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Ahmed A, Takla A, Salama A, Mohamed MS, Choudhary N. An Uncommon Presentation of Renal Angiomyolipoma: A Case Report. Cureus 2024; 16:e55410. [PMID: 38567223 PMCID: PMC10985555 DOI: 10.7759/cureus.55410] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/02/2024] [Indexed: 04/04/2024] Open
Abstract
Renal angiomyolipoma (AML) is a rare benign tumor of the kidney that can occur as a sporadic lesion or a part of tuberous sclerosis. A 77-year-old female patient with a history of hypertension, hyperlipidemia, and an unclear history of left nephrectomy in 1999 presented with progressive shortness of breath and palpitations. Her vital signs showed elevated blood pressure, and the examination was benign and non-focal. A work-up showed multiple lesions in her lungs and right kidney, representing lymphangioleiomyomatosis. The patient was diagnosed with tuberous sclerosis and was followed up by pulmonology and nephrology. She underwent embolization of the renal AML, after which her blood pressure (BP) was more controlled, and she reported feeling well and symptom-free. Renal AML, as a part of tuberous sclerosis, is a rare cause of secondary hypertension. Embolization of AML is effective in controlling BP.
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Affiliation(s)
- Asmaa Ahmed
- Internal Medicine, Rochester General Hospital, Rochester, USA
| | - Andrew Takla
- Internal Medicine, Rochester General Hospital, Rochester, USA
| | - Amr Salama
- Cardiology, University of Alabama, Birmingham, USA
| | | | - Naila Choudhary
- Cardiology, Sands-Constellation Heart Institute, Rochester Regional Health, Rochester, USA
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Bagaria DK, Gupta S, Pandey S, Choudhary N, Priyadarshini P, Kumar A, Alam J, Mishra B, Sagar S, Kumar S, Gupta A. Abdominal wall reconstruction (AWR) for post-trauma laparotomy ventral hernia and follow-up assessment of functional quality of life (QOL): experience of a level-1 trauma centre in India. Hernia 2024:10.1007/s10029-024-02978-1. [PMID: 38388814 DOI: 10.1007/s10029-024-02978-1] [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: 10/20/2023] [Accepted: 01/25/2024] [Indexed: 02/24/2024]
Abstract
PURPOSE The aim of this study was to examine the postoperative outcomes and follow-up QOL of patients after AWR at a level-1 trauma centre in India. METHODS The study cohort included AWR patients treated between January 2011 and July 2022. The Activities Assessment Scale (AAS) was used to measure QOL, and the Ventral Hernia Recurrence Inventory (VHRI) was used to determine the occurrence of recurrence. In patients suspected of having recurrence, thorough clinical examination and relevant imaging were performed to confirm or rule out recurrence. RESULTS Out of 89 patients, 35 patients whose complete perioperative and follow-up data were available were enrolled. The mean age of the patients was 28 (SD, 9) years. The mean defect size was 14. 9 (SD, 7) cm. The mean time from laparotomy to AWR surgery was 21 months. During the postoperative course, 37% of patients developed complications, such as SSI and seroma. The mean follow-up time was 53 (SD, 43) months. Upon comparing procedures involving the mesh placed in the sublay position with procedures involving the mesh placed in other positions, no statistically significant difference in the recurrence rate (one in each group, p = 0.99), surgical complication rate (33% v/s 66%, p = 0.6), or mean AAS QOL score (94.7 v/s 98, p = 0.4) was observed. The specificity of the VHRI for diagnosing recurrence was 79%. CONCLUSION Overall, the recurrence rate was low in these patients despite the presence of large hernia defects. Long-term QOL was not affected by the specific procedure used. Timely planning and execution are more important than the specific repair approach for post-trauma laparotomy ventral hernia.
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Affiliation(s)
- D K Bagaria
- Division of Trauma Surgery and Critical Care, Jai Prakash Narayan Apex Trauma Centre, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India
| | - S Gupta
- Division of Trauma Surgery and Critical Care, Jai Prakash Narayan Apex Trauma Centre, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India
| | - S Pandey
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - N Choudhary
- Division of Trauma Surgery and Critical Care, Jai Prakash Narayan Apex Trauma Centre, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India.
