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Raghupathy R, Chaturvedi UC, Al-Sayer H, Elbishbishi EA, Agarwal R, Nagar R, Kapoor S, Misra A, Mathur A, Nusrat H, Azizieh F, Khan MA, Mustafa AS. Elevated levels of IL-8 in dengue hemorrhagic fever. J Med Virol 1998; 56:280-5. [PMID: 9783699 DOI: 10.1002/(sici)1096-9071(199811)56:3<280::aid-jmv18>3.0.co;2-i] [Citation(s) in RCA: 124] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Dengue virus causes dengue fever, a mild febrile illness, and at times dengue hemorrhagic fever (DHF), a severe illness the pathogenesis of which is not fully understood. Given the crucial roles played by interleukin-8 (IL-8) as a chemoattractant cytokine and in inflammatory processes, levels of circulating IL-8 in the sera and IL-8 mRNA in the peripheral blood mononuclear cells (PBMC) were measured in 99 patients of a recent dengue epidemic that occurred in India in 1996 and in 21 normal healthy controls. Twenty-six of the patients had dengue fever (DF) and the remaining 73 were diagnosed as having different grades of DHF. All the control normal sera were negative for IL-8, so were their PBMC for IL-8 mRNA. Increased levels of IL-8 in the sera and IL-8 mRNA in their PBMC were observed in patients with severe illness of DHF grades III and IV. Only two out of 26 patients of DF and one out of 10 DHF grade I patient were positive for IL-8 and all three deteriorated to DHF grade IV within 24 hr. All six patients of DHF grade IV who died had higher serum level of IL-8 above 200 pg/ml, the highest being 5,568 pg/ml in one patient; the presence of mRNA for IL-8 was very high in all patients. A striking correlation was observed between increased levels of IL-8 and severe DHF, with greater levels in patients with increased grade of the disease and death. These results suggest that IL-8 may have an important role and may be an indicator of increasing severity of the disease and death.
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Chaturvedi UC, Elbishbishi EA, Agarwal R, Raghupathy R, Nagar R, Tandon R, Pacsa AS, Younis OI, Azizieh F. Sequential production of cytokines by dengue virus-infected human peripheral blood leukocyte cultures. J Med Virol 1999; 59:335-40. [PMID: 10502266 DOI: 10.1002/(sici)1096-9071(199911)59:3<335::aid-jmv13>3.0.co;2-e] [Citation(s) in RCA: 68] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
The study was undertaken to elucidate the sequence of appearance of T helper (Th)1- and Th2-type cytokines in human peripheral blood leucocyte cultures infected in vitro with dengue type 2 virus. Commercial sandwich enzyme-linked immunosorbent assay kits were used to assay the levels of tumour necrosis factor-alpha (TNF-alpha), interferon-gamma (IFN-gamma), interleukin (IL)-2, IL-4, IL-5, IL-6, and IL-10 in culture supernatants. Culture supernatants were also screened for the cytotoxic factor and the dengue virus titres determined. The cytokines that appeared in the culture supernatants on the first day post-infection (p.i.) were cytotoxic factor, TNF-alpha, IL-2, and IL-6; their levels were highest on the second day p.i. IFN-gamma appeared on the second day with a peak on the third day p.i. The levels of these cytokines declined quickly, except for human cytotoxic factor (hCF) and IL-2. The cytokines that appeared later were IL-10 and IL-5 on the fourth day and IL-4 on the sixth day p.i. Dengue virus replicated in the peripheral blood leucocyte (PBL) cultures and was present throughout the course of the study. The findings of the present study show that dengue virus induced a predominant Th1-type cytokine response during the first 3 days of infection of PBL cultures that was replaced by a Th2-type response later.
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Nagar R. Syntheses, characterization, and microbial activity of some transition metal complexes involving potentially active O and N donor heterocyclic ligands. J Inorg Biochem 1990; 40:349-56. [PMID: 2086721 DOI: 10.1016/0162-0134(90)80069-a] [Citation(s) in RCA: 67] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The formation of binary as well as ternary metal complexes of type MLL' (where M(II) = Cu(II), Ni(II), Co(II), and Zn(II); L = 8-hydroxyquinoline, and L' = 2-furoic acid) has been studied. The complexes were synthesized and characterized by elemental analyses, molecular weight determination, the IR and electronic spectra, conductivity, and magnetic measurements. The presence of coordinated water molecules was demonstrated by thermogravimetric analysis. The microbial activity of these ligands and their metal complexes was determined on gram positive (Staphylococcus aureus) and gram negative (Escherichia coli) bacteria, the antifungal activity on some common fungi, viz. Aspergillus niger, Aspergillus nidulense, and Penicillium citrinum.
