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Nain N, Singh A, Khan S, Kukreti S. G-quadruplex formation at human DAT1 gene promoter: Effect of cytosine methylation. Biochem Biophys Rep 2023; 34:101464. [PMID: 37096205 PMCID: PMC10121379 DOI: 10.1016/j.bbrep.2023.101464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 03/28/2023] [Accepted: 03/31/2023] [Indexed: 04/26/2023] Open
Abstract
The dopamine transporter gene (DAT1), a recognized genetic risk factor for attention deficit hyperactivity disorder (ADHD) is principally responsible for the regulation of dopamine synaptic levels and serves as a key target in many psychostimulants drugs. DAT1 gene methylation has been considered an epigenetic marker in ADHD. The identification of G-rich sequence motifs potential to form G-quadruplexes is correlated with functionally important genomic regions. Herein, biophysical and biochemical techniques are employed to investigate the structural polymorphism along with the effect of cytosine methylation on a 26-nt G-rich sequence present in the promoter region of the DAT1 gene. The gel electrophoresis, circular dichroism spectroscopy, and UV-thermal melting data are well correlated and conclude the formation of a parallel (bimolecular), as well as antiparallel (tetramolecular) G-quadruplex in Na+ solution. Interestingly, the existence of uni-, bi-, tri-, and tetramolecular quadruplex structures in K+ solution exhibited only the parallel type G-quadruplex. The results demonstrate that in presence of either cation (Na+ or K+) the cytosine methylation reserved the structural topologies unaltered. However, methylation lowers the thermal stability of G-quadruplexes and the duplex structures, as well. These findings provide insights to understand the regulatory mechanisms underlying the formation of the G-quadruplex structure induced by DNA methylation.
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Singh RK, Singh A, Anand S, Kumar D, Ahmad A, Tanwar AS. Knowledge and Information Resources about Child Abuse among Government and Private Dental Practitioner in Uttar Pradesh, India. Niger J Clin Pract 2023; 26:674-679. [PMID: 37470638 DOI: 10.4103/njcp.njcp_296_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/21/2023]
Abstract
Background and Aim To evaluate knowledge, attitude, and information sources about child abuse and neglect (CAN) among dentists in Varanasi district of Uttar Pradesh state, India. Subjects and Methods A cross-sectional online survey was carried out of dentist working in government and private hospitals in the Varanasi district, Uttar Pradesh State, India (n = 674). The structured questionnaire was sent through electronic mail that contained the consent form, instructions for filling, and returning the questionnaire. The data obtained were systematically compiled and the Chi-square test was applied to test the association. The significance level of P ≤ 0.05 was applied. Results A maximum number of dental practitioners from the government (81.97%) and private sector (85.98%) were aware of the child protection law. A significant number of government and private dental practitioners were satisfied with their knowledge (p = 0.0092); however, 83.79% suggested that the continuing education programs/courses were important tool to update their knowledge. The girl child was maximum sufferer (p = 0.0056) of CAN. Only 14.08% of practitioners acted on the suspected cases, and a statistical significant relation was observed between the government and private dental practitioners for not taking any action on child abuse and neglect (p = 0.0010). Conclusions Data from this study may provide a useful contribution to the current limited knowledge about the familiarity of dental practitioners with child maltreatment and their skills to recognize and manage CAN cases in their practice. The majority of dental practitioners knew about the child protection law in India, but they were reluctant to report such cases due to the fear of anger from the parents and family of the child. Continuing education programs/courses were the most preferred method for increasing the knowledge regarding CAN. They should report the CAN cases to local legislators and health authorities so to prevent child abuse and neglect from ever occurring.
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Arun J, Singh A, Shashidhar E, Patel G, Verma Y, Sapcota S. THE ROLE OF IMMUNOTHERAPY IN CANCER TREATMENT: CHECKPOINT INHIBITORS, CAR-T CELLS, AND VACCINES. GEORGIAN MEDICAL NEWS 2023:105-112. [PMID: 37522784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 08/01/2023]
Abstract
Immunotherapy causes cancer patients' immune systems to activate in search of and eliminate cancer cells. As a therapeutic area for cancer, it has expanded in importance and demonstrated promising results in treating many cancers. Checkpoint blockade (CPB) therapy may stimulate a suppressed immune response to provide long-lasting therapeutic results. However, the absence of a tumor-reactive immune infiltration is probably why response rates are still low. Using chimeric antigen receptor (CAR)-modified T cells to fight cancer may significantly impact immunology. This study explored using checkpoint inhibitors, car-T cells, and vaccines in immunotherapy to treat cancers. Drugs used for CPB aim to reduce immunological suppression, allowing for more effective CAR T cells and dendritic cell (DC) vaccines, providing some optimism that this may be increased, both of which have proven therapeutic efficacy in specific cancers. However, drug-induced side effects and the tumor microenvironment's propensity for immunosuppression mean treatment effectiveness is still inadequate. The outcomes of current preclinical tests suggest that novel therapies targeting lymphocyte-activation gene 3 (LAG3), T cell immunoglobulin and mucin-domain containing-3 (TIM3), cytotoxic T lymphocyte-associated protein 4 (CTLA-4), and programmed cell death protein 1 (PD-1) could be used as adjuvant therapies to modify the tumor microenvironment.
