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Haldar S, Sarkar B, Dixit A. Dose to Organ at Risk and its Characteristic Variation with the Clinically Used Different Prescription Levels for Early-stage Left-sided Breast Cancer. Clin Oncol (R Coll Radiol) 2024; 36:21-29. [PMID: 38040550 DOI: 10.1016/j.clon.2023.11.038] [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] [Received: 01/06/2023] [Revised: 05/27/2023] [Accepted: 11/22/2023] [Indexed: 12/03/2023]
Abstract
AIMS To evaluate the organ at risk (OAR) dose and its characteristic variation with different clinically usable prescription doses (RxD) for breast and chest wall radiotherapy in patients with early-stage left-sided breast cancer. MATERIALS AND METHODS In total, 145 patients with early-stage breast cancers (T1N0M0-T2N0M0) on the left side were treated with radiotherapy after a modified radical mastectomy or breast conservation surgery, with a mean age of 45.1 ± 21.6 years. The patient received 4050 cGy of field-in-field (three-dimensional conformal radiotherapy) treatment limited to the breast or chest wall, excluding the supraclavicular node, axillary node and internal mammary chain, over 15 fractions. Additional plans of 5000 cGy/25 fractions, 4500 cGy/20 fractions and 2600 cGy/5 fractions were created with no or minor changes to the original plan. Mathematical modelling was used to study the distinctive change in the dose-volume characteristics for various OARs as a function of the RxD. OAR dosages, both absolute and normalised, were expressed in terms of the RxD. The mathematical (functional) relationship between OAR doses and different prescription levels was deduced by the least squares fit method. RESULT The left lung mean dose, V5Gy (%), V10Gy (%) and V20Gy (%) and the heart mean dose, V10Gy (%) and V20Gy (%) were evaluated. The dose-volume parameters showed a parabolic variation (x2) with the RxD. Prescription normalised OAR doses showed a linear relationship with the RxD; relative dose increased with diminishing RxD. Normalised lung and heart mean doses exhibited saturation (linear relationship) with RxD variation. Paired sample t-test results between RxD versus all evaluated parameters were found to be statistically significant (P = 0.004). The Pearson correlation coefficient between different prescription levels for left lung mean dose (range 0.942-1.0), heart mean dose (range 1.0-1.0), left lung V5Gy (%) (range 0.987-1.0), left lung V10Gy (%) (range 0.991-0.999), heart V10Gy (%) (range 0.998-1.0). CONCLUSION The functional form of absolute OAR dose-volume parameters versus RxD is parabolic and the RxD normalised OAR dose-volume parameter versus RxD is a straight line with a negative slope as RxD increases. This indicates an increase in the relative OAR dose-volume parameters if the RxD is reduced. This study is the first of its kind to compare the OAR doses as a function of clinically used degenerate prescription levels. These data will help to comprehend the OAR doses while adopting a new dose fractionation regimen and reviewing the radiotherapy treatment plans.
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Affiliation(s)
- S Haldar
- Department of Radiation Oncology, Saroj Gupta Cancer Centre and Research Institute, Kolkata, India; Department of Physics, Institute of Applied Science and Humanities, GLA University, Mathura, India
| | - B Sarkar
- Department of Radiation Oncology, Apollo Multispeciality Hospital, Kolkata, India.
| | - A Dixit
- Department of Mathematics, Institute of Applied Science and Humanities, GLA University, Mathura, India
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Gupta RK, Anthwal D, Bhalla M, Tyagi JS, Choudhary S, Haldar S. Direct Detection of Fluoroquinolone Resistance in Sputum Samples from Tuberculosis Patients by High Resolution Melt Curve Analysis. Curr Microbiol 2023; 81:27. [PMID: 38041739 DOI: 10.1007/s00284-023-03519-2] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 10/07/2023] [Indexed: 12/03/2023]
Abstract
Multidrug-resistant tuberculosis (MDR-TB) requires treatment with fluoroquinolone (FLQ) drugs, however, the excessive use of FLQ has led to the rise of extensively drug-resistant TB. In 2019, ~ 20% of total MDR-TB cases were estimated to be resistant to FLQ drugs. In the present study, we developed and evaluated the utility of high-resolution melt curve analysis (HRM) for the rapid detection of FLQ-resistant Mycobacterium tuberculosis for the first time directly from sputum samples. A reference plasmid library was generated for the most frequently observed mutations of gyrA gene and was used to discriminate between mutant and wild-type samples in the FLQ-HRM assay. The developed assay was evaluated on n = 25 MDR M. tuberculosis clinical isolates followed by validation on archived sputum DNA (n = 88) using DNA sequencing as a gold standard. The FLQ-HRM assay showed a 100% sensitivity [95% Confidence Interval (CI): 71.5 to 100] and specificity (95% CI: 39.7 to 100) in smear-positive category, and a sensitivity of 88.9% (95% CI: 77.3 to 95.8) with 84.2% (95% CI: 60.4 to 96.6) specificity in smear-negative category. The assay showed a high level of concordance of ~ 90% (κ = 0.74) with DNA sequencing, however, we were limited by the absence of phenotypic drug susceptibility testing data. In conclusion, HRM is a rapid, cost-effective (INR 150/USD 1.83) and closed-tube method for direct detection of FLQ resistance in sputum samples including direct smear-negative samples.
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Affiliation(s)
- Rakesh Kumar Gupta
- Department of Experimental Medicine and Biotechnology, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, India
- Department of Bioscience and Biotechnology, Banasthali Vidyapith, P.O. Banasthali Vidyapith, Rajasthan, 304022, India
| | - Divya Anthwal
- Department of Experimental Medicine and Biotechnology, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, India
- Department of Bioscience and Biotechnology, Banasthali Vidyapith, P.O. Banasthali Vidyapith, Rajasthan, 304022, India
| | - Manpreet Bhalla
- Department of Microbiology, National Institute of Tuberculosis and Respiratory Diseases, Mehrauli, New Delhi, India
| | - Jaya Sivaswami Tyagi
- Department of Biotechnology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - Sangeeta Choudhary
- Department of Bioscience and Biotechnology, Banasthali Vidyapith, P.O. Banasthali Vidyapith, Rajasthan, 304022, India
| | - Sagarika Haldar
- Department of Experimental Medicine and Biotechnology, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, India.
- Translational Health Science and Technology Institute, NCR Biotech Science Cluster, 3Rd Milestone, Faridabad-Gurgaon Expressway, PO box #04, Faridabad, India.
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Sharma P, Gupta RK, Anthwal D, Dass M, Yadav R, Behera A, Sethi S, Singhal R, Dhooria S, Aggarwal AN, Haldar S. Evaluation of Mycobacterium tuberculosis derived cell-free DNA using pleural fluid and paired plasma samples for the diagnosis of pleural tuberculosis. Tuberculosis (Edinb) 2023; 142:102369. [PMID: 37536090 DOI: 10.1016/j.tube.2023.102369] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 06/13/2023] [Accepted: 06/25/2023] [Indexed: 08/05/2023]
Abstract
Pleural tuberculosis (pTB) is a grave clinical challenge. A novel cell-free M. tuberculosis DNA (cfM.tb-DNA) probe-based-qPCR assay was developed for the diagnosis of pTB. Total cell-free DNA was extracted from pleural fluid (PF) and paired plasma samples and cfM.tb-DNA was quantified by probe-based qPCR targeting devR (109-bp) gene of M. tuberculosis in patients with pleural effusion. Patient categorization was done using 'Composite-Reference-Standard' formulated for the study. Assay cut-offs were determined from samples in the 'Development set' (n = 17; 'Definite & Probable' pTB; n = 9 and 'Non-TB'; n = 8) by ROC-curve analysis and applied to 'Validation set' (n = 112; 'Definite' pTB; n = 8, 'Probable' pTB; n = 34, 'Possible' pTB; n = 28 and 'Non-TB'; n = 42). cfM.tb-DNA qPCR had a sensitivity of 62.5% (95%CI; 24.4,91.4) in 'Definite' pTB category and 59.5% (95%CI; 43.2,74.3) in 'Definite & Probable' pTB category with 95.2% (95%CI; 83.8,99.4) specificity using PF. In plasma (n = 85), the assay had a sub-optimal sensitivity of 7.6% (95%CI; 0.95,25.1) with 88.2% (95%CI; 72.5,96.7) specificity in 'Definite & Probable' pTB group. Xpert MTB/RIF assay detected only six-samples in the 'Validation set'. Logistic regression analysis indicated that PF-cfM.tb-DNA qPCR provided incremental advantage over existing pTB diagnostic algorithms. To the best of our knowledge, this is the first report describing the utility of cfM.tb-DNA for pTB diagnosis in India.
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Affiliation(s)
- Pratibha Sharma
- Department of Experimental Medicine and Biotechnology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Rakesh Kumar Gupta
- Department of Experimental Medicine and Biotechnology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Divya Anthwal
- Department of Experimental Medicine and Biotechnology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Manisha Dass
- Department of Experimental Medicine and Biotechnology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Rakesh Yadav
- Department of Medical Microbiology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Ashish Behera
- Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Sunil Sethi
- Department of Medical Microbiology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Ritu Singhal
- Department of Microbiology, National Institute of Tuberculosis and Respiratory Diseases, New Delhi, India
| | - Sahajal Dhooria
- Department of Pulmonary Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Ashutosh Nath Aggarwal
- Department of Pulmonary Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Sagarika Haldar
- Department of Experimental Medicine and Biotechnology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
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Dass M, Kaur M, Aittan S, Sharma P, Punia S, Muthumohan R, Anthwal D, Gupta RK, Mahajan G, Kumari P, Sharma N, Taneja RS, Sharma LK, Shree R, Tyagi JS, Lal V, Haldar S. MPT51 and MPT64-based antigen detection assay for the diagnosis of extrapulmonary tuberculosis from urine samples. Diagn Microbiol Infect Dis 2023; 107:115973. [PMID: 37348159 DOI: 10.1016/j.diagmicrobio.2023.115973] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 04/26/2023] [Accepted: 04/27/2023] [Indexed: 06/24/2023]
Abstract
In view of WHO's "End-TB" strategy, we developed a non-invasive, urine-based ELISA, targeting 2 Mycobacterium tuberculosis antigens namely MPT51 and MPT64 for extrapulmonary TB (EPTB) diagnosis. Suspected EPTB patients (n = 137) [Pleural TB, Abdominal TB and Tuberculous meningitis] were categorized in "Definite" EPTB (n = 10) [Xpert-MTB/RIF and/or culture-positive], "Probable" EPTB (n = 77) and "Non-EPTB" (n = 50) groups using defined composite reference standards. ROC-curves were generated using ELISA results of "Definite" EPTB and "Non-EPTB" groups for both antigens independently and cut-off values were selected to provide 86.3% (95%CI:73.3-94.2) specificity for MPT51 and 92% (95%CI:80.8-97.8) for MPT64. The sensitivity of MPT51-ELISA and MPT64-ELISA was 70% (95%CI:34.7-93.3) and 90% (95%CI:55.5-99.7) for "Definite" EPTB group and 32.5% (95%CI:22.2-44.1) and 30.8% (95%CI:20.8-42.2) for "Probable" EPTB group, respectively. Combining the results of both ELISAs showed a 100% (95%CI:69.1-100) sensitivity in "Definite" EPTB group and 41.6% (95%CI:30.4-53.4) in "Probable" EPTB group, with an 80% (95%CI:66.3-89.9) specificity. The results demonstrated the potential of urine-based ELISAs as screening tests for EPTB diagnosis.
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Affiliation(s)
- Manisha Dass
- Department of Experimental Medicine and Biotechnology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Mohinder Kaur
- Department of Experimental Medicine and Biotechnology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Simran Aittan
- Department of Experimental Medicine and Biotechnology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Pratibha Sharma
- Department of Experimental Medicine and Biotechnology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Sachin Punia
- Department of Experimental Medicine and Biotechnology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Rajagopalan Muthumohan
- Centre for Biodesign and Diagnostics, Translational Health Science and Technology Institute, NCR Biotech Science Cluster, Faridabad, India
| | - Divya Anthwal
- Department of Experimental Medicine and Biotechnology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Rakesh K Gupta
- Department of Experimental Medicine and Biotechnology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Gargi Mahajan
- Department of Experimental Medicine and Biotechnology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Pooja Kumari
- Department of Biotechnology, All India Institute of Medical Sciences, New Delhi, India
| | - Neera Sharma
- Department of Biochemistry, Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Rajesh S Taneja
- Department of Medicine, Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Lokesh K Sharma
- Department of Biochemistry, Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Ritu Shree
- Department of Neurology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Jaya S Tyagi
- Department of Biotechnology, All India Institute of Medical Sciences, New Delhi, India
| | - Vivek Lal
- Department of Neurology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Sagarika Haldar
- Department of Experimental Medicine and Biotechnology, Post Graduate Institute of Medical Education and Research, Chandigarh, India; Centre for Biodesign and Diagnostics, Translational Health Science and Technology Institute, NCR Biotech Science Cluster, Faridabad, India.
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5
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Boyalla V, Bodinier B, Kralj-Hans I, Haldar S, Khan HR, Shi R, Cantor E, Hussain W, Jones DG, Jarman JWE, Markides V, Chadeau-Hyam M, Harding SE, Cleland JGF, Wong T. Novel biomarkers predict ablation outcomes in long stranding persistent atrial fibrillation. Europace 2022. [DOI: 10.1093/europace/euac053.613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): NIHR
Background
Ablation of long-standing persistent atrial fibrillation (LSPAF) is not always successful. The arrhythmia burden was reduced by 75% by 12 months in majority (72%) of patients with LSPAF who underwent surgical or percutaneous ablation in the CASA-AF trial. We hypothesised that biomarker(s) improve prediction of clinical success and offer insights into mechanisms.
