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Behera MR, Kaul A, Kishore R, Karthikeyan B, Bhadauria DS, Mishra P, Prasad N, Gupta A, Sharma RK. Optimization of treatment modality in elderly end-stage renal disease population: Peritoneal dialysis versus transplant. Indian J Nephrol 2018; 28:433-440. [PMID: 30647497 PMCID: PMC6309383 DOI: 10.4103/ijn.ijn_305_17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Despite kidney transplantation (KT) being considered as the best treatment modality for end-stage renal disease (ESRD), patient and graft survival in the elderly population is poorer than younger individuals. Many authors argue that prolonged life expectancy outweighs the risk of remaining on dialysis, but few studies had compared the treatment modalities, especially with peritoneal dialysis (PD). A retrospective study was conducted at a tertiary care institute to compare outcome of elderly ESRD patients, who received KT with those continued on PD; and to evaluate the predictors of patient survival. Patient survival at 1 year was (76.2% vs. 91.1%); 5 years (53.7% vs. 21.8%); and 10 years (35.6% vs. 0.00%) among KT and PD population, respectively. Infection was the most common cause of death among KT group (35 [41.2%] vs. 34 [28.2%]) while cardiovascular mortality in PD group (55 [46.2%] vs. 7 [8.2%]). Technique survival at 1, 5, and 10 years in PD group was 92.8%, 58.5%, and 0%, respectively. Similarly, graft survival at 1, 5, and 10 years in KT group was 98.7%, 90.2%, and 90.2%, respectively. Multivariate analysis showed body mass index (BMI) (hazard ratio [HR] 0.88, 95% confidence interval [CI] 0.82–0.93, p < 0.001), and albumin (HR 0.55, 95% CI 0.37–0.80, p = 0.002) were significant predictors of survival. In the 1st year, patient survival was better in PD than KT, but after adjustment for BMI and albumin, both short-term and long-term survival in elderly KT group was better than that of PD. Hence, elderly ESRD patients should not be barred from KT just because of age.
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Kaul A, Behera MR, Rai MK, Mishra P, Bhaduaria DS, Yadav S, Agarwal V, Karoli R, Prasad N, Gupta A, Sharma RK. Neutrophil Gelatinase-associated Lipocalin: As a Predictor of Early Diabetic Nephropathy in Type 2 Diabetes Mellitus. Indian J Nephrol 2018. [PMID: 29515302 PMCID: PMC5830810 DOI: 10.4103/ijn.ijn_96_17] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
This study was carried out to look for diagnostic and prognostic role of neutrophil gelatinase-associated lipocalin (NGAL) in early diabetic nephropathy (DN) in type 2 diabetes individuals. NGAL was measured in both urinary and serum sample of 144 type 2 diabetes individuals stratified into three categories based on urinary albumin-creatinine ratio and 54 control populations with estimated glomerular filtration rate >60 mL/min/1.73 m2 and serum creatinine <1.2 mg/dl. The serum NGAL (sNGAL), urine NGAL (uNGAL), and uNGAL/urine creatinine were significantly higher in diabetic individuals than in the control populations with significant difference in between the groups (P < 0.05). Difference of above values between control value and normoalbuminuria was also statistically significant (P < 0.05). Again, sNGAL and uNGAL correlate positively with albuminuria (P < 0.05). Tubular injury may precede glomerular injury in diabetic individuals, and NGAL can be used as a biomarker to diagnose DN even earlier to incipient nephropathy. Both sNGAL and uNGAL can predict albuminuria and be used as a noninvasive tool for diagnosis, staging, and progression of DN.
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Prasad N, Patel MR, Pandey A, Jaiswal A, Bhadauria D, Kaul A, Sharma RK, Mohindra S, Pandey G, Goel A, Gupta A. Direct-acting Antiviral Agents in Hepatitis C Virus-infected Renal Allograft Recipients: Treatment and Outcome Experience from Single Center. Indian J Nephrol 2018; 28:220-225. [PMID: 29962673 PMCID: PMC5998719 DOI: 10.4103/ijn.ijn_190_17] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Hepatitis C virus (HCV) infection in renal allograft recipient is associated with increased morbidity and mortality. At present, only few studies related to treatment and outcomes of HCV-infected renal allograft recipients with DAAs have been published. We aimed the study to assess the efficacy and safety of sofosbuvir-based regimens in HCV-infected renal allograft recipients. We analyzed data of 22 eligible HCV-infected renal allograft recipients (14 genotype-3, 6 genotype-1, one each genotype-2 and 4) who were treated with DAAs at our institute. DAA regimen included sofosbuvir and ribavirin with or without ledipasvir or daclatasvir for 12–24 weeks. Patients were followed up for 24 weeks after completion of treatment. A rapid viral response of 91%, end of therapy response of 100%, and sustained viral response at 12 and 24 weeks of 100% with rapid normalization of liver enzymes were observed. Therapy was well tolerated except for ribavirin-related anemia. A significant decrease in tacrolimus trough levels was observed and most patients required increase in tacrolimus dose during the study. Treatment with newer DAAs is effective and safe for the treatment of HCV-infected renal allograft recipients.
