1
|
Clavé E, Beyssac O, Bernard S, Royer C, Lopez-Reyes G, Schröder S, Rammelkamp K, Forni O, Fau A, Cousin A, Manrique JA, Ollila A, Madariaga JM, Aramendia J, Sharma SK, Fornaro T, Maurice S, Wiens RC. Radiation-induced alteration of apatite on the surface of Mars: first in situ observations with SuperCam Raman onboard Perseverance. Sci Rep 2024; 14:11284. [PMID: 38760365 PMCID: PMC11101483 DOI: 10.1038/s41598-024-61494-5] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Accepted: 05/06/2024] [Indexed: 05/19/2024] Open
Abstract
Planetary exploration relies considerably on mineral characterization to advance our understanding of the solar system, the planets and their evolution. Thus, we must understand past and present processes that can alter materials exposed on the surface, affecting space mission data. Here, we analyze the first dataset monitoring the evolution of a known mineral target in situ on the Martian surface, brought there as a SuperCam calibration target onboard the Perseverance rover. We used Raman spectroscopy to monitor the crystalline state of a synthetic apatite sample over the first 950 Martian days (sols) of the Mars2020 mission. We note significant variations in the Raman spectra acquired on this target, specifically a decrease in the relative contribution of the Raman signal to the total signal. These observations are consistent with the results of a UV-irradiation test performed in the laboratory under conditions mimicking ambient Martian conditions. We conclude that the observed evolution reflects an alteration of the material, specifically the creation of electronic defects, due to its exposure to the Martian environment and, in particular, UV irradiation. This ongoing process of alteration of the Martian surface needs to be taken into account for mineralogical space mission data analysis.
Collapse
Affiliation(s)
- E Clavé
- DLR - Institute of Optical Sensor Systems, Berlin, Germany.
| | - O Beyssac
- Institut de Minéralogie, de Physique des Matériaux et de Cosmochimie, CNRS, UMR 7590, Muséum National d'Histoire Naturelle, Sorbonne Université, Paris, France
| | - S Bernard
- Institut de Minéralogie, de Physique des Matériaux et de Cosmochimie, CNRS, UMR 7590, Muséum National d'Histoire Naturelle, Sorbonne Université, Paris, France
| | - C Royer
- Earth, Atmospheric, and Planetary Sciences, Purdue University, West Lafayette, IN, USA
- Laboratoire Atmosphères, Milieux, Observations Spatiales, CNRS, Univ. Saint-Quentin-en-Yvelines, Sorbonne Univ, Guyancourt, France
| | - G Lopez-Reyes
- Research Group ERICA, Universidad de Valladolid, Valladolid, Spain
| | - S Schröder
- DLR - Institute of Optical Sensor Systems, Berlin, Germany
| | - K Rammelkamp
- DLR - Institute of Optical Sensor Systems, Berlin, Germany
| | - O Forni
- Institut de Recherche en Astrophysique et Planétologie, CNRS, CNES, Université de Toulouse, Toulouse, France
| | - A Fau
- Institut de Recherche en Astrophysique et Planétologie, CNRS, CNES, Université de Toulouse, Toulouse, France
| | - A Cousin
- Institut de Recherche en Astrophysique et Planétologie, CNRS, CNES, Université de Toulouse, Toulouse, France
| | - J A Manrique
- Research Group ERICA, Universidad de Valladolid, Valladolid, Spain
| | - A Ollila
- Los Alamos National Laboratory, Los Alamos, NM, USA
| | - J M Madariaga
- Department of Analytical Chemistry, University of the Basque Country UPV/EHU, 48940, Leioa, Spain
| | - J Aramendia
- Department of Analytical Chemistry, University of the Basque Country UPV/EHU, 48940, Leioa, Spain
| | - S K Sharma
- Hawaii Institute of Geophysics and Planetology, University of Hawaii, Honolulu, HI, 96822, USA
| | - T Fornaro
- INAF-Astrophysical Observatory of Arcetri, Largo E. Fermi 5, 50125, Firenze, Italy
| | - S Maurice
- Institut de Recherche en Astrophysique et Planétologie, CNRS, CNES, Université de Toulouse, Toulouse, France
| | - R C Wiens
- Earth, Atmospheric, and Planetary Sciences, Purdue University, West Lafayette, IN, USA
| |
Collapse
|
2
|
Mor J, Sharma SK. Decoupling of ion-transport from polymer segmental relaxation and higher ionic-conductivity in poly(ethylene oxide)/succinonitrile composite-based electrolytes having low lithium salt doping. Phys Chem Chem Phys 2024; 26:13306-13315. [PMID: 38639464 DOI: 10.1039/d4cp00735b] [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: 04/20/2024]
Abstract
Only limited enhancement in room-temperature ionic-conductivity for poly(ethylene oxide), PEO, based electrolytes is possible due to coupling between ionic-conductivity and segmental relaxation. In the present study, we have achieved ionic-conductivity of 1.07 × 10-3 and 6.20 × 10-4 S cm-1 at 313 and 298 K, respectively, by adding 45 wt% of succinonitrile (SN) in PEO having low LiTFSI loading (Li : EO = 1 : 20). This enhancement in the ionic-conductivity is attributed to faster ion transport (diffusion coefficient, D = 3.63 × 10-5 cm2 s-1) occurring through the ion-transport channels as confirmed by positron annihilation lifetime spectroscopy. The ionic-transport through these channels is observed to be highly decoupled from the segmental relaxations as confirmed using broadband dielectric spectroscopy through Ratner's approach. The observed decoupling of ionic-conductivity from PEO segmental relaxation in PEO-SN composite-based electrolytes would be useful to design rather inexpensive all solid-state polymer electrolytes for Li ion batteries.
Collapse
Affiliation(s)
- J Mor
- Radiochemistry Division, Bhabha Atomic Research Centre, Mumbai 400 085, India.
- Homi Bhabha National Institute, Anushaktinagar, Mumbai 400 094, India
| | - S K Sharma
- Radiochemistry Division, Bhabha Atomic Research Centre, Mumbai 400 085, India.
- Homi Bhabha National Institute, Anushaktinagar, Mumbai 400 094, India
| |
Collapse
|
3
|
Lahiri D, Krishna KVM, Verma AK, Modak P, Vishwanadh B, Chattopadhyay S, Shibata T, Sharma SK, Sarkar SK, Clifton PH, Biswas A, Garg N, K Dey G. Comprehensive characterization of the structure of Zr-based metallic glasses. Sci Rep 2024; 14:4911. [PMID: 38418473 PMCID: PMC10902397 DOI: 10.1038/s41598-024-53509-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 02/01/2024] [Indexed: 03/01/2024] Open
Abstract
Structure of metallic glasses fascinates as the generic amorphous structural template for ubiquitous systems. Its specification necessitates determination of the complete hierarchical structure, starting from short-range-order (SRO) → medium-range-order (MRO) → bulk structure and free volume (FV) distribution. This link has largely remained elusive since previous investigations adopted one-technique-at-a-time approach, focusing on limited aspects of any one domain. Reconstruction of structure from experimental data inversion is non-unique for many of these techniques. As a result, complete and precise structural understanding of glass has not emerged yet. In this work, we demonstrate the first experimental pathway for reconstruction of the integrated structure, forZr 67 Ni 33 andZr 52 Ti 6 Al 10 Cu 18 Ni 14 glasses. Our strategy engages diverse (× 7) multi-scale techniques [XAFS, 3D-APT, ABED/NBED, FEM, XRD, PAS, FHREM] on the same glass. This strategy complemented mutual limitations of techniques and corroborated common parameters to generate complete, self-consistent and precise parameters. Further, MRO domain size and inter-void separation were correlated to identify the presence of FV at MRO boundaries. This enabled the first experimental reconstruction of hierarchical subset: SRO → MRO → FV → bulk structure. The first ever image of intermediate region between MRO domains emerged from this link. We clarify that determination of all subsets is not our objective; the essence and novelty of this work lies in directing the pathway towards finite solution, in the most logical and unambiguous way.
Collapse
Affiliation(s)
- Debdutta Lahiri
- High Pressure and Synchrotron Radiation Physics Division, Bhabha Atomic Research Centre, Mumbai, 400085, India.
| | - K V Mani Krishna
- Materials Science Division, Bhabha Atomic Research Centre, Mumbai, 400085, India
| | - Ashok K Verma
- High Pressure and Synchrotron Radiation Physics Division, Bhabha Atomic Research Centre, Mumbai, 400085, India.
| | - P Modak
- High Pressure and Synchrotron Radiation Physics Division, Bhabha Atomic Research Centre, Mumbai, 400085, India
| | - B Vishwanadh
- Materials Science Division, Bhabha Atomic Research Centre, Mumbai, 400085, India
| | - Soma Chattopadhyay
- Physical Sciences Department, Elgin Community College, 1700 Spartan Drive, Elgin, IL, 60123, USA
| | - Tomohiro Shibata
- Materials Science, Kennametal Inc., 1600 Technology Way, Latrobe, PA, 15650, USA
| | - S K Sharma
- Radiochemistry Division, Bhabha Atomic Research Centre, Mumbai, 400085, India
| | - Sudip Kumar Sarkar
- Materials Science Division, Bhabha Atomic Research Centre, Mumbai, 400085, India
| | | | - A Biswas
- Materials Science Division, Bhabha Atomic Research Centre, Mumbai, 400085, India
| | - Nandini Garg
- High Pressure and Synchrotron Radiation Physics Division, Bhabha Atomic Research Centre, Mumbai, 400085, India
| | - G K Dey
- Materials Group, Bhabha Atomic Research Centre, Mumbai, 400085, India
| |
Collapse
|
4
|
Sharma SK, Mandal TK. Correction to: Elemental Composition and Sources of Fine Particulate Matter (PM 2.5) in Delhi, India. Bull Environ Contam Toxicol 2023; 110:88. [PMID: 37131083 DOI: 10.1007/s00128-023-03727-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 04/15/2023] [Indexed: 05/04/2023]
Affiliation(s)
- S K Sharma
- CSIR-National Physical Laboratory, Dr. K S Krishnan Road, New Delhi, 110 012, India.
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201 002, India.
| | - T K Mandal
- CSIR-National Physical Laboratory, Dr. K S Krishnan Road, New Delhi, 110 012, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201 002, India
| |
Collapse
|
5
|
Singh SP, Singh H, Saini S, Mishra GK, Sharma SK. Studies on the breeding potential and entomological indices of dengue vector Aedes aegypti and Aedes albopictus in the district Ghaziabad of Uttar Pradesh, India. J Vector Borne Dis 2023; 60:187-192. [PMID: 37417168 DOI: 10.4103/0972-9062.353270] [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] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND & OBJECTIVES The female Aedes mosquito is a vector of many arboviruses-borne diseases. The evidence and information regarding their breeding habitats are vital for implementing appropriate control policies. METHODS An entomological survey was done at three sites in Ghaziabad district of Uttar Pradesh, India viz. Indirapuram, Vasundhara, and Vaishali to generate the first boundary line information of breeding sites of Aedes aegypti larvae for the early prevention and control interventions for dengue management. RESULTS A total of 2994 containers were checked in 1169 households at the time of the survey for breeding sites of Aedes mosquito during the pre-monsoon, monsoon, and post-monsoon period, out of which 667 containers were found positive in 518 positive households. The total HI, CI, and BI were 44.31, 22.27, and 57.05 respectively. The maximum and minimum breeding indices were found during monsoon and pre-monsoon respectively. The most preferred containers for Aedes breeding were cement tanks for lotus plants in nurseries, drums, and small and large size pots for storage of water and ornamental plants mostly in 8 plant nurseries. INTERPRETATION & CONCLUSION Breeding of Aedes was found in nurseries and desert coolers which were the primary breeding containers found during the survey. The containers found positive during surveys were emptied or destroyed with the help of the local community and the breeding status of nurseries was informed to the health authorities of Ghaziabad to take necessary action against the breeding sites of the Aedes mosquitoes.
Collapse
Affiliation(s)
- S P Singh
- ICMR-National Institute of Malaria Research, New Delhi, India
| | - Himmat Singh
- ICMR-National Institute of Malaria Research, New Delhi, India
| | - Suruchi Saini
- State Malaria Office, State Health Department, Ghaziabad, India
| | - G K Mishra
- State Malaria Office, State Health Department, Ghaziabad, India
| | - S K Sharma
- ICMR-National Institute of Malaria Research, New Delhi, India
| |
Collapse
|
6
|
Sharma SK, Mandal TK. Elemental Composition and Sources of Fine Particulate Matter (PM 2.5) in Delhi, India. Bull Environ Contam Toxicol 2023; 110:60. [PMID: 36892662 PMCID: PMC9995727 DOI: 10.1007/s00128-023-03707-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 02/20/2023] [Indexed: 05/04/2023]
Abstract
In this study we have analysed the elemental composition of fine particulate matter (PM2.5) to examine the seasonal changes and sources of the elements in Delhi, India from January, 2017 to December, 2021. During the entire sampling period, 19 elements (Al, Fe, Ti, Cu, Zn, Cr, Ni, As, Mo, Cl, P, S, K, Pb, Na, Mg, Ca, Mn, and Br) of PM2.5 were identified by Wavelength Dispersive X-ray Fluorescence Spectrometer. The higher annual mean concentrations of S (2.29 µg m-3), Cl (2.26 µg m-3), K (2.05 µg m-3), Ca (0.96 µg m-3) and Fe (0.93 µg m-3) were recorded during post-monsoon season followed by Zn > Pb > Al > Na > Cu > Ti > As > Cr > Mo > Br > Mg > Ni > Mn > and P. The annual mean concentrations of elemental composition of PM2.5 accounted for 10% of PM2.5 (pooled estimate of 5 year). Principal Component Analysis (PCA) identified the five main sources [crustal/soil/road dust, combustion (BB + FFC), vehicular emissions (VE), industrial emissions (IE) and mixed source (Ti, Cr and Mo rich-source)] of PM2.5 in Delhi, India.
Collapse
Affiliation(s)
- S K Sharma
- CSIR-National Physical Laboratory, Dr. K S Krishnan Road, New Delhi, 110 012, India.
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201 002, India.
| | - T K Mandal
- CSIR-National Physical Laboratory, Dr. K S Krishnan Road, New Delhi, 110 012, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201 002, India
| |
Collapse
|
7
|
Utpalla P, Mor J, Sharma SK. On enhancing the Li-ion conductivity of quasi-solid-state electrolytes by suppressing the flexibility of zeolitic imidazolate framework-8 via a mixed ligand strategy. Phys Chem Chem Phys 2023; 25:3959-3968. [PMID: 36648501 DOI: 10.1039/d2cp05811a] [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: 01/11/2023]
Abstract
Zeolitic imidazole frameworks (ZIFs) have emerged as potential conductive materials for Li ion-transport in polymer solid state electrolytes. However, developing ZIFs with high Li ionic conductivity is rather limited due to their flexible frameworks allowing dual ion conduction. Herein, we have used a mixed ligand strategy for fine-tuning the aperture and enhancing the rigidity of ZIF-8, which restricts the passage of large size anions. Poly(ethylene oxide)-based quasi-solid state electrolytes utilizing mixed ligand ZIF-7-8 frameworks as passive fillers show a continuous enhancement in Li ion-conductivity exclusively attributed to modifications in the flexibility and pore architecture of ZIF-8 as confirmed through broadband dielectric spectroscopy and positron annihilation spectroscopy. This study shows that polymer segmental relaxation and conductivity relaxation processes are decoupled in these electrolytes. Consequently, our proposed approach provides a new strategy for manufacturing a polymer-based electrolyte with enhanced ionic conductivity.
Collapse
Affiliation(s)
- P Utpalla
- Radiochemistry Division, Bhabha Atomic Research Centre, Mumbai 400 085, India. .,Homi Bhabha National Institute, Mumbai 400 094, India
| | - J Mor
- Radiochemistry Division, Bhabha Atomic Research Centre, Mumbai 400 085, India.
| | - S K Sharma
- Radiochemistry Division, Bhabha Atomic Research Centre, Mumbai 400 085, India. .,Homi Bhabha National Institute, Mumbai 400 094, India
| |
Collapse
|
8
|
Gupta N, Gupta SM, Sharma SK. Synthesis of in situ Generated Cu−CNT Hybrid Nanofluid and the Study of Their Thermo‐physical Properties. ChemistrySelect 2023. [DOI: 10.1002/slct.202203102] [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]
Affiliation(s)
- Nikita Gupta
- USBAS Guru Gobind Singh Indraprastha University New Delhi 110078 India
| | | | - S. K. Sharma
- USCT Guru Gobind Singh Indraprastha University New Delhi 110078 India
| |
Collapse
|
9
|
Verma R, Aravind JMVVS, Deb P, Rao JN, Dey P, Dubey AK, Shukla R, Majumder DB, Sharma SK, Mishra S, Meena M, Rongali L, Sethi B, Sagar K, Kumar GV, Babu NS, Sharma A. Modular electromagnetic railgun accelerator for high velocity impact studies. Rev Sci Instrum 2022; 93:124703. [PMID: 36586908 DOI: 10.1063/5.0104365] [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] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Accepted: 11/03/2022] [Indexed: 06/17/2023]
Abstract
A modular electromagnetic railgun accelerator facility named "RAFTAR" (i.e., Railgun Accelerator Facility for Technology and Research) has been commissioned and its performance has been characterized for high velocity impact testing on materials in a single-shot mode. In the first tests, RAFTAR demonstrated an acceleration of more than 1000 m/s for an 8 g solid aluminum-7075 armature projectile. The current fed was 220 kA, having a muzzle time of about 1.75 ms. It is a single pulse breech-fed rectangular bore (14 × 13 mm2) railgun, and its 1.15 m long barrel assembly consists of two parallel copper bars with an inter-gap of 13 mm that are encased within 50 mm thick high strength reinforced fiberglass sheets (Garolite G10-FR4) and bolted from both the sides. RAFTAR is powered by two capacitor bank modules that have a maximum stored energy of 160 kJ each (containing eight 178 μF/15 kV capacitors), two high power ignitron switches, and a pulse shaping inductor. To obtain consistent acceleration of the armature inside the barrel, reversal of driving current is prevented, and its pulse duration is stretched by tactical integration of the crowbar switch and bitter coil inductor in the circuit. Armature projectile velocity measurement in-bore and outside in free space was performed by the time-of-flight technique using indigenously made miniature B-dot sensors and a novel shorting-foil arrangement, respectively. The time resolved measurement of the in-bore armature evidenced a velocity-skin-effect in the high acceleration phase. There is good agreement between the experimentally measured and theoretically predicted efficiency, confirming the optimal choice of operating parameters. The conclusion summarizes important experimental findings and analyzes the underlying causes that limit the performance of railguns.
