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Mohanty L, John TJ, Pawar SD, Ramanan PV, Agarkhedkar S, Haldar P. The Immunogenicity of Monovalent Oral Poliovirus Vaccine Type 1 (mOPV1) and Inactivated Poliovirus Vaccine (IPV) in the EPI Schedule of India. Vaccines (Basel) 2024; 12:424. [PMID: 38675806 PMCID: PMC11054616 DOI: 10.3390/vaccines12040424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 02/21/2024] [Accepted: 02/26/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND In 2016, the Global Polio Eradication Initiative (GPEI) recommended the cessation of using type 2 oral poliovirus vaccine (OPV) and OPV, with countries having to switch from the trivalent to bivalent OPV (bOPV) with the addition of inactivated poliovirus vaccine (IPV) in their routine immunization schedule. The current GPEI strategy 2022-2026 includes a bOPV cessation plan and a switch to IPV alone or a combination of vaccine schedules in the future. The focus of our study was to evaluate the immunogenicity of monovalent OPV type 1 (mOPV1) with IPV and IPV-only schedules. METHODS This was a three-arm, multi-center randomized-controlled trial conducted in 2016-2017 in India. Participants, at birth, were randomly assigned to the bOPV-IPV (Arm A) or mOPV1-IPV (Arm B) or IPV (Arm C) schedules. Serum specimens collected at birth and at 14, 18, and 22 weeks old were analyzed with a standard microneutralization assay for all the three poliovirus serotypes. RESULTS The results of 598 participants were analyzed. The type 1 cumulative seroconversion rates four weeks after the completion of the schedule at 18 weeks were 99.5% (97.0-99.9), 100.0% (97.9-100.0), and 96.0% (92.0-98.1) in Arms A (4bOPV + IPV), B (4mOPV1 + IPV), and C (3IPV), respectively. Type 2 and type 3 seroconversions at 18 weeks were 80.0% (73.7-85.1), 76.9% (70.3-82.4); 93.2% (88.5-96.1), 100.0% (98.0-100.0); and 81.9% (75.6-86.8), 99.4% (96.9-99.9), respectively, in the three arms. CONCLUSIONS This study shows the high efficacy of different polio vaccines for serotype 1 in all three schedules. The type 1 seroconversion rate of mOPV1 is non-inferior to bOPV. All the vaccines provide high type-specific immunogenicity. The program can adopt the use of different vaccines or schedules depending on the epidemiology from time to time.
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Affiliation(s)
| | - T. Jacob John
- Department of Clinical Virology, Christian Medical College, Vellore 632002, India;
| | | | | | - Sharad Agarkhedkar
- Department of Paediatrics, Padmashree Dr D.Y. Patil Medical College, Pune 411018, India;
| | - Pradeep Haldar
- Ministry of Health and Family Welfare, Government of India, New Delhi 110011, India;
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Mohanty L, Prabhu M, Kumar Mishra A, Purty AJ, Kanungo R, Ghosh G, Prahan Kumar R, Newton Raj A, Bhushan S, Kumar Jangir M, Gupta A, Bhakri A. Safety and immunogenicity of a single dose, live-attenuated 'tetravalent dengue vaccine' in healthy Indian adults; a randomized, double-blind, placebo controlled phase I/II trial. Vaccine X 2022; 10:100142. [PMID: 35252836 PMCID: PMC8892502 DOI: 10.1016/j.jvacx.2022.100142] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 01/08/2022] [Accepted: 01/25/2022] [Indexed: 11/24/2022] Open
Abstract
Dengue Tetravalent Vaccine, Live-attenuated Recombinant of Panacea Biotec is a lyophilized vaccine based on novel formulation. Dengue Tetravalent Vaccine targets protection against dengue disease caused by all four dengue virus serotypes. Dengue Tetravalent Vaccine Phase I/II clinical trial is the first study conducted in an Indian population and proved to be safe and immunogenic.