| | - P Priyadarshini
- Division of Trauma Surgery and Critical Care, Jai Prakash Narayan Apex Trauma Centre, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India
| | - A Kumar
- Division of Trauma Surgery and Critical Care, Jai Prakash Narayan Apex Trauma Centre, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India
| | - J Alam
- Division of Trauma Surgery and Critical Care, Jai Prakash Narayan Apex Trauma Centre, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India
| | - B Mishra
- Division of Trauma Surgery and Critical Care, Jai Prakash Narayan Apex Trauma Centre, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India
| | - S Sagar
- Division of Trauma Surgery and Critical Care, Jai Prakash Narayan Apex Trauma Centre, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India
| | - S Kumar
- Division of Trauma Surgery and Critical Care, Jai Prakash Narayan Apex Trauma Centre, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India
| | - A Gupta
- Division of Trauma Surgery and Critical Care, Jai Prakash Narayan Apex Trauma Centre, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India
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Agarwala V, MV C, Daga A, Basu M, Ganguly M, Kumar S, Mandal K, Chakraborty S, Sunani D, Choudhary N, Basu K, Das S, Mallik S. 1578P Scalp cooling system for prevention of chemotherapy induced alopecia: A single center one-year prospective observational study. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1671] [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: 11/01/2022] Open
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Levstik A, Mohammed M, Eid M, Samdani AJ, Evans J, Balmer-Swain M, Funderburk M, Choudhary N, Depta JP. LATE DEVICE-RELATED THROMBUS OF A PERCUTANEOUS PATENT FORAMEN OVALE CLOSURE DEVICE. J Am Coll Cardiol 2022. [DOI: 10.1016/s0735-1097(22)03898-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Velarde GP, Choudhary N, Bravo-Jaimes K, Smotherman C, Sherazi S, Kraemer DF. Effect of atorvastatin on lipogenic, inflammatory and thrombogenic markers in women with the metabolic syndrome. Nutr Metab Cardiovasc Dis 2021; 31:634-640. [PMID: 33485731 DOI: 10.1016/j.numecd.2020.10.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 10/05/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND AIM Specific drug therapy to target the underlying proinflammatory and prothrombotic state in patients with metabolic syndrome (MS) is lacking. We sought to study the effect of high-intensity atorvastatin on markers of lipogenesis, inflammation and thrombogenesis, in women with MS in the absence of cardiovascular disease or diabetes. METHODS AND RESULTS This randomized double-blinded controlled trial included 88 women with MS (according to National Cholesterol Education Panel Adult Treatment Panel III criteria) and low atherosclerotic cardiovascular risk. Participants were randomized to receive atorvastatin 80 mg or matching placebo. Thrombogenic, lipogenic and inflammatory markers were collected at the time of enrollment, after a 6-week dietary run-in phase (time of randomization), and at 6- and 12-weeks after randomization. At 6 weeks post-randomization, there was significant reduction in total cholesterol, low density lipoprotein cholesterol, triglycerides, apolipoprotein-B (Apo-B) and Apo-B/Apo-A1 ratio in the atorvastatin arm compared to placebo. This difference persisted at 12-weeks post randomization. There was no significant difference in fasting blood glucose, high-density lipoprotein cholesterol, high sensitivity C-reactive protein, serum leptin, Apo-A1, intercellular adhesion molecule 1 and platelet activity. A significant increase in vascular adhesion molecule 1 at 6 and 12 weeks was seen within the atorvastatin arm. No difference was observed in blood pressure and waist circumference. CONCLUSIONS In conclusion, high-intensity atorvastatin has an early and significant impact on lipoproteins and apolipoproteins but did not lower inflammatory, thrombogenic or biomarkers of platelet activity and aggregation in women with MS. The use of statins for primary prevention in these patients should be further explored.
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Affiliation(s)
- Gladys P Velarde
- Division of Cardiology, University of Florida College of Medicine, Jacksonville FL, USA.
| | - Naila Choudhary
- Division of Cardiology, University of Florida College of Medicine, Jacksonville FL, USA
| | - Katia Bravo-Jaimes
- Division of Cardiovascular Medicine, University of Texas Health Science Center at Houston, Houston TX, USA
| | - Carmen Smotherman
- Division of Cardiology, University of Florida College of Medicine, Jacksonville FL, USA; Center for Health Equity and Quality Research, University of Florida College of Medicine, Jacksonville, FL, USA
| | - Saadia Sherazi
- Department of Internal Medicine, University of Rochester Medical Center, Rochester NY, USA
| | - Dale F Kraemer
- Division of Cardiology, University of Florida College of Medicine, Jacksonville FL, USA; Center for Health Equity and Quality Research, University of Florida College of Medicine, Jacksonville, FL, USA
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Patel N, Choudhary N, Tompkins C, Ammar KA, Tajik AJ, Chandrasekaran K, Paterick TE. Syncope in Young Women: Broadening the Differential Diagnosis. Rev Cardiovasc Med 2017; 18:100-114. [DOI: 10.3909/ricm0865] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Velarde GP, Garcia E, Sherazi S, Choudhary N, Kraemer D. Abstract 087: Impact of High Intensity Statin on Biologic and Clinical Markers of the Metabolic Syndrome in Women. Circ Cardiovasc Qual Outcomes 2017. [DOI: 10.1161/circoutcomes.10.suppl_3.087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background:
The metabolic syndrome (MBS) increases the risk of cardiovascular disease in both men and women. This risk is higher in women. The role of statins in the treatment of MBS remains uncertain.