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Mondal K, Mourya A, Choudhary S, Mandal A, Singh A, Aggarwal LM. Plan quality score to evaluate the dwell time deviation restricted inverse planning by simulated annealing and graphically optimized treatment plans for template based interstitial brachytherapy. Cancer Radiother 2023; 27:196-205. [PMID: 37088572 DOI: 10.1016/j.canrad.2022.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 09/15/2022] [Accepted: 10/18/2022] [Indexed: 04/25/2023]
Abstract
PURPOSE To evaluate the impact of dwell time deviation constraint (DTDC) on the quality of IPSA-optimized treatment plans in comparison with graphical plans using plan quality scores (PQS). MATERIAL AND METHODS Seventy optimized plans (graphical & IPSA with different DTDC values) of ten cervical cancer patients were generated. Various DVH parameters like D90, V100, V150, V200, V300 were compared to evaluate the impact of DTDC on target coverage and high dose regions inside target for different plans. Similarly, for the OAR dose, values of D2cc were compared. Various planning parameters like CI, COIN, DHI, DNR, ODI, EI and gain factor (GF) for different OARs were calculated. Based on these indices a plan quality score (PQS) was formulated and calculated. PQS values were used to see the impact of DTDC on plan quality of IPSA in comparison with dosimetric quality of graphical plan. RESULTS We have found that target coverage is similar for IPSA and graphically optimized treatment plans. However, dose homogeneity was improved in IPSA compared to graphical optimization whereas conformality was better in graphically optimized plans. OAR dose was less in IPSA plans. High-dose regions inside the target were also reduced in IPSA comparatively. However, IPSA plans optimized with various values of DTDC did not necessarily reduce high-dose regions beyond 0.6. Plan quality scores (PQS) were 6.31, 6.31, 6.34, and 6.17 for the graphically optimized plan, IPSA with DTDC values of 0.0, 0.4, and 1.0 respectively. CONCLUSION We found that IPSA is dosimetrically advantageous over graphical optimization. IPSA with a DTDC value of 0.4 improved overall plan quality. However, DTDC value beyond 0.6 produces dosimetrically sub-optimal plans hence the use of DTDC should be very selective and limited.
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Singh A, Kukal S, Kanojia N, Singh M, Saso L, Kukreti S, Kukreti R. Lipid Mediated Brain Disorders: A Perspective. Prostaglandins Other Lipid Mediat 2023; 167:106737. [PMID: 37086954 DOI: 10.1016/j.prostaglandins.2023.106737] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 04/10/2023] [Accepted: 04/18/2023] [Indexed: 04/24/2023]
Abstract
The brain, one of the most resilient organs of the body is highly enriched in lipid content, suggesting the essential role of lipids in brain physiological activities. Lipids constitute an important structural part of the brain and act as a rich source of metabolic energy. Besides, lipids in their bioactive form (known as bioactive lipids) play an essential signaling and regulatory role, facilitating neurogenesis, synaptogenesis, and cell-cell communication. Brain lipid metabolism is thus a tightly regulated process. Any alteration/dysregulation of lipid metabolism greatly impact brain health and activity. Moreover, since central nervous system (CNS) is the most metabolically active system and lacks an efficient antioxidative defence system, it acts as a hub for the production of reactive oxygen species (ROS) and subsequent lipid peroxidation. These peroxidation events are reported during pathological changes such as neuronal tissue injury and inflammation. Present review is a modest attempt to gain insights into the role of dysregulated bioactive lipid levels and lipid oxidation status in the pathogenesis and progression of neurodegenerative disorders. This may open up new avenues exploiting lipids as the therapeutic targets for improving brain health, and treatment of nervous system disorders.