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Comparative Study |
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Pacsa AS, Agarwal R, Elbishbishi EA, Chaturvedi UC, Nagar R, Mustafa AS. Role of interleukin-12 in patients with dengue hemorrhagic fever. FEMS IMMUNOLOGY AND MEDICAL MICROBIOLOGY 2000; 28:151-5. [PMID: 10799806 DOI: 10.1111/j.1574-695x.2000.tb01470.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Interleukin (IL)-12 has a broad range of activities including regulation of cytokine synthesis and selective promotion of Th1-type cell development. A shift from a Th1-type response to Th2-type has been suggested to be important in the pathogenesis of dengue hemorrhagic fever (DHF). This study was undertaken to investigate the possible role of IL-12 in this shift. A total of 76 patients with various grades of dengue illness and 21 normal healthy controls were tested for IL-12 levels in serum samples and IL-12 mRNA in their peripheral blood mononuclear cells. The results showed that the levels of IL-12 were the highest in patients with dengue fever (270+/-102 pg ml(-1)) followed by decreasing levels in the patients with DHF grade I (198+/-86 pg ml(-1); P<0.05) and DHF grade II (84+/-52 pg ml(-1); P<0.001). Neither IL-12 nor its mRNA could be detected in the patients with DHF grades III and IV. The cytokine appeared and reached peak levels during the first 4 days of illness, started to decline by day 5-8 and disappeared by day 9 onwards. The absence of IL-12 during severe illness and late phases of the disease may be responsible for the shift to a Th2-type response and thus for the pathogenesis of DHF.
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Agarwal R, Elbishbishi EA, Chaturvedi UC, Nagar R, Mustafa AS. Profile of transforming growth factor-beta 1 in patients with dengue haemorrhagic fever. Int J Exp Pathol 1999; 80:143-9. [PMID: 10469270 PMCID: PMC2517771 DOI: 10.1046/j.1365-2613.1999.00107.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The pathogenesis of dengue haemorrhagic fever (DHF) is incompletely understood but it has been suggested that various cytokines may have a role in the process. In this study the profile of the cytokine Transforming Growth Factor-beta 1 (TGF-beta1) was investigated in the sera of 79 patients with various grades of dengue illness and in 21 normal healthy controls. Also, TGF-beta1-specific mRNA was examined in their peripheral blood mononuclear cells (PBMC). The results showed that neither TGF-beta1 protein nor its mRNA were detected in healthy controls. In dengue patients, the TGF-beta1 protein and its mRNA were detected in 96%. However, among the patient groups, the levels of TGF-beta1 were lowest in patients with dengue fever (DF; mean value 315 +/- 95 pg/ml) and were highest in patients with DHF grade IV (mean value 1350 +/- 280 pg/ml; P = < 0. 001). The cytokine appeared during the first four days of illness (304 +/- 90 pg/ml) and gradually increased, reaching peak levels (1050 +/- 215 pg/ml) after the 9th day of the illness. Thus TGF-beta1 in the sera and TGF-beta1-mRNA in the PBMC were present in most of the patients with dengue (96%) but the cytokine levels were highest during the later periods of illness and in patients with DHF grade IV, suggesting a possible role of TGF-beta1 in the pathogenesis of DHF.
