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Preoperative vaginal cleansing with chlorhexidine and cetrimide solution for reduction of postoperative infectious morbidity at a tertiary care center in North India: A prospective cohort study. Int J Gynaecol Obstet 2024; 164:708-713. [PMID: 37551118 DOI: 10.1002/ijgo.15041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 07/02/2023] [Accepted: 07/25/2023] [Indexed: 08/09/2023]
Abstract
OBJECTIVE To determine the effect of preoperative vaginal cleansing with chlorhexidine and cetrimide solution on postoperative infectious morbidity. METHODS This prospective cohort study was conducted over a period of 18 months in the Department of Obstetrics and Gynecology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India. Women undergoing cesarean section were alternately allotted to study and control groups. Women with chorioamnionitis, antepartum hemorrhage, rupture of membranes for more than 24 h, and fever in the preoperative period were excluded. The study group received preoperative vaginal cleansing with antiseptic solution (7.5% chlorhexidine w/v and 15% cetrimide w/v); the control group did not receive vaginal cleansing. Both groups were followed for the presence of any infectious morbidity until they were discharged from the hospital. RESULTS Age, body mass index (calculated as weight in kilograms divided by the square of height in meters), gestational age, and the parity of the women in the study and control groups were comparable (n = 760). The rate of endometritis was lower in the study group, but the difference was not statistically significant (P = 0.054). Post-cesarean febrile morbidity and wound sepsis were significantly lower in the study group (P = 0.017 and P = 0.02, respectively). On subgroup analysis, women in the study group with rupture of the membranes before cesarean delivery had lower wound sepsis and a reduced duration of hospital stay. Women in the study group with emergency cesarean delivery showed a significant reduction in wound sepsis, febrile morbidity, and length of hospital stay. CONCLUSION Preoperative vaginal cleansing with chlorhexidine and cetrimide solution before a cesarean section reduces postoperative infectious morbidity.
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Task-based and Magnified Mirror Therapy for Unilateral Spatial Neglect among post-stroke subjects: Study protocol for a randomized controlled trial. PLoS One 2024; 19:e0296276. [PMID: 38265989 PMCID: PMC10807845 DOI: 10.1371/journal.pone.0296276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Accepted: 12/01/2023] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND Unilateral spatial neglect (USN) is a commonly occurring neurocognitive disability after a stroke. The neglect may affect the motor recovery of the upper and lower limbs and functional performances. Mirror therapy, a simple and economical approach has the potential to reduce the USN and related impairments. AIM The primary objective of this study is to determine the effectiveness of task-based and magnified mirror therapy on the USN and on the motor recovery of the post-stroke subjects. The secondary objective is to investigate the effectiveness of the intervention on the function and disability of the subjects. METHODS In this randomized controlled, assessor-blinded trial, 86 post-stroke subjects will be recruited from the neuro-rehabilitation laboratory of a rehabilitation institute, located in northern India. The participants,aged20 to 80 years, with 1 to 36 months of stroke onset, hemiparesis, and the USN, will be considered eligible for the study. In addition to the conventional rehabilitation, the experimental group(n = 43) will receive 40 sessions (8 weeks) of Task-based and MAGnified Mirror Therapy for Unilateral Spatial Neglect (T-MAGUSN). The control group (n = 43) will undergo a dose-matched conventional program only. The participants will be assessed at baseline, post-intervention and 4-week follow-up using primary (Line Bisection Test, Letter Cancellation Test, and Fugl-Myer Assessment) and secondary (Catherine Bergego Scale, Berg Balance Scale, Functional Ambulation Classification, Modified Rankin Scale) outcome measures. DISCUSSION This proposed study will lead to the development of a novel rehabilitation protocol for the management of USN, aiming to enhance motor and functional recovery. The investigation will consider both the upper and lower limbs for the intervention, reducing the impact of cognitive disability in stroke. TRIAL REGISTRATION Clinical Trial Registry of India (CTRI) as CTRI/2023/05/053184 (www.ctri.nic.in/Clinicaltrials/pmaindet2.php?trialid=74659).
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Prediction of complications of pre-eclampsia using the fullPIERS high risk predictive model. Int J Gynaecol Obstet 2023; 163:983-988. [PMID: 37328916 DOI: 10.1002/ijgo.14920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Revised: 05/14/2023] [Accepted: 05/23/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVE To determine the predicted probability percentage of complications in women with pre-eclampsia using the Pre-eclampsia Integrated Estimate of Risk (fullPIERS) model within the first 24 h after admission and assess the model's predictive value for complications of pre-eclampsia. METHODS This was a prospective cohort study in which the fullPIERS model was applied to 256 pregnant women with pre-eclampsia within the first 24 h after admission. These women were then followed for 48 h to 7 days for maternal and fetal complications. Reciever operating characteristics (ROC) curves were generated to assess the performance of the fullPIERS model for adverse outcomes of pre-eclampsia. RESULTS Of the 256 women enrolled in the study, 101 women (39.5%) developed maternal complications, 120 women (46.9%) developed fetal complications, and 159 women (62.1%) developed both. With an area under the ROC curve of 0.843 (95% confidence interval 0.789-0.897), the fullPIERS model had good discriminating ability to predict complications at any time point between 48 h and 7 days after admission. The sensitivity and specificity of the model at a ≥5.9% cut-off value for predicting adverse maternal outcomes were 60% and 97%, respectively; they were 44% and 96%, respectively, for predicting combined fetomaternal complications with a cut-off value of 4.9%. CONCLUSIONS The fullPIERS model performs reasonably well in predicting adverse maternal and fetal outcomes in women with pre-eclampsia.
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Carle's obstetric early warning score as a screening tool for critical care admission. Indian J Med Res 2023; 158:339-346. [PMID: 37988032 DOI: 10.4103/ijmr.ijmr_2478_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Indexed: 11/22/2023] Open
Abstract
BACKGROUND OBJECTIVES Early warning systems (EWS) involve serial observations (track) with criteria (trigger) to timely identify patients at risk of complications. Carle designed a statistically based clinically modified obstetric early warning score (Carle's OEWS). This study evaluated Carle's OEWS and its individual components for predicting admission to the obstetric critical care unit (OCCU). Maternal near-miss and maternal mortality were the secondary outcomes. METHODS A prospective observational study was conducted among 1250 pregnant women with a period of gestation ≥28 week admitted in the labour wards of a tertiary centre over 18 months. The physiological parameters of OEWS were recorded and aggregate score was calculated at admission and at regular intervals thereafter, till discharge or OCCU admission. RESULTS The area under receiver operating characteristic (ROC) curve of OEWS was 0.975 for predicting OCCU admission, 0.971 for near-miss, and 0.996 for predicting maternal mortality and was significant for all outcomes. All individual parameters, except diastolic blood pressure, had a significant relative risk for predicting OCCU requirement. INTERPRETATION CONCLUSIONS Carle's OEWS is a useful screening tool for predicting obstetric OCCU admission and can be routinely used in labour wards to ensure timely intervention.
