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Kumar R, Grover N, Jain N. 1O 2 Mediated Conversion of β-Enaminonitriles to α-Keto Amides Photosensitized by Recyclable H 2TPP in Visible Light. J Org Chem 2024; 89:4722-4732. [PMID: 38502937 DOI: 10.1021/acs.joc.3c02965] [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] [Subscribe] [Scholar Register] [Indexed: 03/21/2024]
Abstract
We report a one-step approach for the conversion of β-enaminonitriles to synthetically versatile α-keto amides in moderate to high yields under visible light irradiation photosensitized by porphyrins. The method is mild, cost-effective, and sustainable and requires air as the sole reagent/oxidant. The reaction is believed to proceed via an ene-type pathway initiated by 1O2, followed by dehydration, imine hydrolysis, and subsequent nucleophilic substitution of the cyanide group by amine. The method offers a broad substrate scope and has also been extended for synthesis of α-keto esters with aliphatic alcohols as nucleophiles. The porphyrin recovered after the reaction can be reused multiple times.
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Affiliation(s)
- Rohit Kumar
- Department of Chemistry, Indian Institute of Technology, New Delhi-110016, India
| | - Nitika Grover
- Department of Chemistry, Indian Institute of Technology, New Delhi-110016, India
| | - Nidhi Jain
- Department of Chemistry, Indian Institute of Technology, New Delhi-110016, India
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Karunakaran P, Jain N, Lad DP. How Do We Manage Chronic Lymphocytic Leukemia in India. Curr Hematol Malig Rep 2024; 19:56-64. [PMID: 38300458 DOI: 10.1007/s11899-023-00722-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/24/2023] [Indexed: 02/02/2024]
Abstract
PURPOSE OF REVIEW Chronic lymphocytic leukemia was an ignored leukemia in India until a decade back, given its low prevalence and absence of novel drugs to treat it. Healthcare in India is heterogeneous, with variations in population, health systems, and reimbursement options. We have focused on opinions from three hemato-oncologists incorporating an opinion poll from 44 hemato-oncologists across India on the common issues in CLL to give an idea of the practice pan-India. RECENT FINDINGS More CLL patients are being diagnosed in their early stages. There is an attempt to use prognostic and predictive markers in making shared decisions for managing CLL. There is still a role for chemoimmunotherapy (CIT) in India, given limited health insurance coverage. But with the availability of inexpensive generics, the patient preference for non-CIT options like Bruton's tyrosine kinase (BTK) inhibitors is palpable. The CLL scene in India is changing rapidly. With the wide availability of economical generic small molecule inhibitors, monoclonal antibodies, and coverage by social health insurance schemes, India is poised to cater to most CLL patient needs.
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Affiliation(s)
| | | | - Deepesh P Lad
- Department of Clinical Hematology and Medical Oncology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India.
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Syal R, Mohammed S, Kumar R, Jain N, Bhatia P. Continuous erector spinae plane block for analgesia and better pulmonary functions in patients with multiple rib fractures: a prospective descriptive study. Braz J Anesthesiol 2024; 74:744289. [PMID: 34624374 PMCID: PMC10877332 DOI: 10.1016/j.bjane.2021.09.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 09/01/2021] [Accepted: 09/05/2021] [Indexed: 11/15/2022]
Abstract
BACKGROUND The present study explored the role of continuous erector spinae plane (ESP) block for analgesia as well as its impact on pulmonary functions in patients with multiple rib fractures. METHODS Ten patients with multiple rib fractures were enrolled after getting informed and written consent. Ultrasound-guided ESP block was performed at the level midway between the fractured ribs followed by the insertion of the catheter. Pre- and post-block VAS score, hemodynamics, respiratory rate (RR), peripheral oxygen saturation (SpO2), inspiratory capacity (IC), blood gases (PaO2 and PCO2), and complications were compared. RESULTS Pain scores at rest as well as on movement showed a significant reduction from 5.9 and 7.5 pre block to 1.6 and 2.5 respectively at 96.ßhours (p.ß<.ß0.0001). Similarly, RR, SpO2, IC, and PaO2 were significantly better after the block placement (p.ß<.ß0.001). CONCLUSION Continuous ESP block provide adequate analgesia with better respiratory functions in patients with multiple rib fractures.
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Affiliation(s)
- Rashmi Syal
- All India Institute of Medical Sciences, Department of Anesthesiology and Critical Care, Jodhpur, India.
| | - Sadik Mohammed
- All India Institute of Medical Sciences, Department of Anesthesiology and Critical Care, Jodhpur, India
| | - Rakesh Kumar
- All India Institute of Medical Sciences, Department of Anesthesiology and Critical Care, Jodhpur, India
| | - Nidhi Jain
- All India Institute of Medical Sciences, Department of Anesthesiology and Critical Care, Jodhpur, India
| | - Pradeep Bhatia
- All India Institute of Medical Sciences, Department of Anesthesiology and Critical Care, Jodhpur, India
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R, Chukwu C, Chung K, Cianciolo G, Cipressa L, Clark S, Clarke H, Clarke R, Clarke S, Cleveland B, Cole E, Coles H, Condurache L, Connor A, Convery K, Cooper A, Cooper N, Cooper Z, Cooperman L, Cosgrove L, Coutts P, Cowley A, Craik R, Cui G, Cummins T, Dahl N, Dai H, Dajani L, D'Amelio A, Damian E, Damianik K, Danel L, Daniels C, Daniels T, Darbeau S, Darius H, Dasgupta T, Davies J, Davies L, Davis A, Davis J, Davis L, Dayanandan R, Dayi S, Dayrell R, De Nicola L, Debnath S, Deeb W, Degenhardt S, DeGoursey K, Delaney M, Deo R, DeRaad R, Derebail V, Dev D, Devaux M, Dhall P, Dhillon G, Dienes J, Dobre M, Doctolero E, Dodds V, Domingo D, Donaldson D, Donaldson P, Donhauser C, Donley V, Dorestin S, Dorey S, Doulton T, Draganova D, Draxlbauer K, Driver F, Du H, Dube F, Duck T, Dugal T, Dugas J, Dukka H, Dumann H, Durham W, Dursch M, Dykas R, Easow R, Eckrich E, Eden G, Edmerson E, Edwards H, Ee LW, Eguchi J, Ehrl Y, Eichstadt K, Eid W, Eilerman B, Ejima Y, Eldon H, Ellam T, Elliott L, 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S, Girakossyan I, Girndt M, Giuffrida A, Glenwright M, Glider T, Gloria R, Glowski D, Goh BL, Goh CB, Gohda T, Goldenberg R, Goldfaden R, Goldsmith C, Golson B, Gonce V, Gong Q, Goodenough B, Goodwin N, Goonasekera M, Gordon A, Gordon J, Gore A, Goto H, Goto S, Goto S, Gowen D, Grace A, Graham J, Grandaliano G, Gray M, Green JB, Greene T, Greenwood G, Grewal B, Grifa R, Griffin D, Griffin S, Grimmer P, Grobovaite E, Grotjahn S, Guerini A, Guest C, Gunda S, Guo B, Guo Q, Haack S, Haase M, Haaser K, Habuki K, Hadley A, Hagan S, Hagge S, Haller H, Ham S, Hamal S, Hamamoto Y, Hamano N, Hamm M, Hanburry A, Haneda M, Hanf C, Hanif W, Hansen J, Hanson L, Hantel S, Haraguchi T, Harding E, Harding T, Hardy C, Hartner C, Harun Z, Harvill L, Hasan A, Hase H, Hasegawa F, Hasegawa T, Hashimoto A, Hashimoto C, Hashimoto M, Hashimoto S, Haskett S, Hauske SJ, Hawfield A, Hayami T, Hayashi M, Hayashi S, Haynes R, Hazara A, Healy C, Hecktman J, Heine G, Henderson H, Henschel R, Hepditch A, Herfurth K, Hernandez G, Hernandez Pena A, Hernandez-Cassis C, Herrington WG, Herzog C, Hewins S, Hewitt D, Hichkad L, Higashi S, Higuchi C, Hill C, Hill L, Hill M, Himeno T, Hing A, Hirakawa Y, Hirata K, Hirota Y, Hisatake T, Hitchcock S, Hodakowski A, Hodge W, Hogan R, Hohenstatt U, Hohenstein B, Hooi L, Hope S, Hopley M, Horikawa S, Hosein D, Hosooka T, Hou L, Hou W, Howie L, Howson A, Hozak M, Htet Z, Hu X, Hu Y, Huang J, Huda N, Hudig L, Hudson A, Hugo C, Hull R, Hume L, Hundei W, Hunt N, Hunter A, Hurley S, Hurst A, Hutchinson C, Hyo T, Ibrahim FH, Ibrahim S, Ihana N, Ikeda T, Imai A, Imamine R, Inamori A, Inazawa H, Ingell J, Inomata K, Inukai Y, Ioka M, Irtiza-Ali A, Isakova T, Isari W, Iselt M, Ishiguro A, Ishihara K, Ishikawa T, Ishimoto T, Ishizuka K, Ismail R, Itano S, Ito H, Ito K, Ito M, Ito Y, Iwagaitsu S, Iwaita Y, Iwakura T, Iwamoto M, Iwasa M, Iwasaki H, Iwasaki S, Izumi K, Izumi K, Izumi T, Jaafar SM, Jackson C, Jackson Y, Jafari G, Jahangiriesmaili M, Jain N, Jansson K, Jasim H, Jeffers L, Jenkins A, Jesky M, Jesus-Silva J, Jeyarajah D, Jiang Y, Jiao X, Jimenez G, Jin B, Jin Q, Jochims J, Johns B, Johnson C, Johnson T, Jolly S, Jones L, Jones L, Jones S, Jones T, Jones V, Joseph M, Joshi S, Judge P, Junejo N, Junus S, Kachele M, Kadowaki T, Kadoya H, Kaga H, Kai H, Kajio H, Kaluza-Schilling W, Kamaruzaman L, Kamarzarian A, Kamimura Y, Kamiya H, Kamundi C, Kan T, Kanaguchi Y, Kanazawa A, Kanda E, Kanegae S, Kaneko K, Kaneko K, Kang HY, Kano T, Karim M, Karounos D, Karsan W, Kasagi R, Kashihara N, Katagiri H, Katanosaka A, Katayama A, Katayama M, Katiman E, Kato K, Kato M, Kato N, Kato S, Kato T, Kato Y, Katsuda Y, Katsuno T, Kaufeld J, Kavak Y, Kawai I, Kawai M, Kawai M, Kawase A, Kawashima S, Kazory A, Kearney J, Keith B, Kellett J, Kelley S, Kershaw M, Ketteler M, Khai Q, Khairullah Q, Khandwala H, Khoo KKL, Khwaja A, Kidokoro K, Kielstein J, Kihara M, Kimber C, Kimura S, Kinashi H, Kingston H, Kinomura M, Kinsella-Perks E, Kitagawa M, Kitajima M, Kitamura 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Effects of empagliflozin on progression of chronic kidney disease: a prespecified secondary analysis from the empa-kidney trial. Lancet Diabetes Endocrinol 2024; 12:39-50. [PMID: 38061371 PMCID: PMC7615591 DOI: 10.1016/s2213-8587(23)00321-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Sodium-glucose co-transporter-2 (SGLT2) inhibitors reduce progression of chronic kidney disease and the risk of cardiovascular morbidity and mortality in a wide range of patients. However, their effects on kidney disease progression in some patients with chronic kidney disease are unclear because few clinical kidney outcomes occurred among such patients in the completed trials. In particular, some guidelines stratify their level of recommendation about who should be treated with SGLT2 inhibitors based on diabetes status and albuminuria. We aimed to assess the effects of empagliflozin on progression of chronic kidney disease both overall and among specific types of participants in the EMPA-KIDNEY trial. METHODS EMPA-KIDNEY, a randomised, controlled, phase 3 trial, was conducted at 241 centres in eight countries (Canada, China, Germany, Italy, Japan, Malaysia, the UK, and the USA), and included individuals aged 18 years or older with an estimated glomerular filtration rate (eGFR) of 20 to less than 45 mL/min per 1·73 m2, or with an eGFR of 45 to less than 90 mL/min per 1·73 m2 with a urinary albumin-to-creatinine ratio (uACR) of 200 mg/g or higher. We explored the effects of 10 mg oral empagliflozin once daily versus placebo on the annualised rate of change in estimated glomerular filtration rate (eGFR slope), a tertiary outcome. We studied the acute slope (from randomisation to 2 months) and chronic slope (from 2 months onwards) separately, using shared parameter models to estimate the latter. Analyses were done in all randomly assigned participants by intention to treat. EMPA-KIDNEY is registered at ClinicalTrials.gov, NCT03594110. FINDINGS Between May 15, 2019, and April 16, 2021, 6609 participants were randomly assigned and then followed up for a median of 2·0 years (IQR 1·5-2·4). Prespecified subgroups of eGFR included 2282 (34·5%) participants with an eGFR of less than 30 mL/min per 1·73 m2, 2928 (44·3%) with an eGFR of 30 to less than 45 mL/min per 1·73 m2, and 1399 (21·2%) with an eGFR 45 mL/min per 1·73 m2 or higher. Prespecified subgroups of uACR included 1328 (20·1%) with a uACR of less than 30 mg/g, 1864 (28·2%) with a uACR of 30 to 300 mg/g, and 3417 (51·7%) with a uACR of more than 300 mg/g. Overall, allocation to empagliflozin caused an acute 2·12 mL/min per 1·73 m2 (95% CI 1·83-2·41) reduction in eGFR, equivalent to a 6% (5-6) dip in the first 2 months. After this, it halved the chronic slope from -2·75 to -1·37 mL/min per 1·73 m2 per year (relative difference 50%, 95% CI 42-58). The absolute and relative benefits of empagliflozin on the magnitude of the chronic slope varied significantly depending on diabetes status and baseline levels of eGFR and uACR. In particular, the absolute difference in chronic slopes was lower in patients with lower baseline uACR, but because this group progressed more slowly than those with higher uACR, this translated to a larger relative difference in chronic slopes in this group (86% [36-136] reduction in the chronic slope among those with baseline uACR <30 mg/g compared with a 29% [19-38] reduction for those with baseline uACR ≥2000 mg/g; ptrend<0·0001). INTERPRETATION Empagliflozin slowed the rate of progression of chronic kidney disease among all types of participant in the EMPA-KIDNEY trial, including those with little albuminuria. Albuminuria alone should not be used to determine whether to treat with an SGLT2 inhibitor. FUNDING Boehringer Ingelheim and Eli Lilly.