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Meena P, Kakkar A, Kumar M, Khatri N, Nagar RK, Singh A, Malhotra P, Shukla M, Saraswat SK, Srivastava S, Datt R, Pandey S. Advances and clinical challenges for translating nerve conduit technology from bench to bed side for peripheral nerve repair. Cell Tissue Res 2020; 383:617-644. [PMID: 33201351 DOI: 10.1007/s00441-020-03301-x] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 09/14/2020] [Indexed: 12/19/2022]
Abstract
Injuries to the peripheral nervous system remain a large-scale clinical problem. These injuries often lead to loss of motor and/or sensory function that significantly affects patients' quality of life. The current neurosurgical approach for peripheral nerve repair involves autologous nerve transplantation, which often leads to clinical complications. The most pressing need is to increase the regenerative capacity of existing tubular constructs in the repair of large nerve gaps through development of tissue-engineered approaches that can surpass the performance of autografts. To fully realize the clinical potential of nerve conduit technology, there is a need to reconsider design strategies, biomaterial selection, fabrication techniques and the various potential modifications to optimize a conduit microenvironment that can best mimic the natural process of regeneration. In recent years, a significant progress has been made in the designing and functionality of bioengineered nerve conduits to bridge long peripheral nerve gaps in various animal models. However, translation of this work from lab to commercial scale has not been achieve. The current review summarizes recent advances in the development of tissue engineered nerve guidance conduits (NGCs) with regard to choice of material, novel fabrication methods, surface modifications and regenerative cues such as stem cells and growth factors to improve regeneration performance. Also, the current clinical potential and future perspectives to achieve therapeutic benefits of NGCs will be discussed in context of peripheral nerve regeneration.
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Review |
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Agarwal R, Chaturvedi UC, Misra A, Mukerjee R, Kapoor S, Nagar R, Tandon R, Mathur A. Production of cytotoxic factor by peripheral blood mononuclear cells (PBMC) in patients with dengue haemorrhagic fever. Clin Exp Immunol 1998; 112:477-81. [PMID: 9649218 PMCID: PMC1904990 DOI: 10.1046/j.1365-2249.1998.00598.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
A unique cytokine, human cytotoxic factor (hCF), has been shown to occur in the sera of patients with dengue fever (DF) and dengue haemorrhagic fever (DHF). The present study was undertaken to investigate the ability of fresh PBMC of such patients to produce hCF. The PBMC were cultured for 24 h and the culture supernatants (CS) were analysed for the presence of hCF by cytotoxicity assay, competitive ELISA and dot blot tests. In 90% of 246 cases CS were positive for hCF by the three tests. CS were positive for hCF in PBMC collected from days 1-20 of illness but not at later periods. Higher cytotoxic activity was observed in CS of days 1-4 of illness and was highest in cases of DHF grade IV and lowest in cases of DF. Dot blot hybridization of RNA extracted from the PBMC of the patients showed the presence of mRNA for hCF in 94% of cases. A similar number of patients showed the presence of hCF in situ in the PBMC smears by fluorescent antibody technique. hCF was found only in CD4+ T cells. The findings thus present direct evidence of the production of hCF by CD4 T cells of cases of DF/DHF.
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research-article |
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Kumar A, Sawhney G, Kumar Nagar R, Chauhan N, Gupta N, Kaul A, Ahmed Z, Sangwan PL, Satheesh Kumar P, Yadav G. Evaluation of the immunomodulatory and anti-inflammatory activity of Bakuchiol using RAW 264.7 macrophage cell lines and in animal models stimulated by lipopolysaccharide (LPS). Int Immunopharmacol 2020; 91:107264. [PMID: 33340782 DOI: 10.1016/j.intimp.2020.107264] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 11/23/2020] [Accepted: 11/27/2020] [Indexed: 12/01/2022]
Abstract
Bakuchiol (BAK) has been reported to have a diverse pharmacological property as an antibiotic, anti-cancer, anti-hypolipidemic, anti-inflammatory and anti-convulsant agent. This study aimed to elucidate the immunomodulation and anti-inflammatory mechanism of bakuchiol using lipopolysaccharide stimulated RAW 264.7 macrophages and various animal models. The present study has shown that BAK significantly suppressed the pro-inflammatory cytokine expression in a dose-dependent manner and its oral administration significantly decreased delayed hypersensitivity responses as compared to control group. The assessment of immunomodulatory activity was carried out by the testing Hemagglutinating antibody (HA) titer, delayed type hypersensitivity (DTH) responses and phagocytic index by carbon clearance test. On the other hand, it showed significant decrease in circulating antibody titer and carbon clearance assay in a concentration-dependent manner. BAK has significantly potentiated the cellular immunity as well as humoral immunity by facilitating the footpad thickness responses in sheep RBCs in sensitized mice by significantly decreasing circulating antibody titer. Molecular studies revealed that BAK inhibited the activation of upstream mediator nuclear factor-κB by suppressing the phosphorylation of IκBα and p65. The responses were statistically significant as compared with the control (*p < 0.05, **p < 0.01).
