1
|
Nandakumar K, Mohan V, Alsaif F, Senthilkumar S. Author Correction: Design and analysis of solitary AC-AC converter using reduced components for efficient power generation system. Sci Rep 2024; 14:10233. [PMID: 38702508 PMCID: PMC11068887 DOI: 10.1038/s41598-024-61208-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2024] Open
Affiliation(s)
- K Nandakumar
- Department of Electrical and Electronics Engineering, E.G.S. Pillay Engineering College, Nagapattinam, Tamilnadu, 611002, India.
| | - V Mohan
- Department of Electrical and Electronics Engineering, E.G.S. Pillay Engineering College, Nagapattinam, Tamilnadu, 611002, India
| | - Faisal Alsaif
- Department of Electrical Engineering, College of Engineering, King Saud University, 11421, Riyadh, Saudi Arabia
| | - S Senthilkumar
- Department of Electronics and Communication Engineering, E.G.S. Pillay Engineering College, Nagapattinam, Tamilnadu, 611002, India
| |
Collapse
|
2
|
Nandakumar K, Mohan V, Alsaif F, Senthilkumar S. Design and analysis of solitary AC-AC converter using reduced components for efficient power generation system. Sci Rep 2024; 14:9323. [PMID: 38654037 PMCID: PMC11039732 DOI: 10.1038/s41598-024-60230-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2024] [Accepted: 04/19/2024] [Indexed: 04/25/2024] Open
Abstract
Considering different applications that require varied power and voltage conversion levels between AC grids and AC loads, AC-AC power conversion between AC grids has become an inevitable technology of energy management systems. An isolated converter for performing AC-to-AC transmission is proposed with minimal components for reduced losses and enhanced system efficiency. Single-phase direct buck-boost AC to AC converter with minimum components constituted with two dual IGBT control units (IGBT 1-IGBT 4), inductor (Lf), and capacitor (Cf) is proposed in this work. The MATLAB/Simulink platform is used to provide in-depth analysis of the circuit and components along with the design guidelines, and simulation outcomes of this proposed model. The voltage gains of G = 2.13, power factor of 0.97, and overall efficiency of 98% are achieved in the proposed system with minimum components of 4 switches, 2 conductors, and 1 capacitor and inductor respectively. The obtained results are compared with existing technology to evaluate the proposed system.
Collapse
Affiliation(s)
- K Nandakumar
- Department of Electrical and Electronics Engineering, E.G.S. Pillay Engineering College, Nagapattinam, Tamilnadu, 611002, India.
| | - V Mohan
- Department of Electrical and Electronics Engineering, E.G.S. Pillay Engineering College, Nagapattinam, Tamilnadu, 611002, India
| | - Faisal Alsaif
- Department of Electrical Engineering, College of Engineering, King Saud University, 11421, Riyadh, Saudi Arabia
| | - S Senthilkumar
- Department of Electronics and Communication Engineering, E.G.S. Pillay Engineering College, Nagapattinam, Tamilnadu, 611002, India
| |
Collapse
|
3
|
Che Mood A, Justine M, Bukry SA, Mohan V. The association of fatigue severity with pain level, obesity indices and functional performances in women with knee osteoarthritis. Med J Malaysia 2024; 79:1-7. [PMID: 38555878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/02/2024]
Abstract
INTRODUCTION Knee osteoarthritis is most common among women with obesity. It may lead to physical inactivity that, in turn, causes fatigue or lack of physical enthusiasm to perform meaningful daily activities. Hence, this study aimed to examine whether pain level, obesity indices and functional performances are associated with fatigue severity in women with knee osteoarthritis (KOA). MATERIALS AND METHODS This cross-sectional study recruited women referred to physiotherapy to manage OA. The measurements included fatigue severity (fatigue severity scale); pain level (numerical rating scale); obesity indices (body mass index, fat %, waist circumference); functional performances (upper limb strength, lower limb strength, mobility, exercise capacity and quality of life). A simple linear regression analysis was used to determine which independent variable may be associated with fatigue severity. RESULTS Ninety-six women with unilateral KOA participated in this study (Mean age, 55.70, Standard Deviation, SD 6.90) years; Mean fatigue severity, 34.51, SD 14.03). The simple linear regression analysis showed that pain level (β=4.089, p<0.001), fat % (β=0.825, p<0.001) and QoL (β=0.304, p<0.001) were significantly associated with fatigue. After controlling for pain level, only fat % was significantly associated with fatigue (β=0.581, p=0.005). CONCLUSION Pain level, fat %, and QoL appear to be associated with fatigue severity in women with KOA. In addition, pain symptoms may interact with factors associated with fatigue severity.
Collapse
Affiliation(s)
- A Che Mood
- Universiti Teknologi MARA, Faculty of Health Sciences, Centre for Physiotherapy Studies, Puncak Alam Campus, Selangor, Malaysia
| | - M Justine
- Universiti Teknologi MARA, Faculty of Health Sciences, Centre for Physiotherapy Studies, Puncak Alam Campus, Selangor, Malaysia.
| | - S A Bukry
- Universiti Teknologi MARA, Faculty of Health Sciences, Centre for Physiotherapy Studies, Puncak Alam Campus, Selangor, Malaysia
| | - V Mohan
- Bournemouth University, Faculty of Health and Social Science, Department of Rehabilitation and Sports Sciences, Bournemouth, Dorset, United Kingdom
| |
Collapse
|
4
|
Shah IA, Rashid R, Bhat A, Rashid H, Bashir R, Asrar MM, Wani IA, Ahmad Charoo B, Radha V, Mohan V, Ashraf Ganie M. A novel mutation in the KCNJ11 gene (p.Val36Glu), predisposes to congenital hyperinsulinemia. Gene 2023:147576. [PMID: 37336273 DOI: 10.1016/j.gene.2023.147576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 05/31/2023] [Accepted: 06/14/2023] [Indexed: 06/21/2023]
Abstract
The hypoglycemia induced by insulin hypersecretion in congenital hyperinsulinemia (CHI), a rare life-threatening condition can lead to irreversible brain damage in neonates. Inactivating mutations in the genes encoding KATP channel (ABCC8 and KCNJ11) as well as HNF4A, HNF1A, HADH, UCP2, and activating mutations in GLUD1, GCK, and SLC16A1 have been identified as causal. A 3-month-old male infant presenting tonic-clonic seizures and hyperinsulinemia was clinically assessed and subjected to genetic analysis. Besides the index patient, his parents were clinically investigated, and a detailed family history was also recorded. The laboratory investigations and the genetic test results of the parents were compared with the index patient. The biochemical and hormonal profile of the patient confirmed his suffering from CHI and did not respond to diazoxide treatment. The genetic testing revealed that the subject harbored a novel homozygous missense mutation in the KCNJ11 gene, (c.107T>A, p.Val36Glu.). The bioinformatic analysis revealed that valine is highly conserved and predicted that the variant allele (p.Val36Glu) is likely pathogenic and causal for CHI. Parents were heterozygous carriers and did not report any abnormal metabolic profile. Identification of such mutations is critical and likely to change the therapeutic interventions for such patients in the future.
Collapse
Affiliation(s)
- Idrees A Shah
- Multidisciplinary Research Unit, Sheri Kashmir Institute of Medical Sciences, Srinagar, IN; Department of Clinical Research, Sheri Kashmir Institute of Medical Sciences, Srinagar, IN
| | - Rabiya Rashid
- Department of Clinical Research, Sheri Kashmir Institute of Medical Sciences, Srinagar, IN; Department of Life Sciences, Jaipur National University, Jaipur, IN
| | - Abid Bhat
- Departments of Endocrinology, Sheri Kashmir Institute of Medical Sciences, Srinagar, IN
| | - Haroon Rashid
- Department of Clinical Research, Sheri Kashmir Institute of Medical Sciences, Srinagar, IN
| | - Rohina Bashir
- Department of Clinical Research, Sheri Kashmir Institute of Medical Sciences, Srinagar, IN
| | - Mir M Asrar
- Multidisciplinary Research Unit, Sheri Kashmir Institute of Medical Sciences, Srinagar, IN; Department of Clinical Research, Sheri Kashmir Institute of Medical Sciences, Srinagar, IN
| | - Imtiyaz A Wani
- Department of Clinical Research, Sheri Kashmir Institute of Medical Sciences, Srinagar, IN
| | - Bashir Ahmad Charoo
- Department of Pediatrics and Neonatology, Sheri Kashmir Institute of Medical Sciences, Srinagar, IN
| | | | - V Mohan
- Madras Diabetes Research Foundation, Chennai, IN; Dr. Mohan's Diabetes Specialties Centre, Chennai, India
| | - Mohd Ashraf Ganie
- Multidisciplinary Research Unit, Sheri Kashmir Institute of Medical Sciences, Srinagar, IN; Department of Clinical Research, Sheri Kashmir Institute of Medical Sciences, Srinagar, IN; Departments of Endocrinology, Sheri Kashmir Institute of Medical Sciences, Srinagar, IN.
| |
Collapse
|
5
|
Wall JD, Sathirapongsasuti JF, Gupta R, Rasheed A, Venkatesan R, Belsare S, Menon R, Phalke S, Mittal A, Fang J, Tanneeru D, Deshmukh M, Bassi A, Robinson J, Chaudhary R, Murugan S, Ul-Asar Z, Saleem I, Ishtiaq U, Fatima A, Sheikh SS, Hameed S, Ishaq M, Rasheed SZ, Memon FUR, Jalal A, Abbas S, Frossard P, Fuchsberger C, Forer L, Schoenherr S, Bei Q, Bhangale T, Tom J, Gadde SGK, B V P, Naik NK, Wang M, Kwok PY, Khera AV, Lakshmi BR, Butterworth AS, Chowdhury R, Danesh J, di Angelantonio E, Naheed A, Goyal V, Kandadai RM, Kumar H, Borgohain R, Mukherjee A, Wadia PM, Yadav R, Desai S, Kumar N, Biswas A, Pal PK, Muthane UB, Das SK, Ramprasad VL, Kukkle PL, Seshagiri S, Kathiresan S, Ghosh A, Mohan V, Saleheen D, Stawiski EW, Peterson AS. South Asian medical cohorts reveal strong founder effects and high rates of homozygosity. Nat Commun 2023; 14:3377. [PMID: 37291107 PMCID: PMC10250394 DOI: 10.1038/s41467-023-38766-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 05/15/2023] [Indexed: 06/10/2023] Open
Abstract
The benefits of large-scale genetic studies for healthcare of the populations studied are well documented, but these genetic studies have traditionally ignored people from some parts of the world, such as South Asia. Here we describe whole genome sequence (WGS) data from 4806 individuals recruited from the healthcare delivery systems of Pakistan, India and Bangladesh, combined with WGS from 927 individuals from isolated South Asian populations. We characterize population structure in South Asia and describe a genotyping array (SARGAM) and imputation reference panel that are optimized for South Asian genomes. We find evidence for high rates of reproductive isolation, endogamy and consanguinity that vary across the subcontinent and that lead to levels of rare homozygotes that reach 100 times that seen in outbred populations. Founder effects increase the power to associate functional variants with disease processes and make South Asia a uniquely powerful place for population-scale genetic studies.
Collapse
Affiliation(s)
- Jeffrey D Wall
- Institute for Human Genetics, University of California, San Francisco, CA, 94143, USA.
- Dept of Ornithology and Mammology, California Academy of Sciences, San Francisco, CA, 94118, USA.