Objective
To identify biomarkers that predict success (75% arrhythmia burden reduction) after ablation for LSPAF at 12-months.
Methods
Amongst patients participating in the CASA-AF RCT (ISRCTN18250790), pre-ablation serum samples were selected for 20 patients who met criteria for ablation-success at 12 months, and 20 who did not. Olink ProteomicsTM (Sweden) provided analyses using three biomarker panels [inflammation (INFL), cardiovascular III (CVD III), and cell cytology (CELL)] each containing 92 biomarkers. Univariate and multivariable analyses were adjusted for age, sex, BMI, LA diameter and CRP. ROC analysis was undertaken to assess the diagnostic accuracy of the biomarkers. To counter the false discovery rate, Benjamini-Hochberg correction was utilised.
Results
When patients with ablation-success and -failure were compared, no differences in demographics or cardiac function were found. On univariate analysis, several biomarkers in each panel were associated with ablation-success. Multivariable analysis narrowed the range of biomarkers and identified those that were jointly predictive of outcome: INFL (MCP1 + CD8A + CD40, Figure 1), CVD III (FAS + CPB1) and CELL (GCG + ENTPD6 + IL17RB). These joint biomarkers were analysed using ROC (Figure 2), which showed that increases of biomarkers on the INFL panel (MCP1 + CD8A + CD40) were associated with a greater risk of failure and achieved the highest AUC for prediction of outcome [0.82 (0.75-0.87)].
Conclusion
The increase in the serum concentration of markers of inflammation (MCP1 + CD8A + CD40) might be used to identify patients less likely to have sustained benefit from LSPAF ablation. Further studies are required to confirm their prognostic value as pre-procedural biomarkers.
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Affiliation(s)
- V Boyalla
- Royal Brompton & Harefield Hospital, London, United Kingdom of Great Britain & Northern Ireland
| | - B Bodinier
- Imperial College London, London, United Kingdom of Great Britain & Northern Ireland
| | - I Kralj-Hans
- Royal Brompton & Harefield Hospital, London, United Kingdom of Great Britain & Northern Ireland
| | - S Haldar
- Royal Brompton & Harefield Hospital, London, United Kingdom of Great Britain & Northern Ireland
| | - HR Khan
- Royal Brompton & Harefield Hospital, London, United Kingdom of Great Britain & Northern Ireland
| | - R Shi
- Royal Brompton & Harefield Hospital, London, United Kingdom of Great Britain & Northern Ireland
| | - E Cantor
- Royal Brompton & Harefield Hospital, London, United Kingdom of Great Britain & Northern Ireland
| | - W Hussain
- Royal Brompton & Harefield Hospital, London, United Kingdom of Great Britain & Northern Ireland
| | - DG Jones
- Royal Brompton & Harefield Hospital, London, United Kingdom of Great Britain & Northern Ireland
| | - JWE Jarman
- Royal Brompton & Harefield Hospital, London, United Kingdom of Great Britain & Northern Ireland
| | - V Markides
- Royal Brompton & Harefield Hospital, London, United Kingdom of Great Britain & Northern Ireland
| | - M Chadeau-Hyam
- Imperial College London, London, United Kingdom of Great Britain & Northern Ireland
| | - SE Harding
- Imperial College London, London, United Kingdom of Great Britain & Northern Ireland
| | - JGF Cleland
- Imperial College London, London, United Kingdom of Great Britain & Northern Ireland
| | - T Wong
- Royal Brompton & Harefield Hospital, London, United Kingdom of Great Britain & Northern Ireland
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Cantor E, Butcher C, Chow JJ, Sohaib SMA, Valli H, Shun-Shin M, Shi R, Boyalla V, O’connor M, Chen Z, Haldar S, Mason M, Lane R, Francis D, Wong T. The acute haemodynamic response with endocardial biventricular pacing: comparing RV paced and LBBB patients. Europace 2022. [DOI: 10.1093/europace/euac053.495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): Boston Scientific
Background
A third of patients that receive cardiac resynchronisation (CRT) are non-responders. Predictors of positive response include broader QRS duration, non-ischaemic aetiology and sinus rhythm, but it is still unclear whether lead placement site determines a positive responder.
Purpose
We assessed the acute haemodynamic response of endocardial biventricular pacing in patients with intrinsic left bundle brunch block (LBBB) versus LBBB due to pre-existing right ventricular pacing (RVP).
Methods
Patients who fulfilled standard criteria for CRT implantation but had failed conventional (coronary sinus) left ventricular (LV) lead placement (primary or revision) or were deemed clinical ‘non-responders after > 6 months of conventional CRT were enrolled. The acute haemodynamic response during endocardial biventricular pacing was assessed with a roving LV lead at 9 different locations (basal and mid: septal, anterior, posterior and lateral walls and apex). Acute changes in beat-to-beat systolic blood pressure (SBP) in the left ventricle were recorded and analysed.
Results
We recruited 23 patients across 10 UK centres: 14 intrinsic LBBB and 9 dependent on RVP. Patient characteristics were comparable: age (mean 67 + 10.6 years vs. 62 + 15.4 years), ischaemic (63% vs 50%), QRS (160 + 18ms vs. 190 + 36ms, p =0.07). Of the RVP group 5/9 had septal RV leads (the remainder apically positioned).
There was no difference in the SBP improvement between the groups: change in SBP ranged from -5.25 – 19.91mmHg (median 3mmHg) in RVP patients vs -5.92 – 23.03mmHg (median 3mmHg) for intrinsic LBBB. However, the improvement in SBP was more consistent across the different segments in the patients with RVP (group A), as compared to intrinsic LBBB (group B), where the lateral wall and then non-septal walls provided the greatest haemodynamic improvement.
Figure 1: depicts SBP improvement (in mmHg) during endocardial biventricular pacing in different positions within the LV for patients with RVP (A) vs underlying intrinsic LBBB (B): 9 segment model of the LV: Ant (anterior wall), Lat (lateral wall), Post (posterior wall), Sept (septum). Outer ring represents the four basal LV locations, middle ring the mid LV locations and centre ring the apex. Scale depicts mmHg improvement in SBP.
Conclusion
When implanting an LV lead for patients who are RV pacing dependent any position within the LV provides an acute haemodynamic improvement, compared with those with intrinsic LBBB, where a targeted lateral wall approach is more important. This finding corroborates the key differences in LV activation patterns for induced versus intrinsic LBBB.
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Affiliation(s)
- E Cantor
- Royal Brompton and Harefield Hospital, London, United Kingdom of Great Britain & Northern Ireland
| | - C Butcher
- Royal Brompton and Harefield Hospital, London, United Kingdom of Great Britain & Northern Ireland
| | - JJ Chow
- Imperial College Healthcare NHS Trust, London, United Kingdom of Great Britain & Northern Ireland
| | - S M A Sohaib
- Barts Health NHS Trust, London, United Kingdom of Great Britain & Northern Ireland
| | - H Valli
- Royal Brompton and Harefield Hospital, London, United Kingdom of Great Britain & Northern Ireland
| | - M Shun-Shin
- Royal Brompton and Harefield Hospital, London, United Kingdom of Great Britain & Northern Ireland
| | - R Shi
- Royal Brompton and Harefield Hospital, London, United Kingdom of Great Britain & Northern Ireland
| | - V Boyalla
- Royal Brompton and Harefield Hospital, London, United Kingdom of Great Britain & Northern Ireland
| | - M O’connor
- Royal Brompton and Harefield Hospital, London, United Kingdom of Great Britain & Northern Ireland
| | - Z Chen
- Royal Brompton and Harefield Hospital, London, United Kingdom of Great Britain & Northern Ireland
| | - S Haldar
- Royal Brompton and Harefield Hospital, London, United Kingdom of Great Britain & Northern Ireland
| | - M Mason
- Royal Brompton and Harefield Hospital, London, United Kingdom of Great Britain & Northern Ireland
| | - R Lane
- Royal Brompton and Harefield Hospital, London, United Kingdom of Great Britain & Northern Ireland
| | - D Francis
- Imperial College Healthcare NHS Trust, London, United Kingdom of Great Britain & Northern Ireland
| | - T Wong
- Royal Brompton and Harefield Hospital, London, United Kingdom of Great Britain & Northern Ireland
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Kumari P, Dhiman A, Lavania S, Sharma P, Rath D, Anthwal D, Gupta RK, Kochar A, Sharma N, Gadpayle A, Taneja R, Sharma L, Haldar S, Sharma TK, Tyagi JS. Assessment of DNA aptamers targeting GlcB and HspX antigens for application in the diagnosis of abdominal tuberculosis. Tuberculosis (Edinb) 2022; 134:102206. [DOI: 10.1016/j.tube.2022.102206] [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] [Received: 11/10/2021] [Revised: 03/31/2022] [Accepted: 04/03/2022] [Indexed: 02/07/2023]
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8
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Anthwal D, Jamwal S, Gupta RK, Singhal R, Verma AK, Bhalla M, Myneedu VP, Sarin R, Choudhary S, Tyagi JS, Haldar S. Direct Molecular Detection of Drug-Resistant Tuberculosis from Transported Bio-Safe Dried Sputum on Filter-Paper. Curr Microbiol 2022; 79:110. [PMID: 35175411 DOI: 10.1007/s00284-022-02780-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 01/20/2022] [Indexed: 11/27/2022]
Abstract
In 2019, amongst half a million new rifampicin-resistant tuberculosis (TB) cases, 78% were multi drug-resistant TB (MDR-TB). Access to rapid and Universal-Drug susceptibility testing (DST) to patients in remote areas is a major challenge to combat drug-resistant TB. To overcome this challenge, we had recently reported the development of 'TB Concentration & Transport kit' for bio-safe ambient temperature transport of dried sputum on filter-paper (Trans-Filter). The present study was conducted to evaluate the utility of DNA extracted from sputum on Trans-Filter in a Multiplex PCR-based sequencing assay (Mol-DSTseq) for diagnosing drug-resistant TB. The developed Mol-DSTseq assays were standardized on Mycobacterium tuberculosis clinical isolates (n = 98) and further validated on DNA extracted from sputum on Trans-Filter (n = 100). Using phenotypic DST as gold standard, the Mol-DSTseq assay showed 100% (95% Confidence Interval [CI] 79.4-100%) and 73.3% (95% CI 54.1-87.7%) sensitivity for detecting rifampicin and isoniazid resistance with a specificity of 85.1% (95% CI 66.2-95.8%) and 100% (95% CI:82.3-100%), respectively. For fluoroquinolones and aminoglycosides, the Mol-DSTseq assay showed a sensitivity of 78.5% (95% CI 49.2-95.3%) and 66.6% (95% CI 9.4-99.1%) with a specificity of 88.2% (95% CI 72.5-96.7%) and 100% (95% CI 93.1-100%), respectively. The Mol-DSTseq assays exhibited a high concordance of ~ 83-96% (κ value: 0.65-0.81) with phenotypic DST for all drugs. In conclusion, the 'TB Concentration and Transport kit' was compatible with Mol-DSTseq assays and has the potential to provide 'Universal-DST' to patients residing in distant areas in high burden countries, like India for early initiation of anti-tubercular treatment.
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Affiliation(s)
- Divya Anthwal
- Department of Experimental Medicine and Biotechnology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
- Department of Bioscience and Biotechnology, Banasthali Vidyapith, P.O. Banasthali Vidyapith, Tonk, Rajasthan, India
| | - Shaina Jamwal
- Department of Experimental Medicine and Biotechnology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Rakesh Kumar Gupta
- Department of Experimental Medicine and Biotechnology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
- Department of Bioscience and Biotechnology, Banasthali Vidyapith, P.O. Banasthali Vidyapith, Tonk, Rajasthan, India
| | - Ritu Singhal
- Department of Microbiology, National Institute of Tuberculosis and Respiratory Diseases, Mehrauli, New Delhi, India
| | - Ajoy Kumar Verma
- Department of Microbiology, National Institute of Tuberculosis and Respiratory Diseases, Mehrauli, New Delhi, India
| | - Manpreet Bhalla
- Department of Microbiology, National Institute of Tuberculosis and Respiratory Diseases, Mehrauli, New Delhi, India
| | - Vithal Prasad Myneedu
- Department of Microbiology, National Institute of Tuberculosis and Respiratory Diseases, Mehrauli, New Delhi, India
| | - Rohit Sarin
- Department of Microbiology, National Institute of Tuberculosis and Respiratory Diseases, Mehrauli, New Delhi, India
| | - Sangeeta Choudhary
- Department of Bioscience and Biotechnology, Banasthali Vidyapith, P.O. Banasthali Vidyapith, Tonk, Rajasthan, India
| | - Jaya Sivaswami Tyagi
- Department of Biotechnology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - Sagarika Haldar
- Department of Experimental Medicine and Biotechnology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
- Translational Health Science and Technology Institute, NCR Biotech Science Cluster, 3rd Milestone, Faridabad - Gurgaon Expressway, PO box #04, Faridabad, India.
