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Kim AY, Woo W, Saxena A, Tanidir IC, Yao A, Kurniawati Y, Thakur V, Shin YR, Shin JI, Jung JW, Barron DJ. Treatment of hypoplastic left heart syndrome: a systematic review and meta-analysis of randomised controlled trials. Cardiol Young 2024; 34:659-666. [PMID: 37724575 DOI: 10.1017/s1047951123002986] [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] [Indexed: 09/21/2023]
Abstract
BACKGROUND This meta-analysis aimed to consolidate existing data from randomised controlled trials on hypoplastic left heart syndrome. METHODS Hypoplastic left heart syndrome specific randomised controlled trials published between January 2005 and September 2021 in MEDLINE, EMBASE, and Cochrane databases were included. Regardless of clinical outcomes, we included all randomised controlled trials about hypoplastic left heart syndrome and categorised them according to their results. Two reviewers independently assessed for eligibility, relevance, and data extraction. The primary outcome was mortality after Norwood surgery. Study quality and heterogeneity were assessed. A random-effects model was used for analysis. RESULTS Of the 33 included randomised controlled trials, 21 compared right ventricle-to-pulmonary artery shunt and modified Blalock-Taussig-Thomas shunt during the Norwood procedure, and 12 regarded medication, surgical strategy, cardiopulmonary bypass tactics, and ICU management. Survival rates up to 1 year were superior in the right ventricle-to-pulmonary artery shunt group; this difference began to disappear at 3 years and remained unchanged until 6 years. The right ventricle-to-pulmonary artery shunt group had a significantly higher reintervention rate from the interstage to the 6-year follow-up period. Right ventricular function was better in the modified Blalock-Taussig-Thomas shunt group 1-3 years after the Norwood procedure, but its superiority diminished in the 6-year follow-up. Randomised controlled trials regarding medical treatment, surgical strategy during cardiopulmonary bypass, and ICU management yielded insignificant results. CONCLUSIONS Although right ventricle-to-pulmonary artery shunt appeared to be superior in the early period, the two shunts applied during the Norwood procedure demonstrated comparable long-term prognosis despite high reintervention rates in right ventricle-to-pulmonary artery shunt due to pulmonary artery stenosis. For medical/perioperative management of hypoplastic left heart syndrome, further randomised controlled trials are needed to deliver specific evidence-based recommendations.
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Affiliation(s)
- A Y Kim
- Division of Pediatric Cardiology, Department of Pediatrics, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
| | - W Woo
- Department of Thoracic and Cardiovascular Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - A Saxena
- Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India
| | - I C Tanidir
- Department of Pediatric Cardiology, Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey
| | - A Yao
- Department of Health Service Promotion, University of Tokyo, Japan
| | - Y Kurniawati
- Department of Pediatric Cardiology, National Cardiovascular Center Harapan Kita, Jakarta, Indonesia
| | - V Thakur
- Department of Pediatrics, Labatt Family Heart Center, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Y R Shin
- Department of Cardiovascular Surgery, Yonsei University College of Medicine, Seoul, Korea
| | - J I Shin
- Department of Pediatrics, Labatt Family Heart Center, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
- Severance Underwood Meta-research Center, Institute of Convergence Science, Yonsei University, Seoul, South Korea
| | - J W Jung
- Division of Pediatric Cardiology, Department of Pediatrics, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
| | - D J Barron
- Division of Cardiovascular Surgery, Department of Surgery, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
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Kaur R, Pathania S, Kajal M, Thakur V, Kaur J, Singh K. Integrated analysis of smRNAome, transcriptome, and degradome data to decipher microRNAs regulating costunolide biosynthesis in Saussurea lappa. Plant Sci 2023; 331:111689. [PMID: 36965630 DOI: 10.1016/j.plantsci.2023.111689] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 03/03/2023] [Accepted: 03/21/2023] [Indexed: 06/18/2023]
Abstract
Saussurea lappa (S. lappa) has been known to synthesize medicinally important, costunolide. Due to its immense therapeutic importance, understanding of regulatory mechanism associated with its biosynthesis is crucial. The identification of genes and transcription factors (TFs) in S. lappa, created a clear picture of costunolide biosynthesis pathways. Further to understand the regulation of costunolide biosynthesis by miRNAs, an integrated study of transcriptome, miRNAs, and degradome was performed. Identified candidate miRNAs and associated feed-forward loops (FFLs) illustrates their regulatory role in secondary metabolite biosynthesis. Small RNA and degradome sequencing were performed for leaf and root tissues to determine miRNAs-targets pairs. A total of 711 and 525 such targets were obtained for novel and known miRNAs respectively. This data was used to generate costunolide-specific miRNA-TF-gene interactome to perform systematic analyses through graph theoretical approach. Interestingly, miR171c.1 and sla-miR121 were identified as key regulators to connect and co-regulate both mevalonate and sesquiterpenoid pathways to bio-synthesize costunolide. Tissue-specific FFLs were identified to be involved in costunolide biosynthesis which further suggests the evolutionary co-relation of root-specific networks in synthesis of secondary metabolites in addition to leaf-specific networks. This integrative approach allowed us to determine candidate miRNAs and associated tissue-specific motifs involved in the diversification of secondary metabolites. MiRNAs identified in present study can provide alternatives for bioengineering tool to enhance the synthesis of costunolide and other secondary metabolites in S. lappa.
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Affiliation(s)
- Ravneet Kaur
- Department of Biotechnology, Panjab University, BMS Block I, Sector 25, Chandigarh 160014, India.
| | - Shivalika Pathania
- Department of Biotechnology, Panjab University, BMS Block I, Sector 25, Chandigarh 160014, India
| | - Monika Kajal
- Department of Biotechnology, Panjab University, BMS Block I, Sector 25, Chandigarh 160014, India
| | - Vasundhara Thakur
- Department of Biotechnology, Panjab University, BMS Block I, Sector 25, Chandigarh 160014, India
| | - Jagdeep Kaur
- Department of Biotechnology, Panjab University, BMS Block I, Sector 25, Chandigarh 160014, India
| | - Kashmir Singh
- Department of Biotechnology, Panjab University, BMS Block I, Sector 25, Chandigarh 160014, India
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van Nisselrooij AEL, Moon-Grady AJ, Wacker-Gussmann A, Tomek V, Malčić I, Grzyb A, Pavlova A, Kazamia K, Thakur V, Sinkovskaya E, Harkel ADJT, Haak MC. The aorto-left ventricular tunnel from a fetal perspective: original case series and literature review. Prenat Diagn 2022; 42:267-277. [PMID: 35018638 PMCID: PMC9303731 DOI: 10.1002/pd.6090] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 12/16/2021] [Accepted: 12/29/2021] [Indexed: 11/24/2022]
Abstract
Introduction Aorto‐left ventricular tunnel (ALVT) accounts for <0.1% of congenital heart defects. Evidence on the prognosis from a fetal perspective is limited. With this retrospective international case series, we provide information on the outcome of fetuses with ALVT. Methods All members of the Association for European Pediatric and Congenital Cardiology's (AEPC) fetal working group and fetal medicine units worldwide were invited for participation. We observed antenatal parameters, neonatal outcome and postnatal follow‐up. Additionally, a systematic search of the literature was performed. Results Twenty fetuses with ALVT were identified in 10 participating centers (2001–2019). Fetal echocardiographic characteristics of ALVT included an increased cardiac–thorax ratio (95%), left ventricular end‐diastolic diameter (90%) and a dysplastic aortic valve (90%). Extracardiac malformations were rare (5%). Eight fetuses died at a median gestational age (GA) of 21 + 6 weeks (range, 19–24): all showed signs of hydrops prior to 24 weeks or at autopsy. All others (60%, 12/2) were live–born (median GA 38 + 4, range 37–40), underwent surgery and were alive at last follow up (median 3.2 years, range 0.1–17). The literature reported 22 ALVT fetuses with similar outcome. Conclusions In the absence of fetal hydrops, ALVT carries a good prognosis. Fetuses who survive to 24 weeks without hydrops are likely to have a good outcome. What's already known about this topic?Aorto‐left ventricular tunnel (ALVT) is an extremely rare diagnosis that may cause congenital heart failure and fetal hydrops, leading to fetal or neonatal death. A few case reports show that after corrective surgery in the neonatal period, cases with ALVT tend to have a good prognosis.