Collapse
Affiliation(s)
- Rishi Verma
- Pulsed Power & Electromagnetics Division, Bhabha Atomic Research Centre Facility, Atchutapuram, Vishakhapatnam 531011, AP, India
| | - J M V V S Aravind
- Pulsed Power & Electromagnetics Division, Bhabha Atomic Research Centre Facility, Atchutapuram, Vishakhapatnam 531011, AP, India
| | - Pankaj Deb
- Pulsed Power & Electromagnetics Division, Bhabha Atomic Research Centre Facility, Atchutapuram, Vishakhapatnam 531011, AP, India
| | - J N Rao
- Pulsed Power & Electromagnetics Division, Bhabha Atomic Research Centre Facility, Atchutapuram, Vishakhapatnam 531011, AP, India
| | - P Dey
- Pulsed Power & Electromagnetics Division, Bhabha Atomic Research Centre Facility, Atchutapuram, Vishakhapatnam 531011, AP, India
| | - A K Dubey
- Pulsed Power & Electromagnetics Division, Bhabha Atomic Research Centre Facility, Atchutapuram, Vishakhapatnam 531011, AP, India
| | - R Shukla
- Pulsed Power & Electromagnetics Division, Bhabha Atomic Research Centre Facility, Atchutapuram, Vishakhapatnam 531011, AP, India
| | - D B Majumder
- Pulsed Power & Electromagnetics Division, Bhabha Atomic Research Centre Facility, Atchutapuram, Vishakhapatnam 531011, AP, India
| | - S K Sharma
- Pulsed Power & Electromagnetics Division, Bhabha Atomic Research Centre Facility, Atchutapuram, Vishakhapatnam 531011, AP, India
| | - Shobhna Mishra
- Pulsed Power & Electromagnetics Division, Bhabha Atomic Research Centre Facility, Atchutapuram, Vishakhapatnam 531011, AP, India
| | - Manraj Meena
- Pulsed Power & Electromagnetics Division, Bhabha Atomic Research Centre Facility, Atchutapuram, Vishakhapatnam 531011, AP, India
| | - Lakshman Rongali
- Pulsed Power & Electromagnetics Division, Bhabha Atomic Research Centre Facility, Atchutapuram, Vishakhapatnam 531011, AP, India
| | - Bijayalaxmi Sethi
- Pulsed Power & Electromagnetics Division, Bhabha Atomic Research Centre Facility, Atchutapuram, Vishakhapatnam 531011, AP, India
| | - K Sagar
- Pulsed Power & Electromagnetics Division, Bhabha Atomic Research Centre Facility, Atchutapuram, Vishakhapatnam 531011, AP, India
| | - G Vinod Kumar
- Pulsed Power & Electromagnetics Division, Bhabha Atomic Research Centre Facility, Atchutapuram, Vishakhapatnam 531011, AP, India
| | - N S Babu
- Pulsed Power & Electromagnetics Division, Bhabha Atomic Research Centre Facility, Atchutapuram, Vishakhapatnam 531011, AP, India
| | - Archana Sharma
- Pulsed Power & Electromagnetics Division, Bhabha Atomic Research Centre Facility, Atchutapuram, Vishakhapatnam 531011, AP, India
| |
Collapse
|
10
|
Johansson I, Balasubramanian K, Bangdiwala S, Mielniczuk L, Hage C, Sharma SK, Branch K, Yonga G, Kragholm K, Sliwa K, Roy A, Stork S, McMurray JJV, Conen D, Yusuf S. Factors associated with health-related quality of life in heart failure in 23,000 patients from 40 countries: results of the global congestive heart failure research program. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Poor health-related quality of life (HRQL) is common in heart failure (HF) and strongly predicts death and HF hospitalization in all regions of the world. Understanding facors associated with HRQL could therefore lead to improved prognosis in HF patients. Despite that the majority of HF occurs in low- and middle-income countries, there are limited data characterizing self-perceived health HRQL and its correlates in these settings.
Purpose
To examine clinical and social correlates of HRQL in patients with HF from high- (HIC), upper middle- (UMIC), lower middle-(LMIC) and low-income (LIC) countries.
Methods
Between 2017 and 2020, we enrolled 23,292 patients with HF (32% inpatients, 61% men) from 40 countries in the Global Congestive Heart Failure Study. We recorded HRQL at baseline using Kansas City Cardiomyopathy Questionnaire (KCCQ)-12. In a cross-sectional analysis, we compared age- and sex-adjusted mean KCCQ-12 summary scores (SS: 0–100, higher=better) between patients from different country income levels. We used multivariable linear regression examining correlations (estimates expressed as β-coefficients) of KCCQ-12-SS with sociodemographic-, comorbidity-, treatment- and symptom-covariates. The adjusted model (37 covariates) was informed by univariable findings, clinical importance and backward selection. We used partial R2-estimates to understand the contribution to the variability in KCCQ-12-SS of 4 different groups of covariates. (sociodemographic, comorbidities, treatments and signs and symptoms of congestion).
Results
Mean age was 63 years and 40% were in NYHA class III–IV. Average HRQL was 55± SD 0.5. It was 62.5 (95% CI 62.0–63.1) in HIC, 56.8 (56.1–57.4) in UMIC, 48.6 (48.0–49.3) in LMIC, and 38.5 (37.3–39.7) in LICs (p<0.0001). Strong correlates (β-coefficient [95% CI]) of KCCQ-12-SS were NYHA class III vs class I/II (−12.1 [−12.8 to −11.4] and class IV vs. class I/II (−16.5 [−17.7 to −15.3]), effort dyspnea (−9.5 [−10.2 to −8.8]) and living in LIC vs. HIC (−5.8 [−7.1 to −4.4]). Symptoms explained most of the KCCQ-12-SS variability (partial R2=0.32 of total adjusted R2=0.51), followed by sociodemographic factors (R2=0.12). Results were consistent in populations across income levels.
Conclusion
The most important correlates of HRQL in HF patients relate to HF symptom severity, irrespective of country-income level. Improved symptom control may have a big impact on HRQL, especially in LICs.
Funding Acknowledgement
Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): Bayer AG
Collapse
Affiliation(s)
- I Johansson
- Population Health Research Institute, McMaster University , Hamilton , Canada
| | - K Balasubramanian
- Population Health Research Institute, McMaster University , Hamilton , Canada
| | - S Bangdiwala
- Population Health Research Institute, McMaster University , Hamilton , Canada
| | - L Mielniczuk
- Ottawa Heart Institute, Division of Cardiology , Ottawa , Canada
| | - C Hage
- Karolinska Institute, Cardiology Unit, Department of Medicine K2 , Stockholm , Sweden
| | - S K Sharma
- B P Koirala Institute of Health Sciences , Dharan , Nepal
| | - K Branch
- University of Washington Medical Center, Division of Cardiology , Seattle , United States of America
| | - G Yonga
- University of Nairobi , Nairobi , Kenya
| | - K Kragholm
- Aalborg University Hospital , Aalborg , Denmark
| | - K Sliwa
- University of Cape Town, Department of Medicine and Cardiology , Cape Town , South Africa
| | - A Roy
- All India Institute of Medical Sciences (AIIMS), Department of Cardiology , New Delhi , India
| | - S Stork
- Comprehensive Heart Failure Center (CHFC) , Wurzburg , Germany
| | - J J V McMurray
- BHF Glasgow Cardiovascular Research Centre , Glasgow , United Kingdom
| | - D Conen
- Population Health Research Institute, McMaster University , Hamilton , Canada
| | - S Yusuf
- Population Health Research Institute, McMaster University , Hamilton , Canada
| |
Collapse
|
11
|
Giustino G, Serrao GW, Melarcode-Krishnamoorty P, Vengrenyuk A, Kyaw H, Gidwani U, Sharma SK, Kini A. Development of an app-based bedside clinical decision-making tool for mechanical cardiocirculatory support in patients with cardiogenic shock: the MCS-Aid app. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Patients presenting with cardiogenic shock remain at high risk of morbidity and mortality. Several mechanical cardiocirculatory support (MCS) devices have been developed and their use is rapidly increase in clinical practice. However, there is significant heterogeneity in patient selection, timing of implantation, and post-implantation management across centers and operators.
Purpose
We sought to develop and smartphone app-based clinical decision-making tool to help bedside selection and post-implantation management of MCS devices in patients presenting with cardiogenic shock or cardiac arrest.
Methods
The MCS-Aid app will consistent of 3 major sections: (i) initial device selection based on clinical presentation (patients with cardiogenic shock or cardiac arrest post-ROSC); (ii) guide for escalation or addition of MCS based on the individual hemodynamic scenario; (iii) guide for weaning after implantation of MCS device. The app will have an interactive interface that will allow the user to select the most appropriate next step in management based on the clinical information being entered. A calculator to derive key hemodynamic parameters (e.g. cardiac power output or pulmonary artery pulsatility index) will be incorporated in the App to inform clinical decision-making when appropriate. An example of an algorithm that will be part of the MCS-Aid app is illustrated in the figure.
Conclusions
The MCS-Aid app is an user-friendly bedside clinical decision tool that could help fellows-in-training, early-career interventionalist and interventional cardiologist to select the appropriate MCS device according to the individual clinical and hemodynamic scenario.
Funding Acknowledgement
Type of funding sources: Private company. Main funding source(s): Abiomed
Collapse
Affiliation(s)
- G Giustino
- Mount Sinai Hospital , New York , United States of America
| | - G W Serrao
- Mount Sinai Hospital , New York , United States of America
| | | | - A Vengrenyuk
- Mount Sinai Hospital , New York , United States of America
| | - H Kyaw
- Mount Sinai Hospital , New York , United States of America
| | - U Gidwani
- Mount Sinai Hospital , New York , United States of America
| | - S K Sharma
- Mount Sinai Hospital , New York , United States of America
| | - A Kini
- Mount Sinai Hospital , New York , United States of America
| |
Collapse
|
12
|
Mendieta Badimon G, Mehta S, Baber U, Collier T, Dangas G, Sharma SK, Cohen DJ, Angiolillo D, Briguori C, Escaned J, Gabriel Steg P, Huber K, Michael Gibson C, Pocock S, Mehran R. Effect of aspirin discontinuation according to individualised patient bleeding and ischemic risks after PCI: a TWILIGHT trial sub-analysis. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The TWILIGHT trial demonstrated a reduction in BARC 2, 3 or 5 (BARC-235) bleeding without an increase in ischemic events at 1-year in high-risk PCI patients randomized to placebo or aspirin (ASA) on a background of ticagrelor 3-months after PCI. However, the effect of ASA discontinuation according to baseline risk of bleeding and ischemic events remain unclear.
Purpose
To a) develop separate models to predict the risk of bleeding and ischemic events, and b) to assess treatment effect of ASA discontinuation across the risk strata.
Methods
Using the TWILIGHT patient database (N=7,119), two multivariable models, one for BARC-235 bleeding and one for CV death, nonfatal MI or nonfatal ischemic stroke (ischemic endpoint) were developed, and their predictive capacity was assessed. The effect of randomized treatment on bleeding and ischemic events across different patient risk-group categories as determined by the risk scores was investigated.
Results
At 1-year, 350 (5.4%) patients experienced a BARC-235 bleeding event and 258 (3.6%) experienced an ischemic event. Independent predictors of BARC-235 included haemoglobin levels at index PCI, proton-pump inhibitor non-use at discharge, age, liver disease and active smoking (c-statistic 0.64). Independent predictors of the ischemic outcome included a positive troponin ACS, prior CABG, diabetes, age, peripheral artery disease, prior PCI, a history of congestive heart failure, active smoking, the level of index PCI complexity, and prior MI (c-statistic 0.71). The risk of a BARC-235 almost doubled between patients in lower versus higher bleeding risk categories (4.3% versus 7.9%) and ischemic risk more than tripled between patients in lower versus higher ischemic risk categories (2.0% versus 7.0%) (see Figure 1). There was no evidence of a differential treatment effect for dual antiplatelet therapy versus ticagrelor monotherapy across the different risk categories of bleeding (interaction P=0.54) and ischemic risk (interaction P=0.95) (Table 1).
Conclusion
Individual patient bleeding and ischemic risks after PCI can both be readily characterised with good discrimination. The effect of ASA discontinuation in preventing bleeding in ticagrelor-treated patients was consistent regardless of baseline bleeding risk. There was no evidence for increased ischemic events with ASA discontinuation according to baseline ischemic risk.
Funding Acknowledgement
Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): AstraZenecaIcahn School of Medicine at Mount Sinai
Collapse
Affiliation(s)
| | - S Mehta
- Population Health Research Institute, McMaster University and Hamilton Health Sciences , Hamilton , Canada
| | - U Baber
- The University of Oklahoma Health Sciences Center, Cardiology , Oklahoma City , United States of America
| | - T Collier
- London School of Hygiene and Tropical Medicine, Medical Statistics , London , United Kingdom
| | - G Dangas
- The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai , New York City , United States of America
| | - S K Sharma
- The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai , New York City , United States of America
| | - D J Cohen
- Cardiovascular Research Foundation, New York, NY 10019, USA & St. Francis Hospital, Roslyn, NY 11576 , New York , United States of America
| | - D Angiolillo
- University of Florida College of Medicine, Cardiology , Jacksonville , United States of America
| | - C Briguori
- Mediterranea Cardiocentro , Naples , Italy
| | - J Escaned
- Hospital Clínico San Carlos IDISCC, Complutense University of Madrid , Madrid , Spain
| | - P Gabriel Steg
- Université de Paris, AP-HP, Hôpital Bichat, French Alliance for Cardiovascular Trials and INSERM , Paris , France
| | - K Huber
- Wilhelminen Hospital, Sigmund Freud University, Medical Faculty, 3rd Department of Medicine, Cardiology and Intensive Care Medicine , Vienna , Austria
| | - C Michael Gibson
- Beth Israel Deaconess Medical Center & Harvard Medical School, Cardiovascular Medicine , Boston , United States of America
| | - S Pocock
- London School of Hygiene and Tropical Medicine, Medical Statistics , London , United Kingdom
| | - R Mehran
- The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai , New York City , United States of America
| |
Collapse
|
13
|
Tiwari V, Ali FB, Patra A, Dhiman A, Sharma SK. The conundrum of olecranon aperture and its relation to the distal end of the humerus in a modern Indian population: An anatomical and surgical perspective. Morphologie 2022; 107:199-206. [PMID: 36127255 DOI: 10.1016/j.morpho.2022.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 07/24/2022] [Accepted: 08/24/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE We aimed to clarify the morphology of the olecranon aperture (OA) of the humerus with its relationship to the distal end of the humerus (epicondylar width) and the width of the medullary canal. METHODS In total, 156 dry adult humeri were examined for the presence of OA. When present, we reported their shape, measured transverse (TD) and vertical diameter (VD), the distance from its medial border to the tip of medial epicondyle (D1), lateral border to the tip of lateral epicondyle (D2) and lower border to the tip of trochlea (D3). The epicondylar width (EW) and the width of the medullary canal were also measured in all the humeri. RESULTS OA was reported in 32 humeri (20.6%) with left side predominance, translucent septum in 35.8%, and opaque septum in 43.6%. The most typical shape noted was oval. On right side, mean VD and TD was 4.30±0.54mm and 5.85±0.45mm, respectively, whereas on left, these value were 4.21±0.56mm and 5.64±0.43mm, respectively. The mean of D1, D2 and D3 was 25.86±0.43mm, 26.50±0.28mm and 15.07±0.53mm on right and 24.80±0.41mm, 26.84±0.21mm and 15.81±0.31mm on left with significant difference (P<0.05). The medullary canal was significantly smaller in humeri with OA. CONCLUSION Topographic location of OA may have possible role in determining safe zone for retrograde nailing in supracondylar humeral fractures. Since OA has a direct relation to the size of the intramedullary canal, it is crucial during preoperative planning and choosing an adequate surgical approach involving lower segment of humerus.
Collapse
Affiliation(s)
- V Tiwari
- All India Institute of Medical Sciences Bathinda, Bathinda, Punjab, India
| | - F B Ali
- Government Medical College Ratlam, Ratlam, India
| | - A Patra
- All India Institute of Medical Sciences Bathinda, Bathinda, Punjab, India.
| | - A Dhiman
- All India Institute of Medical Sciences Bathinda, Bathinda, Punjab, India; All India Institute of Medical Sciences, Bilaspur, India
| | - S K Sharma
- All India Institute of Medical Sciences Bathinda, Bathinda, Punjab, India; All India Institute of Medical Sciences, Bilaspur, India
| |
Collapse
|
14
|
Sharma SK, Mandal TK, Banoo R, Rai A, Rani M. Long-Term Variation in Carbonaceous Components of PM 2.5 from 2012 to 2021 in Delhi. Bull Environ Contam Toxicol 2022; 109:502-510. [PMID: 35322279 PMCID: PMC8942158 DOI: 10.1007/s00128-022-03506-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 03/07/2022] [Indexed: 05/20/2023]
Abstract
Carbonaceous species [organic carbon (OC), elemental carbon (EC), elemental matter (EM), primary organic carbon (POC), secondary organic carbon (SOC), total carbon (TC), and total carbonaceous matter (TCM)] of PM2.5 were analyzed to study the seasonal variability and long-term trend of carbonaceous aerosols (CAs) in megacity Delhi, India from January, 2012 to April, 2021. The average concentrations (± standard deviation) of PM2.5, OC, EC, TC, EM, TCM, POC and SOC were 127 ± 77, 15.7 ± 11.6, 7.4 ± 5.1, 23.1 ± 16.5, 8.2 ± 5.6, 33.3 ± 23.9, 9.3 ± 6.3 and 6.5 ± 5.3 µg m-3, respectively during the sampling period (10-year average). The average CAs accounted for 26% of PM2.5 concentration during the entire sampling period. In addition, the seasonal variations in PM2.5, OC, EC, POC, SOC, and TCM levels were recorded with maxima in post-monsoon and minima in monsoon seasons. The linear relationship of OC and EC, OC/EC and EC/TC ratios suggested that the vehicular emissions (VE), fossil fuel combustion (FFC) and biomass burning (BB) are the major sources of CAs at megacity Delhi, India.
Collapse
Affiliation(s)
- S K Sharma
- CSIR-National Physical Laboratory, Dr. K S Krishnan Road, New Delhi, 110 012, India.