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9
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Anthwal D, Gupta RK, Singhal R, Bhalla M, Verma AK, Khayyam KU, Myneedu VP, Sarin R, Gupta A, Gupta NK, Singh M, Sivaswami Tyagi J, Haldar S. Compatibility of a novel filter paper-based bio-safe sputum transport kit with line probe assay for diagnosing drug-resistant tuberculosis: a single-site evaluation study. ERJ Open Res 2021; 7:00137-2021. [PMID: 34350282 PMCID: PMC8326685 DOI: 10.1183/23120541.00137-2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 04/08/2021] [Indexed: 01/29/2023] Open
Abstract
Background Near-patient access to appropriate tests is a major obstacle for the efficient diagnosis of tuberculosis (TB) and associated drug resistance. Methods We recently developed the “TB Concentration & Transport” kit for bio-safe, ambient-temperature transportation of dried sputum on Trans-Filter, and the “TB DNA Extraction” kit for DNA extraction from Trans-Filter for determining drug resistance by DNA sequencing. In the present study, we evaluated the compatibility of Kit-extracted DNA with Hain's line probe assays (LPAs), which are endorsed by National TB programmes for the detection of drug resistance in sputum collected from presumptive multidrug-resistant TB patients (n=207). Results Trans-Filter-extracted DNA was seamlessly integrated with the LPA protocol (Kit-LPA). The sensitivity of Kit-LPA for determining drug resistance was 83.3% for rifampicin (95% CI 52–98%), 77.7% for isoniazid (95% CI 52–94%), 85.7% for fluoroquinolones (95% CI 42–100%) and 66.6% for aminoglycosides (95% CI 9–99%), with a specificity range of 93.7% (95% CI 87–97) to 99.1% (95% CI 95–100) using phenotypic drug susceptibility testing (DST) as a reference standard. A high degree of concordance was noted between results obtained from Kit-LPA and LPA (99% to 100% (κ value: 0.83–1.0)). Conclusions This study demonstrates successful integration of our developed kits with LPA. The adoption of these kits across Designated Microscopy Centres in India can potentially overcome the existing challenge of transporting infectious sputum at controlled temperature to centralised testing laboratories and can provide rapid near-patient cost-effective “Universal DST” services to TB subjects residing in remote areas. The adoption of bio-safe “TB Concentration & Transport” kit by Microscopy Centres can potentially overcome the challenge of transporting infectious sputum to central laboratories and provide universal DST services to TB subjects residing in remote areas.https://bit.ly/2QrQ5qL
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Affiliation(s)
- Divya Anthwal
- Dept of Experimental Medicine and Biotechnology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.,Translational Health Science and Technology Institute, NCR Biotech Science Cluster, Faridabad, India
| | - Rakesh Kumar Gupta
- Dept of Experimental Medicine and Biotechnology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.,Translational Health Science and Technology Institute, NCR Biotech Science Cluster, Faridabad, India
| | - Ritu Singhal
- Dept of Microbiology, National Institute of Tuberculosis and Respiratory Diseases, New Delhi, India
| | - Manpreet Bhalla
- Dept of Microbiology, National Institute of Tuberculosis and Respiratory Diseases, New Delhi, India
| | - Ajoy Kumar Verma
- Dept of Microbiology, National Institute of Tuberculosis and Respiratory Diseases, New Delhi, India
| | - Khalid Umar Khayyam
- Dept of Microbiology, National Institute of Tuberculosis and Respiratory Diseases, New Delhi, India
| | - Vithal Prasad Myneedu
- Dept of Microbiology, National Institute of Tuberculosis and Respiratory Diseases, New Delhi, India
| | - Rohit Sarin
- Dept of Microbiology, National Institute of Tuberculosis and Respiratory Diseases, New Delhi, India
| | | | | | - Manjula Singh
- India TB Research Consortium, Indian Council of Medical Research, New Delhi, India
| | - Jaya Sivaswami Tyagi
- Translational Health Science and Technology Institute, NCR Biotech Science Cluster, Faridabad, India.,Dept of Biotechnology, All India Institute of Medical Sciences, New Delhi, India
| | - Sagarika Haldar
- Dept of Experimental Medicine and Biotechnology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.,Translational Health Science and Technology Institute, NCR Biotech Science Cluster, Faridabad, India
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10
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Salvador-Montanes O, Fitzgerald J, Jackson N, Haldar S, Cotton J, Gizurarson S, Nanthakumar K, Porta-Sanchez A. Atrial fibrillation substrate mapping with decrement evoked potential mapping. Europace 2021. [DOI: 10.1093/europace/euab116.138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Foundation. Main funding source(s): Sociedad Española de Cardiologia.
OnBehalf
DEFINE-AF
Background
Identifying and targeting atrial substrate zones that are vulnerable to unidirectional block and slow conduction may be critical to improve the outcomes of atrial fibrillation (AF) ablation. Functional mapping of the atrial substrate with Decrement Evoked Potential (DeEP) and a single extrastimulus in this population could potentially lead to novel therapeutic strategies.
Aim
1) To systematically analyze whether the DEEP are present in the atrial tissue and their locations after pulmonary vein isolation. 2) To assess their relationship with the underlying voltage. 3) To assess the presence of DEEP as a function of the subtype of AF.
Methods
Consecutive patients with AF undergoing ablation were prospectively enrolled at 3 institutions. A biatrial voltage map was created and after pulmonary vein isolation (PVI). A drive train and an extrastimulus (atrial refractory period + 20ms) was delivered from an epicardial site (proximal CS) and an endocardial site (left atrial appendage (LAA). A multipolar mapping catheter was sequentially placed at 8 left atrial sites and 5 right atrial sites. Electrograms (EGMs) that showed a local delay of >10ms in activation with the extrastimulus were identified as DEEPs. Patients were followed for a mean of 11 ± 5 months
Results
74 patients, 63 pers AF (85%), mean age 62 ± 8, mean LA size 41 ±12 mm were enrolled. Of 19240 EGMs analyzed, 8.2% showed DEEPs (54.6% with CS pacing and 45.4% with LAA pacing, p = 0.0001). The mean local decrement seen was 39 ms. Most DEEPs (76.2%) were identified in sites with a normal EGM at baseline with preserved voltages. DEEPs were differentially distributed within the regions mapped, more frequently in LA than RA (9.2% vs 6.6%, p < 0.0001). Patients with persistent AF had a higher proportion of DEEPs than patients with paroxysmal AF (9.7% vs 5.1%, p < 0.001).
Conclusions
Atrial DEEPs are: 1) More often identified when pacing endocardially. 2) More common in patients with persistent AF. 3) More frequent in the LA than in the RA. 4) Mostly located in regions with normal voltages at baseline. All those findings suggest the importance of the functional substrate mapping in the atrium and could lead to novel therapeutic targets. Abstract Figure. Example of atrial DEEP
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Affiliation(s)
- O Salvador-Montanes
- Quiron University Hospital, Cardiology Department. Arrhythmia Service. , Madrid, Spain
| | - J Fitzgerald
- John Hunter Hospital, Cardiology, Newcastle, Australia
| | - N Jackson
- John Hunter Hospital, Cardiology, Newcastle, Australia
| | - S Haldar
- Royal Brompton and Harefield Hospital, Cardiology, London, United Kingdom of Great Britain & Northern Ireland
| | - J Cotton
- Royal Brompton and Harefield Hospital, Cardiology, London, United Kingdom of Great Britain & Northern Ireland
| | - S Gizurarson
- Landspitali University Hospital, Cardiology, Reykjavik, Iceland
| | - K Nanthakumar
- University Health Network, The Hull Family Cardiac Fibrillation Management Laboratory, Toronto, Canada
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11
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Anthwal D, Gupta RK, Gomathi NS, Tripathy SP, Das D, Pati S, Panwalkar N, Desikan P, Bala K, Singh UB, Bhalla M, Singhal R, Verma AK, Khayyam KU, Myneedu VP, Sarin R, Sharma S, Bansal AK, Gupta UD, Patil SA, Goyal A, Gupta A, Singh M, Gupta NK, Haldar S, Tyagi JS. Evaluation of 'TBDetect' sputum microscopy kit for improved detection of Mycobacterium tuberculosis: a multi-centric validation study. Clin Microbiol Infect 2020; 27:911.e1-911.e7. [PMID: 32835794 DOI: 10.1016/j.cmi.2020.08.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 08/14/2020] [Accepted: 08/15/2020] [Indexed: 11/16/2022]
Abstract
OBJECTIVES The present study aimed to evaluate the performance of the 'TBDetect' kit-based bio-safe fluorescent microscopy filter (BioFM-Filter) microscopy in comparison with direct smear microscopy and culture for the detection of pulmonary tuberculosis (TB) in a multi-centric setting in India. METHODS The TBDetect kit enables sputum concentration through filtration using the BioFM-Filter for improved and bio-safe smear microscopy. We evaluated the performance of the TBDetect kit in a six-site multi-centric validation study on sputum collected from 2086 presumptive TB patients. RESULTS The combined positivity of TBDetect microscopy performed on these sputum samples was 20% (n = 417/2086) vs 16.1% of light-emitting diode fluorescence microscopy (LED-FM, n = 337/2086) and 16% of Ziehl Neelsen (ZN) smear microscopy (n = 333/2086). The increment in positivity of TBDetect over both LED-FM and ZN smears was significant (p < 0.001). The overall sensitivity of TBDetect for six sites was ~55% (202/367, 95% confidence interval (CI): 50, 60%) vs 52% (191/367, 95% CI: 47, 57%) for LED-FM (p 0.14) and 50.9% (187/367, 95% CI: 46, 56%) for ZN smear (p < 0.05), using Mycobacterium Growth Indicator Tube culture (MGIT, n = 1949, culture positive, n = 367) as the reference standard. A bio-safety evaluation at six sites confirmed efficient sputum disinfection by TBDetect; 99.95% samples (1873/1874) were sterile after 42 days of incubation. Scientists and technicians at the study sites indicated the ease of use and convenience of TBDetect microscopy during feedback. CONCLUSIONS TBDetect added value to the smear microscopy test due to its improved performance, convenience and user safety. These findings indicate that equipment-free TBDetect technology has the potential to improve TB diagnosis in basic laboratory settings by leveraging on the existing nationwide network of designated microscopy centres and primary healthcare centres.
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Affiliation(s)
- Divya Anthwal
- Translational Health Science and Technology Institute, NCR Biotech Science Cluster, Faridabad, India; Department of Experimental Medicine and Biotechnology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Rakesh Kumar Gupta
- Translational Health Science and Technology Institute, NCR Biotech Science Cluster, Faridabad, India; Department of Experimental Medicine and Biotechnology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | | | | | - Dasarathi Das
- Regional Medical Research Center, Bhubaneshwar, India
| | | | | | - Prabha Desikan
- Bhopal Memorial Hospital and Research Centre, Bhopal, India
| | - Kiran Bala
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Urvashi B Singh
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Manpreet Bhalla
- Department of Microbiology, National Institute of Tuberculosis and Respiratory Diseases, New Delhi, India
| | - Ritu Singhal
- Department of Microbiology, National Institute of Tuberculosis and Respiratory Diseases, New Delhi, India
| | - Ajoy Kumar Verma
- Department of Microbiology, National Institute of Tuberculosis and Respiratory Diseases, New Delhi, India
| | - Khalid Umar Khayyam
- Department of Microbiology, National Institute of Tuberculosis and Respiratory Diseases, New Delhi, India
| | - Vithal Prasad Myneedu
- Department of Microbiology, National Institute of Tuberculosis and Respiratory Diseases, New Delhi, India
| | - Rohit Sarin
- Department of Microbiology, National Institute of Tuberculosis and Respiratory Diseases, New Delhi, India
| | - Sandeep Sharma
- National JALMA Institute of Leprosy and Other Mycobacterial Diseases, Agra, India
| | - Avi Kumar Bansal
- National JALMA Institute of Leprosy and Other Mycobacterial Diseases, Agra, India
| | - Umesh D Gupta
- National JALMA Institute of Leprosy and Other Mycobacterial Diseases, Agra, India
| | - Sripad A Patil
- National JALMA Institute of Leprosy and Other Mycobacterial Diseases, Agra, India
| | - Abhinav Goyal
- Advanced Microdevices Pvt Ltd, Industrial Area, Ambala Cantt, India
| | - Ashawant Gupta
- Advanced Microdevices Pvt Ltd, Industrial Area, Ambala Cantt, India
| | - Manjula Singh
- India Tuberculosis Research Consortium (ITRC), Indian Council of Medical Research, V. Ramalingaswami Bhawan, Ansari Nagar, New Delhi, India
| | | | - Sagarika Haldar
- Translational Health Science and Technology Institute, NCR Biotech Science Cluster, Faridabad, India; Department of Experimental Medicine and Biotechnology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
| | - Jaya Sivaswami Tyagi
- Translational Health Science and Technology Institute, NCR Biotech Science Cluster, Faridabad, India; Department of Biotechnology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India.
