences, Tucson, AZ, USA
| | - Belinda Sun
- Department of Medicine, College of Medicine, University of Arizona Health Sciences, Tucson, AZ, USA
| | - Christian Bime
- Department of Medicine, College of Medicine, University of Arizona Health Sciences, Tucson, AZ, USA
| | - Xiaoguang Sun
- Department of Medicine, College of Medicine, University of Arizona Health Sciences, Tucson, AZ, USA
| | - Kenneth S Knox
- Department of Medicine, College of Medicine, University of Arizona, Phoenix, AZ, USA
| | - Elliott D Crouser
- Division of Pulmonary and Critical Care Medicine, The Ohio State University, Columbus, OH, USA
| | - Nora Sammani
- Department of Medicine, College of Medicine, University of Arizona Health Sciences, Tucson, AZ, USA
| | - Taylor Gonzales
- Department of Medicine, College of Medicine, University of Arizona Health Sciences, Tucson, AZ, USA
| | - Bhupinder Natt
- Department of Medicine, College of Medicine, University of Arizona Health Sciences, Tucson, AZ, USA
| | - Sachin Chaudhary
- Department of Medicine, College of Medicine, University of Arizona Health Sciences, Tucson, AZ, USA
| | - Yves Lussier
- Department of Medicine, College of Medicine, University of Arizona Health Sciences, Tucson, AZ, USA
| | - Joe G N Garcia
- Department of Medicine, College of Medicine, University of Arizona Health Sciences, Tucson, AZ, USA.
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19
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Polani Chandrasekar R, Saravana Kumar D, Dzeyie K, Vignesh M, Sankara D, Raveendran I, Premkumar B, Ponnaiah M, Parasuraman G, Chaudhary S, Bhatnagar T, Kathuria S, Jain S, Singh S, Murhekar M. Outbreak of ceftriaxone-resistant Salmonella enterica serotype Typhi attributed to eating chicken at hotel X, Tiruchirappalli, India, 2018. Int J Infect Dis 2020. [DOI: 10.1016/j.ijid.2020.09.186] [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: 11/29/2022] Open
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20
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Ripperger TJ, Uhrlaub JL, Watanabe M, Wong R, Castaneda Y, Pizzato HA, Thompson MR, Bradshaw C, Weinkauf CC, Bime C, Erickson HL, Knox K, Bixby B, Parthasarathy S, Chaudhary S, Natt B, Cristan E, El Aini T, Rischard F, Campion J, Chopra M, Insel M, Sam A, Knepler JL, Capaldi AP, Spier CM, Dake MD, Edwards T, Kaplan ME, Scott SJ, Hypes C, Mosier J, Harris DT, LaFleur BJ, Sprissler R, Nikolich-Žugich J, Bhattacharya D. Orthogonal SARS-CoV-2 Serological Assays Enable Surveillance of Low-Prevalence Communities and Reveal Durable Humoral Immunity. Immunity 2020; 53:925-933.e4. [PMID: 33129373 PMCID: PMC7554472 DOI: 10.1016/j.immuni.2020.10.004] [Citation(s) in RCA: 239] [Impact Index Per Article: 59.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 10/01/2020] [Accepted: 10/05/2020] [Indexed: 12/21/2022]
Abstract
We conducted a serological study to define correlates of immunity against SARS-CoV-2. Compared to those with mild coronavirus disease 2019 (COVID-19) cases, individuals with severe disease exhibited elevated virus-neutralizing titers and antibodies against the nucleocapsid (N) and the receptor binding domain (RBD) of the spike protein. Age and sex played lesser roles. All cases, including asymptomatic individuals, seroconverted by 2 weeks after PCR confirmation. Spike RBD and S2 and neutralizing antibodies remained detectable through 5-7 months after onset, whereas α-N titers diminished. Testing 5,882 members of the local community revealed only 1 sample with seroreactivity to both RBD and S2 that lacked neutralizing antibodies. This fidelity could not be achieved with either RBD or S2 alone. Thus, inclusion of multiple independent assays improved the accuracy of antibody tests in low-seroprevalence communities and revealed differences in antibody kinetics depending on the antigen. We conclude that neutralizing antibodies are stably produced for at least 5-7 months after SARS-CoV-2 infection.
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MESH Headings
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Antibodies, Neutralizing/blood
- Antibodies, Viral/blood
- Arizona/epidemiology
- Betacoronavirus/immunology
- Betacoronavirus/isolation & purification
- COVID-19
- COVID-19 Testing
- Clinical Laboratory Techniques/methods
- Coronavirus Infections/blood
- Coronavirus Infections/diagnosis
- Coronavirus Infections/epidemiology
- Coronavirus Infections/immunology
- Coronavirus Nucleocapsid Proteins
- Female
- Humans
- Immunity, Humoral
- Male
- Middle Aged
- Nucleocapsid Proteins/immunology
- Pandemics
- Phosphoproteins
- Pneumonia, Viral/blood
- Pneumonia, Viral/diagnosis
- Pneumonia, Viral/epidemiology
- Pneumonia, Viral/immunology
- Prevalence
- Protein Interaction Domains and Motifs
- SARS-CoV-2
- Seroepidemiologic Studies
- Spike Glycoprotein, Coronavirus/chemistry
- Spike Glycoprotein, Coronavirus/immunology
- Young Adult
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Affiliation(s)
- Tyler J Ripperger
- Department of Immunobiology, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA
| | - Jennifer L Uhrlaub
- Department of Immunobiology, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA; University of Arizona Center on Aging, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA
| | - Makiko Watanabe
- Department of Immunobiology, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA; University of Arizona Center on Aging, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA
| | - Rachel Wong
- Department of Immunobiology, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA; Division of Biological and Biomedical Sciences, Washington University, St. Louis, MO, USA
| | - Yvonne Castaneda
- Department of Immunobiology, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA; University of Arizona Center on Aging, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA
| | - Hannah A Pizzato
- Department of Immunobiology, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA; Division of Biological and Biomedical Sciences, Washington University, St. Louis, MO, USA
| | - Mallory R Thompson
- Department of Surgery, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA; Department of Cellular and Molecular Medicine, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA
| | - Christine Bradshaw
- Department of Immunobiology, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA; University of Arizona Center on Aging, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA
| | - Craig C Weinkauf
- Department of Surgery, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA
| | - Christian Bime
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA
| | - Heidi L Erickson
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA
| | - Kenneth Knox
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA; Department of Medicine, University of Arizona, Phoenix, Phoenix, AZ, USA
| | - Billie Bixby
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA
| | - Sairam Parthasarathy
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA
| | - Sachin Chaudhary
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA
| | - Bhupinder Natt
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA
| | - Elaine Cristan
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA
| | - Tammer El Aini
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA
| | - Franz Rischard
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA
| | - Janet Campion
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA
| | - Madhav Chopra
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA
| | - Michael Insel
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA
| | - Afshin Sam
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA
| | - James L Knepler
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA
| | - Andrew P Capaldi
- Department of Molecular and Cellular Biology, University of Arizona, Tucson, Tucson, AZ, USA; Functional Genomics Core, University of Arizona, Tucson, AZ, USA
| | - Catherine M Spier
- Department of Pathology, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA
| | - Michael D Dake
- Office of the Senior Vice-President for Health Sciences, University of Arizona, Tucson, AZ, USA
| | - Taylor Edwards
- University of Arizona Genomics Core and the Arizona Research Labs, University of Arizona Genetics Core, University of Arizona, Tucson, AZ, USA
| | - Matthew E Kaplan
- Functional Genomics Core, University of Arizona, Tucson, AZ, USA
| | - Serena Jain Scott
- Division of Geriatrics, General Medicine and Palliative Care, Department of Medicine, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA
| | - Cameron Hypes
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA; Department of Emergency Medicine, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA
| | - Jarrod Mosier
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA; Department of Emergency Medicine, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA
| | - David T Harris
- Department of Immunobiology, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA; University of Arizona Health Sciences Biobank, University of Arizona, Tucson, AZ, USA
| | | | - Ryan Sprissler
- University of Arizona Genomics Core and the Arizona Research Labs, University of Arizona Genetics Core, University of Arizona, Tucson, AZ, USA; BIO5 Institute, University of Arizona, Tucson, AZ, USA
| | - Janko Nikolich-Žugich
- Department of Immunobiology, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA; University of Arizona Center on Aging, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA; BIO5 Institute, University of Arizona, Tucson, AZ, USA.