Background Dengue fever is the most prevalent mosquito-borne viral disease in the world, with 390 million dengue infections occurring every year. There is an unmet medical need to develop a safe, effective and affordable dengue vaccine against all four Dengue serotype viruses-DENV1, DENV-2, DENV-3 and DENV-4. Panacea Biotec Ltd (PBL) has developed a cell culture-derived, live-attenuated, lyophilized Tetravalent Dengue Vaccine (TDV). Here, in phase I/II study we assessed the safety and immunogenicity of single dose ‘Dengue Tetravalent Vaccine’ in healthy Indian adults. Methods In the study, 100 healthy adult volunteers aged 18–60 years were enrolled. The participants were allocated to TDV and placebo groups in 3:1 ratio, i.e. 75 participants to TDV group and 25 participants to the placebo group. Enrolled participants were administered a single dose of 0.5 ml of the test vaccine / placebo by subcutaneous route. Primary outcome for safety included all solicited AEs up to 21 days, unsolicited AEs up to 28 days and all AEs/serious adverse events (SAEs) till day 90 post-vaccination. For immunogenicity assessment the primary outcome was seroconversion & seropositivity rate by PRNT50 to all four serotype till 90 days. Results Overall, 100 subjects were vaccinated out of which 8 subjects (5 subjects in vaccine group and 3 subjects in placebo group) dropped out from the study. The most commonly reported solicited local AE was pain and most common solicited systemic AE was headache and fever. No SAE was reported during the study. There was no statistically significant difference between TDV and placebo groups in terms of AEs. Of the 92 subjects who completed all scheduled visits in the study, 59 (81.9%) achieved seroconversion for DENV-1, 56 (77.8%) for DENV-2; 59 (81.9%) for DENV-3 and 57 (79.2%) for DENV-4 in TDV group. The seroconversion rate in the TDV group was statistically significant (p < 0.001) compared to placebo. Clinical trial registration: CTRI/2017/02/007923.
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Key Words
- ADE, Antibody Dependent Enhancement
- Antibody dependent enhancement”
- Dengue prevalence,
- Dengue vaccine development” and
- Dengue vaccine”,
- Dengue”,
- GMT, Geometric Mean Titer
- PFU, Plaque Forming Unit
- PP, Per Protocol
- PRNT, Plaque Reduction Neutralization Test
- SAE, Serious Adverse Event
- TDV, Tetravalent Dengue Vaccine
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Affiliation(s)
- Lalitendu Mohanty
- Department of Clinical Research, Panacea Biotec Limited, G-3, B-1 Extension/ Mohan Co-operative Industrial Estate, Mathura Road, New Delhi, Delhi 110044, India
| | - Madhav Prabhu
- KLES Dr Prabhakar Kore Hospital and Medical Research Centre, Nehru Nagar, Belagavi 590010, Karnataka, India
| | - Amit Kumar Mishra
- Pondicherry Institute of Medical Sciences (PIMS-A Unit of Madras Medical Mission), Kalapet, Pondicherry 605014, India
| | - Anil J Purty
- Pondicherry Institute of Medical Sciences (PIMS-A Unit of Madras Medical Mission), Kalapet, Pondicherry 605014, India
| | - Reba Kanungo
- Pondicherry Institute of Medical Sciences (PIMS-A Unit of Madras Medical Mission), Kalapet, Pondicherry 605014, India
| | - Goutam Ghosh
- GIET University, Gunupur, Gobriguda, Po-Kharling, Rayagada, Odisha-765022, India
| | - R Prahan Kumar
- Pondicherry Institute of Medical Sciences (PIMS-A Unit of Madras Medical Mission), Kalapet, Pondicherry 605014, India
| | - A Newton Raj
- Pondicherry Institute of Medical Sciences (PIMS-A Unit of Madras Medical Mission), Kalapet, Pondicherry 605014, India
| | - Sumit Bhushan
- Department of Clinical Research, Panacea Biotec Limited, G-3, B-1 Extension/ Mohan Co-operative Industrial Estate, Mathura Road, New Delhi, Delhi 110044, India
| | - Manoj Kumar Jangir
- Department of Clinical Research, Panacea Biotec Limited, G-3, B-1 Extension/ Mohan Co-operative Industrial Estate, Mathura Road, New Delhi, Delhi 110044, India
| | - Anu Gupta
- Department of Clinical Research, Panacea Biotec Limited, G-3, B-1 Extension/ Mohan Co-operative Industrial Estate, Mathura Road, New Delhi, Delhi 110044, India
| | - Anju Bhakri
- Department of Clinical Research, Panacea Biotec Limited, G-3, B-1 Extension/ Mohan Co-operative Industrial Estate, Mathura Road, New Delhi, Delhi 110044, India