What does this study add?This is the first study that evaluates prenatal characteristics, prognostic parameters and outcome following a prenatal diagnosis of ALVT in a cohort of cases worldwide, including a systematic review of the literature as well. In the absence of fetal hydrops, ALVT carries a good prognosis. Fetuses who survive to 24 weeks without hydrops are likely to have a good outcome.
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Affiliation(s)
- A E L van Nisselrooij
- Department of Fetal Medicine and Obstetrics, Leiden University Medical Centre, Leiden, the Netherlands
| | - A J Moon-Grady
- Division of Pediatric Cardiology, Department of Pediatrics, University of California, San Francisco, California
| | - A Wacker-Gussmann
- Department of Pediatric Cardiology and Congenital Heart Disease, German Heart Centre Munich, Munich, Germany
| | - V Tomek
- Children's Heart Centre Prague, University Hospital Motol, Prague, Czech Republic
| | - I Malčić
- Department of Child's Cardiology, Zagreb University Hospital, Zagreb, Croatia
| | - A Grzyb
- Department of Perinatal Cardiology and Congenital Anomalies, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - A Pavlova
- Department of Cardiology, Ukrainian Children's Cardiac Centre, Kyiv, Ukraine
| | - K Kazamia
- Children's Heart Centre Stockholm-Uppsala, Karolinska University Hospital, Stockholm, Sweden
| | - V Thakur
- Division of Cardiology, Labatt Family Heart Centre, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - E Sinkovskaya
- Department of Obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk, Virginia
| | - A D J Ten Harkel
- Department of Fetal Medicine and Obstetrics, Leiden University Medical Centre, Leiden, the Netherlands
| | - M C Haak
- Department of Fetal Medicine and Obstetrics, Leiden University Medical Centre, Leiden, the Netherlands
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Hanumanthu V, Thakur V, Chatterjee D, Vinay K. Periocular cutaneous amyloidosis in multiple myeloma. QJM 2021; 114:603-604. [PMID: 33878191 DOI: 10.1093/qjmed/hcab084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- V Hanumanthu
- Department of Dermatology, Venereology and Leprology, Sector 12, Chandigarh 160012, Punjab, India
| | - V Thakur
- Department of Dermatology, Venereology and Leprology, Sector 12, Chandigarh 160012, Punjab, India
| | - D Chatterjee
- Department of Histopathology; Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh 160012, Punjab, India
| | - K Vinay
- Department of Histopathology; Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh 160012, Punjab, India
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Narang T, Kamat D, Thakur V, Lavania M, Singh I, Ahuja M, Dogra S. Equal rates of drug resistance in leprosy cases with relapse and recurrent /chronic type 2 reaction; Time to revise the guidelines for drug resistance testing in leprosy. Clin Exp Dermatol 2021; 47:297-302. [PMID: 34382256 DOI: 10.1111/ced.14884] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 07/12/2021] [Accepted: 08/09/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Leprosy relapse/recurrence is a serious concern especially in a leprosy endemic nation like India. It is believed that bacilli persisting even after multi-drug therapy could cause relapse; recently however drug resistance as a cause for recurrences and chronic erythema nodosum leprosum (ENL) has been speculated. Our objective was to study drug resistance patterns in cases of leprosy relapse and chronic/recurrent ENL's. METHODOLOGY This cross-sectional study conducted over a period of 1 year included patients diagnosed as leprosy relapse and those with chronic/recurrent (c/r) ENL. Skin biopsy specimens were subjected to conventional PCR for resistance testing for rifampicin, dapsone and ofloxacin, targeting rpoB, folP and gyrA gene of M.leprae respectively. RESULTS A total of 61 patients (25 smear negative) were included in the study. Of these, 37 were diagnosed as leprosy relapse and 24 had c/r ENL. Drug resistance to at least one drug was identified in 10 (16.4%) cases. Rates of drug resistance were 5.4% (2/37) for dapsone, 10.8% (4/37) for rifampicin and 2.7% (1/37) for ofloxacin amongst cases of relapse where as it was 12.5% (3/24) and 8.3% (2/24) for dapsone and rifampicin respectively amongst those with c/rENL.. Multi drug resistance was seen in 3.3% (2/61) patients. CONCLUSION Drug resistance rate amongst those with c/rENL was almost equaled that of relapse. Smear negative leprosy relapse cases also had resistance to bactericidal drugs. These findings call for modifications in criteria for testing under leprosy drug resistance surveillance and all cases of relapse and those with recalcitrant c/rENL should be tested.
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Affiliation(s)
- T Narang
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, India
| | - D Kamat
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, India
| | - V Thakur
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, India
| | - M Lavania
- Enteric Viruses Group, ICMR-National Institute of Virology, Pune, India
| | - I Singh
- Department of Molecular Biology, Stanley Browne Laboratory, TLM Community Hospital, New Delhi, India
| | - M Ahuja
- Department of Molecular Biology, Stanley Browne Laboratory, TLM Community Hospital, New Delhi, India
| | - S Dogra
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, India
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Thakur V, Gupta P, Vinay K. Dermoscopic features of post kala azar dermal leishmaniasis. J Eur Acad Dermatol Venereol 2021; 35:e460-e462. [PMID: 33725369 DOI: 10.1111/jdv.17222] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 03/10/2021] [Indexed: 12/14/2022]
Affiliation(s)
- V Thakur
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - P Gupta
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - K Vinay
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Thakur V, Bains S, Kaur R, Singh K. Identification and characterization of SlbHLH, SlDof and SlWRKY transcription factors interacting with SlDPD gene involved in costunolide biosynthesis in Saussurea lappa. Int J Biol Macromol 2021; 173:146-159. [PMID: 33482203 DOI: 10.1016/j.ijbiomac.2021.01.114] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 12/26/2020] [Accepted: 01/17/2021] [Indexed: 11/27/2022]
Abstract
The genes involved in costunolide biosynthesis in Saussurea lappa have been identified recently by our lab. However, the study of transcriptional regulators of these genes was lacking for better opportunities for engineering the pharmacologically important biosynthetic pathway. Therefore, we cloned the promoter region of diphosphomevalonate decarboxylase gene (DPD) and analyzed its cis-acting regulatory elements to reveal the potential transcription factor (TF) binding sites for Dof, bHLH and WRKY family proteins in the gene promoter. The transcriptome study approach followed by the hidden Markov model based search, digital gene expression, co-expression network analysis, conserved domain properties and evolutionary analyses were carried out to screen out seven putative TFs for the DPD-TF interaction studies. Yeast one-hybrid assays were performed and three TFs were reported, namely, SlDOF2, SlbHLH3 and SlWRKY2 from Dof, bHLH and WRKY families, respectively that interacted positively with the DPD gene of the costunolide biosynthetic pathway. The tissue specific relative gene expression studies also supported the linked co-expression of the gene and its interacting TFs The present report will improve the understanding of transcriptional regulation pattern of costunolide biosynthetic pathway.
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Affiliation(s)
- Vasundhara Thakur
- Department of Biotechnology, Panjab University, BMS Block I, Sector 25, Chandigarh 160014, India
| | - Savita Bains
- Department of Biotechnology, Panjab University, BMS Block I, Sector 25, Chandigarh 160014, India
| | - Ravneet Kaur
- Department of Biotechnology, Panjab University, BMS Block I, Sector 25, Chandigarh 160014, India
| | - Kashmir Singh
- Department of Biotechnology, Panjab University, BMS Block I, Sector 25, Chandigarh 160014, India.
