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Immanuel T, Krishnan P, Raghuraman R, Veerappan N, Dam-Roy S. New records of Chondrilla australiensis and Chondrilla grandistellata (Demospongiae: Chondrosida: Chondrillidae) from Havelock Island, South Andaman, India. JOURNAL OF THREATENED TAXA 2015. [DOI: 10.11609/jott.2432.7.14.8167-8172] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
<p>The genus <em>Chondrilla</em> is reported from the Andaman group of Islands off Havelock Island for the first time, with two species, <em>C. grandistellata</em> and <em>C. australiensis</em> in this study. This genus has previously been reported and represented by four species in Indian waters viz., <em>Chondrilla mixta, C. sacciformis, C. kilakaria </em>and<em> C. australiensis.</em> <em>C. australiensis</em> is light brown to reddish-brown in colour; encrusts primarily on live boulder corals; contains oxyasters measuring 14.8-(18.5)-22.2 µm and spherasters measuring 17.3-(26)-29.7 µm. <em>C. grandistellata</em> is tan or brown in colour with unevenly distributed white speckles; Contains large spherasters that measure 106.3-(143.3)-175.6 µm. In this study it is suggested that <em>C. sacciformis</em> specimens reported previously from India may be <em>C. grandistellata</em>; this probable conspecificity is also discussed. </p><div> </div>
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Izharuddin E, Marimuthu K, Fong PB, Qi KJ, Chow A, Lye DC, Krishnan P, Ang B. Comparative risk factors for nosocomial New Delhi metallo-beta-lactamase (NDM-1) producing Enterobacteriaceae and non-carbapenemase producing (NCP) Enterobacteriaceae. Antimicrob Resist Infect Control 2015. [PMCID: PMC4475083 DOI: 10.1186/2047-2994-4-s1-p134] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Krishnan P, Saposnik G, Ovbiagele B, Zhang L, Symons S, Aviv R. Contribution and additional impact of imaging to the SPAN-100 score. AJNR Am J Neuroradiol 2015; 36:646-52. [PMID: 25572947 DOI: 10.3174/ajnr.a4195] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2014] [Accepted: 10/16/2014] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Stroke Prognostication by Using Age and NIHSS score (SPAN-100 index) facilitates stroke outcomes. We assessed imaging markers associated with the SPAN-100 index and their additional impact on outcome determination. MATERIALS AND METHODS Of 273 consecutive patients with acute ischemic stroke (<4.5 hours), 55 were characterized as SPAN-100-positive (age +NIHSS score ≥ 100). A comprehensive imaging review evaluated differences, using the presence of the hyperattenuated vessel sign, ASPECTS, clot burden score, collateral score, CBV, CBF, and MTT. The primary outcome assessed was favorable outcome (mRS ≤ 2). Secondary outcomes included recanalization, lack of neurologic improvement, and hemorrhagic transformation. Uni- and multivariate analyses assessed factors associated with favorable outcome. Area under the curve evaluated predictors of favorable clinical outcome. RESULTS Compared with the SPAN-100-negative group, the SPAN-100-positive group (55/273; 20%) demonstrated larger CBVs (<0.001), poorer collaterals (P < .001), and increased hemorrhagic transformation rates (56.0% versus 36%, P = .02) despite earlier time to rtPA (P = .03). Favorable outcome was less common among patients with SPAN-100-positive compared with SPAN-100-negative (10.9% versus 42.2%; P < .001). Multivariate regression revealed poorer outcome for SPAN-100-positive (OR = 0.17; 95% CI, 0.06-0.38; P = .001), clot burden score (OR = 1.14; 95% CI, 1.05-1.25; P < .001), and CBV (OR = 0.58; 95% CI, 0.46-0.72; P = .001). The addition of the clot burden score and CBV improved the predictive value of SPAN-100 alone for favorable outcome from 60% to 68% and 74%, respectively. CONCLUSIONS SPAN-100-positivity predicts a lower likelihood of favorable outcome and increased hemorrhagic transformation. CBV and clot burden score contribute to poorer outcomes among high-risk patients and improve stroke-outcome prediction.
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Krishnan P, Muthusami P, Heyn C, Shroff M. Advances in pediatric neuroimaging. Indian J Pediatr 2015; 82:154-65. [PMID: 25557178 DOI: 10.1007/s12098-014-1657-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2014] [Accepted: 12/03/2014] [Indexed: 12/19/2022]
Abstract
Conventional MRI protocols are an integral part of routine clinical imaging in pediatric patients. The advent of several newer MRI techniques provides crucial insight into the structural integrity and functional aspects of the developing brain, especially with the introduction of 3T MRI systems in clinical practice. The field of pediatric neuroimaging continues to evolve, with greater emphasis on high spatial resolution, faster scan time, as well as a quest for visualization of the functional aspects of the human brain. MR vendors are increasingly focusing on optimizing MR technology to make it suitable for children, in whom as compared to adults the head size is usually smaller and demonstrates inherent neuroanatomical differences relating to brain development. The eventual goal of these advances would be to evolve as potential biomarkers for predicting neurodevelopment outcomes and prognostication, in addition to their utility in routine diagnostic and therapeutic decision-making. Advanced MR techniques like diffusion tensor imaging, functional MRI, MR perfusion, spectroscopy, volumetric imaging and arterial spin labeling add to our understanding of normal brain development and pathophysiology of various neurological disease processes. This review is primarily focused on outlining advanced MR techniques and their current and potential pediatric neuroimaging applications as well as providing a brief overview of advances in hardware and machine design.