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Burgula H, Mohanty L, Mohanty A, Khujur ST, Chaitanya A, Devasi M. Study of Incidence, Clinical profile and Outcomes among patients hospitalized for COVID-19 with Acute Kidney Injury. J Assoc Physicians India 2022; 70:11-12. [PMID: 35443445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
UNLABELLED The ongoing COVID-19 pandemic has thrown newer challenges for the health care professionals to manage the affected patients. Though the so called second wave is in a declining trend at present but possible third wave is looming in the near future. Initially patients appeared to have a respiratory limited disease but there are now increasing reports of multiple organ involvement including renal disease in association with COVID-19. The current study aims to highlight the incidence of acute kidney injury (AKI) in COVID-19 patients, as well as the clinical profile and outcomes in that subset of patients in a tertiary hospital setting, in order to better understand the role renal disease plays in the disease process. MATERIAL Methods: This retrospective, observational study involved a review of data from electronic health records of patients aged more than 18 years with laboratory confirmed COVID-19 admitted to our hospital from February 27 to May 30, 2021. Data was analysed using SPSS version-21.0 by descriptive statistics. We describe the incidence of AKI, dialysis requirement, requirement of mechanical ventilation and mortality. OBSERVATION Results of 400 hospitalized patients with COVID-19, 252(63%) were male, 148(37%) were female. AKI occurred in 72 (18%) patients. The proportions with stages 1, 2, or 3 AKI were 35(48.3%), 11 (15.1%), and 26 (36.6%), respectively. 22 (32%) patients with AKI required dialysis. About 42(58.33%) patients with AKI were admitted in Intensive care Unit and 35(48%) patients with AKI required mechanical ventilation. In-hospital mortality was (25%) among patients with AKI versus (7.01%) among those without AKI (OR, 4.42; 95% confidence interval, 2.23 to 8.73). CONCLUSION Conclusions AKI is common among patients hospitalized with COVID-19 and is associated with high morbidity and mortality.
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Affiliation(s)
| | - L Mohanty
- Kalinga Institute of Medical Sciences, Bhubaneswar
| | - Ap Mohanty
- Kalinga Institute of Medical Sciences, Bhubaneswar
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Ahmad M, Verma H, Deshpande J, Kunwar A, Bavdekar A, Mahantashetti NS, Krishnamurthy B, Jain M, Mathew MA, Pawar SD, Sharma DK, Sethi R, Visalakshi J, Mohanty L, Bahl S, Haldar P, Sutter RW. Immunogenicity of Fractional Dose Inactivated Poliovirus Vaccine in India. J Pediatric Infect Dis Soc 2021; 11:60-68. [PMID: 34791350 PMCID: PMC8865014 DOI: 10.1093/jpids/piab091] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 09/17/2021] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Following the withdrawal of Sabin type 2 from trivalent oral poliovirus vaccine (tOPV) in 2016, the introduction of ≥1 dose of inactivated poliovirus vaccine (IPV) in routine immunization was recommended, either as 1 full dose (0.5mL, intramuscular) or 2 fractional doses of IPV (fIPV-0.1mL, intradermal). India opted for fIPV. We conducted a comparative assessment of IPV and fIPV. METHODS This was a 4-arm, open-label, multicenter, randomized controlled trial. Infants were enrolled and vaccines administered according to the study design, and the blood was drawn at age 6, 14, and 18 weeks for neutralization testing against all 3 poliovirus types. RESULTS Study enrolled 799 infants. The seroconversion against type 2 poliovirus with 2 fIPV doses was 85.8% (95% confidence interval [CI]: 80.1%-90.0%) when administered at age 6 and 14 weeks, 77.0% (95% CI: 70.5-82.5) when given at age 10 and 14 weeks, compared to 67.9% (95% CI: 60.4-74.6) following 1 full-dose IPV at age 14 weeks. CONCLUSION The study demonstrated the superiority of 2 fIPV doses over 1 full-dose IPV in India. Doses of fIPV given at 6 and 14 weeks were more immunogenic than those given at 10 and 14 weeks. Clinical Trial Registry of India (CTRI). Clinical trial registration number was CTRI/2017/02/007793.