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Dubey P, Shrivastava J, Choubey BP, Agrawal A, Thakur V. Neurodevelopmental outcome of healthy term newborn with serum bilirubin >15 mg/dl at one year. J Neonatal Perinatal Med 2020; 14:339-344. [PMID: 33337390 DOI: 10.3233/npm-200511] [Citation(s) in RCA: 4] [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] [Indexed: 02/05/2023]
Abstract
BACKGROUND Neonatal hyperbilirubinemia is a common medical emergency in early neonatal period. Unconjugated bilirubin is neurotoxic and can lead to lifelong neurological sequelae in survivors. OBJECTIVE To find out the association between serum bilirubin and neurodevelopmental outcome at 1 year of age using Development Assessment Scale for Indian Infants (DASII). METHODS A prospective cohort study was conducted in the Department of Pediatrics of a tertiary care institution of Central India between January 2018 and August 2019. Total 108 term healthy neonates, with at least one serum bilirubin value of >15 mg/dl, were included. Subjects were divided into three groups based on the serum bilirubin; group 1: (15-20 mg/dl) -85(78.7%) cases, group 2: (20-25 mg/dl) -17(15.7%), and group 3: (>25 mg/dl) -6(5.5%). Developmental assessment was done using DASII at 3, 6, 9, 12 months of age. RESULTS Out of 108 cases, 101(93.5%) received phototherapy, and 7(6.5%) received double volume exchange transfusion. Severe delay was observed in 5(4.6%) and mild delay in 2(1.9%) cases in the motor domain of DASII at one year. Severe delay in the motor domain was associated with mean TSB of 27.940±2.89 mg/dl and mild delay with mean TSB of 22.75±1.76 mg/dl (p = 0.001). On cluster analysis, delay was observed in locomotion 1 score in 11(13%) cases (p = 0.003) and manipulation score in 6(7.1%) cases in group 1. CONCLUSION Increased serum bilirubin was a significant risk factor for the delayed neurodevelopment in babies with neonatal jaundice. Even a moderate level of bilirubin significantly affects the developmental outcome.
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Affiliation(s)
- P Dubey
- Department of Pediatrics, Gandhi Medical College & Kamla Nehru Hospital, Bhopal, MP, India
| | - J Shrivastava
- Department of Pediatrics, Gandhi Medical College & Kamla Nehru Hospital, Bhopal, MP, India
| | - B P Choubey
- Department of Pediatrics, Gandhi Medical College & Kamla Nehru Hospital, Bhopal, MP, India
| | - A Agrawal
- Department of Pediatrics, Gandhi Medical College & Kamla Nehru Hospital, Bhopal, MP, India
| | - V Thakur
- Department of Pediatrics, Gandhi Medical College & Kamla Nehru Hospital, Bhopal, MP, India
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Affiliation(s)
- V Thakur
- Department of Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Sector 12, Chandigarh 160012, India
| | - S Kumar
- Department of Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Sector 12, Chandigarh 160012, India
| | - A Bishnoi
- Department of Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Sector 12, Chandigarh 160012, India
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Choudhary R, Ashraf R, Thakur V, Kumaran MS. Teriflunomide-induced drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome. Clin Exp Dermatol 2020; 46:166-169. [PMID: 32557734 DOI: 10.1111/ced.14339] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 06/02/2020] [Accepted: 06/10/2020] [Indexed: 12/14/2022]
Affiliation(s)
- R Choudhary
- Department of Dermatology, Venereology, and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - R Ashraf
- Department of Dermatology, Venereology, and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - V Thakur
- Department of Dermatology, Venereology, and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - M S Kumaran
- Department of Dermatology, Venereology, and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Thakur V, Bains S, Pathania S, Sharma S, Kaur R, Singh K. Comparative transcriptomics reveals candidate transcription factors involved in costunolide biosynthesis in medicinal plant-Saussurea lappa. Int J Biol Macromol 2020; 150:52-67. [DOI: 10.1016/j.ijbiomac.2020.01.312] [Citation(s) in RCA: 5] [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] [Received: 12/11/2019] [Revised: 01/28/2020] [Accepted: 01/28/2020] [Indexed: 01/01/2023]
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Thakur N, Sant R, Nicholls S, McDonald S, Thakur V, Thakur Y. 2892 Minitouch Outpatient Endometrial Ablation for Heavy Menstrual Bleeding - The Way Forward! J Minim Invasive Gynecol 2019. [DOI: 10.1016/j.jmig.2019.09.243] [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: 12/01/2022]
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Manhas M, Mittal S, Sharma AK, Gupta KK, Pathania V, Thakur V. Biological approach in repair of partially inflamed dental pulp using second-generation platelet-rich fibrin and mineral trioxide aggregate as a pulp medicament in primary molars. J Indian Soc Pedod Prev Dent 2019; 37:399-404. [PMID: 31710016 DOI: 10.4103/jisppd.jisppd_133_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
AIM The purpose of this study was to evaluate and compare clinically and radiographically PRF, MTA and Ca(OH)2 as a pulp dressing material in primary molars. MATERIAL AND METHODS The study was conducted on 30 children between 6-9 years of age. Pulpotomy was performed using MTA(Gp I), PRF + MTA(Gp II) and PRF +Ca(OH)2(Group III). The teeth were evaluated clinically and radiographically after 1,3 and 6 months and were subjected to statistics analysis. RESULTS After 6 months follow-up the overall success rate was found to be highest in Gp I with success rate of 97% followed by Gp II 95% and Gp III 78.3%. The results were found to be statistically insignificant (P ≤ 0.05). CONCLUSION All materials used in the present study were equally effective as the success rates are statistically insignificant.
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Affiliation(s)
- Maria Manhas
- Department of Pedodontics, Himachal Dental College, Sundar Nagar, Himachal Pradesh, India
| | - Sudhir Mittal
- Department of Pedodontics, Himachal Dental College, Sundar Nagar, Himachal Pradesh, India
| | - A K Sharma
- Department of Pedodontics, Himachal Dental College, Sundar Nagar, Himachal Pradesh, India
| | - K K Gupta
- Department of Pedodontics, Himachal Dental College, Sundar Nagar, Himachal Pradesh, India
| | - V Pathania
- Department of Pedodontics, Himachal Dental College, Sundar Nagar, Himachal Pradesh, India
| | - V Thakur
- Department of Pedodontics, Himachal Dental College, Sundar Nagar, Himachal Pradesh, India
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Awasti S, Vinay K, Thakur V, Kumar R, Holla AP, Sahni K, Parsad D, Kanwar AJ. Comparison of efficacy of cold trypsinization versus warm trypsinization in preparation of autologous non-cultured epidermal cell suspension for treatment of stable vitiligo. J Eur Acad Dermatol Venereol 2019; 33:e237-e239. [PMID: 30768811 DOI: 10.1111/jdv.15502] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- S Awasti
- Department of Dermatology, Venereology, and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - K Vinay
- Department of Dermatology, Venereology, and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - V Thakur
- Department of Dermatology, Venereology, and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - R Kumar
- Department of Zoology, Panjab University, Chandigarh, 160012, India
| | - A P Holla
- Department of Dermatology, Venereology, and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - K Sahni
- Department of Dermatology, Venereology, and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - D Parsad
- Department of Dermatology, Venereology, and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - A J Kanwar
- Department of Dermatology, Venereology, and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India
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Bains S, Thakur V, Kaur J, Singh K, Kaur R. Elucidating genes involved in sesquiterpenoid and flavonoid biosynthetic pathways in Saussurea lappa by de novo leaf transcriptome analysis. Genomics 2018; 111:1474-1482. [PMID: 30343181 DOI: 10.1016/j.ygeno.2018.09.022] [Citation(s) in RCA: 6] [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: 04/26/2018] [Revised: 09/16/2018] [Accepted: 09/30/2018] [Indexed: 12/13/2022]
Abstract
Saussurea lappa (family Asteraceae) possesses immense pharmacological potential mainly due to the presence of sesquiterpene lactones. In spite of its medicinal importance, S. lappa has been poorly explored at the molecular level. We initiated leaf transcriptome sequencing of S. lappa using the illumina highseq 2000 platform and generated 62,039,614 raw reads. Trinity assembler generated 122,434 contigs with an N50 value of 1053 bp. The assembled transcripts were compared against the non-redundant protein database at NCBI. The Blast2GO analysis assigned gene ontology (GO) terms, categorized into molecular functions (3132), biological processes (4477) and cellular components (1.927). Using KEGG, around 476 contigs were assigned to 39 pathways. For secondary metabolic pathways, we identified transcripts encoding genes involved in sesquiterpenoid and flavonoid biosynthesis. Relatively low number of transcripts were also found encoding for genes involved in the alkaloid pathway. Our data will contribute to functional genomics and metabolic engineering studies in this plant.