Objectives:
To evaluate the ability of high dose atorvastatin to modify components of MBS
Methods:
Age matched women with MBS (n =88, mean age 52.4 ± 9.2 years), recruited from the Women’s Heart Clinic at the University of Rochester and who met the study inclusion criteria were randomly assigned to either 80 mg of atorvastatin or matching placebo (44 in each arm) in a double blinded fashion. The duration of treatment was 12 weeks. Statistical analysis was performed using Students t-test using SAS 9.3 (Cary, NC).
Results:
At 6 weeks after randomization, there was significant reduction in the mean LDL, triglycerides, CRP, and Apo-B (p <0.0001, 0.0006, 0.01 and <0.0001) respectively in the atorvastatin arm. There was no difference in fasting blood glucose (FBG), serum HDL, serum Leptin, Apo-A1, and platelet activity (p value NS). A trend towards a decrease in waist circumference (WC) in the atorvastatin arm (p 0.05), while no impact in systolic blood pressure (p 0.92) was seen. These differences persisted at 12 weeks after randomization.
Conclusion:
High dose atorvastatin has an early and significant impact on biomarkers in women with MBS and is not associated with a rise in FBG. The use of statins for primary prevention in this group of patients should be further explored
Table:
Lipogenic, Inflammatory Markers at 6 weeks Post Randomization.
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Biswas R, Saxena P, Gupta U, Choudhary N, Chawla R. Persistent Trophoblastic Disease at Cesarean Scar. Kathmandu Univ Med J (KUMJ) 2016; 14:376-379. [PMID: 29336430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Pregnancy over the cesarean scar is the rarest cause of ectopic pregnancy and development of persistent trophoblastic disease at the scar site is extremely rare. A high index of suspicion is needed for early diagnosis and management of cesarean scar molar pregnancy. This condition is difficult to diagnose and must be considered in the patient with a history of cesarean section who has persistent vaginal bleeding or symptoms of pregnancy after suction evacuation. Diagnosis can be confirmedby measuring ß Human Chorionic Gonadotropin levels, transvaginal ultrasound with doppler flow evaluation. As this is an uncommon condition, this case report with conservative non surgical approach will add up to its clinical spectrum.
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Affiliation(s)
- R Biswas
- Department of Obstetrics and Gynaecology, Lady Hardinge Medical College, New Delhi, India
| | - P Saxena
- Department of Obstetrics and Gynaecology, Lady Hardinge Medical College, New Delhi, India
| | - U Gupta
- Department of Obstetrics and Gynaecology, Lady Hardinge Medical College, New Delhi, India
| | - N Choudhary
- Department of Obstetrics and Gynaecology, Lady Hardinge Medical College, New Delhi, India
| | - R Chawla
- Department of Obstetrics and Gynaecology, Lady Hardinge Medical College, New Delhi, India
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Choudhary N, Tompkins C, Polonsky B, McNitt S, Calkins H, Mark Estes NA, Krahn AD, Link MS, Marcus FI, Towbin JA, Zareba W. Clinical Presentation and Outcomes by Sex in Arrhythmogenic Right Ventricular Cardiomyopathy: Findings from the North American ARVC Registry. J Cardiovasc Electrophysiol 2016; 27:555-62. [PMID: 26840461 DOI: 10.1111/jce.12947] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2015] [Revised: 01/11/2016] [Accepted: 01/19/2016] [Indexed: 11/26/2022]
Abstract
BACKGROUND Sex differences in clinical presentation and outcomes of hereditary arrhythmias are commonly reported. We aimed to compare clinical presentation and outcomes in men and women with arrhythmogenic right ventricular cardiomyopathy (ARVC) enrolled in the North American ARVC Registry. METHODS A total of 125 ARVC probands (55 females, mean age 38 ± 12; 70 males, mean age 41 ± 15) diagnosed, as either "affected" or "borderline" were included. Baseline clinical characteristics and time-dependent outcomes including syncope, ventricular tachycardia (VT), fast VT (>240 bpm), ventricular fibrillation (VF), and death were compared between males and females. RESULTS The percentage of ARVC subjects diagnosed as "affected" (84% vs. 89%; P = 0.424) or "borderline" (16% vs. 11%; P = 0.424) was similar between females and males. Among the baseline characteristics, inverted T-waves in V2 trended to be more common in women (P = 0.09), whereas abnormal signal-averaged ECGs (SAECGs; P < 0.001) and inducible VT/VF (P = 0.026) were more frequent in men. During a mean follow-up of 37 ± 20 months, the probability of ICD-recorded VT/VF or death was not significantly different between men and women (P = 0.456). However, there was a trend toward lower risk of fast VT/VF or death in women compared to men (hazard ratio 0.41, 95% CI 0.151-1.113, P = 0.066). Abnormal SAECG and evidence of intramyocardial fat by cardiac MRI was associated with adverse outcomes in men (P = 0.006 and 0.02 respectively). CONCLUSION In the North American ARVC Registry, we found similar frequency of "affected" and "borderline" subjects between men and women. Sex-related differences were observed in baseline ECG, SAECG, Holter-recorded ventricular arrhythmias, and VT inducibility. Men showed a trend toward greater risk of fast VT than women.