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Ryder M, Sabarai A, Saccà C, Sachson R, Sadler E, Safiee NS, Sahani M, Saillant A, Saini J, Saito C, Saito S, Sakaguchi K, Sakai M, Salim H, Salviani C, Sammons E, Sampson A, Samson F, Sandercock P, Sanguila S, Santorelli G, Santoro D, Sarabu N, Saram T, Sardell R, Sasajima H, Sasaki T, Satko S, Sato A, Sato D, Sato H, Sato H, Sato J, Sato T, Sato Y, Satoh M, Sawada K, Schanz M, Scheidemantel F, Schemmelmann M, Schettler E, Schettler V, Schlieper GR, Schmidt C, Schmidt G, Schmidt U, Schmidt-Gurtler H, Schmude M, Schneider A, Schneider I, Schneider-Danwitz C, Schomig M, Schramm T, Schreiber A, Schricker S, Schroppel B, Schulte-Kemna L, Schulz E, Schumacher B, Schuster A, Schwab A, Scolari F, Scott A, Seeger W, Seeger W, Segal M, Seifert L, Seifert M, Sekiya M, Sellars R, Seman MR, Shah S, Shah S, Shainberg L, Shanmuganathan M, Shao F, Sharma K, Sharpe C, Sheikh-Ali M, Sheldon J, Shenton C, Shepherd A, Shepperd M, Sheridan R, Sheriff Z, Shibata Y, Shigehara T, Shikata K, Shimamura K, Shimano H, Shimizu Y, Shimoda H, Shin K, Shivashankar G, Shojima N, Silva R, Sim CSB, Simmons K, Sinha S, Sitter T, Sivanandam S, Skipper M, Sloan K, Sloan L, Smith R, Smyth J, Sobande T, Sobata M, Somalanka S, Song X, Sonntag F, Sood B, Sor SY, Soufer J, Sparks H, Spatoliatore G, Spinola T, Squyres S, Srivastava A, Stanfield J, Staplin N, Staylor K, Steele A, Steen O, Steffl D, Stegbauer J, Stellbrink C, Stellbrink E, Stevens W, Stevenson A, Stewart-Ray V, Stickley J, Stoffler D, Stratmann B, Streitenberger S, Strutz F, Stubbs J, Stumpf J, Suazo N, Suchinda P, Suckling R, Sudin A, Sugamori K, Sugawara H, Sugawara K, Sugimoto D, Sugiyama H, Sugiyama H, Sugiyama T, Sullivan M, Sumi M, Suresh N, Sutton D, Suzuki H, Suzuki R, Suzuki Y, Suzuki Y, Suzuki Y, Swanson E, Swift P, Syed S, Szerlip H, Taal M, Taddeo M, Tailor C, Tajima K, Takagi M, Takahashi K, Takahashi K, Takahashi M, Takahashi T, Takahira E, Takai T, Takaoka M, Takeoka J, Takesada A, Takezawa M, Talbot M, Taliercio J, Talsania T, Tamori Y, Tamura R, Tamura Y, Tan CHH, Tan EZZ, Tanabe A, Tanabe K, Tanaka A, Tanaka A, Tanaka N, Tang S, Tang Z, Tanigaki K, Tarlac M, Tatsuzawa A, Tay JF, Tay LL, Taylor J, Taylor K, Taylor K, Te A, Tenbusch L, Teng KS, Terakawa A, Terry J, Tham ZD, Tholl S, Thomas G, Thong KM, Tietjen D, Timadjer A, Tindall H, Tipper S, Tobin K, Toda N, Tokuyama A, Tolibas M, Tomita A, Tomita T, Tomlinson J, Tonks L, Topf J, Topping S, Torp A, Torres A, Totaro F, Toth P, Toyonaga Y, Tripodi F, Trivedi K, Tropman E, Tschope D, Tse J, Tsuji K, Tsunekawa S, Tsunoda R, Tucky B, Tufail S, Tuffaha A, Turan E, Turner H, Turner J, Turner M, Tuttle KR, Tye YL, Tyler A, Tyler J, Uchi H, Uchida H, Uchida T, Uchida T, Udagawa T, Ueda S, Ueda Y, Ueki K, Ugni S, Ugwu E, Umeno R, Unekawa C, Uozumi K, Urquia K, Valleteau A, Valletta C, van Erp R, Vanhoy C, Varad V, Varma R, Varughese A, Vasquez P, Vasseur A, Veelken R, Velagapudi C, Verdel K, Vettoretti S, Vezzoli G, Vielhauer V, Viera R, Vilar E, Villaruel S, Vinall L, Vinathan J, Visnjic M, Voigt E, von-Eynatten M, Vourvou M, Wada J, Wada J, Wada T, Wada Y, Wakayama K, Wakita Y, Wallendszus K, Walters T, Wan Mohamad WH, Wang L, Wang W, Wang X, Wang X, Wang Y, Wanner C, Wanninayake S, Watada H, Watanabe K, Watanabe K, Watanabe M, Waterfall H, Watkins D, Watson S, Weaving L, Weber B, Webley Y, Webster A, Webster M, Weetman M, Wei W, Weihprecht H, Weiland L, Weinmann-Menke J, Weinreich T, Wendt R, Weng Y, Whalen M, Whalley G, Wheatley R, Wheeler A, Wheeler J, Whelton P, White K, Whitmore B, Whittaker S, Wiebel J, Wiley J, Wilkinson L, Willett M, Williams A, Williams E, Williams K, Williams T, Wilson A, Wilson P, Wincott L, Wines E, Winkelmann B, Winkler M, Winter-Goodwin B, Witczak J, Wittes J, Wittmann M, Wolf G, Wolf L, Wolfling R, Wong C, Wong E, Wong HS, Wong LW, Wong YH, Wonnacott A, Wood A, Wood L, Woodhouse H, Wooding N, Woodman A, Wren K, Wu J, Wu P, Xia S, Xiao H, Xiao X, Xie Y, Xu C, Xu Y, Xue H, Yahaya H, Yalamanchili H, Yamada A, Yamada N, Yamagata K, Yamaguchi M, Yamaji Y, Yamamoto A, Yamamoto S, Yamamoto S, Yamamoto T, Yamanaka A, Yamano T, Yamanouchi Y, Yamasaki N, Yamasaki Y, Yamasaki Y, Yamashita C, Yamauchi T, Yan Q, Yanagisawa E, Yang F, Yang L, Yano S, Yao S, Yao Y, Yarlagadda S, Yasuda Y, Yiu V, Yokoyama T, Yoshida S, Yoshidome E, Yoshikawa H, Young A, Young T, Yousif V, Yu H, Yu Y, Yuasa K, Yusof N, Zalunardo N, Zander B, Zani R, Zappulo F, Zayed M, Zemann B, Zettergren P, Zhang H, Zhang L, Zhang L, Zhang N, Zhang X, Zhao J, Zhao L, Zhao S, Zhao Z, Zhong H, Zhou N, Zhou S, Zhu D, Zhu L, Zhu S, Zietz M, Zippo M, Zirino F, Zulkipli FH. Impact of primary kidney disease on the effects of empagliflozin in patients with chronic kidney disease: secondary analyses of the EMPA-KIDNEY trial. Lancet Diabetes Endocrinol 2024; 12:51-60. [PMID: 38061372 DOI: 10.1016/s2213-8587(23)00322-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND The EMPA-KIDNEY trial showed that empagliflozin reduced the risk of the primary composite outcome of kidney disease progression or cardiovascular death in patients with chronic kidney disease mainly through slowing progression. We aimed to assess how effects of empagliflozin might differ by primary kidney disease across its broad population. METHODS EMPA-KIDNEY, a randomised, controlled, phase 3 trial, was conducted at 241 centres in eight countries (Canada, China, Germany, Italy, Japan, Malaysia, the UK, and the USA). Patients were eligible if their estimated glomerular filtration rate (eGFR) was 20 to less than 45 mL/min per 1·73 m2, or 45 to less than 90 mL/min per 1·73 m2 with a urinary albumin-to-creatinine ratio (uACR) of 200 mg/g or higher at screening. They were randomly assigned (1:1) to 10 mg oral empagliflozin once daily or matching placebo. Effects on kidney disease progression (defined as a sustained ≥40% eGFR decline from randomisation, end-stage kidney disease, a sustained eGFR below 10 mL/min per 1·73 m2, or death from kidney failure) were assessed using prespecified Cox models, and eGFR slope analyses used shared parameter models. Subgroup comparisons were performed by including relevant interaction terms in models. EMPA-KIDNEY is registered with ClinicalTrials.gov, NCT03594110. FINDINGS Between May 15, 2019, and April 16, 2021, 6609 participants were randomly assigned and followed up for a median of 2·0 years (IQR 1·5-2·4). Prespecified subgroupings by primary kidney disease included 2057 (31·1%) participants with diabetic kidney disease, 1669 (25·3%) with glomerular disease, 1445 (21·9%) with hypertensive or renovascular disease, and 1438 (21·8%) with other or unknown causes. Kidney disease progression occurred in 384 (11·6%) of 3304 patients in the empagliflozin group and 504 (15·2%) of 3305 patients in the placebo group (hazard ratio 0·71 [95% CI 0·62-0·81]), with no evidence that the relative effect size varied significantly by primary kidney disease (pheterogeneity=0·62). The between-group difference in chronic eGFR slopes (ie, from 2 months to final follow-up) was 1·37 mL/min per 1·73 m2 per year (95% CI 1·16-1·59), representing a 50% (42-58) reduction in the rate of chronic eGFR decline. This relative effect of empagliflozin on chronic eGFR slope was similar in analyses by different primary kidney diseases, including in explorations by type of glomerular disease and diabetes (p values for heterogeneity all >0·1). INTERPRETATION In a broad range of patients with chronic kidney disease at risk of progression, including a wide range of non-diabetic causes of chronic kidney disease, empagliflozin reduced risk of kidney disease progression. Relative effect sizes were broadly similar irrespective of the cause of primary kidney disease, suggesting that SGLT2 inhibitors should be part of a standard of care to minimise risk of kidney failure in chronic kidney disease. FUNDING Boehringer Ingelheim, Eli Lilly, and UK Medical Research Council.
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Rajput V, Pramanik R, Malik V, Yadav R, Samson R, Kadam P, Bhalerao U, Tupekar M, Deshpande D, Shah P, Shashidhara LS, Boargaonkar R, Patil D, Kale S, Bhalerao A, Jain N, Kamble S, Dastager S, Karmodiya K, Dharne M. Genomic surveillance reveals early detection and transition of delta to omicron lineages of SARS-CoV-2 variants in wastewater treatment plants of Pune, India. Environ Sci Pollut Res Int 2023; 30:118976-118988. [PMID: 37922087 DOI: 10.1007/s11356-023-30709-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 10/23/2023] [Indexed: 11/05/2023]
Abstract
The COVID-19 pandemic has emphasized the urgency for rapid public health surveillance methods to detect and monitor the transmission of infectious diseases. The wastewater-based epidemiology (WBE) has emerged as a promising tool for proactive analysis and quantification of infectious pathogens within a population before clinical cases emerge. In the present study, we aimed to assess the trend and dynamics of SARS-CoV-2 variants using a longitudinal approach. Our objective included early detection and monitoring of these variants to enhance our understanding of their prevalence and potential impact. To achieve our goals, we conducted real-time quantitative polymerase chain reaction (RT-qPCR) and Illumina sequencing on 442 wastewater (WW) samples collected from 10 sewage treatment plants (STPs) in Pune city, India, spanning from November 2021 to April 2022. Our comprehensive analysis identified 426 distinct lineages representing 17 highly transmissible variants of SARS-CoV-2. Notably, fragments of Omicron variant were detected in WW samples prior to its first clinical detection in Botswana. Furthermore, we observed highly contagious sub-lineages of the Omicron variant, including BA.1 (~28%), BA.1.X (1.0-72%), BA.2 (1.0-18%), BA.2.X (1.0-97.4%) BA.2.12 (0.8-0.25%), BA.2.38 (0.8-1.0%), BA.2.75 (0.01-0.02%), BA.3 (0.09-6.3%), BA.4 (0.24-0.29%), and XBB (0.01-21.83%), with varying prevalence rates. Overall, the present study demonstrated the practicality of WBE in the early detection of SARS-CoV-2 variants, which could help track future outbreaks of SARS-CoV-2. Such approaches could be implicated in monitoring infectious agents before they appear in clinical cases.