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201 002, India.
| | - T K Mandal
- CSIR-National Physical Laboratory, Dr. K S Krishnan Road, New Delhi, 110 012, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201 002, India
| | - R Banoo
- CSIR-National Physical Laboratory, Dr. K S Krishnan Road, New Delhi, 110 012, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201 002, India
| | - A Rai
- CSIR-National Physical Laboratory, Dr. K S Krishnan Road, New Delhi, 110 012, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201 002, India
| | - M Rani
- CSIR-National Physical Laboratory, Dr. K S Krishnan Road, New Delhi, 110 012, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201 002, India
| |
Collapse
|
15
|
Farley KA, Stack KM, Shuster DL, Horgan BHN, Hurowitz JA, Tarnas JD, Simon JI, Sun VZ, Scheller EL, Moore KR, McLennan SM, Vasconcelos PM, Wiens RC, Treiman AH, Mayhew LE, Beyssac O, Kizovski TV, Tosca NJ, Williford KH, Crumpler LS, Beegle LW, Bell JF, Ehlmann BL, Liu Y, Maki JN, Schmidt ME, Allwood AC, Amundsen HEF, Bhartia R, Bosak T, Brown AJ, Clark BC, Cousin A, Forni O, Gabriel TSJ, Goreva Y, Gupta S, Hamran SE, Herd CDK, Hickman-Lewis K, Johnson JR, Kah LC, Kelemen PB, Kinch KB, Mandon L, Mangold N, Quantin-Nataf C, Rice MS, Russell PS, Sharma S, Siljeström S, Steele A, Sullivan R, Wadhwa M, Weiss BP, Williams AJ, Wogsland BV, Willis PA, Acosta-Maeda TA, Beck P, Benzerara K, Bernard S, Burton AS, Cardarelli EL, Chide B, Clavé E, Cloutis EA, Cohen BA, Czaja AD, Debaille V, Dehouck E, Fairén AG, Flannery DT, Fleron SZ, Fouchet T, Frydenvang J, Garczynski BJ, Gibbons EF, Hausrath EM, Hayes AG, Henneke J, Jørgensen JL, Kelly EM, Lasue J, Le Mouélic S, Madariaga JM, Maurice S, Merusi M, Meslin PY, Milkovich SM, Million CC, Moeller RC, Núñez JI, Ollila AM, Paar G, Paige DA, Pedersen DAK, Pilleri P, Pilorget C, Pinet PC, Rice JW, Royer C, Sautter V, Schulte M, Sephton MA, Sharma SK, Sholes SF, Spanovich N, St Clair M, Tate CD, Uckert K, VanBommel SJ, Yanchilina AG, Zorzano MP. Aqueously altered igneous rocks sampled on the floor of Jezero crater, Mars. Science 2022; 377:eabo2196. [PMID: 36007009 DOI: 10.1126/science.abo2196] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The Perseverance rover landed in Jezero crater, Mars, to investigate ancient lake and river deposits. We report observations of the crater floor, below the crater's sedimentary delta, finding the floor consists of igneous rocks altered by water. The lowest exposed unit, informally named Séítah, is a coarsely crystalline olivine-rich rock, which accumulated at the base of a magma body. Fe-Mg carbonates along grain boundaries indicate reactions with CO2-rich water, under water-poor conditions. Overlying Séítah is a unit informally named Máaz, which we interpret as lava flows or the chemical complement to Séítah in a layered igneous body. Voids in these rocks contain sulfates and perchlorates, likely introduced by later near-surface brine evaporation. Core samples of these rocks were stored aboard Perseverance for potential return to Earth.
Collapse
Affiliation(s)
- K A Farley
- Division of Geological and Planetary Sciences, California Institute of Technology, Pasadena, CA 91125, USA
| | - K M Stack
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109, USA
| | - D L Shuster
- Department of Earth and Planetary Science, University of California, Berkeley, Berkeley, CA 94720, USA
| | - B H N Horgan
- Department of Earth, Atmospheric, and Planetary Sciences, Purdue University, West Lafayette, IN 47907, USA
| | - J A Hurowitz
- Department of Geosciences, Stony Brook University, Stony Brook, NY 11794, USA
| | - J D Tarnas
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109, USA
| | - J I Simon
- Center for Isotope Cosmochemistry and Geochronology, Astromaterials Research and Exploration Science Division, NASA Johnson Space Center, Houston, TX 77058, USA
| | - V Z Sun
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109, USA
| | - E L Scheller
- Division of Geological and Planetary Sciences, California Institute of Technology, Pasadena, CA 91125, USA
| | - K R Moore
- Division of Geological and Planetary Sciences, California Institute of Technology, Pasadena, CA 91125, USA
| | - S M McLennan
- Department of Geosciences, Stony Brook University, Stony Brook, NY 11794, USA
| | - P M Vasconcelos
- School of Earth and Environmental Sciences, University of Queensland, Brisbane, QLD 4072, Australia
| | - R C Wiens
- Planetary Exploration Team, Los Alamos National Laboratory, Los Alamos, NM 87545, USA
| | - A H Treiman
- Lunar and Planetary Institute, Universities Space Research Association, Houston, TX 77058, USA
| | - L E Mayhew
- Department of Geological Sciences, University of Colorado, Boulder, Boulder, CO 80309, USA
| | - O Beyssac
- Institut de Minéralogie, de Physique des Matériaux et de Cosmochimie, Centre National de la Recherche Scientifique, Sorbonne Université, Muséum National d'Histoire Naturelle, 75005 Paris, France
| | - T V Kizovski
- Department of Earth Sciences, Brock University, St. Catharines, ON L2S 3A1, Canada
| | - N J Tosca
- Department of Earth Sciences, University of Cambridge, Cambridge CB2 3EQ, UK
| | - K H Williford
- Blue Marble Space Institute of Science, Seattle, WA 98104, USA
| | - L S Crumpler
- New Mexico Museum of Natural History and Science, Albuquerque, NM 8710, USA
| | - L W Beegle
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109, USA
| | - J F Bell
- School of Earth and Space Exploration, Arizona State University, Tempe, AZ 85287, USA
| | - B L Ehlmann
- Division of Geological and Planetary Sciences, California Institute of Technology, Pasadena, CA 91125, USA
| | - Y Liu
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109, USA
| | - J N Maki
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109, USA
| | - M E Schmidt
- Department of Earth Sciences, Brock University, St. Catharines, ON L2S 3A1, Canada
| | - A C Allwood
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109, USA
| | - H E F Amundsen
- Center for Space Sensors and Systems, University of Oslo, 2007 Kjeller, Norway
| | - R Bhartia
- Photon Systems Inc., Covina, CA 91725, USA
| | - T Bosak
- Department of Earth, Atmospheric and Planetary Sciences, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - A J Brown
- Plancius Research, Severna Park, MD 21146, USA
| | - B C Clark
- Space Science Institute, Boulder, CO 80301, USA
| | - A Cousin
- Institut de Recherche en Astrophysique et Planétologie, Université de Toulouse 3 Paul Sabatier, Centre National de la Recherche Scientifique, Centre National d'Etude Spatiale, 31400 Toulouse, France
| | - O Forni
- Institut de Recherche en Astrophysique et Planétologie, Université de Toulouse 3 Paul Sabatier, Centre National de la Recherche Scientifique, Centre National d'Etude Spatiale, 31400 Toulouse, France
| | - T S J Gabriel
- Astrogeology Science Center, US Geological Survey, Flagstaff, AZ 86001, USA
| | - Y Goreva
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109, USA
| | - S Gupta
- Department of Earth Sciences and Engineering, Imperial College London, London SW7 2AZ, UK
| | - S-E Hamran
- Center for Space Sensors and Systems, University of Oslo, 2007 Kjeller, Norway
| | - C D K Herd
- Department of Earth and Atmospheric Sciences, University of Alberta, Edmonton, AB T6G 2E3, Canada
| | - K Hickman-Lewis
- Department of Earth Sciences, The Natural History Museum, London SW7 5BD, UK.,Dipartimento di Scienze Biologiche, Geologiche e Ambientali, Università di Bologna, 40126 Bologna, Italy
| | - J R Johnson
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - L C Kah
- Department of Earth and Planetary Sciences, University of Tennessee, Knoxville, TN 37996, USA
| | - P B Kelemen
- Department of Earth and Environmental Sciences, Lamont Doherty Earth Observatory of Columbia University, Palisades, NY 10964, USA
| | - K B Kinch
- Niels Bohr Institute, University of Copenhagen, 1350 Copenhagen, Denmark
| | - L Mandon
- Laboratoire d'Etudes Spatiales et d'Instrumentation en Astrophysique, Observatoire de Paris, Centre National de la Recherche Scientifique, Sorbonne Université, Université Paris Diderot, 92195 Meudon, France
| | - N Mangold
- Laboratoire de Planétologie et Géosciences, Centre National de la Recherche Scientifique, Nantes Université, Université Angers, 44000 Nantes, France
| | - C Quantin-Nataf
- Laboratoire de Géologie de Lyon: Terre, Université de Lyon, Université Claude Bernard Lyon1, Ecole Normale Supérieure de Lyon, Université Jean Monnet Saint Etienne, Centre National de la Recherche Scientifique, 69622 Villeurbanne, France
| | - M S Rice
- Department of Geology, Western Washington University, Bellingham, WA 98225 USA
| | - P S Russell
- Department of Earth, Planetary, and Space Sciences, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - S Sharma
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109, USA
| | - S Siljeström
- Department of Methodology, Textiles and Medical Technology, Research Institutes of Sweden, 11486 Stockholm, Sweden
| | - A Steele
- Earth and Planetary Laboratory, Carnegie Science, Washington, DC 20015, USA
| | - R Sullivan
- Cornell Center for Astrophysics and Planetary Science, Cornell University, Ithaca, NY 14853, USA
| | - M Wadhwa
- School of Earth and Space Exploration, Arizona State University, Tempe, AZ 85287, USA
| | - B P Weiss
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109, USA.,Department of Earth, Atmospheric and Planetary Sciences, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - A J Williams
- Department of Geological Sciences, University of Florida, Gainesville, FL 32611, USA
| | - B V Wogsland
- Department of Earth and Planetary Sciences, University of Tennessee, Knoxville, TN 37996, USA
| | - P A Willis
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109, USA
| | - T A Acosta-Maeda
- Hawai'i Institute of Geophysics and Planetology, University of Hawai'i at Mānoa, Honolulu, HI 96822, USA
| | - P Beck
- Institut de Planétologie et Astrophysique de Grenoble, Centre National de la Recherche Scientifique, Université Grenoble Alpes, 38000 Grenoble, France
| | - K Benzerara
- Institut de Minéralogie, de Physique des Matériaux et de Cosmochimie, Centre National de la Recherche Scientifique, Sorbonne Université, Muséum National d'Histoire Naturelle, 75005 Paris, France
| | - S Bernard
- Institut de Minéralogie, de Physique des Matériaux et de Cosmochimie, Centre National de la Recherche Scientifique, Sorbonne Université, Muséum National d'Histoire Naturelle, 75005 Paris, France
| | - A S Burton
- NASA Johnson Space Center, Houston, TX 77058, USA
| | - E L Cardarelli
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109, USA
| | - B Chide
- Planetary Exploration Team, Los Alamos National Laboratory, Los Alamos, NM 87545, USA
| | - E Clavé
- Centre Lasers Intenses et Applications, Centre National de la Recherche Scientifique, Commissariat à l'Energie Atomique, Université de Bordeaux, 33400 Bordeaux, France
| | - E A Cloutis
- Centre for Terrestrial and Planetary Exploration, University of Winnipeg, Winnipeg, MB R3B 2E9, Canada
| | - B A Cohen
- NASA Goddard Space Flight Center, Greenbelt, MD 20771, USA
| | - A D Czaja
- Department of Geology, University of Cincinnati, Cincinnati, OH 45221, USA
| | - V Debaille
- Laboratoire G-Time, Université Libre de Bruxelles, 1050 Brussels, Belgium
| | - E Dehouck
- Laboratoire de Géologie de Lyon: Terre, Université de Lyon, Université Claude Bernard Lyon1, Ecole Normale Supérieure de Lyon, Université Jean Monnet Saint Etienne, Centre National de la Recherche Scientifique, 69622 Villeurbanne, France
| | - A G Fairén
- Centro de Astrobiología, Consejo Superior de Investigaciones Científicas-Instituto Nacional de Técnica Aeroespacial, 28850 Madrid, Spain.,Department of Astronomy, Cornell University, Ithaca, NY 14853, USA
| | - D T Flannery
- School of Earth and Atmospheric Sciences, Queensland University of Technology, Brisbane, QLD 4001, Australia
| | - S Z Fleron
- Department of Geosciences and Natural Resource Management, University of Copenhagen, 1350 Copenhagen, Denmark
| | - T Fouchet
- Laboratoire d'Etudes Spatiales et d'Instrumentation en Astrophysique, Observatoire de Paris, Centre National de la Recherche Scientifique, Sorbonne Université, Université Paris Diderot, 92195 Meudon, France
| | - J Frydenvang
- Globe Institute, University of Copenhagen, 1350 Copenhagen, Denmark
| | - B J Garczynski
- Department of Earth, Atmospheric, and Planetary Sciences, Purdue University, West Lafayette, IN 47907, USA
| | - E F Gibbons
- Department of Earth and Planetary Sciences, McGill University, Montreal, QC H3A 0E8, Canada
| | - E M Hausrath
- Department of Geoscience, University of Nevada, Las Vegas, Las Vegas, NV 89154, USA
| | - A G Hayes
- Department of Astronomy, Cornell University, Ithaca, NY 14853, USA
| | - J Henneke
- National Space Institute, Technical University of Denmark, 2800 Kongens Lyngby, Denmark
| | - J L Jørgensen
- National Space Institute, Technical University of Denmark, 2800 Kongens Lyngby, Denmark
| | - E M Kelly
- Hawai'i Institute of Geophysics and Planetology, University of Hawai'i at Mānoa, Honolulu, HI 96822, USA
| | - J Lasue
- Institut de Recherche en Astrophysique et Planétologie, Université de Toulouse 3 Paul Sabatier, Centre National de la Recherche Scientifique, Centre National d'Etude Spatiale, 31400 Toulouse, France
| | - S Le Mouélic
- Laboratoire de Planétologie et Géosciences, Centre National de la Recherche Scientifique, Nantes Université, Université Angers, 44000 Nantes, France
| | - J M Madariaga
- Department of Analytical Chemistry, University of the Basque Country, 48940 Leioa, Spain
| | - S Maurice
- Institut de Recherche en Astrophysique et Planétologie, Université de Toulouse 3 Paul Sabatier, Centre National de la Recherche Scientifique, Centre National d'Etude Spatiale, 31400 Toulouse, France
| | - M Merusi
- Niels Bohr Institute, University of Copenhagen, 1350 Copenhagen, Denmark
| | - P-Y Meslin
- Institut de Recherche en Astrophysique et Planétologie, Université de Toulouse 3 Paul Sabatier, Centre National de la Recherche Scientifique, Centre National d'Etude Spatiale, 31400 Toulouse, France
| | - S M Milkovich
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109, USA
| | | | - R C Moeller
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109, USA
| | - J I Núñez
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - A M Ollila
- Los Alamos National Laboratory, Los Alamos, NM 87545 USA
| | - G Paar
- Institute for Information and Communication Technologies, Joanneum Research, 8010 Graz, Austria
| | - D A Paige
- Department of Earth, Planetary, and Space Sciences, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - D A K Pedersen
- National Space Institute, Technical University of Denmark, 2800 Kongens Lyngby, Denmark
| | - P Pilleri
- Institut de Recherche en Astrophysique et Planétologie, Université de Toulouse 3 Paul Sabatier, Centre National de la Recherche Scientifique, Centre National d'Etude Spatiale, 31400 Toulouse, France
| | - C Pilorget
- Institut d'Astrophysique Spatiale, Université Paris-Saclay, 91405 Orsay, France.,Institut Universitaire de France, Paris, France
| | - P C Pinet
- Institut de Recherche en Astrophysique et Planétologie, Université de Toulouse 3 Paul Sabatier, Centre National de la Recherche Scientifique, Centre National d'Etude Spatiale, 31400 Toulouse, France
| | - J W Rice
- School of Earth and Space Exploration, Arizona State University, Tempe, AZ 85287, USA
| | - C Royer
- Institut de Minéralogie, de Physique des Matériaux et de Cosmochimie, Centre National de la Recherche Scientifique, Sorbonne Université, Muséum National d'Histoire Naturelle, 75005 Paris, France
| | - V Sautter
- Institut de Minéralogie, de Physique des Matériaux et de Cosmochimie, Centre National de la Recherche Scientifique, Sorbonne Université, Muséum National d'Histoire Naturelle, 75005 Paris, France
| | - M Schulte
- Mars Exploration Program, Planetary Science Division, NASA Headquarters, Washington, DC 20546, USA
| | - M A Sephton
- Department of Earth Sciences and Engineering, Imperial College London, London SW7 2AZ, UK
| | - S K Sharma
- Hawai'i Institute of Geophysics and Planetology, University of Hawai'i at Mānoa, Honolulu, HI 96822, USA
| | - S F Sholes
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109, USA
| | - N Spanovich
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109, USA
| | - M St Clair
- Million Concepts, Louisville, KY 40204, USA
| | - C D Tate
- Department of Astronomy, Cornell University, Ithaca, NY 14853, USA
| | - K Uckert
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109, USA
| | - S J VanBommel
- McDonnell Center for the Space Sciences and Department of Earth and Planetary Sciences, Washington University in St. Louis, St. Louis, MO 63130, USA
| | | | - M-P Zorzano
- Department of Astronomy, Cornell University, Ithaca, NY 14853, USA
| |
Collapse
|
16
|
Yadav S, Kalal N, Sharma SK, Deora S. Effect of nurse-led lifestyle modification follow up program on health outcomes and quality of life among post myocardial infarction patients: a randomized controlled trial. Eur J Cardiovasc Nurs 2022. [DOI: 10.1093/eurjcn/zvac060.089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
India has among the world's highest burden of cardiovascular disease, potentially contributed by myocardial infarction. Despite growing trouble, there are no known post-discharge programs & randomized trials reporting health status outcomes & quality of life among post-myocardial infarction patients. Cardiac rehabilitation programs reduce mortality, therefore, it is crucial to understand the local burden of the disease, common challenges, public perceptions, develop timely & effective interventional programs.
Purpose
This study aimed to evaluate the effect of a nurse-led lifestyle modification follow-up program on health outcomes & quality of life among post-myocardial infarction patients.
Methods
A two-arm randomized controlled trial was adopted & 104 post-myocardial infarction patients were recruited from August to December 2021. An equal number of participants were randomly assigned to intervention & control group by random number table generator. The control group patients received routine care, while the intervention group was provided routine care along with a nurse-led lifestyle modification follow-up program(health education, educational booklet, & telephone follow- up). A low-cost intervention based on information-motivation-behavioural skill model was developed. It was designed according to the needs of patients to know their risk factors, help patients establish a knowledge base, & adapt to the post-illness lifestyle changes. Data were assessed & compared by using the demographic datasheet, health outcomes datasheet, & MacNew heart disease quality of life questionnaire. All evaluations were conducted at baseline after 12 weeks post-discharge, by face-to-face interview & biophysiological measurements.
Results
The nurse-led lifestyle modification follow-up program was convenient for clinical application. The intervention group showed a appreciable improvement in low density lipoprotein(p=0.045), systolic blood pressure(p=0.009), diastolic blood pressure(p=0.044), body mass index(p=0.043), and NT ProBNP(p=0.007). The program effectively improved the lifestyle behaviours thereby considerably improving the quality of life in all the subscales-physical, emotional & social (p<0.001) after 12 weeks of discharge.
Conclusion
In the Indian context, it is a novel & extensive approach to improve access to health care and emphasizes post-discharge self-management. The greatest benefit of this program was allowing the intervention group participants to consult with us immediately. Since lifestyles vary among different individuals, we considered individuality when providing education & involving them in implementation of an intervention to enhance their confidence & ultimately achieve optimal health outcomes & quality of life. The findings of this study are important for health care professionals caring for post-myocardial infarction patients & direct incorporation of such programs into routine practice to reduce morbidity & mortality.