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Journal Article |
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Patra S, Lukhmana S, Tayler Smith K, Kannan AT, Satyanarayana S, Enarson DA, Nagar RK, Marcel M, Reid T. Profile and treatment outcomes of elderly patients with tuberculosis in Delhi, India: implications for their management. Trans R Soc Trop Med Hyg 2013; 107:763-8. [PMID: 24189479 DOI: 10.1093/trstmh/trt094] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Given India's high rate of TB, rising burden of non-communicable diseases (NCDs) and growing elderly population, elderly TB patients may be at higher risk of adverse outcomes including death, loss-to-follow-up (LTFU) and treatment failure. This may call for modifications in their management. This study thus aimed to compare the profile and treatment outcomes between elderly (≥60 years) and non-elderly (15-59 years) TB patients. METHODS This was a retrospective cohort study using routinely-collected programme data from a chest clinic in Delhi, India. It included all elderly and selected non-elderly TB patients registered for treatment between 2005 and 2010. Data on patients' clinical and demographic characteristics and treatment outcomes were analysed. RESULTS There were 812 elderly and 1624 non-elderly TB patients. Elderly patients were more likely to be male (63.2% vs 51.1%) and have smear-positive TB (56.0% vs 47.4%). Adverse outcomes were more frequent among elderly patients (adjusted OR 1.9, 95% CI: 1.5-2.4), specifically deaths (adjusted OR 5.0, 95% CI: 3.1-8.1) and lost-to-follow-up (adjusted OR 1.4, 95% CI: 1.0-1.9). CONCLUSIONS The profile and worse outcomes of elderly Indian TB patients may be indicative of co-existing NCDs. This needs further investigation and likely calls for a more comprehensive and intensive approach to their management.
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Research Support, Non-U.S. Gov't |
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Gupta V, Nagar R. Effect of cooking, fermentation, dehulling and utensils on antioxidants present in pearl millet rabadi - a traditional fermented food. Journal of Food Science and Technology 2010; 47:73-6. [PMID: 23572604 DOI: 10.1007/s13197-010-0018-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2008] [Accepted: 06/06/2009] [Indexed: 11/25/2022]
Abstract
Effect of cooking, fermentation, dehulling and the use of utensils on flavonoids (quercitin and pelargonidin) - antioxidants present in pearl millet (Pennisetum typhoideum) rabadi, along with proximate composition and sensory acceptability of the product were studied. Study revealed an increased ash and flavonoids and reduced crude fibre after cooking in all samples, while fermentation enhanced the crude protein and reduced fat and crude fibre after 16 h in fermented-cooked-fermented rabadi prepared in steel and earthen pot and cooked-fermented rabadi in earthen pot. Enhanced flavonoids were observed in all samples after 16 h fermentation. Fermented-cooked-fermented samples were better with high (ρ<0.05) protein in steel pot rabadi and high (ρ<0.001) ash and quercitin (ρ<0.1 in earthen pot rabadi. Major nutrients were unaffected after dehulling except the crude fibre, which decreased and quercitin increased significantly (ρ<0.1). Remarkable rise in quercitin was observed when rabadi was fermented-cooked and fermented in earthen pot. Sensory evaluation showed the acceptance of all samples in the range of liked extremely (fermented-cooked-fermented-steel pot) to liked slightly (fermented-cooked in earthen pot).
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Journal Article |
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Chaturvedi UC, Nagar R, Mathur A. Effect of dengue virus infection on Fc-receptor functions of mouse macrophages. J Gen Virol 1983; 64 (Pt 11):2399-407. [PMID: 6644274 DOI: 10.1099/0022-1317-64-11-2399] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Fc-receptor-mediated attachment and ingestion of opsonized sheep erythrocytes (EA) by the macrophages of spleen and peritoneal cavity were studied during dengue virus type 2 (DV) infection of Swiss albino mice. Following intracerebral inoculation, virus antigen could be demonstrated by immunofluorescence in the splenic macrophages from day 4 and in peritoneal macrophages from day 5 post-infection, with a higher number of positive cells discernible on the 7th and 8th days. The virus could be isolated from spleen tissue from day 5. The total number of cells was markedly reduced from day 4 onwards both in the spleen and peritoneal cavity. A loss in the capacity to attach and ingest EA was noticed, the lowest values of attachment index (AI) and phagocytic index (PI) being reached on day 4. At later periods the AI values increased markedly but continued to be significantly less than those in uninfected control mice. The PI values continued to be lower throughout. The dichotomy between the Fc-mediated attachment and ingestion may be a mechanism for prevention of virus infection of macrophages.