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Affiliation(s)
- Vinay Rajput
- National Collection of Industrial Microorganisms (NCIM), Biochemical Sciences Division, CSIR-National Chemical Laboratory (NCL), Pune, Maharashtra, 411008, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, Uttar Pradesh, 201002, India
| | - Rinka Pramanik
- National Collection of Industrial Microorganisms (NCIM), Biochemical Sciences Division, CSIR-National Chemical Laboratory (NCL), Pune, Maharashtra, 411008, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, Uttar Pradesh, 201002, India
| | - Vinita Malik
- National Collection of Industrial Microorganisms (NCIM), Biochemical Sciences Division, CSIR-National Chemical Laboratory (NCL), Pune, Maharashtra, 411008, India
| | - Rakeshkumar Yadav
- National Collection of Industrial Microorganisms (NCIM), Biochemical Sciences Division, CSIR-National Chemical Laboratory (NCL), Pune, Maharashtra, 411008, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, Uttar Pradesh, 201002, India
| | - Rachel Samson
- National Collection of Industrial Microorganisms (NCIM), Biochemical Sciences Division, CSIR-National Chemical Laboratory (NCL), Pune, Maharashtra, 411008, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, Uttar Pradesh, 201002, India
| | - Pradnya Kadam
- Department of Biology, Indian Institute of Science Education and Research (IISER), Pune, Maharashtra, 41108, India
| | - Unnati Bhalerao
- Department of Biology, Indian Institute of Science Education and Research (IISER), Pune, Maharashtra, 41108, India
| | - Manisha Tupekar
- Department of Biology, Indian Institute of Science Education and Research (IISER), Pune, Maharashtra, 41108, India
| | - Dipti Deshpande
- Department of Biology, Indian Institute of Science Education and Research (IISER), Pune, Maharashtra, 41108, India
| | - Priyanki Shah
- The Pune Knowledge Cluster (PKC), Savitribai Phule Pune University (SPPU), Pune, Maharashtra, India
| | - L S Shashidhara
- Department of Biology, Indian Institute of Science Education and Research (IISER), Pune, Maharashtra, 41108, India
- The Pune Knowledge Cluster (PKC), Savitribai Phule Pune University (SPPU), Pune, Maharashtra, India
| | | | - Dhawal Patil
- Ecosan Services Foundation (ESF), Pune, Maharashtra, 411030, India
| | - Saurabh Kale
- Ecosan Services Foundation (ESF), Pune, Maharashtra, 411030, India
| | - Asim Bhalerao
- Fluid Robotics Private Limited (FRPL), Pune, Maharashtra, 411052, India
| | - Nidhi Jain
- Fluid Robotics Private Limited (FRPL), Pune, Maharashtra, 411052, India
| | - Sanjay Kamble
- Chemical Engineering and Process Development Division, CSIR-National Chemical Laboratory, Pune, Maharashtra, 411008, India
| | - Syed Dastager
- National Collection of Industrial Microorganisms (NCIM), Biochemical Sciences Division, CSIR-National Chemical Laboratory (NCL), Pune, Maharashtra, 411008, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, Uttar Pradesh, 201002, India
| | - Krishanpal Karmodiya
- Department of Biology, Indian Institute of Science Education and Research (IISER), Pune, Maharashtra, 41108, India
| | - Mahesh Dharne
- National Collection of Industrial Microorganisms (NCIM), Biochemical Sciences Division, CSIR-National Chemical Laboratory (NCL), Pune, Maharashtra, 411008, India.
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, Uttar Pradesh, 201002, India.
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Mitchell JD, Laurie M, Xia Q, Dreyfus B, Jain N, Jain A, Lane D, Lenihan DJ. Risk profiles and incidence of cardiovascular events across different cancer types. ESMO Open 2023; 8:101830. [PMID: 37979325 PMCID: PMC10774883 DOI: 10.1016/j.esmoop.2023.101830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Accepted: 09/04/2023] [Indexed: 11/20/2023] Open
Abstract
BACKGROUND Cancer survivors are at increased risk for cardiovascular (CV) disease, although additional data are needed to better understand the incidence of CV events across different malignancies. This study sought to characterize the incidence of major adverse CV events [myocardial infarction, stroke, unstable angina (MACE), or heart failure (HF)] across multiple cancer types after cancer diagnosis. PATIENTS AND METHODS Patients were identified from a USA-based administrative claims database who had index cancer diagnoses of breast, lung, prostate, melanoma, myeloma, kidney, colorectal, leukemia, or lymphoma between 2011 and 2019, with continuous enrollment for ≥12 months before diagnosis. Baseline CV risk factors and incidence rates of CV events post-index were identified for each cancer. Multivariable Cox hazards models assessed the cumulative incidence of MACE, accounting for baseline risk factors. RESULTS Among 839 934 patients across nine cancer types, CV risk factors were prevalent. The cumulative incidence of MACE was highest in lung cancer and myeloma, and lowest in breast cancer, prostate cancer, and melanoma. MACE cumulative incidence for lung cancer was 26% by 4 years (2.7-fold higher relative to breast cancer). The incidence of stroke was especially pronounced in lung cancer, while HF was highest in myeloma and lung cancer. CONCLUSIONS CV events were especially increased following certain cancer diagnoses, even after accounting for baseline risk factors. Understanding the variable patient characteristics and associated CV events across different cancers can help target appropriate CV risk factor modification and develop strategies to minimize adverse CV events and improve patient outcomes.
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Affiliation(s)
- J D Mitchell
- Cardio-Oncology Center of Excellence, Washington University in St. Louis, St. Louis, USA; International Cardio-Oncology Society, Tampa, USA.
| | - M Laurie
- Bristol Myers Squibb, Lawrenceville, USA
| | - Q Xia
- Bristol Myers Squibb, Lawrenceville, USA
| | - B Dreyfus
- Bristol Myers Squibb, Lawrenceville, USA
| | - N Jain
- Mu Sigma, Northbrook, USA
| | - A Jain
- Mu Sigma, Northbrook, USA
| | - D Lane
- Bristol Myers Squibb, Lawrenceville, USA
| | - D J Lenihan
- International Cardio-Oncology Society, Tampa, USA; Cape Cardiology Group, Saint Francis Healthcare, Cape Girardeau, USA
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Jain P, Chauhan AK, Singh K, Garg R, Jain N, Singh R. Correlation of perceived stress with monthly cyclical changes in the female body. J Family Med Prim Care 2023; 12:2927-2933. [PMID: 38186841 PMCID: PMC10771141 DOI: 10.4103/jfmpc.jfmpc_874_23] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 07/10/2023] [Accepted: 07/12/2023] [Indexed: 01/09/2024] Open
Abstract
Background Women are liable to stress-related disorders as female sex hormone, estrogen has been indicated to be protective against stress disorders. The hormone level varies with different phases of menstrual cycle. Moreover, postmenopausal women are at risk for stress-related disorders. So this study was done to correlate the different phases of menstrual cycle with the perceived stress in different phases of monthly cycle. Methods This study was conducted in the Department of Physiology, Shri Guru Ram Rai Institute of Medical and Health Sciences (SGRRIMHS), Dehradun. Four hundred girls in the age group of 18-26 years were selected for the study. The Perceived Stress Scale (PSS) questionnaire was circulated via Google forms after briefing them about the study. Informed consent was also taken. The menstrual history of the subjects was enquired by one-to-one interaction. The participants completed the PSS questionnaire twice in the same cycle. Data collected were statistically analyzed, using Independent t-test and Chi-square test and point biserial correlation test. Result The analysis showed strong statistical association of PSS with two phases of menstrual cycle. The PSS score was higher in the late luteal and menstrual phase, while it was less in the late follicular phase (P < 0.05). Conclusion: The decreased oestrogen levels in the late luteal & menstrual phase are strongly associated with perceived stress in our study. Hormonal changes in the monthly cycles are related with stress, behavioral shift and many other physical changes in females. This information to the family physicians would be beneficial in counseling the females regarding various changes occurring during the menstrual cycle.
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Affiliation(s)
- Prashant Jain
- Department of Physiology, Shri Guru Ram Rai Institute of Medical and Health Sciences (SGRRIMHS), Dehradun, Uttarakhand, India
| | - Anil Kumar Chauhan
- Department of Physiology, SKS Hospital Medical College and Research Center, Mathura, Uttar Pradesh, India
| | - Kavita Singh
- Department of Physiology, Shri Guru Ram Rai Institute of Medical and Health Sciences (SGRRIMHS), Dehradun, Uttarakhand, India
| | - Rinku Garg
- Department of Physiology, School of Medical Sciences and Research, Sharda University, Greater Noida, Uttar Pradesh, India
| | - Nidhi Jain
- Department of Physiology, Shri Guru Ram Rai Institute of Medical and Health Sciences (SGRRIMHS), Dehradun, Uttarakhand, India
| | - Randhir Singh
- Department of Physiology, Shri Guru Ram Rai Institute of Medical and Health Sciences (SGRRIMHS), Dehradun, Uttarakhand, India
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Ballal S, Singh A, Jain N, Bhati H, Salahuddin , Patel J D. AN IN-DEPTH ASSESSMENT OF THE TUMOR'S IMPACT ON SARCOPENIA. Georgian Med News 2023:38-43. [PMID: 38096513] [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: 12/18/2023]
Abstract
Loss of muscle mass is a typical symptom of cancer and it is strongly correlated with poor prognosis. Cancer-related Sarcopenia is unresponsive to conventional dietary changes and exercise, in contrast to age-associated muscle atrophy. This particular type of weakness differs from different kinds of muscle loss in that it is triggered by a number of interrelated mechanisms, notably inflammatory processes, abnormal metabolic processes, proteolysis, and autophagy. This research is to examine evidence supporting the theory that tumors have a causal role in causing muscular atrophy. It seeks to investigate the precise regulators that the tumour generates and how they affect the processes that result in muscle waste. The evaluation looks for new directions for further studies and medical treatments. The analysis is based on a thorough examination of the scientific literature and research that shows how tumor and muscle atrophy are related. It concentrates on studies that clarify the numerous strategies by which malignancies cause the loss of muscle. This article highlights particular mechanisms by which these tumor-derived substances affect the development of muscle loss, including inflammatory processes, metabolic disturbance, proteolysis, and autophagy. The discovery of such targets offers hope for the creation of efficient treatment strategies that can enhance the long-term outlook and quality of life of cancer sufferers who are experiencing muscle loss.
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Affiliation(s)
- S Ballal
- 1Department of Biochemistry, School of Sciences, JAIN (Deemed-to-be University), Karnataka, India
| | - A Singh
- 2School of Pharmacy & Research, Dev Bhoomi Uttarakhand University, Dehradun, India
| | - N Jain
- 3Department of Allied Healthcare and Sciences, Vivekananda Global University, Jaipur, India
| | - H Bhati
- 4Department of General Surgery, TMMC&RC, Teerthanker Mahaveer University, Moradabad, Uttar Pradesh, India
| | - - Salahuddin
- 5Department of Pharmacy, Noida Institute of Engineering and Technology (Pharmacy Institute), Uttar Pradesh, India
| | - D Patel J
- 6Department of Pharmacology, Parul University, PO Limda, Tal. Waghodia, District Vadodara, Gujarat, India
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Schrank BR, Manzar GS, Wu SY, Gunther JR, Fang P, Jabbour EJ, Lim TY, Daver NG, Cykowski MD, Fuller GN, Cachia D, Kamiya-Matsuoka C, Woodman KH, DiNardo CD, Jain N, Short NJ, Sasaki K, Dabaja B, Kantarjian HM, Pinnix CC. Dorsal Column Myelopathy Following Intrathecal Chemotherapy for Leukemia. Int J Radiat Oncol Biol Phys 2023; 117:e486-e487. [PMID: 37785537 DOI: 10.1016/j.ijrobp.2023.06.1715] [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] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Intrathecal (IT) methotrexate (Mtx) and/or cytarabine (AraC) improve CNS disease control in patients (pts) with hematologic malignancies. There are increasing number of case reports of irreversible, primarily dorsal column myelopathy in pts treated with IT chemotherapy. By describing the largest case series of myelopathy following IT chemotherapy, we aim to raise awareness about this devastating albeit rare complication. MATERIALS/METHODS We retrospectively reviewed 25 pts with leukemia who developed paraplegia following IT chemotherapy between 2/2006 and 9/2021. Clinical/treatment characteristics, response, and toxicity were extracted from the medical records. RESULTS Seventeen pts (68%) were male, 16 had B-cell ALL (64%), 4 had AML (16%), 2 had CML (8%), 2 had T-ALL (8%), and 1 had BPDCN (4%). The median age at diagnosis was 38 years (IQR 30-59). All pts required systemic salvage treatment after induction chemotherapy with a median number of 3 regimens received (IQR 2-5.5). In total, the median number of IT treatments was 19 per pt (IQR 14-27). Most pts (84%, n = 21) received single agent IT Mtx alternating with single agent AraC. Fifteen pts (60%) received triple IT therapy with a median of 3 treatments (IQR 0-8). Prior to the onset of myelopathy, 10 pts (40%) received allogeneic SCT and 9 pts (36%) were treated with radiation therapy. Median follow-up from diagnosis was 1.9 yrs (IQR 1.3-4.1). Myelopathy was progressive and irreversible in all pts (n = 25); 84% (n = 21) experienced sensory loss, and all pts had extremity weakness. Symptoms were ascending in 11 pts (44%) and descending in 4 pts (16%). Irreversible bowel/bladder incontinence developed in 12 pts (48%). CSF analysis at the time of symptom onset was negative for leukemia cells in most pts (n = 21, 84%) and showed malignant cells in 4 pts (16%). CSF studies showed elevated protein in 21 pts (84%). Myelin basic protein was elevated in all 13 assessed pts. On T2 weighted spinal MRI, all pts had enhancement of the dorsal columns, including 80% of pts with this dorsal column abnormality reported at the time of the study and 20% of pts (n = 5) with the dorsal enhancement noted retrospectively. Due to concern for occult disease, 20 pts (80%) received additional CNS-directed therapy after symptom onset. Twenty-two pts (88%) died at last follow-up. The time between neurological symptom onset and death was a median 3.5 months (IQR 2.6 and 5). Three pts (12%) are alive with paraplegia at a median of 4.4 years from symptom onset. CONCLUSION Dorsal column myelopathy is a rare but devastating condition that can occur after IT chemotherapy in heavily pre-treated leukemia pts. T2 weighted spinal MRI can be helpful in the evaluation of pts that present with unexplained weakness and sensory changes. We recommend delaying additional CNS-directed therapy until work-up to rule out alternative etiologies is complete. Future strategies are desperately needed to address this irreversible treatment complication.