Collapse
Affiliation(s)
- S Yadav
- All India Institute of Medical Sciences, College of Nursing , Jodhpur , India
| | - N Kalal
- All India Institute of Medical Sciences, College of Nursing , Jodhpur , India
| | - S K Sharma
- All India Institute of Medical Sciences, College of Nursing , Jodhpur , India
| | - S Deora
- All India Institute of Medical Sciences, Department of Cardiology , Jodhpur , India
| |
Collapse
|
17
|
Kasaudhan SM, Ghimire A, Sharma SK, Baral D, Jha N, Singh SB. Undiagnosed and Uncontrolled Hypertension and Access to Health Care among Residents of an Urban Area of Eastern Nepal: a Cross-sectional Study. Kathmandu Univ Med J (KUMJ) 2022; 20:273-279. [PMID: 37042365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2023]
Abstract
Background The burden and complication of hypertension is increasing as most of the people living with hypertension are unaware of their condition and those who are already diagnosed with it do not have their blood pressure under control. Objective To assess the prevalence of undiagnosed and uncontrolled hypertension among residents of Itahari sub metropolitan city of eastern Nepal, along with its associated socio demographic and behavioral risk factors and access to health care services. Method Cross sectional study was conducted in five wards of Itahari, among 1161 participants, using population proportionate to sample size sampling technique. Face to face interview was conducted with participants for data collection applying semi- structured questionnaire and physical measurement like blood pressure, weight and height. Result Prevalence of hypertension was 26.5% includingundiagnosed 11.0% and previously diagnosed 15.5%. Among diagnosed, 76.6% had uncontrolled blood pressure and 56.70% were taking anti-hypertensive medicine, and 7.8% were under Ayurvedic medicine. More than 70% participants preferred private health facility for treatment and 22.7% had faced financial barrier to seek healthcare. About 64% of participants did not visit health services or had visited only once in past six months. Increasing age, Body Mass Index (BMI), smoking status and positive family history were found to be significantly associated with hypertension at < 0.05 level. Conclusion Prevalence of hypertension is high and awareness regarding available health services in local primary health center and its utilization is lacking among participants. Regular screening program for hypertension and awareness program to disseminate the knowledge of availability of primary health center should be conducted.
Collapse
Affiliation(s)
- S M Kasaudhan
- School of Public Health and Community Medicine, BP. Koirala Institute of Health Sciences, Dharan, Nepal
| | - A Ghimire
- School of Public Health and Community Medicine, BP. Koirala Institute of Health Sciences, Dharan, Nepal
| | - S K Sharma
- Department of Internal Medicine, BP. Koirala Institute of Health Sciences, Dharan, Nepal
| | - D Baral
- School of Public Health and Community Medicine, BP. Koirala Institute of Health Sciences, Dharan, Nepal
| | - N Jha
- School of Public Health and Community Medicine, BP. Koirala Institute of Health Sciences, Dharan, Nepal
| | - S B Singh
- School of Public Health and Community Medicine, BP. Koirala Institute of Health Sciences, Dharan, Nepal
| |
Collapse
|
18
|
Koirala B, Adhikari SR, Shrestha A, Vaidya A, Aryal KK, Kalaunee SP, Shrestha A, Mishra SR, Sharma SK, Karki A, Maharjan B, Singh S, Schwarz D, Gupta N, Bukhman G, Karmacharya BM. A National Equity Initiative to Address Noncommunicable Diseases and Injuries: Findings and Recommendation from the Nepal NCDI Poverty Commission. Kathmandu Univ Med J (KUMJ) 2022; 20:376-383. [PMID: 37042383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2023]
Abstract
We aimed to assess the burden of NCDIs across socioeconomic groups, their economic impact, existing health service readiness and availability, current policy frameworks and national investment, and planned programmatic initiatives in Nepal through a comprehensive literature review. Secondary data from Global Burden of Disease estimates from GBD 2015 and National Living Standard Survey 2011 were used to estimate the burden of NCDI and present the relationship of NCDI burden with socioeconomic status. The Commission used these data to define priority NCDI conditions and recommend potential cost-effective, poverty-averting, and equity-promoting health system interventions. NCDIs disproportionately affect the health and well-being of poorer populations in Nepal and cause significant impoverishment. The Commission found a high diversity of NCDIs in Nepal, with approximately 60% of the morbidity and mortality caused by NCDIs without primary quantified behavioral or metabolic risk factors, and nearly half of all NCDI-related DALYs occurring in Nepalese younger than 40 years. The Commission prioritized an expanded set of twenty-five NCDI conditions and recommended introduction or scale-up of twenty-three evidence-based health sector interventions. Implementation of these interventions would avert an estimated 9680 premature deaths per annum by 2030 and would cost approximately $8.76 per capita. The Commission modelled potential financing mechanisms, including increased excise taxation on tobacco, alcohol, and sugar-sweetened beverages, which would provide significant revenue for NCDI-related expenditures. Overall, the Commission's conclusions are expected to be a valuable contribution to equitable NCDI planning in Nepal and similar resource-constrained settings globally.
Collapse
Affiliation(s)
- B Koirala
- Tribhuvan University, Institute of Medicine, Department of Cardiothoracic and Vascular Surgery,Maharajgunj, Kathmandu. and Kathmandu Institute of Child Health, Budhanilkantha, Kathmandu
| | - S R Adhikari
- Tribhuvan University Faculty of Humanities and Social Sciences, Central Department of Economics, Kritipur, Kathmandu
| | - A Shrestha
- Dhulikhel Hospital, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre
| | - A Vaidya
- Kathmandu Medical College and Teaching Hospital, Department of Community Medicine, Sinamangal, Kathmandu
| | - K K Aryal
- Bergen Center for Ethics and Priority Setting in Health, Department of Global Public Health and Primary Care, University of Bergen
| | | | - A Shrestha
- Dhulikhel Hospital, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre
| | - S R Mishra
- Nepal Development Society, Chitwan, Nepal
| | - S K Sharma
- B.P. Koirala Institute of Health Sciences, Dharan
| | - A Karki
- School of Health, Medical and Applied Sciences, Central Queensland University
| | - B Maharjan
- Kathmandu Institute of Child Health, Budhanilkantha, Kathmandu
| | - S Singh
- Kathmandu Institute of Child Health, Budhanilkantha, Kathmandu
| | - D Schwarz
- Brigham and Women's Hospital, Division of Global Health Equity; Harvard Medical School, Department of Medicine
| | - N Gupta
- Center for Integration Science, Brigham and Women's Hospital; Program in Global NCDs and Social Change, Harvard Medical School; NCD Synergies Project, Partners In Health; NCDI Poverty Network, Boston, USA
| | - G Bukhman
- Center for Integration Science, Brigham and Women's Hospital; Program in Global NCDs and Social Change, Harvard Medical School; NCD Synergies Project, Partners In Health; NCDI Poverty Network, Boston, USA
| | - B M Karmacharya
- Dhulikhel Hospital, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre
| |
Collapse
|
19
|
Kalra S, Dhar M, Afsana F, Aggarwal P, Aye TT, Bantwal G, Barua M, Bhattacharya S, Das AK, Das S, Dasgupta A, Dhakal G, Dhingra A, Esfahanian F, Gadve S, Jacob J, Kapoor N, Latheef A, Mahadeb Y, Maskey R, Naseri W, Ratnasingam J, Raza A, Saboo B, Sahay R, Shah M, Shaikh S, Sharma SK, Shrestha D, Somasundaram N, Tiwaskar M, Jawdekar A. Asian Best Practices for Care of Diabetes in Elderly (ABCDE). Rev Diabet Stud 2022; 18:100-134. [PMID: 35831938 PMCID: PMC10044048 DOI: 10.1900/rds.2022.18.100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
The elderly population with diabetes is diverse with the majority experiencing a decline in physical and mental capabilities, impacting the entire diabetes management process. Therefore, a need for geriatric-specific guidelines, especially for the Asian population, was identified and
subsequently developed by an expert panel across government and private institutions from several Asian countries. The panel considered clinical evidence (landmark trials, position papers, expert opinions), recommendations from several important societies along with their decades of clinical
experience and expertise, while meticulously devising thorough geriatric-specific tailored management strategies. The creation of the ABCDE best practices document underscores and explores the gaps and challenges and determines optimal methods for diabetes management of the elderly population
in the Asian region.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | | | - Sambit Das
- Dr.Sambit's Centre of Diabetes and Endocrinology, India
| | | | | | | | | | | | | | | | - Ali Latheef
- National Diabetes Centre, Indira Gandhi Memorial, India
| | | | | | | | | | - Abbas Raza
- Shaukat Khanum Cancer Hospital and Research Centre, Pakistan
| | - Banshi Saboo
- Diabetes Care and Hormone Clinic, Ahmedabad, India
| | | | | | | | | | | | | | | | | |
Collapse
|
20
|
Jain S, Dhir V, Leishangthem B, Kalyan M, Verma I, Naidu G, Sharma SK, Sharma A, Jain S. AB0417 SHORT-TERM EFFECT OF METHOTREXATE ON APOLIPOPROTEINS AND LIPID PROFILE IN PATIENTS WITH ACTIVE RHEUMATOID ARTHRITIS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.4367] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundMethotrexate (MTX) forms the first line therapy for rheumatoid arthritis (RA). The cardioprotective effect of MTX is well established, but whether this is just due to control of inflammation, or is also via an effect on serum lipoproteins, is unclear. Although a few studies have studied the effect of the MTX on the traditional lipid profile in RA1, there is no data on the effect of MTX on apolipoproteins (Apo A1, Apo B, ApoB/ApoA1), which are considered better cardiovascular risk predictors than the traditional lipid profile.ObjectivesTo determine the short-term effect of MTX on apolipoproteins and traditional lipid profile in patients with active RA.MethodsDMARD-naïve patients with active RA (SJC≥2 and TJC≥4) who had been enrolled in the multicentre, RCT comparing two different MTX escalation strategies in RA (MEIRA)2 and for whom paired serum samples were available before and after MTX treatment were included. All these patients received MTX monotherapy started at 15 mg/week and escalated to 25 mg/week by 4-8 weeks. Serum levels of apolipoprotein A1 (Apo A1), apolipoprotein B (Apo B), total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL), and triglycerides (TG) were measured before starting MTX and after 16 weeks of MTX monotherapy. Proatherosclerotic indices (TC/HDL and ApoB/ApoA1) were also calculated.ResultsA total of 103 patients [mean age 40 (8) years, 93 (90%) females, mean BMI 25.1 (4.8) kg/m2, all non-smokers and non-alcoholics] were included. No study participant had comorbid diabetes mellitus or coronary artery disease; none of them were taking glucocorticoids or hypolipidemic drugs. An increase in Apo A1 levels [by a mean of 5.6 mg/dL (p=0.02)], and HDL levels [by a mean of 1.6 mg/dL (p=0.04)] was seen after 16 weeks of MTX monotherapy. Although a numerical increase in levels of TC (mean 4.6 mg/dL, p=0.07), LDL (mean 2 mg/dL, p=0.34) and TG (mean 6.6 mg/dL, p=0.35) was also noted, none of these were statistically significant. No obvious change in Apo B levels and TC/HDL ratio occurred due to MTX therapy. However, the ApoB/ApoA1 ratio decreased significantly from 0.8 to 0.7 (p=0.002) with 16 weeks of MTX therapy (Table 1).Table 1.Baseline and end of treatment values of apolipoprotein A1 (Apo A1), apolipoprotein B (Apo B), total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglycerides (TG), and proatherosclerotic indices (TC/HDL and ApoB/ApoA1).Parameter (mg/dL)BaselineAfter 16 weeks of MTX therapyp-valueApo A1126.0 (25.1)131.6 (23.4)0.02Apo B92.3 (18.9)92.0 (20.9)0.84ApoB/ApoA10.8 (0.2)0.7 (0.2)0.002TC164.5 (32.4)169.1 (36.8)0.07HDL40.9 (9.8)42.5 (9.7)0.04TC/HDL4.2 (1.1)4.1 (1.1)0.34LDL88.8 (25.2)90.8 (29.8)0.34TG139.8 (69.6)146.4 (91.3)0.35All values represented as mean (SD).Apo A1=apolipoprotein A1, ApoB=apolipoprotein B, TC=total cholesterol, LDL=low-density lipoprotein, HDL=high-density lipoprotein, TG=triglyceridesConclusionMTX therapy led to a mild but significant increase in HDL, ApoA1 and a reduction in ApoB/ApoA1 over short-term. This could potentially represent one of the mechanisms by which MTX exerts its cardioprotective effect; however, these changes need to be carefully interpreted over longer term and in context of the lipid paradox operating in RA.References[1]Navarro-Millán I, Charles-Schoeman C, Yang S, et al. Changes in lipoproteins associated with methotrexate or combination therapy in early rheumatoid arthritis: results from the treatment of early rheumatoid arthritis trial. Arthritis Rheum. 2013;65(6):1430-1438.[2]Jain S, Dhir V, Aggarwal A, et al. Comparison of two dose escalation strategies of methotrexate in active rheumatoid arthritis: a multicentre, parallel group, randomised controlled trial. Ann Rheum Dis. 2021;80(11):1376-1384.Disclosure of InterestsNone declared
Collapse
|
21
|
Jain S, Dhir V, Aggarwal A, Gupta R, Leishangthem B, Naidu G, Khullar A, Dhawan V, Sharma SK, Sharma A, Jain S. POS0566 PREDICTORS OF RESPONSE TO METHOTREXATE MONOTHERAPY IN ACTIVE RHEUMATOID ARTHRITIS: RESULTS FROM A MULTICENTRE, RANDOMIZED CONTROLLED TRIAL (MEIRA). Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.4257] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundMethotrexate (MTX) is the gold standard, first-line therapy for rheumatoid arthritis (RA). However, not all patients respond to MTX, and the predictors of its response or non-response have not yet been reliably identified. Identification of these predictors will facilitate personalized therapeutic choices, and improve patient outcomes.ObjectivesTo identify the clinico-laboratory predictors of response to MTX monotherapy in active RA.MethodsThis study included patients with active RA (SJC≥2 and TJC≥4) aged 18-55 years, with disease duration <5 years, who were not receiving DMARDs (except HCQ and low-dose prednisolone) and had been enrolled in the multicentre, parallel group RCT comparing two different MTX escalation strategies in RA (MEIRA)1. All these patients received MTX monotherapy which was started at 15 mg/week, escalated to 25 mg/week by 4-8 weeks, and continued till 16 weeks. MTX response was defined as EULAR good or moderate response (based on DAS28-CRP-3v) at 16 weeks. Stepwise, multivariable logistic regression was done using key demographic (age, gender, BMI, comorbidities), clinical (disease duration, DAS28, HAQ), and laboratory parameters (RF, anti-CCP, ESR, CRP, RBC MTX-polyglutamates 1-4, IL-6, MMP-3) as independent variables to identify predictors of MTX response. A two-tailed p-value <0.05 was used for defining statistical significance. (Trial Reg: CTRI/2018/12/016549)ResultsOut of a total of 178 included patients [84% females, mean age 40 (9) years, mean DAS28-CRP=5.4 (1.1)], 113 (63.5%) were classified as MTX responders at 16 weeks. Age (OR=0.95, p=0.01), BMI (OR=1.12, p=0.006), and RF (OR=0.34, p=0.045) were found to be independent predictors of MTX response on multivariable analysis (Table 1). On sensitivity analysis with DAS28-ESR-based EULAR response, age (OR=0.94, p=0.003) and RF (OR=0.42, p=0.059) were replicated as independent predictors of MTX response, in addition to pre-treatment swollen joint count (OR=0.94, p=0.05).Table 1.Results of multivariable logistic regression analysis for prediction of response (as defined by DAS28-CRP-based EULAR good or moderate response) to methotrexate monotherapy in RAVariableOR (unadjusted)Unadjusted p-valueOR (adjusted)Adjusted p-valueAge0.97 (0.93-1.002)0.060.95 (0.91-0.99)0.01Male sex0.78 (0.35-1.76)0.55-BMI1.1 (1.02-1.19)0.011.12 (1.03-1.22)0.006Presence of comorbidities0.67 (0.31-1.44)0.31-Disease duration0.98 (0.79-1.22)0.87-Baseline DAS281.1 (0.81-1.49)0.54-Baseline HAQ1.04 (0.66-1.64)0.86-Baseline TJC1.01 (0.96-1.05)0.72-Baseline SJC0.97 (0.91-1.02)0.24-Baseline ESR1.01 (1.00-1.02)0.27-Baseline CRP1.00 (0.99-1.01)0.85-RF positive0.31 (0.11-0.85)0.020.34 (0.12-0.98)0.045Anti-CCP positive0.73 (0.27-1.99)0.54-MTX PG1 (16 weeks)0.99 (0.94-1.04)0.69-MTX PG2 (16 weeks)0.98 (0.95-1.02)0.37-MTX PG3 (16 weeks)0.99 (0.96-1.02)0.43-MTX PG4 (16 weeks)0.99 (0.95-1.03)0.62-Serum IL-6 (baseline)0.98 (0.95-1.02)0.33-Serum MMP-3 (baseline)1.00 (1.00-1.00)0.48-BMI= Body Mass Index, CCP= Cyclic Citrullinated Peptides, CRP= C-reactive protein, DAS= Disease Activity Score, ESR= Erythrocyte Sedimentation Rate, HAQ= Health Assessment Questionnaire, MTX= Methotrexate, PG= polyglutamate, OR=Odds Ratio, RF=Rheumatoid Factor, SJC= Swollen Joint Count, TJC= Tender Joint CountNote: Only variables with p-value <0.2 on univariable analysis were included in the multivariable analysis.ConclusionYounger age, RF negativity, higher BMI, and lower pre-treatment swollen joint count are potential predictors of response to MTX monotherapy in RA.References[1]Jain S, Dhir V, Aggarwal A, et al. Comparison of two dose escalation strategies of methotrexate in active rheumatoid arthritis: a multicentre, parallel group, randomised controlled trial. Ann Rheum Dis. 2021;80(11):1376-1384.Disclosure of InterestsNone declared.
Collapse
|
22
|
Sharma SK, Adhikari S, Shah N, Aebischer Perone S, Lab B, Heller O, Chappuis F. Familial hypercholesterolemia in community-based KHDC Nepal program-baseline data. Eur J Prev Cardiol 2022. [DOI: 10.1093/eurjpc/zwac056.184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public Institution(s). Main funding source(s): HUG and Republic and Canton of Geneva – Service de solidarité internationaleBP Koirala Institute of Health Sciences
Familial hypercholesterolemia (FH) is either underdiagnosed or diagnosed after primary coronary events. Although homozygous variant of FH is considered rare, heterozygous FH is estimated to occur in about 1 in 200 to 300 individuals. There is no study pertaining to prevalence of FH in Nepal which could be a factor influencing cardiovascular morbidity and mortality.
We present a baseline data of FH in an ongoing in participants of community-based cardiovascular and kidney diseases preventive (KHDC Nepal) program in Mechinagar municipality in Eastern Nepal.
KHDC is a program to collaborate among health post, primary health center or equivalent, and local government along with community representatives created to educate, screen, and intervene for selective NCDs. This program is in alignment with the World Health Organization’s Package of Essential Noncommunicable (WHO PEN) disease interventions for primary health care in low-resource settings. General health status and lifestyle habits, physical examination, and blood pressure were assessed. Blood tests done included fasting lipid profile, serum creatinine, FBS, and HbA1c. A mechanism was developed to follow-up screened positive persons in the primary health centers. Referrals were made to the tertiary care center as needed.