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Affiliation(s)
- Mohammad Ahmad
- Office of the WHO Representative to India, New Delhi, India,Corresponding Author: Mohammad Ahmad, MBBS, MD, National Professional Officer - Research, Office of the WHO Representative to India, 537, A Wing, Nirman Bhawan, Maulana Azad Road, New Delhi 110 011, India. E-mail:
| | | | | | | | | | | | | | - Manish Jain
- Mahatma Gandhi Institute of Medical Sciences, Sewagram, Wardha, Maharashtra, India
| | | | | | - Deepa K Sharma
- ICMR-National Institute of Virology, Pune, Maharashtra, India
| | - Raman Sethi
- Office of the WHO Representative to India, New Delhi, India
| | | | | | - Sunil Bahl
- South East Asian Regional Office of World Health Organization, New Delhi, India
| | - Pradeep Haldar
- Ministry of Health and Family Welfare, Government of India, New Delhi, India
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Mohanty L, Sharma S, Behera B, Panwar S, Paliwal C, Gupta A, Chilkoti DC, Singh A. A randomized, open label trial to evaluate and compare the immunogenicity and safety of a novel liquid hexavalent DTwP-Hib/Hep B-IPV (EasySix™) to licensed combination vaccines in healthy infants. Vaccine 2018; 36:2378-2384. [DOI: 10.1016/j.vaccine.2017.09.029] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Revised: 09/07/2017] [Accepted: 09/08/2017] [Indexed: 11/26/2022]
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Mohanty L, Sharma S, Behera B, Panwar S, Paliwal C, Singh A, Gupta A, Chilkoti DC. A randomized, open-label clinical trial to evaluate immunogenicity and safety of an indigenously developed DTwP-Hib tetravalent combination vaccine (Easyfour®-TT) with Quadrovax® in Indian infants. Hum Vaccin Immunother 2017; 13:2025-2031. [PMID: 28700282 DOI: 10.1080/21645515.2017.1342020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
An open-label, randomized, multi-center trial was conducted to compare the immunogenicity and safety of an indigenously developed tetravalent DTwP-Hib vaccine, Easyfour®-TT with a commercially available vaccine, Quadrovax®. A total of 244 infants in good health, aged 6-10 weeks, were randomized in a 1:1 allocation to receive three doses of the test or comparator vaccine. Immunogenicity of the vaccines was determined by measuring the baseline and post-vaccination antibody response against the vaccine antigens; safety was evaluated in terms of local and systemic reactions (solicited and unsolicited) reported during the trial. Similar levels of seroprotection/seroresponse were achieved, 4 weeks after receiving 3 doses of Easyfour®-TT and Quadrovax®, and the antibody response of Easyfour®-TT was found non-inferior to Quadrovax®, against all four vaccine antigens. Both vaccines were well tolerated and had similar reactogenicity profiles, with a significantly lower occurrence of local (redness at injection site) and systemic reactions (irritability post-vaccination) with Easyfour®-TT vaccine as compared to Quadrovax® (p < 0.05). All adverse events resolved completely with no sequelae. All through the study, only one serious adverse event was observed that completely resolved upon treatment and was deemed unrelated to the vaccine administered. This study demonstrated that Easyfour®-TT vaccine was safe and immunogenic. CLINICAL TRIAL REGISTRATION NUMBER CTRI/2014/12/005326 (registered with the Clinical Trial Registry of India (CTRI)).