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12
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Tay SH, Goh HJ, Govindharajulu P, Cheng J, Camps SG, Haldar S, Velan SS, Sun L, Li Y, Henry CJ, Leow MKS. Brown fat activity determined by infrared thermography and thermogenesis measurement using whole body calorimetry (BRIGHT Study). Physiol Res 2020; 69:85-97. [PMID: 31852199 DOI: 10.33549/physiolres.934190] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
To assess BAT activity in humans at a population level, infrared thermography (IRT) represents a safe, readily repeatable and affordable alternative to 18F-FDG-PET. Building upon a previously proposed method by our laboratory, we further refined the image computational algorithm to quantify BAT activation in the cervical-supraclavicular (C-SCV) region of healthy young men under thermo-neutral and cold exposure conditions. Additionally, we validated the whole-body calorimeter (WBC) in reliably measuring cold-induced thermogenesis. The temperature gradient between C-SCV-deltoid regions, and the corresponding difference in heat power output, increased upon cold air exposure relative to thermo-neutral conditions (by 74.88 %, p<0.0001; and by 71.34 %, p<0.0001 respectively). Resting and cumulative energy expenditure (EE) rose significantly (by 13.14 % and 9.12 % respectively, p=0.0001) while positive correlations between IRT measures and EE were found with cold air exposure (percentage change in heat power gradient between ROI and deltoid, cold air: r(2)=0.29, p=0.026, Pearson's correlation). IRT and WBC can be used to study BAT activation. The refined algorithm allows for more automation and objectivity in IRT data analysis, especially under cold air exposures.
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Affiliation(s)
- S H Tay
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore.
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13
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Dhiman A, Kumar C, Mishra SK, Sikri K, Datta I, Sharma P, Singh TP, Haldar S, Sharma N, Bansal A, Ahmad Y, Kumar A, Sharma TK, Tyagi JS. Theranostic Application of a Novel G-Quadruplex-Forming DNA Aptamer Targeting Malate Synthase of Mycobacterium tuberculosis. Mol Ther Nucleic Acids 2019; 18:661-672. [PMID: 31704587 PMCID: PMC6849348 DOI: 10.1016/j.omtn.2019.09.026] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 08/29/2019] [Accepted: 09/27/2019] [Indexed: 12/28/2022]
Abstract
The successful management of tuberculosis (TB) requires efficient diagnosis and treatment. Further, the increasing prevalence of drug-resistant TB highlights the urgent need to develop novel inhibitors against both drug-susceptible and drug-resistant forms of disease. Malate synthase (MS), an enzyme of the glyoxylate pathway, plays a vital role in mycobacterial persistence, and therefore it is considered as an attractive target for novel anti-TB drug development. Recent studies have also ascribed an adhesin function to MS and established it as a potent diagnostic biomarker. In this study, a panel of Mycobacterium tuberculosis (Mtb) MS-specific single-stranded DNA aptamers was identified by Systematic Evolution of Ligands by EXponential enrichment (SELEX). The best-performing G-quadruplex-forming 44-mer aptamer, MS10, was optimized post-SELEX to generate an 11-mer aptamer, MS10-Trunc. This aptamer was characterized by various biochemical, biophysical, and in silico techniques. Its theranostic activity toward Mtb was established using enzyme inhibition, host cell binding, and invasion assays. MS10-Trunc aptamer exhibited high affinity for MS (equilibrium dissociation constant [KD] ∼19 pM) and displayed robust inhibition of MS enzyme activity with IC50 of 251.1 nM and inhibitor constant (Ki) of 230 nM. This aptamer blocked mycobacterial entry into host cells by binding to surface-associated MS. In addition, we have also demonstrated its application in the detection of tuberculous meningitis (TBM) in patients with sensitivity and specificity each of >97%.
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Affiliation(s)
- Abhijeet Dhiman
- Department of Biotechnology, All India Institute of Medical Sciences, New Delhi 110029, India; Faculty of Pharmacy, Uttarakhand Technical University, Dehradun 248007, Uttarakhand, India
| | - Chanchal Kumar
- Department of Biotechnology, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Subodh Kumar Mishra
- Discipline of Biosciences and Biomedical Engineering, Indian Institute of Technology Indore, Simrol, Indore 453552, India
| | - Kriti Sikri
- Department of Biotechnology, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Ishara Datta
- Department of Biotechnology, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Pradeep Sharma
- Department of Biophysics, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Tej P Singh
- Department of Biophysics, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Sagarika Haldar
- Department of Experimental Medicine and Biotechnology, PGIMER, Sector 12, Chandigarh 160012, India; Multidisciplinary Clinical and Translational Research Group, Translational Health Science and Technology Institute, Faridabad, Haryana 121001, India
| | - Neera Sharma
- Department of Biochemistry, Dr. Ram Manohar Lohia Hospital, New Delhi 110001, India
| | - Anjali Bansal
- Department of Pediatrics, Dr. Ram Manohar Lohia Hospital, New Delhi 110001, India
| | - Yusra Ahmad
- Faculty of Pharmacy, Uttarakhand Technical University, Dehradun 248007, Uttarakhand, India
| | - Amit Kumar
- Discipline of Biosciences and Biomedical Engineering, Indian Institute of Technology Indore, Simrol, Indore 453552, India
| | - Tarun Kumar Sharma
- Multidisciplinary Clinical and Translational Research Group, Translational Health Science and Technology Institute, Faridabad, Haryana 121001, India.
| | - Jaya Sivaswami Tyagi
- Department of Biotechnology, All India Institute of Medical Sciences, New Delhi 110029, India; Multidisciplinary Clinical and Translational Research Group, Translational Health Science and Technology Institute, Faridabad, Haryana 121001, India.
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14
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Karim N, Marinelli A, Cantor E, Boyalla V, Malaczynska-Rajpold K, Ahmed O, Khan H, Haldar S, Jones D, Hussein W, Markides V, Wong T, Jarman J. P2831Safety of atrial fibrillation catheter ablation in the elderly. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.1141] [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
Catheter ablation for drug refractory, symptomatic atrial fibrillation (AF), is becoming increasingly common and can be beneficial in alleviating symptoms. However, in the elderly, there are concerns about the risks an invasive procedure poses, with limited published data available in those aged over 80 years.
Purpose
To determine the complication risk of AF catheter ablation in the elderly
Methods
Complications were identified from patient records in 3156 consecutive patients who underwent radiofrequency catheter ablation for AF, at a tertiary cardiology centre between 2013–2017. All cases were performed under general anesthesia.
Results
In this cohort of 3156 patients (mean age= 62.9±11.0 years, female = 29.9%), 90 (2.85%) (mean age= 66±10.0 years, female = 49.5%) complications were identified. In patients aged ≥80 years, complications occurred in 5 out of 99 patients (5.05%) (mean age= 82.6±1.2, female=100%), compared to 85 out of 3057 patients (2.78%) in those aged <80 years (mean age= 65±10.3, female = 49.4%). The difference was not significant p=0.18. Complications in the elderly all occurred acutely, and included groin haematoma (2.02%), pneumonia (2.02%) and pericardial effusion (1.01%).
Conclusion
Catheter ablation for AF in patients ≥80 years of age, is not associated with a significant increase in complication risk, compared to those who are younger.
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Affiliation(s)
- N Karim
- Royal Brompton Hospital, London, United Kingdom
| | - A Marinelli
- Royal Brompton Hospital, London, United Kingdom
| | - E Cantor
- Royal Brompton Hospital, London, United Kingdom
| | - V Boyalla
- Royal Brompton Hospital, London, United Kingdom
| | | | - O Ahmed
- Royal Brompton Hospital, London, United Kingdom
| | - H Khan
- Royal Brompton Hospital, London, United Kingdom
| | - S Haldar
- Royal Brompton Hospital, London, United Kingdom
| | - D Jones
- Royal Brompton Hospital, London, United Kingdom
| | - W Hussein
- Royal Brompton Hospital, London, United Kingdom
| | - V Markides
- Royal Brompton Hospital, London, United Kingdom
| | - T Wong
- Royal Brompton Hospital, London, United Kingdom
| | - J Jarman
- Royal Brompton Hospital, London, United Kingdom
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15
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Shi R, Pope MTB, Boyalla V, Jones DG, Haldar S, Hussain W, Markides V, Betts TR, Wong T. P978Core to block: a new ablation strategy for treating persistent atrial fibrillation. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0571] [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
Ablation strategy targeting the core of atrial fibrillation (AF) rotors alone can lead to both stabilisation and destabilisation of rotational activity. Non-contact dipole density mapping system is designed to rapidly identify dynamic regional atrial activation patterns of interest (API) during AF.
Purpose
To assess the feasibility of an ablation strategy consisted of pulmonary vein isolation + targeting the core of APIs followed by linear ablation to the nearest non-conducting boundary to treat persistent AF.
Methods
The ablation strategy includes: 1. Antral pulmonary vein electrical isolation (APVI); 2. APIs (focal, localised rotational and localised irregular activation; Figure1) detection by dipole density mapping; 3. API core ablation followed by linear ablation to the nearest non-conduction barrier (APVI/mitral valve); 4. repeat step 2 and 3 in LA (RA, if necessary) until sinus rhythm is achieved.
Results
Consecutive 40 persistent AF patients (mean 62±12 years, 29 males, AF duration 10±4 months, LA diameter 42±9 mm) were included from 2 centres. An average of 2.0±0.7 APIs per patient were targeted post-APVI. Acute AF termination by ablation was achieved in 27/40 (68%) patients. The mean ablation time of APVI and “Core to block” was 33±12 mins and 31±22 mins, respectively. No major complication occurred. During a mean follow-up of 12±5 months, 32/40 patients (80%) maintained sinus rhythm.
Conclusion
APVI + “Core to block” guided by the dipole density mapping is feasible for treating persistent AF. A larger randomised study is needed to test the effectiveness of this ablation strategy.
Acknowledgement/Funding
None
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Affiliation(s)
- R Shi
- Royal Brompton Hospital, Cardiac Electrophysiology, London, United Kingdom
| | - M T B Pope
- Oxford University Hospitals NHS Trust, Department of cardiology, Oxford, United Kingdom
| | - V Boyalla
- Royal Brompton Hospital, Cardiac Electrophysiology, London, United Kingdom
| | - D G Jones
- Royal Brompton Hospital, Cardiac Electrophysiology, London, United Kingdom
| | - S Haldar
- Royal Brompton Hospital, Cardiac Electrophysiology, London, United Kingdom
| | - W Hussain
- Royal Brompton Hospital, Cardiac Electrophysiology, London, United Kingdom
| | - V Markides
- Royal Brompton Hospital, Cardiac Electrophysiology, London, United Kingdom
| | - T R Betts
- Oxford University Hospitals NHS Trust, Department of cardiology, Oxford, United Kingdom
| | - T Wong
- Royal Brompton Hospital, Cardiac Electrophysiology, London, United Kingdom
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16
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Shi R, Chen Z, Butcher C, Zaman Z, Boyalla V, Wang YK, Riad O, Sathishkumar A, Norman M, Haldar S, Jones DG, Hussain W, Markides V, Wong T. P3756Diverse activation patterns during persistent atrial fibrillation characterised by dipole density non-contact mapping. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0608] [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
Global simultaneous recording of activation during atrial fibrillation (AF) can elucidate underlying mechanisms contributing to AF maintenance. A better understanding of these mechanisms may allow for a personalised ablation strategy to treat persistent AF.
Purpose
To characterise left atrial endocardial activation patterns during AF using a novel non-contact dipole density mapping.
Methods
Activation patterns were characterised into three sub-types: (i) focal with centrifugal activation (FCA); (ii) localised rotational activation (LRA); (iii) localised irregular activation (LIA). Continuous activation patterns were quantified and distributed in the left atrium.
Results
A total of 144 persistent AF segments with 1068 activation patterns from 25 patients were analysed. The most common pattern was LIA (63%), which consist of four disparate features: slow conduction (45%), pivoting (30%), collision (16%) and acceleration (7%). LRA was the second commonest pattern (20%). FCA (17%) arose frequently from the PVs/ostia. Continuous AF activations comprise multiple combinations of FCA, LRA and LIA, transitioning from one to the next without a discernible order. Preferential conduction areas were typically seen in mid-anterior (48%) and lower-posterior (40%) walls where dominant activations were made up of LRA and LIA.
Conclusion
AF is characterised by heterogenous activation patterns that vary between individuals. Clinical implications of individualised ablation strategies guided by dipole density mapping will have to be determined.