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Affiliation(s)
- Savita Bains
- Deparment of Biotechnology, Panjab University, BMS Block I, Sector 25, Chandigarh 160014, India
| | - Vasundhara Thakur
- Deparment of Biotechnology, Panjab University, BMS Block I, Sector 25, Chandigarh 160014, India
| | - Jagdeep Kaur
- Deparment of Biotechnology, Panjab University, BMS Block I, Sector 25, Chandigarh 160014, India
| | - Kashmir Singh
- Deparment of Biotechnology, Panjab University, BMS Block I, Sector 25, Chandigarh 160014, India
| | - Ravneet Kaur
- Deparment of Biotechnology, Panjab University, BMS Block I, Sector 25, Chandigarh 160014, India.
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Thakur Y, Thakur V, Karunaratne C, Nicholls S. Minitouch Endometrial Ablation: Review of Outcomes and Resource Usage at Basildon University Hospital. J Minim Invasive Gynecol 2017. [DOI: 10.1016/j.jmig.2017.08.396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Shroff N, Shroff R, Thakur Y, Thakur V, Penketh R, Tas B. Smartphone Speculum: Design, Development and Initial Experience. J Minim Invasive Gynecol 2017. [DOI: 10.1016/j.jmig.2017.08.118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Ghani M, Chapiro J, Letzen B, Thakur V, Lin M, Papademetris X, Schernthaner R, Huber S, Geschwind J. Identifying enhancement-based staging markers on baseline MR imaging in patients with colorectal cancer liver metastases undergoing loco-regional tumor therapy. J Vasc Interv Radiol 2017. [DOI: 10.1016/j.jvir.2016.12.621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Abstract
Purpose of Review: Gossypibomas remain a dreaded and unwanted complication of surgical practice. Despite significant interest and numerous guidelines, the number of reported cases remains sparse due to various factors, including potential legal implications. Herein, we review related data from India to ascertain if the problem is better or worse than that reported in world literature. Materials and Methods: A literature search was performed on PubMed and Google Scholar, to collect and analyze all case reports and case reviews regarding the condition in India. Results: On analysis of the results, there were 100 publications reporting a total of 126 events. The average patient age was 38.65 years. Average time to discovery was 1225.62 days. Forty-nine percent of reported cases were discovered within the 1st year. The most common clinical features were pain (73.8%), palpable mass (47.6%), vomiting (35%), abdominal distention (26%), and fever (12.6%). Spontaneous expulsion of the gossypiboma was noted in five cases (3.96%). Transmural migration was seen in 36 cases (28.57%). Conclusions: Despite advancements in surgical approaches and preventive measures, gossypibomas continue to be a cause of significant morbidity. A safe working culture, open communication, teamwork, and an accurate sponge count remain our best defence against this often unpredictable complication of surgery.
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Affiliation(s)
- T Patial
- Department of General Surgery, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India
| | - V Thakur
- Department of General Surgery, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India
| | - N Vijhay Ganesun
- Department of General Surgery, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India
| | - M Sharma
- Department of Forensic Medicine, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India
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Thakur Y, Thakur V, Nicholls S. Outpatient Endometrial Ablation (Minitouch) – A Procedure with Minimal Resource Requirements. J Minim Invasive Gynecol 2016. [DOI: 10.1016/j.jmig.2016.08.283] [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: 11/24/2022]
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Le Port A, Roycroft E, Thakur V, Lavery S. Characterisation of eleven new polymorphic microsatellite markers for the coastal stingray Dasyatis brevicaudata (Dasyatidae Hutton 1875), and cross-amplification in seven dasyatid species. BIOCHEM SYST ECOL 2016. [DOI: 10.1016/j.bse.2016.02.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Simard D, Thakur V. Sci-Fri PM: Dosimetry - 03: Delta4 diode absolute dose response for large and small target volume IMRT QA. Med Phys 2014. [DOI: 10.1118/1.4894958] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Thakur V, Talwar M, Singh PP. Low free to total PSA ratio is not a good discriminator of chronic prostatitis and prostate cancer: An Indian experience. Indian J Cancer 2014; 51:335-337. [PMID: 25494133 DOI: 10.4103/0019-509x.146790] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Aims: To find out the utility of free to total PSA ratio in discriminating chronic prostatitis and prostate cancer. Setting and design: The patients visited urology clinics at Batra Hospital and Medical Research Center, New Delhi. Background: The use of serum free to total PSA as a diagnostic tool for prostate cancer has led to early detection of prostate cancer; however, the effect of inflammation on f/t PSA ratio restricts its use in early detection of cancer. Materials and Methods: The study was conducted in age related 101 patients which include 27 carcinoma patients (group I), 34 BPH patients (group II) and 40 chronic prostatitis patients (group III). Serum total PSA (tPSA) and free PSA (fPSA) were analyzed on Elecsys 2010. These were compared with histological reports of biopsy specimen. Other biochemistry tests were done on Randox Imola. P Value was calculated using one way ANOVA with posthoc Bonferroni analysis. Results: Serum total PSA levels were comparable in group I and III and were higher than group II (P < 0.049). Serum fPSA in group I was not significantly different from group II and III, However, group II has higher levels than group III (P < 0.035). Difference was significant for f/t PSA ratio in group I and II (P < 0.00) and group II and III (P < 0.000).Group I and III were with comparable levels (P < 0.807). Conclusions: f/t PSA ratio is not a good discriminator for malignancy and chronic prostatitis. This limitation of f/t PSA ratio must be taken into consideration while interpreting the results clinically.