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Affiliation(s)
- Naila Choudhary
- Division of Cardiology, University of Florida College of Medicine, Jacksonville, Florida, USA
| | - Christine Tompkins
- Division of Cardiology, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Bronislava Polonsky
- Division of Cardiology, University of Rochester School of Medicine, Rochester, New York, USA
| | - Scott McNitt
- Division of Cardiology, University of Rochester School of Medicine, Rochester, New York, USA
| | - Hugh Calkins
- Division of Cardiology, John Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - N A Mark Estes
- Division of Cardiology, Tufts University School of Medicine, Boston, Massachusetts, USA
| | - Andrew D Krahn
- Division of Cardiology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Mark S Link
- Division of Cardiology, Tufts University School of Medicine, Boston, Massachusetts, USA
| | - Frank I Marcus
- Division of Cardiology, University of Arizona College of Medicine, Tucson, Arizona, USA
| | - Jeffrey A Towbin
- Division of Pediatrics, University of Tennesse, Memphis, Tennessee, USA
| | - Wojciech Zareba
- Division of Cardiology, University of Rochester School of Medicine, Rochester, New York, USA
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Krishan S, Jain D, Bathina Y, Kale A, Saraf N, Saigal S, Choudhary N, Baijal S, Soin A. Non-invasive quantification of hepatic steatosis in living, related liver donors using dual-echo Dixon imaging and single-voxel proton spectroscopy. Clin Radiol 2016; 71:58-63. [DOI: 10.1016/j.crad.2015.10.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Revised: 09/30/2015] [Accepted: 10/05/2015] [Indexed: 01/01/2023]
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Sherazi S, McNitt S, Choudhary N, Shah AH, Aktas MK, Asgher A, Schwarz KQ, Zareba W. Predictors of mortality in patients hospitalized for congestive heart failure with left ventricular ejection fraction ≥ 40. Cardiol J 2015; 22:382-90. [PMID: 25588532 DOI: 10.5603/cj.a2015.0003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2014] [Revised: 12/13/2014] [Accepted: 12/20/2014] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND There are limited data regarding the predictors of mortality in patients with acute congestive heart failure (CHF) and left ventricular ejection fraction (LVEF) ≥ 40%. METHODS We evaluated clinical characteristics, mortality and prognostic factors in a sample of consecutive patients hospitalized for CHF with LVEF ≥ 40%. Multivariable Cox regression models were developed to predict mortality using baseline clinical characteristics and echocardiographic variables. RESULTS The study population consisted of 191 patients, mean age 70 ± 14.6 years (60% female) with average follow-up of 4.0 ± 2.8 years. Cumulative 5-year mortality was 58% in the entire population and it was 59% in men and 57% in women (p = 0.411). In multivariable analyses, predictors of mortality were the following: blood urea nitrogen (BUN) > 25 mg/dL (HR = 1.77; p = 0.002); absence of hypertension (HR = 1.58; p = 0.032), left ventricular end diastolic dimension (LVEDD) ≤ 4.1 cm (HR = 1.73; p = 0.011) and LVEF ≤ 45% (HR = 1.69; p = 0.027). CONCLUSIONS Patients hospitalized for heart failure with LVEF ≥ 40% have very high mortality. Absence of hypertension, elevated BUN and lower LVEF ≤ 45% indicate increased risk of short- and long-term mortality. Lower LVEDD is an independent predictor of mortality in heart failure patients with LVEF ≥ 40%.
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Affiliation(s)
- Saadia Sherazi
- Department of Cardiology at University of Rochester Medical Center, Rochester, New York, United States.