Acknowledgement/Funding
None
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Affiliation(s)
- R Shi
- Royal Brompton Hospital, Cardiac Electrophysiology, London, United Kingdom
| | - Z Chen
- Royal Brompton Hospital, Cardiac Electrophysiology, London, United Kingdom
| | - C Butcher
- Royal Brompton Hospital, Cardiac Electrophysiology, London, United Kingdom
| | - Z Zaman
- Royal Brompton Hospital, Cardiac Electrophysiology, London, United Kingdom
| | - V Boyalla
- Royal Brompton Hospital, Cardiac Electrophysiology, London, United Kingdom
| | - Y K Wang
- University of Auckland, Auckland Bioengineering Institute, Auckland, New Zealand
| | - O Riad
- Royal Brompton Hospital, Cardiac Electrophysiology, London, United Kingdom
| | - A Sathishkumar
- Royal Brompton Hospital, Cardiac Electrophysiology, London, United Kingdom
| | - M Norman
- Royal Brompton Hospital, Cardiac Electrophysiology, London, United Kingdom
| | - S Haldar
- Royal Brompton Hospital, Cardiac Electrophysiology, London, United Kingdom
| | - D G Jones
- Royal Brompton Hospital, Cardiac Electrophysiology, London, United Kingdom
| | - W Hussain
- Royal Brompton Hospital, Cardiac Electrophysiology, London, United Kingdom
| | - V Markides
- Royal Brompton Hospital, Cardiac Electrophysiology, London, United Kingdom
| | - T Wong
- Royal Brompton Hospital, Cardiac Electrophysiology, London, United Kingdom
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Anthwal D, Lavania S, Gupta RK, Verma A, Myneedu VP, Sharma PP, Verma H, Malhotra V, Gupta A, Gupta NK, Sarin R, Haldar S, Tyagi JS. Development and evaluation of novel bio-safe filter paper-based kits for sputum microscopy and transport to directly detect Mycobacterium tuberculosis and associated drug resistance. PLoS One 2019; 14:e0220967. [PMID: 31408508 PMCID: PMC6692035 DOI: 10.1371/journal.pone.0220967] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [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: 01/11/2019] [Accepted: 07/26/2019] [Indexed: 11/18/2022] Open
Abstract
India has the highest burden of Tuberculosis (TB) and multidrug-resistant TB (MDR-TB) worldwide. Innovative technology is the need of the hour to identify these cases that remain either undiagnosed or inadequately diagnosed due to the unavailability of appropriate tools at primary healthcare settings. We developed and evaluated 3 kits, namely ‘TB Detect’ (containing BioFM-Filter device), ‘TB Concentration and Transport’ (containing Trans-Filter device) and ‘TB DNA Extraction’ kits. These kits enable bio-safe equipment-free concentration of sputum on filters and improved fluorescence microscopy at primary healthcare centres, ambient temperature transport of dried inactivated sputum filters to central laboratories and molecular detection of drug resistance by PCR and DNA sequencing (Mol-DST). In a 2-site evaluation (n = 1190 sputum specimens) on presumptive TB patients, BioFM-Filter smear exhibited a significant increase in positivity of 7% and 4% over ZN smear and LED-FM smear (p<0.05), respectively and an increment in smear grade status (1+ or 2+ to 3+) of 16% over ZN smear and 20% over LED-FM smear. The sensitivity of Mol-DST in presumptive MDR-TB and XDR-TB cases (n = 148) was 90% for Rifampicin (95% confidence interval [CI], 78–96%), 84% for Isoniazid (95% CI, 72–92%), 83% for Fluoroquinolones (95% CI, 66–93%) and 75% for Aminoglycosides (95% CI, 35–97%), using phenotypic DST as the reference standard. Test specificity was 88–93% and concordance was ~89–92% (κ value 0.8–0.9). The patient-friendly kits described here address several of the existing challenges and are designed to provide ‘Universal Access’ to rapid TB diagnosis, including drug-resistant disease. Their utility was demonstrated by application to sputum at 2 sites in India. Our findings pave the way for larger studies in different point-of-care settings, including high-density urban areas and remote geographical locations.
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Affiliation(s)
- Divya Anthwal
- Center for Bio-design and Diagnostics, Translational Health Science and Technology Institute, NCR Biotech Science Cluster, 3rd Milestone, Faridabad–Gurgaon Expressway, Faridabad, India
| | - Surabhi Lavania
- Department of Biotechnology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - Rakesh Kumar Gupta
- Center for Bio-design and Diagnostics, Translational Health Science and Technology Institute, NCR Biotech Science Cluster, 3rd Milestone, Faridabad–Gurgaon Expressway, Faridabad, India
| | - Ajoy Verma
- Department of Microbiology, National Institute of Tuberculosis and Respiratory Diseases, Mehrauli, New Delhi, India
| | - Vithal Prasad Myneedu
- Department of Microbiology, National Institute of Tuberculosis and Respiratory Diseases, Mehrauli, New Delhi, India
| | - Prem Prakash Sharma
- Department of Microbiology, National Institute of Tuberculosis and Respiratory Diseases, Mehrauli, New Delhi, India
| | | | | | - Ashawant Gupta
- Advanced Microdevices Pvt Ltd, Industrial Area, Ambala Cantt, India
| | | | - Rohit Sarin
- Department of Microbiology, National Institute of Tuberculosis and Respiratory Diseases, Mehrauli, New Delhi, India
- * E-mail: (JST); (SH); (RS)
| | - Sagarika Haldar
- Center for Bio-design and Diagnostics, Translational Health Science and Technology Institute, NCR Biotech Science Cluster, 3rd Milestone, Faridabad–Gurgaon Expressway, Faridabad, India
- * E-mail: (JST); (SH); (RS)
| | - Jaya Sivaswami Tyagi
- Center for Bio-design and Diagnostics, Translational Health Science and Technology Institute, NCR Biotech Science Cluster, 3rd Milestone, Faridabad–Gurgaon Expressway, Faridabad, India
- Department of Biotechnology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
- * E-mail: (JST); (SH); (RS)
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Khan H, Haldar S, Boyalla V, Kralj-Hans I, Nyktari E, Jones DG, Hussain W, Jarman J, Keegan J, Cowie M, Markides V, Mohiaddin R, Wong T. 346Left atrial reverse remodelling is not associated with improved success in treatment of long standing persistent atrial fibrillation. Eur Heart J Cardiovasc Imaging 2019. [DOI: 10.1093/ehjci/jez103.001] [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: 11/13/2022] Open
Affiliation(s)
- H Khan
- Imperial College London, London, United Kingdom of Great Britain & Northern Ireland
| | - S Haldar
- Royal Brompton Hospital, London, United Kingdom of Great Britain & Northern Ireland
| | - V Boyalla
- Royal Brompton Hospital, London, United Kingdom of Great Britain & Northern Ireland
| | - I Kralj-Hans
- Royal Brompton Hospital, London, United Kingdom of Great Britain & Northern Ireland
| | - E Nyktari
- Royal Brompton Hospital, London, United Kingdom of Great Britain & Northern Ireland
| | - D G Jones
- Harefield Hospital, London, United Kingdom of Great Britain & Northern Ireland
| | - W Hussain
- Harefield Hospital, London, United Kingdom of Great Britain & Northern Ireland
| | - J Jarman
- Royal Brompton Hospital, London, United Kingdom of Great Britain & Northern Ireland
| | - J Keegan
- Royal Brompton Hospital, London, United Kingdom of Great Britain & Northern Ireland
| | - M Cowie
- Imperial College London, London, United Kingdom of Great Britain & Northern Ireland
| | - V Markides
- Royal Brompton Hospital, London, United Kingdom of Great Britain & Northern Ireland
| | - R Mohiaddin
- Royal Brompton Hospital, London, United Kingdom of Great Britain & Northern Ireland
| | - T Wong
- Royal Brompton Hospital, London, United Kingdom of Great Britain & Northern Ireland
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Charters P, O’Brien H, Haldar S, Ash-Miles J. A comparison of the PROMIS trial data with practice in a tertiary referral centre. Clin Radiol 2019. [DOI: 10.1016/j.crad.2019.03.003] [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: 11/29/2022]
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20
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Das R, Dhiman A, Mishra SK, Haldar S, Sharma N, Bansal A, Ahmad Y, Kumar A, Tyagi JS, Sharma TK. Structural switching electrochemical DNA aptasensor for the rapid diagnosis of tuberculous meningitis. Int J Nanomedicine 2019; 14:2103-2113. [PMID: 30988611 PMCID: PMC6440448 DOI: 10.2147/ijn.s189127] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Background Tuberculous meningitis (TBM) is the most devastating manifestation of extra-pulmonary tuberculosis. About 33% of TBM patients die due to very late diagnosis of the disease. Conventional diagnostic methods based on signs and symptoms, cerebrospinal fluid (CSF) smear microscopy or liquid culture suffer from either poor sensitivity or long turnaround time (up to 8 weeks). Therefore, in order to manage the disease efficiently, there is an urgent and unmet need for a rapid and reliable diagnostic test. Methods In the current study, to address the diagnostic challenge of TBM, a highly rapid and sensitive structural switching electrochemical aptasensor was developed by combining the electrochemical property of methylene blue (MB) with the molecular recognition ability of a ssDNA aptamer. To demonstrate the clinical diagnostic utility of the developed aptasensor, a blinded study was performed on 81 archived CSF specimens using differential pulse voltammetry. Results The electrochemical aptasensor developed in the current study can detect as low as 10 pg HspX in CSF background and yields a highly discriminatory response (P<0.0001) for TBM and not-TBM categories with ~95% sensitivity and ~97.5% specificity and has the ability to deliver sample-to-answer in ≤30 minutes. Conclusion In summary, we demonstrate a new aptamer-based electrochemical biosensing strategy by exploiting the target-induced structural switching of H63 SL-2 M6 aptamer and electroactivity of aptamer-tagged MB for the detection of HspX in CSF samples for the diagnosis of TBM. Further, the clinical utility of this sensor could be extended for the diagnosis of other forms of tuberculosis in the near future.
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Affiliation(s)
- Ritu Das
- AptaBharat Innovation Pvt. Ltd., Faridabad, India,
| | - Abhijeet Dhiman
- Department of Biotechnology, All India Institute of Medical Sciences (AIIMS), New Delhi, India, .,Faculty of Pharmacy, Uttarakhand Technical University (UTU), Dehradun, India
| | - Subodh Kumar Mishra
- Discipline of Biosciences and Biomedical Engineering, Indian Institute of Technology Indore, Simrol, India
| | - Sagarika Haldar
- Center for Biodesign and Diagnostics, Translational Health Science and Technology Institute, Faridabad, India, , .,Department of Experimental Medicine and Biotechnology, Post Graduate Institute of Medical Education & Research, Chandigarh, India
| | | | | | - Yusra Ahmad
- Faculty of Pharmacy, Uttarakhand Technical University (UTU), Dehradun, India
| | - Amit Kumar
- Discipline of Biosciences and Biomedical Engineering, Indian Institute of Technology Indore, Simrol, India
| | - Jaya Sivaswami Tyagi
- Department of Biotechnology, All India Institute of Medical Sciences (AIIMS), New Delhi, India, .,Center for Biodesign and Diagnostics, Translational Health Science and Technology Institute, Faridabad, India, ,
| | - Tarun Kumar Sharma
- AptaBharat Innovation Pvt. Ltd., Faridabad, India, .,Center for Biodesign and Diagnostics, Translational Health Science and Technology Institute, Faridabad, India, ,
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Fitzgerald J, May A, McGee M, Leitch J, Haldar S, Sanchez AP, Gizurarson S, Nanthakumar K, Jackson N. Decrement Evoked Potential Mapping (DEEP) for Atrial Fibrillation Ablation. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Kumari P, Lavania S, Tyagi S, Dhiman A, Rath D, Anthwal D, Gupta RK, Sharma N, Gadpayle AK, Taneja RS, Sharma L, Ahmad Y, Sharma TK, Haldar S, Tyagi JS. A novel aptamer-based test for the rapid and accurate diagnosis of pleural tuberculosis. Anal Biochem 2018; 564-565:80-87. [PMID: 30352198 DOI: 10.1016/j.ab.2018.10.019] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 10/17/2018] [Accepted: 10/17/2018] [Indexed: 12/30/2022]
Abstract
Pleural tuberculosis (pTB) is diagnosed by using a composite reference standard (CRS) since microbiological methods are grossly inadequate and an accurate diagnostic test remains an unmet need. The present study aimed to evaluate the utility of Mycobacterium tuberculosis (Mtb) antigen and DNA-based tests for pTB diagnosis. Patients were classified as 'Definite TB', 'Probable TB' and 'Non-TB' disease according to the CRS. We assessed the performance of in-house antigen detection assays, namely antibody-based Enzyme-Linked ImmunoSorbent Assay (ELISA) and aptamer-based Aptamer-Linked Immobilized Sorbent Assay (ALISA), targeting Mtb HspX protein and DNA-based tests namely, Xpert MTB/RIF and in-house devR-qPCR. ROC curves were generated for the combined group of 'Definite TB' and 'Probable TB' vs. 'Non-TB' disease group and cut-off values were derived to provide specificity of ≥98%. The sensitivity of ALISA was ∼93% vs. ∼24% of ELISA (p-value ≤0.0001). devR-qPCR exhibited a sensitivity of 50% vs. ∼22% of Xpert (p-value ≤0.01). This novel aptamer-based ALISA test surpasses the sensitivity criterion and matches the specificity requirement spelt out in the 'Target product profile' for extrapulmonary tuberculosis samples by Unitaid (Sensitivity ≥80%, Specificity 98%). The superior performance of the aptamer-based ALISA test indicates its translational potential to bridge the existing gap in pTB diagnosis.