We analyzed initial 7289 participants, 20 years or above, who were enrolled in KHDC program in the year 2020. We assessed for FH using Dutch Lipid Clinic Network(DLCN), Simon Broome and AHA criteria. Participants were categorized as definite, probable, possible, or no FH based on the scores of DLCN criteria; as definite and probable based on Simon Broome criteria and as clinically diagnosed FH based on AHA criteria.
The median age of the patient was 54 years, the majority being females (62.7%). A total of 70(0.96%) of the participants had elevated LDL-C levels of more than 190mg/dl detected during the screening and had no secondary cause for hyperlipidemia. According to DLCN criteria, 65(0.89%) participants were grouped under possible FH, 5(0.06%) were grouped under probable FH while none of them could be delineated as definite FH. According to Simon Broome criteria, 14(0.2%) participants were grouped under probable and none of them could be delineated as definite. According to AHA criteria, 10 (0.13%) participants were categorized as clinically diagnosed FH. DNA analysis was not available in our setup. Clinically manifested atherosclerotic disease was recorded in 5 participants. None of the participants were aware of the FH.
This community-based program of the adult population help create baseline data of FH in Nepal. Larger study with genetic analysis is likely to reveal true prevalence of FH in Nepal.
Collapse
Affiliation(s)
- S K Sharma
- BP Koirala Institute of Health Sciences, Dharan, Nepal
| | - S Adhikari
- BP Koirala Institute of Health Sciences, Dharan, Nepal
| | - N Shah
- BP Koirala Institute of Health Sciences, Dharan, Nepal
| | | | - B Lab
- Geneva University Hospitals, Geneva, Switzerland
| | - O Heller
- Geneva University Hospitals, Geneva, Switzerland
| | - F Chappuis
- Geneva University Hospitals, Geneva, Switzerland
| |
Collapse
|
23
|
Unnikrishnan AG, Sahay RK, Phadke U, Sharma SK, Shah P, Shukla R, Viswanathan V, Wangnoo SK, Singhal S, John M, Kumar A, Dharmalingam M, Jain S, Shaikh S, Verberk WJ. Cardiovascular risk in newly diagnosed type 2 diabetes patients in India. PLoS One 2022; 17:e0263619. [PMID: 35358208 PMCID: PMC8970505 DOI: 10.1371/journal.pone.0263619] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 01/21/2022] [Indexed: 11/20/2022] Open
Abstract
Background Type 2 diabetes mellitus (T2DM) worldwide continues to increase, in particular in India. Early T2DM diagnosis followed by appropriate management will result in more cardiovascular event free life years. However, knowledge of the cardiovascular profile of newly diagnosed T2DM patients is still limited. The aim of this study was to understand the extent of cardiovascular disease (CVD) risk of newly diagnosed T2DM patients in India. Methods A cross sectional observational study was conducted to evaluate clinical laboratory and socio-demographic parameters of 5,080 newly diagnosed T2DM patients (48.3 ± 12.8 years of age; 36.7% female). In addition, we determined their cardiovascular risk according to the guidelines of the Lipid Association of India (LAI) and the criteria of the QRISK3 score. Results Of the newly T2DM diagnosed patients in India 2,007(39.5%) were classified as “High risk” and 3,073 (60.5%) were classified as “Very high risk” based on LAI criteria. On average, patients had 1.7 ± 0.9 major atherosclerotic cardiovascular disease (ASCVD) risk factors. Low HDL-C value was the most frequent major risk (2,823; 55.6%) followed by high age (2,502; 49.3%), hypertension (2,141; 42.1%), smoking/tobacco use (1,078; 21.2%) and chronic kidney disease stage 3b or higher (568; 11.2%). In addition, 4,192 (82.5%) patients appeared to have at least one cholesterol abnormality and, if the latest LAI recommendations are applied, 96.5% (4,902) presented with lipid values above recommended targets. Based on the QRISK3 calculation Indian diabetes patients had an average CVD risk of 15.3 ± 12.3%, (12.2 ± 10.1 vs. 17.1 ± 13.5 [p<0.001] for females and males, respectively). Conclusions Newly diagnosed Indian T2DM patients are at high ASCVD risk. Our data therefore support the notion that further extension of nationwide ASCVD risk identification programs and prevention strategies to reduce the occurrence of cardiovascular diseases are warranted.
Collapse
Affiliation(s)
| | - R. K. Sahay
- Department of Endocrinology, Osmania Medical College, Osmania General Hospital, Hyderabad, India
| | - Uday Phadke
- Sahyadri Hospital, Erandwane, Pune, Maharashtra, India
| | - S. K. Sharma
- Galaxy Speciality Centre, Jaipur, Rajasthan, India
| | - Parag Shah
- Gujarat Endocrine Centre, Ahmedabad, Gujarat, India
| | - Rishi Shukla
- Dr Rishi Shukla Centre for Diabetes & Endocrine Diseases, Kanpur, Uttar Pradesh, India
| | | | | | - Santosh Singhal
- Director, Sparsh Health Care & CHS Apple Hospital, Gwalior, Madhya Pradesh, India
| | - Mathew John
- Providence Endocrine and Diabetes Specialty Centre, Trivandrum, India
| | - Ajay Kumar
- Diabetes Care & Research Centre, Patna, Bihar, India
| | | | - Subodh Jain
- Diabetes Care Centre, Prayagraj, Uttar Pradesh, India
| | - Shehla Shaikh
- KGN Diabetes & Endocrinology Centre, Nagpada, Mumbai, Maharashtra, India
| | - Willem J. Verberk
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
- * E-mail:
| |
Collapse
|
24
|
Verma V, Sharma SK. Critical Analysis of Existing Punjabi Grammar Checker and a Proposed Hybrid Framework Involving Machine Learning and Rule-Base Criteria. ACM T ASIAN LOW-RESO 2022. [DOI: 10.1145/3514237] [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: 10/18/2022]
Abstract
An important area of research involving Artificial Intelligence (AI) is Natural Language Processing (NLP). The objective of training a machine is to imitate and manipulate text and speech of humans. Progressive research is undertaken to find connection between humans and their usage of language commonly used being referred as Natural Language. Various tools for different languages have been developed for operating the natural languages widely used by public. NLP integrates various disciplines and works cohesively for processing text, Information Retrieval, AI etc. One such tool used for checking the accuracy of a given sentence in any language is referred to as a Grammar Checker. So a Grammar checker of a particular language explores grammatical errors (if any) and provide remedial suggestions for correction of the same. Such feature is imbibed by virtue of Natural Language Processing using Computational Linguistics. We have justified the need of an emerging Machine Learning technique by critically evaluating existing Punjabi Grammar checker that was developed earlier in light of certain real time cases. This process is accomplished by critically evaluating the output of each phase and identifying the component accountable for generating maximum errors and false alarms. Based on this analysis, we have proposed a hybrid framework as an efficient way of analyzing correction in sentences. This is attainable through the said booming technique of Machine Learning explicitly using Deep Neural Networks in combination with existing rule-based approach. It's a novel approach as no work using machine learning has been done earlier in Punjabi Grammar Checker.
Collapse
Affiliation(s)
- Vikas Verma
- Department of Computer Science and Applications, DAV University, India
| | - S K Sharma
- Department of Computer Science and Applications, DAV University, India
| |
Collapse
|
25
|
Raina P, Singh SK, Goswami AK, Kashyap MK, Khullar M, Sharma SK, Barwal KC. MN/CA9 gene expression as a potential tumor marker for renal cell carcinoma. Mol Cell Biochem 2022; 477:333-343. [PMID: 34716861 DOI: 10.1007/s11010-021-04279-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 10/15/2021] [Indexed: 02/07/2023]
Abstract
MN/CA9 is a cell surface glycoprotein and a tumor-associated antigen. It plays a crucial role in the regulation of cell proliferation and oncogenesis. There is no ideal tumor marker currently available for renal cell carcinoma (RCC) with sufficient sensitivity and specificity. Therefore, we studied MN/CA9 gene expression in the tumor tissue, apparently normal kidney tissue, preoperative blood, and urine samples of patients with RCC. We included thirty cases of renal tumors (26 RCC and 4 benign tumors) in the study. We applied an RT-PCR assay for MN/CA9 gene expression to 26 RCC kidney tumor samples and four benign kidney tumor tissue samples. We also evaluated MN/CA9 gene expression in preoperative blood and urine samples of 15 of these cases. Additionally, thirty-five grossly normal renal tissue samples, including 21 from kidneys with RCC, were also evaluated for gene expression. The RT-PCR analysis revealed that twenty-one out of 26 RCC tissue samples showed MN/CA9 gene expression compared to three out of 35 non-malignant renal tissue samples (p < 0.05). Two out of four benign renal tissue samples also expressed this gene. We also observed MN/CA9 gene expression in nine out of 15 blood samples and four out of 15 urine samples. All patients with urinary MN/CA9 gene expression showed expression in blood and tumor tissue samples. We found a correlation in terms of MN/CA9 expression between blood and tumor tissue samples of RCC patients as those who exhibit MN/CA9 expression in blood were also positive at the tumor tissue levels. The difference in MN/CA9 gene expression in tumor tissue, blood, and urine samples in relation to the stage of the disease, nuclear grade, and histological cell-type was not statistically significant. However, all the three patients who had metastatic RCC had MN/CA9 gene expression in their blood. The existence of a tumor-associated antigen such as MN/CA9 may present a possible target for molecular diagnosis and management of RCC.
Collapse
Affiliation(s)
- Pamposh Raina
- Department of Urology, Indira Gandhi Medical College, Shimla, Himachal Pradesh, 171001, India
- Department of Urology, Postgraduate Institute of Medical Education & Research, Chandigarh, 160012, India
| | - S K Singh
- Department of Urology, Postgraduate Institute of Medical Education & Research, Chandigarh, 160012, India
| | - Anil K Goswami
- Department of Urology, Postgraduate Institute of Medical Education & Research, Chandigarh, 160012, India
| | - Manoj Kumar Kashyap
- Department of Experimental Medicine and Biotechnology, Postgraduate Institute of Medical Education & Research, Chandigarh, 160012, India
- Amity Stem Cell Institute, Amity Medical School, Amity University Haryana, Amity Education Valley, Panchgaon (Manesar), Gurugram, HR, 122413, India
| | - Madhu Khullar
- Department of Experimental Medicine and Biotechnology, Postgraduate Institute of Medical Education & Research, Chandigarh, 160012, India
| | - S K Sharma
- Department of Urology, Postgraduate Institute of Medical Education & Research, Chandigarh, 160012, India
| | - Kailash Chander Barwal
- Department of Urology, Indira Gandhi Medical College, Shimla, Himachal Pradesh, 171001, India.
- Department of Urology, Postgraduate Institute of Medical Education & Research, Chandigarh, 160012, India.
| |
Collapse
|
26
|
Bandara EMS, Edirisinghe DIU, Wanniarachchi DDCDS, Peiris H, Perera PPR, Jayakrishan AG, Waikar HD, Sharma SK, Abeysuriya V, Chandrasena LG. A comparative study on fatty acid profile in selected vessels of coronary artery bypass graft (CABG). PLoS One 2022; 17:e0260780. [PMID: 35061685 PMCID: PMC8782383 DOI: 10.1371/journal.pone.0260780] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 10/22/2021] [Indexed: 11/19/2022] Open
Abstract
Atherosclerosis is one of the leading non-communicable diseases in Sri Lanka. Analysis of fatty acid composition in blood vessels is important in understanding the development of atherosclerosis. Here, analyses of fatty acid profiles in major arteries which are commonly used in Coronary Artery Bypass Graft surgery (CABG) were subjected to investigation. Patients (n = 27) undergoing elective CABG were enrolled in the study. A small biopsy segment of the saphenous vein (SV), radial artery (RA), and left internal mammary artery (LIMA) of patients was obtained during the surgery. The fatty acid (FA) profile of tissue samples was analyzed using Gas Chromatography-Mass Spectroscopy (GCMS). Among the different arteries tested, palmitic acid and stearic acid were the predominant fatty acids. As far as monounsaturated FA (MUFA) are concerned, oleic acid was found to be the most abundant MUFA in vessels. The FA profile of LIMA samples had a higher SFA percentage and lower unsaturated FA percentage compared to other vessels. Furthermore, the vessel samples of RA indicated the highest percentage of pro-inflammatory ω -6 polyunsaturated fatty acids (PUFA) as well as a higher percentage ratio between ω -6: ω -3 PUFA. The fatty acid composition and ω -6: ω -3 PUFA ratio suggests that LIMA graft is preferred for CABG over RA and SV.
Collapse
Affiliation(s)
- E. M. S. Bandara
- Department of Medical Laboratory Science, Faculty of Allied Health Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka
| | - D. I. U. Edirisinghe
- Instrument Center, Faculty of Applied Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka
| | | | - H. Peiris
- Department of Biochemistry, Faculty of Medical Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka
| | - P. P. R. Perera
- Department of Biochemistry, Faculty of Medical Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka
| | - A. G. Jayakrishan
- Nawaloka Hospital Research and Education Foundation, Nawaloka Hospitals PLC, Colombo, Sri Lanka
| | - H. D. Waikar
- Nawaloka Hospital Research and Education Foundation, Nawaloka Hospitals PLC, Colombo, Sri Lanka
| | - S. K. Sharma
- Nawaloka Hospital Research and Education Foundation, Nawaloka Hospitals PLC, Colombo, Sri Lanka
| | - V. Abeysuriya
- Nawaloka Hospital Research and Education Foundation, Nawaloka Hospitals PLC, Colombo, Sri Lanka
| | - L. G. Chandrasena
- Nawaloka Hospital Research and Education Foundation, Nawaloka Hospitals PLC, Colombo, Sri Lanka
| |
Collapse
|
27
|
Agarwal R, Sharma SK. Silicone band loop myopexy for treatment of myopic strabismus fixus. Strabismus 2022; 30:38-41. [DOI: 10.1080/09273972.2021.2022719] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Richa Agarwal
- Department of Ophthalmology, All India Institute of Medical Sciences, Gorakhpur
| | | |
Collapse
|
28
|
Bhatia M, Srivastav M, Devi S, Sharma SK, Kakkar V, Saini K. Optimization and Evaluation of Ketoconazole Loaded Nanostructured Lipid Carriers Employing Microwave-Assisted Technique. Indian J Pharm Sci 2022. [DOI: 10.36468/pharmaceutical-sciences.907] [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: 11/22/2022] Open
|
29
|
Sahoo P, Kundu S, Roy S, Sharma SK, Ghosh J, Mishra S, Mukherjee A, Ghosh CK. Fundamental understanding of the size and surface modification effects on r1, the relaxivity of Prussian blue nanocube@ m-SiO 2: a novel targeted chemo-photodynamic theranostic agent to treat colon cancer. RSC Adv 2022; 12:24555-24570. [PMID: 36128364 PMCID: PMC9425834 DOI: 10.1039/d2ra03995h] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 08/08/2022] [Indexed: 11/21/2022] Open
Abstract
A targeted multimodal strategy on a single nanoplatform is attractive in the field of nanotheranostics for the complete ablation of cancer. Herein, we have designed mesoporous silica (m-SiO2)-coated Prussian blue nanocubes (PBNCs), functionalized with hyaluronic acid (HA) to construct a multifunctional PBNC@m-SiO2@HA nanoplatform that exhibited good biocompatibility, excellent photodynamic activity, and in vitro T1-weighted magnetic resonance imaging ability (r1 ∼ 3.91 mM−1 s−1). After loading doxorubicin into the as-prepared PBNC@m-SiO2@HA, the developed PBNC@m-SiO2@HA@DOX displayed excellent pH-responsive drug release characteristics. Upon irradiation with 808 nm (1.0 W cm−2) laser light, PBNC@m-SiO2@HA@DOX exhibited synergistic photodynamic and chemotherapeutic efficacy (∼78% in 20 minutes) for human colorectal carcinoma (HCT 116) cell line compared to solo photodynamic or chemotherapy. Herein, the chemo-photodynamic therapeutic process was found to follow the apoptotic pathway via ROS-mediated mitochondrion-dependent DNA damage with a very low cellular uptake of PBNC@m-SiO2@HA@DOX for the human embryonic kidney (HEK 293) cell line, illustrating its safety. Hence, it may be stated that the developed nanoplatform can be a potential theranostic agent for future applications. Most interestingly, we have noted variation in r1 at each step of the functionalization along with size variation that has been the first time modelled on the basis of the Solomon–Bloembergen–Morgan theory considering changes in the defect crystal structure, correlation time, water diffusion rate, etc., due to varied interactions between PBNC and water molecules. A targeted multimodal strategy on a single nanoplatform is attractive in the field of nanotheranostics for the complete ablation of cancer.![]()
Collapse
Affiliation(s)
- Panchanan Sahoo
- School of Materials Science and Nanotechnology, Jadavpur University, Kolkata-700032, India
- Agricultural and Ecological Research Unit, Biological Science Division, Indian Statistical Institute, Giridih, Jharkhand, India
| | - Sudip Kundu
- School of Materials Science and Nanotechnology, Jadavpur University, Kolkata-700032, India
| | - Shubham Roy
- Department of Physics, Jadavpur University, Kolkata-700032, India
| | - S. K. Sharma
- Eko X-Ray & Imaging Institute, 54, Jawaharlal Nehru Road, Kolkata-700071, India
| | - Jiten Ghosh
- XRD and SEM Units, Materials Characterization and Instrumentation Division, CSIR-Central Glass and Ceramic Research Institute, India
| | - Snehasis Mishra
- School of Materials Science and Nanotechnology, Jadavpur University, Kolkata-700032, India
| | - Abhishek Mukherjee
- Agricultural and Ecological Research Unit, Biological Science Division, Indian Statistical Institute, Giridih, Jharkhand, India
| | - Chandan Kumar Ghosh
- School of Materials Science and Nanotechnology, Jadavpur University, Kolkata-700032, India
| |
Collapse
|
30
|
Baral R, Shrestha LB, Ortuño-Gutiérrez N, Pyakure P, Rai B, Rimal SP, Singh S, Sharma SK, Khanal B, Selvaraj K, Kumar AMV. Low yield but high levels of multidrug resistance in urinary tract infections in a tertiary hospital, Nepal. Public Health Action 2021; 11:70-76. [PMID: 34778019 DOI: 10.5588/pha.21.0044] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 07/21/2021] [Indexed: 11/10/2022] Open
Abstract
SETTING There are concerns about the occurrence of multidrug resistance (MDR) in patients with urine tract infections (UTI) in Nepal. OBJECTIVE To determine culture positivity, trends in MDR among Escherichia coli and Klebsiella pneumoniae infections and seasonal changes in culture-positive UTI specimens isolated from 2014 to 2018 at the B P Koirala Institute of Health Sciences, Dharan, Eastern Nepal. DESIGN This was a cross-sectional study using secondary laboratory data. RESULTS Among 116,417 urine samples tested, 19,671 (16.9%) were culture-positive, with an increasing trend in the number of samples tested and culture positivity. E. coli was the most common bacteria (54.3%), followed by K. pneumoniae (8.8%). Among E. coli and K. pneumoniae isolates, MDR was found in respectively 42.5% and 36.0%. MDR was higher in males and people aged >55 years, but showed a decreasing trend over the years. The numbers of isolates increased over the years, with a peak always observed from July to August. CONCLUSION Low culture positivity is worrying and requires further work into improving diagnostic protocols. Decreasing trends in MDR are a welcome sign. Information on seasonal changes that peak in July-August can help laboratories better prepare for this time with adequate buffer stocks to ensure culture and antibiotic susceptibility testing.