| | - J Fah Sathirapongsasuti
- MedGenome Inc., Foster City, CA, 94404, USA
- GenomeAsia 100K Foundation, Foster City, CA, 94404, USA
| | - Ravi Gupta
- MedGenome Labs Pvt. Ltd., Bengaluru, Karnataka, 560099, India
| | - Asif Rasheed
- Center for Non-Communicable Disease, Karachi, Karachi City, Sindh, 75300, Pakistan
| | - Radha Venkatesan
- Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialties Centre, Chennai, Tamil Nadu, 600086, India
| | - Saurabh Belsare
- Institute for Human Genetics, University of California, San Francisco, CA, 94143, USA
| | - Ramesh Menon
- MedGenome Labs Pvt. Ltd., Bengaluru, Karnataka, 560099, India
| | - Sameer Phalke
- MedGenome Labs Pvt. Ltd., Bengaluru, Karnataka, 560099, India
| | | | - John Fang
- Thermo Fisher Scientific, Santa Clara, CA, 95051, USA
| | - Deepak Tanneeru
- MedGenome Labs Pvt. Ltd., Bengaluru, Karnataka, 560099, India
| | | | - Akshi Bassi
- MedGenome Labs Pvt. Ltd., Bengaluru, Karnataka, 560099, India
| | - Jacqueline Robinson
- Institute for Human Genetics, University of California, San Francisco, CA, 94143, USA
| | | | | | - Zameer Ul-Asar
- Center for Non-Communicable Disease, Karachi, Karachi City, Sindh, 75300, Pakistan
| | - Imran Saleem
- Center for Non-Communicable Disease, Karachi, Karachi City, Sindh, 75300, Pakistan
| | - Unzila Ishtiaq
- Center for Non-Communicable Disease, Karachi, Karachi City, Sindh, 75300, Pakistan
| | - Areej Fatima
- Center for Non-Communicable Disease, Karachi, Karachi City, Sindh, 75300, Pakistan
| | | | | | | | | | | | - Anjum Jalal
- Faisalabad Institute of Cardiology, Faisalabad, Pakistan
| | - Shahid Abbas
- Faisalabad Institute of Cardiology, Faisalabad, Pakistan
| | - Philippe Frossard
- Center for Non-Communicable Disease, Karachi, Karachi City, Sindh, 75300, Pakistan
| | - Christian Fuchsberger
- Department of Biostatistics, University of Michigan, Ann Arbor, MI, 48109, USA
- Institute for Biomedicine, Eurac Research, Bolzano, Italy
- Institute of Genetic Epidemiology, Department of Genetics and Pharmacology, Medical University of Innsbruck, Innsbruck, Austria
| | - Lukas Forer
- Institute of Genetic Epidemiology, Department of Genetics and Pharmacology, Medical University of Innsbruck, Innsbruck, Austria
| | - Sebastian Schoenherr
- Institute of Genetic Epidemiology, Department of Genetics and Pharmacology, Medical University of Innsbruck, Innsbruck, Austria
| | - Qixin Bei
- Department of Molecular Biology, Genentech, South San Francisco, CA, 94080, USA
| | - Tushar Bhangale
- Department of Human Genetics, Genentech, South San Francisco, CA, 94080, USA
| | - Jennifer Tom
- Product Development Data Sciences, Genentech, South San Francisco, CA, 94080, USA
| | | | - Priya B V
- Narayana Nethralaya Foundation, Bengaluru, Karnataka, 560010, India
| | | | - Minxian Wang
- Program in Medical and Population Genetics & Cardiovascular Disease Initiative, Broad Institute of MIT and Harvard, Cambridge, MA, 02142, USA
| | - Pui-Yan Kwok
- Institute for Human Genetics, University of California, San Francisco, CA, 94143, USA
- Cardiovascular Research Institute and Department of Dermatology, University of California San Francisco, San Francisco, CA, 94143, USA
- Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan
| | - Amit V Khera
- Harvard Medical School, Boston, MA, 02115, USA
- Division of Cardiology, Department of Medicine, Brigham and Women's Hospital, MA, 02115, Boston, USA
- Verve Therapeutics, Cambridge, MA, 02139, USA
| | - B R Lakshmi
- MDCRC, Royal Care Super Speciality Hospital 1/520, Neelambur, Coimbatore, Tamil Nadu, 641062, India
| | - Adam S Butterworth
- British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- National Institute for Health Research Blood and Transplant Research Unit in Donor Health and Genomics, University of Cambridge, Cambridge, UK
- National Institute for Health Research Cambridge Biomedical Research Centre, University of Cambridge and Cambridge University Hospitals, Cambridge, UK
- Health Data Research UK Cambridge, Wellcome Genome Campus and University of Cambridge, Cambridge, UK
| | - Rajiv Chowdhury
- British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - John Danesh
- British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- National Institute for Health Research Blood and Transplant Research Unit in Donor Health and Genomics, University of Cambridge, Cambridge, UK
- National Institute for Health Research Cambridge Biomedical Research Centre, University of Cambridge and Cambridge University Hospitals, Cambridge, UK
- Health Data Research UK Cambridge, Wellcome Genome Campus and University of Cambridge, Cambridge, UK
- Department of Human Genetics, Wellcome Sanger Institute, Hinxton, UK
| | - Emanuele di Angelantonio
- British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- National Institute for Health Research Blood and Transplant Research Unit in Donor Health and Genomics, University of Cambridge, Cambridge, UK
- National Institute for Health Research Cambridge Biomedical Research Centre, University of Cambridge and Cambridge University Hospitals, Cambridge, UK
- Health Data Research UK Cambridge, Wellcome Genome Campus and University of Cambridge, Cambridge, UK
| | - Aliya Naheed
- Initiative for Non Communicable Diseases, Health Systems and Population Studies Division, icddr,b, Dhaka, Bangladesh
| | - Vinay Goyal
- All India Institute of Medical Sciences (AIIMS), New Delhi, India
- Medanta Hospital, New Delhi, India
- Medanta, The Medicity, Gurgaon, India
| | | | | | - Rupam Borgohain
- Nizams Institute of Medical Sciences (NIMS), Hyderabad, India
| | - Adreesh Mukherjee
- Bangur Institute of Neurosciences and Institute of Post Graduate Medical Education and Research (IPGME&R), Kolkata, India
| | | | - Ravi Yadav
- National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
| | - Soaham Desai
- Shree Krishna Hospital and Pramukhaswami Medical College, Bhaikaka University, Karamsad, Gujarat, India
| | - Niraj Kumar
- All India Institute of Medical Sciences, Rishikesh, India
| | - Atanu Biswas
- Bangur Institute of Neurosciences and Institute of Post Graduate Medical Education and Research (IPGME&R), Kolkata, India
| | - Pramod Kumar Pal
- National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
| | - Uday B Muthane
- Parkinson and Ageing Research Foundation, Bengaluru, India
| | - Shymal K Das
- Bangur Institute of Neurosciences and Institute of Post Graduate Medical Education and Research (IPGME&R), Kolkata, India
| | | | - Prashanth L Kukkle
- All India Institute of Medical Sciences, Rishikesh, India
- Manipal Hospital, Miller Road, Bengaluru, India
- Parkinson's Disease and Movement Disorders Clinic, Bengaluru, India
| | - Somasekar Seshagiri
- GenomeAsia 100K Foundation, Foster City, CA, 94404, USA
- Department of Molecular Biology, Genentech, South San Francisco, CA, 94080, USA
| | - Sekar Kathiresan
- Program in Medical and Population Genetics & Cardiovascular Disease Initiative, Broad Institute of MIT and Harvard, Cambridge, MA, 02142, USA
- Verve Therapeutics, Cambridge, MA, 02139, USA
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, 02114, USA
| | - Arkasubhra Ghosh
- Narayana Nethralaya Foundation, Bengaluru, Karnataka, 560010, India
| | - V Mohan
- Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialties Centre, Chennai, Tamil Nadu, 600086, India
| | - Danish Saleheen
- Center for Non-Communicable Disease, Karachi, Karachi City, Sindh, 75300, Pakistan
- Seymour, Paul and Gloria Milstein Division of Cardiology at Columbia University, New York, NY, 10032, USA
| | - Eric W Stawiski
- MedGenome Inc., Foster City, CA, 94404, USA
- GenomeAsia 100K Foundation, Foster City, CA, 94404, USA
- Department of Molecular Biology, Genentech, South San Francisco, CA, 94080, USA
- Caribou Biosciences, Berkeley, CA, 94710, USA
| | - Andrew S Peterson
- MedGenome Inc., Foster City, CA, 94404, USA.
- GenomeAsia 100K Foundation, Foster City, CA, 94404, USA.
- Department of Molecular Biology, Genentech, South San Francisco, CA, 94080, USA.
- Broadwing Bio, South San Francisco, CA, 94080, USA.
| |
Collapse
|
6
|
Diehm N, Pelz S, Kalka C, Keo HH, Mohan V, Schumacher MC, Do DD, Hoppe H. Venous Leak Embolization in Patients with Venogenic Erectile Dysfunction via Deep Dorsal Penile Vein Access: Safety and Early Efficacy. Cardiovasc Intervent Radiol 2023; 46:610-616. [PMID: 36949182 PMCID: PMC10156837 DOI: 10.1007/s00270-023-03412-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Accepted: 02/28/2023] [Indexed: 03/24/2023]
Abstract
PURPOSE This all-comers registry aimed to assess safety and early efficacy of venous embolization in patients with venogenic erectile dysfunction due to venous leak in an unselected cohort. METHODS Between October 2019 and September 2022, patients with venogenic erectile dysfunction resistant to phosphodiesterase-5-inhibitors were treated with venous embolization using ultrasound-guided anterograde access via a deep dorsal penile vein in a single center. A mix of ethiodized oil and modified cyanoacrylate-based glue n-butyl 2 cyanoacrylate (NBCA) monomer plus methacryloxy-sulpholane monomer (Glubran-2, GEM, Italy) was used as liquid embolic agent. Prior to embolization, venous leak had been verified based on penile duplex sonography and computed tomography cavernosography. Procedural success was defined as technically successful and complete target vein embolization. The primary safety outcome measure was any major adverse event 6 weeks after the procedure. The primary feasibility outcome measure was IIEF-15 (International Index of Erectile Function-15) score improvement ≥ 4 points in ≥ 50% of subjects on 6 weeks follow-up post intervention. RESULTS Fifty consecutive patients (mean age 61.8 ± 10.0 years) with severe erectile dysfunction due to venous leak underwent venous embolization. Procedural success was achieved in 49/50 (98%) of patients with no major adverse events on follow-up. The primary feasibility outcome measure at 6 weeks was reached by 34/50 (68%) of patients. CONCLUSION Venous leak embolization via deep dorsal penile vein access using a liquid embolic agent was safe for all and efficacious in the majority of patients with severe venogenic erectile dysfunction on 6 weeks follow-up.
Collapse
Affiliation(s)
- N Diehm
- Vascular Institute Central Switzerland, Aarau, Switzerland
- University of Applied Sciences Furtwangen, Villingen-Schwenningen, Germany
- University of Bern, Bern, Switzerland
| | - S Pelz
- Vascular Institute Central Switzerland, Aarau, Switzerland
- University of Bern, Bern, Switzerland
| | - C Kalka
- Vascular Institute Central Switzerland, Aarau, Switzerland
| | - H H Keo
- Vascular Institute Central Switzerland, Aarau, Switzerland
- Department of Angiology, University Hospital of Basel, Basel, Switzerland
| | - V Mohan
- Vascular Institute Central Switzerland, Aarau, Switzerland
| | - M C Schumacher
- Department of Urology, Hirslanden Clinic Aarau, Aarau, Switzerland
| | - D D Do
- Vascular Institute Central Switzerland, Aarau, Switzerland
- University of Bern, Bern, Switzerland
| | - H Hoppe
- University of Bern, Bern, Switzerland.
- SwissIntervention Microtherapy Center, Bern, Switzerland.
- Campus Stiftung Lindenhof Bern, Swiss Institute for Translational and Entrepreneurial Medicine, Bern, Switzerland.
- University of Lucerne, Lucerne, Switzerland.
| |
Collapse
|
7
|
Mohan V, Pinto-Sanchez M, Nardelli A, Magee M, Borojevic R, De Palma G, Britz-McKibbin P, Collins S, Bercik P. A265 TEMPORAL DYNAMICS OF SYMPTOMS AND GUT MICROBIOTA IN EPISODES OF IRRITABLE BOWEL SYNDROME. J Can Assoc Gastroenterol 2023. [PMCID: PMC9991343 DOI: 10.1093/jcag/gwac036.265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/09/2023] Open
Abstract
Background Irritable bowel syndrome (IBS) is a disorder of gut-brain axis that manifests with chronic abdominal pain, altered bowel habits, and frequent psychiatric comorbidities. Despite mounting evidence showing gut microbiota composition and associated metabolites being altered in IBS, the mechanisms by which they drive the symptoms are unclear. We have previously shown that several IBS symptoms co-occur, that their severity vary among IBS subtypes (10.1093/jcag/gwab049.050), and that several bacterial taxa are differentially modulated during periods of symptom flares and remission. Here we investigate whether the changes in gut microbiome and bacterial metabolites are linked to symptom occurrence and severity. Purpose To investigate temporal associations of IBS symptoms with gut microbiota profiles and metabolites. Method 16S rRNA gene sequencing was performed on stool samples of 28 IBS patients (IBS-D n=20, IBS-C n=8) and 10 healthy controls (HC), collected weekly over a period of 25 weeks, during which gut and mood symptoms were recorded (total of 950 samples). Correlations between principal ordinates obtained from symptom scores and microbiota beta diversity were studied using Procrustes analysis in R. Metabolomics was performed by Mass Spectrometry and analysed using MetaboAnalyst 5.0. Statistical significance was set at p<0.05. Result(s) Significant correlation was found between the symptom scores and microbiota beta diversity ordinates over time in 7 patients (5 IBS-D and 2 IBS-C subjects) out of 28 IBS patients. Metabolomics performed on samples selected based on Procrustes analysis and symptom severity scores of individual subjects showed that several pathways are altered in IBS patients (both subtypes) compared to HC, including primary bile acid biosynthesis, beta alanine metabolism, pyrimidine and histidine metabolism. Furthermore, during symptom flares, ornithine, citrulline and gluconic acid vary in IBS-D, while amino acids cysteine, methionine, threonine, and glycine vary in IBS-C subjects. Conclusion(s) Our results suggest that IBS symptoms and changes in gut microbiota composition and metabolites must be studied in conjunction, in order to understand the mechanisms underlying IBS pathophysiology. We found that same pathways are altered in IBS subjects irrespective of their subtype, suggestive of a basal metabolic shift in IBS patients. This shift may make them sensitive to further gut microbial modulation of carbohydrate and protein metabolism in IBS-D and IBS-C subjects, respectively, leading to symptom flares. Further analyses are needed to investigate these metabolites and associated bacteria, as they can help identifying subsets of patients with specific disease mechanisms. This will be a steppingstone in moving away from symptom-based subtyping towards mechanism-based grouping and developing effective treatment strategies accordingly. Disclosure of Interest None Declared
Collapse
Affiliation(s)
| | | | | | - M Magee
- Department of Chemistry and Chemical Biology, McMaster University, Hamilton, Canada
| | | | | | - P Britz-McKibbin
- Department of Chemistry and Chemical Biology, McMaster University, Hamilton, Canada
| | | | | |
Collapse
|
8
|
Puri R, Mehta V, Duell PB, Wangnoo SK, Rastogi A, Mohan V, Zargar AH, Kalra S, Sahoo AK, Iyengar SS, Yusuf J, Mukhopadhyay S, Singla MK, Shaikh A, Kohli S, Mathur S, Jain S, Narasingan SN, Gupta V, Agarwala R, Mittal V, Varma A, Panda JK, Shetty S, Yadav M, Muruganathan A, Dabla P, Pareek KK, Manoria PC, Nanda R, Sattur GB, Pancholia AK, Wong ND. Management of diabetic dyslipidemia in Indians: Expert consensus statement from the Lipid Association of India. J Clin Lipidol 2023; 17:e1-e14. [PMID: 36577628 DOI: 10.1016/j.jacl.2022.11.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 11/03/2022] [Accepted: 11/09/2022] [Indexed: 11/27/2022]
Abstract
In 2021 an estimated 74 million individuals had diabetes in India, almost all type 2 diabetes. More than half of patients with diabetes are estimated to be undiagnosed and more 90% have dyslipidemia that is associated with accelerated development of atherosclerotic cardiovascular disease (ASCVD). Patients of Indian descent with diabetes have multiple features that distinguish them from patients with diabetes in Western populations. These include characteristics such as earlier age of onset, higher frequency of features of the metabolic syndrome, more prevalent risk factors for ASCVD, and more aggressive course of ASCVD complications. In light of the unique features of diabetes and diabetic dyslipidemia in individuals of Indian descent, the Lipid Association of India developed this expert consensus statement to provide guidance for management of diabetic dyslipidemia in this very high risk population. The recommendations contained herein are the outgrowth of a series of 165 webinars conducted by the Lipid Association of India across the country from May 2020 to July 2021, involving 155 experts in endocrinology and cardiology and an additional 2880 physicians.
Collapse
Affiliation(s)
- Raman Puri
- Senior Consultant Cardiologist, Indraprastha Apollo Hospitals, New Delhi, India(Drs Puri).