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Raghuwanshi B, Singh A, Singh A. Recurrent Viral Infections Post COVID 19. Mymensingh Med J 2023; 32:587-589. [PMID: 37002775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2023]
Abstract
The novel corona virus causing severe acute respiratory symptoms appeared in China at the end of year 2019 and soon spread globally resulting in Pandemic. The susceptibility to novel corona virus infection and severity of symptoms in an individual is an outcome of immune system of the host. The Human leucocyte Antigen (HLA) of an individual is responsible for regulation of immune system. Thus, genetic variability of the HLA can affect the individual's response to Novel corona virus infection in terms of susceptibility and severity. The memory B cells which persist in the body after initial infection protect by faster response to repeat infection by the virus. However viral mutations prevent recognition by memory B cells and therefore repeat infection by virus leads to slow immune response as immunity to the mutated virus is not present.
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A.M. F, Singh A, L.V. Y. Influence of priming treatments on seed germination and growth characteristics
of Moringa oleifera seedlings under laboratory and greenhouse conditions. FOOD RESEARCH 2023. [DOI: 10.26656/fr.2017.6(s4).010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/19/2023] Open
Abstract
Seed priming is the treatment of seeds with various priming substances to improve
germination and seedling quality, and plant growth. The procedure entails advancing the
seed to an equivalent stage of the germination process to achieve rapid and uniform
emergence when planted, which is required in the case of Moringa oleifera to reduce the
damage of ageing seeds, stimulate their performance, and overcome uneven germination
rate due to seedcoat hardening, that leads to wide variation in terms of commercial
qualities in the planting field. Therefore, a series of seed priming experiments were
conducted to determine the optimal methods of priming treatments that maximise
Moringa oleifera total germination, germination rate, and seedling vigour. Moringa
oleifera seeds were treated with hydropriming, osmopriming (KNO3), and nutripriming
(SeedActivator) for 4, 8, and 12 hrs. Germinability was improved by priming treatments.
Results indicated that the highest germination percentage was recorded on seeds subjected
to hydropriming (63.25%), followed by nutripriming (61.75%) and osmopriming (60%)
with the exact duration of 4 hrs soaking time. All pre-germination treatments have
significantly early mean germination days (MGT) compared to the unprimed seeds. In the
seed pouch study, seeds treated with hydropriming for 4 hrs had shown the best results to
improve roots growth in total root length (cm), root volume (cm3
), the number of forks,
and the number of crossings with 240.52 cm vs. 163.64 cm, 0.47 cm3 vs. 0.29 cm3
, 517.80
vs. 271.47 and 59.20 vs. 28.53 respectively when compared to unprimed seeds. The
positive effect of priming can also be seen in the seedling growth of M. oleifera grown in
a pot with two different growing media.
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Devaprasad M, Rastogi N, Satish R, Patel A, Singh A, Dabhi A, Shivam A, Bhushan R, Meena R. Characterization of paddy-residue burning derived carbonaceous aerosols using dual carbon isotopes. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 864:161044. [PMID: 36572314 DOI: 10.1016/j.scitotenv.2022.161044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 11/24/2022] [Accepted: 12/15/2022] [Indexed: 06/17/2023]
Abstract
A large scale paddy-residue burning (PRB) happens every year in the northwest Indo-Gangetic Plain (IGP) during the post-monsoon season, and winds transport pollutants from the source region up to the northern Indian Ocean affecting air quality of the IGP and marine region. In this study, day-night pairs of fine aerosol samples (n = 69) were collected during October-November over Patiala (30.2°N, 76.3°E, 250 m amsl), a site located in the source region of PRB. Carbonaceous aerosols (CA) were characterised using chemical species and dual carbon isotopes (13C and 14C) to estimate bio vs non-bio contributions and understand their characteristics. Percentage of bio fraction (fbio, estimated using 14C) in CA varied from 74 % to 87 % (avg: 80 ± 3) during days and 71 % to 96 % (avg: 85 ± 7 %) during nights. Further, the fbio was found to be better correlated with aerosol mass spectrometer derived f60 compare to levoglucosan (LG) or nssK+, suggesting f60 a useful proxy for PRB. The δ13C varied from -27.7 ‰ to -26.0 ‰ (avg: -27.0 ± 0.4 ‰) and - 28.7 ‰ to -26.4 ‰ (avg: -27.5 ± 0.7 ‰) during day and night, respectively. Measured δ13C of the samples was found to be more enriched than expected by 0.3 to 2.0 ‰, indicating the presence of aged CA also in Patiala even during PRB period. From fbio versus δ13C correlation, and from Miller-Trans plot, δ13C of PRB is found to be -28.9 ± 1.1 ‰, which also infers that Miller-Trans plot can be used to understand source isotopic signature in the absence of radiocarbon measurements in aerosols. Further, the characteristics ratios of organic carbon (OC) to elemental carbon (EC) (11.9 ± 4.1), LG to potassium (K+) (0.84 ± 0.15), OC/LG (19.7 ± 2.0) and K+/EC (0.75 ± 0.27) were calculated by considering samples with fbio higher than 0.90, which can be used for source apportionment studies. Such studies are crucial in assessing the effects of PRB on regional air quality and climate.