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Soin AS, Raut V, Mohanka R, Rastogi A, Goja S, Balachandran M, Saigal S, Saraf N, Bhangui P, Sumana KR, Singla P, Srinivasan T, Choudhary N, Tiwari A, Raina V, Govil D, Mohan N, Vohra V. Use of ABO-incompatible grafts in living donor liver transplantation--first report from India. Indian J Gastroenterol 2014; 33:72-6. [PMID: 24369388 DOI: 10.1007/s12664-013-0424-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2013] [Accepted: 10/13/2013] [Indexed: 02/04/2023]
Abstract
ABO incompatibility is the commonest reason for rejection of donors in living donor liver transplantation (LDLT). The donor pool could be expanded by 25 % to 35 % if the ABO barrier is overcome. In the absence of pre-conditioning, transplantation across the blood groups is fraught with the almost universal risk of antibody-mediated rejection (AMR) that rapidly leads to graft loss. However, AMR can be prevented by removal of preformed antibodies and reducing their production by B cells. We describe our initial experience of three cases of ABO-incompatible (ABO-i) LDLT: a 42-year-old male, an 8-month-old male and a 28-month-old female, all of blood group O+ who received blood group B + right lobe, B + left lateral segment, and A + left lateral segment liver grafts, respectively. Pre-LDLT conditioning included administration of anti-CD20 antibody (Rituximab(®)) to the adult 4 weeks prior, and four to seven sessions of double-filtration plasmapheresis to all, to remove preformed antibodies and achieve anti-donor blood group antibody (ADA) titers of ≤ 1:16 IgG and ≤ 1:8 IgM, respectively. In addition, cases 1 and 3 received mycophenolate mofetil for 7 days prior to LDLT. After LDLT, all three patients achieved normal graft function over 8-17 days with no evidence of AMR and without the need for further plasmapheresis. Postoperative complications included portal vein thrombosis (one successfully re-explored), CMV (one), Pseudomonas and Klebsiella sepsis (one each), and abdominal collection (one treated with percutaneous drainage). All are currently well with normal graft function and low ADA titers at 8, 16, and 19 months after ABO-i LDLT.
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Affiliation(s)
- A S Soin
- Medanta Institute of Liver Diseases and Transplantation, Medanta-The Medicity, Gurgaon, Haryana, 122 001, India,
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Choudhary N, Kabbli G, Duncanson LJ, Passick M, Halloran K, Cao JJ. Comparison of myocardial mechanical properties in patients with dilated cardiomyopathy with and without acute heart failure. J Cardiovasc Magn Reson 2014. [PMCID: PMC4043470 DOI: 10.1186/1532-429x-16-s1-p239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Ananthakrishnan G, Choudhary N, Roy A, Sengoda VG, Postnikova E, Hartung JS, Stone AL, Damsteegt VD, Schneider WL, Munyaneza JE, Brlansky RH. Development of Primers and Probes for Genus and Species Specific Detection of 'Candidatus Liberibacter Species' by Real-Time PCR. Plant Dis 2013; 97:1235-1243. [PMID: 30722431 DOI: 10.1094/pdis-12-12-1174-re] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Huanglongbing (HLB), also known as citrus greening, is currently the most devastating disease impacting citrus production. The disease is associated with three different 'Candidatus Liberibacter species', 'Ca. Liberibacter asiaticus', 'Ca. Liberibacter americanus', and 'Ca. Liberibacter africanus', which induce similar and overlapping symptoms. When HLB-symptomatic trees are tested, one of the Candidatus Liberibacters is normally detected by conventional or real-time PCR (qPCR). The most widely used assays use primers and probes based on the 16S ribosomal RNA (rRNA) gene. The 16S rRNA-based assays to detect the three species are species-specific and must be performed sequentially. We describe a single assay that detected all species of 'Ca. Liberibacter' at the genus level, providing increased convenience. Recent molecular analyses of 'Ca. Liberibacter species' and other bacteria suggest that the rpoB gene (encoding the β-subunit of RNA polymerase) provides an alternative target for bacterial identification. We report here the design of a single pair of degenerate primers and a hybridization probe corresponding to the rpoB region and their application for the detection of all three citrus 'Ca. Liberibacter species', enabling detection of 'Ca. Liberibacter' at the genus level. In addition, species-specific primers and probes based on the rplJ/rplK genes were designed and used for detection at the species level in a multiplexed format. Both the genus- and species-specific assays were validated in both SYBR Green I and TaqMan formats, and with both plant and insect extracts that contained the pathogen. These one-step qPCR diagnostic methods are useful for the detection of all species of Liberibacter infecting citrus. In addition, the degenerate genus-specific primers and probe successfully detected 'Ca. Liberibacter solanacearum', a psyllid-transmitted pathogen associated with disease in tomato, carrot, and potato.