| | - Vimal Mehta
- Director-Professor, Department of Cardiology, G.B. Pant Institute of Postgraduate Medical Education and Research, New Delhi, India(Drs Mehta and Yusuf)
| | - P Barton Duell
- Professor of Medicine, Knight Cardiovascular Institute and Division of Endocrinology, Diabetes and Clinical Nutrition, Oregon Health & Science University, Portland, OR, USA (Drs Duell)
| | - S K Wangnoo
- Sr. Consultant Endocrinologist & Diabetologist, Indraprastha Apollo Hospitals, New Delhi, India (Drs Wangnoo)
| | - Ashu Rastogi
- Assistant Professor, Department of Endocrinology & Metabolism, PGIMER Chandigarh, Punjab, India (Drs Rastogi)
| | - V Mohan
- Director Madras Diabetic Research Foundation & Chairman & chief Diabetologist, Dr Mohan Diabetes specialities Centre, Chennai, Tamil Nadu, India (Drs Mohan)
| | - Abdul Hamid Zargar
- Medical Director, Center for Diabetes & Endocrine Care, National Highway, Gulshan Nagar, Srinagar, J&K, India (Drs Zargar)
| | - Sanjay Kalra
- Consultant, Department of Endocrinology, Bharti Hospital, Karnal, Haryana, India (Drs Kalra)
| | - Abhay Kumar Sahoo
- Associate Professor in Endocrinology at IMS and SUM Hospital, Bhubaneshwar, India (Drs Sahoo)
| | - S S Iyengar
- Sr. Consultant and Head, Department of Cardiology, Manipal Hospital, Bangalore, Karnataka, India (Drs Iyengar)
| | - Jamal Yusuf
- Director-Professor, Department of Cardiology, G.B. Pant Institute of Postgraduate Medical Education and Research, New Delhi, India(Drs Mehta and Yusuf)
| | - Saibal Mukhopadhyay
- Director-Professor and Head, Department of Cardiology, G.B. Pant Institute of Postgraduate Medical Education and Research, New Delhi, India (Drs Mukhopadhyay)
| | - Mani Kant Singla
- Director, MKS Endocrinologist, Ludhiana, Punjab, India (Drs Singla)
| | - Altamash Shaikh
- Sr. Consultant, Endocrinology, Saifee Hospital, Mumbai, Maharashtra, India (Drs Shaikh)
| | - Sunil Kohli
- Professor and Head Department of Medicine, Hamdard Institute of Medical Sciences, New Delhi, India (Drs Kohli)
| | - Sandeep Mathur
- Professor and Head of Department of Endocrinology, SMS Medical College and Hospital, Jaipur, Rajasthan, India (Drs Mathur)
| | - Sachin Jain
- Ex. Director Professor Lady Harding Medical College, New Delhi, India (Drs Jain)
| | - S N Narasingan
- Former Adjunct Professor of medicine, Dr MGR Medical University, and Managing Director, SNN Specialities Clinic, Chennai, Tamil Nadu, India (Drs Narasingan)
| | - Vipul Gupta
- Medical Director, Gupta Ultrasound & Heart care Centre, New Delhi, India (Drs Gupta)
| | - Rajeev Agarwala
- Sr. Consultant Cardiologist, Jaswant Rai Speciality Hospital, Meerut, Uttar Pradesh, India (Drs Agarwala)
| | - Vinod Mittal
- Sr. Consultant Diabetologist & Head, Centre for Diabetes & Metabolic disease, Delhi Heart & Lung Institute, Delhi, India (Drs Mittal)
| | - Amit Varma
- Professor & Head Department of Medicine, SGRR Institute of medical and health Sciences, Dehradun, Uttarakhand, India (Drs Varma)
| | - Jayant Kumar Panda
- Professor & Head, PG Department of Internal Medicine, SCB Medical College, Cuttack, Odisha, India (Drs Panda)
| | - Sadanand Shetty
- Head, Department of Cardiology, K.J Somaiya Super Speciality Institute, Sion (East), Mumbai, Maharashtra, India (Drs Shetty)
| | - Madhur Yadav
- Director-Professor of Medicine, Lady Harding Medical College, New Delhi, India (Drs Yadav)
| | - A Muruganathan
- Sr. Consultant Internal Medicine, AG Hospital, Tirupur, Tamil Nadu, India (Drs Muruganathan)
| | - Pradeep Dabla
- Professor of Biochemistry, G.B. Pant Institute of Postgraduate Medical Education and Research, New Delhi, India (Drs Dabla)
| | - K K Pareek
- Head, Department of Medicine, S. N. Pareek Hospital, Dadabari, Kota, Rajasthan, India (Drs Pareek)
| | - P C Manoria
- Director, Heart and critical Care Hospital, Bhopal, Madhya Pradesh, India (Drs Manoria)
| | - Rashmi Nanda
- Consultant Physician, Cardiac Care Centre, South Extension, New Delhi, India (Drs Nanda)
| | - G B Sattur
- Sr. Consultant Physician and Diabetologist, Sattur Medical Care, Hubli, Karnataka, India (Drs Sattur)
| | - A K Pancholia
- Head of Department, Medicine & Preventive Cardiology, Arihant Hospital & RC, Indore, Madhya Pradesh, India (Drs Pancholia)
| | - Nathan D Wong
- Professor and Director, Heart Disease Prevention Program, Division of Cardiology, University of California Irvine, USA (Drs Wong)
| |
Collapse
|
9
|
Lee CEC, Subramani P, Ananth P, Bhalraam U, Victor C, Venkatesan R, Prathiba V, Anjana RM, Palmer CNA, Struthers AD, Singh JS, Mordi IR, Mohan V, Lang CC. High prevalence of asymptomatic left ventricular diastolic dysfunction and its detection among South Asian patients with Type 2 Diabetes Mellitus compared with White Europeans. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Heart failure (HF) is an important manifestation of Type 2 Diabetes (T2D). The development of HF in T2D may be preceded by Stage B HF. Asymptomatic left ventricular impairment, especially left ventricular diastolic dysfunction (LVDD), is a defining early feature of Stage B HF. Detection of Stage B HF is crucial as it provides an opportune target for intervention with cardio-protective therapy to prevent the development of symptomatic HF in T2D. The risk of T2DM is higher in South Asian populations resulting in increased risk of macrovascular and microvascular complications. The prevalence of Stage B HF in South Asian patients with T2DM is not known.
Purpose
(i) To compare the prevalence of Stage B HF in South Asians in India compared with White Europeans in Scotland; (ii) To test the role of NT-proBNP in identifying Stage B HF
Methods
This study involved the comparison between two independently conducted, cross-sectional studies. The patients were asymptomatic patients with T2DM with no prior history of cardiovascular disease from Chennai, India (n=246) and Tayside, Scotland (n=246). All patients underwent transthoracic echocardiogram (echo) examination to detect the presence of structural and functional echo features of Stage B HF: left atrial enlargement (LAE), left ventricular hypertrophy (LVH), LVDD and LV systolic dysfunction (LVSD). Receiver operating curves (ROC) were used to determine the predictive ability of NT-proBNP to predict LAE/LVDD/LVD/LVSD.
Results
The prevalence of Stage B HF was high in South-Asian patients with T2DM (median age of 55 [49, 62] with a high prevalence of LVDD (5% had LVH, 7.3% had LAE, 70% had LVDD and 0% had LVSD (Figure 1B). 10% of the South Asian patients had at least 2 factors contributing to Stage B HF and these patients had higher NT-proBNP titres (703.4 [500.0, 949.2] vs 423.7 [35.0, 754.2], p<0.001). ROC curves show that NT-proBNP can predict these participants with 2 or more echo features [Figure 2B, AUC: 0.7043 (0.6159, 0.7928) p<0.05]. The prevalence of Stage B HF among White Europeans (median age of 67 [61, 72].) was lower compared with South Asian patients: 15% had LVH, 13% had LAE, 19% had LVDD and 2% had LVSD (Figure 1A). 8% of White Europeans had at least 2 factors contributing to Stage B HF and these had higher NT-proBNP titres (368.9 [154.6, 1087.8] vs 186.8 [79.7, 411.5], p=0.02). ROC curves show that NT-proBNP can predict participants with 2 or more factors [Figure 2A, AUC: 0.6399 (0.5122, 0.7676) p<0.05].
Conclusion
Our study has shown that South Asian patients with T2DM have a high prevalence of Stage B HF compared with White Europeans and that the predominant Stage B HF feature is LVDD.
We also found that NTproBNP could potentially be used to detect Stage B HF and help identify at-risk patients for cardio-protective therapy such as SGLT2 inhibitor therapy that has been shown to prevent the development of future HF events.
Funding Acknowledgement
Type of funding sources: None.
Collapse
Affiliation(s)
- C E C Lee
- University of Dundee, Division of Molecular and Clinical Medicine , Dundee , United Kingdom
| | - P Subramani
- Madras Diabetes Research Foundation , Chennai , India
| | - P Ananth
- Madras Diabetes Research Foundation , Chennai , India
| | - U Bhalraam
- University of Dundee, Division of Molecular and Clinical Medicine , Dundee , United Kingdom
| | - C Victor
- University of Dundee, Division of Molecular and Clinical Medicine , Dundee , United Kingdom
| | - R Venkatesan
- Madras Diabetes Research Foundation , Chennai , India
| | - V Prathiba
- Madras Diabetes Research Foundation , Chennai , India
| | - R M Anjana
- Madras Diabetes Research Foundation , Chennai , India
| | - C N A Palmer
- University of Dundee, Division of Molecular and Clinical Medicine , Dundee , United Kingdom
| | - A D Struthers
- University of Dundee, Division of Molecular and Clinical Medicine , Dundee , United Kingdom
| | - J S Singh
- University of Dundee, Division of Molecular and Clinical Medicine , Dundee , United Kingdom
| | - I R Mordi
- University of Dundee, Division of Molecular and Clinical Medicine , Dundee , United Kingdom
| | - V Mohan
- Madras Diabetes Research Foundation , Chennai , India
| | - C C Lang
- University of Dundee, Division of Molecular and Clinical Medicine , Dundee , United Kingdom
| |
Collapse
|
10
|
S Ram CV, Mohan V, Pandit K, Kumar S, Sahay R, John M, Shaikh S, Revankar S, Kumar N. Management of Hypertension in Patients with Diabetes: A Comprehensive Review of the Perceptions and Practices of Health Care Providers in India. J Assoc Physicians India 2022; 70:11-12. [PMID: 35833397 DOI: 10.5005/japi-11001-0041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVES This study evaluated the perception and practices of health care providers (physicians, diabetologists, and endocrinologists) regarding the treatment of hypertension in patients with diabetes in India. METHODS Health care providers throughout India who treated patients with diabetes and hypertension were invited to participate in an online survey and periodic 21 virtual meetings. They were questioned about their perception and practices in managing these patients, and strategies to improve blood pressure (BP). RESULTS The online survey was completed by 2,513 health care providers, and 344 participated in virtual meetings. More than 50% reported that 31-50% of their patients with diabetes also had hypertension. Home BP monitoring was recommended by 88%, and lifestyle modifications were consistently recommended. Choice of antihypertensive treatment varied based on comorbidities, and a renin-angiotensin system blocker plus a calcium channel blocker (CCB) was the most common combination for dual antihypertensive therapy. Suggested strategies to improve BP control included patient awareness/education, lifestyle modifications, better follow-up/monitoring, and optimization of therapy. CONCLUSION Indian health care providers were aware of clinical recommendations and practices regarding treatment of patients with diabetes and hypertension, and generally make clinical decisions consistent with current guidelines. Optimization of care for these patients is essential to reduce cardiovascular disease risk and improve patient outcomes.
Collapse
Affiliation(s)
- C Venkata S Ram
- Director, Apollo Institute for Blood Pressure Management and Apollo Blood Pressure Clinics, Apollo Hospitals, Hyderabad, Telangana; Corresponding Author
| | - V Mohan
- Chairman and Chief Diabetologist, Dr. Mohan's Diabetes Specialities Centre, Chennai, Tamil Nadu
| | - Kaushik Pandit
- Consultant Endocrinologist and Diabetologist, Fortis Hospital and Belle Vue Clinic, Kolkata, West Bengal
| | - Surender Kumar
- Chairman, Department of Endocrinology, Sir Ganga Ram Hospital, New Delhi, Delhi
| | - Rakesh Sahay
- Professor of Endocrinology, Department of Endocrinology, Osmania Medical College, Hyderabad, Telangana
| | - Mathew John
- Consultant Endocrinologist, Providence Endocrine and Diabetes Specialty Centre, Trivandrum, Kerala
| | - Shehla Shaikh
- Consultant Endocrinologist, Prince Aly Khan Hospital and Saifee Hospital, Mumbai, Maharashtra
| | | | - Neeraj Kumar
- Assistant Manager, Scientific Services, USV Private Limited, Mumbai, Maharashtra, India
| |
Collapse
|
11
|
Thirumoorthy C, Deepa M, Srikumar BN, Hannah W, Venkatesan U, Nikhil PJ, Hemavathy S, Binukumar B, Anjana RM, Ram U, Balasubramanyam M, Saravanan P, Mohan V, Gokulakrishnan K. Altered levels of neurobiological biomarkers at the interface of depression and gestational diabetes mellitus in Asian Indian women. Neuropeptides 2022; 93:102245. [PMID: 35461022 DOI: 10.1016/j.npep.2022.102245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 03/17/2022] [Accepted: 04/03/2022] [Indexed: 11/21/2022]
Abstract
AIM Gestational diabetes mellitus (GDM) might predispose the mothers to depression. Studies have reported the role of biomarkers either in GDM or depression, but very few have examined them in GDM with depression. The present study profiled the circulating levels of brain-derived neurotrophic factor (BDNF), Beta Endorphin (BE) and nesfatin-1 in women with GDM (with and without depression). METHODS 160 pregnant women at 24-28 weeks of pregnancy (NGT/GDM with & without depression, n = 40 each) were randomly selected from the ongoing STRiDE (STratification of Risk of Diabetes in Early pregnancy) study. Depression score was derived using PHQ-9 questionnaire and ELISA was used to quantify the biomarkers. RESULTS Circulatory levels of BDNF, BE and nesfatin-1 were lower in GDM women with or without depression compared to NGT without depression, however, nesfatin-1 levels were higher in NGT with depression. Notably, GDM with depression had the lowest levels of BDNF and BE. Both BDNF and BE levels were negatively correlated with depression, 1 h and 2 h plasma glucose. Regression analysis confirmed that each standard deviation decreases in BDNF and BE were independently associated with higher odds of GDM with or without depression even after adjusting for potential confounders. CONCLUSION Our study has identified altered levels of a panel of neurobiological biomarkers (BDNF/BE/nesfatin-1) in those with combined GDM and depression. BDNF/BE could be potential biomarkers to assess the higher risk of coexisting depression and GDM.
Collapse
Affiliation(s)
- C Thirumoorthy
- Department of Neurochemistry, National Institute of Mental Health & Neuro Sciences (NIMHANS), Bengaluru, India
| | - M Deepa
- Department of Epidemiology, Madras Diabetes Research Foundation (MDRF), Chennai, India
| | - B N Srikumar
- Department of Neurophysiology, National Institute of Mental Health & Neuro Sciences (NIMHANS), Bangalore, India
| | - W Hannah
- Department of Epidemiology, Madras Diabetes Research Foundation (MDRF), Chennai, India
| | - U Venkatesan
- Department of Epidemiology, Madras Diabetes Research Foundation (MDRF), Chennai, India
| | - P J Nikhil
- Department of Neurochemistry, National Institute of Mental Health & Neuro Sciences (NIMHANS), Bengaluru, India
| | - S Hemavathy
- Department of Epidemiology, Madras Diabetes Research Foundation (MDRF), Chennai, India
| | - B Binukumar
- Department of Biostatistics, National Institute of Mental Health & Neuro Sciences (NIMHANS), Bangalore, India
| | - R M Anjana
- Department of Diabetology, Madras Diabetes Research Foundation (MDRF), Chennai, India
| | - Uma Ram
- Seethapathy Clinic & Hospital, Chennai, India
| | - M Balasubramanyam
- Department of Cell & Molecular Biology, Madras Diabetes Research Foundation (MDRF), Chennai, India
| | - P Saravanan
- Populations, Evidence and Technologies, Division of Health Sciences, Warwick Medical School, University of Warwick, UK; Department of Diabetes, Endocrinology and Metabolism, George Eliot Hospital, Nuneaton, UK
| | - V Mohan
- Department of Diabetology, Madras Diabetes Research Foundation (MDRF), Chennai, India
| | - K Gokulakrishnan
- Department of Neurochemistry, National Institute of Mental Health & Neuro Sciences (NIMHANS), Bengaluru, India.
| |
Collapse
|
12
|
Abstract
Due to the shortage of fossil fuel usage, the solar Photovoltaic (PV) energy has increased grownup over the last decade. Most conventional applications of renewable energy are being phased out in order to reduce costs and save the environment. PV plants undergo numerous failures in faults detection and ultimate power developments. These consequences demonstrate in the environmental field and internal components. Even when internal standards are followed, the faults are unavoidable and undetectable. Due to this performance of manufacturing plants are not predictable. As a result, a proper fault detection mechanism is required for a PV system to detect faults and avoid energy losses. To address these issues, this research work proposed Internet of Things (IoT) sensor-based fault identification in a solar PV system. The PV panel status is monitored using pressure, light intensity, voltage, and current sensors. These sensor data’s are stored in the cloud for further analysis using a web-based control server. To classify the sensor data, models of Support Vector Machine (SVM), and Extreme Learning Machine (ELM) are utilized. The experimental results indicate that ELM achieves a classification accuracy of 96.32%. Which is higher than SVM and other optimization control techniques. The proposed model uses the IoT cloud to provide real-time monitoring and fault detection in plant environmental and electrical parameters.