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Kim A, Krishnan P, Spies J. Pre-procedural MRA for treatment planning prior to prostate artery embolization. J Vasc Interv Radiol 2015. [DOI: 10.1016/j.jvir.2014.12.292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Krishnan P, Gayathri K, Rajakumar PR, Jayaramakrishnan V, Gunasekaran S, Anbalagan G. Studies on crystal growth, vibrational, optical, thermal and dielectric properties of new organic nonlinear optical crystal: Bis (2,3-dimethoxy-10-oxostrychnidinium) phthalate nonahydrate single crystal. SPECTROCHIMICA ACTA. PART A, MOLECULAR AND BIOMOLECULAR SPECTROSCOPY 2014; 131:114-124. [PMID: 24825664 DOI: 10.1016/j.saa.2014.03.040] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2013] [Revised: 03/17/2014] [Accepted: 03/20/2014] [Indexed: 06/03/2023]
Abstract
In this paper, we report the synthesis, growth and characterization of a new organic NLO single crystal of Bis (2,3-dimethoxy-10-oxostrychnidinium) phthalate nonahydrate, for the first time. The single crystal XRD study reveals that the crystal belongs to monoclinic system. The molecular structure and the nature of the vibrations were identified by vibrational and NMR spectroscopic studies. The UV absorption edge was found to be 330nm with a wide optical transmittance window covering the visible region. The crystal exhibits physicochemical stability upto 90.56°C. Various thermodynamic parameters were calculated from the TG data. The Kurtz powder second harmonic generation revealed that the SHG efficiency of the grown crystal was about 2.8 times that of KDP and was found to be phase matchable. The measured low value of birefringence indicates its suitability for NLO devices. The PL spectrum exhibited two peaks (355 and 406nm) due to the donation of protons from carboxylic acid to quartenium nitrogen. The dielectric behavior of the grown crystal was analyzed for different frequencies at different temperatures.
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Kunheri B, Arjunan A, Krishnan P, Pillai B, Prasad S, Bernier-Chastagner V, Desandes E, Carrie C, Alapetite C, Hankinson T, Jones D, Handler M, Foreman N, Liu A, Smiley NP, Alden T, Hartsell W, Fangusaro J, Hill-Kayser CE, Lustig RA, Minturn JE, Both S, Waanders AJ, Belasco JB, Armstrong C, Phillips PC, Fisher MJ, Hill-Kayser CE, Paltin I, Lustig RA, Fisher MJ, Both S, Belasco JB, Cole KA, Waanders AJ, Phillips PC, Minturn JE, Wells E, Vezina G, Kilburn L, Rood B, Crozier F, Hwang E, Packer R, Janssens GO, van den Bosch S, van Kollenburg PG, Gidding CE, Schieving JH, Kaanders JH, van Lindert EJ, Kramer K, Pandit-Taskar N, Souweidane MM, Wolden S, DeSelm C, Cheung NKV, Lassen-Ramshad Y, Hansen J, Seiersen K, Petersen JBB, Mahajan A, Grosshans D, Ris D, Chintagumpala M, Okcu F, McAleer MF, Moore B, Stancel H, Minard C, Guffey D, Kahalley L, Blomgren K, Zhou K, Xie C, Zhu C, McAleer MF, Zhao Z, Weinberg J, Sandberg D, Hughes D, Mahajan A, Anderson P, Guha-Thakurta N, Muller K, Hoffmann M, Seidel C, Warmuth-Metz M, Pietsch T, Kordes U, Sander A, Rossler J, Graf N, Scheithauer H, Kortmann RD, Kramm CM, von Bueren AO, Gunther J, Sato M, Chintagumpala M, Jo E, Paulino A, Adesina A, Ketonen L, Jones J, Su J, Okcu F, Khatua S, Dauser R, Whitehead W, Weinberg J, Mahajan A, Gandola L, Pecori E, Biassoni V, Chiruzzi C, Schiavello E, Meroni S, Spreafico F, Pignoli E, Massimino M, Jalali R, Krishna U, Gupta T, Goswami S, Deodhar J, Dutta D, Kannan S, Goel A, Sarin R, Sastry J, Ronghe M, Murphy D, Forbes K, Jones R, Cowie F, Brown J, Indelicato D, Goksel EO, Tezcanli E, Bilge H, Yasemin, Yarar Y, Sato M, Gunther J, Mahajan A, Jo E, Paulino A, Adesina A, Jones J, Ketonen L, Su J, Okcu M, Khatua S, Dauser R, Whitehead W, Weinberg J, Chintagumpala M, Paulino A, Jo E, Sato M, Su J, Okcu MF, Mahajan A, Dauser R, Whitehead W, Adesina A, Chintagumpala M, Danielsson A, Tisell M, Rydenhag B, Caren H. RADIATION ONCOLOGY. Neuro Oncol 2014; 16:i117-i122. [PMCID: PMC4046296 DOI: 10.1093/neuonc/nou080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/10/2023] Open
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Krishnan P, Singh R, Verma APS, Joshi DK, Singh S. Changes in seed water status as characterized by NMR in developing soybean seed grown under moisture stress conditions. Biochem Biophys Res Commun 2014; 444:485-90. [PMID: 24472549 DOI: 10.1016/j.bbrc.2014.01.091] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2013] [Accepted: 01/18/2014] [Indexed: 10/25/2022]