| | - Deepta Bhattacharya
- Department of Immunobiology, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA; BIO5 Institute, University of Arizona, Tucson, AZ, USA.
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Ron A, Chaudhary S, Zhang G, Ning H, Zoghlin E, Wilson SD, Averitt RD, Refael G, Hsieh D. Ultrafast Enhancement of Ferromagnetic Spin Exchange Induced by Ligand-to-Metal Charge Transfer. Phys Rev Lett 2020; 125:197203. [PMID: 33216570 DOI: 10.1103/physrevlett.125.197203] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 08/17/2020] [Accepted: 10/02/2020] [Indexed: 06/11/2023]
Abstract
We theoretically predict and experimentally demonstrate a nonthermal pathway to optically enhance superexchange interaction energies in a material based on exciting ligand-to-metal charge-transfer transitions, which introduces lower-order virtual hopping contributions that are absent in the ground state. We demonstrate this effect in the layered ferromagnetic insulator CrSiTe_{3} by exciting Te-to-Cr charge-transfer transitions using ultrashort laser pulses and detecting coherent phonon oscillations that are impulsively generated by superexchange enhancement via magneto-elastic coupling. This mechanism kicks in below the temperature scale where short-range in-plane spin correlations begin to develop and disappears when the excitation energy is tuned away from the charge-transfer resonance, consistent with our predictions.
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Affiliation(s)
- A Ron
- Department of Physics, California Institute of Technology, Pasadena, California 91125, USA
- Institute for Quantum Information and Matter, California Institute of Technology, Pasadena, California 91125, USA
- Raymond and Beverly Sackler School of Physics and Astronomy, Tel-Aviv University, Tel Aviv, 69978, Israel
| | - S Chaudhary
- Department of Physics, California Institute of Technology, Pasadena, California 91125, USA
- Institute for Quantum Information and Matter, California Institute of Technology, Pasadena, California 91125, USA
| | - G Zhang
- Department of Physics, University of California, San Diego, La Jolla, California 92093, USA
| | - H Ning
- Department of Physics, California Institute of Technology, Pasadena, California 91125, USA
- Institute for Quantum Information and Matter, California Institute of Technology, Pasadena, California 91125, USA
| | - E Zoghlin
- Materials Department, University of California, Santa Barbara, Santa Barbara, California 93106, USA
| | - S D Wilson
- Materials Department, University of California, Santa Barbara, Santa Barbara, California 93106, USA
| | - R D Averitt
- Department of Physics, University of California, San Diego, La Jolla, California 92093, USA
| | - G Refael
- Department of Physics, California Institute of Technology, Pasadena, California 91125, USA
- Institute for Quantum Information and Matter, California Institute of Technology, Pasadena, California 91125, USA
| | - D Hsieh
- Department of Physics, California Institute of Technology, Pasadena, California 91125, USA
- Institute for Quantum Information and Matter, California Institute of Technology, Pasadena, California 91125, USA
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Pulcini C, Goyal M, Hall M, Gruhler H, Chaudhary S, Alpern E, Fein J, Fleegler E. 286 Firearm Injuries: Long-Term Health Outcomes and Health Care Expenditures for Children. Ann Emerg Med 2020. [DOI: 10.1016/j.annemergmed.2020.09.300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Chaudhary S, Natt B, Bime C, Knox KS, Glassberg MK. Antifibrotics in COVID-19 Lung Disease: Let Us Stay Focused. Front Med (Lausanne) 2020; 7:539. [PMID: 33072773 PMCID: PMC7531602 DOI: 10.3389/fmed.2020.00539] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 07/30/2020] [Indexed: 01/28/2023] Open
Abstract
After decades of research, two therapies for chronic fibrotic lung disease are now approved by the FDA, with dozens more anti-fibrotic therapies in the pipeline. A great deal of enthusiasm has been generated for the use of these drugs, which are by no means curative but clearly have a favorable impact on lung function decline over time. Amidst a flurry of newly developed and repurposed drugs to treat the coronavirus disease 2019 (COVID-19) and its accompanying acute respiratory distress syndrome (ARDS), few have emerged as effective. Historically, survivors of severe viral pneumonia and related acute lung injury with ARDS often have near full recovery of lung function. While the pathological findings of the lungs of patients with COVID-19 can be diverse, current reports have shown significant lung fibrosis predominantly in autopsy studies. There is growing enthusiasm to study anti-fibrotic therapy for inevitable lung fibrosis, and clinical trials are underway using currently FDA-approved anti-fibrotic therapies. Given the relatively favorable outcomes of survivors of virus-mediated ARDS and the low prevalence of clinically meaningful lung fibrosis in survivors, this perspective examines if there is a rationale for testing these repurposed antifibrotic agents in COVID-19-associated lung disease.