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Assessing the costs of ozone pollution in India for wheat producers, consumers, and government food welfare policies. Proc Natl Acad Sci U S A 2023; 120:e2207081120. [PMID: 37523550 PMCID: PMC10410720 DOI: 10.1073/pnas.2207081120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 06/17/2023] [Indexed: 08/02/2023] Open
Abstract
We assess wheat yield losses occurring due to ozone pollution in India and its economic burden on producers, consumers, and the government. Applying an ozone flux-based risk assessment, we show that ambient ozone levels caused a mean 14.18% reduction in wheat yields during 2008 to 2012. Furthermore, irrigated wheat was particularly sensitive to ozone-induced yield losses, indicating that ozone pollution could undermine climate-change adaptation efforts through irrigation expansion. Applying an economic model, we examine the effects of a counterfactual, "pollution-free" scenario on yield losses, wheat prices, consumer and producer welfare, and government costs. We explore three policy scenarios in which the government support farmers at observed levels of either procurement prices (fixed-price), procurement quantities (fixed-procurement), or procurement expenditure (fixed-expenditure). In pollution-free conditions, the fixed-price scenario absorbs the fall in prices, thus increasing producer welfare by USD 2.7 billion, but total welfare decreases by USD 0.24 billion as government costs increase (USD 2.9 billion). In the fixed-procurement and fixed-expenditure scenarios, ozone mitigation allows wheat prices to fall by 38.19 to 42.96%. The producers lose by USD 5.10 to 6.01 billion, but the gains to consumers and governments (USD 8.7 to 10.2 billion) outweigh these losses. These findings show that the government and consumers primarily bear the costs of ozone pollution. For pollution mitigation to optimally benefit wheat production and maximize social welfare, new approaches to support producers other than fixed-price grain procurement may be required. We also emphasize the need to consider air pollution in programs to improve agricultural resilience to climate change.
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Nano Zinc-Enabled Strategies in Crops for Combatting Zinc Malnutrition in Human Health. FRONT BIOSCI-LANDMRK 2023; 28:158. [PMID: 37664935 DOI: 10.31083/j.fbl2808158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 06/23/2023] [Accepted: 07/03/2023] [Indexed: 09/05/2023]
Abstract
Deficits in the mineral Zn are responsible for a sizable proportion of the world's disease burden and child mortality. With the increasing success rate of biofortification in major crops, the development of a genotype with enhanced Zn bioavailability will be an efficient and sustainable solution to nutrient deficiency-related problems. Due to the complex chemistry of the human system, the absorption of Zn from cereals is lower. This complexity is alleviated by phytate, a major phosphorus-storing compound in cereal and legume seeds, which negatively affects Zn binding. The results of recent studies on the distribution of elements and micronutrient speciation in seeds provide strong evidence for the presence of distinct Zn pools. This observation is supported by data from biofortified transgenic plant research. Several studies identify nicotinamide, a metal chelator, as a pivotal molecule. The loading of Zn into grains has been reported to increase with nicotinamide levels, which is a crucial finding. Intestinal Zn absorption can be greatly improved by nicotinamide. Furthermore, bioavailability tests suggest that the use of nano Zn-enabled devices could be an effective strategy to enable plant biofortification, which may significantly boost the Zn content in various cereal crops. This review comprehensively evaluated the scientific publications indexed in WoS, Scopus, and various other reliable databases and explored insights into how nano-enabled technology could be a solution for enhancing Zn content in cereal crops for combating malnutrition in humans.
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Intrauterine instillation of autologous platelet-rich plasma in infertile females with thin endometrium undergoing intrauterine insemination: an open-label randomized controlled trial. AJOG GLOBAL REPORTS 2023; 3:100172. [PMID: 36960130 PMCID: PMC10027558 DOI: 10.1016/j.xagr.2023.100172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023] Open
Abstract
BACKGROUND Thin endometrium in infertile female patients has always been a clinical challenge for the treating reproductive physicians. OBJECTIVE This study aimed to evaluate the effect of intrauterine instillation of autologous platelet-rich plasma on endometrial thickness and vascularity in infertile female patients with thin endometrium undergoing ovarian stimulation with intrauterine insemination. STUDY DESIGN This prospective randomized control study included 120 women undergoing ovarian stimulation with intrauterine insemination, aged between 21 and 37 years, with persistent thin endometrium (<7 mm) on ≥1 cycle in previous ovarian stimulation cycles, even after conventional treatment with estradiol valerate. The women were randomly assigned to study group A and control group B. Baseline endometrial thickness and endometrial vascularity were noted. Intrauterine instillation of autologous platelet-rich plasma was done on the day of trigger in group A, whereas estradiol valerate was given in group B. Another evaluation of endometrial parameters was done on the day of intrauterine insemination. The cycle was repeated for 3 cycles or until the pregnancy was achieved, whichever occurred earlier. Parameters were noted for both groups. Primary outcomes were the change in endometrial thickness and endometrial vascularity. Secondary outcomes were positive pregnancy rate and clinical pregnancy rate. RESULTS In group A, mean pre-platelet-rich plasma endometrial thickness was 4.66±0.79 mm, which significantly increased to 7.47±0.85 mm after platelet-rich plasma instillation (P<.05) after 3 cycles. This increase was significantly greater than that observed in group B. There was significant increase in endometrial vascularity in group A compared with group B (P<.05). The positive pregnancy rate and clinical pregnancy rate in group A were 23.73% and 18.64%, respectively, and significantly higher than those in group B. CONCLUSION Autologous platelet-rich plasma is a promising, easily procurable, and novel option for management of infertile females with thin endometrium not responding to conventional treatment. Using it in intrauterine insemination cycles can reduce costs and psychological burden of this subgroup of women by reducing the need for resorting to advanced options such as in vitro fertilization and surrogacy.