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Affiliation(s)
- V Thakur
- Department of Laboratory Medicine, Clinical Biochemistry Lab, New Delhi, India
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Thakur V, Ruo R, Seuntjens J, Parker W, Doucet R, Soisson E. SU-E-T-429: Delivery Accuracy of Stereotactic Radiosurgery with Tomotherapy Using Treatment Planning System Version V4.0 and the Recent Upgrade V4.2. Med Phys 2013. [DOI: 10.1118/1.4814863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Thakur V, Soisson E, Ruo R, Doucet R, Seuntjens J. Delivery Accuracy of Stereotactic Radiosurgery (SRS) With Tomotherapy as Compared to Linear Accelerator and Robotic-based Radiosurgery. Int J Radiat Oncol Biol Phys 2012. [DOI: 10.1016/j.ijrobp.2012.07.2218] [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]
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Thakur V, Rankin K, Hartling L, Mackie A. 049 A Systematic Review Examining the Pharmacologic Management of Aortic Root Dilation in Marfan Syndrome. Can J Cardiol 2012. [DOI: 10.1016/j.cjca.2012.07.061] [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: 10/27/2022] Open
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Marti D, Graveline M, Thakur V, Ruo R, Soisson E, Patrocinio H. 2051 POSTER Feasibility of Frameless Cranial Radiosurgery With Infrared Markers Fixed to an Immobilization Mask That is Monitored Under X-ray and Infrared Image Guidance System. Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)71009-7] [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: 10/17/2022]
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Graveline M, Marti D, Thakur V, Ruo R, Soisson E, Patrocinio H, Roberge D. 2061 POSTER Clinical Evaluation of 6 Degree-of-freedom X-ray Image-guidance Fusion Algorithm and Robotic Positioning System for Frameless Cranial Radiosurgery. Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)71019-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: 10/17/2022]
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Thakur V, Ruo R, Doucet R, Soisson E, Seuntjens J, Parker W. SU-E-T-885: A Planning Comparison of Dynamic Conformal Arc (DCA), Static Non- Coplanar Intensity Modulated Radiotherapy (NCP-IMRT), Volumetric Modulated Arc Therapy (RapidArc), Robotic Radiosurgery (Cyberknife), and Helical Tomotherapy (HI-ART TomoTherapy. Med Phys 2011. [DOI: 10.1118/1.3612849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Mohapatra DP, Thakur V, Brar SK. Antibacterial efficacy of raw and processed honey. Biotechnol Res Int 2010; 2011:917505. [PMID: 21350671 PMCID: PMC3042689 DOI: 10.4061/2011/917505] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/15/2010] [Revised: 11/11/2010] [Accepted: 12/18/2010] [Indexed: 01/22/2023]
Abstract
In vitro antibacterial activity of methanol, ethanol, and ethyl acetate extracts of raw and processed honey was tested against Gram-positive bacteria (Staphylococcus aureus, Bacillus subtilis, Bacillus cereus, Enterococcus faecalis, and Micrococcus luteus) and Gram-negative bacteria (Escherichia coli, Pseudomonas aeruginosa, and Salmonella typhi). Both types of honey showed antibacterial activity against tested organisms with the zone of inhibition (ZOI) ranging from 6.94 to 37.94 mm, while E. coli, S. typhi, and P. aeruginosa showed that sensibility towards all the extracts with ZOI ranges between 13.09 to 37.94 mm. The methanol extract showed more potent activity than other organic extracts. Gram-negative bacteria were found to be more susceptible as compared to Gram-positive bacteria except E. faecalis. The broth microdilution assay gave minimum inhibitory concentrations (MIC) value of 625 μg/mL, while the minimum bactericidal concentration (MBC) ranges between 625 μg/mL 2500 μg/mL. The study showed that honey has antibacterial activity (bacteriostatic and bactericidal effect), similar to antibiotics, against test organisms and provides alternative therapy against certain bacteria.
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Affiliation(s)
- D P Mohapatra
- INRS-ETE, Université du Québec, Québec, QC, Canada G1K 9A9
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Mathur JS, Mehra KS, Thakur V, Nema HV. Evaluation of various vasoconstrictors in cataract surgery. Acta Ophthalmol 2009; 47:411-4. [PMID: 5820157 DOI: 10.1111/j.1755-3768.1969.tb02898.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Odejinmi FO, Rizzuto MI, Macrae RE, Thakur V. Changing trends in the laparoscopic management of ectopic pregnancy in a London district general hospital: 7-years experience. J OBSTET GYNAECOL 2008; 28:614-7. [PMID: 19003657 DOI: 10.1080/01443610802355544] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
We set out to evaluate the effect of a programme introduced in January 2003 to make operative laparoscopy the standard surgical treatment for women requiring surgery for ectopic pregnancy. This was a retrospective and prospective clinical data analysis performed at The Whipps Cross University Hospital in London, with a comparison of data taken before and after the introduction of the programme. A total of 116 women who had surgical management for ectopic pregnancy from January 2000 to December 2002 and 313 women who had surgery for ectopic pregnancy between January 2003 and December 2006 took part in the study. A programme was started in January 2003 to make operative laparoscopy the surgical management of choice. The main outcome measure was the proportion of women requiring surgery who had operative laparoscopy in the two study periods. The chi(2)-test was used to determine if there was any statistically significant difference between proportions. A difference was deemed statistically significant if p < 0.05. The results showed that there was a progressive rise in the proportion of ectopic pregnancies managed by operative laparoscopy following the change in January 2003. A total of 34% of women were managed laparoscopically between 2000 and 2002, increasing to 90% between 2003 and 2006. This difference was statistically significant (p < 0.001). In 2006, some 96% of women requiring surgery were managed by laparoscopic surgery. The findings of this study indicate that it is possible to implement changes which increase and sustain a high rate of laparoscopic surgery for women with ectopic pregnancy requiring surgery in a district general hospital setting.
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Affiliation(s)
- F O Odejinmi
- Department of Obstetrics and Gynaecology, Whipps Cross University Hospital, London, UK.
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Thakur V, Kumar R, Gupta PN. Utility of C-2 (Cyclosporine) monitoring in postrenal transplant patients: A study in the Indian population. Indian J Nephrol 2008; 18:118-21. [PMID: 20142917 PMCID: PMC2813134 DOI: 10.4103/0971-4065.43691] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
The study was planned and conducted to assess the benefit of C-2 levels (blood cyclosporine levels two hours postdosing) monitoring over trough (C0) levels (predosing) in postrenal transplant patients. The patient population included 34 postrenal transplant individuals (28 males and six females, mean age of 39.9 ± 12.3 years). The patients were first-transplant patients and were receiving a microemulsion form of cyclosporine A (CsA) as an immunosuppressant along with azathioprine and prednisolone. In addition, they were not on any enzyme inducer/inhibitor drugs, except for diltiazem. Timed collection of C0 and C-2 samples was done and the samples were immediately processed using the cedia cyclosporine plus assay kit. Estimation was done on a Beckman synchron CX5CE fully automated chemistry analyzer. Serum urea nitrogen and creatinine levels were checked. Poor graft survival was found in this population with 29.3% patients showing graft rejection. The graft rejection patients were assigned to two groups: group I with chronic graft rejection patients (17.6%) and group II with acute graft rejection patients (11.7%). Group III consisted of graft survival patients (70.7%). Mean ± SD was calculated for C0 and C2 levels. Individual values for C0 and C-2 were plotted on a scatter chart. C0 and C-2 levels were normalized by calculating them as the percentage of their targets (data not shown) and compared using the Kruskal Wallis one-way analysis of variance. C0 levels in all the three groups were within the recommended therapeutic range (150–300 ng/mL) (P < 0.182). Blood C-2 concentrations did not achieve the recommended target levels in these patients. One-way analysis of variance for C-2 values when expressed as the percentage of the target values did not show any significant difference between these groups (P < 0.84). No significant difference was found in C0 levels between groups I, II, and group III patients when expressed as the percentage of the target values (P < 0.182). The mean serum urea nitrogen level was 26.4 ± 8.1 mg/dL whereas the mean serum creatinine level was 1.79 ± 0.8 mg/dL. As is evident in the present study, the target C2 levels of cyclosporine dosage were not achieved whereas the C0 levels in all the three groups were within the optimum therapeutic range. As the incidence of graft dysfunction was also proportionately high, the importance of C2 monitoring is further highlighted on the basis of this study The contributory factors for levels lower than the target levels, such as the use of low doses of cyclosporine and interacting drugs should be carefully monitored in clinical practice. The achievement of optimum levels of C-2 may help in reducing the higher incidence of graft rejection in these patients. This practice is of equal importance in reducing cyclosporine-related renal toxicity, a rather irreversible process.