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Affiliation(s)
- Lalitendu Mohanty
- a Clinical Research Department , Panacea Biotec Ltd. , G-3, B-1 Extn/ Mohan Co-op, New Delhi , Delhi , India
| | - Sunil Sharma
- a Clinical Research Department , Panacea Biotec Ltd. , G-3, B-1 Extn/ Mohan Co-op, New Delhi , Delhi , India
| | - Beauty Behera
- a Clinical Research Department , Panacea Biotec Ltd. , G-3, B-1 Extn/ Mohan Co-op, New Delhi , Delhi , India
| | - Sachin Panwar
- a Clinical Research Department , Panacea Biotec Ltd. , G-3, B-1 Extn/ Mohan Co-op, New Delhi , Delhi , India
| | - Charu Paliwal
- a Clinical Research Department , Panacea Biotec Ltd. , G-3, B-1 Extn/ Mohan Co-op, New Delhi , Delhi , India
| | - Anit Singh
- a Clinical Research Department , Panacea Biotec Ltd. , G-3, B-1 Extn/ Mohan Co-op, New Delhi , Delhi , India
| | - Anu Gupta
- a Clinical Research Department , Panacea Biotec Ltd. , G-3, B-1 Extn/ Mohan Co-op, New Delhi , Delhi , India
| | - Deepak Chandra Chilkoti
- a Clinical Research Department , Panacea Biotec Ltd. , G-3, B-1 Extn/ Mohan Co-op, New Delhi , Delhi , India
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Sutter RW, Bahl S, Deshpande JM, Verma H, Ahmad M, Venugopal P, Rao JV, Agarkhedkar S, Lalwani SK, Kunwar A, Sethi R, Takane M, Mohanty L, Chatterjee A, John TJ, Jafari H, Aylward RB. Immunogenicity of a new routine vaccination schedule for global poliomyelitis prevention: an open-label, randomised controlled trial. Lancet 2015; 386:2413-21. [PMID: 26388534 DOI: 10.1016/s0140-6736(15)00237-8] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Polio eradication needs a new routine immunisation schedule--three or four doses of bivalent type 1 and type 3 oral poliovirus vaccine (bOPV) and one dose of inactivated poliovirus vaccine (IPV), but no immunogenicity data are available for this schedule. We aimed to assess immunogenicity of this vaccine schedule. METHODS We did an open-label, randomised controlled trial in four centres in India. After informed consent was obtained from a parent or legally acceptable representative, healthy newborn babies were randomly allocated to one of five groups: trivalent OPV (tOPV); tOPV plus IPV; bOPV; bOPV plus IPV; or bOPV plus two doses of IPV (2IPV). The key eligibility criteria were: full-term birth (≥37 weeks of gestation); birthweight ≥2·5 kg; and Apgar score of 9 or more. OPV was administered at birth, 6 weeks, 10 weeks, and 14 weeks; IPV was administered intramuscularly at 14 weeks. The primary study objective was to investigate immunogenicity of the new vaccine schedule, assessed by seroconversion against poliovirus types 1, 2, and 3 between birth and 18 weeks in the per-protocol population (all participants with valid serology results on cord blood and at 18 weeks). Neutralisation assays tested cord blood and sera collected at 14 weeks, 18 weeks, 19 weeks, and 22 weeks by investigators masked to group allocation. This trial was registered with the India Clinical Trials Registry, number CTRI/2013/06/003722. FINDINGS Of 900 newborn babies enrolled between June 13 and Aug 29, 2013, 782 (87%) completed the per-protocol requirements. Between birth and age 18 weeks, seroconversion against poliovirus type 1 in the tOPV group occurred in 162 of 163 (99·4%, 95% CI 96·6-100), in 150 (98·0%, 94·4-99·6) of 153 in the tOPV plus IPV group, in 153 (98·7%, 95·4-99·8) of 155 in the bOPV group, in 155 (99·4%, 96·5-100) of 156 in the bOPV plus IPV group, and in 154 (99·4%, 96·5-100) of 155 in the bOPV plus 2IPV group. Seroconversion against poliovirus type 2 occurred in 157 (96·3%, 92·2-98·6) of 163 in the tOPV group, 153 (100%, 97·6-100·0) of 153 in the tOPV plus IPV group, 29 (18·7%, 12·9-25·7) of 155 in the bOPV group, 107 (68·6%, 60·7-75·8) of 156 in the bOPV plus IPV group, and in 121 (78·1%, 70·7-84·3) of 155 in the bOPV plus 2IPV group. Seroconversion against poliovirus type 3 was achieved in 147 (90·2%, 84·5-94·3) of 163 in the tOPV group, 152 (99·3%, 96·4-100) of 153 in the tOPV plus IPV group, 151 (97·4%, 93·5-99·3) of 155 in the bOPV group, 155 (99·4%, 96·5-100) of 156 in the bOPV plus IPV group, and 153 (98·7%, 95·4-99·8) of 155 in the bOPV plus 2IPV group. Superiority was achieved for vaccine regimens including IPV against poliovirus type 3 compared with those not including IPV (tOPV plus IPV vs tOPV alone, p=0·0008; and bOPV plus IPV vs bOPV alone, p=0·0153). 