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Affiliation(s)
| | - N Choudhary
- University of Florida, CREC, Lake Alfred, FL 33850
| | - Avijit Roy
- University of Florida, CREC, Lake Alfred, FL 33850
| | - V G Sengoda
- USDA-ARS, Yakima Agricultural Research Laboratory, Wapato, WA 98951
| | | | | | - A L Stone
- USDA-ARS, FDWSRU, Fort Detrick, MD 21702
| | | | | | - J E Munyaneza
- USDA-ARS, Yakima Agricultural Research Laboratory, Wapato, WA 98951
| | - R H Brlansky
- University of Florida, CREC, Lake Alfred, FL 33850
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Choudhary N, Chen L, Kotyra L, Wittlin S, Alexis J. Improvement in Glycemic Control after Left Ventricular Assist Device Implantation in Advanced Heart Failure Patients with Diabetes Mellitus. J Card Fail 2013. [DOI: 10.1016/j.cardfail.2013.06.074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Choudhary N, Chen L, Sherazi S, Alexis J, Storozynsky E, Massey H, Hay C. Incidence, Microbiologic Profile and Outcomes of Device Related Infections in Advanced Heart Failure Patients Treated with Left Ventricular Assist Device. J Card Fail 2013. [DOI: 10.1016/j.cardfail.2013.06.069] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Zhang X, Tao Y, Chopra M, Troiani L, Marcus K, Choudhary N, Wray S, Krolczyk S, Markovic-Plese S. Alemtuzumab (Anti-CD52 mAb) Induces Expansion of Treg and Th2 Cells and Inhibits Th1 and Th17 Cells in Treated Patients with Relapsing Remitting Multiple Sclerosis (RRMS) (P02.119). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p02.119] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Hameed MM, Choudhary N, Nasar F, sherazi S, Shah A, Gadir K. THE UNDERUTILIZATION OF SPIRONOLACTONE, AND RATES OF HYPERKALEMIA IN PATIENTS WITH CARDIOMYOPATHY HOSPITALIZED FOR HEART FAILURE. J Am Coll Cardiol 2012. [DOI: 10.1016/s0735-1097(12)60953-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Choudhary N, Dhiman R, Bhalla A, Sharma N, Duseja A, Chawla Y. 5 comparison of clinical prognostic indicators (cpi) with model for end-stage liver disease (meld) and king's college hospital (kch) criteria for mortality prediction in acute liver failure. J Clin Exp Hepatol 2011; 1:135. [PMID: 25755335 PMCID: PMC3940556 DOI: 10.1016/s0973-6883(11)60142-4] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
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Aggarwal A, Sherazi S, Levitan B, Lakshmanadoss U, Choudhary N, Shah A, Hsi D. Corrected QT interval as a predictor of mortality in elderly patients with syncope. Cardiol J 2011; 18:395-400. [PMID: 21769820] [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: 05/31/2023] Open
Abstract
BACKGROUND Prolonged corrected QT interval (QTc) holds independent prognostic importance in predicting mortality in patients with coronary artery disease, diabetes mellitus and congestive heart failure. However, its association with all cause or cardiac mortality in the general population remains unclear. We evaluated the relationship between prolonged QTc and total mortality among patients with syncope. METHODS This was a retrospective study of 348 patients presenting to the emergency department with syncope of any etiology over a period of one year. All patients with atrial fibrillation, left bundle branch block and cardiac devices (pacemaker/defibrillator) were excluded. Prolonged QTc interval was defined as QTc interval ≥ 440 ms. The primary end point for this study was total mortality in patients presenting with syncope. RESULTS There were 58 (16%) deaths in this population during a mean follow-up of 30 months. Patients with prolonged QTc interval had significantly higher mortality when compared to those with normal QTc interval (22% vs 11%; p = 0.004). This significance was not retained after adjustment for covariates in the Cox regression model, where we found that age ≥ 65 years (hazard ratio [HR] 7.9; 95% confidence interval [CI] 1.9-32.9; p = 0.004) and QTc interval ≥ 500 ms (HR 3.5; 95% CI 1.56-8.12; p = 0.002) were predictors of increased mortality among patients with syncope. CONCLUSIONS In elderly patients presenting to the emergency department with syncope, QTc interval ≥ 500 ms helps identify patients at higher risk of adverse outcomes.
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Affiliation(s)
- Ashim Aggarwal
- Department of Internal Medicine, Unity Health System, 1555 Long Pond Road, Rochester, NY 14616, USA.