Collapse
Affiliation(s)
- R Baral
- BP Koirala Institute of Health Sciences (BPKIHS), Dharan, Nepal
| | - L B Shrestha
- BP Koirala Institute of Health Sciences (BPKIHS), Dharan, Nepal
| | | | - P Pyakure
- BP Koirala Institute of Health Sciences (BPKIHS), Dharan, Nepal.,School of Public Health and Community Medicine, BPKIHS, Dharan, Nepal
| | - B Rai
- BP Koirala Institute of Health Sciences (BPKIHS), Dharan, Nepal
| | - S P Rimal
- BP Koirala Institute of Health Sciences (BPKIHS), Dharan, Nepal
| | - S Singh
- BP Koirala Institute of Health Sciences (BPKIHS), Dharan, Nepal
| | - S K Sharma
- BP Koirala Institute of Health Sciences (BPKIHS), Dharan, Nepal
| | - B Khanal
- BP Koirala Institute of Health Sciences (BPKIHS), Dharan, Nepal
| | - K Selvaraj
- All India Institute of Medical Sciences, Nagpur, India
| | - A M V Kumar
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France.,The Union South-East Asia Office, New Delhi, India.,Yenepoya Medical College, Yenepoya (deemed University), Mangaluru, India
| |
Collapse
|
31
|
Tavenier AH, Chiarito M, Cao D, Pivato CA, Nicolas J, Nardin M, Sartori S, Baber U, Angiolillo DJ, Capodanno D, Kini AS, Sharma SK, Dangas G, Mehran R. Guided and unguided de-escalation from potent P2Y12 inhibitors among patients with ACS: a meta-analysis. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Dual antiplatelet therapy (DAPT) with a potent P2Y12 inhibitor is recommended in patients with acute coronary syndrome (ACS) and should be tailored according to ischemic and bleeding risks, which are highest in the acute phase, and gradually attenuate overtime. De-escalation strategies of DAPT aim to optimize this balance of risks.
Purpose
We compared guided or unguided DAPT de-escalation strategies from potent P2Y12 inhibitors to either clopidogrel or lower doses of potent P2Y12 inhibitors versus standard DAPT with potent P2Y12 inhibitors among patients with ACS.
Methods
PubMed, Google Scholar and Cochrane Central Register of Controlled Trials were searched from inception till March 10th 2021. 1633 records were screened on DAPT de-escalation strategies after ACS for inclusion. Aspirin monotherapy and non-randomized trials were excluded.
The primary endpoint was BARC ≥2 bleeding. Other endpoints included MACE (defined according to the definitions reported in the original study protocols), all-cause death, cardiovascular death, myocardial infarction, stent thrombosis, and stroke. Hazard ratios (HRs) and 95% CIs were used as metric of choice for treatment effects with random-effects models. Heterogeneity was assessed with the I2 index. We assessed the interaction between de-escalation strategy (guided vs. unguided) and treatment with a random-effects meta-regression analysis with the empirical Bayes method. This study has been submitted to PROSPERO for registration.
Preliminary findings
Four randomised trials and a total of 8,082 patients randomly allocated to a de-escalation strategy (genetic guided to clopidogrel, n=1,242; platelet function guided to clopidogrel, n=1,304; unguided to clopidogrel (n=323); unguided to lower dose, n=1,170) or standard DAPT (n=4,043) were included in our analysis. De-escalation strategy had a reduction in BARC ≥2 bleeding (HR 0.57, 95% CI 0.37–0.89; I2=81%). MACE (HR 0.79, 95% CI 0.62–1.02; I2=0%), all-cause death (HR 0.89, 95% CI 0.58–1.36), cardiovascular death (HR 0.63, 95% CI 0.36–1.10; I2=0%), myocardial infarction (HR 0.81, 95% CI 0.56–1.17; I2=0%), stent thrombosis (HR 0.57, 95% CI 0.19–1.74; I2=0%) and stroke (HR 0.73, 95% CI 0.39–1.35; I2=0%) did not differ between patients with a de-escalation strategy and those without. Meta-regression analysis did not show any significant interaction between de-escalation method (guided vs. unguided) and treatment effects, except for BARC ≥2 bleeding (P interaction = 0.070), suggesting a greater reduction with unguided de-escalation.
Conclusion
A de-escalation strategy of DAPT after ACS was associated with a lower number of clinically relevant bleeding events, mostly in patients who underwent unguided de-escalation, while no association with increased ischemic events was found. However, the observed broad confidence intervals limit the certainty of our findings.
Funding Acknowledgement
Type of funding sources: None. BARC ≥2 bleedingMACE
Collapse
Affiliation(s)
- A H Tavenier
- Icahn School of Medicine at Mount Sinai, New York, United States of America
| | - M Chiarito
- Icahn School of Medicine at Mount Sinai, New York, United States of America
| | - D Cao
- Icahn School of Medicine at Mount Sinai, New York, United States of America
| | - C A Pivato
- Icahn School of Medicine at Mount Sinai, New York, United States of America
| | - J Nicolas
- Icahn School of Medicine at Mount Sinai, New York, United States of America
| | - M Nardin
- Icahn School of Medicine at Mount Sinai, New York, United States of America
| | - S Sartori
- Icahn School of Medicine at Mount Sinai, New York, United States of America
| | - U Baber
- University of Oklahoma Health Sciences Center, Oklahoma City, United States of America
| | - D J Angiolillo
- University of Florida College of Medicine, Jacksonville, United States of America
| | | | - A S Kini
- Icahn School of Medicine at Mount Sinai, New York, United States of America
| | - S K Sharma
- Icahn School of Medicine at Mount Sinai, New York, United States of America
| | - G Dangas
- Icahn School of Medicine at Mount Sinai, New York, United States of America
| | - R Mehran
- Icahn School of Medicine at Mount Sinai, New York, United States of America
| |
Collapse
|
32
|
Cao D, Baber U, Dangas G, Sartori S, Zhongjie Z, Giustino G, Angiolillo DJ, Mehta S, Gibson CM, Sardella G, Sharma SK, Shlofmitz R, Collier T, Pocock S, Mehran R. Ticagrelor monotherapy after percutaneous coronary intervention in patients with concomitant diabetes mellitus and chronic kidney disease: a TWILIGHT substudy. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Diabetes mellitus (DM) and chronic kidney disease (CKD) are established risk factors for cardiovascular events, with patients presenting both conditions being at extremely high risk. P2Y12 inhibitor monotherapy with ticagrelor after a short course of dual antiplatelet therapy has emerged as a bleeding avoidance strategy for high-risk patients undergoing percutaneous coronary intervention (PCI).
Purpose
To investigate ischemic and bleeding outcomes associated with ticagrelor monotherapy versus ticagrelor plus aspirin according to the presence or absence of CKD and DM.
Methods
The TWILIGHT trial enrolled patients undergoing PCI with a drug-eluting stent who fulfilled at least one clinical and one angiographic high-risk criterion. Both DM and CKD (estimated glomerular filtration rate <60 mL/min/1.73m2) were clinical study entry criteria. Following 3 months of ticagrelor plus aspirin, patients who had been adherent to treatment and free from major adverse events were randomly assigned to either aspirin or placebo in addition to ticagrelor for 1 year. The primary endpoint was Bleeding Academic Research Consortium (BARC) type 2, 3 or 5 bleeding. The key secondary endpoint was the composite of all-cause death, myocardial infarction, or stroke. Net adverse clinical events (NACE) were defined as BARC type 3 or 5 bleeding, all-cause death, myocardial infarction, or stroke.
Results
Of the 6273 patients included in the analysis, 8.0% had both CKD and DM (DM+/CKD+), 8.9% had CKD only (DM-/CKD+), 29.0% had DM only (DM+/CKD-), and 52.1% had neither CKD nor DM (DM-/CKD-). At 1-year follow-up, there was a progressive increase in the rates of bleeding and ischemic events according to DM and CKD status (Figure 1). Ticagrelor plus placebo reduced the primary bleeding endpoint as compared with ticagrelor plus aspirin across all study groups, including DM+/CKD+ patients (4.7% vs. 8.7%; HR 0.52, 95% CI 0.25–1.07), with no evidence of heterogeneity (p-interaction=0.68). Similar treatment effects of ticagrelor monotherapy were observed for major BARC type 3 or 5 bleeding (p-interaction=0.17), with DM+/CKD+ patients showing the greatest absolute risk reduction (0.9% vs. 5.1%; HR 0.16, 95% CI 0.04–0.72). The key secondary endpoint was not significantly different between treatment arms across study groups, with the exception of a reduced risk in DM+/CKD- patients receiving ticagrelor monotherapy (p-interaction=0.033). A similar pattern in the DM+/CKD- group was observed for NACE (p-interaction=0.030) (Figure 2).
Conclusions
Among high-risk patients undergoing PCI, ticagrelor monotherapy reduced the risk of clinically relevant and major bleeding without a significant increase in ischemic events as compared with ticagrelor plus aspirin, irrespective of the presence of DM and CKD. Furthermore, ticagrelor monotherapy seemed to be associated with a more favourable net benefit in patients with DM without CKD.
Funding Acknowledgement
Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): Investigator-initiated grant from AstraZeneca Figure 1. Event rates according to DM/CKD statusFigure 2. Effects of ticagrelor monotherapy
Collapse
Affiliation(s)
- D Cao
- Icahn School of Medicine at Mount Sinai, New York, United States of America
| | - U Baber
- University of Oklahoma Health Sciences Center, Oklahoma City, United States of America
| | - G Dangas
- Icahn School of Medicine at Mount Sinai, New York, United States of America
| | - S Sartori
- Icahn School of Medicine at Mount Sinai, New York, United States of America
| | - Z Zhongjie
- Icahn School of Medicine at Mount Sinai, New York, United States of America
| | - G Giustino
- Icahn School of Medicine at Mount Sinai, New York, United States of America
| | - D J Angiolillo
- University of Florida College of Medicine, Jacksonville, United States of America
| | - S Mehta
- McMaster University, Hamilton, Canada
| | - C M Gibson
- Beth Israel Deaconess Medical Center, Boston, United States of America
| | - G Sardella
- Umberto I Polyclinic of Rome, Rome, Italy
| | - S K Sharma
- Icahn School of Medicine at Mount Sinai, New York, United States of America
| | - R Shlofmitz
- St. Francis Hospital, Roslyn, United States of America
| | - T Collier
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - S Pocock
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - R Mehran
- Icahn School of Medicine at Mount Sinai, New York, United States of America
| | | |
Collapse
|
33
|
Ansari MA, Saha S, Das A, Lal R, Das B, Choudhury BU, Roy SS, Sharma SK, Singh IM, Meitei CB, Changloi KL, Singh LS, Singh NA, Saraswat PK, Ramakrishna Y, Singh D, Hazarika S, Punitha P, Sandhu SK, Prakash N. Energy and carbon budgeting of traditional land use change with groundnut based cropping system for environmental quality, resilient soil health and farmers income in eastern Indian Himalayas. J Environ Manage 2021; 293:112892. [PMID: 34062423 DOI: 10.1016/j.jenvman.2021.112892] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 05/21/2021] [Accepted: 05/23/2021] [Indexed: 06/12/2023]
Abstract
Energy intensive traditional cereals based monoculture often lead to high greenhouse gas emissions and degradation of land and environmental quality. Present study aimed at evaluating the energy and carbon budget of diversified groundnut (Arachis hypogea L) based cropping system with over existing traditional practice towards the development of a sustainable production technology through restoration of soil and environmental quality and enhancement of farming resiliency by stabilizing farmers' income. The trials comprised of three introduced groundnut based systems viz. groundnut- pea (Pisum sativum), groundnut-lentil (Lens esculenta) and groundnut-toria (Brasssica campestris var. Toria) replacing three existing systems viz. maize (Zea mays L) - fallow, maize - toria, and rice (Oryza sativa L)-fallow systems. Four years study revealed that adoption of groundnut based systems reduced non-renewable energy input use (fertilizers, chemical, machinery and fossil fuels) by 25.5%, consequently that reduced the cost of production. Repeated analysis of variance measurement also affirmed that groundnut based systems (groundnut-pea>groundnut-lentil> groundnut-toria) increased the energy use efficiency, energy productivity, carbon use efficiency, net returns and decreased the specific energy and energy intensiveness. Groundnut based systems increased the mean system productivity and water productivity in terms of groundnut equivalent yield by 3.7 and 3.1 folds over existing practice. The savings of fossil fuel reduced greenhouse gas emissions owing to reduced use of farm machinery and synthetic fertilizers. Groundnut based systems significantly (p < 0.05) enhanced the soil carbon concentration (8.7-18.1%) and enzymatic activities (27.1-51.8%) over existing practice. Consequently, estimated soil quality index values were 35.9-77.3% higher under groundnut based systems than existing practice. Thus, the study indicated the resilient nature of groundnut based systems as an environmentally safe and sustainable production technology for enhancing resource use efficiency, reduce carbon emission, energy intensiveness and cost of production in the Eastern Himalaya region of India and similar ecosystems.
Collapse
Affiliation(s)
- M A Ansari
- ICAR Research Complex for NEH Region, Manipur Centre, Lamphelpat, Imphal, 795004, India
| | - Saurav Saha
- ICAR Research Complex for NEH Region, Mizoram Centre, Kolasib, 796081, Mizoram, India
| | - Anup Das
- ICAR Research Complex for NEH Region, Tripura Centre, Lembucherra, 799 210, Tripura, India.