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P10.12.A CDK12/CDK13 inhibition disrupts a transcriptional program critical for glioblastoma survival. Neuro Oncol 2022. [DOI: 10.1093/neuonc/noac174.177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Glioblastoma multiforme (GBM) is the most prevalent and aggressive malignant tumor of the central nervous system. With a median survival of only one year, GBM patients have a particularly poor prognosis, highlighting a clear need for novel therapeutic strategies to target this disease. Transcriptional cyclin-dependent kinases (CDK), which phosphorylate key residues of RNA polymerase II (RNAPII) C-terminal domain (CTD), play a major role in sustaining aberrant transcriptional programs that are key to development and maintenance of cancer cells.
Material and Methods
We used pharmacological inhibition and genetic ablation to study effects of CDK12/CDK13 depletion on the proliferatory and migratory capacity of GBM cells and mouse xenografts. SLAM-seq, CUT&RUN and cell cycle assays were used to study the mechanistic effects of CDK12/CDK13 depletion in GBM cells.
Results
CDK12/CDK13 depletion markedly reduced the proliferatory and migratory capacity of GBM cells, as well as in vivo growth. CDK12/CDK13 inhibition potentiated existing chemotherapeutic treatments. Mechanistically, inhibition of CDK12/CDK13 leads to a genome-wide abrogation of RNAPII CTD phosphorylation, which in turn disrupts transcription and cell cycle progression in GBM cells.
Conclusion
These results provide proof-of-concept for the potential of CDK12 and CDK13 as therapeutic targets for GBM.
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Role of Placenta Accreta Index for Diagnosis of Placenta Accreta Spectrum in High-Risk Patients. J Obstet Gynaecol India 2022; 72:55-60. [PMID: 35928094 PMCID: PMC9343486 DOI: 10.1007/s13224-021-01541-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 08/02/2021] [Indexed: 10/20/2022] Open
Abstract
Background Antenatal diagnosis of placenta accreta spectrum (PAS) can ensure multidisciplinary management at center of excellence which can reduce maternal and fetal complications. This can be established by a scoring system which provides a standardized criterion for the diagnosis and management. The objective of our study was to assess the placenta accreta index (PAI) and its individual parameters for diagnosis of PAS in high-risk patients. Methods A prospective study was conducted on 71 pregnant women with placenta previa and previous cesarean section. After informed consent, history was taken and ultrasonography was used to calculate the PAI for each patient. Definitive diagnosis was made clinically during cesarean section or by histopathology for those requiring hysterectomy. The data were evaluated using the latest version of Statistical Package for the Social Sciences software. Results All ultrasound parameters of placenta accreta index were statistically significant for predicting PAS (p value < 0.001). ROC curve with AUC of 0.87 95% CI of 0.77-0.94 showed that a score of 4.75 was the best cutoff value to diagnose PAS. Out of the 30 patients found to have placental invasion, 22 had a PAI score of more than 4.75. The score was found to have a sensitivity of 73.3%, specificity 95.1%, positive predictive value 91.7%, negative predictive value 83% and diagnostic accuracy 85.9%. Conclusions Women with placenta previa and history of previous CS should undergo screening by PAI, and a cutoff value of ≥ 4.75 should be viewed with high index of suspicion for the presence of PAS.
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Comparative Evaluation of Solubility of Gutta-Percha in Three Different Solvents: A Cone-Beam Computed Tomography (CBCT) Study. Cureus 2022; 14:e26788. [PMID: 35971348 PMCID: PMC9371471 DOI: 10.7759/cureus.26788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/12/2022] [Indexed: 11/06/2022] Open
Abstract
Background Gutta-percha is the most frequently used filling material for root canal obturation. This thermoplastic material fulfills the primary requisites for root canal filling, one of which is easily removable material in cases of endodontic retreatment. The most commonly used solvents were chloroform, xylene, and orange oil due to their effectiveness in dissolving and removing maximum gutta-percha in a minimum time. Aims The aim is to evaluate and compare the solubility of gutta-percha in three different organic solvents, i.e., orange oil, xylene, and chloroform. Methods and material Forty extracted mandibular second premolars with a single canal were selected. The sample was categorized into control, orange oil, xylene, and chloroform. Access cavity preparations with cleaning and shaping were performed by k files and rotary files, followed by obturation. Two drops of assigned solvent were placed on the orifices of the obturated canal, and corona-gutta-percha ha was removed by gates glidden drills. Cone-beam computed tomography (CBCT) images were taken before and after the gutta-percha removal, and the solvents' efficacy was assessed. Statistical analysis The statistical test applied for the analysis was one-way analysis of variance (ANOVA). The confidence interval and p-value were set for this test at 95% and < 0.05, respectively. Results Gutta-percha Removal was found to be maximum with orange oil (Group II) followed by xylene (Group III) >Chloroform (Group IV) >Control Group. The Statistical Analysis by ANOVA revealed a significant difference between the four groups with a p-value of less than 0.05. Furthermore, the pair-wise comparison revealed that the amount of gutta-percha removal with orange oil significantly differs from xylene and chloroform, with a significance level of less than 0.021,001. However, there was no difference observed between control and chloroform. Conclusions Within the limitations of this in vitro study, it can be concluded that the maximum amount of gutta-percha removal was found in the orange oil group. The amount of gutta-percha removal with orange oil significantly differs from xylene and chloroform, with a significance level of less than 0.02,001. Hence there was no difference observed between Control and Chloroform groups.