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Rizzuto M, Thakur V, Macrae R. 241: Laparoscopic Management of Ectopic Pregnancy in the Presence of a Significant Haemoperitoneum. J Minim Invasive Gynecol 2007. [DOI: 10.1016/j.jmig.2007.08.183] [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: 11/24/2022]
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Mukherjee U, Thakur V, Katiyar D, Goyal HK, Pendharkar D. Uterine choriocarcinoma in a postmenopausal woman. Med Oncol 2006; 23:301-3. [PMID: 16720931 DOI: 10.1385/mo:23:2:301] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2005] [Revised: 11/30/1999] [Accepted: 08/19/2005] [Indexed: 11/11/2022]
Abstract
Uterine choriocarcinoma developing in patients beyond reproductive age is a rare occurrence. We report a case of choriocarcinoma of uterine corpus in a 54-yr-old woman after 7 yr of menopause and 25 yr after last child birth. She presented with pain in the abdomen, and on radiological investigation a left uterine adnexal mass of 3.4 x 2.8 cm size was detected. Her serum CA125 level was 40 mIU/mL (normal up to 35 mIU/mL). Hysterectomy revealed an intramural growth in left uterine cornu measuring 3.5 x 3.0 x 2.5 cm. Histological features of the tumor were consistent with choriocarcinoma, and immunohistochemistry detected strong reactivity for beta-hCG in the tumor cells. Serum beta-hCG level 4 wk after surgery was 1345 mIU/mL. The patient was put on combination chemotherapy (EMACO). She achieved serological remission but showed a rise in serum beta-hCG level 4 wk after completion of chemotherapy. We conclude that a high level of suspicion may help in preoperative diagnosis of uterine choriocarcinoma in the postmenopausal age group. However, the response to chemotherapy in these cases may not be as encouraging as in choriocarcinoma of reproductive age.
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Affiliation(s)
- U Mukherjee
- Pathology Division, Batra Hospital and Medical Research Centre, New Delhi 110062, India.
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Thakur V, Gilbert HL, Akinfenwa O. A case report of prenatal diagnosis of PentaX syndrome in association with isolated borderline ventriculomegaly. J OBSTET GYNAECOL 2005; 25:208-9. [PMID: 15889456 DOI: 10.1080/01443610500051775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
We report of case of pentaX syndrome that was diagnosed prenatally. PentaX aneuploidy is very rare with only 25 cases reported so far. This is the third case of prenatal diagnosis of pentaX syndrome in 2nd trimester. This patients underwent an amniocentesis for ventriculomegaly which confirmed the diagnosis.
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Affiliation(s)
- V Thakur
- The Fetal Medicine Unit, Homerton University Hospital, London E9 6S, UK
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Thakur V, Sarin SK, Rehman S, Guptan RC, Kazim SN, Kumar S. Role of HBV genotype in predicting response to lamivudine therapy in patients with chronic hepatitis B. Indian J Gastroenterol 2005; 24:12-5. [PMID: 15778519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Predictors of response of chronic hepatitis B (CHB) to lamivudine therapy need better definition. Whether hepatitis B virus (HBV) genotypes could serve as such a predictor has not been well studied. AIM To study the association of HBV genotypes with the outcome of lamivudine treatment in patients with CHB. METHODS Seventy-six patients with CHB (45 HBeAg +ve) received lamivudine 100 mg/day, orally for 12 mo. Infecting HBV genotypes were determined in pre-treatment specimens using restriction fragment length polymorphism. End-of-treatment response (ETR) and sustained viral response (SVR) were defined as undetectable HBV DNA (< 0.5 pg/mL) at 12 and 18 months, respectively. RESULTS ETR was observed in 26 (34%) and SVR in 11 (14%) patients receiving lamivudine. The pre-treatment characteristics of the responders and non-responders were comparable. Genotypes A and D were observed in 28 (37%) and 48 (63%) patients, respectively. The frequency of genotypes A and D was comparable between responders (28.6% vs. 37.5%) and non-responders (71.4% vs. 62.5%), respectively (p=ns). Of the 26 responders, SVR could be evaluated in 20 subjects; 9 (45%) relapsed and 11 achieved SVR. Patients with genotype D achieved higher SVR rate than genotype A (10 of 48, 28.8% vs. 1 of 28, 3.5% p =0.0359). CONCLUSIONS Forty-five percent of Indian patients with CHB who achieve ETR relapse, and SVR to lamivudine therapy is achieved in 14%. Patients with genotype D achieve higher SVR rate than with genotype A.
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Affiliation(s)
- V Thakur
- Department of Gastroenterology, G B Pant Hospital, New Delhi-110 002, India
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Cataldo V, Thakur V. 212 MUSCLE PARALYSIS IN A PATIENT WITH TYPE 1 RTA. J Investig Med 2005. [DOI: 10.2310/6650.2005.00006.211] [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: 11/18/2022]
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Elmore K, Thakur V. 211 INDADEQUACY OF CUFFED VENOUS CATHETERS IN HEMODIALYSIS SUBJECTS:. J Investig Med 2005. [DOI: 10.2310/6650.2005.00006.210] [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: 11/18/2022]
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Thakur V, Singh PP, Talwar M, Mukherjee U. Utility of free/total prostate specific antigen (f/t PSA) ratio in diagnosis of prostate carcinoma. Dis Markers 2004; 19:287-92. [PMID: 15258330 PMCID: PMC3851065 DOI: 10.1155/2004/913870] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The discovery that PSA exists in serum in both free and complexed forms led to development of immunoassays specific for different PSA forms. This helped in measuring free PSA in the presence of PSA-ACT (PSA-alpha antichymotrypsin), hence it was possible to calculate the percent free PSA or free to total PSA ratio, measurement of which was helpful in reducing the number of unnecessary biopsies significantly, while maintaining a high clinical sensitivity for detection of cancer. The study was performed on 103 consecutive male patients (mean age 68 +/- 10.8 years SD) comprising of 90 patients with benign disease (87%) and 13 prostate carcinoma patients (13%), who had histologically proven prostate cancer. Patients with total PSA between 2-25 ng/ml were included in the study. 30 normal healthy males with age 58 +/- 10 years, served as control. Serum total PSA and free PSA were analyzed using streptavidin biotin EIA method (M/s Roche Diagnostics, Germany). The mean total PSA in normal healthy control subjects was 1.86 +/- 1.07 ng/ml. It was increased significantly in diseased condition. Its mean concentration in carcinoma patients was 12.6 +/- 5.3 ng/ml and in benign patients it was 6.3 +/- 4.6 ng/ml. The free to total PSA ratio in all the three groups was significantly different (p < 0.004) from each other. In carcinoma patients, mean f/t PSA ratio was 0.12 +/- 0.06 as compared to 0.21 +/- 0.11 and 0.28 +/- 0.17 in benign patients and in control respectively. The sensitivity and specificity of the test was calculated at different f/t PSA ratio cutoff. At 0.1 cutoff value, sensitivity of the test was 54% and specificity was 83%. The positive predictive value (ppv) was 32% and negative predictive value (npv) was 92%. From cutoff value of 0.12 to 0.16, sensitivity was increased from 54% to 85% but specificity was reduced from 78% to 67%. The ppv did not show much change and npv was increased from 92% to 97%. Increasing the cut off value thereafter showed no change in sensitivity but specificity was further reduced to 40%, therefore in this patient series, f/t PSA ratio cutoff of 0.16 was found to be the appropriate cutoff value. Combination of this ratio cutoff with other parameters like serum total PSA, DRE and TRUS helped in increasing the sensitivity of the test and this also helped in reducing the number of unnecessary biopsies. In 103 men who were biopsied, 13 (12.6%) prostatic carcinoma were identified. Among these 13 cancer patients, 9 patients had abnormal findings in DRE.7 individuals out of these 9, also had free to total PSA ratio lower than 0.16 and would have been biopsied and diagnosed anyway. If we use only f/t PSA ratio less than 0.16, to decide whom to biopsy, we would have biopsied and diagnosed 11/13 cases i.e. sensitivity of 85% but If we decide to biopsy those patients who had abnormal DRE and those who had low f/t PSA ratio, we could identify 13/13 carcinoma i.e. 100% sensitivity. Combining the f/t PSA ratio with total PSA, DRE and TRUS findings could help in reducing the number of unnecessary biopsies. 37 patients who were negative for malignancy having total PSA in the range of 5-20 ng/ml, normal DRE and TRUS findings, have been biopsied but with combination of total PSA in the range of 5-20 ng/ml, normal findings in digital rectal examination and TRUS and f/t PSA ratio more than 0.16 (cutoff), we could have avoided 16 biopsies which were unnecessary that means there was 43% reduction in unnecessary biopsies.