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Kaul A, Bhaduaria D, Pradhan M, Sharma RK, Prasad N, Gupta A. Pregnancy Check Point for Diagnosis of CKD in Developing Countries. J Obstet Gynaecol India 2017; 68:440-446. [PMID: 30416269 DOI: 10.1007/s13224-017-1055-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Accepted: 10/04/2017] [Indexed: 11/29/2022] Open
Abstract
Objective Evidences suggest that females with CKD are associated with high risk of maternal and fetal complications. Early referral in CKD with pregnancy for specialist care may prove useful for maternal and fetal outcome. Methods Study looked for assessment of impact of CKD detection at the time of pregnancy and its impact on fetal and maternal outcome. Results A total of 465 females were retrospectively evaluated for renal status during their pregnancies, 172 females were unaware about their renal illness at the time of pregnancy, while 208 females were under regular obstetrical and nephrological follow-up during their pregnancy. 44.1% of these females in both groups had GFR < 60 ml/min. Preeclampsia was observed in 17.6% of planned pregnancies, while it was observed in 47.5% of unplanned pregnancies. Worsening of renal failure during and following pregnancy was observed among all stages of CKD, and there was greater decline in GRF with progression to ESRD earlier during or after pregnancy among unplanned pregnancies. Planned pregnancy group had better fetal outcome. Low birth babies weighing < 2500 g in unplanned group were much higher than in planned pregnancies. Conclusions Chronic kidney disease is often clinically silent until renal impairment is advanced. Pregnancy can be a check point for detection of renal disease and managed appropriately for better maternal and fetal outcome.
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Sharma RK, Phulia SK, Jerome A, Singh I. Ovsynch Plus protocol improves ovarian response in anovular Murrah buffaloes in low-breeding season. Reprod Domest Anim 2017; 52:1030-1035. [PMID: 28691349 DOI: 10.1111/rda.13020] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Accepted: 06/05/2017] [Indexed: 11/30/2022]
Abstract
The objective of the study was to evaluate the efficacy of ovarian response and pregnancy rate in anovular buffaloes following Ovsynch and Ovsynch Plus protocols. Buffaloes (n = 55) were divided into two groups: Ovsynch group (n = 26): GnRH (10 μg, GnRH1) on Day 0, PGF2 α (25 mg) on Day 7, GnRH (10 μg, GnRH2) on Day 9; Ovsynch Plus group (n = 29): 500 IU equine chorionic gonadotropin (eCG) 72 hr (day -3) prior to Ovsynch protocol, followed by fixed timed artificial insemination (FTAI) 6 and 24 hr after GnRH2 injection in bot groups. Transrectal ultrasonography was performed daily, that is, from day 0 and -3 in Ovsynch and Ovsynch Plus group, respectively for ovarian response and pregnancy diagnosis at day 30 post-insemination. In Ovsynch Plus group, administration of eCG prior to GnRH1 increased (p < .001) the diameter (mm) of dominant follicle (DF) from 10.15 ± 0.26 to 12.23 ± 0.34 within 72 hr of treatment resulting higher ovulatory response to GnRH1. Ovulation after GnRH1 was higher (p < .01) in Ovsynch Plus group (96.6%) than Ovsynch group (61.5%). However, ovulation rate to GnRH2 was similar (p > .05) between groups (Ovsynch group: 76.9% vs. Ovsynch Plus group: 70.0%). Mean DF diameter (mm) that ovulated to both GnRHs was higher (p < .01) than non-ovulated counterparts in both groups (Ovsynch group: 10.80 ± 0.27 vs. 8.47 ± 0.53; Ovsynch Plus group: 11.99 ± 0.24 vs. 9.5 ± 0.63). Pregnancy was established in buffaloes which responded to both GnRHs, irrespective of groups, being higher (p = .52) in Ovsynch Plus group (34.5%) than Ovsynch group (23.1%), though non-significant. In summary, this study showed that eCG inclusion prior to Ovsynch regimen improves ovulatory response in anovular buffaloes during low-breeding season.