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Hiccups and Acute Symptomatic Hyponatremia: A Rare Manifestation of COVID-19. Cureus 2022; 14:e24090. [PMID: 35573499 PMCID: PMC9106551 DOI: 10.7759/cureus.24090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/12/2022] [Indexed: 11/05/2022] Open
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DeepComp: A Hybrid Framework for Data Compression Using Attention Coupled Autoencoder. ARABIAN JOURNAL FOR SCIENCE AND ENGINEERING 2022. [DOI: 10.1007/s13369-022-06587-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Can the nation-wide COVID-19 lockdown help India identify region-specific strategies for air pollution? SPATIAL INFORMATION RESEARCH 2022; 30:233-247. [PMCID: PMC8683321 DOI: 10.1007/s41324-021-00426-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 11/26/2021] [Accepted: 12/04/2021] [Indexed: 02/26/2024]
Abstract
Air pollution is a serious concern with the developing economics in India and gets more severe when it has major cities ranked among the top 30 polluted cities worldwide. To find a solution, different programs and/or policies have been launched for air quality management country-wide. Unfortunately, no such plan could effectively solve the purpose rather than an unexpected COVID-19 pandemic situation in India. Our study focused on the air pollution status and air quality index (AQI) in 42 cities (that includes 6 metros) representing North, South, East, West, Central, and North-East region of India during the pre-lockdown, four lockdowns and unlock phases. The results depict most of the pollutants except ozone (O3) were significantly reduced in the lockdown-1, and marginally increased in subsequent lockdown phases. Regarding the average AQI, its value was highest in North Indian cities (227), followed by East India (172), Central India (141), North-East India (130), West India (124), and South India (83) during the pre-lockdown. Due to COVID-19 induced lockdown, North Indian cities observed the highest dip in average AQI (108), followed by Central India (113), East India (82), West India (73), South India (55), and North-East India (49) in the lockdown and unlock phases. Thus, the study gave a conspicuous vision on mitigation of air pollution under this pandemic; and, if strategic centralized policies are sensibly implemented and by involving the participation of people of India, then there is a feasibility of air pollution issue management.
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Publisher Correction to: Development of the Asia Pacific Consortium on Osteoporosis (APCO) framework: clinical standards of care for the screening, diagnosis, and management of osteoporosis in the Asia-Pacific region. Osteoporos Int 2021; 32:1277-1278. [PMID: 34043033 PMCID: PMC8192350 DOI: 10.1007/s00198-021-05953-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Development of the Asia Pacific Consortium on Osteoporosis (APCO) Framework: clinical standards of care for the screening, diagnosis, and management of osteoporosis in the Asia-Pacific region. Osteoporos Int 2021; 32:1249-1275. [PMID: 33502559 PMCID: PMC8192320 DOI: 10.1007/s00198-020-05742-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 11/11/2020] [Indexed: 01/07/2023]
Abstract
UNLABELLED Guidelines for doctors managing osteoporosis in the Asia-Pacific region vary widely. We compared 18 guidelines for similarities and differences in five key areas. We then used a structured consensus process to develop clinical standards of care for the diagnosis and management of osteoporosis and for improving the quality of care. PURPOSE Minimum clinical standards for assessment and management of osteoporosis are needed in the Asia-Pacific (AP) region to inform clinical practice guidelines (CPGs) and to improve osteoporosis care. We present the framework of these clinical standards and describe its development. METHODS We conducted a structured comparative analysis of existing CPGs in the AP region using a "5IQ" model (identification, investigation, information, intervention, integration, and quality). One-hundred data elements were extracted from each guideline. We then employed a four-round Delphi consensus process to structure the framework, identify key components of guidance, and develop clinical care standards. RESULTS Eighteen guidelines were included. The 5IQ analysis demonstrated marked heterogeneity, notably in guidance on risk factors, the use of biochemical markers, self-care information for patients, indications for osteoporosis treatment, use of fracture risk assessment tools, and protocols for monitoring treatment. There was minimal guidance on long-term management plans or on strategies and systems for clinical quality improvement. Twenty-nine APCO members participated in the Delphi process, resulting in consensus on 16 clinical standards, with levels of attainment defined for those on identification and investigation of fragility fractures, vertebral fracture assessment, and inclusion of quality metrics in guidelines. CONCLUSION The 5IQ analysis confirmed previous anecdotal observations of marked heterogeneity of osteoporosis clinical guidelines in the AP region. The Framework provides practical, clear, and feasible recommendations for osteoporosis care and can be adapted for use in other such vastly diverse regions. Implementation of the standards is expected to significantly lessen the global burden of osteoporosis.
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High Time for Routine Implementation of the Robson Ten-Group Classification for Cesarean Sections Reporting in India!!! J Obstet Gynaecol India 2021; 71:101-102. [PMID: 33814810 PMCID: PMC7960845 DOI: 10.1007/s13224-020-01382-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 10/06/2020] [Indexed: 10/23/2022] Open
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Robotic total intersphincteric resection with total mesorectal excision in low rectal cancer - a video vignette. Colorectal Dis 2020; 22:2344-2345. [PMID: 32767841 DOI: 10.1111/codi.15297] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Accepted: 07/29/2020] [Indexed: 01/19/2023]
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Novel use of the Bakri balloon to minimize empty pelvis syndrome following laparoscopic total pelvic exenteration. Colorectal Dis 2020; 22:2322-2325. [PMID: 32810348 DOI: 10.1111/codi.15319] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 08/11/2020] [Indexed: 12/21/2022]
Abstract
AIM Pelvic exenteration is the only surgical option for locally advanced pelvic malignancies infiltrating the surrounding organs. The resultant pelvic void after the procedure is responsible for a number of complications, collectively termed empty pelvis syndrome (EPS). We aim to show how EPS can be minimized by presenting a case series demonstrating the surgical technique of laparoscopic total pelvic exenteration with bilateral pelvic node dissection along with a novel use of the Bakri balloon. METHOD This is a case series of three successive patients undergoing laparoscopic total pelvic exenteration for locally advanced primary, nonmetastatic rectal adenocarcinoma over a period of 1 month in a specialized colorectal unit at a tertiary cancer centre. The Bakri balloon was deployed in all three patients and retained for variable time intervals postoperatively. Features of EPS were prospectively documented. RESULTS In the first patient, the Bakri balloon was completely deflated and removed on postoperative day (POD) 5. The patient developed subacute intestinal obstruction which resolved with conservative management by POD 12. In the second and third patients, the Bakri balloon was deflated in a sequential manner, beginning on POD 8, until it was finally removed on POD 11. Neither of these patients had any abdominal complaints. A postoperative CT scan of both these patients showed the small bowel loops clearly above the pelvic inlet. CONCLUSIONS The Bakri balloon is a simple, safe and cost-effective method to reduce the complications of EPS following laparoscopic total pelvic exenteration. A prospective study is ongoing to objectively quantify the benefits of this technique.