Collapse
Affiliation(s)
- V. Mohan
- Department of Electrical and Electronics Engineering, E.G.S. Pillay Engineering College, Nagapattinam, Tamilnadu, India
| | - S. Senthilkumar
- Department of Electronics and Communication Engineering, E.G.S. Pillay Engineering College, Nagapattinam, Tamilnadu, India
| |
Collapse
|
13
|
Mohan V, Bruin N, van de Kamer J, Sonke J, Vogel W. OC-0506 Salivary gland dose response modelling using PSMA PET/CT. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02606-8] [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]
|
14
|
Saboo B, Misra A, Kalra S, Mohan V, Aravind SR, Joshi S, Chowdhury S, Sahay R, Kesavadev J, John M, Kapoor N, Das S, Krishnan D, Salis S. Role and importance of high fiber in diabetes management in India. Diabetes Metab Syndr 2022; 16:102480. [PMID: 35594690 DOI: 10.1016/j.dsx.2022.102480] [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: 12/28/2021] [Revised: 03/31/2022] [Accepted: 04/02/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND & AIMS India is facing a triple burden of pre-diabetes, diabetes, and obesity. Unhealthy eating habits and physical inactivity have been linked to the onset and progression of type 2 diabetes mellitus (T2DM). Despite dietary recommendations, individuals consume inadequate amounts or unsuitable type of dietary fiber (DF) which needs correction. An Expert group attempted to review and report on the role and importance of high DF in the management of T2DM and offer practical guidance on high fiber use in daily diet. METHODOLOGY Twelve diabetologists and two expert dietitians from India were chosen to ensure diversity of the members both in professional interest and cultural background. The authors convened virtually for one group meeting and actively participated in a detailed discussion. Multiple reviews of the draft document followed by focused teleconference calls & email helped to reach consensus on final recommendations between Aug 2021 and Dec 2021. RESULTS Evidence has shown that medical nutrition therapy (MNT) is a valuable approach and an essential component of T2DM prevention and management. Studies have shown that fiber rich diabetes nutrition (FDN) has multi-systemic health benefits, including, improvement in glycemic control, reduction in glucose spikes, decrease in hyperinsulinemia, improvement in plasma lipid concentrations and weight management in T2DM patients. CONCLUSION A high fiber diet is vital for people with diabetes and associated conditions. Increasing fiber intake, preferably through food or through dietary supplement, may help. Fiber rich diabetes nutrition (FDN) is recommended in order to prevent and manage T2DM.
Collapse
Affiliation(s)
- Banshi Saboo
- DiaCare - A Complete Diabetes Care Centre, Ahmedabad, Gujarat, India.
| | - Anoop Misra
- Fortis C-DOC Center of Excellence for Diabetes, Metabolic Diseases, And Endocrinology, New Delhi, India
| | | | - V Mohan
- Dr. Mohan's Diabetes Specialties Centre, Chennai, India
| | - S R Aravind
- Diacon Hospital, Bengaluru, Karnataka, India
| | - Shashank Joshi
- Department of Diabetology and Endocrinology, Lilavati Hospital & Research Centre, Maharashtra, Mumbai, India
| | - Subhankar Chowdhury
- Dept. of Endocrinology, IPGME & R and SSKM Hospital, Kolkata, West Bengal, India
| | - Rakesh Sahay
- Department of Endocrinology, Aster Prime Hospital, Hyderabad, Telangana, India
| | | | - Mathew John
- Providence Endocrine and Diabetes Specialty Centre, Trivandrum, Kerala, India
| | - Nitin Kapoor
- Department of Endocrinology, Diabetes & Metabolism, CMC, Vellore, Tamil Nādu, India
| | - Sambit Das
- Department of Endocrinology, Apollo Hospitals, Bhubaneswar, Orissa, India
| | - Dharini Krishnan
- DV Living Science Enterprise Pvt Ltd, Mylapore, Chennai, Tamil Nadu, India
| | - Sheryl Salis
- Nurture Health Solutions, Mumbai, Maharashtra, India
| |
Collapse
|
15
|
Gupta D, Kaushik D, Mohan V. Role of neurotransmitters in the regulation of cutaneous wound healing. Exp Brain Res 2022; 240:1649-1659. [PMID: 35488904 DOI: 10.1007/s00221-022-06372-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 04/13/2022] [Indexed: 11/04/2022]
Abstract
Wound healing is a highly coordinated and dynamic process of tissue repair after injury. The global burden of disease associated with wounds, both acute and chronic, is a significantly rising health concern. Upon skin wounding, neurons have the ability to sense the disruption to mediate the release of neurotransmitters into the wound microenvironment. Serotonin that has long been recognised as a potential vasoconstrictor is now also being contemplated to play a role in re-epithelialisation of wounds. While the role of neuropeptides in stimulating diabetic wound healing is being increasingly emphasised, on the other hand, dopamine is being widely studied for its dual role in mediating both pro- and antiangiogenic effects at the site of the wounds. Similarly, epinephrine levels that are known to be elevated during stress is now recognised as a contributing factor towards delayed wound closure, thereby serving as an inhibitor of wound healing. Thus, each neurotransmitter regulates wound repair and their active regeneration in a typical way. Strengthening our understanding of the molecular pathways via which the neurotransmitter modulates the immune system to control wound healing can yield potential therapeutic measures. Further investigations regarding the safety, efficacy, and cost-effectiveness of these processes are a prerequisite for their possible translation into clinical trials.
Collapse
Affiliation(s)
- Divya Gupta
- Department of Life Sciences, Neurosciences, Gurugram University, Sector-51, Gurugram, Haryana, India
| | - Dhirender Kaushik
- Department of Life Sciences, Neurosciences, Gurugram University, Sector-51, Gurugram, Haryana, India
| | - Vandana Mohan
- Department of Life Sciences, Neurosciences, Gurugram University, Sector-51, Gurugram, Haryana, India.
| |
Collapse
|
16
|
Bhavadharini B, Anjana RM, Deepa M, Pradeepa R, Uma R, Saravanan P, Mohan V. Association between number of abnormal glucose values and severity of fasting plasma glucose in IADPSG criteria and maternal outcomes in women with gestational diabetes mellitus. Acta Diabetol 2022; 59:349-357. [PMID: 34705110 DOI: 10.1007/s00592-021-01815-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 05/21/2021] [Indexed: 12/17/2022]
Abstract
AIMS The International Association for Diabetes in Pregnancy Study Group (IADPSG) criteria recommend a single-step diagnostic oral glucose tolerance test (OGTT) for diagnosis of gestational diabetes mellitus (GDM). The aim of this study was to examine the association between the number of abnormal glucose values and levels of FPG with pregnancy outcomes. METHODS Pregnant women (n=1,044) were screened for GDM at maternity centers in South India using IADPSG criteria. OGTTs were classified based on the number of abnormal glucose values (any one value or more than one value high) and fasting plasma glucose (FPG) values (<92mg/dl,92-100mg/dl,>100mg/dl) and correlated with pregnancy outcomes. Odds ratio were adjusted for age, BMI, gestational week at diagnosis, family history of diabetes, previous history of GDM, gestational week at delivery and birth weight. For macrosomia and large for gestation age, birth weight was excluded from the model. RESULTS Risk of caesarean section was significantly higher in women with any one abnormal glucose value (OR: 1.49; 95%CI: 1.07-2.09). This further increased in those with >1 value (OR: 1.35; 95%CI: 0.87-2.10), when compared to women with all values normal. Risk of large for gestation age (LGA) was higher in women with FPG 92-100mg/dl (OR: 1.37; 95%CI: 0.80-2.35) and in those with FPG >100mg/dl (OR: 1.87; 95%CI: 1.04-3.35), compared to those with FPG <92mg/dl. CONCLUSIONS The risk for poor pregnancy outcomes starts in those with one abnormal value in the OGTT or with FPG >92mg/dl but becomes significantly higher in those with higher abnormal values.
Collapse
Affiliation(s)
| | - R M Anjana
- Dr. Mohan's Diabetes Specialities Centre, IDF Centre of Excellence in Diabetes Care, Madras Diabetes Research Foundation, ICMR Center for Advanced Research On Diabetes, Conran Smith Road, No:6B, Gopalapuram, Chennai, Pin: 600086, India
| | - M Deepa
- Dr. Mohan's Diabetes Specialities Centre, IDF Centre of Excellence in Diabetes Care, Madras Diabetes Research Foundation, ICMR Center for Advanced Research On Diabetes, Conran Smith Road, No:6B, Gopalapuram, Chennai, Pin: 600086, India
| | - R Pradeepa
- Dr. Mohan's Diabetes Specialities Centre, IDF Centre of Excellence in Diabetes Care, Madras Diabetes Research Foundation, ICMR Center for Advanced Research On Diabetes, Conran Smith Road, No:6B, Gopalapuram, Chennai, Pin: 600086, India
| | - R Uma
- Seethapathy Hospital and Clinic, Chennai, India
| | - P Saravanan
- Population, Evidence and Technologies, Warwick Medical School, Division of Health Sciences, University of Warwick, Coventry, UK
- Academic Department of Diabetes, Endocrinology & Metabolism, George Eliot Hospital, Nuneaton, UK
| | - V Mohan
- Dr. Mohan's Diabetes Specialities Centre, IDF Centre of Excellence in Diabetes Care, Madras Diabetes Research Foundation, ICMR Center for Advanced Research On Diabetes, Conran Smith Road, No:6B, Gopalapuram, Chennai, Pin: 600086, India.
| |
Collapse
|
17
|
Mohan V, Pinto-Sanchez MI, Nardelli A, Borojevic R, De Palma G, Collins SM, Bercik P. A51 ROLE OF GUT MICROBIOTA IN THE EPISODIC NATURE OF SYMPTOMS IN IRRITABLE BOWEL SYNDROME. J Can Assoc Gastroenterol 2022. [PMCID: PMC8859364 DOI: 10.1093/jcag/gwab049.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background Irritable bowel syndrome (IBS) is a complex functional gastrointestinal disorder with likely heterogenous pathophysiology, multiple symptoms, and comorbidities. Growing evidence shows that the gut microbiota composition and function are altered in IBS patients. However, identifying the critical drivers of clinical expression remains challenging due to the episodic occurrence of IBS symptoms, the inherent variability in composition of gut microbiota across individuals, and high sensitivity of gut microbiota to dietary and environmental cues. Aims To identify whether changes in gut microbiota composition accompany or, predict the occurrence of symptoms. Methods 28 IBS patients (IBS-D n=20, IBS-C n=8) and 10 healthy controls (HC) were followed longitudinally for 25 weeks, collecting stool samples, and recording their symptoms weekly. Stool microbiota profiles were assessed by 16S rRNA gene sequencing using Illumina platform. The sequences were preprocessed, filtered, and annotated using DADA2 and phyloseq pipelines; statistical analyses were performed using FactomineR and microbiomeanalyst packages in R. Statistical significance was set at p<0.05. Results Multifactorial analysis of clinical data classified 950 samples in 6 clusters. Distribution of samples among the clusters was based on Bristol stool scale defining symptomatic periods (scores <3 and >4 indicating abnormal stool) and asymptomatic periods (scores 3 or 4), with several gut and mood symptoms varying significantly between the two categories. IBS-D patients, but not IBS-C patients presented with changes in symptoms severity, such as pain, diarrhea, constipation, and anxiety during the symptomatic periods. Depression scores were, however, higher in IBS-C compared to IBS-D patients. In contrast, immune makers such as fecal b-defensin-2 and calprotectin were higher during asymptomatic periods in IBS-D, but not in IBS-C patients. Bacterial diversity profiles differed among IBS patients (IBS-D and IBS-C) and HC, namely Shannon index and Bray-Curtis distance, but they did not change significantly between the symptomatic and asymptomatic periods within each subtype. Despite this, several bacterial taxa unique to each cluster were identified using linear mixed models. Conclusions Our results demonstrate the need to study patterns of co-occurrence of IBS symptoms and their severity during symptomatic and asymptomatic periods to better understand the role of identified bacterial taxa in the symptom generation. Identifying their temporal changes and cross-feeding patterns in individual patients will shed light on the underlying mechanistic role of gut microbiota in IBS, which might be otherwise obscured by group generalizations. Funding Agencies CIHR
Collapse
Affiliation(s)
- V Mohan
- McMaster University Faculty of Health Sciences, Hamilton, ON, Canada
| | | | - A Nardelli
- Medicine, McMaster University, Hamilton, ON, Canada
| | - R Borojevic
- Medicine, McMaster University, Hamilton, ON, Canada
| | - G De Palma
- McMaster University, Hamilton, ON, Canada
| | | | - P Bercik
- Medicine, McMaster University, Hamilton, ON, Canada
| |
Collapse
|
18
|
Arjun R, Felix V, Niyas VKM, Kumar MAS, Krishnan RB, Mohan V, Ansar A, Gautaam S, Lalitha S. COVID-19-associated rhino-orbital mucormycosis: a single-centre experience of 10 cases. QJM 2022; 114:831-834. [PMID: 34181023 DOI: 10.1093/qjmed/hcab176] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- R Arjun
- Department of Infectious Diseases, KIMSHEALTH, Thiruvananthapuram, Kerala 695029, India
| | - V Felix
- Department of Otorhinolaryngology, KIMSHEALTH, Thiruvananthapuram, Kerala 695029, India
| | - V K M Niyas
- Department of Infectious Diseases, KIMSHEALTH, Thiruvananthapuram, Kerala 695029, India
| | - M A S Kumar
- Department of Otorhinolaryngology, KIMSHEALTH, Thiruvananthapuram, Kerala 695029, India
| | - R B Krishnan
- Department of Otorhinolaryngology, KIMSHEALTH, Thiruvananthapuram, Kerala 695029, India
| | - V Mohan
- Department of Microbiology, KIMSHEALTH, Thiruvananthapuram, Kerala 695029, India
| | - A Ansar
- Department of Otorhinolaryngology, KIMSHEALTH, Thiruvananthapuram, Kerala 695029, India
| | - S Gautaam
- Department of Otorhinolaryngology, KIMSHEALTH, Thiruvananthapuram, Kerala 695029, India
| | - S Lalitha
- Department of Otorhinolaryngology, KIMSHEALTH, Thiruvananthapuram, Kerala 695029, India
| |
Collapse
|
19
|
Mohan V, Ashwani K. Pro-apoptotic, anti-metastatic, and anti-telomerase activity of Tinospora cordifolia and its active polysaccharide arabinogalactan during Benzo(a)pyrene-induced lung carcinogenesis. Indian J Pharmacol 2022; 54:198-207. [PMID: 35848691 PMCID: PMC9396687 DOI: 10.4103/ijp.ijp_962_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND The present study aims to unravel the pro-apoptotic, anti-metastatic, and anti-telomerase activity of aqueous extract of Tinospora cordifolia stem (Aq.Tc) and its active component arabinogalactan (AG) during Benzo(a)pyrene [B(a)P]-induced lung tumorigenesis in mice. MATERIALS AND METHODS Lung tumors were induced in male BALB/c mice using B(a)P as a carcinogen. Animals were administered twice with 50 mg/kg b.wt (i.p.) dosage of B(a)P at the 2nd and 4th week of the study. Mice were orally treated with Aq.Tc and AG on alternate days at a dose of 200 mg/kg b.wt and 7.5 mg/kg b.wt, respectively, for continuous 22 weeks. RESULTS Oral administration of animals with Aq.Tc and AG suppressed the development of lung carcinogenesis by modulating the mRNA and protein expressions of different apoptotic genes; bcl-2, bax, caspase 3, and caspase 9. The pro-apoptotic proficiency of Aq.Tc and AG was further confirmed by DNA agarose gel electrophoresis showing fragmentation in B(a)P + Aq.Tc group and smear formation in B(a)P + AG group. In contrast to the control group, an increase in tumor invasion factors such as matrix metalloproteinases-2 (MMP-2) and MMP-9 was also observed in B(a)P treated animals. Nevertheless, Aq.Tc and AG treatment effectively mitigated the B(a)P-induced upregulation of MMP-2 and MMP-9. The activity of the telomerase enzyme was also observed to be upregulated in B(a)P treated animals which consecutively found to get normalized with the parallel administration of Aq.Tc and AG. CONCLUSION Aq.Tc and AG successfully mitigated the altered expression of apoptosis, metastasis, and telomerase activity-associated genes during pulmonary carcinogenesis.