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Etta PK, Sharma RK, Gupta A. Study of chronic kidney disease-mineral bone disorders in newly detected advanced renal failure patients: A Hospital-based cross-sectional study. SAUDI JOURNAL OF KIDNEY DISEASES AND TRANSPLANTATION 2017; 28:874-885. [PMID: 28748891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023] Open
Abstract
We aim to evaluate the disturbances in mineral metabolism, abnormalities in bone mineral density (BMD), and extraskeletal calcification in newly detected, untreated predialysis stage 4 and 5 chronic kidney disease (CKD) patients at a tertiary care hospital in North India. This is cross-sectional observational study. A total of 95 (68 males, 27 females) newly detected patients underwent clinical evaluation, biochemical assessment [serum calcium, phosphorus, alkaline phosphatase (ALP), albumin, creatinine, intact parathyroid hormone (iPTH), 25- hydroxyvitamin D (25(OH)D)], BMD measurement (at spine, hip, and forearm) by dual-energy X-ray absorptiometry (DXA), lateral abdominal radiograph [for abdominal aortic calcification (AAC)], skeletal survey (to look for any abnormality including fractures), and echocardiography [for any cardiac valvular calcification (CVC)]. Symptoms related to CKD-mineral bone disorder were seen in 33.6% of the study patients. Prevalence of hypocalcemia, hyperphosphatemia, hyperparathyroidism, and hypovitaminosis D was 64.2%, 81.1%, 49.5%, and 89.5%, respectively. CVC was seen in 22.1% of patients on echocardiography, mostly involving the mitral valve. Patients with CVC were more likely to be males and smokers. There was no significant difference in iPTH levels between patients with or without CVC. AAC was seen in 10.5% of patients on lateral abdominal X-ray. Patients with AAC had higher levels of iPTH, phosphorus, and ALP and lower levels of calcium compared to patients without AAC. BMD by DXA showed a low bone mass in 41.05% of our patients and was more prevalent in CKD stage 5. Most of the study patients had hyperparathyroidism and low 25(OH)D levels. Our study shows that newly detected, naïve Indian CKD patients have a high prevalence of disturbances of mineral metabolism including hyperparathyroidism, Vitamin D deficiency, abnormal BMD, and valvular and vascular calcification, even before initiating dialysis.
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Choudhary KK, Bharadwaj A, Sharma RK, Jerome A, Khanna S. Relationship of temperament with oestrous behaviour, resumption of ovarian cyclicity and milk yield in post-partum Murrah buffaloes. Reprod Domest Anim 2017; 52:962-968. [DOI: 10.1111/rda.13004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Accepted: 05/03/2017] [Indexed: 11/29/2022]
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Arora R, Sharma RK, Tewari S, Kapoor H. Periodontal surgery in a stage II Parkinson’s disease patient: Report of a case with special considerations. World J Neurol 2017; 7:24-27. [DOI: 10.5316/wjn.v7.i2.24] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Revised: 11/30/2016] [Accepted: 03/13/2017] [Indexed: 02/07/2023] Open
Abstract
Parkinson’s disease (PD) is an idiopathic progressive neurological disorder characterised by resting tremor, restrictions in mobility and muscular rigidity that can lead to problems in maintaining oral health. Here we report a case where crown lengthening surgeries were successfully performed in a PD patient for complete oral rehabilitation. Certain special considerations that are required before and during periodontal surgery in such patients are also elucidated. Often dentists and PD patients are reluctant to embark on complex dental procedures resulting in a compromised outcome. However, early intervention along with proper education and motivation of these patients can aid in achieving satisfactory results.
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Abstract
The MIB-1 antibody against a nuclear protein Ki-67 was used to study the proliferation of cells in the rabbit retinal transplants. Fragmented pieces of embryonic day 15 rabbit retinas were transplanted into the subretinal space of adult rabbits and allowed to survive for different times. Fragmented donor tissue starts organizing in rosettes 1 day after transplantation. The transplanted cells continue to proliferate in the host eye and their pattern of proliferation resembles that of normal developing retina, suggesting that the factors responsible for the proliferation pattern are preserved after transplantation. The dividing cells in metaphase line up in the luminal layers of the rosettes. Certain cells become postmitotic in the regions corresponding to the inner retina first, followed by the cells in the luminal layers of rosettes. Cells in the regions between the rosettes, corresponding to the inner nuclear layer, presumably the Müller cells, proliferate significantly for the equivalent age of postnatal day 2. Few cells in these regions proliferate for at least the equivalent age of postnatal day 11 in transplants. There is a layer of nonproliferating, degenerating cells in the transplant situated close to the host retina. However, some cells in this layer, situated at the host-graft interface, proliferate. These cells proliferate for a long time possibly indicating gliosis.