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Tripathi M, Singh PK, Vibha D, Choudhary N, Garg A, Bal CS, Sarkar C, Bhatia R, Padma MV, Gaikwad S, Singh MB, Prasad K, Chandra PS. Electrophysiological characteristics of seizure clusters. Clin EEG Neurosci 2010; 41:143-6. [PMID: 20722348 DOI: 10.1177/155005941004100307] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The phenomenon of temporal clustering of seizures is well known, but its effect on seizure localization has not been rigorously analyzed. The aim of our study was to assess electrophysiological localization during Video EEG (VEEG) monitoring in patients with intractable epilepsy demonstrating a cluster of seizures. The study was conducted on 203 intractable epilepsy patients, aged 2 to 60 years (19.96 +/- 10.87). Patients with unilateral temporal lobe epilepsy having clusters were compared with patients not having clusters, and the effect of clustering on concordance was addressed. Fully consistent localization was observed in 116 patients, partially consistent localization in 18 patients, and inconsistent localization in 19 patients. ANOVA did not reveal any significant difference in these groups (p=0.65). A total of 770 seizures recorded from 149 patients was analyzed for clustering effect. Clustering was present in 603/770 seizures pairs (78.31%). In the cluster group, 483 (80.09%) seizure pairs were concordant for seizure onset, while 98 (16.25%) were discordant and 22 (3.65%) were indeterminate. In the noncluster group, 134 (80.24%) seizure pairs were concordant for seizure onset, while 23 (13.77%) were discordant and 10 (5.98%) were indeterminate. The study found that cluster seizures occurring within an interseizure interval (ISI) less than 8 hours are independent and have the same localizing value as those seizures with longer ISIs.
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Affiliation(s)
- M Tripathi
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India.
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Shah AUHA, Khan ZA, Choudhary N, Lohölter C, Schäfer S, Marie GPL, Farooq U, Witulski B, Wirth T. Iodoxolone-based hypervalent iodine reagents. Org Lett 2009; 11:3578-81. [PMID: 19610610 DOI: 10.1021/ol9014688] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The fast access to simple (Z)-3-iodo acrylic acid derivatives which can be easily oxidized to the corresponding hypervalent iodine(III) reagents is described. They can be used for various reactions with superior or similar reactivity as conventional hypervalent iodine(III) reagents.
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Affiliation(s)
- Azhar-ul-Haq A Shah
- School of Chemistry, Cardiff University, Park Place, Cardiff CF10 3AT, United Kingdom
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Tripathi M, Choudhary N, Chandra P, Deepak K. PO18-WE-53 Effect of temporal lobe epilepsy surgery on cardiovascular autonomic functions. J Neurol Sci 2009. [DOI: 10.1016/s0022-510x(09)70982-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Bagga R, Choudhary N, Suri V, Mahajan U, Rani Gupta K, Arya VK, Vijayverghia R, Kaur Dhaliwal L. First and second trimester induced abortions in women with cardiac disorders: A 12-year analysis from a developing country. J OBSTET GYNAECOL 2009; 28:732-7. [DOI: 10.1080/01443610802463686] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Kumar N, Choudhary N, Kaul B, Ahlawat SR. A middle aged man with acute onset quadriparesis: a diagnostic exercise. J Postgrad Med 2006; 52:308-11. [PMID: 17102557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023] Open
Affiliation(s)
- N Kumar
- Department of Medicine, Maulana Azad Medical College and Assoc LN Hospitals, New Delhi, India.
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Choudhary N, Saha SC, Gopalan S. Abortion procedures in a tertiary care institution in India. Int J Gynaecol Obstet 2005; 91:81-6. [PMID: 16098979 DOI: 10.1016/j.ijgo.2005.06.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2004] [Revised: 05/23/2005] [Accepted: 06/01/2005] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To determine the complications rate of termination of pregnancy (TOP) and the risk factors for complications following TOP. METHODS Retrospective observational study of the records of 1287 women who underwent TOP in the Department of Obstetrics and Gynaecology of the Postgraduate Institute of Medical Education and Research, Chandigarh, India, between 1997 and 2001. First-trimester abortion was performed in 1088 women (85%) and second-trimester abortion in 199 women (15%). Most women (76%) were aged between 26 and 30 years; they were educated and requested TOP primarily to limit the number of their children or to space their births. A malformed fetus was the indication for TOP in 5.9% cases, and 16% of the women had medical disorders associated with the pregnancy. Suction evacuation was the method of choice for first-trimester abortion (88%); dinoprostone gel and extra-amniotic saline solution plus oxytocin infusion were the primary methods (71%) for second-trimester abortion. RESULTS Uterine perforation occurred in 1 patient (0.09%) after a first-trimester abortion. The total rate of complications was 3.79% after first-trimester and 4.0% after second-trimester abortions. Excessive hemorrhage and retained placenta were chief complications associated with second-trimester abortion. Incomplete abortion (1.5%) and minor infection were seen in 2.3% patients. The rate of complications was higher among parous women. Postabortion insertion of a CuT intrauterine device increased the need for a second course of antibiotics. CONCLUSION Termination of pregnancy is safe if adequate care is taken while performing the procedure.