Abstract
Changes in water status of developing seeds of Soybean (Glycine max L. Merrill.) grown under different moisture stress conditions were characterized by proton nuclear magnetic resonance (NMR)- spin-spin relaxation time (T2). A comparison of the seed development characteristics, composition and physical properties indicated that, characteristics like seed weight, seed number/ear, rate of seed filling increased with development stages but decreased with moisture stress conditions. The NMR- spin-spin relaxation (T2) component like bound water increased with seed maturation (40-50%) but decreased with moisture stress conditions (30-40%). The changes in seed water status to increasing levels of moisture stress and seed maturity indicates that moisture stress resulted in more proportion of water to bound state and intermediate state and less proportion of water in free-state. These changes are further corroborated by significant changes in protein and starch contents in seeds under high moisture stress treatments. Thus seed water status during its development is not only affected by development processes but also by moisture stress conditions. This study strongly indicated a clear moisture stress and development stage dependence of seed tissue water status in developing soybean seeds.
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Adlekha S, Chadha T, Krishnan P, Sumangala B. Prevalence of helicobacter pylori infection among patients undergoing upper gastrointestinal endoscopy in a medical college hospital in kerala, India. Ann Med Health Sci Res 2013; 3:559-63. [PMID: 24380008 PMCID: PMC3868123 DOI: 10.4103/2141-9248.122109] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Helicobacter pylori related gastritis is a major health ailment in developing nations. There is high morbidity and mortality ranging from chronic gastritis to gastric malignancies. Prevalence of H. pylori infection varies markedly from country to country and in a country, region to region. AIM To study the prevalence of H. pylori gastritis in patients undergoing endoscopy and its association with the development of gastrointestinal diseases. SUBJECTS AND METHODS The study was carried out in a Medical College Hospital in Kerala, India. Patients presenting with dyspeptic symptoms were subjected to upper gastrointestinal endoscopy and investigated for H. pylori infection through histopathological examination and rapid urease test of biopsy specimen. Diagnosis of H. pylori infection was made if one or both diagnostic test results were positive. Data analysis was carried out using the statistical package for social sciences, for Windows version 16.0 (SPSS 16; Chicago, IL, USA). RESULTS H. pylori infection was diagnosed in 62.0% (329/530) of patients screened. There was no statistically significant difference in sex and age related distribution (<50 year age group and >50 year age group) of H. pylori infection. However, a statistically significant association of H. pylori infection with the presence of endoscopic abnormalities, peptic ulcer, and dysplasia/cancer was seen. CONCLUSION The prevalence of H. pylori infection is significantly high in rural and suburban population of Ernakulam district, Kerala. Early detection and prompt treatment are essential for prevention of serious complications.
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Elnour S, Krishnan P, O'Sullivan G. Outcomes after institution of a new oxytocin infusion protocol. Int J Obstet Anesth 2013; 23:86-7. [PMID: 24361189 DOI: 10.1016/j.ijoa.2013.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2013] [Accepted: 09/15/2013] [Indexed: 11/19/2022]
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Abstract
Lipomas are the tumors of mature lipocytes with its occurrence most often on the torso, neck, upper thighs, upper arms, and armpits, but they can occur almost anywhere in the body. They are the rare tumors of intestine, more frequently located in large intestine compared to small intestine. We present the case of a 58-year-old post-menopausal lady presenting with rectal bleeding and utero-vaginal prolapse. The prolapsing mass was excised, and histopathological examination diagnosed the lesion to be a lipoma.