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Affiliation(s)
- B R Schrank
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - G S Manzar
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - S Y Wu
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - J R Gunther
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - P Fang
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - E J Jabbour
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - T Y Lim
- Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - N G Daver
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - M D Cykowski
- Department of Pathology and Genomic Medicine, Houston Methodist, Houston, TX
| | - G N Fuller
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - D Cachia
- Department of Neurology, UMass Memorial Health, Worcester, MA
| | - C Kamiya-Matsuoka
- Department of Neuro-Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - K H Woodman
- Department of Neuro-Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - C D DiNardo
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - N Jain
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - N J Short
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - K Sasaki
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - B Dabaja
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - H M Kantarjian
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - C C Pinnix
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
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Abstract
An unprecedented C-1 selective mono-arylation/acylation of N-protected carbazoles with aryl diazonium salts/glyoxylic acids has been developed in visible light by dual catalytic system comprising of Eosin Y and palladium acetate. The methodology has good functional group tolerance and high regioselectivity and furnishes the monosubstituted products in moderate to good yields at room temperature.
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Affiliation(s)
- Nidhi Jain
- Department of Chemistry, Indian Institute of Technology Delhi, New Delhi 110016, India
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12
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Clarke S, Geczy R, Balgi A, Park S, Zhao R, Swaminathan M, Tieu R, Hoang N, Webb C, Watt E, Wong M, Fujisawa M, Jain N, Zhang A, Thomas A. Abstract 1785: Multi-step engineering of gene-edited CAR T cells using RNA lipid nanoparticles. Cancer Res 2023. [DOI: 10.1158/1538-7445.am2023-1785] [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] [Subscribe] [Scholar Register] [Indexed: 04/07/2023]
Abstract
Abstract
Autologous chimeric antigen receptor (CAR) T therapies utilize patient cells and can be limited by cell quality, and the high manufacturing burden of viral vectors. As such, there is a need for allogeneic, “off-the-shelf” CAR T cells to make these transformative treatments widely available. However, allogeneic therapies require multiple genetic engineering steps to express CAR and to delete proteins responsible for graft-versus-host disease. Messenger RNA (mRNA) is a promising approach for expression of therapeutic proteins and gene editing nucleases. In this work, we demonstrate a new method for multi-step engineering of gene-edited CAR T cells using RNA lipid nanoparticles (LNPs).
LNPs encapsulating Spy-Cas9 mRNA, TCR and CD52 guide RNA (sgRNA), and CAR mRNA were produced using microfluidics. The CAR construct contained an anti-CD19 scFv binding domain and CD3ζ/4-1BB co-stimulatory domains. Microgram quantities of RNA LNPs were produced to optimize LNP packaging, cargo ratios, and sgRNA combinations. Lead candidates were scaled to milligrams. Purified human primary T cells were cultured, activated, and expanded in serum-free media in plates, flasks and bioreactors. CAR+, TCR− or CD52− cells were generated by addition of the corresponding LNP to activated cells. Cytotoxic killing was determined by co-culture assays with leukemia cells. Gene knockout, CAR expression, viability and cell killing were measured using flow-cytometry.
CD19 CAR was selected as a relevant protein for expression, with TCR and CD52 proteins as gene knockout targets. Single-step addition of CAR LNPs to T cells resulted in transfection efficiencies of 95.0 ± 2.1% and high protein expression. Upon TCR or CD52 LNP addition to T cells, the onset of gene editing was within 48 hours, reaching single target knockout efficiencies of 92.3 ± 3.0% (TCR−), and double knockouts (TCR−/CD52−) of 74.5 ± 6.1%. Similar results were obtained when comparing different LNP batch sizes (microgram to milligram RNA) and cell culture vessels (125,000 to 45 million cells), demonstrating scalability of both the LNP production and cell treatment. Cell viabilities above 90% were maintained at all steps and for all RNA LNPs. Finally, as proof-of-concept for multi-step engineering, sequential addition of TCR LNPs and CAR LNPs resulted in simultaneous CAR expression and TCR gene knockout. These “off-the-shelf” gene-edited CAR T cells were functionally equivalent to non-edited cells in a B cell killing assay, efficiently clearing over 80% of leukemia target cells at a 1:1 ratio.
Our findings demonstrate the advantages of LNPs for RNA delivery to T cells. The simple and gentle nature of LNP cell treatment allows for multiple genetic engineering steps for simultaneous expression and deletion of proteins. Furthermore, LNPs can be easily manufactured using microfluidics, enabling small-scale screening of RNA libraries and rapid scale-up of lead candidates for clinical translation.
Citation Format: Samuel Clarke, R Geczy, A Balgi, S Park, R Zhao, M Swaminathan, R Tieu, N Hoang, C Webb, E Watt, M Wong, M Fujisawa, N Jain, Angela Zhang, Anitha Thomas. Multi-step engineering of gene-edited CAR T cells using RNA lipid nanoparticles [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 1785.
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Affiliation(s)
- Samuel Clarke
- 1Precision NanoSystems ULC, Vancouver, British Columbia, Canada
| | - R Geczy
- 1Precision NanoSystems ULC, Vancouver, British Columbia, Canada
| | - A Balgi
- 1Precision NanoSystems ULC, Vancouver, British Columbia, Canada
| | - S Park
- 1Precision NanoSystems ULC, Vancouver, British Columbia, Canada
| | - R Zhao
- 1Precision NanoSystems ULC, Vancouver, British Columbia, Canada
| | - M Swaminathan
- 1Precision NanoSystems ULC, Vancouver, British Columbia, Canada
| | - R Tieu
- 1Precision NanoSystems ULC, Vancouver, British Columbia, Canada
| | - N Hoang
- 1Precision NanoSystems ULC, Vancouver, British Columbia, Canada
| | - C Webb
- 1Precision NanoSystems ULC, Vancouver, British Columbia, Canada
| | - E Watt
- 1Precision NanoSystems ULC, Vancouver, British Columbia, Canada
| | - M Wong
- 1Precision NanoSystems ULC, Vancouver, British Columbia, Canada
| | - M Fujisawa
- 1Precision NanoSystems ULC, Vancouver, British Columbia, Canada
| | - N Jain
- 1Precision NanoSystems ULC, Vancouver, British Columbia, Canada
| | - Angela Zhang
- 1Precision NanoSystems ULC, Vancouver, British Columbia, Canada
| | - Anitha Thomas
- 1Precision NanoSystems ULC, Vancouver, British Columbia, Canada
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13
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Jain N, Lamberti M, Deolankar J, Marchalik D, McClure T, Browne W, Smirniotopoulos J. Abstract No. 565 Multi-Institutional Prospective Analysis of Percutaneous Image-Guided Large-Bore Gallstone Extraction for Inoperable Acute Calculous Cholecystitis. J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.423] [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: 02/27/2023] Open
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14
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Carrato K, Jain N, Eckert A, Lamberti M, Sutton C, Sens J, Horton K, Khan A, Tabori N, Sivananthan G, Smirniotopoulos J. Abstract No. 120 Genicular Nerve Radiofrequency Ablation: Is There a Predictor of Outcomes? J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.170] [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: 02/27/2023] Open
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15
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Dixit V, Sharma A, Jangid A, Jain N. Photo‐Induced Functionalization of para‐Benzoquinones: Access to Dihydroquinoxalines with a Tetrasubstituted Carbon Stereocenter. Adv Synth Catal 2023. [DOI: 10.1002/adsc.202300016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
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16
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Ritu R, Kolb DF, Jain N, Koenig B. Synthesis of Linear Enamides and Enecarbamates via Photoredox Acceptorless Dehydrogenation. Adv Synth Catal 2023. [DOI: 10.1002/adsc.202201259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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17
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Jha P, Chaturvedi S, Bhat R, Jain N, Mishra AK. Insights of ligand binding in modeled h5-HT 1A receptor: homology modeling, docking, MM-GBSA, screening and molecular dynamics. J Biomol Struct Dyn 2022; 40:11625-11637. [PMID: 34387135 DOI: 10.1080/07391102.2021.1961865] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 12/24/2022]
Abstract
The pharmacologically characterized receptor subtype of the serotonin family, the 5HT1A receptor is implicated in the pathophysiology and treatment of depression and anxiety-related disorders. Being the most extensively targeted receptor for developing novel antidepressants and anxiolytics, a near-ideal theoretical model can aid in high-throughput screening of promising drug candidates. However, the design of potential drug candidates suffers owing to a lack of complete structural information. In this work, homology models of 5-HT1A receptor are generated using two distinct alignments (CW and PSTA) and model building methods (KB and EB). The developed models are validated for virtual screening using a ligand dataset of agonists and antagonists. The best-suited model was efficient in discriminating agonist/antagonist binding. Correlation plots between pKi and docking (R2agonist≥ 0.6, R2antagonist≥ 0.7) and MM-GBSA dG bind values (R2agonist≥ 0.5, R2antagonist≥ 0.7) revealed optimum corroboration between in vitro and in silico outcomes, which further suggested the usefulness of the developed model for the design of high-affinity probes for the neurological disorders.Communicated by Ramaswamy H. Sarma.
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Affiliation(s)
- Preeti Jha
- Department of Immunology, Genetics and Pathology, Medical Radiation Science, Rudbeck Laboratory, Uppsala, Sweden.,Division of Cyclotron and Radiopharmaceutical Sciences, Institute of Nuclear Medicine and Allied Sciences, Defence Research and Development Organization, Delhi, India.,Department of Chemistry, Indian Institute of Technology Delhi, New Delhi, India
| | - Shubhra Chaturvedi
- Division of Cyclotron and Radiopharmaceutical Sciences, Institute of Nuclear Medicine and Allied Sciences, Defence Research and Development Organization, Delhi, India
| | - Ruchika Bhat
- Department of Chemistry, Indian Institute of Technology Delhi, New Delhi, India.,SCFBio, Indian Institute of Technology Delhi, New Delhi, India
| | - Nidhi Jain
- Department of Chemistry, Indian Institute of Technology Delhi, New Delhi, India
| | - Anil K Mishra
- Division of Cyclotron and Radiopharmaceutical Sciences, Institute of Nuclear Medicine and Allied Sciences, Defence Research and Development Organization, Delhi, India
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18
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Jain N, Hamilton D, Mital S, Ilias A, Brinkmann M, McPhedran K. Long-term passive wastewater surveillance of SARS-CoV-2 for seven university dormitories in comparison to municipal surveillance. Sci Total Environ 2022; 852:158421. [PMID: 36058330 PMCID: PMC9433341 DOI: 10.1016/j.scitotenv.2022.158421] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 08/22/2022] [Accepted: 08/26/2022] [Indexed: 05/28/2023]
Abstract
Wastewater-based surveillance (WBS) has been an effective tool for monitoring and understanding potential SARS-CoV-2 transmission across small and large-scale communities. In this study at the University of Saskatchewan, the assessment of SARS-CoV-2 was done over eight months during the 2021-2022 academic year. Wastewater samples were collected using passive samplers that were deployed in domestic sewer lines near adjacent campus residences and extracted for viral RNA, followed by Reverse Transcription quantitative Polymerase Chain Reaction (RT-qPCR). The results showed similar trends for SARS-CoV-2 detection frequencies and viral loads across university residences, the whole campus, and from related WBS at Saskatoon Wastewater Treatment Plant. The maximum daily detection frequency for seven dormitories considered was about 75 %, while maximum daily case numbers for the residences and campus-wide were about 11 and 75 people, respectively. In addition, self-reported rates of infection on campus peaked during similar time frames as increases in viral load were detected at the Saskatoon wastewater treatment plant. These similarities indicate the usefulness and cost-effectiveness of monitoring the spread of COVID-19 in small-scale communities using WBS.