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Singh A, Brown A, MOODLEY P, Moriarty J. WCN23-0456 HIGH ON TACROLIMUS - A case of Tacrolimus toxicity due to CBD oil. Kidney Int Rep 2023. [DOI: 10.1016/j.ekir.2023.02.880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2023] Open
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Thomas Z, Georgy J, Thumaty D, John A, Joel A, Wisely J, Jambunathan P, Kumar M P, Kovilapu H, Chacko R, Madhurima P, Prabhu A, Shreemal B, Kandagaddala M, Balakrishnan R, Singh A. 78P Dose-dense epirubicin and cisplatin (ddEP) in localised osteosarcoma. ESMO Open 2023. [DOI: 10.1016/j.esmoop.2023.101115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Kukal S, Bora S, Kanojia N, Singh P, Paul PR, Rawat C, Sagar S, Bhatraju NK, Grewal GK, Singh A, Kukreti S, Satyamoorthy K, Kukreti R. Valproic Acid-Induced Upregulation of Multidrug Efflux Transporter ABCG2/BCRP via PPAR α-Dependent Mechanism in Human Brain Endothelial Cells. Mol Pharmacol 2023; 103:145-157. [PMID: 36414374 DOI: 10.1124/molpharm.122.000568] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 10/26/2022] [Accepted: 11/03/2022] [Indexed: 11/23/2022] Open
Abstract
Despite the progress made in the development of new antiepileptic drugs (AEDs), poor response to them is a rising concern in epilepsy treatment. Of several hypotheses explaining AED treatment failure, the most promising theory is the overexpression of multidrug transporters belonging to ATP-binding cassette (ABC) transporter family at blood-brain barrier. Previous data show that AEDs themselves can induce these transporters, in turn affecting their own brain bioavailability. Presently, this induction and the underlying regulatory mechanism involved at human blood-brain barrier is not well elucidated. Herein, we sought to explore the effect of most prescribed first- and second-line AEDs on multidrug transporters in human cerebral microvascular endothelial cells, hCMEC/D3. Our work demonstrated that exposure of these cells to valproic acid (VPA) induced mRNA, protein, and functional activity of breast cancer resistance protein (BCRP/ABCG2). On examining the substrate interaction status of AEDs with BCRP, VPA, phenytoin, and lamotrigine were found to be potential BCRP substrates. Furthermore, we observed that siRNA-mediated knockdown of peroxisome proliferator-activated receptor alpha (PPARα) or use of PPARα antagonist, resulted in attenuation of VPA-induced BCRP expression and transporter activity. VPA was found to increase PPARα expression and trigger its translocation from cytoplasm to nucleus. Findings from chromatin immunoprecipitation and luciferase assays showed that VPA enhances the binding of PPARα to its response element in the ABCG2 promoter, resulting in elevated ABCG2 transcriptional activity. Taken together, these in vitro findings highlight PPARα as the potential molecular target to prevent VPA-mediated BCRP induction, which may have important implications in VPA pharmacoresistance. SIGNIFICANCE STATEMENT: Induction of multidrug transporters at blood-brain barrier can largely affect the bioavailability of the substrate antiepileptic drugs in the brains of patients with epilepsy, thus affecting their therapeutic efficacy. The present study reports a mechanistic pathway of breast cancer resistance protein (BCRP/ABCG2) upregulation by valproic acid in human brain endothelial cells via peroxisome proliferator-activated receptor alpha involvement, thereby providing a potential strategy to prevent valproic acid pharmacoresistance in epilepsy.
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Wyton S, Terry F, Perez-Fernandez C, Wood H, Singh A. Excellence reporting in a neonatal intensive care unit during COVID-19 era. JOURNAL OF NEONATAL NURSING : JNN 2023; 29:S1355-1841(23)00028-5. [PMID: 36811089 PMCID: PMC9935277 DOI: 10.1016/j.jnn.2023.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 02/14/2023] [Indexed: 02/19/2023]
Abstract
We are reporting our engagement with the 'Learning from Excellence' initiative in the neonatal intensive care unit during the covid era, with enhanced professional and personal stresses in the workforce. It highlights the positive experiences around technical management of sick neonates and human factors, like team working, leadership and communication.