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Affiliation(s)
- Pooja Kumari
- Department of Biotechnology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India
| | - Surabhi Lavania
- Department of Biotechnology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India
| | - Shaifali Tyagi
- Center for Bio-design and Diagnostics, Translational Health Science and Technology Institute, NCR Biotech Science Cluster, 3rd Milestone, Faridabad, Gurgaon Expressway, PO box #04, Faridabad, 121001, India
| | - Abhijeet Dhiman
- Department of Biotechnology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India; Faculty of Pharmacy, Uttarakhand Technical University, Dehradun, Uttarakhand, India
| | - Deepak Rath
- Dr. Ram Manohar Lohia Hospital, New Delhi, 110001, India
| | - Divya Anthwal
- Center for Bio-design and Diagnostics, Translational Health Science and Technology Institute, NCR Biotech Science Cluster, 3rd Milestone, Faridabad, Gurgaon Expressway, PO box #04, Faridabad, 121001, India
| | - Rakesh Kumar Gupta
- Center for Bio-design and Diagnostics, Translational Health Science and Technology Institute, NCR Biotech Science Cluster, 3rd Milestone, Faridabad, Gurgaon Expressway, PO box #04, Faridabad, 121001, India
| | - Neera Sharma
- Dr. Ram Manohar Lohia Hospital, New Delhi, 110001, India
| | - A K Gadpayle
- Dr. Ram Manohar Lohia Hospital, New Delhi, 110001, India
| | - R S Taneja
- Dr. Ram Manohar Lohia Hospital, New Delhi, 110001, India
| | - Lokesh Sharma
- Dr. Ram Manohar Lohia Hospital, New Delhi, 110001, India
| | - Yusra Ahmad
- Faculty of Pharmacy, Uttarakhand Technical University, Dehradun, Uttarakhand, India
| | - Tarun Kumar Sharma
- Center for Bio-design and Diagnostics, Translational Health Science and Technology Institute, NCR Biotech Science Cluster, 3rd Milestone, Faridabad, Gurgaon Expressway, PO box #04, Faridabad, 121001, India; AptaBharat Innovation Pvt. Ltd., Translational Health Science and Technology Institute Incubator, NCR Biotech Science Cluster, 3rd Milestone, Faridabad, Gurgaon Expressway, PO box #04, Faridabad, 121001, India.
| | - Sagarika Haldar
- Center for Bio-design and Diagnostics, Translational Health Science and Technology Institute, NCR Biotech Science Cluster, 3rd Milestone, Faridabad, Gurgaon Expressway, PO box #04, Faridabad, 121001, India.
| | - Jaya Sivaswami Tyagi
- Department of Biotechnology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India; Center for Bio-design and Diagnostics, Translational Health Science and Technology Institute, NCR Biotech Science Cluster, 3rd Milestone, Faridabad, Gurgaon Expressway, PO box #04, Faridabad, 121001, India.
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Velayutham B, Nair D, Kannan T, Padmapriyadarsini C, Sachdeva KS, Bency J, Klinton JS, Haldar S, Khanna A, Jayasankar S, Swaminathan S. Factors associated with sputum culture conversion in multidrug-resistant pulmonary tuberculosis. Int J Tuberc Lung Dis 2018; 20:1671-1676. [PMID: 27931345 DOI: 10.5588/ijtld.16.0096] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Sputum culture conversion in pulmonary multidrug-resistant tuberculosis (MDR-TB) is important to make treatment-related decisions and prevent transmission of disease. OBJECTIVE To identify factors associated with sputum culture conversion, and to determine time to culture conversion and the impact of culture conversion on successful treatment outcomes in MDR-/rifampicin (RMP) resistant TB. METHOD Retrospective analysis of data from treatment cards and registers of MDR-/RMP-resistant patients initiated on treatment under India's Revised National TB Control Programme in Delhi, West Bengal and Kerala from January 2009 to December 2011. Proportions were calculated and logistic regression analysis was performed. RESULTS Of 836 patients, 787 were analysed, 651 (83%) of whom experienced culture conversion: respectively 57%, 73% and 79% culture converted by month 3, 4 and 6 of treatment. The median time to culture conversion was 91.3 days. Patients with body mass index (BMI) 16 kg/m2 (OR 0.403, P = 0.001) and 1618 kg/m2 (OR 0.519, P = 0.039) were less likely to have culture conversion. High rates of culture conversion were observed in patients with successful treatment outcomes compared to those without treatment success (462/469, 99% vs. 183/311, 59%; P 0.0001). CONCLUSION Low BMI is associated with poor sputum culture conversion in MDR-/RMP-resistant TB patients. Lack of culture conversion can impact successful treatment outcomes.
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Affiliation(s)
- B Velayutham
- National Institute for Research in Tuberculosis, Chennai
| | - D Nair
- National Institute for Research in Tuberculosis, Chennai
| | - T Kannan
- National Institute for Research in Tuberculosis, Chennai
| | | | - K S Sachdeva
- Central TB Division, Ministry of Health and Family Welfare, New Delhi
| | - J Bency
- National Institute for Research in Tuberculosis, Chennai
| | - J S Klinton
- National Institute for Research in Tuberculosis, Chennai
| | - S Haldar
- State TB Cell-West Bengal, Central TB Division, Kolkata
| | - A Khanna
- State TB Cell-Delhi, Central TB Division, New Delhi
| | - S Jayasankar
- State TB Cell-Kerala, Central TB Division, Thiruvananthapuram
| | - S Swaminathan
- Indian Council of Medical Research, New Delhi, India
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Lavania S, Anthwal D, Bhalla M, Singh N, Haldar S, Tyagi JS. Direct detection of Mycobacterium tuberculosis rifampin resistance in bio-safe stained sputum smears. PLoS One 2017; 12:e0189149. [PMID: 29216262 PMCID: PMC5720740 DOI: 10.1371/journal.pone.0189149] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 08/09/2017] [Accepted: 11/20/2017] [Indexed: 11/19/2022] Open
Abstract
Direct smear microscopy of sputum forms the mainstay of TB diagnosis in resource-limited settings. Stained sputum smear slides can serve as a ready-made resource to transport sputum for molecular drug susceptibility testing. However, bio-safety is a major concern during transport of sputum/stained slides and for laboratory workers engaged in processing Mycobacterium tuberculosis infected sputum specimens. In this study, a bio-safe USP (Universal Sample Processing) concentration-based sputum processing method (Bio-safe method) was assessed on 87 M. tuberculosis culture positive sputum samples. Samples were processed for Ziehl-Neelsen (ZN) smear, liquid culture and DNA isolation. DNA isolated directly from sputum was subjected to an IS6110 PCR assay. Both sputum DNA and DNA extracted from bio-safe ZN concentrated smear slides were subjected to rpoB PCR and simultaneously assessed by DNA sequencing for determining rifampin (RIF) resistance. All sputum samples were rendered sterile by Bio-safe method. Bio-safe smears exhibited a 5% increment in positivity over direct smear with a 14% increment in smear grade status. All samples were positive for IS6110 and rpoB PCR. Thirty four percent samples were RIF resistant by rpoB PCR product sequencing. A 100% concordance (κ value = 1) was obtained between sequencing results derived from bio-safe smear slides and bio-safe sputum. This study demonstrates that Bio-safe method can address safety issues associated with sputum processing, provide an efficient alternative to sample transport in the form of bio-safe stained concentrated smear slides and can also provide information on drug (RIF) resistance by direct DNA sequencing.
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Affiliation(s)
- Surabhi Lavania
- Department of Biotechnology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
- School of Biotechnology, Gautam Buddha University, Yamuna Express way, Greater Noida, Uttar Pradesh, India
| | - Divya Anthwal
- Center for Bio-design and Diagnostics, Translational Health Science and Technology Institute, NCR Biotech Science Cluster, 3rd Milestone, Faridabad–Gurgaon Express way, Faridabad, India
| | - Manpreet Bhalla
- Department of Microbiology, National Institute of Tuberculosis and Respiratory Diseases, Mehrauli, New Delhi, India
| | - Nagendra Singh
- School of Biotechnology, Gautam Buddha University, Yamuna Express way, Greater Noida, Uttar Pradesh, India
| | - Sagarika Haldar
- Center for Bio-design and Diagnostics, Translational Health Science and Technology Institute, NCR Biotech Science Cluster, 3rd Milestone, Faridabad–Gurgaon Express way, Faridabad, India
- * E-mail: , (JST); (SH)
| | - Jaya Sivaswami Tyagi
- Department of Biotechnology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
- Center for Bio-design and Diagnostics, Translational Health Science and Technology Institute, NCR Biotech Science Cluster, 3rd Milestone, Faridabad–Gurgaon Express way, Faridabad, India
- * E-mail: , (JST); (SH)
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Khan H, Hnatkova H, Kralj-Hans I, Haldar S, Jones DG, Hussain W, Jarman J, Cowie M, Markides V, Malik M, Wong T. 72Heart rate variability evaluation in patients with long standing persistent atrial fibrillation treated with thoracoscopic surgical ablation with ganglionic plexi ablation or catheter ablation - recordings from implantable loop recorder. Europace 2017. [DOI: 10.1093/europace/eux283.067] [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: 11/14/2022] Open
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Tyagi S, Sharma N, Tyagi JS, Haldar S. Challenges in pleural tuberculosis diagnosis: existing reference standards and nucleic acid tests. Future Microbiol 2017; 12:1201-1218. [PMID: 28972418 DOI: 10.2217/fmb-2017-0028] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Pleural tuberculosis (pTB) is a grave form of extrapulmonary tuberculosis. Microbiological tests are usually found to be inadequate for pTB diagnosis. The absence of a uniform 'composite reference standard' is challenging; therefore, diagnosis is usually performed using a combination of diversified criteria. Nucleic acid tests vary in diagnostic accuracy and have not yet been integrated into clinical decision making. This review assesses the varied criteria used for pTB classification and the challenges afflicting pleural fluid-based DNA diagnostic tests, namely, PCR and Xpert® MTB/RIF. In the 58 studies (PCR: n = 33; Xpert: n = 25) analyzed, reference standards were heterogeneous and PCR/Xpert pooled sensitivity values (range: 0-100%) were inadequate. However, the consistent high specificity of Xpert (range: 90-100%) indicated its utility as a 'rule-in' test. There is an urgent need to evaluate existing and new molecular tests in well-designed studies to accurately assess their utility for pTB diagnosis. To conclude, rapid and accurate tests are warranted for pTB diagnosis.
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Affiliation(s)
- Shaifali Tyagi
- Center for Bio-design & Diagnostics, Translational Health Science & Technology Institute, NCR Biotech Science Cluster, 3rd Milestone, Faridabad - Gurgaon Expressway, PO Box No 04, Faridabad 121001, India
| | - Neera Sharma
- Department of Biochemistry, Dr RML Hospital, New Delhi 110001, India
| | - Jaya Sivaswami Tyagi
- Center for Bio-design & Diagnostics, Translational Health Science & Technology Institute, NCR Biotech Science Cluster, 3rd Milestone, Faridabad - Gurgaon Expressway, PO Box No 04, Faridabad 121001, India.,Department of Biotechnology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India
| | - Sagarika Haldar
- Center for Bio-design & Diagnostics, Translational Health Science & Technology Institute, NCR Biotech Science Cluster, 3rd Milestone, Faridabad - Gurgaon Expressway, PO Box No 04, Faridabad 121001, India
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Khan H, Di Salvo G, Kralj-Hans I, Sivalinganathan M, Hamid S, Butcher C, Haldar S, Panniker S, Jones D, Hussain W, Bahrami T, De Souza T, Markides V, Cowie M, Wong T. P5244Left atrial appendage exclusion as treatment strategy of ablation in longstanding persistent atrial fibrillation does not adversely affect the left atrial function in human. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p5244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Porta Sanchez A, Haldar S, Magtibay K, Masse S, Kusha M, Azam MA, Asta J, Lai PFH, Deno DC, Nanthakumar K. 1155Assessment of transmurality during lesion formation with electrograms. Europace 2017. [DOI: 10.1093/ehjci/eux152.003] [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: 11/12/2022] Open
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Porta Sanchez A, Haldar S, Magtibay K, Masse S, Kusha M, Azam MA, Asta J, Lai PFH, Deno DC, Nanthakumar K. P382Bipolar electrograms directed across wavefronts provide greater physiological accuracy. Europace 2017. [DOI: 10.1093/ehjci/eux141.107] [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: 11/14/2022] Open
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Shi R, Viswanathan K, Mantziari L, Butcher C, Lim E, Khan H, Panikker S, Hussain W, Haldar S, Jones D, Ernst S, Foran J, Markides V, Wong T. P1464Acute and medium-term outcomes following ablation of complex scar-related atrial tachycardia using a high-resolution mapping system. Europace 2017. [DOI: 10.1093/ehjci/eux158.091] [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: 11/13/2022] Open
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Maiti R, Haldar S, Majumdar D, Singha A, Ray SK. Hybrid opto-chemical doping in Ag nanoparticle-decorated monolayer graphene grown by chemical vapor deposition probed by Raman spectroscopy. Nanotechnology 2017; 28:075707. [PMID: 27976628 DOI: 10.1088/1361-6528/aa53e9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The novel opto-chemical doping effect in Ag nanoparticle-decorated monolayer graphene grown by chemical vapor deposition has been investigated using Raman spectroscopy for the first time. We used both noble metal nanoparticles and optical excitation, in a hybrid opto-chemical route, to tune the doping level in graphene. Metal nanoparticle-induced chemical effects and laser power-induced substrate effects alter the doping nature of graphene from p- to n-type. Compared with earlier studies, the proposed method significantly lowers the laser intensity required for optical power-dependent doping, resulting in prevention of damage to the sample due to local heating. Some other interesting observations are the enhanced peak intensity in the Raman spectrum of graphene, enhancement of the D-band intensity and the introduction of G-band splitting. This novel, cheap and easily implemented hybrid optical-chemical doping strategy could be very useful for tuning graphene plasmons on the widely used Si/SiO2 substrates for various photonic device applications.