12 serious adverse events occurred (six in the tOPV group, one in the tOPV plus IPV group, three in the bOPV group, zero in the bOPV plus IPV group, and two in the bOPV plus 2IPV group), none of which was attributed to the trial intervention. INTERPRETATION The new vaccination schedule improves immunogenicity against polioviruses, especially against poliovirus type 3. FUNDING WHO, through a grant from Rotary International (grant number 59735).
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Affiliation(s)
| | - Sunil Bahl
- World Health Organization, India-National Polio Surveillance Project, New Delhi, India; World Health Organization, Regional Office for South East Asia, New Delhi, India
| | | | | | - Mohammad Ahmad
- World Health Organization, India-National Polio Surveillance Project, New Delhi, India
| | - P Venugopal
- Andhra Medical College, Visakhapatnam, India
| | | | | | - Sanjay K Lalwani
- Bharati Vidyapeeth Deemed University Medical College, Pune, India
| | - Abhishek Kunwar
- World Health Organization, India-National Polio Surveillance Project, New Delhi, India
| | - Raman Sethi
- World Health Organization, India-National Polio Surveillance Project, New Delhi, India
| | | | | | - Arani Chatterjee
- Panacea Biotec Ltd, New Delhi, India; Biological E Ltd, Hyderabad, India
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Narayan T, Jamadar S, Shivakumar M, Shreedhar B, Mohanty L, Shenoy S. The clinically N0 neck in oral squamous cell carcinoma: cracking the histopathological code. Int J Oral Maxillofac Surg 2007. [DOI: 10.1016/j.ijom.2007.08.045] [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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Affiliation(s)
- L Mohanty
- Department of Pathology, SCB Medical College, Cuttack, Orissa, India
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Abstract
Information from histopathologic examination of coronary arterial atherosclerotic plaques treated with in vivo laser energy is sparse. Directional atherectomy provides biopsies for study of tissue changes (injury) due to coronary arterial debulking devices, including laser. Sixteen patients who presented with acute ischemic coronary syndromes underwent debulking of a total of 17 obstructive intracoronary lesions with pulsed-wave holmium:YAG laser (2.1 microm wavelength). Laser was performed with the "pulse and retreat" technique which incorporates slow catheter advancement (0.5-1 mm/s) with controlled emission of energy. Immediately postlasing, directional atherectomy was utilized to obtain irradiated plaque tissue for pathologic examination. Extent of laser-induced tissue injury to plaques was graded as 0 (no tissue damage), 1 (small foci or charring and vacuoles), 2 (large amount of charring, edge disruption and vacuoles) and 3 (extensive tissue damage). Angiographically and clinically, all 17 lesions were successfully debulked with the laser energy (mean 47+/-25 pulses), with a reduction of target lesion percent diameter stenosis from 92+/-6% to 47+/-25%. Adjunct balloon dilations further reduced the target lesions to a final of 10+/-10% stenosis. The histopathologic examination of the lased specimens demonstrated that 13 lesions (76%) had no evidence of laser-induced injury (Grade 0). Four lesions had low-level injury (Grade 1), and none had evidence of Grade 2 or 3 laser-induced trauma. Therefore, a laser debulking technique, which incorporates slow catheter advancement with controlled emission of pulses, does not cause significant injurious effects to the irradiated plaque.