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Debnath J, Satija L, Sharma RK, Rastogi V, Singh H, Mohan R, Khanna SK. TRANSVAGINAL SALINE INFUSION SONOHYSTEROGRAPHY: INITIAL RESULTS. Med J Armed Forces India 2017; 56:135-139. [PMID: 28790677 DOI: 10.1016/s0377-1237(17)30129-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Transvaginal sonohysterography was carried out with dynamic instillation of normal saline in the uterine cavity in fourteen infertile patients. Sonohysterography was found to be simple, accurate and specific in delineating endometrial cavity lesions like polyp, submucosal myoma, intrauterine synechiae and endometrial hyperplasia.
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Karuppanasamy K, Sharma RK, Phulia SK, Jerome A, Kavya KM, Ghuman SPS, Kumar H, Singh I, Krishnaswamy N. Ovulatory and fertility response using modified Heatsynch and Ovsynch protocols in the anovular Murrah buffalo (Bubalus bubalis). Theriogenology 2017; 95:83-88. [PMID: 28460685 DOI: 10.1016/j.theriogenology.2017.02.022] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Revised: 02/25/2017] [Accepted: 02/27/2017] [Indexed: 11/25/2022]
Abstract
We studied the effect of modified Heatsynch and Ovsynch protocols on the ovulatory response (OR), estrus induction rate (EIR) and conception rate (CR) in the anovular postpartum Murrah buffalo (n = 35). In the modified Heatsynch protocol (Group I; n = 12), buffaloes were given two GnRH at 2 h interval on treatment day 0, PGF (PGF2α) on day 7 and estradiol (E2) 1 mg on day 8. Two FTAI were done at 20 h intervals after E2 administration. In the modified Ovsynch protocol (Group II; n = 15), GnRH was given on day 0, 7 and 16 with a PGF on day 14. Two FTAI were done; one at last GnRH and the other 20 h later. Group III served as untreated negative control (n = 8). During the treatment, ovarian changes were monitored by transrectal ultrasonography and plasma progesterone (P4) and E2. Administration of two GnRH at 2 h interval neither increased the OR nor strengthened the subsequent P4 priming. Interestingly, in group I, none of the buffalo ovulated to E2 though the EIR was 100% indicating the occurrence of behavioral, but not ovulatory estrus. Administration of GnRH 7 day prior to the commencement of Ovsynch protocol (Group II) did not improve the CR (21.4%), though the OR was 71.4%. No significant difference was found in the diameter of largest follicle between the ovulated and non-ovulated buffalo in response to GnRH suggesting that follicle of ≥9.5 mm is necessary but not sufficient to induce ovulation in the anovular buffalo. In both the protocols, the plasma P4 was higher on day 7 in those buffaloes that ovulated to GnRH. Buffaloes treated with modified Ovsynch regimens were 5.27 times more likely to become pregnant than modified Heatsynch protocol. It is concluded that modified Ovsynch protocol is superior to modified Heatsynch protocol in terms of OR and CR.
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Kumar S, Archak S, Tyagi RK, Kumar J, Vk V, Jacob SR, Srinivasan K, Radhamani J, Parimalan R, Sivaswamy M, Jayaprakash P, Tyagi S, Yadav M, Rani J, Sharma S, Bhagat I, Meeta M, Bains NS, Chowdhury AK, Saha BC, Bhattacharya PM, Kumari J, Singh MC, Gangwar OP, Prasad P, Bharadwaj SC, Gogoi R, Sharma JB, Gm SK, Saharan MS, Singh AK, Khan Z, Bag M, Roy A, Prasad TV, Sharma RK, Dutta M, Sharma I, Bansal KC. Correction: Evaluation of 19,460 Wheat Accessions Conserved in the Indian National Genebank to Identify New Sources of Resistance to Rust and Spot Blotch Diseases. PLoS One 2017; 12:e0175610. [PMID: 28384321 PMCID: PMC5383313 DOI: 10.1371/journal.pone.0175610] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Kumar R, Ghosh M, Kumar N, Balhara AK, Gupta M, Sharma RK, Singh I. Polymorphism in 5′ untranslated region of heat-shock protein 70 gene as marker of post-partum anoestrus in Murrah buffaloes. Reprod Domest Anim 2017; 52:505-512. [DOI: 10.1111/rda.12941] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Accepted: 01/10/2017] [Indexed: 12/25/2022]
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Javed R, Taku AK, Sharma RK, Badroo GA. Molecular characterization of Rhodococcus equi isolates in equines. Vet World 2017; 10:6-10. [PMID: 28246441 PMCID: PMC5301179 DOI: 10.14202/vetworld.2017.6-10] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Accepted: 12/07/2016] [Indexed: 11/29/2022] Open
Abstract