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Affiliation(s)
- R Maiti
- Department of Physics, Indian Institute of Technology, Kharagpur, Kharagpur-721302, India
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Pathak M, Mandal GP, Patra AK, Samanta I, Pradhan S, Haldar S. Effects of dietary supplementation of cinnamaldehyde and formic acid on growth performance, intestinal microbiota and immune response in broiler chickens. Anim Prod Sci 2017. [DOI: 10.1071/an15816] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
An experiment was conducted to investigate the effects of replacing antibiotic growth promoter (AGP) with a combination of essential oil and organic acids (EO + OA) on growth performance, gut microbiota and immune response in broiler chickens. In Experiment 1, 320 day-old broiler chicks were randomly distributed to 32 pens with 10 birds in each pen and the pens were equally allotted to four treatment groups. In Experiment 2, 120 day-old chicks were divided into the same four treatment groups, each group containing three replicated pens with 10 birds in each pen. The groups were (1) Negative Control (NC) without AGP or other growth-promoting feed additives; (2) AGP (NC + enramycin; 125 mg/kg feed; (3) OA (NC + OA; 500 mg/kg feed); and (4) EO + OA (NC + a combination of cinnamaldehyde and calcium formate; 500 mg/kg feed). Experiment 1 lasted for 40 days, whereas Experiment 2 continued for 28 days. In Experiment 2, all birds were orally challenged with Escherichia coli (108 bacteria/bird) on Day 14. Overall intake, growth and feed conversion ratio (FCR) on Day 40 had no difference (P > 0.05) among the groups in Experiment 1. In Experiment 2, growth, feed intake and FCR were not affected by any dietary treatments until Day 14, but after being challenged with E. coli, bodyweight gain and FCR improved (P < 0.05) for AGP and EO + OA compared with NC. Mortality rate was also lower (P < 0.05) for AGP and EO + OA than NC in Experiment 2. Villi height was higher (P < 0.001) in OA and EO + OA groups compared with NC and AGP groups. Any treatment did not affect (P > 0.05) the counts of total bacteria, E. coli and Lactobacillus in the contents of ileum and caecum. However, Salmonella counts in the ileal and caecal contents decreased (P < 0.001) for AGP, OA and EO + OA compared with NC group. Clostridium counts were lower for EO + OA group than for NC and AGP groups in the ileum, and for AGP, OA and EO + OA groups than for NC in the caeca (P < 0.05). Antibody titer on Day 35 against Newcastle disease vaccine was higher in EO + OA group than in NC, AGP and OA groups (P < 0.001). In conclusion, EO + OA did not affect growth and FCR in broilers. However, AGP and EO + AO improved growth performance and FCR after being challenged with E. coli. Moreover, EO + OA was effective in reducing the Clostridium count in the small intestine and caecum and increasing the villus height and antibody titer against Newcastle disease vaccine.
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Evans J, Silberbauer J, Glover B, Kontogeorgis A, McLellan A, Panikker S, Sieniewicz B, Martin C, Burg M, Providencia R, Behar J, Burke M, Withers K, White J, Lencioni M, Carolan-Rees G, Wood K, Patrick H, Griffith M, Gomes J, Kirubakaran S, O'Nunain S, Bencat M, McCready J, Michael K, Hashemi J, Gupta D, Akl S, Redfearn D, Lim E, Panikker S, Butcher C, Khan H, Mantziari L, Jarman J, Hussain W, Jones D, Clague J, Ernst S, Markides V, Wong T, Ezzat V, Schilling R, Lowe M, Whitaker J, Virmani R, Kutys R, Jarman J, Fastl T, Haldar S, Butcher C, Khan H, Mantziari L, O'Neill M, Corado C, Nicol E, Foran J, Markides V, Niederer S, Wong T, Behar J, Sohal M, Jais P, Derval N, Spragg D, Van Gelder B, Bracke F, Steendijk P, Rinaldi C, Chooneea B, Gajendragadkar P, Ahsan S, Begley D, Dhinoja M, Earley M, Ezzat V, Finlay M, Grace A, Heck P, Hunter R, Lambiase P, Lowe M, Rowland E, Schilling R, Segal O, Sporton S, Virdee M, Chow A, Apap Bologna R, Camilleri W, Sammut M, Aquilina O, Barra S, Papageorgiou N, Falconer D, Duehmke R, Rehal O, Ahsan S, Ezzat V, Dhinoja M, Ioannou A, Segal O, Sporton S, Rowland E, Lowe M, Lambiase P, Agarwal S, Chow A, Toth D, Mountney P, Reiml S, Panayioutu M, Brost A, Fahn B, Sohal M, Patel N, Claridge S, Jackson T, Adhya S, Sieniwicz B, O'Neill M, Razavi R, Rhode K, Rinaldi C, Tjong F, Brouwer T, Koop B, Soltis B, Shuros A, Knops R. ORAL ABSTRACTS (2)EP & Ablation19CARDIAC ABLATION PATIENT REPORTED OUTCOMES MEASURES (PROMS): ANALYSIS OF POST-ABLATION AND 1 YEAR FOLLOW-UP DATA20INTENTIONAL CORONARY VEIN EXIT AND CARBON DIOXIDE INSUFFLATION TO ALLOW SAFE SUBXIPHOID EPICARDIAL ACCESS FOR VENTRICULAR MAPPING AND ABLATION - FIRST EXPERIENCE21PACED FRACTIONATION DETECTION AS A TOOL FOR MAPPING SCARS IN VT22DOES USE OF CONTACT-FORCE SENSING CATHETERS IMPROVE THE OUTCOME OF ABLATION OF VENTRICULAR TACHYCARDIA?23RETROGRADE AORTIC ACCESS OF THE PULMONARY VENOUS ATRIUM PROVIDES EQUIVALENT OUTCOMES TO RIGHT ATRIAL OR TRANSEPTAL ACCESS OF THE LEFT ATRIUM IN PATIENTS WITH CONGENITAL HEART DISEASE24COMPUTATIONAL THREE-DIMENSION LEFT ATRIAL APPENDAGE WALL THICKNESS MAPS AND HISTOLOGICAL ANALYSIS TO GUIDE LEFT ATRIAL APPENDAGE ELECTRICAL ISOLATIONPacing & Devices25IDENTIFYING THE OPTIMAL LOCATION FOR LV ENDOCARIDAL PACING:RESULTS FROM A MULTICENTRE INTERNATIONAL REGISTRY OF LV ENDOCARDIAL PACING26UK MULTI-CENTRE REGISTRY OF TRANSVENOUS LEAD EXTRACTION: CLINICAL OUTCOME USING TRACTION, CUTTING SHEATHS AND LASER TECHNIQUES27SKIN FISTULA FORMATION - A NEW EXPERIENCE WITH THE NEW TYRX ABSORBABLE ANTIMICROVIAL ENVELOPE28BIFOCAL RIGHT VENTRICULAR PACING IN PATIENTS WITH FAILED CORONARY-SINUS LEAD IMPLANTS: LONG-TERM RESULTS FROM MULTICENTRE REGISTRY29REAL TIME X-MRI GUIDED LEFT VENTRICULAR LEAD IMPLANTATION FOR TARGETED DELIVERY OF CARDIAC RESYNCHRONIZATION THERAPY30ACUTE AND CHRONIC PERFORMANCE OF COMMUNICATING LEADLESS ANTI-TACHYCARDIA PACEMAKER AND SUBCUTANEOUS IMPLANTABLE DEFIBRILLATOR. Europace 2016. [DOI: 10.1093/europace/euw271] [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: 11/12/2022] Open
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Zeriouh M, Popov AF, Sabashnikov A, Haldar S, Weymann A, Wong T, Simon A, Bahrami T. The Totally Thoracoscopic Surgical Ablation with an Alternative Method of Conduction Testing: How we do it. Thorac Cardiovasc Surg 2015. [DOI: 10.1055/s-0035-1544499] [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: 10/24/2022]
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Haldar S, Mandalia U, Skelton E, Chow V, Turner SS, Ramesar K, Tighe D, Williams M, Howlett D. Diagnostic investigation of parotid neoplasms: a 16-year experience of freehand fine needle aspiration cytology and ultrasound-guided core needle biopsy. Int J Oral Maxillofac Surg 2014; 44:151-7. [PMID: 25457828 DOI: 10.1016/j.ijom.2014.09.025] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [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: 05/17/2014] [Revised: 07/25/2014] [Accepted: 09/30/2014] [Indexed: 01/12/2023]
Abstract
This study aimed to examine the diagnostic yield of fine needle aspiration cytology (FNAC) and ultrasound-guided core needle biopsy (USCB) in the diagnosis of parotid neoplasia. A 16-year retrospective analysis was performed of patients entered into our pathology database with a final diagnosis of parotid neoplasia. FNAC and USCB data were compared to surgical excision where available. One hundred and twenty FNAC, 313 USCB, and 259 surgical specimens were analyzed from 397 patients. Fifty-six percent of FNAC and 4% of USCB were non-diagnostic. One hundred and thirty-two (33%) patients had a final diagnosis made by USCB and did not undergo surgery. Surgery was performed in 257 (65%) patients, 226 (88%) of whom had a preoperative biopsy. Most lesions were benign, but there were 62 parotid and 13 haematological malignancies diagnosed; false-negative results were obtained in three FNAC and two USCB samples. The sensitivity and specificity of FNAC were 70% and 89%, respectively, and for USCB were 93% and 100%, respectively. This study represents the largest series of patients with a parotid neoplasm undergoing USCB for diagnosis. USCB is highly accurate with a low non-diagnostic rate and should be considered an integral part of parotid assessment.
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Affiliation(s)
- S Haldar
- Department of Radiology, Eastbourne District General Hospital, Eastbourne, East Sussex, UK.
| | - U Mandalia
- Department of Radiology, Eastbourne District General Hospital, Eastbourne, East Sussex, UK
| | - E Skelton
- Department of Radiology, Eastbourne District General Hospital, Eastbourne, East Sussex, UK
| | - V Chow
- Department of Radiology, Eastbourne District General Hospital, Eastbourne, East Sussex, UK
| | - S S Turner
- Department of Radiology, Eastbourne District General Hospital, Eastbourne, East Sussex, UK
| | - K Ramesar
- Department of Radiology, Eastbourne District General Hospital, Eastbourne, East Sussex, UK
| | - D Tighe
- Department of Radiology, Eastbourne District General Hospital, Eastbourne, East Sussex, UK
| | - M Williams
- Department of Radiology, Eastbourne District General Hospital, Eastbourne, East Sussex, UK
| | - D Howlett
- Department of Radiology, Eastbourne District General Hospital, Eastbourne, East Sussex, UK
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Tighe D, Haldar S, Mandalia U, Skelton E, Ramesar K, Williams M, Howlett D. Diagnostic investigation of parotid neoplasms - A 14 year experience of freehand fine needle aspiration cytology and ultrasound guided core needle biopsy. Br J Oral Maxillofac Surg 2014. [DOI: 10.1016/j.bjoms.2014.07.074] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Panikker S, Lord J, Jarman J, Foran JP, Haldar S, Jones DG, Salukhe T, Clague JR, Markides V, Wong T. 45 * Real world experience left atrial appendage closure provides superior cost benefits relative to new and established oral anticoagulants. Europace 2014. [DOI: 10.1093/europace/euu240.3] [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: 11/14/2022] Open
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Schmitz D, Schmitz-Antoniak C, Warland A, Darbandi M, Haldar S, Bhandary S, Eriksson O, Sanyal B, Wende H. The dipole moment of the spin density as a local indicator for phase transitions. Sci Rep 2014; 4:5760. [PMID: 25041757 PMCID: PMC4104392 DOI: 10.1038/srep05760] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [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: 03/21/2014] [Accepted: 07/02/2014] [Indexed: 11/17/2022] Open
Abstract
The intra-atomic magnetic dipole moment - frequently called 〈Tz〉 term - plays an important role in the determination of spin magnetic moments by x-ray absorption spectroscopy for systems with nonspherical spin density distributions. In this work, we present the dipole moment as a sensitive monitor to changes in the electronic structure in the vicinity of a phase transiton. In particular, we studied the dipole moment at the Fe2+ and Fe3+ sites of magnetite as an indicator for the Verwey transition by a combination of x-ray magnetic circular dichroism and density functional theory. Our experimental results prove that there exists a local change in the electronic structure at temperatures above the Verwey transition correlated to the known spin reorientation. Furthermore, it is shown that measurement of the dipole moment is a powerful tool to observe this transition in small magnetite nanoparticles for which it is usually screened by blocking effects in classical magnetometry.