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Affiliation(s)
- O Topaz
- Division of Cardiology, McGuire VA Medical Center, Medical College of Virginia Hospital, Virginia Commonwealth University, 1201 Broad Rock Boulevard, Richmond, VA 23249, USA.
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Mohanty P, Mohanty L, Devi BP. Multiple cutaneous malignancies in xeroderma pigmentosum. Indian J Dermatol Venereol Leprol 2001; 67:96-7. [PMID: 17664721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
A case of xeroderma pigmentosum with multiple cutaneous malignancies is being reported. The case presented with freckles, letigens, and keratosis, a non-tender ulcerated nodular lesion on the nose, a nodular ulcerated lesion on the right outer canthus of the conjunctiva, and a nodular growth which developed on the right cheek which on histopathology was found to be squamous cell carcinoma, basal cell carcinoma and malignant melanoma respectively.
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Affiliation(s)
- P Mohanty
- Department of Skin and VD, SB Medical College, Cuttack, Orrisa, India
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Weisz-Carrington P, Blount M, Kipreos B, Mohanty L, Lippman R, Todd WM, Trent B. Telepathology between Richmond and Beckley Veterans Affairs Hospitals: report on the first 1000 cases. Telemed J 2000; 5:367-73. [PMID: 10908452 DOI: 10.1089/107830299311934] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE A telepathology connection between Richmond VAMC and Beckley VAMC using dynamic robotic telepathology to provide pathology services remotely was established. MATERIALS AND METHODS This study reports a 14-month experience using telepathology to diagnose surgical specimens obtained from patients at the Beckley VA Medical Center and viewed in Richmond 250 miles away. Over 14 months, 2325 slides representing 1000 cases were viewed. RESULTS Discrepancies were observed in 20 of 2325 slides, or 0.86% of the total. None of the patients, where a discrepancy was found, were adversely affected by the preliminary report given. CONCLUSIONS This study demonstrates that telepathology is a reliable and cost-effective alternative to on-site pathology services and reviews advantages and disadvantages of the system.
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Affiliation(s)
- P Weisz-Carrington
- Department of Pathology and Laboratory Medicine, Hunter Holmes McGuire VAMC, Richmond, Virginia
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Mohapatra DK, Mohanty L, Mohanty RC, Mohapatra PK. Biotoxicity of mercury to Chlorella vulgaris as influenced by amino acids. Acta Biol Hung 1998; 48:497-504. [PMID: 9847462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
The toxicity of mercury ion, on Chlorella vulgaris, is largely influenced by amino acids. Five amino acids, namely alanine, asparagine, glutamic acid, cysteine and histidine, were added separately to the medium containing static dose of mercury. Survival (%) of the alga was reduced with the increasing concentrations of mercury. Of these five amino acids, cysteine was found to be the most effective while alanine and glutamic acid were the least effective on reducing the toxic effect of mercury on the alga measured in terms of growth, chlorophyll and protein content. The order of detoxification was Alanine < Glutamate < Asparargine < Histidine < Cysteine. Amino acids from ligands with Hg2+ making it less toxic to the alga and produce an additional source of energy for growth and development.