Collapse
Affiliation(s)
- Vandana Mohan
- Department of Biophysics, Basic Medical Sciences Block, Panjab University South Campus, Chandigarh, India
| | - Koul Ashwani
- Department of Biophysics, Basic Medical Sciences Block, Panjab University South Campus, Chandigarh, India,Address for correspondence: Prof. Koul Ashwani, Department of Biophysics, Basic Medical Sciences Block, Panjab University, South Campus, Sector 25, Chandigarh - 160 014, India. E-mail:
| |
Collapse
|
20
|
Aggarwal R, Suneja A, Mohan V, Guleria K. A critical assessment of stillbirths at a tertiary care hospital. Indian J Public Health 2022; 66:15-19. [PMID: 35381708 DOI: 10.4103/ijph.ijph_1364_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023] Open
Abstract
BACKGROUND Globally in 2015, 2.6 million stillbirths occurred with estimated stillbirth rate (SBR) of 18.4/1000 births. India is the world capital of stillbirth accounting for 22.6% of world's stillbirths. OBJECTIVES The objective of the study is to study the demographic profile of women experiencing stillbirth, to understand the risk factors for stillbirth in low resource settings, and to find the etiology of stillbirth so as to facilitate designing of a stillbirth prevention strategy. METHODS This was a cross-sectional observational study done at a tertiary care hospital of Delhi from June 2017 to December 2019. All babies delivered after 20 weeks of gestation showing no sign of life after birth were considered stillborn. Prestructured proforma was filled for each case and data were analyzed. RESULTS A total of 50,461 births took place during the study period, out of which 1824 were stillborn, making SBR of 36.15/1000 births of our institution. Most of the women belonged to age group 21-25 years and more than 50% of women were illiterate. Twenty-nine percent of women were completely unbooked, 48% were referred from other centers and 23% were registered at our hospital. Placental causes accounted for 22%, hypertension for 23%, and labor complications for 9% of cases while in 22% cases, cause could not be found. CONCLUSION Stillbirth remains a neglected issue. A significant proportion of stillbirths are preventable by adequate antenatal care. Notification of stillbirths will give us the exact figures and realization of the seriousness of the problem which will help us work towards the solutions.
Collapse
Affiliation(s)
- Richa Aggarwal
- Associate Professor, Department of Obstetrics and Gynecology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
| | - Amita Suneja
- Director Professor and Head, Department of Obstetrics and Gynecology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
| | - Vandana Mohan
- Senior Resident, Department of Obstetrics and Gynecology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
| | - Kiran Guleria
- Director Professor, Department of Obstetrics and Gynecology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
| |
Collapse
|
21
|
Kishore M, Kumar A, Mohan V. Struma Ovarii: A Rare Presentation in a Paediatric Patient. J Clin Diagn Res 2022. [DOI: 10.7860/jcdr/2022/57917.16941] [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: 11/06/2022]
Abstract
Struma Ovarii (SO) is a rare form of teratoma of ovary containing predominantly thyroid tissue, usually comprising more than 50% of the overall mass. It accounts for 1% of all ovarian tumours in adults. Due to its rare presentation in paediatric age group, the exact incidence is not known.The association of SO with hyperthyroidism has been noted in approximately 8% of cases. Radiological evaluation helps in preliminary diagnosis of a complex ovarian cyst, however, a definitive diagnosis of SO can only be made upon extensive histopathological evaluation. Present report is of SO in a 12-year-old female patient, who initially presented with pain abdomen, vomiting and hyperthyroidism with mildly elevated thyroid hormones Triiodothyronine (T3) and Tetraiodothyronine (T4). Magnetic Resonance Imaging (MRI) whole abdomen showed evidence of right-sided dermoid with mild ascites. An exploratory laparotomy was done followed by right ovarian cystectomy and histopathology revealed a mature teratoma predominantly comprising of thyroid tissue (>90% of total ovarian mass), thereby confirming the diagnosis of SO. After one month of surgical resection, the patient’s thyroid profile showed decrease in fT3 and fT4 levels. The index case highlights the unusual occurrence of SO in a paediatric patient along with the role of an extensive histopathological evaluation in diagnosis of the same.
Collapse
|
22
|
|
23
|
Arora M, Nazar GP, Sharma N, Jain N, Davidson F, Mohan S, Mohan D, Ali MK, Mohan V, Tandon N, Narayan KMV, Prabhakaran D, Bauld L, Srinath Reddy K. COVID-19 and tobacco cessation: lessons from India. Public Health 2022; 202:93-99. [PMID: 34933205 PMCID: PMC8633921 DOI: 10.1016/j.puhe.2021.11.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 10/20/2021] [Accepted: 11/11/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVES The Government of India prohibited the sale of tobacco products during the COVID-19 lockdown to prevent the spread of the SARS-CoV-2 virus. This study assessed the tobacco cessation behaviour and its predictors among adult tobacco users during the initial COVID-19 lockdown period in India. METHODS A cross-sectional study was conducted with 801 adult tobacco users (both smoking and smokeless tobacco) in two urban metropolitan cities of India over a 2-month period (July to August 2020). The study assessed complete tobacco cessation and quit attempts during the lockdown period. Logistic and negative binomial regression models were used to study the correlates of tobacco cessation and quit attempts, respectively. RESULTS In total, 90 (11.3%) tobacco users reported that they had quit using tobacco after the COVID-19 lockdown period. Overall, a median of two quit attempts (interquartile range 0-6) was made by tobacco users. Participants with good knowledge on the harmful effects of tobacco use and COVID-19 were significantly more likely to quit tobacco use (odds ratio [OR] 2.2; 95% confidence interval [CI] 1.2-4.0) and reported more quit attempts (incidence risk ratio 5.7; 95% CI 2.8-11.8) compared to those with poor knowledge. Participants who had access to tobacco products were less likely to quit tobacco use compared to those who had no access (OR 0.3; 95% CI 0.2-0.5]. CONCLUSIONS Access restrictions and correct knowledge on the harmful effects of tobacco use and COVID-19 can play an important role in creating a conducive environment for tobacco cessation among users.
Collapse
Affiliation(s)
- M Arora
- HRIDAY, New Delhi, India; Public Health Foundation of India, Haryana, New Delhi, India.
| | - G P Nazar
- HRIDAY, New Delhi, India; Public Health Foundation of India, Haryana, New Delhi, India
| | | | - N Jain
- Public Health Foundation of India, Haryana, New Delhi, India
| | - F Davidson
- Usher Institute and SPECTRUM Consortium, University of Edinburgh, Edinburgh, United Kingdom
| | - S Mohan
- Public Health Foundation of India, Haryana, New Delhi, India; Centre for Chronic Disease Control, New Delhi, India
| | - D Mohan
- Madras Diabetes Research Foundation, Chennai, India
| | - M K Ali
- Rollins School of Public Health, Emory University, Atlanta, USA
| | - V Mohan
- Madras Diabetes Research Foundation, Chennai, India
| | - N Tandon
- All India Institute of Medical Sciences, New Delhi, India
| | | | - D Prabhakaran
- Public Health Foundation of India, Haryana, New Delhi, India; Centre for Chronic Disease Control, New Delhi, India
| | - L Bauld
- Usher Institute and SPECTRUM Consortium, University of Edinburgh, Edinburgh, United Kingdom
| | - K Srinath Reddy
- Public Health Foundation of India, Haryana, New Delhi, India
| |
Collapse
|
24
|
Arora K, Tomar PC, Mohan V. Diabetic neuropathy: an insight on the transition from synthetic drugs to herbal therapies. J Diabetes Metab Disord 2021; 20:1773-1784. [PMID: 34900824 PMCID: PMC8630252 DOI: 10.1007/s40200-021-00830-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 06/03/2021] [Indexed: 12/11/2022]
Abstract
The global pandemic of prediabetes and diabetes has led to a severe corresponding complication of these disorders. Neuropathy is one of the most prevalent complication of diabetes is, affecting blood supply of the peripheral nervous system that may eventually results into loss of sensations, injuries, diabetic foot and death. The utmost identified risk of diabetic neuropathy is uncontrolled high blood glucose levels. However, aging, body mass index (BMI), oxidative stress, inflammation, increased HbA1c levels and blood pressure are among the other key factors involved in the upsurge of this disease. The so far treatment to deal with diabetic neuropathy is controlling metabolic glucose levels. Apart from this, drugs like reactive oxygen species (ROS) inhibitors, aldose reductase inhibitors, PKC inhibitors, Serotonin-norepinephrine reuptake inhibitors (SNRIs), anticonvulsants, N-methyl-D-aspartate receptor (NMDAR) antagonists, are the other prescribed medications. However, the related side-effects (hallucinations, drowsiness, memory deficits), cost, poor pharmacokinetics and drug resistance brought the trust of patients down and thus herbal renaissance is occurring all over the word as the people have shifted their intentions from synthetic drugs to herbal remedies. Medicinal plants have widely been utilized as herbal remedies against number of ailments in Indian medicinal history. Their bioactive components are very much potent to handle different chronic disorders and complications with lesser-known side effects. Therefore, the current article mainly concludes the etiology and pathophysiology of diabetic neuropathy. Furthermore, it also highlights the important roles of medicinal plants and their naturally occurring bioactive compounds in addressing this disease.
Collapse
Affiliation(s)
- Komal Arora
- Department of Life Sciences, Neurosciences, Gurugram University, Gurugram, India
| | - Pushpa C. Tomar
- Department of Biotechnology, Faculty of Engineering & Technology, Manav Rachna International Institute of Research & Studies, Haryana 121004 Faridabad, India
| | - Vandana Mohan
- Department of Life Sciences, Neurosciences, Gurugram University, Gurugram, India
| |
Collapse
|
25
|
Stein DR, Osiowy C, Gretchen A, Thorlacius L, Fudge D, Lang A, Sekirov I, Morshed M, Levett PN, Tran V, Kus JV, Gubbay J, Mohan V, Charlton C, Kanji JN, Tipples G, Serhir B, Therrien C, Roger M, Jiao L, Zahariadis G, Needle R, Gilbert L, Desnoyers G, Garceau R, Bouhtiauy I, Longtin J, El-Gabalawy N, Dibernardo A, Lindsay LR, Drebot M. Evaluation of commercial SARS-CoV-2 serological assays in Canadian public health laboratories. Diagn Microbiol Infect Dis 2021; 101:115412. [PMID: 34425450 PMCID: PMC8377389 DOI: 10.1016/j.diagmicrobio.2021.115412] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 04/12/2021] [Accepted: 04/18/2021] [Indexed: 01/22/2023]
Abstract
The COVID-19 pandemic has led to the influx of immunoassays for the detection of antibodies towards severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) into the global market. The Canadian Public Health Laboratory Network Serology Task Force undertook a nationwide evaluation of twelve laboratory and 6 point-of-care based commercial serological assays for the detection of SARS-CoV-2 antibodies. We determined that there was considerable variability in the performance of individual tests and that an orthogonal testing algorithm should be prioritized to maximize the accuracy and comparability of results across the country. The manual enzyme immunoassays and point-of-care tests evaluated had lower specificity and increased coefficients of variation compared to automated enzyme immunoassays platforms putting into question their utility for large-scale sero-surveillance. Overall, the data presented here provide a comprehensive approach for applying accurate serological assays for longitudinal sero-surveillance and vaccine trials while informing Canadian public health policy.
Collapse
Affiliation(s)
- Derek R Stein
- Cadham Provincial Laboratory, Serology and Parasitology, Winnipeg, Manitoba, Canada.
| | - Carla Osiowy
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Ainsley Gretchen
- Cadham Provincial Laboratory, Serology and Parasitology, Winnipeg, Manitoba, Canada
| | | | - Denise Fudge
- Shared Health Manitoba, Winnipeg, Manitoba, Canada
| | - Amanda Lang
- Roy Romanow Provincial Laboratory, Regina, Saskatchewan, Canada
| | - Inna Sekirov
- British Columbia Centre for Disease Control Public Health Laboratory, Vancouver, British Columbia, Canada
| | - Muhammad Morshed
- British Columbia Centre for Disease Control Public Health Laboratory, Vancouver, British Columbia, Canada
| | - Paul N Levett
- British Columbia Centre for Disease Control Public Health Laboratory, Vancouver, British Columbia, Canada
| | - Vanessa Tran
- Public Health Ontario Laboratory, Toronto, Ontario Canada
| | - Julianne V Kus
- Public Health Ontario Laboratory, Toronto, Ontario Canada
| | | | - Vandana Mohan
- Public Health Ontario Laboratory, Toronto, Ontario Canada
| | - Carmen Charlton
- Public Health Laboratory, Alberta Precision Laboratories, Edmonton, Alberta, Canada; Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada; Li Ka Shing Institute of Virology, Edmonton, Alberta
| | - Jamil N Kanji
- Public Health Laboratory, Alberta Precision Laboratories, Edmonton, Alberta, Canada
| | - Graham Tipples
- Public Health Laboratory, Alberta Precision Laboratories, Edmonton, Alberta, Canada; Li Ka Shing Institute of Virology, Edmonton, Alberta
| | - Bouchra Serhir
- Laboratoire de santé publique du Quebec, Montreal, Quebec, Canada
| | | | - Michel Roger
- Laboratoire de santé publique du Quebec, Montreal, Quebec, Canada
| | - Lei Jiao
- Newfoundland and Labrador Public Health Microbiology Laboratory, St. John's, Newfoundland and Labrador, Canada
| | - George Zahariadis
- Newfoundland and Labrador Public Health Microbiology Laboratory, St. John's, Newfoundland and Labrador, Canada
| | - Robert Needle
- Newfoundland and Labrador Public Health Microbiology Laboratory, St. John's, Newfoundland and Labrador, Canada
| | - Laura Gilbert
- Newfoundland and Labrador Public Health Microbiology Laboratory, St. John's, Newfoundland and Labrador, Canada
| | - Guillaume Desnoyers
- New Brunswick Virology Reference Centre, CHU Dumont, Moncton, New Brunswick, Canada
| | - Richard Garceau
- New Brunswick Virology Reference Centre, CHU Dumont, Moncton, New Brunswick, Canada
| | | | - Jean Longtin
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Nadia El-Gabalawy
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Antonia Dibernardo
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - L Robbin Lindsay
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Michael Drebot
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| |
Collapse
|
26
|
Gupta R, Kesavadev J, Krishnan G, Agarwal S, Saboo B, Shah M, Mittal A, Durani S, Luthra A, Singhal A, Rasheed M, Rao GVS, Tripathi V, Jha A, Ghosh A, Mohan V, Singh AK, Phatak S, Panicker J, Bhadada SK, Joshi S, Pal R, Mithal A, Vikram N, Misra A. COVID-19 associated mucormycosis: A Descriptive Multisite Study from India. Diabetes Metab Syndr 2021; 15:102322. [PMID: 34717135 PMCID: PMC8635309 DOI: 10.1016/j.dsx.2021.102322] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 10/21/2021] [Accepted: 10/22/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND AIMS Mucormycosis is an invasive fungal infection and carries a significant morbidity and mortality. A number of cases of mucormycosis have been reported in association with COVID-19. In this study, a consortium of clinicians from various parts of India studied clinical profile of COVID-19 associated mucormycosis (CAM) and this analysis is presented here. METHODS Investigators from multiple sites in India were involved in this study. Clinical details included the treatment and severity of COVID-19, associated morbidities, as well as the diagnosis, treatment and prognosis of mucormycosis. These data were collected using google spreadsheet at one centre. Descriptive analysis was done. RESULTS There were 115 patients with CAM. Importantly, all patients had received corticosteroids. Diabetes was present in 85.2% of patients and 13.9% of patients had newly detected diabetes. The most common site of involvement was rhino-orbital. Mortality occurred in 25 (21.7%) patients. On logistic regression analysis, CT scan-based score for severity of lung involvement was associated with mortality. CONCLUSION Universal administration of corticosteroids in our patients is notable. A large majority of patients had diabetes, while mortality was seen in ∼1/5th of patients, lower as compared to recently published data.