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Dobberstein REA, Brisson BA, McMillan S, Oblak ML, Singh A, Dutton CJ, Zhang M. Perioperative complications and outcomes following partial ear canal ablation and lateral bulla osteotomy in pet rabbits: 20 cases (2009-2021). J Small Anim Pract 2023; 64:350-358. [PMID: 36756788 DOI: 10.1111/jsap.13587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 10/05/2022] [Accepted: 12/15/2022] [Indexed: 02/10/2023]
Abstract
OBJECTIVE To investigate the perioperative complications and outcomes of rabbits undergoing partial ear canal ablation and lateral bulla osteotomy for treatment of chronic otitis. MATERIALS AND METHODS Surgical logbooks were searched to identify rabbits that underwent partial ear canal ablation and lateral bulla osteotomy between December 2009 and September 2021. Data collected included signalment, history, clinical signs, historical and current medical management, physical examination findings, preoperative diagnostic imaging and aural bacterial culture results, surgical procedure information, duration of hospitalisation, complications and final outcome. RESULTS Twenty rabbits with chronic, medically unresponsive otitis underwent 27 partial ear canal ablation and lateral bulla osteotomies. Ten rabbits had pre-existing neurologic deficits and 17 had an ear base abscess at the time of surgery. A total of 13 (65%) rabbits developed at least one complication, either in the perioperative period or between discharge and recheck. Three of these rabbits (15%) underwent revision surgery for persistent or recurrent ear base abscess. Complete resolution of clinical signs ultimately occurred in 12 (60%) rabbits. Three (15%) rabbits showed improved but not completely resolved clinical signs (three facial asymmetry). Five (25%) rabbits died of causes potentially related to chronic otitis and/or partial ear canal ablation and lateral bulla osteotomy; two of these rabbits had undergone revision surgery. CLINICAL SIGNIFICANCE Although this study reports a high complication rate (65%), most complications resolved, with 15 (75%) rabbits having a good to excellent final outcome. Since the majority of rabbits in this study had chronic and severe ear disease, further studies are required to determine if surgical intervention earlier in the disease process could result in a lower complication rate.
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Roshan MV, Razaghi S, Singh A. Simulation-based architecture of a stable large-area [Formula: see text] atmospheric plasma source. Sci Rep 2023; 13:1979. [PMID: 36737465 PMCID: PMC9898294 DOI: 10.1038/s41598-023-29143-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 01/31/2023] [Indexed: 02/05/2023] Open
Abstract
Unified jet-DBD design, [Formula: see text], proposed in this work presents large-scale plasma in an unbounded region of atmospheric air, without any need for the flow of gas, offering efficient exposure to sizable and complex objects. This is a simulation-based architecture for stable non-thermal plasma source with notable experimental results. [Formula: see text] geometry optimizes the electric field and charge distribution for a diffuse discharge in the steady air by a key design parameter of [Formula: see text]. Teflon insulator with a thickness [Formula: see text] imposes an intense and uniform electric field shaped up at the open area in front of the device and generates radially/axially expanded plasma jet. In the [Formula: see text], phase shift increases by [Formula: see text] and the plasma generates more power than the classical plasma jet. Two distinct states of [Formula: see text] operation indicate the mode-swap at [Formula: see text] and power dissipation. In the reactive [Formula: see text] scheme even small changes in the phase angle effectively improves the electric power.