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Laparoscopic low anterior resection with extended total mesorectal excision for locally advanced rectal cancer - a video vignette. Colorectal Dis 2020; 22:1763-1764. [PMID: 32441883 DOI: 10.1111/codi.15146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Accepted: 05/12/2020] [Indexed: 12/14/2022]
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Laparoscopic complete mesocolic excision of left colonic lesion - a video vignette. Colorectal Dis 2020; 22:1801-1802. [PMID: 32619087 DOI: 10.1111/codi.15228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 06/10/2020] [Indexed: 02/08/2023]
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Abdominoperineal excision with prostatectomy in T4 rectal cancer - bladder-sparing robotic pelvic exenteration - a video vignette. Colorectal Dis 2020; 22:1786-1787. [PMID: 32548955 DOI: 10.1111/codi.15200] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Accepted: 05/30/2020] [Indexed: 02/08/2023]
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Neoadjuvant chemoradiation versus upfront surgery for locally advanced rectosigmoid cancers -an ongoing debate. Colorectal Dis 2020; 22:1756-1757. [PMID: 32343478 DOI: 10.1111/codi.15088] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 04/10/2020] [Indexed: 12/24/2022]
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Laparoscopic supralevator posterior exenteration in a case of previous laparoscopic ovarian transposition - a video vignette. Colorectal Dis 2020; 22:1470-1471. [PMID: 32374507 DOI: 10.1111/codi.15109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 04/19/2020] [Indexed: 02/08/2023]
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Mammographic and ultrasonographic concordance in pathologically proven phyllodes tumors: A retrospective study. Breast J 2020; 26:1087-1089. [DOI: 10.1111/tbj.13654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 09/24/2019] [Accepted: 09/24/2019] [Indexed: 11/28/2022]
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Breast calcinosis in a patient with dermatomyositis. Breast J 2020; 26:1047-1049. [DOI: 10.1111/tbj.13679] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 10/13/2019] [Accepted: 10/15/2019] [Indexed: 12/01/2022]
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Concordance between birads and pathologic findings in breast lesions: A retrospective study. Breast J 2020; 26:578-580. [DOI: 10.1111/tbj.13614] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 07/10/2019] [Accepted: 07/10/2019] [Indexed: 12/24/2022]
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Abstract
Rescue cervical cerclage can effectively prolong a nonviable gestation to viability, if done correctly in chosen patients after appropriate counseling. Here, we present a case study of an antenatal woman with advanced cervical changes at 24 weeks who benefited from the rescue cervical cerclage procedure to have a successful pregnancy outcome.
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Cytological yield in detecting malignant cells in axillary lymph nodes showing abnormal morphology on imaging–Our experience in a tertiary center in North India. Breast J 2020; 26:1434-1435. [DOI: 10.1111/tbj.13768] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 01/14/2020] [Accepted: 01/15/2020] [Indexed: 11/28/2022]
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Abstract
Introduction Obstetric early warning score (OEWS) has been used conventionally for early identification of deteriorating obstetric patients in the labor room and ward settings. This study was conducted to determine if this simple clinical score could be used for prognosticating a critically ill patient in the ICU setting instead of sequential organ failure assessment score (SOFA) and acute physiology and chronic health evaluation (APACHE II) score. Materials and Methods A cohort study was conducted at Obstetrics Critical Care Unit, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi. A total of 250 obstetric patients were recruited after informed consent. The OEWS, SOFA, and APACHE II scores were calculated within 24 hours of admission. The patients were followed to study the maternal outcome. Results The area under receiver operator characteristic (AUROC) curve of OEWS, SOFA, and APACHE II for prediction of maternal mortality was 0.894 (95% CI, 0.849–0.929), 0.924 (95% CI, 0.884–0.954), and 0.93 (95% CI, 0.891–0.958), respectively. The standardized mortality ratio (SMR) for OEWS, SOFA, and APACHE II was 66.3, 62.5, and 69.15%, respectively. Conclusion Obstetric early warning score is as effective as the conventional SOFA and APACHE II to prognosticate the obstetric patient. Since OEWS is based only on clinical criteria, it can be done immediately on admission and can help in early allocation of appropriate manpower and resources for optimum outcome. Clinical significance The clinical application of this study will help intensivists to prognosticate the critically ill obstetric patients immediately following admission to the critical care unit. How to cite this article Khergade M, Suri J, Bharti R, Pandey D, Bachani S, Mittal P. Obstetric Early Warning Score for Prognostication of Critically Ill Obstetric Patient. Indian J Crit Care Med 2020;24(6):398–403.
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Acute Primary Tuberculous Ulcer of Glans Penis. Kathmandu Univ Med J (KUMJ) 2019; 17:344-346. [PMID: 33311047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Acute primary tuberculous ulcer of glans penis is a rare entity even in the endemic region. We present a 55 year old male with multiple undermined ulcers for short duration of 4 weeks with raised erythrocyte sedimentation rate, negative Mantoux test and histopathology revealed a diagnosis of tuberculous ulcer which responded well to antitubercular therapy.