Collapse
Affiliation(s)
| | | | - Gopika Krishnan
- Jothydev's Diabetes Research Centre, Trivandrum, Kerala, India
| | | | | | | | - Atul Mittal
- Fortis Memorial Research Institute, Gurugram, Haryana, India
| | - Suhail Durani
- Fortis Memorial Research Institute, Gurugram, Haryana, India
| | - Atul Luthra
- Fortis Memorial Research Institute, Gurugram, Haryana, India
| | - Anuj Singhal
- Fortis Escorts Heart Institute, New Delhi, India
| | | | - G V S Rao
- Dr Rao's ENT Centre, Hyderabad, Telangana, India
| | | | - Alka Jha
- Fortis Rajan Dhall Hospital, New Delhi, India
| | | | - V Mohan
- Dr Mohan's Diabetes Specialities Centre and Madras Diabetes Research Foundation, Chennai, Tamilnadu, India
| | | | | | | | | | | | - Rimesh Pal
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | | | - Naval Vikram
- All India Institute of Medical Sciences, New Delhi, India
| | | |
Collapse
|
27
|
Mohan V, Bruin NM, van de Kamer JB, Sonke JJ, Vogel WV. The effect of eating on the uptake of PSMA ligands in the salivary glands. EJNMMI Res 2021; 11:95. [PMID: 34568982 PMCID: PMC8473516 DOI: 10.1186/s13550-021-00838-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 09/11/2021] [Indexed: 11/25/2022] Open
Abstract
Rationale PSMA-directed therapy for metastatic prostate cancer is gaining adoption as a treatment option. However, accumulation of 177Lu/225Ac-PSMA in the salivary glands remains a problem, with risk of dose-limiting xerostomia and potentially severe effect on the quality of life. Gustatory stimulation is an approach that has commonly been used in radioactive iodine therapy to reduce accumulation in the salivary glands. However, based on theoretical differences in biodistribution, it was hypothesized that this could potentially lead to adverse increased toxicity for PSMA-ligand therapy. The primary objective of this work was to determine if gustatory stimulation by eating an assortment of sweet/fatty/acidic foods during the biodistribution phase of [18F]DCFPyl could result in a clinically relevant (> 30%) change in the uptake of the tracer in the salivary glands. Methods 10 patients who already received a whole-body [18F]DCFPyl PET/CT scan for evaluation of prostate cancer, underwent a repeat (intervention) PET/CT scan within a month of the first (control) scan. During the intervention scan, patients chose from an assortment of sweet/fatty/acidic foods, which they then chewed and swallowed for a period of time starting 1 min before tracer administration to 10 min thereafter. Data from both scans were analyzed by placing VOIs on the major salivary glands and segmenting them using relative thresholds. Results A slight increase in PSMA uptake in the parotid glands was observed on the intervention scan when compared to the baseline scan (+ 7.1% SULmean and + 9.2% SULmax, p < 0.05). No significant difference in PSMA uptake in the submandibular glands was seen. Conclusions Eating only slightly increases uptake of [18F]DCFPyl in the parotid glands. We nonetheless recommend refraining from gustatory stimulation during the administration and early biodistribution phase of radionuclide therapy with PSMA-ligands to reduce the risk of avoidable additional toxicity. Supplementary Information The online version contains supplementary material available at 10.1186/s13550-021-00838-y.
Collapse
Affiliation(s)
- V Mohan
- Department of Nuclear Medicine, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.,Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - N M Bruin
- Department of Nuclear Medicine, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.,Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - J B van de Kamer
- Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - J-J Sonke
- Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - W V Vogel
- Department of Nuclear Medicine, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands. .,Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
| |
Collapse
|
28
|
Wagenaar D, Langendijk J, Mohan V, Steenbakkers R, Vogel W, Both S. PO-1797 Relating proton LETd to biological response of salivary glands using PSMA-PET in clinical patients. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)08248-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
29
|
Sundararajan S, Jayachandran I, Subramanian SC, Anjana RM, Balasubramanyam M, Mohan V, Venkatesan B, Manickam N. Decreased Sestrin levels in patients with type 2 diabetes and dyslipidemia and their association with the severity of atherogenic index. J Endocrinol Invest 2021; 44:1395-1405. [PMID: 33048307 DOI: 10.1007/s40618-020-01429-9] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Accepted: 09/16/2020] [Indexed: 12/18/2022]
Abstract
PURPOSE We earlier reported that Sestrin2 regulates monocyte activation and atherogenic events through AMPK-mTOR nexus under high-glucose and dyslipidemic conditions. However, the statuses of Sestrins in diabetes and dyslipidemia are not known. We report here on the status of Sestrins and their association with diabetic dyslipidemia and atherosclerosis. METHODS Individuals with normal glucose tolerance (NGT) (n = 46), dyslipidemia (n = 42), and patients with Type 2 diabetes with (n = 41) and without dyslipidemia (n = 40) were recruited from a tertiary diabetes centre, Chennai, India to study the mRNA expression levels of Sestrins (1, 2, and 3) in monocytes by RT-qPCR. Serum levels of Sestrins were measured using ELISA. Atherogenic index of plasma was calculated as log (triglyceride/HDL). RESULTS mRNA expressions of Sestrin1 and Sestrin3 were significantly reduced in monocytes under dyslipidemic conditions but not in diabetes condition. Interestingly, Sestrin2 mRNA expression was significantly reduced in all disease conditions including dyslipidemia, and diabetes with and without dyslipidemia. Sestrin2 mRNA levels were negatively correlated with glycemic and lipid parameters and plasma atherogenic index. Furthermore, circulatory Sestrin2 was also found to be significantly decreased in dyslipidemia (415.2 ± 44.7 pg/ml), diabetes (375 ± 45 pg/ml), and diabetes with dyslipidemia (319.2 ± 26.3 pg/ml) compared to NGT (706.3 ± 77 pg/ml) and negatively correlated with glycemic, lipid parameters, and plasma atherogenic index. CONCLUSION We report for the first time that Sestrins levels are significantly decreased in diabetes and dyslipidemic conditions. More strikingly, Sestrin2 had a strong association with atherogenic risk factors and severity of atherogenic index and we suggest that Sestrin2 may be used as a biomarker for assessing atherogenesis.
Collapse
Affiliation(s)
- S Sundararajan
- Department of Vascular Biology, Madras Diabetes Research Foundation and ICMR Centre for Advanced Research On Diabetes, Chennai, India
| | - I Jayachandran
- Department of Vascular Biology, Madras Diabetes Research Foundation and ICMR Centre for Advanced Research On Diabetes, Chennai, India
| | - S C Subramanian
- Clinical Epidemiology, Madras Diabetes Research Foundation, Chennai, India
| | - R M Anjana
- Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, Who Collaborating Centre for Non-Communicable Diseases Prevention and Control, Chennai, India
| | - M Balasubramanyam
- Department of Cell and Molecular Biology, Madras Diabetes Research Foundation, Chennai, India
| | - V Mohan
- Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, Who Collaborating Centre for Non-Communicable Diseases Prevention and Control, Chennai, India
| | - B Venkatesan
- Department of Vascular Biology, Madras Diabetes Research Foundation and ICMR Centre for Advanced Research On Diabetes, Chennai, India.
- Science and Engineering Research Board, New Delhi, India.
| | - N Manickam
- Department of Vascular Biology, Madras Diabetes Research Foundation and ICMR Centre for Advanced Research On Diabetes, Chennai, India.
| |
Collapse
|
30
|
do Vale Moreira NC, Ceriello A, Basit A, Balde N, Mohan V, Gupta R, Misra A, Bhowmik B, Lee MK, Zuo H, Shi Z, Wang Y, Montenegro RM, Fernandes VO, Colagiuri S, Boulton AJM, Hussain A. Race/ethnicity and challenges for optimal insulin therapy. Diabetes Res Clin Pract 2021; 175:108823. [PMID: 33887353 DOI: 10.1016/j.diabres.2021.108823] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [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: 04/15/2021] [Accepted: 04/15/2021] [Indexed: 12/11/2022]
Abstract
AIMS We aimed to review insulin dosing recommendations, insulin regulation and its determinants, glycaemic response to carbohydrates, and the efficacy and safety of insulin therapy in different races/ethnicities. METHODS We searched for articles in PubMed and Google Scholar databases up to 31 March 2021, with the following keywords: "ethnicity", "diabetes", "insulin", "history of insulin", "insulin therapy", "food/rice", "carbohydrate intake", "insulin resistance", "BMI", "insulin dosing", "insulin sensitivity", "insulin response", "glycaemic index", "glycaemic response", "efficacy and safety", with interposition of the Boolean operator "AND".In addition, we reviewed the reference lists of the articles found. RESULTS The differential effect of race/ethnicity has not yet been considered in current insulin therapy guidelines. Nevertheless, body size and composition, body mass index, fat distribution, diet, storage, and energy expenditure vary significantly across populations. Further, insulin sensitivity, insulin response, and glycaemicresponse to carbohydrates differ by ethnicity. These disparities may lead to different insulin requirements, adversely impacting the efficacy and safety of insulin therapy among ethnic groups. CONCLUSIONS Race/ethnicity affects glucose metabolism and insulin regulation.Until now, international guidelines addressing racial/ethnic-specific clinical recommendations are limited. Comprehensive updated insulin therapy guidelines by ethnicity are urgently needed.
Collapse
Affiliation(s)
| | | | - Abdul Basit
- Baquai Medical University, Karachi, Pakistan
| | - Naby Balde
- Endocrinology and Diabetes Department, Donka Conakry University Hospital, Conakry, Guinea; Foundation Diabetes and NCD, Conakry, Guinea; International Diabetes Federation, IDF, Brussels, Belgium
| | - V Mohan
- Dr. Mohans Diabetes Specialties Centre, Chennai, India
| | | | - Anoop Misra
- Fortis-C-DOC Centre of Excellence for Diabetes, Metabolic Diseases and Endocrinology, Delhi, India
| | - Bishwajit Bhowmik
- Centre for Global Health Research, Diabetic Association of Bangladesh, Dhaka, Bangladesh
| | - Moon K Lee
- International Diabetes Federation, IDF, Brussels, Belgium; Division of Endocrinology & Metabolism, Department of Internal Medicine, Uijeongbu Eulji Medical Center, Eulji University School of Medicine, Uijeongbu, Republic of Korea
| | - Hui Zuo
- School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Zumin Shi
- Human Nutrition Department, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Youfa Wang
- Global Health Institute, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China
| | - Renan M Montenegro
- Faculty of Medicine, Federal University of Ceará (FAMED-UFC), Fortaleza-Ceará, Brazil
| | | | - Stephen Colagiuri
- International Diabetes Federation, IDF, Brussels, Belgium; Boden Collaboration, Charles Perkins Centre, University of Sydney, Sydney, Australia
| | - Andrew J M Boulton
- International Diabetes Federation, IDF, Brussels, Belgium; University of Manchester, UK
| | - Akhtar Hussain
- Faculty of Medicine, Federal University of Ceará (FAMED-UFC), Fortaleza-Ceará, Brazil; International Diabetes Federation, IDF, Brussels, Belgium; Centre for Global Health Research, Diabetic Association of Bangladesh, Dhaka, Bangladesh; Faculty of Health Sciences, Nord University, Bodø, Norway.
| |
Collapse
|
31
|
Mohan V, Bruin NM, Tesselaar MET, de Boer JP, Vegt E, Hendrikx JJMA, Al-Mamgani A, van de Kamer JB, Sonke JJ, Vogel WV. Muscarinic inhibition of salivary glands with glycopyrronium bromide does not reduce the uptake of PSMA-ligands or radioiodine. EJNMMI Res 2021; 11:25. [PMID: 33710423 PMCID: PMC7953192 DOI: 10.1186/s13550-021-00770-1] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 03/03/2021] [Indexed: 02/08/2023] Open
Abstract
RATIONALE Salivary glands are highly perfused and express the prostate-specific membrane antigen (PSMA) receptor as well as the sodium-iodide symporter. As a consequence, treatment with 177Lu/225Ac-PSMA for prostate cancer or 131I for thyroid cancer leads to a high radiation dose in the salivary glands, and patients can be confronted with persistent xerostomia and reduced quality of life. Salivation can be inhibited using an antimuscarinic pharmaceutical, such as glycopyrronium bromide (GPB), which may also reduce perfusion. The primary objective of this work was to determine if inhibition with GPB could provide a considerable (> 30%) reduction in the accumulation of administered 123I or 68Ga-PSMA-11 in salivary glands. METHODS Ten patients who already received a whole-body 68Ga-PSMA-11 PET/CT scan for (re)staging of prostate cancer underwent a repeat PET/CT scan with tracer administration at 90 min after intravenous injection of 0.2 mg GPB. Four patients in follow-up after thyroid cancer, who had been treated with one round of ablative 131I therapy with curative intent and had no signs of recurrence, received 123I planar scintigraphy at 4 h after tracer administration without GPB and a repeated scan at least one week later, with tracer administration at 30 min after intramuscular injection of 0.4 mg GPB. Tracer uptake in the salivary glands was quantified on PET and scintigraphy, respectively, and values with and without GPB were compared. RESULTS No significant difference in PSMA uptake in the salivary glands was seen without or with GPB (Mean SULmean parotid glands control 5.57, intervention 5.72, p = 0.50. Mean SULmean submandibular glands control 6.25, intervention 5.89, p = 0.12). Three out of 4 patients showed increased 123I uptake in the salivary glands after GPB (Mean counts per pixel control 8.60, intervention 11.46). CONCLUSION Muscarinic inhibition of salivation with GPB did not significantly reduce the uptake of PSMA-ligands or radioiodine in salivary glands, and can be dismissed as a potential strategy to reduce toxicity from radionuclide therapies.