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Affiliation(s)
- N Jain
- Department of Civil, Geological, and Environmental Engineering, College of Engineering, University of Saskatchewan, Saskatoon, SK, Canada
| | - D Hamilton
- Department of Civil, Geological, and Environmental Engineering, College of Engineering, University of Saskatchewan, Saskatoon, SK, Canada
| | - S Mital
- Department of Civil, Geological, and Environmental Engineering, College of Engineering, University of Saskatchewan, Saskatoon, SK, Canada
| | - A Ilias
- Department of Civil, Geological, and Environmental Engineering, College of Engineering, University of Saskatchewan, Saskatoon, SK, Canada
| | - M Brinkmann
- Global Institute for Water Security, University of Saskatchewan, Saskatoon, SK, Canada; School of Environment and Sustainability, University of Saskatchewan, Saskatoon, SK, Canada; Toxicology Centre, University of Saskatchewan, Saskatoon, SK, Canada; Centre for Hydrology, University of Saskatchewan, Saskatoon, SK, Canada.
| | - K McPhedran
- Department of Civil, Geological, and Environmental Engineering, College of Engineering, University of Saskatchewan, Saskatoon, SK, Canada; Global Institute for Water Security, University of Saskatchewan, Saskatoon, SK, Canada
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19
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Jain N, Gupta V, Tariq U, Hemanth D. Fast Violence Recognition in Video Surveillance by Integrating Object Detection and Conv-Lstm. INT J ARTIF INTELL T 2022. [DOI: 10.1142/s0218213023400183] [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: 11/06/2022]
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20
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Jain N. 8414 Jain Point a Viable Entry Port in Obese Patients with and without Previous Surgery. J Minim Invasive Gynecol 2022. [DOI: 10.1016/j.jmig.2022.09.406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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21
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Jain N. 8583 Posterior Approach for Uterine Artery Ligation in TLH (Tackling the Uterine Artery First Before the Bladder Dissection). J Minim Invasive Gynecol 2022. [DOI: 10.1016/j.jmig.2022.09.444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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22
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Abstract
The development of novel methodologies that enable the construction of complex chiral molecular scaffolds in an atom and step-economic manner has always been an area of immense interest and significant synthetic value. The transition metal-catalyzed enantioselective sp 3 C-H activation and functionalization reactions serve as an expeditious means for introducing diverse functionalities in a straightforward manner. However, controlling the chemo- and stereoselectivity of these reactions is a significant challenge owing to their ubiquity and low reactivity. In this review, we present a comprehensive account on the recent advances in inter- and intramolecular asymmetric sp 3 C-H bond functionalization utilizing ruthenium, rhodium, and iridium catalysts and get insights into the mechanistic aspects of these transformations.
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Affiliation(s)
- Ramandeep Kaur
- Indian Institute of Technology Delhi, Chemistry, Hauz Khas, 110016, Delhi, INDIA
| | - Nidhi Jain
- Indian Institute of Technology, Chemistry, Hauz Khas, 110016, Delhi, INDIA
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23
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Nayak D, Devarajan K, Pal PP, Ponnam HB, Jain N, Shastri V, Bawaskar R, Chinta R, Khurana A. Efficacy of Arsenicum album 30C in the Prevention of COVID-19 in Individuals Residing in Containment Areas: A Prospective, Multicenter, Cluster-Randomized, Parallel-Arm, Community-Based, Open-Label Study. Complement Med Res 2022; 30:375-385. [PMID: 36195077 DOI: 10.1159/000526897] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 08/29/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVE During the early part of the COVID-19 pandemic, non-pharmacologic interventions were the strategies for the prevention of severe acute respiratory syndrome coronavirus 2. The Ministry of Ayush, Govt. of India, had advised Arsenicum album 30C as a prophylactic to prevent COVID-19. This study was undertaken to evaluate the protective efficacy and safety of the Arsenicum album 30C. METHODS We conducted a prospective, multicenter, cluster-randomized, parallel-arm, community-based, open-label study involving apparently healthy individuals residing in containment areas of 7 cities in India. Clusters are defined as the population residing in the containment areas, who are under restriction for movement. Forty-two clusters were randomly assigned at 2:1 to the Arsenicum album 30C group (30 clusters) or to the control group (12 clusters, which received no specific therapy). The medicine was given twice daily for 7 days. The primary outcome was the incidence of COVID-19, as per the case definition notified by the National Centre for Disease Control, Government of India, during 3-week follow-up period. RESULTS The analysis included 32,186 individuals residing in 42 clusters (containment areas). A total of 22,693 individuals from 30 clusters received Arsenicum album 30C, and 9,493 individuals from 12 clusters were observed in the control group. The overall protective effect of the Arsenicum album 30C was 80.22% (95% confidence interval [CI], 71.16-86.44; 40 cases per 22,693 [6.04 per 10,000 person-weeks] in the Arsenicum album 30C group vs. 84 cases per 9,493 [29.78 per 10,000 person-weeks] in the control group). The protective effect of the Arsenicum album 30C against laboratory-confirmed COVID-19 was 68.22% (95% [CI], 49.64-80; 32 cases per 22,693 [4.83 per 10,000 person-weeks] in the Arsenicum album 30C group vs. 42 cases per 9,493 [14.93 per 10,000 person-weeks] in the control group). Adverse effects observed in both groups were mild and resolved without medication and sequelae. CONCLUSION Homeopathic medicine Arsenicum album 30C was associated with a decrease in the incidence and provided some protection against COVID-19 as compared to nontreatment. Further randomized, double-blind, placebo-controlled trials may be conducted to validate the results of this study. Ziel In der Anfangszeit der COVID-19-Pandemie setzte man auf nicht-medikamentöse Massnahmen zur Prävention von Infektionen mit SARS-CoV-2 (Schweres-Akutes-Respiratorisches-Syndrom-Coronavirus 2). Das Ayush-Ministerium der indischen Regierung empfahl Arsenicum album 30C als Prophylaxe zur COVID-19-Prävention. Das Ziel dieser Studie war die Beurteilung der Schutzwirkung und Sicherheit von Arsenicum album 30C. Methoden An unserer prospektiven, multizentrischen, Cluster-randomisierten, unverblindeten Parallelgruppen-Bevölkerungs-Studie nahmen gesund erscheinende Bewohner von Sperrzonen in sieben indischen Städten teil. Die Cluster waren definiert als die Bewohnerpopulation je einer Sperrzone, für welche Mobilitätsbeschränkungen galten. 42 Cluster wurden per Randomisierung im Verhältnis 2:1 dem Arsenicum-album-30C-Arm (30 Cluster) oder dem Kontrollarm (12 Cluster, die keine spezifische Behandlung erhielten) zugeteilt. Das Medikament wurde sieben Tage lang zweimal täglich angewendet. Die primäre Zielgröße war die COVID-19-Inzidenz laut der vom National Centre for Disease Control der indischen Regierung bekannt gegebenen Falldefinition in einem Nachbeobachtungszeitraum von drei Wochen. Ergebnisse Die Analyse umfasste 32.186 Personen in 42 Clustern (Sperrzonen). Insgesamt 22.693 Personen in 30 Clustern erhielten Arsenicum album 30C, und 9.493 Personen in 12 Clustern wurden als Kontrollarm beobachtet. Die Ergebnisse für Alter, Geschlecht und Komorbidität waren im Behandlungs- und Kontrollarm vergleichbar. Die Gesamt-Schutzwirkung von Arsenicum album 30C betrug 80,22 % (95-%-Konfidenzintervall [KI]: 71,16–86,44; 40 Fälle unter 22.693 [6,04 pro 10.000 Personen-Wochen] im Arsenicum- album- 30C-Arm vs. 84 Fälle unter 9.493 [29,78 pro 10.000 Personen-Wochen] im Kontrollarm). Die Schutzwirkung von Arsenicum album 30C gegen laboranalytisch bestätigte COVID-19-Erkrankung betrug 68,22 % (95-%-KI: 49,64–80; 32 Fälle unter 22.693 [4,83 pro 10.000 Personen-Wochen] im Arsenicum- album- 30C-Arm vs. 42 Fälle unter 9.493 [14,93 pro 10.000 Personen-Wochen] im Kontrollarm). Die beobachteten unerwünschten Wirkungen waren in beiden Gruppen von geringer Schwere und klangen ohne Medikation folgenlos ab. Schlussfolgerung Das Homöopathikum Arsenicum album 30C war im Vergleich zur Nichtbehandlung mit einer Verringerung der Inzidenz assoziiert und bot gewissen Schutz vor COVID-19. Weitere randomisierte, doppelblinde, placebokontrollierte Studien könnten durchgeführt werden, um die Ergebnisse dieser Studie zu validieren.
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Affiliation(s)
- Debadatta Nayak
- Epidemic Cell, Central Council for Research in Homoeopathy, New Delhi, India
| | | | - Partha Pratim Pal
- Clinical Research, Dr. Anjali Chatterji Regional Research for Homoeopathy, Kolkata, India
| | - Hima Bindu Ponnam
- Clinical Research, Homoeopathic Drug Standardisation Unit, Hyderabad, India
| | - Nidhi Jain
- Epidemic Cell, Central Council for Research in Homoeopathy, New Delhi, India
| | - Vipul Shastri
- Department of Pathology, C.D.Pachchigar Homoeopathic Medical College, Surat, India
| | - Ramesh Bawaskar
- Clinical Research, Regional Research Institute for Homoeopathy, Mumbai, India
| | - Raveendar Chinta
- Clinical Research, Regional Research Institute for Homoeopathy, Gudivada, India
| | - Anil Khurana
- Epidemic Cell, Central Council for Research in Homoeopathy, New Delhi, India
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24
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Kumar R, Jain VK, Jain N. Photoredox Hydroxy-arylation of the Terminal Double Bond of N-Substituted 3-Methyleneisoindolin-1-ones in Visible Light. J Org Chem 2022; 87:11939-11946. [PMID: 36041118 DOI: 10.1021/acs.joc.2c00607] [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] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Mild and efficient ruthenium-catalyzed hydroxy-arylation of the terminal double bond of N-substituted 3-methyleneisoindolin-1-ones is described. The reaction takes place with aryl diazonium salt as the arylating reagent and water as the hydroxyl source in visible light at ambient temperature. The strategy entails vicinal difunctionalization of alkene and enables construction of 3-benzyl-3-hydroxyisoindolin-1-one heterocyclic scaffolds in moderate to good yields. C-C and C-O bonds are formed in one pot without any external additive and oxidant through an in situ generation of a carbocation intermediate in green light.
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Affiliation(s)
- Rohit Kumar
- Department of Chemistry, Indian Institute of Technology, New Delhi 110016, India
| | - Vipin Kumar Jain
- Department of Chemistry, Indian Institute of Technology, New Delhi 110016, India
| | - Nidhi Jain
- Department of Chemistry, Indian Institute of Technology, New Delhi 110016, India
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Affiliation(s)
- Ritu
- Department of Chemistry, Indian Institute of Technology Delhi, New Delhi 110016, India
- Fakultät für Chemie und Pharmazie, Universität Regensburg, Regensburg 93040, Germany
| | - Saikat Das
- Fakultät für Chemie und Pharmazie, Universität Regensburg, Regensburg 93040, Germany
| | - Ya-Ming Tian
- Fakultät für Chemie und Pharmazie, Universität Regensburg, Regensburg 93040, Germany
| | - Tobias Karl
- Fakultät für Chemie und Pharmazie, Universität Regensburg, Regensburg 93040, Germany
| | - Nidhi Jain
- Department of Chemistry, Indian Institute of Technology Delhi, New Delhi 110016, India
| | - Burkhard König
- Fakultät für Chemie und Pharmazie, Universität Regensburg, Regensburg 93040, Germany
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Fabara SP, Patel G, Jain N, Bishev D, Tama B, Caputi A, Zarrate D, Al-Tawfiq JA, Tirupathi R. Can Moxidectin Be an Anthelmintic Alternative for Trichuris trichiura and Strongyloides stercoralis: A Systematic Review. Cureus 2022; 14:e27074. [PMID: 36000107 PMCID: PMC9390862 DOI: 10.7759/cureus.27074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 07/20/2022] [Indexed: 11/06/2022] Open
Abstract
Strongyloides stercoralis and Trichuris trichiura parasitic infections are two of the many neglected tropical diseases. These parasitic infections are of considerable public health relevance, particularly in resource-limited countries. Moxidectin, a well-established drug in veterinary medicine, is now a Food and Drug Administration (FDA) approved medication for human onchocerciasis. For the past five years, this medication has been under clinical trials to evaluate its efficacy and safetiness in other helminthic infections. Moxidectin might complement the already existing treatment and control of soil-transmitted helminthiasis (STH). Therefore, we systematically reviewed existing human interventional studies to evaluate the efficacy and safety of this medication when administered alone or in combination with other antiparasitic medications in order to achieve a cure.