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Affiliation(s)
- Sachin Chaudhary
- Interstitial Lung Disease Program, University of Arizona Colleges of Medicine, Tucson, AZ, United States
| | - Bhupinder Natt
- Interstitial Lung Disease Program, University of Arizona Colleges of Medicine, Tucson, AZ, United States
| | - Christian Bime
- Interstitial Lung Disease Program, University of Arizona Colleges of Medicine, Tucson, AZ, United States
| | - Kenneth S Knox
- Interstitial Lung Disease Program, University of Arizona Colleges of Medicine, Tucson, AZ, United States.,Banner-University Medicine Division, Phoenix, AZ, United States
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Ripperger TJ, Uhrlaub JL, Watanabe M, Wong R, Castaneda Y, Pizzato HA, Thompson MR, Bradshaw C, Weinkauf CC, Bime C, Erickson HL, Knox K, Bixby B, Parthasarathy S, Chaudhary S, Natt B, Cristan E, Aini TE, Rischard F, Campion J, Chopra M, Insel M, Sam A, Knepler JL, Capaldi AP, Spier CM, Dake MD, Edwards T, Kaplan ME, Scott SJ, Hypes C, Mosier J, Harris DT, LaFleur BJ, Sprissler R, Nikolich-Žugich J, Bhattacharya D. Detection, prevalence, and duration of humoral responses to SARS-CoV-2 under conditions of limited population exposure. medRxiv 2020:2020.08.14.20174490. [PMID: 32817969 PMCID: PMC7430613 DOI: 10.1101/2020.08.14.20174490] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
We conducted an extensive serological study to quantify population-level exposure and define correlates of immunity against SARS-CoV-2. We found that relative to mild COVID-19 cases, individuals with severe disease exhibited elevated authentic virus-neutralizing titers and antibody levels against nucleocapsid (N) and the receptor binding domain (RBD) and the S2 region of spike protein. Unlike disease severity, age and sex played lesser roles in serological responses. All cases, including asymptomatic individuals, seroconverted by 2 weeks post-PCR confirmation. RBD- and S2-specific and neutralizing antibody titers remained elevated and stable for at least 2-3 months post-onset, whereas those against N were more variable with rapid declines in many samples. Testing of 5882 self-recruited members of the local community demonstrated that 1.24% of individuals showed antibody reactivity to RBD. However, 18% (13/73) of these putative seropositive samples failed to neutralize authentic SARS-CoV-2 virus. Each of the neutralizing, but only 1 of the non-neutralizing samples, also displayed potent reactivity to S2. Thus, inclusion of multiple independent assays markedly improved the accuracy of antibody tests in low seroprevalence communities and revealed differences in antibody kinetics depending on the viral antigen. In contrast to other reports, we conclude that immunity is durable for at least several months after SARS-CoV-2 infection.
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Affiliation(s)
- Tyler J. Ripperger
- Department of Immunobiology, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
| | - Jennifer L. Uhrlaub
- Department of Immunobiology, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
- University of Arizona Center on Aging, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
| | - Makiko Watanabe
- Department of Immunobiology, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
- University of Arizona Center on Aging, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
| | - Rachel Wong
- Department of Immunobiology, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
- Division of Biological and Biomedical Sciences, Washington University, St. Louis, MO, USA
| | - Yvonne Castaneda
- Department of Immunobiology, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
- University of Arizona Center on Aging, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
| | - Hannah A. Pizzato
- Department of Immunobiology, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
- Division of Biological and Biomedical Sciences, Washington University, St. Louis, MO, USA
| | - Mallory R. Thompson
- Department of Surgery, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
- Department of Cellular and Molecular Medicine, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
| | - Christine Bradshaw
- Department of Immunobiology, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
- University of Arizona Center on Aging, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
| | - Craig C. Weinkauf
- Department of Surgery, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
| | - Christian Bime
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
| | - Heidi L. Erickson
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
| | - Kenneth Knox
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
- Department of Medicine, University of Arizona-Phoenix, Phoenix, AZ
| | - Billie Bixby
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
| | - Sairam Parthasarathy
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
| | - Sachin Chaudhary
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
| | - Bhupinder Natt
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
| | - Elaine Cristan
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
| | - Tammer El Aini
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
| | - Franz Rischard
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
| | - Janet Campion
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
| | - Madhav Chopra
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
| | - Michael Insel
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
| | - Afshin Sam
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
| | - James L. Knepler
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
| | - Andrew P. Capaldi
- Department of Molecular and Cellular Biology, University of Arizona – Tucson, Tucson, AZ, USA
- Functional Genomics Core, University of Arizona, Tucson, AZ
| | - Catherine M. Spier
- Department of Pathology, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
| | - Michael D. Dake
- Office of the Senior Vice-President for Health Sciences, University of Arizona, Tucson, USA
| | - Taylor Edwards
- University of Arizona Genomics Core, University of Arizona, Tucson, AZ and the Arizona Research Labs, University of Arizona Genetics Core, University of Arizona, Tucson, AZ, USA
| | | | - Serena Jain Scott
- Division of Geriatrics, General Medicine and Palliative Care, Department of Medicine, University of Arizona College of Medicine-Tucson, Tucson, USA
| | - Cameron Hypes
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
- Department of Emergency Medicine, University of Arizona College of Medicine-Tucson, Tucson, USA
| | - Jarrod Mosier
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
- Department of Emergency Medicine, University of Arizona College of Medicine-Tucson, Tucson, USA
| | - David T. Harris
- Department of Immunobiology, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
- University of Arizona Health Sciences Biobank, University of Arizona, Tucson, USA
| | | | - Ryan Sprissler
- University of Arizona Genomics Core, University of Arizona, Tucson, AZ and the Arizona Research Labs, University of Arizona Genetics Core, University of Arizona, Tucson, AZ, USA
- BIO5 Institute, University of Arizona, Tucson, USA
| | - Janko Nikolich-Žugich
- Department of Immunobiology, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
- University of Arizona Center on Aging, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
- BIO5 Institute, University of Arizona, Tucson, USA
| | - Deepta Bhattacharya
- Department of Immunobiology, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
- BIO5 Institute, University of Arizona, Tucson, USA
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Gupta S, Garg H, Chaudhary S. Parameter estimation and optimization of multi-objective capacitated stochastic transportation problem for gamma distribution. COMPLEX INTELL SYST 2020. [DOI: 10.1007/s40747-020-00156-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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27
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Gupta MK, Kumar S, Chaudhary S. Synthesis and Investigation of Antidiabetic Response of New Coumarin Derivatives Against Streptozotocin Induced Diabetes in Experimental Rats. Pharm Chem J 2020. [DOI: 10.1007/s11094-020-02134-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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28
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El-Shorbagi AN, Chaudhary S. Monobactams: A Unique Natural Scaffold of Four-Membered Ring Skeleton, Recent Development to Clinically Overcome Infections by Multidrug- Resistant Microbes. LETT DRUG DES DISCOV 2019. [DOI: 10.2174/1570180816666190516113202] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Background:
Monobactam antibiotics have been testified to demonstrate significant antibacterial
activity especially the treatment of infections by superbug microbes. Recently, research has
been focused on the structural modifications, and new generation of this privileged natural scaffold.