Aim: The aim was to determine the occurrence of Rhodococcus equi in equines and their environment in Jammu (R.S. Pura, Katra), molecular characterization and to determine the antibiotic resistance pattern of R. equi. Materials and Methods: A total of 96 nasopharyngeal swab samples were collected from equines. The organism was isolated on Columbia nalidixic acid agar containing 5% sheep blood as well as on sheep blood agar and was later confirmed by cultural characteristics and biochemical tests. Molecular detection of R. equi isolates was done by 16S rRNA gene amplification followed by virulence associated protein A (Vap A) gene amplification. Antibiogram was performed against five antibiotics, viz., amoxicillin, penicillin G, streptomycin, rifampicin, and methicillin. Results: During the study, 9 R. equi isolates were identified on the basis of cultural and biochemical tests. In the polymerase chain reaction based detection, 3 among the 9 rhodococcal isolates were positive for species-specific 16S rRNA gene and revealed amplicon of 450 bp for confirmation of 16S rRNA gene. None of the sample was found positive for Vap A gene. In antibiogram, R. equi isolates were found sensitive for amoxicillin, while some isolates were also found resistant to the most conventional antibiotic penicillin G. Conclusion: From this study, it was concluded that R. equi infection is prevalent in equines in Jammu region of India and the indiscriminate use of the antibiotics is leading toward the development of resistant strains of R. equi.
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Jaswani P, Prakash S, Dhar A, Sharma RK, Prasad N, Agrawal S. MicroRNAs Involvement in Renal Pathophysiology: A Bird's Eye View. Indian J Nephrol 2017; 27:337-341. [PMID: 28904427 PMCID: PMC5590408 DOI: 10.4103/ijn.ijn_264_16] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
MicroRNAs (miRNAs) are known to suppress gene expression by binding to messenger RNAs and in turn regulate different pathophysiological processes. Transforming growth factor-β, mitogen-activated protein kinase signaling, and Wnt signaling-like major pathways associated with miRNAs are involved with kidney diseases. The discovery of miRNAs has provided new insights into kidney pathologies and may provide effective therapeutic strategies. Research has demonstrated the role of miRNAs in a variety of kidney diseases including diabetic nephropathy, lupus nephritis, hypertension, nephritic syndrome, acute kidney injury, renal cell carcinoma, and renal fibrosis. miRNAs are implicated as playing a role in these diseases due to their role in apoptosis, cell proliferation, differentiation, and development. As miRNAs have been detected in a stable condition in different biological fluids, they have the potential to be tools to study the pathogenesis of human diseases with a great potential to be used in disease diagnosis and prognosis. The purpose of this review is to examine the role of miRNA in kidney disease.
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Singh S, Sharma RK, Malhotra S, Pothuraju R, Shandilya UK. Lactobacillus rhamnosus NCDC17 ameliorates type-2 diabetes by improving gut function, oxidative stress and inflammation in high-fat-diet fed and streptozotocintreated rats. Benef Microbes 2016; 8:243-255. [PMID: 28008783 DOI: 10.3920/bm2016.0090] [Citation(s) in RCA: 74] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Restoration of dysbiosed gut microbiota through probiotic may have profound effect on type 2 diabetes. In the present study, rats were fed high fat diet (HFD) for 3 weeks and injected with low dose streptozotocin to induce type 2 diabetes. Diabetic rats were then fed Lactobacillus rhamnosus NCDC 17 and L. rhamnosus GG with HFD for six weeks. L. rhamnosus NCDC 17 improved oral glucose tolerance test, biochemical parameters (fasting blood glucose, plasma insulin, glycosylated haemoglobin, free fatty acids, triglycerides, total cholesterol, low-density lipoprotein cholesterol and high-density lipoprotein cholesterol), oxidative stress (thiobarbituric acid reactive substance and activities of catalase, superoxide dismutase and glutathione peroxidase in blood and liver), bifidobacteria and lactobacilli in cecum, expression of glucagon like peptide-1 producing genes in cecum, and adiponection in epididymal fat, while decreased propionate proportions (%) in caecum, and expression of tumour necrosis factor-α and interlukin-6 in epididymal fat of diabetic rats as compared to diabetes control group. These findings offered a base for the use of L. rhamnosus NCDC 17 for the improvement and early treatment of type 2 diabetes.