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P11.36 Ribosome hydroxylase Mina53 is required for Glioblastoma and is involved in regulation of translation rateand fidelity by regulating ribosomal biogenesis. Neuro Oncol 2019. [DOI: 10.1093/neuonc/noz126.182] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Glioblastoma multiforme (GBM) is one of the most aggressive types of tumors with a poor response to standard treatment and a median 5-year survival of less than 5%. Therefore, there is an urgent need for new treatments. Recently, a large number of genome-wide studies have shown that the epigenetic modifiers are frequently deregulated in cancer. Using a mouse GBM model, we performed in vitro and in vivo shRNA screens to identify epigenetic regulators required for the tumorigenic process in GBM. Among these regulators is a ribosome hydroxylase Mina53 which hydroxylates His-39 of ribosomal protein, RPL27a. We have found that the knock-down (KD) of Mina53 reduces the in vitro proliferation and colony forming ability of mouse glioma initiating cells (mGIC) and this is dependent on the catalytic activity of Mina. Knock-down of Mina resulted into a small but significant reduction in the global protein synthesis rate. A tandem affinity purification experiment to identify proteins associated with Mina revealed that it is associated mainly with ribosomal proteins, including its substrate RPL27a. Global proteomic analyses revealed that final amounts and de novo protein synthesis of many ribosomal proteins were reduced upon Mina depletion. Isolation and identification of different polysome fraction bound mRNAs using high-throughput sequencing found that mRNAs encoding many ribosomal proteins have lower number of ribosomes loaded on them in the Mina depleted samples compared to the control. Taken together, this study has found that Mina53 is required for glioblastoma and it regulates translation through regulation of ribosomal biogenesis
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New Insights into Leaf Physiological Responses to Ozone for Use in Crop Modelling. PLANTS (BASEL, SWITZERLAND) 2019; 8:E84. [PMID: 30939811 PMCID: PMC6524376 DOI: 10.3390/plants8040084] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 03/20/2019] [Accepted: 03/23/2019] [Indexed: 01/03/2023]
Abstract
Estimating food production under future air pollution and climate conditions in scenario analysis depends on accurately modelling ozone (O₃) effects on yield. This study tests several assumptions that form part of published approaches for modelling O₃ effects on photosynthesis and leaf duration against experimental data. In 2015 and 2016, two wheat cultivars were exposed in eight hemispherical glasshouses to O₃ ranging from 22 to 57 ppb (24 h mean), with profiles ranging from raised background to high peak treatments. The stomatal O₃ flux (Phytotoxic Ozone Dose, POD) to leaves was simulated using a multiplicative stomatal conductance model. Leaf senescence occurred earlier as average POD increased according to a linear relationship, and the two cultivars showed very different senescence responses. Negative effects of O₃ on photosynthesis were only observed alongside O₃-induced leaf senescence, suggesting that O₃ does not impair photosynthesis in un-senesced flag leaves at the realistic O₃ concentrations applied here. Accelerated senescence is therefore likely to be the dominant O₃ effect influencing yield in most agricultural environments. POD was better than 24 h mean concentration and AOT40 (accumulated O₃ exceeding 40 ppb, daylight hours) at predicting physiological response to O₃, and flux also accounted for the difference in exposure resulting from peak and high background treatments.
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Comparison of placenta accreta spectrum disorders diagnosed in intrapartum and antepartum period- A three year experience in a tertiary referral unit of India. Eur J Obstet Gynecol Reprod Biol 2019; 236:41-45. [PMID: 30878896 DOI: 10.1016/j.ejogrb.2019.03.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Revised: 03/01/2019] [Accepted: 03/02/2019] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To determine the frequency of placenta accreta spectrum (PAS) disorders and to study the demographic profile, risk factors and maternal and fetal outcomes in women with antepartum diagnosis of PAS as compared to women with diagnosis made in the intrapartum period. STUDY DESIGN Retrospective analysis over a 3-year period of all patients who delivered with PAS. The cases were divided into 2 groups. Group 1 consisted of the patients who were diagnosed during the intra partum period and Group 2 was those diagnosed as PAS by ultrasound in the antepartum period. Maternal and fetal outcomes were compared between the 2 groups. The cases that underwent conservative management were also analyzed for need of secondary hysterectomy/placental resolution RESULTS: There were 81,480 deliveries conducted during the study period of which 74 were identified as PAS. Hence PAS was seen in 1:1101 deliveries (0.09%). The estimated blood loss and number of units of blood products required were significantly higher in Group 1 (2.36 ± 0.77 l vs 1.8 ± 0.91 L, p = 0.002; and 10.17 ± 5.12 vs 6.77 ± 4.22, p = 0.005) compared to Group 2. The ICU stay was also more common in Group 1 (p = 0.01). The perinatal mortality was significantly higher in Group 1(45.71% vs 23.08%, p = 0.040). 79.7% women underwent primary cesarean hysterectomy while others were managed conservatively. In conservatively managed group, placental resolution took place in 60% and 40% required secondary hysterectomy. CONCLUSION Antenatal diagnosis of placenta accreta spectrum disorders decreases the maternal morbidity and perinatal mortality.
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Efficacy of Isotretinoin and Antihistamine versus Isotretinoin Alone in the Treatment of Moderate to Severe Acne: A Randomised Control Trial. Kathmandu Univ Med J (KUMJ) 2019; 17:14-19. [PMID: 31734672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Background Acne vulgaris has considerable impact on physical and psychological health. Isotretinoin is considered most effective drug available for acne therapy but with limited acceptance because of its adverse effects. Antihistamine inhibits inflammatory mediators, Propionibacterium acne induced itching, reduction of squalene and sebum in sebocyte, reduces anxiety and further lessens hormonal derangement and inhibits mast cell induced fibrosis and scars. Clinical relevance is lacking in the use of antihistamine in the treatment of acne and its potential efficacy needs to be clarified. Objective To evaluate the efficacy and safety of combining isotretinoin and antihistamine compare to isotretinoin alone in patients with moderate to severe acne at week 12. Method One hundred patients with moderate to severe acne were included in this randomised, controlled comparative study. Fifty patients were treated with isotretinoin and 50 patients were treated with additional antihistamine, levocetirizine and assessment was done at baseline, 4, 8 and 12 weeks of treatment. Result At week 12, compared to isotretinoin only group, combination of isotretinoin and levocetirizine group showed more statistically significant decrease in score of global acne grading system (51.0 vs. 38.5%) and acne lesion counts (non-inflammatory lesion: 63.2 vs. 44.5%; inflammatory lesions: 75.9 vs. 62.7%; total lesions: 66.07 vs. 48.7%; all p< 0.05). Flaring up of acne occurred less frequently and adverse effects were more tolerable in levocetirizine group. Conclusion Use of antihistamine with isotretinoin provides synergic effect while minimizing the side effect of isotretinoin and greater clearance of the lesion and scars.
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Strong Purcell Effect on a Neutral Atom Trapped in an Open Fiber Cavity. PHYSICAL REVIEW LETTERS 2018; 121:173603. [PMID: 30411925 DOI: 10.1103/physrevlett.121.173603] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Indexed: 06/08/2023]
Abstract
We observe a sixfold Purcell broadening of the D_{2} line of an optically trapped ^{87}Rb atom strongly coupled to a fiber cavity. Under external illumination by a near-resonant laser, up to 90% of the atom's fluorescence is emitted into the resonant cavity mode. The sub-Poissonian statistics of the cavity output and the Purcell enhancement of the atomic decay rate are confirmed by the observation of a strongly narrowed antibunching dip in the photon autocorrelation function. The photon leakage through the higher-transmission mirror of the single-sided resonator is the dominant contribution to the field decay (κ≈2π×50 MHz), thus offering a high-bandwidth, fiber-coupled channel for photonic interfaces such as quantum memories and single-photon sources.