Collapse
Affiliation(s)
- V Mohan
- Department of Radiation Oncology, The Netherlands Cancer Institute, Plesmanlaan 121, Amsterdam, 1066 CX, The Netherlands.,Department of Nuclear Medicine, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - N M Bruin
- Department of Radiation Oncology, The Netherlands Cancer Institute, Plesmanlaan 121, Amsterdam, 1066 CX, The Netherlands.,Department of Nuclear Medicine, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - M E T Tesselaar
- Department of Medical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - J P de Boer
- Department of Medical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - E Vegt
- Department of Radiation Oncology, The Netherlands Cancer Institute, Plesmanlaan 121, Amsterdam, 1066 CX, The Netherlands.,Department of Radiology and Nuclear Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - J J M A Hendrikx
- Department of Radiation Oncology, The Netherlands Cancer Institute, Plesmanlaan 121, Amsterdam, 1066 CX, The Netherlands.,Department of Pharmacy and Pharmacology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - A Al-Mamgani
- Department of Radiation Oncology, The Netherlands Cancer Institute, Plesmanlaan 121, Amsterdam, 1066 CX, The Netherlands
| | - J B van de Kamer
- Department of Radiation Oncology, The Netherlands Cancer Institute, Plesmanlaan 121, Amsterdam, 1066 CX, The Netherlands
| | - J-J Sonke
- Department of Radiation Oncology, The Netherlands Cancer Institute, Plesmanlaan 121, Amsterdam, 1066 CX, The Netherlands
| | - W V Vogel
- Department of Radiation Oncology, The Netherlands Cancer Institute, Plesmanlaan 121, Amsterdam, 1066 CX, The Netherlands. .,Department of Nuclear Medicine, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
| |
Collapse
|
32
|
Mohan V, Bruin NM, van de Kamer JB, Sonke JJ, Vogel WV. The increasing potential of nuclear medicine imaging for the evaluation and reduction of normal tissue toxicity from radiation treatments. Eur J Nucl Med Mol Imaging 2021; 48:3762-3775. [PMID: 33687522 PMCID: PMC8484246 DOI: 10.1007/s00259-021-05284-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 02/24/2021] [Indexed: 11/26/2022]
Abstract
Radiation therapy is an effective treatment modality for a variety of cancers. Despite several advances in delivery techniques, its main drawback remains the deposition of dose in normal tissues which can result in toxicity. Common practices of evaluating toxicity, using questionnaires and grading systems, provide little underlying information beyond subjective scores, and this can limit further optimization of treatment strategies. Nuclear medicine imaging techniques can be utilised to directly measure regional baseline function and function loss from internal/external radiation therapy within normal tissues in an in vivo setting with high spatial resolution. This can be correlated with dose delivered by radiotherapy techniques to establish objective dose-effect relationships, and can also be used in the treatment planning step to spare normal tissues more efficiently. Toxicity in radionuclide therapy typically occurs due to undesired off-target uptake in normal tissues. Molecular imaging using diagnostic analogues of therapeutic radionuclides can be used to test various interventional protective strategies that can potentially reduce this normal tissue uptake without compromising tumour uptake. We provide an overview of the existing literature on these applications of nuclear medicine imaging in diverse normal tissue types utilising various tracers, and discuss its future potential.
Collapse
Affiliation(s)
- V Mohan
- Department of Nuclear Medicine, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
- Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - N M Bruin
- Department of Nuclear Medicine, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
- Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - J B van de Kamer
- Department of Nuclear Medicine, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
| | - J-J Sonke
- Department of Nuclear Medicine, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
| | - Wouter V Vogel
- Department of Nuclear Medicine, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.
- Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
| |
Collapse
|
33
|
Raman R, Rajalakshmi R, Surya J, Ramakrishnan R, Sivaprasad S, Conroy D, Thethi JP, Mohan V, Netuveli G. Impact on health and provision of healthcare services during the COVID-19 lockdown in India: a multicentre cross-sectional study. BMJ Open 2021; 11:e043590. [PMID: 33468529 PMCID: PMC7817386 DOI: 10.1136/bmjopen-2020-043590] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 12/28/2020] [Accepted: 01/04/2021] [Indexed: 12/17/2022] Open
Abstract
INTRODUCTION The COVID-19 pandemic resulted in a national lockdown in India from midnight on 25 March 2020, with conditional relaxation by phases and zones from 20 April. We evaluated the impact of the lockdown in terms of healthcare provisions, physical health, mental health and social well-being within a multicentre cross-sectional study in India. METHODS The SMART India study is an ongoing house-to-house survey conducted across 20 regions including 11 states and 1 union territory in India to study diabetes and its complications in the community. During the lockdown, we developed an online questionnaire and delivered it in English and seven popular Indian languages (Hindi, Tamil, Marathi, Telegu, Kannada, Bengali, Malayalam) to random samples of SMART-India participants in two rounds from 5 May 2020 to 24 May 2020. We used multivariable logistic regression to evaluate the overall impact on health and healthcare provision in phases 3 and 4 of lockdown in red and non-red zones and their interactions. RESULTS A total of 2003 participants completed this multicentre survey. The bivariate relationships between the outcomes and lockdown showed significant negative associations. In the multivariable analyses, the interactions between the red zones and lockdown showed that all five dimensions of healthcare provision were negatively affected (non-affordability: OR 1.917 (95% CI 1.126 to 3.264), non-accessibility: OR 2.458 (95% CI 1.549 to 3.902), inadequacy: OR 3.015 (95% CI 1.616 to 5.625), inappropriateness: OR 2.225 (95% CI 1.200 to 4.126) and discontinuity of care: OR 6.756 (95% CI 3.79 to 12.042)) and associated depression and social loneliness. CONCLUSION The impact of COVID-19 pandemic and lockdown on health and healthcare was negative. The exaggeration of income inequality during lockdown can be expected to extend the negative impacts beyond the lockdown.
Collapse
Affiliation(s)
- Rajiv Raman
- Shri Bhagwan Mahavir Vitreoretinal Services, Medical Research Foundation, Sankara Nethralaya, Chennai, India
| | | | - Janani Surya
- Diabetic Retinopathy Project, Sankara Nethralaya, Chennai, India
| | | | - Sobha Sivaprasad
- NIHR Moorfields Biomedical Research Centre, Moorfields Eye Hosp NHS Foundation Trust, London, UK
| | | | | | - V Mohan
- Madras Diabetes Research Foundation, Chennai, India
| | | |
Collapse
|
34
|
Parasher A, Mohan V. Postpartum fatal fulminant hepatic failure presenting with persistent hypoglycemia due to acute fatty liver of pregnancy. J Med Sci 2021. [DOI: 10.4103/jmedsci.jmedsci_179_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
35
|
Mohan V. Foreword. J Assoc Physicians India 2020; 68:8. [PMID: 33247656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Affiliation(s)
- V Mohan
- Chairman and Chief Diabetologist , Dr.Mohan's Diabetes Specialities Centre President and Director, Madras Diabetes Research Foundation
| |
Collapse
|
36
|
Mehreen TS, Kamalesh R, Pandiyan D, Kumar DS, Anjana RM, Mohan V, Ranjani H. Incidence and Predictors of Dysglycemia and Regression to Normoglycemia in Indian Adolescents and Young Adults: 10-Year Follow-Up of the ORANGE Study. Diabetes Technol Ther 2020; 22:875-882. [PMID: 32349530 DOI: 10.1089/dia.2020.0109] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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] [Indexed: 12/14/2022]
Abstract
Background: The prevalence of diabetes in youth is increasing worldwide in parallel with the obesity epidemic. This study aimed to determine the incidence rates of dysglycemia (diabetes or prediabetes) and evaluate the predictors of its progression or regression to normal glucose tolerance (NGT) in a cohort of children and adolescents studied in Chennai, South India. Methods: A longitudinal follow-up of the Obesity Reduction and Awareness of Noncommunicable Diseases through Group Education (ORANGE) cohort was performed after a median of 7.1 years (n = 845; 5928 person-years of follow-up). To determine their diabetes status at follow-up, participants underwent an oral glucose tolerance test (n = 811 with NGT and 34 with prediabetes at baseline), excluding those with diabetes at baseline. Incidence rates for dysglycemia were reported per 1000 person-years of follow-up. Cox proportional hazards model was used to estimate the predictors of progression and regression. Results: Out of 811 individuals with NGT at baseline, 115 developed dysglycemia giving an incidence rate of 20.2 per 1000 person-years (95% confidence interval: 16.8-24.2). Among those with prediabetes at baseline, 70.6% of the individuals converted to NGT and the remaining 29.4% either got converted to diabetes or remained as prediabetes. Higher age, body mass index, fasting plasma glucose, 2-hour plasma glucose (2-h PG), positive family history of diabetes, and systolic blood pressure (BP) were independent predictors of incident dysglycemia, whereas lower age, waist circumference, 2-h PG, systolic BP, and triglycerides predicted regression to normoglycemia. Conclusions: This study highlights the growing burden of dysglycemia in Asian Indian youth and emphasizes the need for targeted preventive actions.
Collapse
Affiliation(s)
- T S Mehreen
- Department of Translational Research, Madras Diabetes Research Foundation, Chennai, India
| | - R Kamalesh
- Department of Research Operations, Madras Diabetes Research Foundation, Chennai, India
| | - D Pandiyan
- Department of Translational Research, Madras Diabetes Research Foundation, Chennai, India
| | - D Sathish Kumar
- Department of Translational Research, Madras Diabetes Research Foundation, Chennai, India
| | - R M Anjana
- Department of Diabetology, Madras Diabetes Research Foundation, Chennai, India
| | - V Mohan
- Department of Diabetology, Madras Diabetes Research Foundation, Chennai, India
| | - H Ranjani
- Department of Translational Research, Madras Diabetes Research Foundation, Chennai, India
| |
Collapse
|
37
|
Chetan MR, Miksza JK, Lawrence I, Anjana RM, Unnikrishnan R, Amutha A, Shanthi Rani CS, Jebarani S, Mohan V, Khunti K, Narendran P. The increased risk of microvascular complications in South Asians with type 1 diabetes is influenced by migration. Diabet Med 2020; 37:2136-2142. [PMID: 31721280 DOI: 10.1111/dme.14184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/11/2019] [Indexed: 11/28/2022]
Abstract
AIM We aimed to explore the association between South Asian ethnicity and complications of type 1 diabetes, and whether this is affected by migration. METHODS In this retrospective cohort study, data on diabetes control and complications were obtained for South Asians in India (South AsiansIndia , n = 2592) and the UK (South AsiansUK , n = 221) and white Europeans in the UK (n = 1431). Multivariable logistic regression was used to identify associations between ethnicity and diabetic kidney disease, retinopathy and neuropathy adjusting for age, sex, BMI, disease duration, HbA1c , blood pressure (BP) and cholesterol. RESULTS South AsiansIndia had significantly greater adjusted odds of diabetic kidney disease [odds ratio (OR) 5.0, 95% confidence intervals (CI) 3.6-7.1] and retinopathy (OR 1.8, 95% CI 1.2-2.5), but lower odds of neuropathy (OR 0.5, 95% CI 0.4-0.6) than white Europeans. South AsiansIndia had significantly greater adjusted odds of diabetic kidney disease (OR 3.0, 95% 1.8-5.3) than South AsiansUK , but there was no significant difference in the odds of other complications. CONCLUSIONS In this hypothesis-generating study, we report that South Asian ethnicity is associated with greater risk of diabetic kidney disease and retinopathy, and lower risk of neuropathy than white European ethnicity. Part of the excess diabetic kidney disease risk is reduced in South AsiansUK . These associations cannot be accounted for by differences in vascular risk factors. Our findings in South Asians with type 1 diabetes mirror previous findings in type 2 diabetes and now need to be validated in a study of the effect of ethnicity on type 1 diabetes complications where healthcare is provided in the same setting.
Collapse
Affiliation(s)
- M R Chetan
- College of Medical and Dental Sciences, Birmingham, UK
| | - J K Miksza
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | - I Lawrence
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | - R M Anjana
- Madras Diabetes Research Foundation, Chennai, India
| | | | - A Amutha
- Madras Diabetes Research Foundation, Chennai, India
| | | | - S Jebarani
- Madras Diabetes Research Foundation, Chennai, India
| | - V Mohan
- Madras Diabetes Research Foundation, Chennai, India
| | - K Khunti
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | - P Narendran
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK
| |
Collapse
|
38
|
Gupta P, Singh K, Shivashankar R, Singh K, Vamadevan A, Mohan V, Kadir MM, Tandon N, Narayan KM, Prabhakaran D, Ali MK. Healthcare utilisation and expenditure patterns for cardio-metabolic diseases in South Asian cities: the CARRS Study. BMJ Open 2020; 10:e036317. [PMID: 32998917 PMCID: PMC7528361 DOI: 10.1136/bmjopen-2019-036317] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 07/20/2020] [Accepted: 08/07/2020] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To estimate average annual expenditures per person, total economic burden and distress health financing associated with the treatment of five cardio-metabolic diseases (CMDs-hypertension, diabetes, heart disease (angina, myocardial infarction and heart failure), stroke and chronic kidney disease) in three metropolitan cities in South Asia. DESIGN Cross-sectional surveys. SETTING We analysed community-based baseline data from the Centre for cArdio-metabolic Risk Reduction in South Asia (CARRS) Study collected in 2010-2011 representing Chennai and New Delhi (India), and Karachi (Pakistan). PARTICIPANTS We used data from non-pregnant adults (≥20 years) from the aforementioned cities that responded to a cost-of-illness questionnaire. We estimated health utilisation and expenditures among those reporting taking treatment(s) for the aforementioned CMDs in the last 1 year. We converted all costs to International Dollars (Int$ 2011) and inflated to 2018 values. The annual costs per person were stratified by city, sociodemographic characteristics, contributor of costs and financing methods. The total economic burden of CMDs for each city was projected using age-standardised prevalence and per-person costs of diseases reported in CARRS, applying these to population data from the most recent census. We also calculated distress financing (DF) as having to borrow or sell assets to pay for CMD treatment and identified sociodemographic groups at most risk of DF using multiple regression. RESULTS Of 16 287 CARRS participants, 2883 (17.7%) reported receiving treatment for CMDs. The total annual expenditures reported per patient for CMDs ranged from Int$358 to Int$2425. Medications constituted 46% of total direct expenditures and out-of-pocket (OOP) expenditures accounted for nearly 80% of financing these health expenditures. Total economic burdens of CMDs were Int$0.42 billion, Int$3.4 billion and Int$1.4 billion in Chennai, New Delhi and Karachi, respectively. Overall, 36.1% experienced DF, and women (OR=4.4), unemployed (OR=10.7) and uninsured (OR=8.1) adults experienced higher odds of DF. CONCLUSION CMDs are associated with large economic burdens in South Asia. Due to most payments coming from OOP expenditures and limited insurance, the odds of DF are high.