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Affiliation(s)
- V Thakur
- Biochemistry Division, Department Of Laboratory Medicine, Batra Hospital & Medical Research Centre, New Delhi, India, 110 062.
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Thakur V, Guptan RC, Hashmi AZ, Sakhuja P, Malhotra V, Sarin SK. Absence of hemochromatosis associated Cys282Tyr HFE gene mutation and low frequency of hemochromatosis phenotype in nonalcoholic chronic liver disease patients in India. J Gastroenterol Hepatol 2004; 19:86-90. [PMID: 14675248 DOI: 10.1111/j.1440-1746.2004.03262.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND AND AIM Hereditary hemochromatosis (HHC) is an autosomal recessive disorder causing primary iron overload syndrome and chronic liver disease (CLD). This genetic disease is commonly associated with C282Y mutation of the HFE gene, commonly seen in the Northern European population. Minor reports on HHC are available from Asia, however, so far no genetic study is available from India. We prospectively studied the prevalence of C282Y mutation in CLD patients and healthy subjects in a tertiary care referral center in India. METHODS A total of 249 consecutive biopsy proven CLD (HBV = 112, HCV = 72, cryptogenic = 65) patients and 134 age matched healthy controls were included. Cases of secondary iron overload, pregnancy, chronic alcoholism, age < 30 years and hepatocellular carcinoma (HCC) were excluded. A transferrin saturation index (TSI) of >60% was suggestive of a phenotypic presentation of HHC. C282Y mutation was studied by restriction fragment length polymorphism (RFLP) using genomic DNA. The 387 bp fragment obtained after polymerase chain reaction was digested with 10 units of endonuclease Rsa1. The mutation was detected by creation of an additional restriction site, giving rise to fragments of 247 111 and 29 bp. RESULTS While the mean TSI was comparable, serum ferritin was significantly higher in CLD patients compared to controls (38 +/- 16%vs 28 +/- 13%; p = not significant (NS), and 125 +/- 18 vs 42 +/- 25 ng/mL; p < 0.001). A TSI of >60% was detected in 24 (9.64%) patients. Only one restriction site was found for endonuclease Rsa1, giving rise to two fragments of 247 and 140 bp, suggesting absence of C282Y mutation in the HFE gene in all patients. CONCLUSIONS Almost 10% of nonalcoholic CLD patients in India have iron overload, but this is independent of C282Y mutation of the HFE gene. Large population based studies are recommended to investigate the prevalence of this rare disorder in India.
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Affiliation(s)
- V Thakur
- Department of Gastroenterology, G.B. Pant Hospital, New Delhi, India
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Harrington K, Fayyad A, Thakur V, Aquilina J. The value of uterine artery Doppler in the prediction of uteroplacental complications in multiparous women. Ultrasound Obstet Gynecol 2004; 23:50-55. [PMID: 14971000 DOI: 10.1002/uog.932] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
OBJECTIVE To investigate the value of second-trimester uterine artery Doppler in the prediction of complications resulting from uteroplacental insufficiency in low- and high-risk multiparous women. METHODS Color flow pulsed Doppler imaging of both uterine arteries at 20 weeks' gestation was performed on 628 multiparous women; 458 of them had no known risk factors and 170 had clinically identifiable high-risk factors at booking. An abnormal result was defined as bilateral notches and a mean resistance index (RI) >/= 0.55 (50th centile) or unilateral notches and a mean RI >/= 0.65 (80th centile). The main outcome measure was adverse pregnancy outcome defined as any case of pre-eclampsia, small-for-gestational age birth weight (< 5th centile), placental abruption, stillbirth or early neonatal death. RESULTS There was an adverse outcome in 30 women (6.6%) in the low-risk group and 48 (28.2%) women in the high-risk group. In the high-risk group the sensitivity to predict adverse pregnancy outcome in screen-positive women was 81.4% for a specificity of 89.0%, a positive predictive value of 71.4% and a negative predictive value of 93.4%. Normal Doppler studies in the high-risk group conferred a risk of adverse perinatal outcome of 6.6%, similar to the risk of adverse outcome in the low-risk population (6.6%). In the low-risk group the sensitivity for an adverse outcome in screen-positive women was 33.3% for a specificity of 92.8% and a positive predictive value of 24.4%. CONCLUSION In high-risk multiparous women, persistent bilateral notches with mean RI >/= 0.55 and unilateral notches with mean RI >/= 0.65 at 20 weeks' gestation identifies the vast majority of women who will subsequently develop complications secondary to uteroplacental insufficiency. Normal uterine artery Doppler studies in these women confers a risk of adverse outcome similar to that of women with an uncomplicated obstetric history. In low-risk women, the screening efficacy of uterine artery Doppler for adverse perinatal outcome is poor and does not justify routine screening.
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Affiliation(s)
- K Harrington
- The Homerton Hospital NHS Trust, Queen Mary and Westfield College, London, UK.
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Thakur V, Guptan RC, Geeret M, Das BC, Sarin SK. Low Prevalence of Hepatitis C Virus Genotype -1b in Chronic Liver Disease Patients in India. EJIFCC 2003; 14:133-140. [PMID: 30275814 PMCID: PMC6156967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND The Hepatitis C Virus (HCV) genome shows significant heterogeneity due to a high rate of mutatio; this has a potential bearing on the outcome of interferon therapy. Genotype-1b is known to be less responsive to interferon. We studied the spectrum of HCV genotypes in chronic liver disease (CLD) patients in India. MATERIAL AND METHODS HCV RNA was extracted from the serum of 44 randomly selected cases of HCV-related CLD, proven by liver biopsy, (mean age of patients 40±15 yr., cirrhotic: 32%) and RT PCR was carried out. The amplicon of 240 bp (second nested PCR) was hybridized to the probes (type specific) coated on to a nitrocellulose membrane. Following this, streptavidin, labeled with alkaline phosphatase, was added to bind with biotinylated hybrid, which with chromogen type-specific band formation resulted. Patients were classified on the occurrence of one (Group I), two (Group II) or multiple genotypes (Group III). RESULTS Genotypes 1 and 3 were the commonest genotypes, followed by type 2 and the rare genotype 4b in a lone patient. Genotype 1 was seen in 39% (1a 23%, and 1b 16%) while genotype 3 in 45% (3a 23% and 3b 7%) patients. Eighty percent (35 of 44) patients had the single genotype (Group I, mean age 46 ± 8 yr.), 14% had two genotypes (Group II, mean age 36 ± 16 yr.) and the remaining (Group III, mean age 22 ± 9 yr.) had multiple genotypes. Serum ALT levels in these three groups of patients were 117 ± 92, 85 ± 45 and 49 ± 7 IU/L respectively. CONCLUSIONS Genotypes 1 and 3 are common in India, with subtype 1b not so common,A unique genotype 4 b was detected in one patient,Indian patients have the possibility of good antiviral response to interferon therapy in chronic HCV infection.