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Shrivastav A, Sharma RK, Sahni YP, Shrivastav N, Gautam V, Jain S. Study of antimicrobial resistance due to extended spectrum beta-lactamase-producing Escherichia coli in healthy broilers of Jabalpur. Vet World 2016; 9:1259-1263. [PMID: 27956778 PMCID: PMC5146307 DOI: 10.14202/vetworld.2016.1259-1263] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Accepted: 10/07/2016] [Indexed: 11/18/2022] Open
Abstract
Aim: To study the prevalence of antimicrobial resistance due to extended spectrum beta-lactamase (ESBL)-producing Escherichia coli in samples collected from the ceca of healthy broilers of poultry sale outlets (PSOs) Jabalpur. Materials and Methods: A total of 400 cecal swab samples were taken randomly from freshly slaughtered poultry of 39 PSOs located at four different zones or areas of Jabalpur and were screened for the presence of ESBL-producing E. coli using standard methods. Further they were characterized phenotypically by standard methods. Results: All the 400 samples were screened for E. coli producing ESBL enzyme. Among the samples positive for E. coli 135 were positive for ESBL E. coli giving an overall prevalence of 33.5%. Conclusion: This study related to the prevalence of ESBL-producing E. coli in healthy broilers in Jabalpur is indicative of antibiotic resistance prevalent in the healthy birds which are used for human consumption as well. It also signifies resistance prevalent against beta-lactam antibiotics including third and fourth generations of cephalosporins.
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Prajapati OP, Verma AK, Sharma RK, Sabaretnam M. Renal transplantation: Assessment of "at risk" diabetic foot and recommendations for mitigation. SAUDI JOURNAL OF KIDNEY DISEASES AND TRANSPLANTATION 2016; 27:893-901. [PMID: 27751995 DOI: 10.4103/1319-2442.190780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
We conducted a prospective study (between November 2013 and January 2015) to identify "foot at risk" in the diabetic renal transplant patients at a Tertiary Care Hospital in India. Patients (151) were divided into three groups: diabetic transplant recipients (n = 42), new onset diabetes after transplantation (NODAT) (n = 59), and controls (nondiabetic renal transplant recipients) (n = 50). Foot neuropathy and vasculopathy were assessed by standard methods. Patients with "at risk" feet were given foot care advice. Of the 151 patients, 144 patients were male and seven were female with a male:female ratio of 20:1. Peripheral neuropathy was present among 42.9% of diabetic transplant patients, 35.6% of NODAT patients, and 12% of control patients. Vasculopathy was present in 28.6% of diabetic transplant patients, 23.7% of NODAT patients, and 2% of control patients. On multivariate analysis, patient's age, mean time interval since transplantation, and HbA1c levels were significantly associated with neuropathy, whereas the duration of diabetes and vibration perception threshold was associated with vasculopathy. After undergoing renal transplantation, a significant number of diabetic and NODAT patients has their "feet at risk" who in future may develop full-blown lesions of the diabetic foot. Proper advice to patients and information to the treating doctor helps to mitigate the risk.
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Sharma RK, Shrestha DG. Climate perceptions of local communities validated through scientific signals in Sikkim Himalaya, India. ENVIRONMENTAL MONITORING AND ASSESSMENT 2016; 188:578. [PMID: 27650439 DOI: 10.1007/s10661-016-5582-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Accepted: 09/07/2016] [Indexed: 06/06/2023]
Abstract
Sikkim, a tiny Himalayan state situated in the north-eastern region of India, records limited research on the climate change. Understanding the changes in climate based on the perceptions of local communities can provide important insights for the preparedness against the unprecedented consequences of climate change. A total of 228 households in 12 different villages of Sikkim, India, were interviewed using eight climate change indicators. The results from the public opinions showed a significant increase in temperature compared to a decade earlier, winters are getting warmer, water springs are drying up, change in concept of spring-water recharge (locally known as Mul Phutnu), changes in spring season, low crop yields, incidences of mosquitoes during winter, and decrease in rainfall in last 10 years. In addition, study also showed significant positive correlations of increase in temperature with other climate change indicators viz. spring-water recharge concept (R (2) = 0.893), warmer winter (R (2) = 0.839), drying up of water springs (R (2) = 0.76), changes in spring season (R (2) = 0.68), low crop yields (R (2) = 0.68), decrease in rainfall (R (2) = 0.63), and incidences of mosquitoes in winter (R (2) = 0.50). The air temperature for two meteorological stations of Sikkim indicated statistically significant increasing trend in mean minimum temperature and mean minimum winter temperature (DJF). The observed climate change is consistent with the people perceptions. This information can help in planning specific adaptation strategies to cope with the impacts of climate change by framing village-level action plan.