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27
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Hassen G, Belete G, Carrera KG, Iriowen RO, Araya H, Alemu T, Solomon N, Bam DS, Nicola SM, Araya ME, Debele T, Zouetr M, Jain N. Clinical Implications of Herbal Supplements in Conventional Medical Practice: A US Perspective. Cureus 2022; 14:e26893. [PMID: 35978741 PMCID: PMC9375827 DOI: 10.7759/cureus.26893] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/15/2022] [Indexed: 11/05/2022] Open
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28
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Nayak D, Nahar K, Bhalerao R, Kaur L, Parveen T, Bhalla R, Michael J, Sharma S, Singh P, Jainab A, Ram H, Chaudhuri A, Parvin U, Jain N, Khurana A. Effectiveness of Arsenicum album 30C in Prevention of COVID-19 in Individuals Residing in Containment Zones of Delhi-A Prospective, Community-based, Parallel Cohort Study. HOMEOPATHY 2022; 111:261-270. [PMID: 35768003 DOI: 10.1055/s-0042-1745755] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE This work was designed as undertaken to evaluate the protective effect of Arsenicum album 30C against COVID-19. DESIGN The work was designed as a prospective parallel cluster cohort study. INTERVENTION Participants were enrolled in a homeopathy intervention (HI) cohort (who received Arsenicum album) or in a non-intervention (NI) cohort (who received no systematic intervention) from COVID-19 containment areas of Delhi. Individuals of age 5 years or above were given four medicated pills of Arsenicum album 30C, while those from 1 to 5 years old were given two medicated pills in each dose. RESULTS The analysis included 10,180 individuals residing in 11 COVID-19 containment areas in Delhi, out of which 6,590 individuals were in the HI cohort and 3,590 individuals were in the NI cohort. The overall protective effect of Arsenicum album 30C was 83.43% (95% confidence interval [CI], 76.77 to 88.17): 45 cases per 6,590 (8.34 per 10,000 person-weeks) in the Arsenicum album 30C group versus 143 cases per 3,590 (45.01 per 10,000 person-weeks) in the NI cohort. The protective effect of Arsenicum album 30C against laboratory confirmed COVID-19 was 74.40% (95% CI, 55.08 to 85.41): 18 cases per 6,590 (3.32 per 10,000 person-weeks) in the Arsenicum album 30C group versus 38 cases per 3,590 (11.85 per 10,000 person-weeks) in the NI cohort. CONCLUSION The use of Arsenicum album 30C was associated with some protection against probable and laboratory-confirmed COVID-19 in a containment-zone setting. Randomized controlled trials are needed to confirm or refute these results.
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Affiliation(s)
- Debadatta Nayak
- Department of Epidemic Cell, Central Council for Research in Homoeopathy, Janakpuri, New Delhi, India
| | - Karanpreet Nahar
- Department of Clinical Research, Dr. D.P Rastogi Central Research Institute of Homoeopathy, Noida, Uttar Pradesh, India
| | - Rupali Bhalerao
- Department of Epidemic Cell, Central Council for Research in Homoeopathy, Janakpuri, New Delhi, India
| | - Lovepreet Kaur
- Department of Epidemic Cell, Central Council for Research in Homoeopathy, Janakpuri, New Delhi, India
| | - Tabassum Parveen
- Department of Epidemic Cell, Central Council for Research in Homoeopathy, Janakpuri, New Delhi, India
| | - Ruchika Bhalla
- Department of Epidemic Cell, Central Council for Research in Homoeopathy, Janakpuri, New Delhi, India
| | - James Michael
- Department of Epidemic Cell, Central Council for Research in Homoeopathy, Janakpuri, New Delhi, India
| | - Swati Sharma
- Department of Epidemic Cell, Central Council for Research in Homoeopathy, Janakpuri, New Delhi, India
| | - Parul Singh
- Department of Epidemic Cell, Central Council for Research in Homoeopathy, Janakpuri, New Delhi, India
| | - Afsana Jainab
- Department of Clinical Research, State Homoeopathic Dispensary, Pataria, Patwai PHC, District-Rampur, Uttar Pradesh, India
| | - Hanuman Ram
- Department of Materia Medica, Madhav Homoeopathic Medical College& Hospital, Madhav Hills, Opposite Banas River, Abu Road, Rajasthan, India
| | - Abhishek Chaudhuri
- Department of Epidemic Cell, Central Council for Research in Homoeopathy, Janakpuri, New Delhi, India
| | - Ummesalma Parvin
- Department of Epidemic Cell, Central Council for Research in Homoeopathy, Janakpuri, New Delhi, India
| | - Nidhi Jain
- Department of Epidemic Cell, Central Council for Research in Homoeopathy, Janakpuri, New Delhi, India
| | - Anil Khurana
- Department of Clinical Research, Central Council for Research in Homoeopathy, Janakpuri, New Delhi, India
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29
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Agarwal S, Kumar M, Gupta A, Rautela RS, Jain N. Effect of Intravenous Calcium Gluconate on Prevention of Post Spinal Hypotension during Spinal Anaesthesia for Caesarean Section: A Randomized Double-Blind Controlled Study. J Nepal Health Res Counc 2022; 20:89-95. [PMID: 35945859 DOI: 10.33314/jnhrc.v20i01.3882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 06/02/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Calcium, a physiological ion, causes vasoconstriction and has a positive ionotropic action on heart. Its use to prevent post-spinal hypotension has been suggested but never formally evaluated for patients undergoing caesarean section. This study investigated the hemodynamic effects of calcium administration in parturients with the primary aim of comparing the incidence of post-spinal hypotension. METHODS Sixty healthy full-term pregnant patients scheduled for caesarean section were randomly allocated to two equal groups to receive either calcium gluconate or normal Saline bolus over 20min by syringe infusion pump under electrocardiography monitoring immediately after the patient was turned supine following spinal anaesthesia. Blood pressure and heart rate were recorded at baseline, and at regular intervals following spinal. Maternal calcium levels were estimated before and after infusion. Neonatal blood gas analysis and calcium level were analyzed. Total mephentermine requirement was recorded in both groups. RESULTS The heart rate values remained comparable to baseline value in group calcium gluconate while in group normal Saline, it decreased significantly at 8,12 and 16min. Blood pressure decreased significantly as compared to the baseline value from 4min onwards in both the groups. However, it was comparable in the two groups at all time points(0.622). Nineteen patients(63.33%) required mephentermine infusion in group calcium gluconate as compared to 23 patients(76.6%) in group normal Saline for maintenance of systolic blood pressure.(p=0.791) Umbilical venous pH (p=0.038) and partial pressure of carbon dioxide(p=0.038) were significantly better in group calcium gluconate. CONCLUSIONS Calcium used for prophylaxis of hypotension in healthy parturients undergoing caesarean section reduced the vasopressor requirements and total mephenteramine dose, but the difference did not attain statistical significance.
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Affiliation(s)
- Shilpa Agarwal
- UCMS and associated GTB Hospital, Shahdara, Delhi, India
| | - Mahender Kumar
- UCMS and associated GTB Hospital, Shahdara, Delhi, India
| | - Anju Gupta
- Department of Anaesthesiology, Pain and critical care, AIIMS, Delhi, India. New Delhi, India
| | - R S Rautela
- UCMS and associated GTB Hospital, Shahdara, Delhi, India
| | - Nidhi Jain
- UCMS and associated GTB Hospital, Shahdara, Delhi, India
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30
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Jain N, Thompson P, Burger J, Ferrajoli A, Takahashi K, Estrov Z, Borthakur G, Bose P, Kadia T, Pemmaraju N, Sasaki K, Konopleva M, Jabbour E, Garg N, Wang X, Kanagal-Shamanna R, Patel K, Wang W, Wang S, Jorgensen J, Lopez W, Ayala A, Plunkett W, Gandhi V, Kantarjian H, O’Brien S, Keating M, Wierda W. S149: LONG TERM OUTCOMES OF IFCG REGIMEN FOR FIRSTLINE TREATMENT OF PATIENTS WITH CLL WITH MUTATED IGHV AND WITHOUT DEL(17P)/TP53 MUTATION. Hemasphere 2022. [DOI: 10.1097/01.hs9.0000843488.43813.af] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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31
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Danda V, Jain N, Abboud R, Charles D, Mihalic A, Cardella J. Abstract No. 282 Impact of the COVID-19 pandemic on the 2021 integrated interventional radiology residency match: analysis of the Texas STAR database. J Vasc Interv Radiol 2022. [PMCID: PMC9136280 DOI: 10.1016/j.jvir.2022.03.363] [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: 11/21/2022] Open
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32
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Jain N, Frenk N, Sivananthan G, Smirniotopoulos J. Abstract No. 217 Safety and efficacy of percutaneous fluoroscopic-guided large bore gallstone extraction. J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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33
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Hassen G, Singh A, Belete G, Jain N, De la Hoz I, Camacho-Leon GP, Dargie NK, Carrera KG, Alemu T, Jhaveri S, Solomon N. Nonalcoholic Fatty Liver Disease: An Emerging Modern-Day Risk Factor for Cardiovascular Disease. Cureus 2022; 14:e25495. [PMID: 35783879 PMCID: PMC9242599 DOI: 10.7759/cureus.25495] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 05/30/2022] [Indexed: 11/05/2022] Open
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34
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Garia A, Kumar S, Jain N. SelectfluorTM Mediated Tandem Fluorination and 1,3‐Carbonyl Migration in ortho‐Carbonyl Anilines: Charge Transfer Enabled ortho‐Selectivity. ASIAN J ORG CHEM 2022. [DOI: 10.1002/ajoc.202200164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Alankrita Garia
- Indian Institute of Technology Delhi Chemistry Hauz Khas Delhi INDIA
| | - Sharvan Kumar
- Indian Institute of Technology Delhi Chemistry Hauz Khas Delhi INDIA
| | - Nidhi Jain
- Indian Institute of Technology Chemistry Hauz Khas 110016 Delhi INDIA
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35
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Singh A, Chidharla A, Agarwal K, Singh P, Jain N, Hassen G, Abdelwahed S, Bhandari R, Patel K, Gupta S, Koritala T, Rabbani R. Vitamin D: The Missing Nutrient Behind the Two Deadly Pandemics, COVID-19 and Cardiovascular Diseases. Cureus 2022; 14:e24133. [PMID: 35573503 PMCID: PMC9106532 DOI: 10.7759/cureus.24133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 04/14/2022] [Indexed: 11/16/2022] Open
Abstract
The coronavirus (COVID-19) pandemic is claiming millions of lives and creating an additional burden on health care, which is already affected by the rise of non-communicable diseases (NCDs). The scientific community, on the other side, is enormously engaged with studies to best identify the characteristics of the virus and minimize its effect while supporting the fight to contain NCDs, mainly cardiovascular diseases (CVDs), which are contributing hugely to the global death toll. Hence, the roles of vitamin D in COVID-19 immunity and cardiovascular health are gaining traction recently. This literature review will mainly focus on summarizing pertinent studies and scientific publications which highlight the association of vitamin D levels with the various outcomes of COVID-19 and CVDs. It will also address how low vitamin D correlates with the epidemiology of CVDs and the inflammatory mechanisms attributed to COVID-19 severity. We believe that our review may open up hindsight perspectives and further discussions among the physicians in tapping the potential of vitamin D supplementation to tackle the morbidity, mortality, and health care cost of the two deadly diseases, COVID-19 and CVDs.
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36
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Hassen G, Kasar A, Jain N, Berry S, Dave J, Zouetr M, Priyanka Ganapathiraju VLN, Kurapati T, Oshai S, Saad M, Pathan J, Kamat S, Tirupathi R, Patel UK, Rana RK. Programmed Death-Ligand 1 (PD-L1) Positivity and Factors Associated with Poor Prognosis in Patients with Gastric Cancer: An Umbrella Meta-Analysis. Cureus 2022; 14:e23845. [PMID: 35530821 PMCID: PMC9076041 DOI: 10.7759/cureus.23845] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 04/05/2022] [Indexed: 02/06/2023] Open
Abstract
Gastric cancer (GC) is one of the most common malignancies throughout the world with late diagnosis and poor prognosis. The expression of programmed death-ligand 1 (PD-L1) in GC is attributed to immune evasion and tumor progression. PD-L1 positivity has both predictive and prognostic biomarker potential. Aiming to summarize a large amount of research and to provide a definitive conclusion to the conflicting results on the prognostic significance of PD-L1 expression in GC, we performed an umbrella review based on existing meta-analyses which were published recently (2016-2021) and indexed in the PubMed database. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was used in August 2021 to screen articles, and data extraction with quality assessment was performed on the selected meta-analyses. Review Manager (RevMan) 5.3 software was used to analyze the HR and OR with a 95% confidence interval (CI) among PD-L1 positive GC patients. We also assessed the between-study heterogeneity (I 2). Forest and Funnel plots were obtained, and a P-value of <0.05 was considered statistically significant. A total of 567 articles were screened, and we selected three meta-analyses with a total of 40 studies conducted over a period of 14 years. In our umbrella review, a total of 8,419 GC patients with an average PD-L1 positivity of 39% were analyzed. We found that PD-L1 positivity in GC patients is associated with poor prognosis (pooled HR =1.44, 95% CI: 1.24-1.68, P<0.00001) having higher mortality reducing the chances of overall survival (OS). However, there are no significant differences in PD-L1 expression among different lymph node (LN) metastases (OR=1.31, 95% CI: 0.98-1.74, P=0.07) and tumor, node, and metastasis (TNM) stages (OR=1.13, 95% CI: 0.80-1.58, P=0.50). Early identification of PD-L1 expression may help tailor cost-effective and targeted immunotherapy among GC patients. More research is needed to further understand how PD-L1 affects LN metastasis and tumor invasion.