Objective:
Efforts have been made to discover the structure-antibacterial relationship of monbactams
in order to avoid the aimless work involving the ongoing generated analogues. This review aims to
summarize the current knowledge and development of monobactams as a broad-spectrum antibacterial
scaffolds. The recent structural modifications that expand the activity, especially in the infections
by resistant-strains, combinational therapies and dosing, as well as the possibility of crosshypersensitivity/
reactivity/tolerability with penicillins and cephalosporins will also be summarized
and inferred. Different approaches will be covered with emphasis on chemical methods and Structure-
Activity Relationship (SAR), in addition to the proposed mechanisms of action. Clinical investigation
of monobactams tackling various aspects will not be missed in this review.
Conclusion:
The conclusion includes the novels approaches, that could be followed to design new
research projects and reduce the pitfalls in the future development of monobactams.
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Affiliation(s)
- Abdel Nasser El-Shorbagi
- Department of Medicinal Chemistry, College of Pharmacy, University of Sharjah, Sharjah 27272, United Arab Emirates
| | - Sachin Chaudhary
- Department of Medicinal Chemistry, College of Pharmacy, University of Sharjah, Sharjah 27272, United Arab Emirates
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Gondal AB, Hines EM, Ayala AE, Chaudhary S, Ghaderi I. Influence of Overlap Syndrome on Morbidity and Mortality after Bariatric Surgery. J Am Coll Surg 2019. [DOI: 10.1016/j.jamcollsurg.2019.08.068] [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]
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30
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Gaur V, Chaudhary S, Tyagi A, Bakhshi S, Sharma P, Kumar S. Differential expression of various miRNAs in pediatric cytogenetically normal acute myeloid leukemia (CN-AML). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz239.069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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31
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Chandrika P, Chaturvedi A, Madipally DJ, Chaudhary S, ZuWallack R. DEPRESSION ASSOCIATES WITH INCREASED RISK OF COPD-RELATED HOSPITALIZATIONS: INSIGHTS FROM NATIONAL INPATIENT SAMPLE. Chest 2019. [DOI: 10.1016/j.chest.2019.08.487] [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: 11/16/2022] Open
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Plevris N, Chuah CS, Allen RM, Arnott ID, Brennan PN, Chaudhary S, Churchhouse AMD, Din S, Donoghue E, Gaya DR, Groome M, Jafferbhoy HM, Jenkinson PW, Lam WL, Lyons M, Macdonald JC, MacMaster M, Mowat C, Naismith GD, Potts LF, Saffouri E, Seenan JP, Sengupta A, Shasi P, Sutherland DI, Todd JA, Veryan J, Watson AJM, Watts DA, Jones GR, Lees CW. Real-world Effectiveness and Safety of Vedolizumab for the Treatment of Inflammatory Bowel Disease: The Scottish Vedolizumab Cohort. J Crohns Colitis 2019; 13:1111-1120. [PMID: 30768123 DOI: 10.1093/ecco-jcc/jjz042] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [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] [Indexed: 02/08/2023]
Abstract
BACKGROUND & AIMS Vedolizumab is an anti-a4b7 monoclonal antibody that is licensed for the treatment of moderate to severe Crohn's disease and ulcerative colitis. The aims of this study were to establish the real-world effectiveness and safety of vedolizumab for the treatment of inflammatory bowel disease. METHODS This was a retrospective study involving seven NHS health boards in Scotland between June 2015 and November 2017. Inclusion criteria included: a diagnosis of ulcerative colitis or Crohn's disease with objective evidence of active inflammation at baseline (Harvey-Bradshaw Index[HBI] ≥5/Partial Mayo ≥2 plus C-reactive protein [CRP] >5 mg/L or faecal calprotectin ≥250 µg/g or inflammation on endoscopy/magnetic resonance imaging [MRI]); completion of induction; and at least one clinical follow-up by 12 months. Kaplan-Meier survival analysis was used to establish 12-month cumulative rates of clinical remission, mucosal healing, and deep remission [clinical remission plus mucosal healing]. Rates of serious adverse events were described quantitatively. RESULTS Our cohort consisted of 180 patients with ulcerative colitis and 260 with Crohn's disease. Combined median follow-up was 52 weeks (interquartile range [IQR] 26-52 weeks). In ulcerative colitis, 12-month cumulative rates of clinical remission, mucosal healing, and deep remission were 57.4%, 47.3%, and 38.5%, respectively. In Crohn's disease, 12-month cumulative rates of clinical remission, mucosal healing, and deep remission were 58.4%, 38.9%, and 28.3% respectively. The serious adverse event rate was 15.6 per 100 patient-years of follow-up. CONCLUSIONS Vedolizumab is a safe and effective treatment for achieving both clinical remission and mucosal healing in ulcerative colitis and Crohn's disease.