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Pfützner A, Hermanns N, Funke K, Forst T, Behnke T, Bitton G, Nagar R, Raz I, Haak T. The Barmer study: impact of standardized warming of the injection site to enhance insulin absorption and reduce prandial insulin requirements and hypoglycemia in obese patients with diabetes mellitus. Curr Med Res Opin 2014; 30:753-60. [PMID: 24392996 DOI: 10.1185/03007995.2014.880049] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND The primary objective of this prospective controlled study was to investigate the impact of standardized injection-site warming on prandial rapid acting insulin dose and glycemic control when studied under real-world conditions. METHODS All 145 participating patients (51 female, 94 male, 13 type 1 and 132 type 2 patients, age: 61.6 ± 8.4 yrs, HbA1c: 7.19 ± 0.50%) were treated with intensive insulin glargine and short-acting insulin analog therapy. After a 4 week treatment optimization run-in period, patients were randomized to continue therapy for three months without (control) or with a local injection-site warming device (InsuPad * ). Observation parameters included HbA1c, insulin dose, frequency of hypoglycemia, body weight and adverse events. RESULTS HbA1c improved in both arms until study end (control group: 6.3 ± 0.5%; injection-site warming device: 6.3 ± 0.5%; both p < 0.001 vs. baseline). To achieve this good control, patients in the control group needed to increase the daily prandial insulin dose by 8.1% (from 66 ± 31 U to 71 ± 38 U, p < 0.05) with stable basal insulin requirements. Patients who used the injection-site warming device required less prandial insulin (70 ± 43 U to 55 ± 34 U; -19%, p < 0.001) and slightly more basal insulin (+3.9%). Total daily insulin dose increased in the control group (+3.7%) and decreased with warming device use (-8.6%, p < 0.001). The number of hypoglycemic events (<63 mg/dL) during the observation period was higher in the control group (6.2 ± 9.9/patient vs. injection-site warming device: 3.3 ± 4.8/patient, p < 0.05). Main study limitations can be seen in the open label design reliability of the collected dose information and the very obese patient cohort. CONCLUSION When treating obese patients to target with insulin therapy, use of an injection-site warming device for 3 months resulted in a lower frequency of hypoglycemic events and a reduction in prandial insulin analog requirements. If these results are confirmed in other patient populations, an injection-site warming device may be useful in achieving treatment targets with a safer and more efficient basal bolus therapy in insulin-treated patients with type 1 and type 2 diabetes.
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Multicenter Study |
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Case Reports |
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Nagar R, Mohan G. Synthetic and pharmacological studies on some transition metal chelates involving N-pyrimidino benzamide-2-carboxylic acid as ligand. J Inorg Biochem 1991; 42:9-16. [PMID: 2066740 DOI: 10.1016/0162-0134(91)80027-f] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
N-pyrimidino benzamide-2-carboxylic acid (NPBCA) and its Cu(II), Ni(II), Co(II), Zn(II), and Mn(II) chelates have been synthesized and characterized by using elemental analyses, molar conductance, molecular weight determination, magnetic moment, infrared, and electronic spectra. Antifungal activity of the synthesized compounds has been screened on common fungi, viz., Aspergillus niger, Aspergillus nidulense, and Candida albicans at 28 degrees C and antibacterial activity has been observed on gram-positive (Staphylococcus aureus) and gram-negative (Escherichia coli) bacteria at 37 degrees C. Anti-inflammatory and ulcerogenic potential of the synthesized compounds have been discussed.
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Abstract
N-pyridinobenzamide-2-carboxylic acid has been synthesized. Its binary and ternary (using 8-hydroxy-quinoline as the other ligand) Cu(II), Ni(II), Co(II), and Zn(II) complexes have been synthesized and characterized by their elemental analysis, molecular weight determination, molar conductance, infrared and electronic spectral data, and magnetic measurements. Antibacterial activity of these ligands and their metal complexes has been determined on gram-positive (Staphylococcus aureus) and gram-negative (Escherichia coli) bacteria at 37 degrees C, and antifungal activity has been determined on common fungi viz. Aspergillus niger, Aspergillus nidulense, and Candida albicans at 28 degrees C. A considerable increase in the biocidal activity of these ligands on being coordinated with metal ions has been reported.