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Lim E, Castellani D, Fong K, Chew B, Tailly T, Emiliani E, Yuen-Chun Teoh J, Chai C, Chin Tiong H, Ong Lay Keat W, Tanidir Y, Ragoori D, Singh A, Bin Hamri S, Traxer O, Somani B, Gauhar V. Thulium fibre versus Moses laser lithotripsy for retrograde intrarenal surgery: Is there a clear winner? Outcomes from the FLEXOR study. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)01255-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Day C, Deetlefs M, O'Brien A, Smith J, Boyd M, Embling N, Patel S, Moody K, Ramabele T, Budge A, Tarwa T, Jim O, Maharaj T, Pandy S, Abrahams JM, Panieri A, Verhage S, Van der Merwe M, Geragotellis A, Amanjee W, Joseph C, Zhao Z, Moosa S, Bunting M, Pulani Y, Mukhari P, De Paiva M, Deyi G, Wonkam RP, Mancotywa N, Dunge A, Msimanga T, Singh A, Monnaruri O, Molale B, Butler TAG, Browde K, Muller C, Van der Walt J, Whitelaw R, Cronwright D, Sinha S, Binase U, Francis I, Boakye D, Dlamini S, Mendelson M, Peter J. Self-reported beta-lactam allergy in government and private hospitals in Cape Town, South Africa. S Afr Med J 2023; 113:69-74. [PMID: 36757070 DOI: 10.7196/samj.2023.v113i2.16760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Indexed: 02/10/2023] Open
Abstract
BACKGROUND Up to a quarter of inpatients in high-income countries (HICs) self-report beta-lactam allergy (BLA), which if incorrect,increases the use of alternative antibiotics, worsening individual health outcomes and driving bacterial resistance. In HICs, up to 95% ofself-reported BLAs are incorrect. The epidemiology of BLA in low- and middle-income African countries is unknown. OBJECTIVES To describe the epidemiology and de-labelling outcomes of self-reported BLA in hospitalised South African (SA) patients. METHODS Point-prevalence surveys were conducted at seven hospitals (adult, paediatric, government and privately funded, district andtertiary level) in Cape Town, SA, between April 2019 and June 2021. Ward prescription records and in-person interviews were conductedto identify and risk-stratify BLA patients using the validated PEN-FAST tool. De-labelling was attempted at the tertiary allergy clinic atGroote Schuur Hospital. RESULTS A total of 1 486 hospital inpatients were surveyed (1 166 adults and 320 children). Only 48 patients (3.2%) self-reported a BLA,with a higher rate in private than in government-funded hospitals (6.3% v. 2.8%; p=0.014). Using the PEN-FAST tool, only 10.4% (n=5/48)of self-reported BLA patients were classified as high risk for true penicillin hypersensitivity. Antibiotics were prescribed to 70.8% (n=34/48)of self-reported BLA patients, with 64.7% (n=22/34) receiving a beta-lactam. Despite three attempts to contact patients for de-labelling atthe allergy clinic, only 3/36 underwent in vivo testing, with no positive results, and 1 patient proceeded to a negative oral challenge. CONCLUSION Unlike HICs, self-reported BLA is low among inpatients in SA. The majority of those who self-reported BLA were low risk fortype 1 hypersensitivity, but outpatient de-labelling efforts were largely unsuccessful.
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Singh A, Choudhary S, Aggrawal L, Verma A, Mourya A, Agarwal S. 18P Prospective randomized comparison of quality of life in locally advanced cervical cancer treated with intracavitary or interstitial brachytherapy. ESMO Open 2023. [DOI: 10.1016/j.esmoop.2023.100873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023] Open
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Srivastava PK, Singh A, Kumari S, Arora S, Choubey AK, Sinha ASK. Production and characterization of sustainable vermimanure derived from poultry litter and rice straw using tiger worm Eisenia fetida. BIORESOURCE TECHNOLOGY 2023; 369:128377. [PMID: 36423761 DOI: 10.1016/j.biortech.2022.128377] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 11/16/2022] [Accepted: 11/18/2022] [Indexed: 06/16/2023]
Abstract
Poultry litter (PL) and rice straw (RS), commonly available waste materials, pose severe threat to environment, if not properly managed. As viable waste treatment method, vermi-transformation of PL into enriched vermimanure was done using RS and cow dung (CD) with different feedstocks (FS) combinations like FS0(CD without earthworm), FS1(CD), FS2(1CD: 1RS), FS3(1CD: 1PL) and FS4(1CD: 1RS: 1PL) for 110 days. Increased growth performance (P < 0.05) of Eisenia fetida, macronutrient levels, and a consistently lower carbon-to-nitrogen ratio (C/N) emphasize the importance of RS and PL in the vermimanuring process. Several analytical techniques have revealed the presence of functional groups, nitrate (NO3-), phosphate (PO43-), and potassium ions (K+) as well as the high porosity of the matured vermimanures. Therefore, using earthworms, the feedstock FS4(1CD: 1RS: 1PL) could be successfully biotransformed into sustainable manure lowering the usage of chemical fertilizers and rice straw burning.