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Affiliation(s)
- Gashaw Hassen
- Progressive Care, Mercy Medical Center, Baltimore, USA.,Medicine and Surgery, Parma University, Parma, ITA.,Medicine, Addis Ababa University, Addis Ababa, ETH
| | - Amita Kasar
- Internal Medicine, Krishna Institute of Medical Sciences, Secunderabad, IND
| | - Nidhi Jain
- Medicine and Surgery, Himalayan Institute of Medical Sciences, Dehradun, IND.,Hematology and Oncology, Brooklyn Cancer Care, Brooklyn, USA.,Internal Medicine, Sir Ganga Ram Hospital, New Delhi, IND
| | - Shivankshi Berry
- Internal Medicine, Dayanand Medical College and Hospital, Ludhiana, IND.,Internal Medicine, Nassau University Medical Center, New York, USA
| | - Jhanvi Dave
- Internal Medicine, B.J. Medical College, Ahmedabad, IND
| | - Michlene Zouetr
- Family Medicine, American Institute of Antigua College of Medicine, St John's, ATG
| | | | | | - Stephanie Oshai
- Medicine and Surgery, College of Medicine, University of Lagos, Lagos, NGA
| | - Mohamed Saad
- Gastroenterology, Theodor Bilharz Research Institute, Giza, EGY
| | | | | | | | - Urvish K Patel
- Public Health and Neurology, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Rishabh K Rana
- Preventive and Social Medicine/Community Medicine, Shahid Nirmal Mahto Medical College, Dhanbad, Dhanbad, IND
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37
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Rajput S, Kaur R, Jain N. Pd and photoredox dual catalysis assisted decarboxylative ortho-benzoylation of N-phenyl-7-azaindoles. Org Biomol Chem 2022; 20:1453-1461. [DOI: 10.1039/d1ob02338a] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Directing group assisted decarboxylative ortho-benzoylation of N-aryl-7-azaindoles with α-keto acids has been achieved by synergistic visible light promoted photoredox and palladium catalysis. The approach tenders rapid entry to aryl ketone...
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38
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Arora M, Nazar GP, Sharma N, Jain N, Davidson F, Mohan S, Mohan D, Ali MK, Mohan V, Tandon N, Narayan KMV, Prabhakaran D, Bauld L, Srinath Reddy K. COVID-19 and tobacco cessation: lessons from India. Public Health 2022; 202:93-99. [PMID: 34933205 PMCID: PMC8633921 DOI: 10.1016/j.puhe.2021.11.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 10/20/2021] [Accepted: 11/11/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVES The Government of India prohibited the sale of tobacco products during the COVID-19 lockdown to prevent the spread of the SARS-CoV-2 virus. This study assessed the tobacco cessation behaviour and its predictors among adult tobacco users during the initial COVID-19 lockdown period in India. METHODS A cross-sectional study was conducted with 801 adult tobacco users (both smoking and smokeless tobacco) in two urban metropolitan cities of India over a 2-month period (July to August 2020). The study assessed complete tobacco cessation and quit attempts during the lockdown period. Logistic and negative binomial regression models were used to study the correlates of tobacco cessation and quit attempts, respectively. RESULTS In total, 90 (11.3%) tobacco users reported that they had quit using tobacco after the COVID-19 lockdown period. Overall, a median of two quit attempts (interquartile range 0-6) was made by tobacco users. Participants with good knowledge on the harmful effects of tobacco use and COVID-19 were significantly more likely to quit tobacco use (odds ratio [OR] 2.2; 95% confidence interval [CI] 1.2-4.0) and reported more quit attempts (incidence risk ratio 5.7; 95% CI 2.8-11.8) compared to those with poor knowledge. Participants who had access to tobacco products were less likely to quit tobacco use compared to those who had no access (OR 0.3; 95% CI 0.2-0.5]. CONCLUSIONS Access restrictions and correct knowledge on the harmful effects of tobacco use and COVID-19 can play an important role in creating a conducive environment for tobacco cessation among users.
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Affiliation(s)
- M Arora
- HRIDAY, New Delhi, India; Public Health Foundation of India, Haryana, New Delhi, India.
| | - G P Nazar
- HRIDAY, New Delhi, India; Public Health Foundation of India, Haryana, New Delhi, India
| | | | - N Jain
- Public Health Foundation of India, Haryana, New Delhi, India
| | - F Davidson
- Usher Institute and SPECTRUM Consortium, University of Edinburgh, Edinburgh, United Kingdom
| | - S Mohan
- Public Health Foundation of India, Haryana, New Delhi, India; Centre for Chronic Disease Control, New Delhi, India
| | - D Mohan
- Madras Diabetes Research Foundation, Chennai, India
| | - M K Ali
- Rollins School of Public Health, Emory University, Atlanta, USA
| | - V Mohan
- Madras Diabetes Research Foundation, Chennai, India
| | - N Tandon
- All India Institute of Medical Sciences, New Delhi, India
| | | | - D Prabhakaran
- Public Health Foundation of India, Haryana, New Delhi, India; Centre for Chronic Disease Control, New Delhi, India
| | - L Bauld
- Usher Institute and SPECTRUM Consortium, University of Edinburgh, Edinburgh, United Kingdom
| | - K Srinath Reddy
- Public Health Foundation of India, Haryana, New Delhi, India
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39
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Gandhi F, Jhaveri S, Avanthika C, Singh A, Jain N, Gulraiz A, Shah P, Nasir F. Impact of Vitamin D Supplementation on Multiple Sclerosis. Cureus 2021; 13:e18487. [PMID: 34754649 PMCID: PMC8567111 DOI: 10.7759/cureus.18487] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/04/2021] [Indexed: 12/14/2022] Open
Abstract
Multiple sclerosis (MS) is an autoimmune disease affecting a large number of people every year. The exact causal factor for this disease is unclear, but it commonly affects middle-aged women, with known triggers like stress, childbirth, infections, poor diet, lack of sleep, etc. Many epidemiological studies have indicated that various genetic abnormalities are also critical drivers of the onset of MS. The major risk factors of MS identified include hypovitaminosis D while environmental protective factors include allele HLA DRB1 1501, obesity, Epstein-Barr virus infection, sexual hormones, and smoking. Our article explores the correlation between the deficiency of vitamin D and the onset and progression of MS. The study uses a systematic review methodology by researching and reviewing scholarly articles exploring the topic. We conducted online searches of literature on Google Scholar and PubMed using the keywords "vitamin D deficiency" and "multiple sclerosis" and accessed the relevant secondary literature sources for review. The variables under study included vitamin D insufficiency as the dependent variable while MS was the independent variable. Causal variables included environmental, genetic, and protective factors. We hypothesized that there is indeed a correlation between vitamin D deficiency and MS. The findings from our review indicate a strong correlation between the insufficiency of vitamin D and the onset and progression of MS. These results are essential in devising interventions to accomplish primary and secondary prevention of MS, as well as integrating vitamin D supplementation in current treatment protocols for MS.
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Affiliation(s)
- Fenil Gandhi
- Internal Medicine, Shree Krishna Hospital, Anand, IND
| | - Sharan Jhaveri
- Internal Medicine, Nathiba Hargovandas Lakhmichand Municipal Medical College, Ahmedabad, IND
| | - Chaithanya Avanthika
- Medicine and Surgery, Karnataka Institute of Medical Sciences, Hubli, IND.,Pediatrics, Karnataka Institute of Medical Sciences, Hubli, IND
| | - Abhishek Singh
- Internal Medicine, Mount Sinai Morningside, New York City, USA
| | - Nidhi Jain
- Internal Medicine, Sir Ganga Ram Hospital, New Delhi, IND
| | - Azouba Gulraiz
- Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | | | - Fareeha Nasir
- Internal Medicine, Harlem Hospital Center, New York City, USA
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40
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Kumar V, Jain N, Raizada N, Aslam M, Mehrotra G, Gambhir JK, Singh G, Madhu SV. Postprandial endothelial dysfunction and CIMT after oral fat challenge in patients with type 2 diabetes mellitus with and without macrovascular disease - A preliminary study. Diabetes Metab Syndr 2021; 15:102317. [PMID: 34695772 DOI: 10.1016/j.dsx.2021.102317] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 10/13/2021] [Accepted: 10/15/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND Very few studies have reported on association of postprandial lipids and endothelial dysfunction among patients with diabetes. Whether endothelial dysfunction particularly postprandial FMD is worse in patients with T2DM with macrovascular disease compared to those without and whether this difference is related to postprandial hypertriglyceridemia (PPHTg) is unclear. Therefore, present study was aimed to assess the relationship between PPHTg and endothelial function in patients with T2DM with and without macrovascular disease. METHOD Endothelial dysfunction by FMD and CIMT were compared in patients with T2DM with and without macrovascular disease (n = 13 each group) and 13 age, sex and BMI matched healthy individuals after an oral fat challenge. RESULTS There was significant postprandial deterioration of FMD 4-hr after fat challenge in patients with diabetes (P < 0.001) as well as healthy individuals (P = 0.004). Patients with diabetes with macrovascular disease had significantly lower fasting (5.7 ± 6.1% vs. 22.7 ± 10.0% and vs. 24.7 ± 5.3%) as well as postprandial (4-hr) (3.1 ± 5.0% vs. 15.3 ± 8.1% and vs. 15.4 ± 5.7%) FMD compared to other two groups. Fasting, postprandial as well as change in FMD and CIMT in patients with diabetes correlated significantly with fasting as well as postprandial triglycerides with stronger correlation in those with macrovascular disease. CONCLUSION Study found significant endothelial dysfunction by FMD that shows substantial further deterioration postprandially following high fat meal in patients with diabetes with macrovascular disease compared to patients with diabetes without macrovascular disease and healthy individuals. Study also indicates that PPHTg is a contributor to endothelial dysfunction. However, more studies are required to corroborate these findings.
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Affiliation(s)
- V Kumar
- Department of Medicine, University College of Medical Sciences (University of Delhi) & GTB Hospital, Delhi-110095, India
| | - N Jain
- Department of Endocrinology, Centre for Diabetes Endocrinology & Metabolism, University College of Medical Sciences (University of Delhi) & GTB Hospital, Delhi-110095, India
| | - N Raizada
- Department of Endocrinology, Centre for Diabetes Endocrinology & Metabolism, University College of Medical Sciences (University of Delhi) & GTB Hospital, Delhi-110095, India
| | - M Aslam
- Department of Endocrinology, Centre for Diabetes Endocrinology & Metabolism, University College of Medical Sciences (University of Delhi) & GTB Hospital, Delhi-110095, India
| | - G Mehrotra
- Department of Radiology, University College of Medical Sciences (University of Delhi) & GTB Hospital, Delhi-110095, India
| | - J K Gambhir
- Department of Biochemistry, University College of Medical Sciences (University of Delhi) & GTB Hospital, Delhi-110095, India
| | - G Singh
- Department of Medicine, University College of Medical Sciences (University of Delhi) & GTB Hospital, Delhi-110095, India
| | - S V Madhu
- Department of Endocrinology, Centre for Diabetes Endocrinology & Metabolism, University College of Medical Sciences (University of Delhi) & GTB Hospital, Delhi-110095, India.
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Jain N, Jain V, Gupta S. Jain Point: To Study the Efficacy and Safety in Previous Upper Abdominal Scars. J Minim Invasive Gynecol 2021. [DOI: 10.1016/j.jmig.2021.09.179] [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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Jain N, Avanthika C, Singh A, Jhaveri S, De la Hoz I, Hassen G, Camacho L GP, Carrera KG. Deep Vein Thrombosis in Intravenous Drug Users: An Invisible Global Health Burden. Cureus 2021; 13:e18457. [PMID: 34745781 PMCID: PMC8563142 DOI: 10.7759/cureus.18457] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 10/03/2021] [Indexed: 12/16/2022] Open
Abstract
The prevalence of intravenous drug use has increased in the past decade and it represents an important risk factor for deep vein thrombosis. Intravenous drug use is a global problem, with the main culprit being heroin. Peer pressure and poverty in high-risk groups such as sex workers, females, and young adults raise the risk of intravenous drug use, which expresses itself in the form of venous thromboembolism eventually. Deep vein thrombosis typically manifests itself eight years after the initial intravenous drug administration, rendering it a silent killer. Aiming to review and summarize existing articles in this context, we performed an exhaustive literature search online on PubMed and Google Scholar indexes using the keywords "Deep Venous Thrombosis (DVT)" and "Intravenous Drug Users (IVDU)." English articles that addressed epidemiology, pathogenesis, clinical manifestations, diagnosis, differential diagnosis, management, and outcomes of DVT, including those in IVDU, were selected and analyzed. The pathogenesis of DVT development in IVDU is mainly attributed to the interplay of trauma to the vessel by repeated injection and the injected drug itself. The right-sided femoral vein is the most common vein affected. Prevalent clinical presentations include local pain, swelling, and redness with typical systemic symptoms including fever, cough, dyspnea, and chest pain on top of addiction features. There appeared to be a delay in reporting symptoms, which was most likely due to the social stigma attached to IVDU. There are over 50 conditions that present with swollen and painful limbs comparable to DVT in IVDU, making precise diagnosis critical for timely treatment. Venous ultrasound is the method of choice for diagnosing DVT. Extended anticoagulant therapy with low-molecular-weight heparin combined with warfarin is the recommended treatment. Intravenous drug abusers having DVT are affected by multiple complications and poorer outcomes such as slower recovery, recurrent venous thromboembolism (VTE), and a longer hospital stay, which put them at higher risk of morbidity, mortality, reduced productivity, and economic burden.