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Affiliation(s)
- N Choudhary
- Department of Obstetrics and Gynaecology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India
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Affiliation(s)
- N Choudhary
- Reproductive Toxicology Unit, Department of Zoology, University of Rajasthan, Jaipur 302004, India
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Abstract
Previous studies have shown higher levels of Chlamydia pneumoniae (C. pneumoniae, CP) antibody titers (CPIgG), C-reactive protein (CRP), and fibrinogen in patients with coronary artery disease. The role of these infectious and inflammatory markers in precipitating acute coronary syndrome (ACS) is unclear. We conducted a cross-sectional study on patients (n = 830, mean age 63 +/- 15 years, 57% male) admitted to the chest pain center of our institution. The differences in the CPIgG, CRP, and fibrinogen levels in patients who were diagnosed with ACS versus those who were not (non-ACS) were evaluated. CPIgG titers tended to be higher in the ACS group than in the non-ACS group. However, when different titers were used to define seropositivity, the difference achieved statistical significance only at the titer of > or =1:1,024 (35% vs 26%, p = 0.004). CRP (median 0.48 vs 0.33 mg/dl, p <0.0001), fibrinogen (median 317 vs 293 mg/dl, p <0.0001), and leukocyte count (median 7.7 vs 6.9 10(9)/L, p <0.0001) were higher in the ACS group. On multivariate analysis, CPIgG > or =1:1,024 (odds ratio [OR] 1.62), diabetes (OR 1.91), hypertension (OR 1.46), prior myocardial infarction (OR 1.78), smoking (OR 1.70), Caucasian race (OR 1.7), high-density lipoprotein (OR 0.98), and elevated troponin-T (OR 12.44) were the only factors independently associated with ACS. Thus, we found a strong association between high level seropositivity to CP and ACS. This may indicate recent re-infection or an exaggerated immune response to CP as an etiologic factor for ACS. This study also suggests that therapeutic interventions may need to be specifically targeted to these patients.
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Affiliation(s)
- H R Chandra
- Division of Cardiology, Department of Internal Medicine, William Beaumont Hospital, Royal Oak, Michigan 48073, USA
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Bose A, Sinha S, Choudhary N, Aruldas K, Moses PD, Joseph A. Experiences of neonatal care in a secondary level hospital. Indian Pediatr 1999; 36:802-6. [PMID: 10742736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Affiliation(s)
- A Bose
- Departments of Community Health and Pediatrics, Christian Medical College, Vellore 632 002, India.
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Jolly JG, Joshi SR, Choudhary N, Chaudhary RK, Gupta D. A rare Rh phenotype in a north Indian family. INDIAN J PATHOL MICR 1994; 37 Suppl:S11-2. [PMID: 8613152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Affiliation(s)
- J G Jolly
- Department of Transfusion Medicine, Sanjay Gandhi Post Graduate Medical Institute, Lucknow
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Nagaraju K, Misra S, Saraswat S, Choudhary N, Masih B, Ramesh V, Naik S. High prevalence of HBV infectivity in blood donors detected by the dot blot hybridisation assay. Vox Sang 1994; 67:183-6. [PMID: 7801609 DOI: 10.1111/j.1423-0410.1994.tb01656.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [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: 01/27/2023]
Abstract
Hepatitis B virus (HBV) continues to be a significant cause for post-transfusion hepatitis in India, in spite of the introduction of compulsory hepatitis B surface antigen (HBsAg) screening. To understand the true HBV-infective pool in the blood donor population, HBV DNA was detected by a 32P-labelled dot blot hybridisation assay in 605 donor units that were negative for HBsAg by a third-generation Elisa. Serum alanine aminotransferase (ALT) was estimated in all these samples and correlated with DNA positivity. The frequency of HBV DNA positivity in HBsAg-negative units was very high (9.91%) and correlated well with the elevation in ALT (p < 0.00005). However, the frequency of elevated ALT was high (11.9%), using the locally determined upper limit of normal, and half of the DNA-positive samples had a normal ALT. Thus, ALT is a poor surrogate marker for HBV infectivity and efforts should be made to apply DNA detection systems in blood banks.
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Affiliation(s)
- K Nagaraju
- Department of Immunology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
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Jolly JG, Choudhary N. AIDS and transfusion practice. INDIAN J PATHOL MICR 1991; 34:305-8. [PMID: 1818039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Affiliation(s)
- J G Jolly
- Department of Transfusion Medicine, Sanjay Gandhi Post-Graduate Institute of Medical Sciences, Lucknow, India
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