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Affiliation(s)
- D Schmitz
- Helmholtz-Zentrum Berlin für Materialien und Energie, Albert-Einstein-Straße 15, D-12489 Berlin, Germany
| | - C Schmitz-Antoniak
- 1] Fakultät für Physik and Center for Nanointegration Duisburg-Essen (CENIDE), Universität Duisburg-Essen, Lotharstr. 1, D-47048 Duisburg, Germany [2]
| | - A Warland
- Fakultät für Physik and Center for Nanointegration Duisburg-Essen (CENIDE), Universität Duisburg-Essen, Lotharstr. 1, D-47048 Duisburg, Germany
| | - M Darbandi
- 1] Fakultät für Physik and Center for Nanointegration Duisburg-Essen (CENIDE), Universität Duisburg-Essen, Lotharstr. 1, D-47048 Duisburg, Germany [2]
| | - S Haldar
- Division of Materials Theory, Department of Physics and Astronomy, Uppsala University, Box-516, SE 75120 Uppsala, Sweden
| | - S Bhandary
- Division of Materials Theory, Department of Physics and Astronomy, Uppsala University, Box-516, SE 75120 Uppsala, Sweden
| | - O Eriksson
- Division of Materials Theory, Department of Physics and Astronomy, Uppsala University, Box-516, SE 75120 Uppsala, Sweden
| | - B Sanyal
- Division of Materials Theory, Department of Physics and Astronomy, Uppsala University, Box-516, SE 75120 Uppsala, Sweden
| | - H Wende
- Fakultät für Physik and Center for Nanointegration Duisburg-Essen (CENIDE), Universität Duisburg-Essen, Lotharstr. 1, D-47048 Duisburg, Germany
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Tapader R, Chatterjee S, Singh AK, Dayma P, Haldar S, Pal A, Basu S. The high prevalence of serine protease autotransporters of Enterobacteriaceae (SPATEs) in Escherichia coli causing neonatal septicemia. Eur J Clin Microbiol Infect Dis 2014; 33:2015-24. [PMID: 24924922 DOI: 10.1007/s10096-014-2161-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2014] [Accepted: 05/12/2014] [Indexed: 01/02/2023]
Abstract
Serine protease autotransporters of Enterobacteriaceae (SPATEs) are secreted proteins demonstrating diverse virulence functions. The distribution of SPATEs is studied among diarrheagenic and extraintestinal pathogenic Escherichia coli. However, the contribution of SPATEs to the virulence of neonatal septicemic Escherichia coli (NSEC) has not yet been elucidated. This study was undertaken to evaluate the prevalence and phylogenetic distribution of different subtypes of SPATEs among NSEC. The presence of virulence factors and subtypes of SPATEs among different E. coli isolates was determined by polymerase chain reaction (PCR). E. coli phylogrouping was done by triplex PCR. Clonality of the isolates was assessed by pulsed-field gel electrophoresis (PFGE). The presence of SPATEs was significantly higher among the septicemic isolates (89 %) than the fecal (7.5 %) and environmental isolates (2.5 %). Vat (vacuolating autotransporter toxin) and Sat (secreted autotransporter toxin) were found to be the two most predominant SPATEs. The incidence of SPATEs was high in septicemic isolates of phylogroups A and B1 (87 %), lacking other virulence factors. The high prevalence of SPATEs in the non-B2 phylogroups of septicemic isolates in comparison with fecal and environmental isolates indicates an association of SPATEs with NSEC. The NSEC isolates were found to be clonally distinct, suggesting that the high prevalence of SPATEs was not due to clonal relatedness of the isolates. This study is the first to show the association of SPATEs with NSEC. The presence of SPATEs in the septicemic/NSEC isolates may be considered as the most discriminatory trait studied here.
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Affiliation(s)
- R Tapader
- Division of Pathophysiology, National Institute of Cholera and Enteric Diseases, Kolkata, 700010, India
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Rambhia KD, Haldar S, Dongre AM, Khopkar US. Granulomatous slack skin with systemic involvement and a fatal outcome in an adolescent. Clin Exp Dermatol 2014; 39:653-4. [DOI: 10.1111/ced.12338] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/19/2013] [Indexed: 11/29/2022]
Affiliation(s)
- K. D. Rambhia
- Department of Dermatology; Seth GS Medical College; KEM Hospital; Parel Mumbai Maharashtra India
| | - S. Haldar
- Department of Dermatology; Seth GS Medical College; KEM Hospital; Parel Mumbai Maharashtra India
| | - A. M. Dongre
- Department of Dermatology; Seth GS Medical College; KEM Hospital; Parel Mumbai Maharashtra India
| | - U. S. Khopkar
- Department of Dermatology; Seth GS Medical College; KEM Hospital; Parel Mumbai Maharashtra India
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Haldar S, Turner SS, Olubaniyi B, Howlett DC. Extensive pneumatosis coli and intraperitoneal free air. Assoc Med J 2013. [DOI: 10.1136/bmj.f3386] [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: 11/03/2022]
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Singh A, Walk C, Ghosh T, Bedford M, Haldar S. Effect of a novel microbial phytase on production performance and tibia mineral concentration in broiler chickens given low-calcium diets. Br Poult Sci 2013; 54:206-15. [PMID: 23647184 DOI: 10.1080/00071668.2013.775403] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- A. Singh
- Department of Animal Nutrition, West Bengal University of Animal & Fishery Sciences , Kolkata, 700037, India
| | - C.L. Walk
- AB Vista, Marlborough , Wiltshire, SN8 4AN, UK
| | - T.K. Ghosh
- Department of Animal Nutrition, West Bengal University of Animal & Fishery Sciences , Kolkata, 700037, India
| | | | - S. Haldar
- Department of Animal Nutrition, West Bengal University of Animal & Fishery Sciences , Kolkata, 700037, India
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Haldar S, Sankhyan N, Sharma N, Bansal A, Jain V, Gupta VK, Juneja M, Mishra D, Kapil A, Singh UB, Gulati S, Kalra V, Tyagi JS. Detection of Mycobacterium tuberculosis GlcB or HspX Antigens or devR DNA impacts the rapid diagnosis of tuberculous meningitis in children. PLoS One 2012; 7:e44630. [PMID: 22984534 PMCID: PMC3440320 DOI: 10.1371/journal.pone.0044630] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2012] [Accepted: 08/06/2012] [Indexed: 01/22/2023] Open
Abstract
Background Tuberculous meningitis (TBM) is the most common form of neurotuberculosis and the fifth most common form of extrapulmonary TB. Early diagnosis and prompt treatment are the cornerstones of effective disease management. The accurate diagnosis of TBM poses a challenge due to an extensive differential diagnosis, low bacterial load and paucity of cerebrospinal fluid (CSF) especially in children. Methodology/Principal Findings We describe the utility of ELISA and qPCR for the detection of Mycobacterium tuberculosis (M. tb) proteins (GlcB, HspX, MPT51, Ag85B and PstS1) and DNA for the rapid diagnosis of TBM. CSF filtrates (n = 532) derived from children were classified as ‘Definite’ TBM (M. tb culture positive, n = 29), ‘Probable and Possible’ TBM (n = 165) and ‘Not-TBM’ including other cases of meningitis or neurological disorders (n = 338). ROC curves were generated from ELISA and qPCR data of ‘Definite’ TBM and Non-Tuberculous infectious meningitis (NTIM) samples and cut-off values were derived to provide ≥95% specificity. devR qPCR, GlcB, HspX and PstS1 ELISAs showed 100% (88;100) sensitivity and 96–97% specificity in ‘Definite’ TBM samples. The application of these cut-offs to ‘Probable and Possible’ TBM groups yielded excellent sensitivity (98%, 94;99) and specificity (98%, 96;99) for qPCR and for GlcB, HspX and MPT51 antigen ELISAs (sensitivity 92–95% and specificity 93–96%). A test combination of qPCR with GlcB and HspX ELISAs accurately detected all TBM samples at a specificity of ∼90%. Logistic regression analysis indicated that these tests significantly added value to the currently used algorithms for TBM diagnosis. Conclusions The detection of M. tb GlcB/HspX antigens/devR DNA in CSF is likely to improve the utility of existing algorithms for TBM diagnosis and also hasten the speed of diagnosis.
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Affiliation(s)
- Sagarika Haldar
- Department of Biotechnology, All India Institute of Medical Sciences, New Delhi, India
| | - Naveen Sankhyan
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Neera Sharma
- Department of Biochemistry and Department of Pediatrics, Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Anjali Bansal
- Department of Biochemistry and Department of Pediatrics, Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Vitul Jain
- Department of Biotechnology, All India Institute of Medical Sciences, New Delhi, India
| | - V. K. Gupta
- Department of Biochemistry and Department of Pediatrics, Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Monica Juneja
- Department of Pediatrics, Maulana Azad Medical College and Lok Nayak Hospital, New Delhi, India
| | - Devendra Mishra
- Department of Pediatrics, Maulana Azad Medical College and Lok Nayak Hospital, New Delhi, India
| | - Arti Kapil
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Urvashi B. Singh
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Sheffali Gulati
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Veena Kalra
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Jaya Sivaswami Tyagi
- Department of Biotechnology, All India Institute of Medical Sciences, New Delhi, India
- * E-mail:
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Muthusamy N, Haldar S, Ghosh TK, Bedford MR. Effects of hydrolysed Saccharomyces cerevisiae yeast and yeast cell wall components on live performance, intestinal histo-morphology and humoral immune response of broilers. Br Poult Sci 2012; 52:694-703. [PMID: 22221235 DOI: 10.1080/00071668.2011.633072] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
1. The effects of enzymatically hydrolysed whole Saccharomyces cerevisiae yeast (HY) and the pellets of yeast cell wall (YCW) on production traits, the microbiology and histo-morphology of the small intestine, and humoral immune responses against Newcastle disease virus (NDV), of Ross 308 broilers were investigated. 2. The control group received a maize-soyabean meal based basal diet for 42 days. In the treated groups the basal diet was supplemented with 1 g/kg of HY and YCW. There were 8 replicate pens per group (n = 12 birds/pen). 3. HY and YCW supplementation improved live weight (P = 0·006) and FCR (P = 0·003) at 42-d as compared with the control group. 4. In the small intestine, Salmonella spp and Escherichia coli numbers were higher (P = 0·01) in the mucosa and lower (P = 0·01) in the digesta of the HY and the YCW fed groups at 25 d of age. Lactobacillus in the duodenal and jejunal digesta was higher (P < 0·05) in the HY and the YCW fed groups as compared with the control. 5. Following oral challenge with Salmonella pullorum, Escherichia coli and Lactobacillus increased (P < 0·05) in the mucosa and decreased in the digesta (P < 0·05) of the HY and YCW supplemented groups, relative to the control. 6. Supplementation of HY and YCW increased villus height in the jejunum (P = 0·02), width of villus in the ileum (P = 0·034) and number of goblet cells in villi of the jejunum (P = 0·006) and ileum (P = 0·01). 7. YCW increased antibody level against NDV at 21 and 42 d of age compared with the control and the HY supplemented diets (P < 0·05). 8. It was concluded that HY and YCW improved growth and feed efficiency in broilers, and considering the improvements in production traits and humoral immune responses, yeast cell wall may be a better dietary tool than the hydrolysed whole yeast cell as a performance enhancer for broilers.
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Affiliation(s)
- N Muthusamy
- Department of Animal Nutrition , West Bengal University of Animal & Fishery Sciences, Kolkata 700037, India
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Haldar S, Bose M, Chakrabarti P, Daginawala HF, Harinath B, Kashyap RS, Kulkarni S, Majumdar A, Prasad HK, Rodrigues C, Srivastava R, Taori GM, Varma-Basil M, Tyagi JS. Improved laboratory diagnosis of tuberculosis – The Indian experience. Tuberculosis (Edinb) 2011; 91:414-26. [DOI: 10.1016/j.tube.2011.06.003] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2010] [Revised: 04/26/2011] [Accepted: 06/12/2011] [Indexed: 11/28/2022]
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Haldar S, Ghosh T, Toshiwati, Bedford M. Effects of yeast (Saccharomyces cerevisiae) and yeast protein concentrate on production performance of broiler chickens exposed to heat stress and challenged with Salmonella enteritidis. Anim Feed Sci Technol 2011. [DOI: 10.1016/j.anifeedsci.2011.03.007] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Ghosh TK, Haldar S, Bedford MR, Muthusami N, Samanta I. Assessment of yeast cell wall as replacements for antibiotic growth promoters in broiler diets: effects on performance, intestinal histo-morphology and humoral immune responses. J Anim Physiol Anim Nutr (Berl) 2011; 96:275-84. [DOI: 10.1111/j.1439-0396.2011.01155.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Neogi S, Chowdhury N, Asakura M, Hinenoya A, Haldar S, Saidi S, Kogure K, Lara R, Yamasaki S. A highly sensitive and specific multiplex PCR assay for simultaneous detection of Vibrio cholerae, Vibrio parahaemolyticus and Vibrio vulnificus. Lett Appl Microbiol 2010; 51:293-300. [DOI: 10.1111/j.1472-765x.2010.02895.x] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Chowdhury N, Asakura M, Neogi S, Hinenoya A, Haldar S, Ramamurthy T, Sarkar B, Faruque S, Yamasaki S. Development of simple and rapid PCR‐fingerprinting methods for
Vibrio cholerae
on the basis of genetic diversity of the superintegron. J Appl Microbiol 2010; 109:304-12. [DOI: 10.1111/j.1365-2672.2009.04658.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- N. Chowdhury
- Graduate School of Life and Environmental Sciences, Osaka Prefecture University, Osaka, Japan
| | - M. Asakura
- Graduate School of Life and Environmental Sciences, Osaka Prefecture University, Osaka, Japan
- Research and Development Centre, Fuso Pharmaceutical Industries Ltd., Osaka, Japan
| | - S.B. Neogi
- Graduate School of Life and Environmental Sciences, Osaka Prefecture University, Osaka, Japan
| | - A. Hinenoya
- Graduate School of Life and Environmental Sciences, Osaka Prefecture University, Osaka, Japan
| | - S. Haldar
- Graduate School of Life and Environmental Sciences, Osaka Prefecture University, Osaka, Japan
| | - T. Ramamurthy
- National Institute of Cholera and Enteric Diseases, Kolkata, India
| | - B.L. Sarkar
- National Institute of Cholera and Enteric Diseases, Kolkata, India
| | - S.M. Faruque
- Molecular Genetics Laboratory, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - S. Yamasaki
- Graduate School of Life and Environmental Sciences, Osaka Prefecture University, Osaka, Japan
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Haldar S, Haendiges S, Edge-Garza D, Oraguzie N, Olmstead J, Peace C, Iezzoni A. APPLYING GENETIC MARKERS FOR SELF-COMPATIBILITY IN THE WSU SWEET CHERRY BREEDING PROGRAM. ACTA ACUST UNITED AC 2010. [DOI: 10.17660/actahortic.2010.859.45] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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