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Affiliation(s)
- N Plevris
- The Edinburgh IBD Unit, Western General Hospital, Edinburgh, UK
| | - C S Chuah
- The Edinburgh IBD Unit, Western General Hospital, Edinburgh, UK
| | - R M Allen
- Department of Gastroenterology, Glasgow Royal Infirmary, Glasgow, UK
| | - I D Arnott
- The Edinburgh IBD Unit, Western General Hospital, Edinburgh, UK
| | - P N Brennan
- Department of Gastroenterology, Ninewells Hospital, Dundee, UK
| | - S Chaudhary
- Department of Gastroenterology, University Hospital Hairmyres, East Kilbride, UK
| | | | - S Din
- The Edinburgh IBD Unit, Western General Hospital, Edinburgh, UK
| | - E Donoghue
- Department of Gastroenterology, Forth Valley Royal Hospital, Larbert, UK
| | - D R Gaya
- Department of Gastroenterology, Glasgow Royal Infirmary, Glasgow, UK
| | - M Groome
- Department of Gastroenterology, Ninewells Hospital, Dundee, UK
| | - H M Jafferbhoy
- Department of Gastroenterology, Victoria Hospital, Kirkcaldy, UK
| | - P W Jenkinson
- The Edinburgh IBD Unit, Western General Hospital, Edinburgh, UK.,Department of Colorectal Surgery, Raigmore Hospital, Inverness, UK
| | - W L Lam
- Department of Gastroenterology, Glasgow Royal Infirmary, Glasgow, UK
| | - M Lyons
- The Edinburgh IBD Unit, Western General Hospital, Edinburgh, UK
| | - J C Macdonald
- Department of Gastroenterology, Queen Elizabeth University Hospital, Glasgow, UK
| | - M MacMaster
- Department of Gastroenterology, Glasgow Royal Infirmary, Glasgow, UK
| | - C Mowat
- Department of Gastroenterology, Ninewells Hospital, Dundee, UK
| | - G D Naismith
- Department of Gastroenterology, Royal Alexandra Hospital, Paisley, UK
| | - L F Potts
- Department of Gastroenterology, Raigmore Hospital, Inverness, UK
| | - E Saffouri
- Department of Gastroenterology, Glasgow Royal Infirmary, Glasgow, UK
| | - J P Seenan
- Department of Gastroenterology, Queen Elizabeth University Hospital, Glasgow, UK
| | - A Sengupta
- Department of Gastroenterology, Victoria Hospital, Kirkcaldy, UK
| | - P Shasi
- Department of Gastroenterology, Ninewells Hospital, Dundee, UK
| | - D I Sutherland
- Department of Gastroenterology, University Hospital Hairmyres, East Kilbride, UK
| | - J A Todd
- Department of Gastroenterology, Ninewells Hospital, Dundee, UK
| | - J Veryan
- Department of Gastroenterology, Glasgow Royal Infirmary, Glasgow, UK
| | - A J M Watson
- Department of Colorectal Surgery, Raigmore Hospital, Inverness, UK
| | - D A Watts
- Department of Gastroenterology, Forth Valley Royal Hospital, Larbert, UK
| | - G R Jones
- The Edinburgh IBD Unit, Western General Hospital, Edinburgh, UK
| | - C W Lees
- The Edinburgh IBD Unit, Western General Hospital, Edinburgh, UK
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Tripathi D, Chaudhary S, Singh S. Awareness of stroke and assessment of knowledge of risk factors among stroke survivors in a tertiary care level hospital. Ann Phys Rehabil Med 2018. [DOI: 10.1016/j.rehab.2018.05.509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Wickstrom K, Ateeli H, Chaudhary S. Medical image of the week: cardiac magnetic resonance imaging findings of severe RV failure. Southwest J Pulm Crit Care 2018. [DOI: 10.13175/swjpcc047-18] [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: 11/22/2022] Open
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35
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Ali H, Ateeli H, Natt B, Chaudhary S. Medical image of the week: Dobhoff tube placement with Roux-en-Y gastric bypass. Southwest J Pulm Crit Care 2018. [DOI: 10.13175/swjpcc045-18] [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: 11/22/2022] Open
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36
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Ali H, Ateeli H, Natt B, Chaudhary S. Medical image of the week: atypical deep sulcus sign. Southwest J Pulm Crit Care 2018. [DOI: 10.13175/swjpcc044-18] [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: 11/22/2022] Open
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Ateeli H, Zaid L, Chaudhary S. Medical image of the week: acute pneumonitis secondary to boric acid exposure. Southwest J Pulm Crit Care 2018. [DOI: 10.13175/swjpcc025-18] [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: 11/22/2022] Open
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Johansson N, Sisodiya S, Shayesteh P, Chaudhary S, Andersen JN, Knudsen J, Wendt OF, Schnadt J. Sonogashira cross-coupling over Au(1 1 1): from UHV to ambient pressure. J Phys Condens Matter 2017; 29:444005. [PMID: 28862150 DOI: 10.1088/1361-648x/aa89c4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
We have studied the reaction of phenylacetylene (PA) with chloro-, bromo-, and iodobenzene on the Au(1 1 1) surface as a model system for the gold-catalysed Sonogashira cross-coupling. Both ultrahigh vacuum-based and ambient pressure x-ray photoelectron spectroscopy show that iodo- and chlorobenzene (IB and CB) undergo the cross-coupling reaction towards diphenylacetylene. Bromobenzene (BB), in contrast, does not react in the UHV experiments. Further, at ambient pressure signs are found for poisoning of the Au(1 1 1) surface by a carbon species formed in the reaction. The understanding obtained in the reaction experiments are based on a thorough investigation of the adsorption of PA, IB, CB, and BB on the Au(1 1 1) surface by soft x-ray absorption spectroscopy and temperature-dependent x-ray photoelectron spectroscopy. In particular, the experiments provide the orientation of the intact adsorbates with respect to the surfaces at liquid nitrogen temperature. Dissociation in the temperature regime between -80 and -15 °C is observed for iodo- and chlorobenzene, but not for BB, in agreement with that only IB and CB, but not BB, react with PA to form diphenylacetylene. The difference is tentatively attributed to a difference in surface orientation of the different halobenzenes.
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Affiliation(s)
- N Johansson
- Division of Synchrotron Radiation Research, Department of Physics, Lund University, Box 118, 221 00 Lund, Sweden
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Affiliation(s)
- Sachin Chaudhary
- Department of Statistics, Banaras Hindu University, Varanasi-221005, Uttar Pradesh, India
| | - J. Kumar
- Department of Statistics, Banaras Hindu University, Varanasi-221005, Uttar Pradesh, India
| | - Sanjeev K. Tomer
- Department of Statistics, Banaras Hindu University, Varanasi-221005, Uttar Pradesh, India
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Chaudhary S, Contag S. The effect of maternal age on fetal and neonatal mortality. J Perinatol 2017; 37:800-804. [PMID: 28358383 DOI: 10.1038/jp.2017.36] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Revised: 01/16/2017] [Accepted: 01/31/2017] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Determine the gestational age at which the risk of fetal or neonatal death associated with delaying delivery by 1 week exceeds the risk of neonatal death associated with immediate delivery, stratified by maternal age intervals. STUDY DESIGN We conducted a retrospective cohort study of live births, stillbirths and neonatal deaths that occurred in the United States between 2010 and 2013 using birth data. Women were classified into six age categories. Singleton, non-anomalous pregnancies without hypertensive disease or diabetes were included. Relative risks were obtained using a generalized linear model comparing the rate of death associated with immediate delivery to those of expectant management. RESULTS For all age groups with the exception of women 44 years and older, immediate delivery was associated with lower relative risk of death by 39 weeks. For <25, 25 to 29, 30 to 34, 35 to 39, 40 to 44, odds ratios (OR) and confidence intervals (CI) were 1.0 (0.32 to 3.10), 0.67 (0.19 to 2.37), 0.80 (0.21 to 2.98), 0.67 (0.19 to 2.36) and 0.45 (0.16 to 1.31), respectively. In women 44 years and older, immediate delivery was associated with a lower relative risk of death by 38 weeks (OR: 0.35, CI: 0.14 to 0.90). CONCLUSION Women greater than 44 years old may benefit from delivery by 38 weeks gestational age to reduce the risk of stillbirth.