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Pfützner A, Dissel S, Forkel C, Grenningloh M, Bitton G, Nagar R, Forst T. Standardized modulation of the injection site allows for insulin dose reduction without deterioration of metabolic control. Curr Med Res Opin 2014; 30:2001-8. [PMID: 24940825 DOI: 10.1185/03007995.2014.933098] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES Use of an injection site modulation device (InsuPad) in intensive insulin treatment reduces frequency of hypoglycemia and prandial insulin requirements by enhancing subcutaneous microcirculation. This meal tolerance test (MTT) investigation was performed as a sub-study during the real-world BARMER study to demonstrate non-inferiority of the reduced insulin doses observed in this study with respect to metabolic control. METHODS The MTT was performed at baseline and after 3 months in insulin treated diabetes patients using the modulation device vs. a control group without device. The dose used for the MTT was individually calculated based on the prandial insulin records from the patient diaries before the test. Blood was drawn for determination of glucose, insulin, C-peptide, proinsulin, triglycerides, free fatty acids, nitrotyrosine, and asymmetric dimethyl-arginine (ADMA) at multiple time-points from 0 to 300 min. A total of 32 patients from one site were included into this MTT study (8 female, 7 type 1 diabetes, age: 49.9 ± 12.5 yrs, HbA1c: 7.2 ± 0.5%). RESULTS During the BARMER study, mean HbA1c was treated to target (<6.5%) in both groups. The prandial insulin dose decreased in the MTT modulation device group by -17.1%, but remained unchanged in the control group (-0.1%, p < 0.001). No change was seen for the basal insulin dose in both treatment arms. There were no differences between the groups with respect to the postprandial curves for glucose, C-peptide, intact proinsulin, free fatty acids, and triglycerides. Insulin absorption was faster with the modulation device (Tmax: 60 ± 28 min vs. 99 ± 46 min, p < 0.05). Key limitations are the small patient sample size and impossibility to determine the short-term effects of device use. CONCLUSIONS The results of this meal tolerance sub-study confirm that the observed prandial insulin dose reduction when using the injection site modulation device has no negative impact on postprandial metabolism.
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Randomized Controlled Trial |
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Chaturvedi Y, Nagar R. Levels of beta-carotene and effects of processing on selected fruits and vegetables of the arid zone of India. PLANT FOODS FOR HUMAN NUTRITION (DORDRECHT, NETHERLANDS) 2001; 56:127-132. [PMID: 11318501 DOI: 10.1023/a:1011174400658] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Some locally available fruits and vegetables of the arid zone of Rajasthan were analyzed for their beta-carotene content; the selected fruits and vegetables were: Dansra (Rhus myserensis), Kachri (Cucumis collosus), fruit Kachri (Cucumis collosus), Kair (Capparis decidua) and Sanghri (Prosopis cineriria). The beta-carotene contents of the samples were estimated in fresh and various processed states (blanched, dried and roasted). The results showed the heat lability of beta-carotene. Among the samples, kair was found to be the richest source of beta-carotene. Variety, too, had an impact on the content of this fat soluble vitamin.
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Chaturvedi UC, Elbishbishi EA, Agarwal R, Raghupathy R, Nagar R, Tandon R, Pacsa AS, Younis OI, Azizieh F. Sequential production of cytokines by dengue virus-infected human peripheral blood leukocyte cultures. J Med Virol 1999. [PMID: 10502266 DOI: 10.1002/(sici)1096-9071(199911)59: 3<335: : aid-jmv13>3.0.co; 2-e] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
The study was undertaken to elucidate the sequence of appearance of T helper (Th)1- and Th2-type cytokines in human peripheral blood leucocyte cultures infected in vitro with dengue type 2 virus. Commercial sandwich enzyme-linked immunosorbent assay kits were used to assay the levels of tumour necrosis factor-alpha (TNF-alpha), interferon-gamma (IFN-gamma), interleukin (IL)-2, IL-4, IL-5, IL-6, and IL-10 in culture supernatants. Culture supernatants were also screened for the cytotoxic factor and the dengue virus titres determined. The cytokines that appeared in the culture supernatants on the first day post-infection (p.i.) were cytotoxic factor, TNF-alpha, IL-2, and IL-6; their levels were highest on the second day p.i. IFN-gamma appeared on the second day with a peak on the third day p.i. The levels of these cytokines declined quickly, except for human cytotoxic factor (hCF) and IL-2. The cytokines that appeared later were IL-10 and IL-5 on the fourth day and IL-4 on the sixth day p.i. Dengue virus replicated in the peripheral blood leucocyte (PBL) cultures and was present throughout the course of the study. The findings of the present study show that dengue virus induced a predominant Th1-type cytokine response during the first 3 days of infection of PBL cultures that was replaced by a Th2-type response later.