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Abstract
Termination of pregnancy (abortion) is a reasonably safe procedure when properly performed. However, even after being performed with due precautions, complications may occur. Retention of fetal products following a mid-trimester abortion is a rare complication of abortion which can then result in secondary infertility. We are here presenting the case of a young woman who underwent an abortion in the 15th week of gestation due to anencephaly in the fetus and who then failed to conceive for the next five years. Transvaginal ultrasonographic examination suggested the presence of bone-like structures in the uterine cavity which were removed hysteroscopically. The patient was able to conceive after the hysteroscopic removal of bony fragments. Retained bony fragments from a previous mid-trimester abortion should thus be kept in the list of differentials of secondary infertility.
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Discussion on the switching between type-2 fuzzy sets and intuitionistic fuzzy sets: An application in medical diagnosis. JOURNAL OF INFORMATION & OPTIMIZATION SCIENCES 2018. [DOI: 10.1080/02522667.2017.1411014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Robust Bain distortion in the premartensite phase of a platinum-substituted Ni 2MnGa magnetic shape memory alloy. Nat Commun 2017; 8:1006. [PMID: 29044121 PMCID: PMC5647333 DOI: 10.1038/s41467-017-00883-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Accepted: 08/02/2017] [Indexed: 12/05/2022] Open
Abstract
The premartensite phase of shape memory and magnetic shape memory alloys (MSMAs) is believed to be a precursor state of the martensite phase with preserved austenite phase symmetry. The thermodynamic stability of the premartensite phase and its relation to the martensitic phase is still an unresolved issue, even though it is critical to the understanding of the functional properties of MSMAs. We present here unambiguous evidence for macroscopic symmetry breaking leading to robust Bain distortion in the premartensite phase of 10% Pt-substituted Ni2MnGa. We show that the robust Bain-distorted premartensite (T2) phase results from another premartensite (T1) phase with preserved cubic-like symmetry through an isostructural phase transition. The T2 phase finally transforms to the martensite phase with additional Bain distortion on further cooling. Our results demonstrate that the premartensite phase should not be considered as a precursor state with the preserved symmetry of the cubic austenite phase.
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PknB remains an essential and a conserved target for drug development in susceptible and MDR strains of M. Tuberculosis. Ann Clin Microbiol Antimicrob 2017; 16:56. [PMID: 28821299 PMCID: PMC5562987 DOI: 10.1186/s12941-017-0234-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Accepted: 08/10/2017] [Indexed: 11/18/2022] Open
Abstract
Background The Mycobacterium tuberculosis (M.tb) protein kinase B (PknB) which is now proved to be essential for the growth and survival of M.tb, is a transmembrane protein with a potential to be a good drug target. However it is not known if this target remains conserved in otherwise resistant isolates from clinical origin. The present study describes the conservation analysis of sequences covering the inhibitor binding domain of PknB to assess if it remains conserved in susceptible and resistant clinical strains of mycobacteria picked from three different geographical areas of India. Methods A total of 116 isolates from North, South and West India were used in the study with a variable profile of their susceptibilities towards streptomycin, isoniazid, rifampicin, ethambutol and ofloxacin. Isolates were also spoligotyped in order to find if the conservation pattern of pknB gene remain consistent or differ with different spoligotypes. The impact of variation as found in the study was analyzed using Molecular dynamics simulations. Results The sequencing results with 115/116 isolates revealed the conserved nature of pknB sequences irrespective of their susceptibility status and spoligotypes. The only variation found was in one strains wherein pnkB sequence had G to A mutation at 664 position translating into a change of amino acid, Valine to Isoleucine. After analyzing the impact of this sequence variation using Molecular dynamics simulations, it was observed that the variation is causing no significant change in protein structure or the inhibitor binding. Conclusions Hence, the study endorses that PknB is an ideal target for drug development and there is no pre-existing or induced resistance with respect to the sequences involved in inhibitor binding. Also if the mutation that we are reporting for the first time is found again in subsequent work, it should be checked with phenotypic profile before drawing the conclusion that it would affect the activity in any way. Bioinformatics analysis in our study says that it has no significant effect on the binding and hence the activity of the protein.
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IgG4-related intraocular inflammation masquerading as ciliary body melanoma in a young girl. Indian J Ophthalmol 2017; 64:601-3. [PMID: 27688285 PMCID: PMC5056551 DOI: 10.4103/0301-4738.191510] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Immunoglobulin G4 (IgG4-related diseases) affects various tissues and organs of the human body. Orbital, adnexal, and scleral inflammations were already reported in the medical literature. To the best of our knowledge, we report the first case of intraocular IgG4-associated inflammatory mass in the ciliary body mimicking as a melanoma in a 23-year-old female from Northeast India. Characteristic histopathology, immunohistochemistry in the tissue, protein chemistry, and raised serum IgG4 were supportive for the diagnosis. As this newly diagnosed disease has multi-organ affection and little is known about its pathogenesis particularly in eye and adnexa, the present case will open many challenges in clinico-pathological diagnosis and research in the future.
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Phytoremediation of metals using lemongrass (Cymbopogon citratus (D.C.) Stapf.) grown under different levels of red mud in soil amended with biowastes. INTERNATIONAL JOURNAL OF PHYTOREMEDIATION 2017; 19:555-562. [PMID: 27936866 DOI: 10.1080/15226514.2016.1267701] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Due to hostile condition of red mud (RM), its utilization for vegetation is restricted. Therefore, RM with biowastes as soil amendment may offer suitable combination to support plant growth with reduced risk of metal toxicity. To evaluate the effects of RM on soil properties, plant growth performance, and metal accumulation in lemongrass, a study was conducted using different RM concentrations (0, 5, 10, and 15% w/w) in soil amended with biowastes [cow dung manure (CD) or sewage-sludge (SS)]. Application of RM in soil with biowastes improved organic matter and nutrient contents and caused reduction in phytoavailable metal contents. Total plant biomass was increased under all treatments, maximally at 5% RM in soil with SS (91.4%) and CD (51.7%) compared to that in control (no RM and biowastes). Lemongrass acted as a potential metal-tolerant plant as its metal tolerance index is >100%. Based on translocation and bioconcentration factors, lemongrass acted as a potential phytostabilizer of Fe, Mn, and Cu in roots and was found efficient in translocation of Al, Zn, Cd, Pb, Cr, As, and Ni from roots to shoot. The study suggests that 5% RM with biowastes preferably SS may be used to enhance phytoremediation potential of lemongrass.