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Affiliation(s)
- S Chaudhary
- Department of Obstetrics and Gynecology, University of Maryland Medical Center, Baltimore, MD, USA
| | - S Contag
- Department of Obstetrics and Gynecology, University of Maryland Medical Center, Baltimore, MD, USA
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Abstract
Effects of electroconvulsive therapy on the pulse rate, blood pressure and electrocardiogram were studied in forty consecutive physically healthy inpatients undergoing ECT for their psychiatric disabilities. Tachycardia and elevated blood pressure occurred frequently. Sinus arrhythmias, atrial and ventricular premature beats and minor ST-T changes were also observed. All these changes reversed within thirty minutes.
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Affiliation(s)
- S Chaudhary
- Classified Specialist (Psychiatry). Military Hospital, Meerut 250 001
| | - S S Rajuria
- Senior Adviser (Anaesthesiology), 158 BH, C/O 99 APO
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Chaudhary S, Meinke L, Ateeli H, Knox KS, Raz Y, Ampel NM. Coccidioidomycosis among persons undergoing lung transplantation in the coccidioidal endemic region. Transpl Infect Dis 2017; 19. [PMID: 28452423 DOI: 10.1111/tid.12713] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Revised: 01/30/2017] [Accepted: 02/05/2017] [Indexed: 12/23/2022]
Abstract
BACKGROUND Coccidioidomycosis, an endemic fungal infection, is more likely to be symptomatic and severe among those receiving allogeneic transplants. While several case series have been published for various transplanted organs, none has described the incidence and outcomes in those receiving lung transplants within the coccidioidal endemic region. METHODS Patients receiving a heart-lung, single-lung, or bilateral-lung transplantation at the University of Arizona between 1985 and 2009 were retrospectively reviewed. RESULTS Coccidioidomycosis occurred post transplantation in 11 (5.8%) of 189 patients. All but one patient was diagnosed with pulmonary coccidioidomycosis and only one had a history of prior coccidioidomycosis. Two patients received transplants from donors found to have coccidioidomycosis at the time of transplantation and one death was directly attributed to coccidioidomycosis. The risk of developing active coccidioidomycosis was significantly higher if the patient did not receive some type of antifungal therapy post transplantation (P<.001). CONCLUSION Within the coccidioidal endemic region, post-transplantation coccidioidomycosis was a definable risk among lung transplant recipients. Use of antifungals appeared to reduce this incidence of disease. Almost all cases resulted in pulmonary disease, suggesting that the lung is the primary site of infection.
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Affiliation(s)
- Sachin Chaudhary
- Pulmonary Division, Department of Medicine, The University of Arizona College of Medicine, Tucson, AZ, USA
| | - Laura Meinke
- Pulmonary Division, Department of Medicine, The University of Arizona College of Medicine, Tucson, AZ, USA
| | - Huthayfa Ateeli
- Pulmonary Division, Department of Medicine, The University of Arizona College of Medicine, Tucson, AZ, USA
| | - Kenneth S Knox
- Pulmonary Division, Department of Medicine, The University of Arizona College of Medicine, Tucson, AZ, USA
| | - Yuval Raz
- Pulmonary Division, Department of Medicine, The University of Arizona College of Medicine, Tucson, AZ, USA
| | - Neil M Ampel
- Infectious Diseases Division of the Department of Medicine, The University of Arizona College of Medicine, Tucson, AZ, USA.,Medicine, Southern Arizona Veterans Affairs Health Care System, Tucson, AZ, USA
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Paudel MS, Kc S, Mandal AK, Poudyal NS, Shrestha R, Paudel BN, Chaudhary S. Acute Upper Gastrointestinal Bleeding in a Tertiary Care Centre of Nepal. JNMA J Nepal Med Assoc 2017; 56:211-216. [PMID: 28746317] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023] Open
Abstract
INTRODUCTION AUGIB is characterized by hematemesis or melena or both. Peptic ulcers and variceal bleed account for majority of cases. Use of proton pump inhibitors in current era is associated with a gradual reduction in burden of peptic ulcer disease. We conducted this study to look into the cause of AUGIB in our community. METHODS We studied 100 patients in one year period who presented to us with hematemesis or melena. The study was conducted in department of Gastroenterology, Bir hospital, Kathmandu. We identified the culprit lesions by upper gastrointestinal endoscopy. RESULTS The average age of patients with AUGIB was 51.6 years with 59 (59%) males. Duodenal ulcers are most common 29 (29%), followed by varices 23 (23%) and gastric ulcers 14 (14%). More than one lesion was identified in 38 (38%) patients. Patients with variceal bleed were more likely to present with hematemesis alone as compared to those with ulcer bleed (P=0.005). Variceal bleed patients presented earlier to the hospital (P=0.005), had lower MAP at presentation (P=0.0002), had lower hemoglobin level (P=0.0001) and higher serum creatinine level at presentation (P=0.001). Patients with variceal bleed were more likely to have consumed alcohol 20 (86.9%) and patients with ulcer bleed were more likely to be smokers 29 (67.4%) or consume tobacco 14 (32.5%) (P=0.006). CONCLUSIONS Ulcer related bleeding is still the most common cause of AUGIB. Many patients with AUGIB have more than one lesions identified during upper gastrointestinal endoscopy.