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Affiliation(s)
- D K Mohapatra
- Department of Botany, Uktal University, Bhubaneswar, India
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Carr ME, Hines S, Carr SL, Todd WM, Taylor TL, Mohanty L. Storage pool disease in chronic lymphocytic leukemia: abnormal aggregation and secretion without bleeding. Am J Med Sci 1997; 313:176-81. [PMID: 9075435 DOI: 10.1097/00000441-199703000-00009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [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: 02/04/2023]
Abstract
Although bleeding complications are relatively common in patients with chronic lymphocytic leukemia, they tend to be related to thrombocytopenia or an acquired clotting factor inhibitor. Chronic lymphocytic leukemia-associated thrombocytopenia, which may also contribute to the hemorrhagic risk, is generally caused by decreased production and immune-mediated destruction. This is the case of a 56-year-old man with longstanding chronic lymphocytic leukemia who developed thrombocytopenia (platelet counts of approximately 50,000/microL) with an associated abnormal platelet morphology. Although the patient did not suffer clinically significant bleeding, several tests of platelet function were grossly abnormal. Electron microscopic examination of the platelets revealed virtually complete absence of dense granules. Platelet aggregation did not occur with adenosine diphosphate (10 microM), collagen (2 micrograms/mL), or ristocetin (1 mg/mL). Doubling the agonist concentrations produced only minimal agglutination with ristocetin. The bleeding time was mildly prolonged at 9.0 and 10.5 minutes. Von Willebrand antigen and ristocetin cofactor levels were normal. Collagen-induced adenosine triphosphate secretion was less than 10% that of a matched normal control. In contrast, platelet force development was virtually normal, reaching 4,800 dynes at 1,200 seconds compared with 5,800 dynes for the healthy control. The patient's clots demonstrated enhanced clot modulus 44,000 dynes/cm2 versus 22,400 dynes/cm2 for the healthy control. The latter finding was primarily because of high fibrinogen concentration. This third report of storage pool disease in a patient with chronic lymphocytic leukemia demonstrates that dense granule release is not required for normal platelet-mediated force development.
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Affiliation(s)
- M E Carr
- Department of Internal Medicine, Medical College of Virginia/Virginia Commonwealth University, USA
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Nayak S, Mohanty RC, Mohanty L. Growth rate of Ankistrodesmus falcatus and Scenedesmus bijuga in mixed culture exposed to monocrotophos. Bull Environ Contam Toxicol 1996; 57:473-479. [PMID: 8672075 DOI: 10.1007/s001289900214] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Affiliation(s)
- S Nayak
- Environmental Biology Laboratory, Department of Botany, Utkal University, Bhubaneswar, 751 004, India
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Nanda M, Rao ES, Behera KC, Das S, Mohanty L. Fine needle aspiration cytology (FNAC) in malignant bone tumours. INDIAN J PATHOL MICR 1994; 37:247-53. [PMID: 7814054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Patients with malignant bone tumours often come at a very late stage of disease to Medical Colleges. Because of their high mortality rate, accurate & quick diagnosis of these lesions become essential, inspite of clinical, radiological and histopathological assessments. A simple, inexpensive, safe & least traumatic technique-fine needle aspiration cytology (FNAC) in diagnosis of 55 malignant bone tumours was carried out. Specific tumour types metastatic tumour (12), Giant cell tumour (12), Ewing's sarcoma (10), Osteosarcoma (7), Multiple myeloma (7), Chordoma (3), Chondrosarcoma (3) and Fibrosarcoma (1) could be ascertained in 87.2% whereas malignant tumour was suggested in 94.5% (52 cases).
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Affiliation(s)
- M Nanda
- Dept. of Pathology, M.K.C.G. Medical College, Orissa
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Mohanty RC, Mohanty L, Mohapatra PK. Effect of glucose, glutamate, and 2-oxoglutarate on mercury toxicity to Chlorella vulgaris. Bull Environ Contam Toxicol 1993; 51:130-137. [PMID: 8100461 DOI: 10.1007/bf00201011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Affiliation(s)
- R C Mohanty
- Department of Botany, Utkal University, Bhubaneswar, India
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