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Affiliation(s)
| | | | | | - BC Das
- ** ICPO, Maulana Azad Medical College New Delhi, India
| | - SK Sarin
- (For Correspondence and reprint requests: - Dr. S. K. Sarin, Professor and Head, Department of Gastroenterology, G. B. Pant Hospital, New Delhi, India Phone:91-11-23232013; FAX:91-11-26468691
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Thakur V, Guptan RC, Arankale V, Sarin SK. Low Specificity of the Third Generation Elisa for HCV Detection in Voluntary Blood Donors in India. EJIFCC 2003; 14:27-30. [PMID: 30323724 PMCID: PMC6178774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE Third generation anti-HCV ELISA is currently recommended for the diagnosis of HCV infection. We determined its specificity in voluntary blood donors (VBDs) and patients with chronic liver disease (CLD) in relation to confirmatory line immunoassay (LIA) and reverse transcription polymerase chain reaction (RT-PCR). MATERIAL AND METHODS 1926 serum samples of VBDs and 16 HCV related CLD patients were screened by ELISA. An optical density/cut-off ratio (OCR) of >1 was taken as positive for anti-HCV antibodies. Samples were confirmed by LIA and HCV-RNA detection by RT-PCR. Interpretation of LIA was done as: indeterminate, reactive or non-reactive. Every 50th VBD sample, negative for anti-HCV by LIA was subjected to LIA and RT-PCR to rule out false negativity of ELISA. RESULTS Anti-HCV was positive in 34 (1.76%) VBDs and all the CLD patients. Only one (2.9%) VBD was reactive by LIA and 6 (17.6%) were HCV-RNA positive. Serum samples from VBDs with OCR >3 were significantly more often (p<0.05) PCR positive than those with an OCR of >3. In the CLD patients, specimens even with OCR between 1-3 were reactive by PCR. All ELISA negative samples were non-reactive by LIA and PCR. CONCLUSIONS (i) There is a high false positivity of the third generation ELISA for the diagnosis of HCV infection in VBDs, (ii) Higher OCR should be used for improving the specificity of ELISA in VBDs, (iii) VBDs with an OCR of >3 should be subjected to HCV-RNA determination.
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Affiliation(s)
- V Thakur
- Department of Gastroenterology, G.B. Pant Hospital, New Delhi, India
| | - RC Guptan
- Department of Gastroenterology, G.B. Pant Hospital, New Delhi, India
| | - V Arankale
- National Institute of Virology,Pune*, India*
| | - SK Sarin
- Department of Gastroenterology, G.B. Pant Hospital, New Delhi, India
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Zhang R, Thakur V, Morse S, Reisin E. Renal and cardiovascular considerations for the nonpharmacological and pharmacological therapies of obesity-hypertension. J Hum Hypertens 2002; 16:819-27. [PMID: 12522462 DOI: 10.1038/sj.jhh.1001496] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Obesity-associated hypertension is a common disease that involves a complex pathogenesis. Failure to control hypertension (HTN) in obese subjects provides a great threat to their renal and cardiovascular functions. The treatment of obesity-associated HTN is often difficult, and requires nonpharmacological and/or pharmacological approaches. Weight reduction is the cornerstone of the therapies of obesity-HTN, as it reverses the multiple components of its pathogenesis. When weight loss cannot be sustained or fails, pharmacological means should then be used. Angiotensin-converting enzyme inhibitors (ACEI) are the drug of choice: they can reduce blood pressure, protect the kidney and heart, and improve the metabolic abnormalities in obese subjects. Angiotensin-2 type-1 receptor blockers have a renoprotective benefit similar to ACEI, and they provide an important alternative to the use of ACEI. Diuretics are very effective in African-American obese hypertensives, but small doses should be used to avoid adverse effects on metabolic profiles. Long-acting calcium channel blockers are also effective and have the advantage of no adverse metabolic effects. Nondihydropyridine calcium channel blockers may provide additional renal and cardiovascular protective effects. The beta-adrenergic receptor blockers can cause further weight gain and metabolic abnormalities in obese subjects; therefore, careful monitoring is needed. There are few clinical data that support the efficacy and benefit of centrally acting alpha-2 agonists and alpha-adrenergic receptor antagonists in the treatment of obesity-HTN.
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Affiliation(s)
- R Zhang
- Louisiana State University Health Science Center, New Orleans, LA 70112-2822, USA
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Saigal S, Kapoor D, Tandon N, Thakur V, Guptan RC, Agarwal SR, Sarin SK. High seroprevalence and clinical significance of hepatitis B and C infection in hospitalized patients with alcoholic cirrhosis. J Assoc Physicians India 2002; 50:1002-6. [PMID: 12421019] [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: 02/27/2023]
Abstract
OBJECTIVES Patients with alcoholic cirrhosis (AC) are frequently infected with hepatotropic viruses which could alter the clinical spectrum of the disease. We studied the seroprevalence of hepatitis B (HBV) and hepatitis C virus (HCV) and their impact on the clinical profile of patients with AC. METHODS Two hundred and ten hospitalized patients of AC were studied and screened for markers of HBV and HCV infection. Clinical, biochemical and virological correlation was done. RESULTS One hundred and forty (66.6%) patients had no viral infection Group I, 50 (23.8%) were positive for HBsAg Group II and 20 (9.5%) for anti-HCV Group III. All patients were males with comparable ages (43.9 years, 44 years and 45.9 years respectively). The amount of alcohol consumed by patients in Group III (130 +/- 115 g/d) was significantly less than Group II (204 +/- 130 g/d, P < 0.05) and Group I (281 +/- 188 g/d, p < 0.001). The duration of alcohol abuse was shorter in Group II and III, although not statistically significant. Presentation as jaundice was common in Group II and III (p < 0.05). The AST and ALT values (IU/L) were significantly higher in Group II (239 +/- 351, 197 +/- 266) and III (157 +/- 170, 86 +/- 52) than Group I (89 +/- 78, 66 +/- 54) (P < 0.05). The serum alkaline phosphatase (IU/L) was higher in Group III (349 +/- 223) as compared to Group II (263 +/- 186) and Group I (162 +/- 62) (P < 0.05). There was however, no difference in Child's grade or the discriminant function between the three groups of patients. CONCLUSIONS (i) One-third of the hospitalized patients with AC are infected with HBV or HCV infection, (ii) these infections hasten clinical presentation of patients with alcoholic liver disease, with lesser amount of alcohol consumption and (iii) jaundice, raised ALT/AST and alkaline phosphatase are more common with superadded viral infection.
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Affiliation(s)
- S Saigal
- Department of Gastroenterology, GB Pant Hospital, New Delhi, India
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Abstract
A 48-yr-old female presented with a 1-yr history of pain in the hypochondrium and epigastrium. All routine investigations and computed tomography (CT) of the abdomen were done. CT findings revealed a well-defined cystic mass in the right ovary, and ascitis with features suggestive of secondaries over the omentum and peritoneal surface. The serum CA125 was 1255 U/mL (normal range 0-35 U/mL), which was indicative of ovarian malignancy. An exploratory laparotomy was performed. Histopathological examination of organs revealed the presence of granuloma. The patient was advised to undergo antitubercular treatment (ATT) and follow-up every month. After 1 mo of ATT, the CA125 level came down to 42 U/mL, which was near normal. As tuberculosis requires only a conservative management, we suggest that in cases of abdominopelvic mass with or without ascitis, high serum CA125 should always raise a suspicion of tuberculosis and a laparoscopy combined with peritoneal biopsy should be performed to confirm the diagnosis. This will prevent unnecessary laparotomies. Moreover, serum CA125 can be used to monitor the response of disease to antitubercular treatment.
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Affiliation(s)
- V Thakur
- Department of Laboratory Medicine, Batra Hospital and Medical Research Centre, New Delhi, India.
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Abstract
A 48-yr-old female presented with a 1-yr history of pain in the hypochondrium and epigastrium. All routine investigations and computed tomography (CT) of the abdomen were done. CT findings revealed a well-defined cystic mass in the right ovary, and ascitis with features suggestive of secondaries over the omentum and peritoneal surface. The serum CA125 was 1255 U/mL (normal range 0-35 U/mL), which was indicative of ovarian malignancy. An exploratory laparotomy was performed. Histopathological examination of organs revealed the presence of granuloma. The patient was advised to undergo antitubercular treatment (ATT) and follow-up every month. After 1 mo of ATT, the CA125 level came down to 42 U/mL, which was near normal. As tuberculosis requires only a conservative management, we suggest that in cases of abdominopelvic mass with or without ascitis, high serum CA125 should always raise a suspicion of tuberculosis and a laparoscopy combined with peritoneal biopsy should be performed to confirm the diagnosis. This will prevent unnecessary laparotomies. Moreover, serum CA125 can be used to monitor the response of disease to antitubercular treatment.
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Affiliation(s)
- V Thakur
- Department of Laboratory Medicine, Batra Hospital and Medical Research Centre, New Delhi, India.
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