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Research Support, Non-U.S. Gov't |
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Agarwal R, Kapoor S, Nagar R, Misra A, Tandon R, Mathur A, Misra AK, Srivastava KL, Chaturvedi UC. A clinical study of the patients with dengue hemorrhagic fever during the epidemic of 1996 at Lucknow, India. THE SOUTHEAST ASIAN JOURNAL OF TROPICAL MEDICINE AND PUBLIC HEALTH 1999; 30:735-40. [PMID: 10928368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
This paper describes the clinical findings in 206 patients with dengue fever (DF) or with dengue hemorrhagic fever (DHF) during the epidemic of 1996 at Lucknow. The age group affected most was 11 to 30 years and 21% of the patients were less than 10 years old. The male:female ratio was 1.9:1. The onset was abrupt in all the patients, severe frontal headache was observed in 97%, myalgia in 90%, skin rash in 40%, vomiting in 29% and arthralgia in knee and hip joints in 9%. Anuria was seen in two patients. Lymphadenopathy was noted in 14%, hepatomegaly in 4%, being associated with mild jaundice in one patient, and splenomegaly in 2% of the patients. Involvement of the heart and lungs was seen in one patient each and no case with encephalitis was recorded. Hemorrhages from various sites were observed in 54% patients and 17 patients had profound shock. The commonest bleeding site was gums. Profound shock was preceded by various warning signs, the commonest being sudden hypotension. Among the patients with profound shock the mortality was 47% while the overall fatality rate was 3.8%. A number of the risk factors existed for a long time in this part of the world, but what precipitated the present epidemic at this time, is not known.
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Gupta R, Kastia S, Rastogi S, Kaul V, Nagar R, Enas EA. Lipoprotein(a) in coronary heart disease: a case-control study. Indian Heart J 2000; 52:407-10. [PMID: 11084780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023] Open
Abstract
To determine the significance of lipoprotein(a) levels in coronary heart disease patients, a case-control study was performed with 48 newly diagnosed coronary heart disease patients and 23 controls who were evaluated using clinical history and biochemical examination. Lipoprotein(a) was measured by quantitative latex-enhanced immunoturbidimetric method. Geometric means of biochemical parameters were obtained. Comprehensive lipid tetrad index was calculated using a previously validated formula. There was no significant difference in prevalence of diabetes, hypertension and smoking in cases and controls. Dietary intake of calories, fats, fatty acids and antioxidant vitamins was also similar. The levels of fasting glucose, cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol and triglycerides were not significantly different in cases and controls (p > 0.05). Low-density lipoprotein/high-density lipoprotein ratio (4.33 +/- 1.5 vs 4.29 +/- 1.8) and total cholesterol/high-density lipoprotein ratio (6.59 + 1.7 vs 6.69 +/- 2.2) were similar. The mean lipoprotein(a) levels were significantly greater in cases (11.95 +/- 2.8 mg/dL, range 1-102 mg/dL) as compared to controls (6.68 +/- 3.4 mg/dL, range 1-73 mg/dL) (t = 2.08, p = 0.041). As compared to controls, in coronary heart disease cases, mean lipoprotein(a) levels in patients upto 50 years (10.27 +/- 2.8 vs 7.27 +/- 3.4 mg/dL) as well as those over 50 years (12.99 +/- 2.9 vs 4.91 +/- 3.5 mg/dL) were significantly more (p < 0.05). Coronary heart disease patients had a slightly greater prevalence of high lipoprotein(a) levels, 20 mg/dL or more (31.3 vs 13.0%; chi 2 = 2.83, l-tailed p < 0.05). Comprehensive lipid tetrad index (total cholesterol x triglycerides x lipoprotein(a) divided by high-density lipoprotein cholesterol) was also slightly higher in cases (14688.2 +/- 3.6) than in controls (8358.2 +/- 4.3) (t = 1.68, 1-tailed p < 0.05). This study shows that lipoprotein(a) levels are significantly more in both younger and older coronary heart disease patients as compared to controls.