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Affiliation(s)
- M S Paudel
- Gastroenterology Unit, Department of Medicine, NAMS, Bir Hospital, Kathmandu, Nepal
| | - S Kc
- Hepatology Unit, Department of Medicine, NAMS, Bir Hospital, Kathmandu, Nepal
| | - A K Mandal
- Gastroenterology Unit, Department of Medicine, NAMS, Bir Hospital, Kathmandu, Nepal
| | - N S Poudyal
- Gastroenterology Unit, Department of Medicine, NAMS, Bir Hospital, Kathmandu, Nepal
| | - R Shrestha
- Gastroenterology Unit, Department of Medicine, NAMS, Bir Hospital, Kathmandu, Nepal
| | - B N Paudel
- Gastroenterology Unit, Department of Medicine, NAMS, Bir Hospital, Kathmandu, Nepal
| | - S Chaudhary
- Gastroenterology Unit, Department of Medicine, NAMS, Bir Hospital, Kathmandu, Nepal
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Shrestha B, Kc S, Chaudhary S, Basnet BK, Mandal AK, Poudyal NS. Outcome of Endoscopic Variceal Band Ligation. JNMA J Nepal Med Assoc 2017; 56:198-202. [PMID: 28746314] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023] Open
Abstract
INTRODUCTION Bleeding from esophageal varices in cirrhosis is an emergent condition with high mortality. One of the preferred modality of treating esophageal varices is EVL. We aimed to find out the outcome of EVL in controlling acute esophageal variceal bleeding, prophylactic banding to prevent future bleeding and the number of sessions required for complete eradication of varices. METHODS This descriptive observational study was carried out in Gastroenterology and Hepatology unit of Bir Hospital, NAMS from June 2016 to May 2017. Consecutive cases who presented in emergency room with acute variceal bleeding due to liver cirrhosis and cases of liver cirrhosis with large varices and red color signs on endoscopic examination were enrolled. They underwent EVL and subsequent re-endoscope at one month interval till the eradication of varices was achieved. RESULTS Among 83 patients, 15 (18.1%) were of Child Pugh class A, 29 (34.9%) B and 39 (47%) were of C. In 20 (24.1%) cases varices could be eradicated in one session of EVL while 57 (68.7%) required two sessions and in 6 (7.2%) cases it took three sessions. Total average EVL session required for obliteration of esophageal varices was 1.84±0.53. There was only one (1.2%) of early re-bleeding post EVL. CONCLUSIONS EVL is an effective modality of treatment in controlling acute esophageal variceal bleeding, in preventing future variceal bleeding as well as in eradicating esophageal varices with very few complications.
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Affiliation(s)
- B Shrestha
- Gastroenterology Unit, Department of Medicine, NAMS, Bir Hospital, Kathmandu, Nepal
| | - S Kc
- Hepatology Unit, Department of Medicine, NAMS, Bir Hospital, Kathmandu, Nepal
| | - S Chaudhary
- Gastroenterology Unit, Department of Medicine, NAMS, Bir Hospital, Kathmandu, Nepal
| | - B K Basnet
- Gastroenterology Unit, Department of Medicine, NAMS, Bir Hospital, Kathmandu, Nepal
| | - A K Mandal
- Gastroenterology Unit, Department of Medicine, NAMS, Bir Hospital, Kathmandu, Nepal
| | - N S Poudyal
- Gastroenterology Unit, Department of Medicine, NAMS, Bir Hospital, Kathmandu, Nepal
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Mandal AK, Chaudhary S, Shrestha B, Paudel MS, Poudyal NS, Paudel BN, Bhattarai B, Ray SK, Ray NM. Efficacy of Prophylactic use of Ciprofloxacin and Metronidazole in Mild and Moderately Severe Acute Pancreatitis. JNMA J Nepal Med Assoc 2017; 56:207-210. [PMID: 28746316] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023] Open
Abstract
INTRODUCTION There are new concepts and developments in the diagnosis and management of acute pancreatitis. Current evidence suggests that there is no role of prophylactic antibiotics use in acute pancreatitis. However, it is still a common practice to administer prophylactic antibiotics in a country like Nepal. So, we have conducted a study in mild and moderately severe acute pancreatitis to study the efficacy of prophylactic antibiotics. METHODS A case control study was conducted among 76 patients comparing efficacy of prophylactic antibiotics versus no antibiotics in patients with mild and moderately severe acute pancreatitis. RESULTS The two most common etiology of acute pancreatitis in AG and NAG were alcohol 21 (55.2%) vs. 24 (63.1%) and biliary 10 (26.3%) vs. 4 (10.5%) respectively. Pancreatic necrosis was seen in five (13.1 %) in AG and four (10.5%) in NAG. Four (10.5%) developed extra pancreatic complications in AG and five (13.1%) in NAG. There was one (2.6%) death in AG and no death in NAG. Abdominal pain improvement seen in AG vs. NAG was 3.2 days vs. 2.4 days (P=0.002). The hospital stay was 7.7±2.23 days in AG and 7.5±1.85 days in NAG (P=0.65). CONCLUSIONS The routine use of prophylactic antibiotics for mild and moderately severe acute pancreatitis is not associated with improvement in meaningful clinical outcomes.
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Affiliation(s)
- A K Mandal
- Gastroenterology Unit, Department of Medicine, NAMS, Bir Hospital, Kathmandu, Nepal
| | - S Chaudhary
- Gastroenterology Unit, Department of Medicine, NAMS, Bir Hospital, Kathmandu, Nepal
| | - B Shrestha
- Gastroenterology Unit, Department of Medicine, NAMS, Bir Hospital, Kathmandu, Nepal
| | - M S Paudel
- Gastroenterology Unit, Department of Medicine, NAMS, Bir Hospital, Kathmandu, Nepal
| | - N S Poudyal
- Gastroenterology Unit, Department of Medicine, NAMS, Bir Hospital, Kathmandu, Nepal
| | - B N Paudel
- Gastroenterology Unit, Department of Medicine, NAMS, Bir Hospital, Kathmandu, Nepal
| | - B Bhattarai
- Interfaith Medical Center, Brooklyn, NY, USA
| | - S K Ray
- Sure Medical PC, Elmhurst, NY, USA
| | - N M Ray
- New York Presbyterian Hospital, Queens, NY, USA
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Poudyal NS, Chaudhary S, Basnet BK, Paudel BN, Shrestha B, Mandal AK, Paudel MS. Colorectal Cancer in Different Age Groups in a Tertiary Hospital in Nepal. JNMA J Nepal Med Assoc 2017; 56:203-206. [PMID: 28746315] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023] Open
Abstract
INTRODUCTION Some studies have suggested that colorectal cancer at a younger age had distinct biological characteristics: different clinical presentations, more advanced stage at time of diagnosis and poorly differentiated carcinoma. The aim of the study is to analyze clinical and histopathological differences between younger (≤40 years of age) and older (>40 years of age) colorectal cancer patients. METHODS A cross-sectional analysis was conducted amongst the colorectal cancer patients who visited Bir Hospital between July 2015 and April 2017. All colonoscopically diagnosed and histopathologically proven cases of colon cancer were included. Chi-square test and independent t - test was performed to analyze the difference between clinical presentations and histopathological findings among two groups of patients and P value of <0.05 was considered as significant. RESULTS Thirty younger patients and thirty older patients were enrolled without any differences in gender proportion. There were no statistical differences between clinical presentation and histological grade and type in younger and older patients. The younger patients had more complaints of altered bowel habit (P <0.001) while older patients mostly presented with per rectal bleeding (P< 0.008). CONCLUSIONS In this study, colorectal cancer at younger ages showed similar characteristics to those of older patients except altered bowel habit was more common in younger patients while per rectal bleeding was more common in older patients. Although colorectal cancer incidence increases with age, younger patients with altered bowel habits, weight loss, anemia and anorexia should also be given due medical attention and undergo evaluation promptly.