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Shukla VV, Gentle SJ, Cooley A, Singh A, Ambalavanan N, Carlo WA, Salas A. Prediction of early oral feeding achievement in preterm infants. Am J Med Sci 2023. [DOI: 10.1016/s0002-9629(23)00608-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Turton B, Sullivan S, Chher T, Hak S, Sokal-Gutierrez K, Wieringa F, Singh A. Caries Incidence Is Associated with Wasting among Cambodian Children. J Dent Res 2023; 102:157-163. [PMID: 36217721 DOI: 10.1177/00220345221126713] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Evidence suggests that dental caries is associated with chronic and acute malnutrition, manifested as stunting and wasting in children. However, studies have not always appropriately accounted for confounding factors or for the temporal ordering between exposure and outcome. This study examined relationships between the development of caries lesions with subsequent stunting and wasting outcomes using data from a population-based cohort in Cambodia. Caries incidence was assessed based on the presence of a new cavitated carious lesion or a new pulpally involved lesion across a 6-mo observation period. Anthropometric measurements were taken at regular intervals. Effects of carious lesions on stunting and wasting were assessed using inverse probability treatment weighting, adjusting for potential confounders, using z scores for height-for-age (HAZ) and weight-for-height (WHZ) as outcomes. In total, 894 children (mean age 20 mo at baseline) were followed over 2 y. At baseline, 350 (39.1%) were identified as having stunting malnutrition. At follow-up, 58 (6.5%) had a new pulpally involved lesion. There was no association between incidence of cavitated or pulpally involved carious lesions at follow-up and stunting (relative risk [RR] = 1.06; 95% confidence interval [CI]: 0.75, 1.50). The incidence of pulpally involved carious lesions had an effect on wasting prevalence (WHZ <-2; RR = 1.35; 95% CI: 0.70, 2.62) and WHZ scores (average treatment effect = -0.294; 95% CI: -0.538, -0.050). This study offers evidence that the development of pulpally involved carious lesions has an effect on WHZ scores. Oral health promotion and clinical prevention and management of dental caries should be explored as interventions to promote normal growth and development among preschool children, particularly in low-income settings.
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Gentle SJ, Singh A, Travers C, Nakhmani A, Carlo WA, Ambalavanan N. Achieved oxygen saturations and risk for bronchopulmonary dysplasia-associated pulmonary hypertension in preterm infants. Am J Med Sci 2023. [DOI: 10.1016/s0002-9629(23)00440-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Chaudhary G, Pradhan AK, Shah S, Roy S, Singh V, Dwivedi SK, Sethi R, Chandra S, Vishwakarma P, Sharma AK, Bhandari M, Shukla A, Singh A. Unraveling the invisible demon: a study of the oxidative stress markers, antioxidant activities and inflammatory markers in patients admitted with complete heart block. Eur Heart J 2023. [DOI: 10.1093/eurheartj/ehac779.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Introduction
Despite the recent advancements in the management of Complete Heart Block (CHB), the aetiology of CHB is still idiopathic in most of the cases. Our study explores this hitherto untouched aspect of complete heart block.
Purpose
We aimed to assess the aetiological profile of Complete Heart Block patients in our study.
Methods
The study population consisted of 60 patients with complete heart block aged between 30 to 80 years, attending as an inpatient in ER. Oxidative stress was measured by serum MDA, serum GSH, serum Catalase activity and serum SOD activity. Antioxidant activity was obtained by measuring the levels of serum total antioxidant capacity. Inflammatory stress was measured by IL-5 and TNF-alpha levels. These values were compared to 30 healthy controls with no prior history of smoking and diabetes mellitus.
Results
The mean age of the patient was 62.48 ± 7.98 years and the gender distribution was 37 males and 23 females out of 60 patients. The mean value of serum MDA (ng/mL) in cases is 1451.26 ± 206.32, and in controls, the mean value is 1197.98 ± 234.71 (p=<0.001). The mean value of serum GSH (mcg/mL) in cases is 46.982 ± 18.613, and in controls, the mean value is 54.155 ± 10.762 (p=0.027). The mean value of serum Catalase Activity (U/min/mg protein) in cases is 10.763 ± 4.038 and in controls, the mean value is 19.878 ± 7.787 (p=0.003). The mean value of serum SOD Activity (U/g) in cases is 24.950 ± 5.4565, and in controls, the mean value is 46.214 ± 14.6309 (p=0.891). The mean value of serum Total Antioxidant Capacity (U/mL) in cases is 5.546 ± 0.620 and in controls, the mean value is 8.346 ± 2.781 (p=0.025). The mean value of serum IL-5 (pg/mL) in cases is 481.442 ± 28.8995, and in controls, the mean value is 67.347 ± 20.445 (p<0.001). The mean value of serum TNF-ALFA (pg/mL) in cases is 196.741 ± 73.771, and in controls, the mean value is 144.530 ± 42.599 (p= 0.081).
Conclusions
During a complete heart block, SOD (p=0.891), CAT (p=0.003), GSH (p=0.027) and total antioxidant (TAOC) (p=0.025) were significantly decreased in cases, compared to healthy controls, thus suggesting that the elevated levels of oxidative free radicals causes endothelial dysfunctioning. The increase in ROS was observed by a highly significant increase of malondialdehyde (MDA) (p=<0.001) showing high ROS-mediated tissue damage. Besides damage by oxidative stress, our study suggests that there are certain inflammatory markers like TNF-α and IL-5 that actively participate in causing heart block. There was a significant increase in the concentration of IL-5 (p<0.001) in the cases as compared to the controls.