Collapse
Affiliation(s)
- Priti Gupta
- Centre for Chronic Disease Control, New Delhi, India
| | - Kalpana Singh
- Centre for Chronic Disease Control, New Delhi, India
| | | | - Kavita Singh
- The Centre for Chronic Conditions and Injuries (CCCI), Public Health Foundation of India, New Delhi, India
| | | | - V Mohan
- Madras Diabetes Research Foundation, Chennai, India
| | | | - Nikhil Tandon
- Department of Endocrinology, Metabolism & Diabetes, All India Institute of Medical Sciences, New Delhi, India
| | - K M Narayan
- Global Health, Emory University School of Public Health, Atlanta, Georgia, USA
| | - Dorairaj Prabhakaran
- Centre for Chronic Disease Control, New Delhi, India
- The Centre for Chronic Conditions and Injuries (CCCI), Public Health Foundation of India, New Delhi, India
| | - Mohammed K Ali
- Hubert Department of Global Health, Emory University, Atlanta, Georgia, USA
| |
Collapse
|
39
|
Gullick G, Mohan V, Gibbs L, Comins C, Braybrooke J, Jenkins J, Bahl A, Caws C. Leptomeningeal Disease in Breast Cancer, Bristol Experience. Clin Oncol (R Coll Radiol) 2020. [DOI: 10.1016/j.clon.2020.02.018] [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]
|
40
|
Bhowmick A, Sarkar P, Baruah MP, Bodhini D, Radha V, Mohan V, Banu S. Association of SLC30A8, CDKAL1, TCF7L2 and HHEX Gene Polymorphisms with Type 2 Diabetes in the Population of North East India. CYTOL GENET+ 2020. [DOI: 10.3103/s0095452720020036] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
|
41
|
Chawla R, Makkar BM, Aggarwal S, Bajaj S, Das AK, Ghosh S, Gupta A, Gupta S, Jaggi S, Jana J, Keswadev J, Kalra S, Keswani P, Kumar V, Maheshwari A, Moses A, Nawal CL, Panda J, Panikar V, Ramchandani GD, Rao PV, Saboo B, Sahay R, Setty KR, Viswanathan V, Aravind SR, Banarjee S, Bhansali A, Chandalia HB, Das S, Gupta OP, Joshi S, Kumar A, Kumar KM, Madhu SV, Mittal A, Mohan V, Munichhoodappa C, Ramachandran A, Sahay BK, Sai J, Seshiah V, Zargar AH. RSSDI consensus recommendations on insulin therapy in the management of diabetes. Int J Diabetes Dev Ctries 2019. [DOI: 10.1007/s13410-019-00783-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
|
42
|
Mohan V, Ramu M, Poongothai S, Kasthuri S. A ProspectIve, OpeN-Label, Randomized Study Comparing EffIcacy and Safety of Teneligliptin VErsus Sitagliptin in Indian Patients with Inadequately Controlled Type 2 Diabetes Mellitus: INSITES Study. J Assoc Physicians India 2019; 67:14-19. [PMID: 31571445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
BACKGROUND Teneligliptin is widely prescribed dipeptidyl peptidase-4 inhibitor (DPP-4i) in India because of its economical pricing. However, there is no headto-head trial comparing teneligliptin with any other DPP-4i in Indian setting. We evaluated the efficacy and safety of teneligliptin versus sitagliptin as add-on to metformin and/or sulfonylureas in patients with type 2 diabetes mellitus (T2DM). METHODS This prospective, open-label, randomized, active-controlled study enrolled 76 patients (1:1) at 2 centres. Patients received teneligliptin 20 mg or sitagliptin 100 mg orally once daily for 12 weeks as add-on to ongoing metformin or sulfonylurea therapy. Primary endpoint was mean change in glycosylated hemoglobin (HbA1c) from baseline at week 12. RESULTS Both arms were comparable (p>0.05) at baseline in terms of age, gender, metformin daily dose, sulfonylurea use, HbA1c, fasting and postprandial blood glucose (FBG and PPBG). At the end of 12 weeks, statistically significant reductions were observed in both teneligliptin and sitagliptin arms in HbA1c (-1.19 ± 1.16% p<0.0001 and -0.92 ± 0.95%, p<0.0001), in FBG (-28.3 ± 63.0 mg/dL, p= 0.01 and -22.9 ± 47.4 mg/dL, p=0.006) and PPBG (-41.3 ± 85.4 mg/dL, p=0.006 and -54.7 ± 85.6 mg/dL, p=0.0005). The reductions in all glycemic parameters were similar between the arms. Both gliptins were well-tolerated with no difference in the number of adverse events. There was no change in QT/QTc intervals or other ECG parameters at week 12 in both arms. In post-hoc comparison, percentage of patients achieving target HbA1c <7% (as per American Diabetes Association guidelines) at week 12 favored teneligliptin arm over sitagliptin arm (33.3% vs. 19.4% patients). CONCLUSION Teneligliptin provided similar glycemic control as compared to sitagliptin and reduced HbA1c, FBG and PPBG values significantly within 12 weeks of treatment. Both gliptins were found to be safe and well-tolerated in Indian patients with T2DM.
Collapse
Affiliation(s)
- V Mohan
- Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialties Centre, Chennai, Tamil Nadu , Corresponding Author
| | - M Ramu
- Madras Diabetes Research Foundation, Chennai, Tamil Nadu
| | - S Poongothai
- Madras Diabetes Research Foundation, Chennai, Tamil Nadu
| | - S Kasthuri
- Madras Diabetes Research Foundation, Chennai, Tamil Nadu
| |
Collapse
|
43
|
Koul A, Garg S, Mohan V. Chemopreventive role of arabinogalactan against experimentally induced pulmonary carcinogenesis: a study in relation to its initiation phase. Drug Chem Toxicol 2019; 44:642-654. [PMID: 31379226 DOI: 10.1080/01480545.2019.1643877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The aim of the present study is to divulge the chemopreventive potential of arabinogalactan (AG) on benzo(a)pyrene [B(a)P] induced initiation of lung carcinogenesis. AG is one of the naturally occurring bioactive polysaccharides which is widely found in medicinal plants. Male Balb/c mice were divided into four experimental groups. Group I served as control. Group II animals were injected with B(a)P (50 mg/kg b. wt. i.p.). Group III animals were administered with AG (7.5 mg/kg b.wt.) orally. Group IV animals received B(a)P and AG as in group II and group III, respectively. B(a)P treatment in mice resulted in imbalance of carcinogen metabolizing enzymes and respiratory marker enzymes at 2nd, 6th and 10th week of the experimental protocol. Also, it leads to the increased protein synthesis as depicted by increased argyrophilic nucleolar organizer regions (AgNOR) positive cells and altered histopathological features. Studies on bronchoalveolar lavage fluid (balf) of B(a)P exposed animals revealed increase in surface tension when compared with control counterparts. Apart from target tissue (lung), B(a)P also led to the clastogenic damage in other tissues (spleen and bone marrow) as depicted by increase in percentage of micronucleus cells at different time intervals. Treatment with AG efficiently counteracted all the above anomalies and restored cellular homeostasis. These observations suggest that AG has the potential to modulate B(a)P induced changes in the pulmonary tissue as well as other tissues which could have implications in delaying the initiation of carcinogenesis, however, further investigations are required to explore its complete mechanism of action.
Collapse
Affiliation(s)
- Ashwani Koul
- Department of Biophysics, Basic Medical Science Block II, Panjab University, Chandigarh, India
| | - Shaffy Garg
- Department of Biophysics, Basic Medical Science Block II, Panjab University, Chandigarh, India
| | - Vandana Mohan
- Department of Biophysics, Basic Medical Science Block II, Panjab University, Chandigarh, India
| |
Collapse
|
44
|
Gujral UP, Prabhakaran D, Pradeepa R, Kandula NR, Kondal D, Deepa M, Zakai NA, Anjana RM, Rautela G, Mohan V, Narayan KMV, Tandon N, Kanaya AM. Isolated HbA1c identifies a different subgroup of individuals with type 2 diabetes compared to fasting or post-challenge glucose in Asian Indians: The CARRS and MASALA studies. Diabetes Res Clin Pract 2019; 153:93-102. [PMID: 31150721 PMCID: PMC6635041 DOI: 10.1016/j.diabres.2019.05.026] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 05/15/2019] [Accepted: 05/22/2019] [Indexed: 12/26/2022]
Abstract
AIMS Guidelines recommend hemoglobin A1c (HbA1c) as a diagnostic test for type 2 diabetes, but its accuracy may differ in certain ethnic groups. METHODS The prevalence of type 2 diabetes by HbA1c, fasting glucose, and 2 h glucose was compared in 3016 participants from Chennai and Delhi, India from the CARRS-2 Study to 757 Indians in the U.S. from the MASALA Study. Type 2 diabetes was defined as fasting glucose ≥ 7.0 mmol/L, 2-h glucose ≥ 11.1 mmol/L, or HbA1c ≥ 6.5%. Isolated HbA1c diabetes was defined as HbA1c ≥ 6.5% with fasting glucose < 7.0 mmol/L and 2 h glucose < 11.1 mmol/L. RESULTS The age, sex, and BMI adjusted prevalence of diabetes by isolated HbA1c was 2.9% (95% CI: 2.2-4.0), 3.1% (95% CI: 2.3-4.1), and 0.8% (95% CI: 0.4-1.8) in CARRS-Chennai, CARRS-Delhi, and MASALA, respectively. The proportion of diabetes diagnosed by isolated HbA1c was 19.4%, 26.8%, and 10.8% in CARRS-Chennai, CARRS-Delhi, and MASALA respectively. In CARRS-2, individuals with type 2 diabetes by isolated HbA1c milder cardio-metabolic risk than those diagnosed by fasting or 2-h measures. CONCLUSIONS In Asian Indians, the use of HbA1c for type 2 diabetes diagnosis could result in a higher prevalence. HbA1c may identify a subset of individuals with milder glucose intolerance.
Collapse
Affiliation(s)
- U P Gujral
- Emory Global Diabetes Research Center, Hubert Department of Global Health, Rollins School of Public Health, 1518 Clifton Road NE, Room 7040 N, Emory University, Atlanta, GA, USA.
| | - D Prabhakaran
- Public Health Foundation of India, Unit No. 316 Situated on 3rd Floor, Rectangle-1 Building, Plot No. D-4, District Centre Saket, New Delhi, India; London School of Hygiene and Tropical Medicine, Keppel Street, London, United Kingdom.
| | - R Pradeepa
- Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-communicable Diseases, Prevention & Control, ICMR Centre for Advanced Research on Diabetes, Chennai, India
| | - N R Kandula
- Division of General Internal Medicine, Northwestern University Feinberg School of Medicine, 750 N Lake Shore Drive, 6th Floor, Chicago, IL, USA.
| | - D Kondal
- Public Health Foundation of India, Unit No. 316 Situated on 3rd Floor, Rectangle-1 Building, Plot No. D-4, District Centre Saket, New Delhi, India.
| | - M Deepa
- Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-communicable Diseases, Prevention & Control, ICMR Centre for Advanced Research on Diabetes, Chennai, India
| | - N A Zakai
- Department of Medicine, Department of Pathology & Laboratory Medicine, Larner College of Medicine at the University of Vermont, 89 Beaumont Avenue, Courtyard at Given S269, Burlington, VT, USA.
| | - R M Anjana
- Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-communicable Diseases, Prevention & Control, ICMR Centre for Advanced Research on Diabetes, Chennai, India.
| | - G Rautela
- Public Health Foundation of India, Unit No. 316 Situated on 3rd Floor, Rectangle-1 Building, Plot No. D-4, District Centre Saket, New Delhi, India.
| | - V Mohan
- Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-communicable Diseases, Prevention & Control, ICMR Centre for Advanced Research on Diabetes, Chennai, India.
| | - K M V Narayan
- Emory Global Diabetes Research Center, Hubert Department of Global Health, Rollins School of Public Health, 1518 Clifton Road NE, Room 7040 N, Emory University, Atlanta, GA, USA; Department of Medicine, School of Medicine, 201 Dowman Drive Emory University, Atlanta, GA, USA.
| | - N Tandon
- Public Health Foundation of India, Unit No. 316 Situated on 3rd Floor, Rectangle-1 Building, Plot No. D-4, District Centre Saket, New Delhi, India; Department of Endocrinology and Metabolism, All Indian Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - A M Kanaya
- Division of General Internal Medicine, University of California, San Francisco, San Francisco, CA, USA.
| |
Collapse
|
45
|
Mohan V, Bruin N, Van de Kamer J, Sonke J, Al-Mamgani A, Vogel W. PV-105 68Ga-PSMA PET/CT for quantitative evaluation of radiotherapy-induced cell loss in salivary glands. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)30525-0] [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]
|
46
|
Bruin N, Mohan V, Van de Kamer J, Al-Mamgani A, Sonke J, Vogel W. PO-1101 Feasibility of PSMA PET/CT for evaluation of radiotherapy toxicity in salivary glands. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31521-x] [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]
|
47
|
Mohan V, Das AK, Unnikrishnan AG, Shah SN, Kumar A, Zargar AH, Kalra S. IMPACT India: Insights for Insulin Therapy in Routine Clinical Practice. J Assoc Physicians India 2019; 67:34-38. [PMID: 31309793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
OBJECTIVE Widely used in the management of diabetes, insulin therapy is influenced by several patient preferences and physician choices. This article reports the findings of the IMPACT survey, designed to assess insights on various factors which influence the choice of insulin therapy in India. METHODS We administered a questionnaire which focused on the practice and patient profiles and the preferred regimens in specific clinical situations using a case scenario. Respondents were asked about preferred insulin regimens for various phases of life, comorbid conditions, dietary choices and psychological factors. RESULTS Overall, 314 doctors participated in the survey. Majority were general physicians (51%) and diabetologists (37%). In clinical practice, the most preferred regimens included premix insulin BD in adults (59%) and elderly (53%), and basal bolus therapy in pregnant women (>47%) and in acute illness (62%). Both regimens were equally preferred for symptomatic patients (41% basal bolus and 38% premix insulin) and those with renal or hepatic failure (36% each). Premix insulin was preferred for patients with high carbohydrate intake (73%) while basal bolus was preferred for patients with variable meal timings (39%) and in pronounced postprandial glucose excursions (45%). Insulin co-formulation and high-mix insulins were not a part of the survey questionnaire. SUMMARY Indian physicians exercise logic in the choice of insulin regimens. Preference is based on patient characteristics including glucophenotype, dietary patterns, psychosocial needs, clinical situations, and comorbid conditions.
Collapse
Affiliation(s)
- V Mohan
- Chairman and Chief of Diabetology, Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre, Non-Communicable Disease Prevention and Control and IDF Centre of Excellence in Diabetes Care and President and Chief of Diabetes Research,Madras Diabetes Research Foundation, ICMR Centre for Advanced Research on Diabetes, Chennai, Tamil Nadu
| | - Ashok Kumar Das
- Department of General Medicine, Pondicherry Institute of Medical Sciences, Puducherry
| | - A G Unnikrishnan
- Department of Endocrinology, Chellaram Diabetes Institute, Pune, Maharashtra
| | - Siddharth N Shah
- Department of Endocrinology, SL Raheja Hospital, Mumbai, Maharashtra
| | - Ajay Kumar
- Department of Diabetology, Diabetes Care and Research Centre, Patna, Bihar
| | - Abdul Hamid Zargar
- Department of Gynaecology and Obstetrics, Sheri-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir
| | - Sanjay Kalra
- Departmentof Endocrinology, Bharti Hospital Karnal, Karnal, Haryana; *Corresponding Author
| |
Collapse
|
48
|
Garg A, Shivashankar R, Vora K, Ali M, Mohan V, Mohan D, Kadir M, Tandon N, Venkat Narayan K, Prabhakaran D. PO206 Family History of Cardiometabolic Diseases (CMDS) as a Determinant of CMD Risk Behaviours: A Secondary Analysis of CARRS Study. Glob Heart 2018. [DOI: 10.1016/j.gheart.2018.09.176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
|
49
|
Yoo S, Singh K, Shivashankar R, Huffman M, Kadir M, Ali M, Mohan V, Narayan K, Tandon N, Prabhakaran D. PO531 Primary and Secondary Prevention of Cardiovascular Diseases In Three South Asian Metropolitan Cities: Analysis of Self-Reported Medication Use In Community-Based CARRS Study. Glob Heart 2018. [DOI: 10.1016/j.gheart.2018.09.407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
|
50
|
Mohan V, Koul A. Anticancer potential of Tinospora cordifolia and arabinogalactan against benzo(a)pyrene induced pulmonary tumorigenesis: a study in relevance to various biomarkers. J Herbmed Pharmacol 2018. [DOI: 10.15171/jhp.2018.35] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
|