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Pfützner A, Nagar R, Pfützner AH, Sachsenheimer D. Eine technologische Lösung zur Verbesserung der Temperaturstabilität von Einmalinsulinpens im täglichen Gebrauch. DIABETOL STOFFWECHS 2017. [DOI: 10.1055/s-0037-1603546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Nagar R, Chaturvedi UC, Shukla MI, Mathur A, Kumar A. Suppressor factor abrogates dengue virus-induced depression of Fc-receptor functions of macrophages. INDIAN JOURNAL OF EXPERIMENTAL BIOLOGY 1985; 23:121-5. [PMID: 4054952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Gupta R, Rastogi S, Nagar R, Kastia S, Kaul V. Dietary and serum iron, body iron stores and coronary heart disease. THE JOURNAL OF THE ASSOCIATION OF PHYSICIANS OF INDIA 2000; 48:489-92. [PMID: 11273140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/16/2023]
Abstract
OBJECTIVES To determine the role of body-iron stores as measured by serum iron, total iron binding capacity (TIBC), transferrin, ferritin and ferritin:transferrin ratio (FTR) in patients with coronary heart disease (CHD). METHODS A case-control study was performed in 58 newly diagnosed CHD patients and 24 controls who were evaluated using clinical history, dietary history and biochemical examination. Dietary iron was determined by history; serum iron and TIBC were measured biochemically and ferritin by enzyme-linked immunoassay. Case-control comparisons were performed by non-parametric Mann-Whitney test. RESULTS There was no significant difference in mean age, prevalence of diabetes, hypertension and smoking, and dietary intake of calories and fats in cases and controls. Dietary iron intake was 11.2 +/- 3.4 mg/day in cases and 11.3 +/- 3.8 mg/day in controls (p > 0.05). Serum fasting glucose, cholesterol, LDL cholesterol, HDL cholesterol and triglycerides were not significantly different in cases and controls (p > 0.05). LDL/HDL ratio (4.17 +/- 1.4 vs. 4.62 +/- 2.3) and total cholesterol/HDL ratio (6.47 +/- 1.6 vs. 6.91 +/- 2.4) were also similar. In the whole study group serum iron (54.8 +/- 35.7 mcg/dl), transferrin (11.6 +/- 7.4%) and ferritin (52.4 +/- 57.8 ng/ml) levels were low. In cases as compared to controls serum iron (56.9 +/- 31 vs. 49.6 +/- 45 mcg/dl; z = 1.707, p = 0.088) and transferrin saturation (12.5 +/- 7.8 vs. 9.5 +/- 6.2%; z = 1.83, p = 0.066) were slightly more. Ferritin levels (48.8 +/- 55 vs. 60.9 +/- 64 ng/ml; z = 2.048, p = 0.040) as well as FTR (5.51 +/- 8.6 vs 7.47 +/- 6.1, z = 2.054, p = 0.040) was significantly lower in cases. CONCLUSIONS In Indian CHD patients the body iron stores are lower as compared to controls.
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Nair S, Nagar R, Gupta R. Antioxidant phenolics and flavonoids in common Indian foods. THE JOURNAL OF THE ASSOCIATION OF PHYSICIANS OF INDIA 1998; 46:708-10. [PMID: 11229280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
To determine antioxidant phenolics and flavonoids in commonly consumed Indian foods we chemically analysed 85 food-stuffs comprising of cereals, pulses, nuts, oilseeds, vegetables, fruits and beverages. Total phenolics were measured biochemically and flavonoids were measured as a sum of quercetin, kaempferol, luteolin and pelargonidin. High flavonoid content (> 100 mg/100 gm) was present in tea, coffee, apple, guava, terminalia bark, fenugreek seeds, mustard seeds, cinnamon, red chili powder, cloves and turmeric. Medium levels (50-100 mg) were found in Indian gooseberry, omum, cumin, cardamom, betel leaf and brandy. Small but significant amounts were also present in food-items of large consumption such as kidney beans, soyabeans, grapes, ginger, coriander powder, bajra and brinjal.
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Nagar R, Maheshwari HB, Mukerjee P, Mittal MM. A study of host defence reaction of breast carcinoma and its correlation with generalised delayed hypersensitivity. Indian J Cancer 1978; 15:63-8. [PMID: 757408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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