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Roy S, Singh V, Ahmed J, Dwivedi SK, Sethi R, Chandra S, Pradhan AK, Vishwakarma P, Sharma AK, Bhandari M, Shukla A, Singh A, Chaudhary G. The surprises in optical coherence tomography (OCT) findings in patients presenting with in-stent restenosis: the road less travelled. Eur Heart J 2023. [DOI: 10.1093/eurheartj/ehac779.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Morphological features of neointimal tissue play a pivotal role in the pathophysiology of In-Stent Restenosis (ISR) after percutaneous coronary intervention, hence understanding these features and patterns is crucial.
Purpose
The present study was designed to qualitatively and quantitatively assess neointimal characteristics of lesions using OCT in patients presenting with ISR.
Methods
This was a single-center, prospective, observational study performed between 1st August 2020 and 30th December 2021 at a tertiary-care center in India. Patients diagnosed with stable angina and acute coronary syndrome with post-procedural angiographically documented restenosis (>50%) were included. Qualitative and quantitative assessment of neointimal hyperplasia patterns was performed using OCT.
Results
A total of 34 patients with ISR were studied. Neointimal hyperplasia was classified as (i) homogenous group (n=18) and (ii) non-homogenous group (n=16). As many as 14 (77.8%) diabetics belonged to the homogenous group. Predominant plaque characteristics such as neoatherosclerosis, cholesterol crystals, and calcium were documented in 14 (77.8%), 12 (66.7%), and 11 (61.1%) patients in the homogenous group and in 10 (62.5%), 10 (62.5%), and 9 (56.2%) patients in the non-homogenous group, respectively. Unexpanded stent struts were identified in 11 (61.1%) and 11 (68.8%) patients in the homogenous and non-homogenous groups, respectively. Mean strut thickness was 93.73 ± 31.03 µm and 83.54 ± 18.0 µm, ISR was 72.50 ± 15.93% and 65.37 ± 21.69%, the neointimal thickness was 588.06 ± 167.82 mm and 666.25 ± 218.05 mm, and neointimal hyperplasia was 54.54 ± 11.23% and 59.26 ± 8.86% in the homogenous and non-homogenous groups, respectively.
Conclusion
Neoatherosclerosis and stent underexpansion was predominantly observed in our study, which was in contrast to most of the existing literature [1,2,3], and only diabetes was found to be significantly associated with homogenous neointimal hyperplasia, irrespective of the generation of the stent.
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Beniwal M, Singh A, Kumar N. Alternative to Buy-and-Hold: Predicting Indices Direction and Improving Returns Using a Novel Hybrid LSTM Model. INT J ARTIF INTELL T 2023. [DOI: 10.1142/s0218213023500288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Song MJ, Quinn R, Nguyen E, Hampton C, Sharma R, Park TS, Koster C, Voss T, Tristan C, Weber C, Singh A, Dejene R, Bose D, Chen YC, Derr P, Derr K, Michael S, Barone F, Chen G, Boehm M, Maminishkis A, Singec I, Ferrer M, Bharti K. Bioprinted 3D outer retina barrier uncovers RPE-dependent choroidal phenotype in advanced macular degeneration. Nat Methods 2023; 20:149-161. [PMID: 36550275 DOI: 10.1038/s41592-022-01701-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 10/25/2022] [Indexed: 12/24/2022]
Abstract
Age-related macular degeneration (AMD), a leading cause of blindness, initiates in the outer-blood-retina-barrier (oBRB) formed by the retinal pigment epithelium (RPE), Bruch's membrane, and choriocapillaris. The mechanisms of AMD initiation and progression remain poorly understood owing to the lack of physiologically relevant human oBRB models. To this end, we engineered a native-like three-dimensional (3D) oBRB tissue (3D-oBRB) by bioprinting endothelial cells, pericytes, and fibroblasts on the basal side of a biodegradable scaffold and establishing an RPE monolayer on top. In this 3D-oBRB model, a fully-polarized RPE monolayer provides barrier resistance, induces choriocapillaris fenestration, and supports the formation of Bruch's-membrane-like structure by inducing changes in gene expression in cells of the choroid. Complement activation in the 3D-oBRB triggers dry AMD phenotypes (including subRPE lipid-rich deposits called drusen and choriocapillaris degeneration), and HIF-α stabilization or STAT3 overactivation induce choriocapillaris neovascularization and type-I wet AMD phenotype. The 3D-oBRB provides a physiologically relevant model to studying RPE-choriocapillaris interactions under healthy and diseased conditions.
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