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Singh J, Sharma RK, Gupta AK. A method of REM-NREM sleep distinction using ECG signal for unobtrusive personal monitoring. Comput Biol Med 2016; 78:138-143. [PMID: 27741420 DOI: 10.1016/j.compbiomed.2016.09.018] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Revised: 09/20/2016] [Accepted: 09/22/2016] [Indexed: 11/26/2022]
Abstract
Computers are used extensively in sleep labs for polysomnography and for assistance in sleep staging. However, the test is highly inconvenient to the patient and requires availability of specially equipped sleep labs. Alternative approaches that enable unobtrusive in-home sleep staging with ECG or other signals are highly desirable. In this paper we describe a method that can be used for distinction of REM and NREM sleep stages using spectral and non-linear features of ECG derived RR interval series. To test the accuracy of the system, we extracted the RR interval series from sleep studies of 20 young healthy individuals. Time domain, spectral and non-linear features were computed and tested for discriminability. Features showing high degree of discrimination were selected. A polynomial support vector machine was trained with selected features - percent power in HF band, LF/HF, Poincare plot parameters, exponents from Detrended fluctuation analysis, and sampEn of the half of the signals. The hyperplane was used to classify the other half of the data. The results show an accuracy of 76.25% with Cohen's kappa as 0.52 for a two-class model of five minute signal. The results dropped to 72.8% accuracy and k=0.48 for the two class model of one minute signal. The minimal set offers a reasonable trade-off for possible in-home monitoring, at least for some conditions that require only REM-NREM distinction. The method after extensive trials and standardisation, can alleviate the load of special purpose PSG labs and enable the tests to be done on general purpose computers.
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Jain JK, Agarwal S, Sharma RK. Total hip Replacement in Crowe type IV dysplastic hips - average 5 year follow-up and literature review. Acta Orthop Belg 2016; 82:539-548. [PMID: 29119895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
This is a retrospective study of 29 patients (34 hips) of Crowe grade IV dysplastic hips aged between 19 and 75 years who underwent THR for osteoarthritis secondary to DDH. The hips were evaluated radiologically for Sharp's acetabular angle, cup inclination, loosening, and ectopic bone formation. Clinically the results were evaluated by pre and postoperative -Harris hip scoring. The mean acetabular angle was 60.8° (range, 45°-68°) preoperatively. In 18 hips, subtrochanteric femoral osteotomy was performed. Pre-operatively, the mean leg length discrepancy was 5 cm (range, 2-8 cm). -Correction within 1 cm was possible in all patients -except in 4 patients. The mean Harris hip Score was 40.80 (32-45.90) preoperatively and 87.96 (74.78-94.72) at last follow-up. THR is successful in high dislocation dysplastic hips. Although there is no gold standard technique of THR in dysplastic hips and treatment of each patient should be individualized. Level of evidence : IV.
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Agarwal S, Gupta G, Sharma RK. Comparison between single stage and two stage bilateral total hip replacement- our results and review of literature. Acta Orthop Belg 2016; 82:484-490. [PMID: 29119888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Bilateral total hip replacement (THR) is a common procedure nowdays. Staging of surgery is still a -matter of debate. We performed a study to compare single stage and two stage bilateral THR and discuss the peri-operative and post-operative advantages and complications. This was a retrospective study. 48 patients underwent single stage and 56 patients underwent two stage bilateral THR. The average follow up period was 64 months and 70 months respectively. The hospital stay was 5.6 days in single stage and 9.0 days in two stage bilateral THR. The total blood loss was 280 ml and 440 ml ; average blood trans-fusion was 1.6 units and 2.2 units and walk without support was started at 42 days and 58 days respectively. No difference in complication rate was seen. Single staged bilateral THR is a safe procedure. The definite benefits are short hospital stay, lower cost and early rehabilitation.