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Affiliation(s)
- N S Poudyal
- Gastroenterology Unit, Department of Medicine, NAMS, Bir Hospital, Kathmandu, Nepal
| | - S Chaudhary
- Gastroenterology Unit, Department of Medicine, NAMS, Bir Hospital, Kathmandu, Nepal
| | - B K Basnet
- Gastroenterology Unit, Department of Medicine, NAMS, Bir Hospital, Kathmandu, Nepal
| | - B N Paudel
- Gastroenterology Unit, Department of Medicine, NAMS, Bir Hospital, Kathmandu, Nepal
| | - B Shrestha
- Gastroenterology Unit, Department of Medicine, NAMS, Bir Hospital, Kathmandu, Nepal
| | - A K Mandal
- Gastroenterology Unit, Department of Medicine, NAMS, Bir Hospital, Kathmandu, Nepal
| | - M S Paudel
- Gastroenterology Unit, Department of Medicine, NAMS, Bir Hospital, Kathmandu, Nepal
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Fahey R, Gilmore W, Papageorge M, Chang D, Azzouni L, Chaudhary S, Balint A, Ashrafi A, Darwish G, Oreadi D, Viswanath A, English R, Mehtani A, Alharthi K, Vyas H, Decoteau C, Stark P. Evaluation of postoperative oedema and pain following third molar extraction with application of pulsed electromagnetic field therapy. Int J Oral Maxillofac Surg 2017. [DOI: 10.1016/j.ijom.2017.02.381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Bhatnagar A, Sinha AA, Chaudhary S, Manuja N, Kaur H, Chaitra TR. Accuracy and evaluation of a new regression equation in predicting the width of unerupted permanent canines and premolar teeth. Eur Arch Paediatr Dent 2017; 18:31-37. [PMID: 28110423 DOI: 10.1007/s40368-016-0263-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Accepted: 12/19/2016] [Indexed: 11/25/2022]
Abstract
AIM To assess the applicability of two regression equations based on mixed dentition analysis and to propose and evaluate a new regression equation using the mandibular incisors and first permanent molars as predictors in calculating the size of unerupted permanent canines and premolar teeth in school children. METHODS Dental study casts of 100 children (50 males and 50 females) aged 11-14 years from schools situated in Moradabad, Uttar Pradesh, India were used. The analysis of Tanaka Johnston, Bernabe Flores-Mir and the proposed equation were tested on the casts. RESULTS The analysis of Tanaka Johnston and Bernabe Flores-Mir tended to overestimate the mesio-distal width of the canines and premolars. The proposed equation also overestimated but the mean difference showed a closer approximation with the actual measured values compared to the other two equations. CONCLUSION Validating studies with a similar population must be conducted to confirm the applicability and precision of the proposed equation.
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Affiliation(s)
- A Bhatnagar
- Department of Paedodontics and Preventive Dentistry, Kothiwal Dental College and Research Centre, Moradabad, UP, 244001, India.
| | - A A Sinha
- Department of Paedodontics and Preventive Dentistry, Kothiwal Dental College and Research Centre, Moradabad, UP, 244001, India
| | - S Chaudhary
- Department of Paedodontics and Preventive Dentistry, Kothiwal Dental College and Research Centre, Moradabad, UP, 244001, India
| | - N Manuja
- Department of Paedodontics and Preventive Dentistry, Kothiwal Dental College and Research Centre, Moradabad, UP, 244001, India
| | - H Kaur
- Department of Paedodontics and Preventive Dentistry, Kothiwal Dental College and Research Centre, Moradabad, UP, 244001, India
| | - T R Chaitra
- Department of Paedodontics and Preventive Dentistry, Kothiwal Dental College and Research Centre, Moradabad, UP, 244001, India
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Bhatnagar A, Chaudhary S, Sinha AA. Evaluation of Three Different Regression Equations Based Mixed Dentition Analysis in Children of Moradabad City, India. Pesqui bras odontopediatria clín integr 2017. [DOI: 10.4034/pboci.2017.171.32] [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: 11/15/2022] Open
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Chaudhary S, Sah JP. Hypercalcemia due to Nasopharyngeal Carcinoma. JNMA J Nepal Med Assoc 2017; 56:182-185. [PMID: 28598460] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023] Open
Abstract
Hypercalcemia is a rare metabolic disorder associated with hyperparathyroidism, malignancy and various other causes. Although common in adult malignancies, hypercalcemia is rare in pediatrics and purports poor prognosis. Nasopharyngeal carcinoma is rare with no reported hypercalcemic presentation. We present here a case of hypercalcemia in a child of nasopharyngeal carcinoma. A 10 year girl presented with backache for 1 month, epistaxis, cough, chest-pain for 1 week alongwith anorexia and weight loss. Investigations revealed anemia and hypercalcemia (23mg/dl; normal range 9-11 mg/dl) with hyperphosphatemia, normal parathyroid levels. Hypercalcemic crisis was managed with saline, furosemide and bisphosphonate. Computed Tomography of paranasal sinuses revealed mass in right nasal cavity. Endoscopic biopsy disclosed undifferentiated nasopharyngeal carcinoma. The child expired despite supportive measures. Thus, hypercalcemia, though rare, may complicate advanced tumors. NPC, being rare in children, requires high index of suspicion with careful clinicoradiological examination and timely management for better chances of survival.
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Affiliation(s)
- S Chaudhary
- Department of Pediatrics & Adolescent Medicine, BP Koirala Institute of Health Sciences, Dharan, Nepal
| | - J P Sah
- Department of Pediatrics & Adolescent Medicine, BP Koirala Institute of Health Sciences, Dharan, Nepal
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