| | - R Lal
- CMASC, Ohio State University, Columbus, OH, 43210, USA
| | - Bappa Das
- ICAR Central Coastal Agricultural Research Institute, Old Goa, 403402, Goa, India
| | - B U Choudhury
- ICAR Research Complex for NEH Region, Umiam, Meghalaya, 793103, Meghalaya, India
| | - S S Roy
- ICAR Research Complex for NEH Region, Manipur Centre, Lamphelpat, Imphal, 795004, India
| | - S K Sharma
- ICAR Research Complex for NEH Region, Manipur Centre, Lamphelpat, Imphal, 795004, India
| | - I M Singh
- ICAR Research Complex for NEH Region, Manipur Centre, Lamphelpat, Imphal, 795004, India
| | - Ch Bungbungcha Meitei
- ICAR Research Complex for NEH Region, Manipur Centre, Lamphelpat, Imphal, 795004, India
| | - Kl Levish Changloi
- ICAR- Krishi Vigyan Kendra, Monsangpantha, Chandel, 795127, Manipur, India
| | - L Somendro Singh
- ICAR- Krishi Vigyan Kendra, Pearsonmun, Churachandpur, 795128, Manipur, India
| | - N Ajitkumar Singh
- ICAR- Krishi Vigyan Kendra, Hungpung, Ukhrul, 795142, Manipur, India
| | - P K Saraswat
- ICAR- Krishi Vigyan Kendra, Tupul, Tamenglong, 795159, Manipur, India
| | - Y Ramakrishna
- ICAR- Krishi Vigyan Kendra, Hungpung, Ukhrul, 795142, Manipur, India
| | - Deepak Singh
- ICAR- Krishi Vigyan Kendra, Monsangpantha, Chandel, 795127, Manipur, India
| | - S Hazarika
- ICAR Research Complex for NEH Region, Umiam, Meghalaya, 793103, Meghalaya, India
| | - P Punitha
- ICAR- Indian Agricultural Research Institute, New Delhi, 110012, India
| | - S K Sandhu
- Directorate General of Commercial Intelligence & Statistics, M/o Commerce & Industry Govt. of India, India
| | - N Prakash
- ICAR Research Complex for NEH Region, Manipur Centre, Lamphelpat, Imphal, 795004, India
| |
Collapse
|
34
|
Chattopadhyay A, Samanta J, Sharma SK, Jain S. Classical hand radiology of Gout, Osteoarthritis and Diffuse Idiopathic Skeletal Hyperostosis (DISH). QJM 2021; 114:336-337. [PMID: 32871011 DOI: 10.1093/qjmed/hcaa263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- A Chattopadhyay
- Clinical Immunology and Rheumatology Unit, Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - J Samanta
- Clinical Immunology and Rheumatology Unit, Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - S K Sharma
- Clinical Immunology and Rheumatology Unit, Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - S Jain
- Clinical Immunology and Rheumatology Unit, Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| |
Collapse
|
35
|
Jain S, Dhir V, Aggarwal A, Maurya S, Gupta R, Leishangthem B, Khullar A, Dhawan V, Naidu G, Sharma SK, Sharma A, Jain S. AB0276 HOW FAST CAN METHOTREXATE BE ESCALATED IN RHEUMATOID ARTHRITIS? A MULTICENTRE, PARALLEL-GROUP RANDOMIZED CONTROLLED TRIAL (MEIRA). Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.3864] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Literature regarding the optimal dose escalation strategy of methotrexate (MTX) in RA is scant and ambiguous (1). Concerns regarding the safety of rapid escalation may lead to delayed attainment of the optimal dose and treatment target.Objectives:To compare the efficacy, safety and tolerability of fast versus usual dose escalation of oral MTX in RA.Methods:This multicenter, open-label (assessor blinded) RCT included patients with active RA (SJC≥2 and TJC≥4) aged 18-55 years, not on DMARDs (except HCQ and/or low-dose prednisolone) and with disease duration <5 years. Patients were randomized 1:1 into two groups with the same starting dose of oral MTX (15 mg/week), but escalated either by 5 mg every 2 weeks (fast escalation group) or 5 mg every 4 weeks (usual escalation group), till a maximum of 25 mg/wk. Primary outcome was proportion of EULAR good responders at 16 weeks. Secondary outcomes were change in DAS28-3 and EULAR responders (good or moderate) at 8 and 16 weeks, change in Indian HAQ at 16 weeks, and symptomatic (questionnaire based) and laboratory adverse effects over 16 weeks. RBC MTX polyglutamate-3 levels were measured using HPLC in both groups. There was an open-label extension phase till 24 weeks (use of other DMARDs was permitted beyond 16 weeks if target was not met), and DAS28-3 at 24 weeks was compared.Trial Reg: CTRI/2018/12/016549Results:178 patients (mean age 39.8 (8.6) years, 84% females) with mean disease duration of 1.9 (1.4) years were randomized (89 in each group). Mean DAS28ESR-3 and DAS28CRP-3 at enrollment were 6.3 (0.9) and 5.4 (1.1). At 16 weeks, there was no significant difference in good EULAR response by DAS28ESR-3 (5.6, 7.9%, p=0.9) or DAS28CRP-3 (28.1, 22.5%, p=0.8) between the two groups (Figure 1). The change in DAS28-ESR-3 at 8, 16 and 24 weeks (or by DASCRP-3, not shown) and improvement in HAQ at 16 weeks were also not significantly different (Table 1). Notably, there was no significant difference in symptomatic GI or CNS adverse effects, incidence of cytopenia, transaminitis or rates of drug discontinuation. RBC MTX polyglutamate-3 levels at 8 and 16 weeks were also similar (Table 1).Table 1.Key secondary efficacy and safety outcomesParameterUsualFastp-valueEfficacyDelta DAS28-ESR-3 (Mean±SD) -8 wk -ITT (n=178)-0.9 ± 1.0-0.8 ± 0.90.5 -PP (n=139)-1.2 ± 1.0-1.1 ± 1.00.5 -16 wk -ITT-1.3 ± 1.1-1.3 ± 1.00.9 -PP-1.6 ± 1.1-1.6 ± 0.91 -24 wk -ITT-1.6 ± 1.3-1.5 ± 1.10.3 -PP-2.1 ± 1.2-1.8 ± 1.10.14Delta Indian HAQ (16 wk)-0.7 ± 0.6-0.8 ± 0.60.2Adverse effectsSerious AE00-Death00-Symptomatic AE ever* n (%)Vomiting7 (8)7 (8)1Nausea22 (26)26 (30)0.5Stomach ache16 (19)17 (20)0.9Loss of appetite/bad taste21 (25)27 (31)0.3Lethargy20 (24)21 (25)1Dizziness19 (23)16 (19)0.5Irritability/anxiety14 (16)14 (16)1Laboratory AE ever* [n/N times done (%)]Transaminitis episodes (>40IU/L)52/224 (23)52/219 (24)0.9 -Significant (>80 IU/L)5/224 (2)8/219 (4)0.4Thrombocytopenia episodes (<150000/uL)10/224 (5)13/218 (6)0.5 -Significant (<100000/uL)2/224 (1)2/218 (1)1Leucopenia episodes (<4000/uL)2/224 (1)3/220 (1.5)0.8 -Significant (<3500/uL)1/224 (0.5)2/220 (1)0.8Methotrexate levelsMTX-polyglutamate-3 (nmol/L)-8 wk25.8 ± 10.526.9 ± 13.60.6-16 wk40.7 ± 20.940.1 ± 23.40.9*Ever=any time during the studyITT= intention-to-treat, PP=per-protocol, AE=adverse effectFigure 1.EULAR response and change in DAS28ESR-3 over timeConclusion:A faster escalation of MTX (5 mg every 2 weeks) reaching 25 mg/week by 4 weeks did not have a significantly higher rate of adverse effects (symptomatic or laboratory) compared to an escalation by 5 mg every 4 weeks. Although not more efficacious, it may shorten the time to recognize MTX failure, and optimize treat-to-target.References:[1]Visser K, Katchamart W, Loza E, et al. Multinational evidence-based recommendations for the use of methotrexate in rheumatic disorders with a focus on RA: integrating systematic literature research and expert opinion of a broad international panel of rheumatologists in the 3E Initiative. Ann Rheum Dis. 2009;68(7):1086–93Disclosure of Interests:None declared
Collapse
|
36
|
Dhir V, V D, Jain S, Pai V, Sharma A, Sharma SK, Naidu G, Jain S. POS0679 A NEW QUESTIONNAIRE AND SCORE (MISA) FOR ASSESSING METHOTREXATE INTOLERANCE IN RHEUMATOID ARTHRITIS. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.4241] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Methotrexate (MTX) intolerance refers to unpleasant symptoms that accompany use of MTX and may lead to its discontinuation. However, it lacks a validated score in RA patients; with the only option being to use the MISS score which was validated for use in children and not adults.Objectives:To develop and validate a questionnaire and score (s) for measuring MTX intolerance and its severity in rheumatoid arthritis.Methods:A 10-item questionnaire called ‘Methotrexate Intolerance and Severity assessment in Adults’ (MISA) was validated in 105 RA patients. A score was calculated by adding the scores of first 7 questions (0 to 3 based on severity on symptoms), to last 3 questions (0 or 1); it ranged from 0 to 24 (MISA score) and was assessed for correctly classifying MTX intolerance (compared to an interview) by ROC analysis. Its area-under-curve (AUC) was compared with ‘Methotrexate Intolerance Severity Score’ (MISS), developed for children. Subsequently, it was administered to 414 RA patients to assess the prevalence and associations of MTX intolerance. In addition, the MISA cross-products score, that was calculated by adding the cross-products (severity (1 to 3) x duration per week (0.5 to 7 days)) of symptoms, was compared to MISA and MISS for assessing severity of intolerance.Results:In the initial phase, 105 RA patients on MTX≥6 months were included, a majority were female (87%), mean age was 51 (13.4) years and methotrexate dose was 18.8±6 mg/week. Thirty-five (33%) were found to be intolerant to MTX based on interview. MISA score had a good predictive ability (AUC of 0.904), to correctly classify MTX intolerance, and was better than MISS score (AUC of 0.823) (Figure 1A). The optimal cut-off for MISA was ≥1, with a sensitivity and specificity of 91.4% and 84.3%. Using the MISA score (≥1), 38.4% of 414 RA patients were found to have MTX intolerance: with nausea, lethargy and irritability being common symptoms. (Figure 1B, C) On multivariable analysis, age (OR 0.972) and BMI (OR 1.061) were significant predictors of MTX intolerance. (Table 1) On assessing for severity of intolerance, MISA cross product score performed the best, with an area-under-curve of 0.899 (95% CI 0.831-0.966), being higher than AUC for MISS and MISA score which were 0.847 (95% CI 0.768-0.927) and 0.837 (95% CI 0.754-0.920).Conclusion:MISA is the first validated questionnaire for assessing methotrexate intolerance in rheumatoid arthritis, with the MISA score having a good accuracy (at cut-off ≥1), to detect MTX intolerance. Methotrexate intolerance was present in more than one-third of RA patients, with nausea, lethargy and irritability being most common.Table 1.Baseline characteristics of 414 RA patients.VariableAll(n=414)Tolerant(n=255)Intolerant(n=159)p-valuetol. vs ntol.P-valuemultivariablemodelFemales, n (%)370 (89)231 (91)139 (87)0.31Age, yrs, mean (SD)50 (12.5)51.2 (12.6)48.2 (12.2)0.016*0.008**Duration of RA, yrs, mean (SD)10.0 (7.0)10.8 (7.4)9.6 (6.3)0.168BMI, Kg/m2a, mean (SD)24.0 (4.9)23.6 (4.9)24.6 (4.7)0.1070.03*RF positiveb, n (%)300 (73)191 (82)109 (78)0.29CDAI, mean (±SD)14.0 (11.8)14 (12.1)14.1 (11.4)0.69Dose of MTX, mg/wk, mean (SD)18.6 (5.6)18.6 (5.5)18.7 (5.8)0.83Injectable MTX, n (%)47 (11)25 (10)22 (14)0.21Use of FA, n (%)395 (95)241 (95)154 (97)0.27Use of other DMARD, n (%)272 (66)160 (62)112 (70)0.11HCQ n (%)209 (51)123 (48)86 (54)0.25Prednisolone n (%)156 (38)87 (34)69 (43)0.0580.21Using antiemetics, n (%)12 (3)1 (0.5)11 (7)<0.001a Available for 262 patients bAvailable for 372 patientsFigure 1.Figure showing the ROC curve for MISA and MISS questionnaires for MTX intolerance (A), Bar diagram showing the prevalence of various symptoms of intolerance in 414 RA patients (B), and Box-and-whiskers plot showing the duration of unpleasant symptoms (C).Disclosure of Interests:None declared
Collapse
|
37
|
Kalra S, Dhingra A, Sharma SK, Bhattacharya S. Sheehan's syndrome as a mimic of premature ovarian insufficiency: need for advocacy. Climacteric 2021; 24:526. [PMID: 33830850 DOI: 10.1080/13697137.2021.1905626] [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: 10/21/2022]
Affiliation(s)
- S Kalra
- Department of Endocrinology, Bharti Hospital, Karnal, India
| | - A Dhingra
- Department of Endocrinology, Gangaram Bansal Hospital, Sri Ganganagar, India
| | - S K Sharma
- Department of Endocrinology, Dr. SK Sharma's Diabetes, Thyroid and Endocrine Centre, Jaipur, India
| | - S Bhattacharya
- Department of Endocrinology, Max Superspeciality Hospital, New Delhi, India
| |
Collapse
|
38
|
Sharanabasav H, Pramesh D, Prasannakumar MK, Chidanandappa E, Yadav MK, Ngangkham U, Parivallal B, Raghavendra BT, Manjunatha C, Sharma SK, Karthik N. Morpho-molecular and mating-type locus diversity of Ustilaginoidea virens: an incitant of false smut of rice from Southern parts of India. J Appl Microbiol 2021; 131:2372-2386. [PMID: 33772985 DOI: 10.1111/jam.15087] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 02/17/2021] [Accepted: 03/21/2021] [Indexed: 11/30/2022]
Abstract
AIMS To characterize the geo-distinct isolates of Ustilaginoidea virens for morpho-molecular and mating-type locus diversity. METHODS AND RESULTS Sixty-one isolates of U. virens collected from Southern India exhibited significant diversity in mycelial width (3·45-5·50 µm), colony colour (yellow, pale yellow, and white), and growth pattern (thick leather mat, raised-fluffy, flat-fluffy, and raised). Field-borne chlamydospores of each isolate were significantly smaller in size (3·34-5·26 µm2 ) compared to those formed on culture media (18·6-100·89 µm2 ). The phylogenetic study based on internal transcribed sequences revealed two clusters; however, most isolates (n = 54) were grouped in cluster-I, indicating common ancestral origin. We also identified 42 haplotypes; among them, Hap_3 has the highest number of isolates (n = 19). Mating-type locus (MAT1) analysis revealed all sixty-one isolates as heterothallic, wherein 37 and 24 isolates belonging to MAT1-1-1 and MAT1-2-1 heterothallic mating types, respectively. The microsynteny analysis of MAT1 loci of one of the Indian strain (Uv-Gvt) along with Uv-8b (China) strain revealed synteny conservation at MAT1 locus, which is flanked by conserved genes SLA2 and a hypothetical protein in the upstream and APN2, COX12 and APC5 in the downstream of the locus. CONCLUSIONS Morpho-molecular study revealed the significant diversity among geo-distinct isolates, and MAT1 loci analysis indicated the distribution of heterothallic mating types in south Indian paddy fields. And also, complete synteny conservation between Indian and Chinese strain was observed at the MAT1 locus. SIGNIFICANCE AND IMPACT OF THE STUDY This is the first report describing the sexuality of Indian strains of the U. virens, which would help better understand the genetic diversity of the U. virens prevailing in Southern India and aid in developing resistant rice cultivars against this pathogen population.
Collapse
Affiliation(s)
- H Sharanabasav
- Rice Pathology Laboratory, All India Coordinated Rice Improvement Programme, University of Agricultural Sciences, Raichur, India
| | - D Pramesh
- Rice Pathology Laboratory, All India Coordinated Rice Improvement Programme, University of Agricultural Sciences, Raichur, India
| | - M K Prasannakumar
- Department of Plant Pathology, University of Agricultural Sciences, Bangalore, India
| | - E Chidanandappa
- Rice Pathology Laboratory, All India Coordinated Rice Improvement Programme, University of Agricultural Sciences, Raichur, India
| | - M K Yadav
- ICAR-National Rice Research Institute, Cuttack, India
| | - U Ngangkham
- ICAR-Research Complex for NEH Region Umia, Meghalaya, India
| | - B Parivallal
- Department of Plant Pathology, University of Agricultural Sciences, Bangalore, India
| | - B T Raghavendra
- Department of Plant Pathology, University of Agricultural Sciences, Raichur, India
| | - C Manjunatha
- ICAR-Indian Agricultural Research Institute, Regional Station, Wellington, India
| | - S K Sharma
- ICAR-Research Complex for NEH Region, Imphal Center, Manipur, India
| | - N Karthik
- University of Madras, Chennai, India
| |
Collapse
|
39
|
Utpalla P, Sharma SK, Deshpande SK, Bahadur J, Sen D, Sahu M, Pujari PK. Role of free volumes and segmental dynamics on ion conductivity of PEO/LiTFSI solid polymer electrolytes filled with SiO 2 nanoparticles: a positron annihilation and broadband dielectric spectroscopy study. Phys Chem Chem Phys 2021; 23:8585-8597. [PMID: 33876020 DOI: 10.1039/d1cp00194a] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The limited ionic conductivity of polymer electrolytes is a major issue for their industrial application. Enhancement of ionic conductivity in the poly(ethylene oxide), PEO, based electrolyte has been achieved by loading passive nanofillers such as SiO2 nanoparticles (NPs). To investigate the role of modifications in free volume characteristics and the polymer chain dynamics induced by the loading of passive fillers on the ionic conductivity of the PEO based ternary electrolyte, a systematic investigation has been carried out using positron annihilation and broadband dielectric spectroscopy. As a result of interfacial interactions, the loading of SiO2 NPs alters the semi-crystalline morphology of PEO resulting in a higher crystallinity at lower loadings due to the surface confinement of PEO chains, and the formation of smaller PEO crystallites at higher loadings due to interparticle nanoconfinement. These modifications are accompanied by a decrease in free volume fraction at the lowest loading (0.5 wt%) followed by an increase at higher loadings (≥2.0 wt%). The Almond-West formalism considering two different universalities in different temperature and frequency ranges has been used to explain the ion-conduction process at different NP loadings. The Li ion conductivity is observed to be maximum for a 5.0 wt% loading of SiO2 NPs. The enhancement in ionic conductivity is observed to be directly correlated with the free volume characteristics and segmental dynamics of the PEO matrix, confirming their role in ion transport in polymer electrolytes.
Collapse
Affiliation(s)
- P Utpalla
- Radiochemistry Division, Bhabha Atomic Research Centre, Mumbai, 400085, India.
| | | | | | | | | | | | | |
Collapse
|
40
|
Kuldeep J, Sharma SK, Singh BN, Siddiqi MI. Computational exploration and anti-mycobacterial activity of potential inhibitors of Mycobacterium tuberculosis acetyl coenzyme A carboxylase as anti-tubercular agents. SAR QSAR Environ Res 2021; 32:191-205. [PMID: 33612029 DOI: 10.1080/1062936x.2021.1882563] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 11/16/2020] [Accepted: 01/25/2021] [Indexed: 06/12/2023]
Abstract
Acetyl Coenzyme A Carboxylase (AccD6) is a homodimeric protein which is involved in the carboxylation of acetyl coenzyme A to produce malonyl coenzyme A, which plays an important role in the biosynthesis of fatty acid chain. However, studies suggest that AccD6 in combination with AccA3 produces malonyl co-A. Certain herbicides are known to inhibit plant ACC. Among these herbicides, haloxyfop was found to inhibit AccD6 at IC50 of 21.1 ± 1 µM. In this study, we have performed molecular docking of the Maybridge database consisting of ~55,000 compounds in the active site of the protein with haloxyfop as a reference molecule, followed by molecular dynamics study and biological activity determination of prioritized compounds. Out of the nine compounds selected for biological evaluation, three compounds - CD07230, HTS08529 and KM08871 - were found to exhibit anti-mycobacterial activity.
Collapse
Affiliation(s)
- J Kuldeep
- Molecular & Structural Biology Division, CSIR-Central Drug Research Institute, Lucknow, India
| | - S K Sharma
- Microbiology Division, CSIR-Central Drug Research Institute, Lucknow, India
| | - B N Singh
- Microbiology Division, CSIR-Central Drug Research Institute, Lucknow, India
| | - M I Siddiqi
- Molecular & Structural Biology Division, CSIR-Central Drug Research Institute, Lucknow, India
| |
Collapse
|
41
|
Raghavendra K, Sharma SK, Yadav RS, Srivastava HC, Bhatt RM, Pant CS, Haque MA, Sreehari U. Durability, household usage and washing pattern of DuraNet © and Interceptor ® long-lasting insecticidal nets in long-term field trials in India. J Vector Borne Dis 2021; 58:219-227. [DOI: 10.4103/0972-9062.328974] [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: 12/24/2022] Open
|
42
|
Sinha S, Gupta G, Biswas S, Gupta K, Singh PP, Jain R, Sharma SK, Das B. Coronin-1 levels in patients with tuberculosis. Indian J Med Res 2021; 154:866-870. [PMID: 35662092 PMCID: PMC9347245 DOI: 10.4103/ijmr.ijmr_4343_20] [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] [Indexed: 11/06/2022] Open
Abstract
Background & objectives: Despite advances in diagnostics and therapeutics, tuberculosis (TB) is widely prevalent and contributes to a significant burden of illness in both developing and developed nations. The present study was aimed to assess the role of coronin in TB patients and healthy controls. Coronin is a leucocyte-specific protein that is actively recruited in mycobacterial phagolysosomes, where it inhibits lysosomal delivery of Mycobacterium by activating a calcium-dependent phosphatase-calcineurin. Methods: In the study, 100 newly diagnosed cases of TB (pulmonary and extra-pulmonary) and healthy controls were prospectively enrolled over one year and the levels of coronin-1a in these patients and controls were measured by quantitative PCR (qPCR). Results: A total of 100 TB patients and 100 healthy individuals as controls were assessed. There were 59 patients with extra-pulmonary TB (EPTB) and 41 of pulmonary TB (PTB). In 47 per cent of patients, corroborative histopathological evidence of TB was also available. Significantly higher values of coronin-1a were observed in TB patients (19.94±2.61) than in healthy controls (16.09±1.91) (P<0.001). Interpretation & conclusions: Coronin 1a appears to play an important role in the TB disease pathophysiology and agents developed against coronin may have a role in the treatment of TB. Further studies are required to assess if coronin-1a levels are elevated in non-tubercular infective a etiologies and whether these can be a potential drug target in patients with TB.
Collapse
|
43
|
Das A, Gandhi P, Saboo B, Reddy S, Chawla R, Zargar A, Kovil R, Chawla M, Sharma SK, Gupta S, Makkar BM, Mittal V, Goswami S, Arvind SR, Jaggi S, Bajaj S, Das S. Optimizing the treatment of newly diagnosed type 2 diabetes mellitus with combination of dipeptidyl peptidase-4 inhibitors and metformin: An expert opinion. J Family Med Prim Care 2021; 10:4398-4409. [PMID: 35280631 PMCID: PMC8884309 DOI: 10.4103/jfmpc.jfmpc_2378_20] [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: 12/03/2020] [Revised: 02/20/2021] [Accepted: 07/09/2021] [Indexed: 11/22/2022] Open
Abstract
The expanding burden of Type 2 Diabetes Mellitus (T2DM) in today's world, with respect to incidence, prevalence, and cost incurred, is an existential risk to society. Various guidelines recommend individualization of treatment. This expert opinion aims to review the recent evidences and reach a consensus on the preferable combination therapy for use in newly diagnosed Indian T2DM patients with HbA1C >7.5%. The core committee included seventeen diabetes specialists. Three statements were developed, discussed, and rated by specialists and recommendations were noted. Specialists were requested to rate the statements using a 9-point Likert's scale with score of 1 being “Strongly Disagree” and 9 being “Strongly Agree”. Statement-specific scores of all the specialists were added and mean score of ≥7.00 was considered to have achieved a consensus. Statements used to meet the consensus were: Statement 1. Majority of newly-diagnosed Indian diabetics have HbA1C >7.5%; Statement 2. Patients with HbA1C >7.5% may be initiated with dual therapy of dipeptidyl peptidase-4 inhibitors (DPP4Is) + Metformin; and Statement 3. In Indian patients with HbA1C >7.5% at diagnosis, DPP4Is + Metformin may be considered as a first-line therapy. Literature review revealed that HbA1C level at the time of diagnosis in majority of Indian T2DM patients is >7.5%. Consensus was reached that dual anti-diabetic therapy should be initiated in patients with HbA1C >7.5%. DPP4Is + Metformin is the preferred cost-effective option and may be considered as a first-line therapy in Indian T2DM patients with HbA1C >7.5% at diagnosis.