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Javed R, Taku AK, Gangil R, Sharma RK. Molecular characterization of virulence genes of Streptococcus equi subsp. equi and Streptococcus equi subsp. zooepidemicus in equines. Vet World 2016; 9:875-81. [PMID: 27651677 PMCID: PMC5021838 DOI: 10.14202/vetworld.2016.875-881] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2016] [Accepted: 07/16/2016] [Indexed: 11/16/2022] Open
Abstract
AIM The aim was to determine the occurrence of streptococci in equines in Jammu (R. S. Pura, Katra), characterization of Streptococci equi subsp. equi and Streptococcus equi subsp. zooepidemicus with respect to their virulence traits and to determine antibiotic sensitivity pattern of virulent Streptococcus isolates. MATERIALS AND METHODS A total of 96 samples were collected from both clinically affected animals (exhibiting signs of respiratory tract disease) and apparently healthy animals and were sent to laboratory. The organisms were isolated on Columbia nalidixic acid agar containing 5% sheep blood as well as on sheep blood agar and confirmed by cultural characteristics and biochemical tests. Molecular detection of Streptococcus was done directly from cultures using sodA and seM gene-based polymerase chain reaction (PCR). Antibiogram was performed against five antibiotics such as amoxicillin, penicillin G, streptomycin, rifampicin, and methicillin. RESULTS During this study, a total 40 streptococcal isolates were obtained out of which 2 isolates were of S. equi subsp. equi, 12 isolates were from S. equi subsp. zooepidemicus. In the PCR-based detection, we revealed amplicons of 235 bp and 679 bp for confirmation of sodA and seM gene, respectively. In antibiogram, two isolates of S. equi subsp. equi were found resistant to penicillin G, and all other isolates were found sensitive to amoxicillin and streptomycin. CONCLUSION The majority of streptococcal infections was due to S. equi subsp. Zooepidemicus, and thus was recognized as a potential pathogen of diseases of equines besides S. equi subsp. equi.
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Uniyal S, Paliwal R, Verma M, Sharma RK, Rai JPN. Isolation and Characterization of Fipronil Degrading Acinetobacter calcoaceticus and Acinetobacter oleivorans from Rhizospheric Zone of Zea mays. BULLETIN OF ENVIRONMENTAL CONTAMINATION AND TOXICOLOGY 2016; 96:833-838. [PMID: 27084098 DOI: 10.1007/s00128-016-1795-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Accepted: 04/01/2016] [Indexed: 06/05/2023]
Abstract
An enrichment culture technique was used for the isolation of bacteria capable of utilizing fipronil as a sole source of carbon and energy. Based on morphological, biochemical characteristics and phylogenetic analysis of 16S rRNA sequence, the bacterial strains were identified as Acinetobacter calcoaceticus and Acinetobacter oleivorans. Biodegradation experiments were conducted in loamy sand soil samples fortified with fipronil (50 µg kg(-1)) and inoculated with Acinetobacter sp. cells (45 × 10(7) CFU mL(-1)) for 90 days. Soil samples were periodically analyzed by gas liquid chromatography equipped with electron capture detector. Biodegradation of fipronil fitted well with the pseudo first-order kinetics, with rate constant value between 0.041 and 0.051 days(-1). In pot experiments, fipronil and its metabolites fipronil sulfide, fipronil sulfone and fipronil amide were found below quantifiable limit in soil and root, shoot and leaves of Zea mays. These results demonstrated that A. calcoaceticus and A. oleivorans may serve as promising strains in the bioremediation of fipronil-contaminated soils.
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Uniyal S, Paliwal R, Sharma RK, Rai JPN. Degradation of fipronil by Stenotrophomonas acidaminiphila isolated from rhizospheric soil of Zea mays. 3 Biotech 2016; 6:48. [PMID: 28330119 PMCID: PMC4746198 DOI: 10.1007/s13205-015-0354-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Accepted: 12/24/2015] [Indexed: 11/28/2022] Open
Abstract
Fipronil is a widely used insecticide in agriculture and can cause potential health hazards to non-target soil invertebrates and nearby aquatic systems. In the present study, a fipronil degrading bacterium was isolated from fipronil contaminated soil, i.e. rhizospheric zone of Zea mays. Morphological, biochemical and molecular characterization of strain indicated that it clearly belongs to Stenotrophomonas acidaminiphila (accession no. KJ396942). A three-factor Box-Behnken experimental design combined with response surface modeling was employed to predict the optimum conditions for fipronil degradation. The optimum pH, temperature and total inocula biomass for the degradation of fipronil were 7.5, 35 °C and 0.175 g L-1, respectively. The bacterial strain was able to metabolize 25 mg L-1 fipronil with 86.14 % degradation in Dorn's broth medium under optimum conditions. Metabolites formed as a result of fipronil degradation were characterized with gas liquid chromatograph. A novel fipronil degradation pathway was proposed for S. acidaminiphila on the basis of metabolites formed. Non-sterilized soil inoculated with S. acidaminiphila was found to follow first order kinetics with a rate constant of 0.046 d-1. Fipronil sulfone, sulfide and amide were formed as the metabolites and were degraded below the quantifiable limit after 90 days of time period. Given the high fipronil degradation observed in the present study, S. acidaminiphila may have potential for use in bioremediation of fipronil contaminated soils.
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