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Affiliation(s)
- Nidhi Jain
- Medicine and Surgery, Himalayan Institute of Medical Sciences, Dehradun, IND
- Internal Medicine, Sir Ganga Ram Hospital, Delhi, IND
- Hematology and Oncology, Brooklyn Cancer Care, Brooklyn, USA
| | | | - Abhishek Singh
- Internal Medicine, Mount Sinai Morningside, New York, USA
| | - Sharan Jhaveri
- Internal Medicine, Smt. Nathiba Hargovandas Lakhmichand Municipal Medical College, Ahmedabad, IND
| | | | - Gashaw Hassen
- Medicine and Surgery, University of Parma, Parma, ITA
- Medicine, Addis Ababa University, Addis Ababa, ETH
- Progressive Care Unit, Mercy Medical Center, Baltimore, USA
| | - Genesis P Camacho L
- Division de Estudios para Graduados, Facultad de Medicina, Universidad del Zulia, Maracaibo, VEN
| | - Keila G Carrera
- Gastroenterology, Universidad de Oriente (VEN), Maturin, VEN
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Affiliation(s)
- Alankrita Garia
- Department of Chemistry Indian Institute of Technology New Delhi 110016 India
| | - Jatin Grover
- Department of Chemistry Indian Institute of Technology New Delhi 110016 India
| | - Nidhi Jain
- Department of Chemistry Indian Institute of Technology New Delhi 110016 India
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44
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Gaddam M, Singh A, Jain N, Avanthika C, Jhaveri S, De la Hoz I, Sanka S, Goli SR. A Comprehensive Review of Intranasal Insulin and Its Effect on the Cognitive Function of Diabetics. Cureus 2021; 13:e17219. [PMID: 34540446 PMCID: PMC8442633 DOI: 10.7759/cureus.17219] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/16/2021] [Indexed: 12/01/2022] Open
Abstract
Diabetes mellitus continues to be a disease that affects a good percentage of our population. The majority affected need insulin on a day-to-day basis. Before the invention of the first manufactured insulin in 1978, dealing with diabetes took a significant toll on patient's lives. As technology and human innovation prevail, significant advancements have taken place in managing this chronic disease. Patients have an option to decide their mode of insulin delivery. Intranasal insulin, one such form, has a rapid mode of action while effectively controlling postprandial hyperglycemia. It has also been proven to reduce hypoglycemia and insulin resistance problems, which seem to be the main adverse effects of using conventional insulin regularly. However, due to the large dosages needed and high incurring costs, Intranasal Insulin is currently being used as adjunctive therapy along with conventional insulin. We conducted a literature search in PubMed indexed journals using the medical terms "Intranasal insulin," "diabetes," and "cognitive impairment" to provide an overview of the mechanism of action of Intranasal Insulin, its distinctive cognitive benefits, and how it can be compared to the standard parenteral insulin therapy. One unique feature of intranasal insulin is its ability to directly affect the central nervous system, bypassing the blood-brain barrier. Not only does this help in reducing the peripheral side effects of insulin, but it has also proven to play a role in improving the cognitive function of diabetics, especially those who have Alzheimer's or mild cognitive impairment, as decreased levels of insulin in the brain has been shown to impact cognitive function negatively. However, it does come with its limitations of poor absorption through the nasal mucosa due to mucociliary clearance and proteolytic enzymes, our body's natural defence mechanisms. This review focuses on the efficacy of intranasal insulin, its potential benefits, limitations, and role in cognitive improvement in people with diabetes with pre-existing cognitive impairment.
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Affiliation(s)
| | | | - Nidhi Jain
- Internal Medicine, Sir Ganga Ram Hospital, New Delhi, IND
| | | | - Sharan Jhaveri
- Internal Medicine, Smt. Nathiba Hargovandas Lakhmichand Municipal Medical College, Ahmedabad, IND
| | | | - Sujana Sanka
- Internal Medicine, JC Medical Center, Orlando, USA
| | - Sri Rupa Goli
- Internal Medicine, Shri Sathya Sai Medical College and Research Institute, Chennai, IND
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45
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Affiliation(s)
- Nidhi Jain
- Department of Engineering Science, Bharati Vidyapeeth College of Engineering, Lavale, Pune, India
| | - Eva Gupta
- Department of Electrical Engineering, ASET, Amity University, Noida, India
- Department of Electrical Engineering, TSSM’s Bhivrabai Sawant College of Engineering and Research, Pune, Maharashtra, India
| | - Nand Jee Kanu
- Department of Mechanical Engineering, S. V. National Institute of Technology, Surat, India
- Department of Mechanical Engineering, JSPM Narhe Technical Campus, Pune, India
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Abstract
An efficient C-3 halogenation of quinolin-4-ones is reported with halogenated fluorescein dyes which serve both as a halogen source and photocatalyst. This reaction shows broad substrate scope and gives good to excellent yields of C-3 brominated/iodinated quinolones with eosin Y/rose bengal in green light under ambient conditions. The mechanistic investigations suggest a radical pathway involving the oxidative dehalogenation of the dye in the presence of air.
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Affiliation(s)
- Ritu
- Department of Chemistry, Indian Institute of Technology, New Delhi-110016, India.
| | - Sharvan Kumar
- Department of Chemistry, Indian Institute of Technology, New Delhi-110016, India.
| | - Parul Chauhan
- Department of Chemistry, Indian Institute of Technology, New Delhi-110016, India.
| | - Nidhi Jain
- Department of Chemistry, Indian Institute of Technology, New Delhi-110016, India.
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47
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Sharma A, Dixit V, Kumar S, Jain N. Visible Light-Mediated In Situ Generation of δ,δ-Disubstituted p-Quinone Methides: Construction of a Sterically Congested Quaternary Stereocenter. Org Lett 2021; 23:3409-3414. [PMID: 33844558 DOI: 10.1021/acs.orglett.1c00862] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
An unprecedented visible light-assisted and zinc triflate-catalyzed construction of a diaryl-substituted quaternary stereocenter is reported. 2-(4-Hydroxyphenyl)-substituted aldehydes and ketones have been prepared in moderate to high yields via multicomponent reaction of acetylene, benzoquinone (BQ), and indole/aniline/thiol. The reaction is believed to proceed via in situ generation of p-quinone methide through a [2+2] cycloaddition-retroelectrocyclization of BQ and acetylene in blue light followed by a zinc triflate-catalyzed vinylogous Michael addition reaction with nucleophiles.
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Affiliation(s)
- Arun Sharma
- Department of Chemistry, Indian Institute of Technology Delhi, Hauz Khas, 110016 New Delhi, India
| | - Vikas Dixit
- Department of Chemistry, Indian Institute of Technology Delhi, Hauz Khas, 110016 New Delhi, India
| | - Sharvan Kumar
- Department of Chemistry, Indian Institute of Technology Delhi, Hauz Khas, 110016 New Delhi, India
| | - Nidhi Jain
- Department of Chemistry, Indian Institute of Technology Delhi, Hauz Khas, 110016 New Delhi, India
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Qureshi M, Lokanathan S, Adapa A, Stansfield J, Jain N, Bhutta A. 952 In-Patient Trauma Surgery in COVID-19 Positive Patients Carries A Significantly Higher Mortality Risk When Compared to In-Patient Covid-19 Negative Patients and Day Case Trauma Patients. Br J Surg 2021. [PMCID: PMC8135882 DOI: 10.1093/bjs/znab134.101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Introduction Covid-19 caused many service changes, yet Trauma surgery continued throughout. We compare mortality rates from In-Patient (IP) and Day Case (DC) trauma patients and compare the mortality rates of patients who tested positive or negative for Covid-19. Method We reviewed all trauma admissions that underwent surgical intervention in both our IP and DC services during 31 days from March 23rd 2020. We recorded their sex, age, operation, Covid-19 symptoms, Covid-19 test results and mortality. The findings were compared between the groups. Results In total 127 patients underwent surgery (66 IP; 61 DC). There were 6 deaths (9.1%) within the IP group and 0 deaths in the DC group (p = 0.006). In the IP group 8 patients (12.1%) tested positive for Covid-19 of which 4 died (50%) compared to the remaining 58 patients (87.9%) of which 2 (3.4%) died (p < 0.001). A higher mortality rate was observed in patients with symptoms but a negative Covid-19 test (6.7%) than patients in whom a test was never indicated (2.3%). Conclusion Covid-19 positive patients requiring in-patient admission for trauma surgery have a significantly higher mortality rate than both in-patient admissions that were Covid-19 negative or asymptomatic and patients that were treated with Day Case Trauma surgery.
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Affiliation(s)
- M Qureshi
- Northern Care Alliance, Manchester, United Kingdom
| | - S Lokanathan
- Northern Care Alliance, Manchester, United Kingdom
| | - A Adapa
- Northern Care Alliance, Manchester, United Kingdom
| | - J Stansfield
- Northern Care Alliance, Manchester, United Kingdom
| | - N Jain
- Northern Care Alliance, Manchester, United Kingdom
| | - A Bhutta
- Northern Care Alliance, Manchester, United Kingdom
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Cheyne N, Jeelani A, Zeiton M, Tablot C, Holt E, Jain N. 866 A Lateral Approach Is More Likely to Be Successful Than A Posterior Approach for An Injection to Reach the Subacromial Space. Br J Surg 2021. [DOI: 10.1093/bjs/znab134.331] [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] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Background
Subacromial injections are common for diagnosis and therapy of shoulder impingement secondary to subacromial bursitis. We evaluated the likelihood of a successful subacromial injection from both the posterior and lateral injection sites.
Method
We reviewed 100 MRI scans of the shoulder and recorded measurements in both the sagittal (representative of posterior injection) and coronal (representative of lateral injection) orientations. We compared these to the lengths of standard needles.
Multiple measurements were taken:
Results
Measuring along the angle of the acromion demonstrated shorter mean distances from the lateral injection site. The distance from skin to mid-point of the acromion) provided mean values of 51.4mm for posterior and 40.1mm for lateral. A standard 40mm (green) needle would reach the midpoint of the acromion in 58% of lateral measurements and 23% from posterior.
Conclusions
Injections are more likely to enter the subacromial space from a lateral rather than a posterior entry point.
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Affiliation(s)
- N Cheyne
- Manchester Foundation Trust, Manchester, United Kingdom
| | - A Jeelani
- Manchester Foundation Trust, Manchester, United Kingdom
| | - M Zeiton
- Manchester Foundation Trust, Manchester, United Kingdom
| | - C Tablot
- Alder Hey Children's Hospital, Liverpool, United Kingdom
| | - E Holt
- Manchester Foundation Trust, Manchester, United Kingdom
| | - N Jain
- Pennine Acute Care Trust, Manchester, United Kingdom
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Havenhand T, Jain N. 384 Use of A Dry Swab During ACL Hamstring Tendon Graft Preparation May Lead to Decreased Graft Diameter at Implantation with Subsequent Rebound in Graft Diameter When Exposed to Haemarthrosis – A Porcine Tendon Study. Br J Surg 2021. [DOI: 10.1093/bjs/znab134.550] [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] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
Introduction
ACL reconstruction surgery commonly utilises a hamstring tendon graft. Grafts are normally covered with a wet swab prior to implantation. The aim of this study was to determine the variance in graft diameter when comparing the traditional wet swab to a dry swab.
Method
Flexor tendons from a selection of fresh pig trotters were isolated and prepared with a standard ACL graft preparation technique. Half of the grafts were covered with a wet swab; the other half were covered with a dry swab. Graft diameters were measured at 10-minute intervals. After 30 minutes the grafts were submerged in Hartmann’s solution to simulate the post-operative haemarthrosis, diameters were checked again after 1 hour in the solution.
Results
Use of a dry swab resulted in a 0.5mm greater reduction in diameter than the wet swab group. The dry swab group also showed an increase in diameter by 0.5mm when soaked in Hartmann’s solution, this was not seen in the wet swab group.
Conclusions
Using a dry swab produces a smaller graft diameter, this would allow smaller bone tunnels, retaining bone stock. The subsequent rebound in diameter when in solution may increase the press fit mechanism and facilitate improved integration into the bone tunnel.
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Affiliation(s)
- T Havenhand
- Pennine Acute Hospitals NHS Trust, Manchester, United Kingdom
| | - N Jain
- Pennine Acute Hospitals NHS Trust, Manchester, United Kingdom
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