Collapse
|
44
|
Konki SK, Khambampati AK, Sharma SK, Kim KY. A deep neural network for estimating the bladder boundary using electrical impedance tomography. Physiol Meas 2020; 41:115003. [PMID: 32726770 DOI: 10.1088/1361-6579/abaa56] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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
OBJECTIVE Accurate bladder size estimation is an important clinical parameter that assists physicians, enabling them to provide better treatment for patients who are suffering from urinary incontinence. Electrical impedance tomography (EIT) is a non-invasive medical imaging method that estimates organ boundaries assuming that the electrical conductivity values of the background, bladder, and adjacent tissues inside the pelvic domain are known a priori. However, the performance of a traditional EIT inverse algorithm such as the modified Newton-Raphson (mNR) for shape estimation exhibits severe convergence problems as it heavily depends on the initial guess and often fails to estimate complex boundaries that require greater numbers of Fourier coefficients to approximate the boundary shape. Therefore, in this study a deep neural network (DNN) is introduced to estimate the urinary bladder boundary inside the pelvic domain. APPROACH We designed a five-layer DNN which was trained with a dataset of 15 subjects that had different pelvic boundaries, bladder shapes, and conductivity. The boundary voltage measurements of the pelvic domain are defined as input and the corresponding Fourier coefficients that describe the bladder boundary as output data. To evaluate the DNN, we tested with three different sizes of urinary bladder. MAIN RESULTS Numerical simulations and phantom experiments were performed to validate the performance of the proposed DNN model. The proposed DNN algorithm is compared with the radial basis function (RBF) and mNR method for bladder shape estimation. The results show that the DNN has a low root mean square error for estimated boundary coefficients and better estimation of bladder size when compared to the mNR and RBF. SIGNIFICANCE We apply the first DNN algorithm to estimate the complex boundaries such as the urinary bladder using EIT. Our work provides a novel efficient EIT inverse solver to estimate the bladder boundary and size accurately. The proposed DNN algorithm has advantages in that it is simple to implement, and has better accuracy and fast estimation.
Collapse
Affiliation(s)
- S K Konki
- Center for Artificial Intelligence, Korea Institute of Science and Technology, Seoul 02792, Republic of Korea
| | | | | | | |
Collapse
|
45
|
Mishra A, Sharma SK, Panigrahi DC. 222Rn Exhalation Flux Rate and 226Ra in the Soils of a Copper-Mineralised Area. Radiat Prot Dosimetry 2020; 191:ncaa174. [PMID: 33230528 DOI: 10.1093/rpd/ncaa174] [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] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 09/10/2020] [Accepted: 10/04/2020] [Indexed: 06/11/2023]
Abstract
Uranium-series radionuclides exist in trace quantities in all soils and rocks on earth in variable concentrations. Among these, 222Rn gas exhaled by the soil of a geological location is the main contributor to the environmental radioactivity. A 222Rn exhalation flux study was carried out in the heavily mineralised area of the Singhbhum Copper Belt of Jharkhand, India. A significant seasonal variation in the soil gas exhalation was observed, which is attributable to the seasonal atmospheric parameters of the study area. The average 222Rn exhalation flux from the soil was estimated to be in the range of 4.5-$20.1\ \mathrm{Bq}\ {\mathrm{m}}^{-2}\ {\mathrm{s}}^{-1}$ with a mean of $10.1\pm 3.9\ \mathrm{mBq}\ {\mathrm{m}}^{-2}\ {\mathrm{s}}^{-1}$ and geometric mean (GM) of $9.5\ \mathrm{mBq}\ {\mathrm{m}}^{-2}\ {\mathrm{s}}^{-1}$. Also, 20 soil samples collected from the study area were analysed by the emanometric method, which estimated the 226Ra specific activity in the soils in the range of 9-$63\ \mathrm{Bq}\ \mathrm{k}{\mathrm{g}}^{-1}$ and a mean value of $39\pm 16\ \mathrm{Bq}\ \mathrm{k}{\mathrm{g}}^{-1}$.
Collapse
Affiliation(s)
- Asheesh Mishra
- Department of Physics, Indian Institute of Technology (Indian School of Mines), Dhanbad 826004, Jharkhand, India
| | - S K Sharma
- Department of Physics, Indian Institute of Technology (Indian School of Mines), Dhanbad 826004, Jharkhand, India
| | - D C Panigrahi
- Department of Mining Engineering, Indian Institute of Technology (Indian School of Mines), Dhanbad 826004, Jharkhand, India
| |
Collapse
|
46
|
Mishra A, Sharma SK, Panigrahi DC, Jha VN, Sarangi AK, Patnaik RL. 222Rn concentration level and inhalation exposure assessment for the population residing in Singhbhum copper belt of Jharkhand. J Radioanal Nucl Chem 2020. [DOI: 10.1007/s10967-020-07419-8] [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: 10/23/2022]
|
47
|
Sharma JB, Dharmendra S, Jain S, Sharma SK, Singh UB, Soneja M, Sinha S, Vanamail P. Evaluation of Gene Xpert as compared to conventional methods in diagnosis of Female Genital Tuberculosis. Eur J Obstet Gynecol Reprod Biol 2020; 255:247-252. [PMID: 33256922 DOI: 10.1016/j.ejogrb.2020.09.046] [Citation(s) in RCA: 6] [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] [Received: 05/05/2020] [Revised: 09/23/2020] [Accepted: 09/28/2020] [Indexed: 12/01/2022]
Abstract
To evaluate Gene Xpert for diagnosis of Female Genital Tuberculosis (FGTB) as compared to conventional methods. STUDY DESIGN It was a prospective study conducted over 167 cases of infertile female genital tuberculosis (FGTB) diagnosed on composite reference standard (CRS) (smear for AFB, histopathological evidence of epithelioid granuloma or definite or possible findings of tuberculosis on laparoscopy). All women underwent endometrial biopsy for AFB microscopy, culture, gene Xpert, PCR and histopathology) and laparoscopy and hysteroscopy for diagnosis and prognostication of disease. The results of Gene Xpert were compared with conventional methods in detection of FGTB. All patients were treated with 6 months course of rifampicin (R), isoniazid (H), pyrazinamide (Z) and ethambutol (E) (RHZE for 2 months, RHE for 4 months) using directly observed treatment short course strategy. RESULTS Mean age, parity, body mass index and history of contact was 28.3 years, 0.28, 22.9 Kg/m2 and 38.92% respectively. Primary infertility was seen in 87.42% cases with mean duration of 2.42 years. Menstrual dysfunctions, abdominal or pelvic pain and lump were seen in 38.92%, 14.37% and 10.77% cases. Abnormal vaginal discharge and adnexal mass were seen in 28.14% and 13.17 % cases. On diagnostic laparoscopy, definite findings of tuberculosis (beaded tubes, tuebrcles and caseous nodules) were seen in 96 (57.48%) women while probable findings of tuberculosis (pelvic or abdominal adhesions, hydrosaplinx, tubo-ovarian mass, pyosalpinx) were seen in 81 (48.50%) women. On laboratory investigations, positive AFB on microscopy or culture was seen in 2.99% casess, PCR was positive in 47.90% gene Xpert was positive in 18.56% cases while epitheloid granuloma was seen on histopathology in 16 (9.58%) cases. Gene Xpert had sensitivity of 35.63%, specificity of 100%, positive predictive value of 100% and negative predictive value of 58.82% and diagnostic accuracy of 66.47% in the present study. CONCLUSION Gene Xpert is a very useful test to rule in tuberculosis whereas when it is negative it is not a good test to rule out tuberculosis.
Collapse
Affiliation(s)
- Jai B Sharma
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India.
| | - Sona Dharmendra
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India
| | - Shefali Jain
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India
| | - S K Sharma
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Urvashi B Singh
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Manish Soneja
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Sanjeev Sinha
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - P Vanamail
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India
| |
Collapse
|
48
|
Jain S, Sharma SK, Vijayan N, Mandal TK. Seasonal characteristics of aerosols (PM 2.5 and PM 10) and their source apportionment using PMF: A four year study over Delhi, India. Environ Pollut 2020; 262:114337. [PMID: 32193082 DOI: 10.1016/j.envpol.2020.114337] [Citation(s) in RCA: 83] [Impact Index Per Article: 20.8] [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: 07/30/2019] [Revised: 02/29/2020] [Accepted: 03/04/2020] [Indexed: 05/05/2023]
Abstract
The present study attempts to explore and compare the seasonal variability in chemical composition and contributions of different sources of fine and coarse fractions of aerosols (PM2.5 and PM10) in Delhi, India from January 2013 to December 2016. The annual average concentrations of PM2.5 and PM10 were 131 ± 79 μg m-3 (range: 17-417 μg m-3) and 238 ± 106 μg m-3 (range: 34-537 μg m-3), respectively. PM2.5 and PM10 samples were chemically characterized to assess their chemical components [i.e. organic carbon (OC), elemental carbon (EC), water soluble inorganic ionic components (WSICs) and heavy and trace elements] and then used for estimation of enrichment factors (EFs) and applied positive matrix factorization (PMF5) model to evaluate their prominent sources on seasonal basis in Delhi. PMF identified eight major sources i.e. Secondary nitrate (SN), secondary sulphate (SS), vehicular emissions (VE), biomass burning (BB), soil dust (SD), fossil fuel combustion (FFC), sodium and magnesium salts (SMS) and industrial emissions (IE). Total carbon contributes ∼28% to the total PM2.5 concentration and 24% to the total PM10 concentration and followed the similar seasonality pattern. SN and SS followed opposite seasonal pattern, where SN was higher during colder seasons while SS was greater during warm seasons. The seasonal differences in VE contributions were not very striking as it prevails evidently most of year. Emissions from BB is one of the major sources in Delhi with larger contribution during winter and post monsoon seasons due to stable meteorological conditions and aggrandized biomass burning (agriculture residue burning in and around the regions; mainly Punjab and Haryana) and domestic heating during the season. Conditional Bivariate Probability Function (CBPF) plots revealed that the maximum concentrations of PM2.5 and PM10 were carried by north westerly winds (north-western Indo Gangetic Plains of India).
Collapse
Affiliation(s)
- Srishti Jain
- CSIR-National Physical Laboratory, Dr. K. S. Krishnan Road, New Delhi, 110 012, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201002, India
| | - S K Sharma
- CSIR-National Physical Laboratory, Dr. K. S. Krishnan Road, New Delhi, 110 012, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201002, India.
| | - N Vijayan
- CSIR-National Physical Laboratory, Dr. K. S. Krishnan Road, New Delhi, 110 012, India
| | - T K Mandal
- CSIR-National Physical Laboratory, Dr. K. S. Krishnan Road, New Delhi, 110 012, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201002, India
| |
Collapse
|
49
|
Acharya N, Jha S, Mishra D, Chattopadhyay A, Jain S, Sharma SK, Sharma A, Jain S, Dhir V. AB0395 SYSTEMIC LUPUS ASSOCIATED MACROPHAGE ACTIVATION SYNDROME – A SINGLE CENTRE EXPERIENCE FROM INDIA. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.5703] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Macrophage activation syndrome (MAS) is a potentially fatal complication of systemic lupus erythematosus (SLE).(1) Overlapping clinical features of SLE activity with MA makes it a clinical diagnosis. There is limited data from developing countries like India.Objectives:To study the clinical features, treatment, and outcomes in SLE-MAS.Methods:This single-centre, retrospective study included patients fulfilling SLICC 2011 criteria for SLE, admitted from January 2017 to November 2019, and diagnosed as MAS by a team of attending physicians. Their demographic and clinical data, treatment, and outcomes were recorded. H score and SLEDAI were calculated. Patients were assessed for HLH classification criteria (2004) and preliminary diagnostic criteria for MAS in childhood SLE (cSLE).Results:Sixteen patients (median age – 26 years, 15 females) were included. Twelve patients (75%) had MAS as the initial presentation of SLE. The common clinical features were fever (100%) and cytopenias (100%). The mean duration of symptoms was 60 days. The most frequent biochemical abnormalities were high ferritin (>500 ng/ml, 100%) and elevated transaminases (100%, aspartate transaminase > alanine transaminase). Common complications were renal (43.8%), neurological (43.8%), and coagulopathy (43.8%). Seven and 16 patients fulfilled the HLH 2004 and cSLE – MAS preliminary criteria, respectively. The median H score was 222, giving a cumulative probability of 96%. All the patients received high-dose steroids. Cyclophosphamide pulse and cyclosporine were administered to 8 (50%) and 6 (37.5%) patients respectively. There were four (25%) in-hospital mortalities.CharacteristicN=16Age (years)26 (19.5 – 30)Duration of symptoms (days)60 (18.7 – 90)Fever16 (100)Pancreatitis1 (6.3)Renal7 (43.8)Neurological7 (43.8)Myocarditis6 (37.5)Hepatomegaly7 (43.8)Splenomegaly3 (18.8)Lymphadenopathy12 (75)Anaemia16 (100)Leukopenia13 (82)Thrombocytopenia14 (88.2)Coagulopathy7 (43.8)Concomitant infection3 (18.8)H score222 (193 – 254)cSLE-MAS diagnostic criteria16 (100%)HLH 2004 (≥5)7 (43.8)Corticosteroids16 (100%)Cyclophosphamide8 (50%)Intravenous immunoglobulin2 (12.5%)Cyclosporine6 (37.5%)Death4 (25%)All data presented as n (%) and median (IQR)cSLE-MAS – Childhood systemic lupus erythematosus – Macrophage activation syndrome, HLH – Hemophagocytic lymphohistiocytosisParameterN = 16Haemoglobin (g/dL)6.9 (5.7 – 7.8)Total leucocyte count (cells/mm3)1400 (1025 -3175)<10003 (18.8)1000 – 25009 (56.3)2500 - 40001 (6.3)Platelet (cells/mm3)57500 (23500 – 95250)<200003 (18.8)20000 – 500003 (18.8)50000 – 1 lac8 (50)Serum ferritin > 500 ng/ml16 (100%)Fibrinogen2.48 (1.6 – 4)Triglycerides (mg/dL)375 (294 -470)AST/ALT (U/L)153 (113 – 234) / 90 (68 – 170)Procalcitonin (pg/mL)0.8 (0.3 – 1.4)Lactate dehydrogenase (U/L)1674 (1081 – 2184)Erythrocyte sedimentation rate (mm in 1sthour)61 (44 – 69)C- reactive protein (mg/L)36 (6.3 – 52)Bone marrow examination14 (87.5)Increased histiocytes with hemophagocytosis5 (32.5)All data presented as n (%) and median (IQR)ALT – Alanine transaminase, AST – Aspartate transaminaseConclusion:Fever, cytopenia, high ferritin, and elevation of transaminases were the commonest features in this series of SLE-MAS. SLE-MAS carried a high mortality (25%) despite aggressive treatment.References:[1]Gavand P-E, Serio I, Arnaud L, Costedoat-Chalumeau N, Carvelli J, Dossier A, et al. Clinical spectrum and therapeutic management of systemic lupus erythematosus-associated macrophage activation syndrome: A study of 103 episodes in 89 adult patients. Autoimmun Rev. 2017;16(7):743–9.Acknowledgments:NONEDisclosure of Interests:None declared
Collapse
|
50
|
Dhir V, Jha S, Sharma A, Jain S, Sharma SK, Naidu G. AB0570 MIXED CONNECTIVE TISSUE DISEASE: NOT THAT UNCOMMON, A SINGLE-CENTER EXPERIENCE FROM INDIA. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.5530] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Mixed connective tissue disease (MCTD) is considered to be uncommon; specifically there is sparse data on MCTD from developing countries like India.Objectives:This study examines the clinical and serological features of these patients in a single center in North-India.Methods:This was a retrospective single-center study of patients diagnosed as MCTD in last 20 years. The patients included fulfilled at least one of the diagnostic criteria namely Alarcón-Segovia, Kasukawa, and Kahns. Demographic details, clinical signs and symptoms, laboratory parameters, treatment and outcome were extracted from medical records and clinic files in a pre-designed proforma.Results:This study included 41 MCTD patients. There was a marked female preponderance (F: M=40:1), and mean age of disease onset and diagnosis was 33.8 ± 10.7 and 39.3 ± 10.2 years. 39 (92%) of the patients fulfilled both Kahn and Kasukawa criteria, while 31 (76%) fulfilled Alarcon-Segovia criteria. Initially patients had been (mis)diagnosed as rheumatoid arthritis, systemic lupus erythematosus (or UCTD) (in five patients each), overlap syndromes or myositis (in 4 patients). ANA was commonly high-titer and specked, U1RNP was positive in all. (Table 1) Other autoantibodies on immunoblot included SSA and Ro52 in half the patients. Raynaud’s was seen in three-fourth at presentation and all the patients over time. Digital gangrene and puffy fingers were seen in 8 (20%) and 18 (46%) patients. Other clinical features included arthritis in 33 (81%), sclerodactyly in 23 (56%) and proximal weakness in 20 patients (49%). Interstitial lung disease and pulmonary arterial hypertension were seen in 20 (57%) and 15 (44%) patients. All patients (except one) received prednisolone, and it was currently used in almost 90%. Intravenous cyclophosphamide was used in one-third, commonly for ILD.Table 1.Laboratory features of patients with MCTDLabs n (%)Leucopenia9 (22)Thrombocytopenia10 (24)Raised globulinsb22 (69)Mean globulins, mean (SD)a5±3.4Elevated CPKb10 (31)CPK Levels U/L, median (IQR)256 (57.5-1036)ANA Speckled Pattern N (%)31d(82)U1RNP N (%)b32 (100%)U1RNP Blot Intensity1+8 (25%)2+1 (3.2%)3+7 (21.8%)4+16 (50%)U1RNP EIA, mean(SD), n=19141.3 ± 82.4Raised RF Titersh10 (35.7%)Low C3 mg/dlf8 (40%)Low C4 mg/dlf3 (15%)FVC, mean (SD) n=2082.4 ± 18.9 ILD on HRCTg20 (57) Dilated PA on CTf10 (50)PAHeon ECHO15 (44.1%)RA/RV Dilated5 (18)SD-standard deviation, IQR- Interquartile range, CPK- Creatinine phosphokinase,, ILD- Interstitial lung disease, PAH- Pulmonary arterial hypertension, ANA- Anti nuclear antibody, IIF- Indirect Immunofluorescence, PA- pulmonary artery, RA/RV- Right atrium/Right Ventricle,a34b32d38e34f20g34h28Conclusion:MCTD was not uncommon in the single-center in North India. Kahn and Kasukawa criteria were found to be the most sensitive for its diagnosis. Digital gangrene was relatively common and sometimes the presenting feature; whereas puffy fingers was present in only half the patients.Disclosure of Interests:None declared
Collapse
|