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Unusually High Serum Levels of CA 19-9 in an Ovarian Tumour: Malignant or Benign? J Clin Diagn Res 2017; 11:QD08-QD10. [PMID: 28511463 DOI: 10.7860/jcdr/2017/21017.9506] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Accepted: 08/20/2016] [Indexed: 11/24/2022]
Abstract
Carbohydrate antigen 19-9 (CA 19-9) is a tumour marker found to be elevated in some ovarian tumours. We share our experience with a 55-year-old postmenopausal lady with unusually high CA19-9 levels arising from a benign mucinous cystadenoma of the ovary. The levels returned to normal eight weeks following staging laparotomy and a total abdominal hysterectomy with bilateral salpingo-oopherectomy. This report shows rare and significant elevation of CA 19-9 levels with benign mucinous cystadenomas of the ovary thus showing that women with unusually elevated tumour markers may actually harbour benign disease. The tumour markers should not be used to predict the malignant status of a tumour.
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Mediastinal staging for non-small cell lung cancer revisited. It is being done under aegis of ICON and Lung cancer consortium asia. Indian J Cancer 2017; 54:68-72. [DOI: 10.4103/0019-509x.219579] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Increasing social welfare by taxing pesticide externalities in the Indian cotton sector. PEST MANAGEMENT SCIENCE 2016; 72:2303-2312. [PMID: 26990306 DOI: 10.1002/ps.4275] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Revised: 03/07/2016] [Accepted: 03/07/2016] [Indexed: 06/05/2023]
Abstract
BACKGROUND Pesticide use in the Indian cotton industry has decreased with the introduction of Bt cotton, but rates are still high in comparison with other countries. The adoption of alternative strategies, such as integrated pest management, has been slow, even though benefits are potentially high, more so if the full costs of the external effects of the technologies are taken into account. In order to estimate true societal benefits of different strategies, we compare their external costs and economic performance under external cost taxation, using a state-of-the-art partial equilibrium model of the Indian agricultural sector. RESULTS Pesticide externalities lower social welfare in the Indian cotton sector by $US 400-2200 million, depending on the technologies employed. A full internalisation reduces producer revenues by $US 100 ha-1 if only Bt cotton is used, and by $US 30 ha-1 if IPM is another option. Consumers do not start to lose surplus until 20-70% are internalised, and losses are smaller if all technologies are available. CONCLUSION External pesticide costs can be internalised partially without substantially affecting consumer surplus while still increasing social welfare, but producers need to have access to and the knowledge to employ all available cotton production technologies to minimise losses. © 2016 Society of Chemical Industry.
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Assessment of systemic inflammatory response after total extraperitoneal repair and Lichtenstein repair for inguinal hernia. Hernia 2016; 21:65-71. [PMID: 27838831 DOI: 10.1007/s10029-016-1543-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2015] [Accepted: 11/06/2016] [Indexed: 11/28/2022]
Abstract
PURPOSE The aim of the study was assessment of the systemic inflammatory response (SIR) intensity by measuring the blood serum levels of high sensitivity C-reactive protein (hsCRP), Interleukin-6 (IL-6) and Total Leukocyte Counts of patients. The estimations were done before and after the patient underwent either open Lichtenstein or endoscopic TEP inguinal hernia repair. This is a prospective observational type of study. METHODS Sixty patients with a diagnosis of unilateral uncomplicated inguinal hernia were included in the study. Patients were divided into two groups. In the first group, endoscopic total extraperitoneal repair (TEP) was done, while the other group underwent Lichtenstein repair. The patient selection was random. Serum markers for SIR were measured prior to and 24 h post-surgery. RESULTS Total extraperitoneal repair (TEP) and open Lichtenstein inguinal hernia repair both cause a significant Systemic Inflammatory Response in the body. The rise in serum markers for SIR post-surgery was statistically significant in both the groups. The rise in serum hsCRP and IL-6 concentrations was observed to be equivocal among the two groups. Statistically significant difference was observed in serum TLC rise: Lichtenstein repair group having a higher value. CONCLUSION Both, open and endoscopic surgical techniques incite a systemic inflammatory response in the body. However, it cannot be conclusively stated that TEP is associated with lesser SIR compared to the Lichtenstein repair on the basis of this study.
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Unusual Branch of External Iliac Artery. J Minim Invasive Gynecol 2016; 22:S163. [PMID: 27678913 DOI: 10.1016/j.jmig.2015.08.611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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RM-063 Neoadjuvant chemotherapy for unresectable carcinoma gall bladder: our experience. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw201.59] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Studies on bio-chemical profiling of Indian gooseberry (Emblica officinalis) for genetic diversity. JOURNAL OF ENVIRONMENTAL BIOLOGY 2016; 37:179-184. [PMID: 27097435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Biochemical profiling of physiologically mature fruits of 51 diverse Indian gooseberry (Emblica officinalis Gaertn) germplasm accessions was collected from Vindhyan hill region of Madhya Pradesh, with a view to select nutraceutically rich genotypes based on important biochemical traits. The mean ascorbic acid and total phenol (tannin) content amongst different accessions was recorded as 496.47 mg 100 g⁻¹ and 4.88% with highest value found in CISH A-12 (654.50 mg 100 g⁻¹) and CISH A-30 (7.18%), respectively. Apart from the above, wide range of variability in the composition of other important biochemical attributes viz., total soluble solids (8.60-17.70°Brix), acidity (1.61-2.94%), total sugar (4.15-9.17), reducing sugar (2.19-4.45%) and TSS/acid ratio (3.89-8.33) was also recorded. Highest significant and positive correlation was observed between total sugar and TSS (0.895) followed by reducing sugar and TSS (0.882). Significant positive correlation between ascorbic acid and tannins (0.551) was an indication to be associated with binding capacity of ascorbic acid over a longer period of storage.
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Less-Invasive or Minimally-Invasive: Does it Really Matter? J Minim Invasive Gynecol 2015; 22:S225. [DOI: 10.1016/j.jmig.2015.08.793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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