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Theodoropoulos K, Mennuni M, Sartori S, Moreno P, Krishnan P, Baber U, Dangas G, Mehran R, Sharma SK, Kini A. Coronary artery disease burden and long-term outcomes in patients with human immune deficiency virus (HIV) undergoing percutaneous coronary intervention: results from a single-center registry. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht309.p3102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Mennuni M, Moreno P, Krishnan P, Sharma SK, Sartori S, Kovacic J, Pyo R, Dangas G, Yu J, Kini A. Impact of vascular closure with the pre-closure technique on adverse events in patients undergoing transfemoral balloon aortic valvuloplasty: results from a single-center registry. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht308.p2208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Krishnan P, Gayathri K, Bhagavannarayana G, Jayaramakrishnan V, Gunasekaran S, Anbalagan G. Growth, spectral, thermal, dielectric, mechanical, linear and nonlinear optical, birefringence, laser damage threshold studies of semi-organic crystal: dibrucinium sulfate heptahydrate. SPECTROCHIMICA ACTA. PART A, MOLECULAR AND BIOMOLECULAR SPECTROSCOPY 2013; 112:152-160. [PMID: 23666350 DOI: 10.1016/j.saa.2013.04.058] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2013] [Revised: 04/02/2013] [Accepted: 04/10/2013] [Indexed: 06/02/2023]
Abstract
Dibrucinium sulfate heptahydrate (DBSH), a semi-organic nonlinear optical material, has been synthesized and single crystals were grown from water-ethanol solution at room temperature up to dimensions of 10×7×2 mm(3). The unit cell parameters were determined from single crystal and powder X-ray diffraction studies. The structural perfection of the grown crystal has been analyzed by high-resolution X-ray diffraction (HRXRD) study. FTIR and Raman studies were performed to identify the functional groups present in the title compound. The activation energy (E), entropy (ΔS), enthalpy (ΔH) and Gibbs free energy (ΔG), of the thermal decomposition reaction have been derived from thermo gravimetric (TGA) and differential thermal (DTA) analysis curves, using Coats-Redfern method. The variation of dielectric properties of the grown crystal with respect to frequency has been investigated at different temperatures. Microhardness measurements revealed the mechanical strength of grown crystal. The optical parameters, the optical band gap E(g) and width of localized states Eu were determined using the transmittance data in the spectral range 200-800 nm. The relative second harmonic efficiency of the compound is found to be 1.4 times greater than that of KDP. Birefringence and Laser damage threshold studies were carried out for the grown crystal.
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Ahmed J, Ahmad N, Jankharia B, Krishnan P, Merchant RH. Effect of deferasirox chelation on liver iron and total body iron concentration. Indian J Pediatr 2013; 80:655-8. [PMID: 23715791 DOI: 10.1007/s12098-013-1030-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2013] [Accepted: 03/28/2013] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To determine efficacy of Deferasirox (DFX) on total body iron and liver iron concentration (LIC) as estimated by serum ferritin (SF) and liver MRI T2. METHODS Thirty patients had baseline MRI T2 of the liver performed to determine LIC before starting DFX therapy and classified as normal >6.3 milliseconds (ms), mild 6.3-2.7 ms, moderate 2.7-1.4 ms and severe iron overload <1.4 ms. DFX was given 25-35 mg/kg/d. The serum ferritin (SF) level was estimated every 3 monthly. Liver iron is expressed as liver R2 = 1,000/T2. The primary end point of the study was to determine change in SF and liver MRI R2 values after 18 mo of therapy. RESULTS All 30 patients had some degree of liver iron overload; 11 (36.6 %) had severe, 15 (50 %) had moderate while 4 (13.3 %) had mild overload. The pre-DFX therapy median SF of all was 3604.5 ng/mL (IQR 2357.0-5056.0) and median liver R2 was 574.71 Hz (IQR 411.3-770.8). After 18 mo, SF dropped significantly to a median of 2036.5 ng/mL (IQR 1700.0-3162.0) (p = 0.0011), while median liver R2 decreased from 574.71 to 568.18 Hz (IQR 393.4-803.2) which was not significant (p = 0.986). CONCLUSIONS DFX monotherapy at the doses used decreases total body iron, but does not significantly decrease liver iron. It is well tolerated by Indian thalassemia patients, with observed side effects including rash, diarrhea, and transient albuminuria. MRI T2 (and derived R2) can serve as useful method in non invasive monitoring of LIC in thalassemia patient management.
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Krishnan P, Vikas N, Titus-Immanuel T, Goutham-Bharathi MP, Anand A, Kumar KV, Kumar SS. Tropical storm off Myanmar coast sweeps reefs in Ritchie's Archipelago, Andaman. ENVIRONMENTAL MONITORING AND ASSESSMENT 2013; 185:5327-5338. [PMID: 23135061 DOI: 10.1007/s10661-012-2948-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2012] [Accepted: 10/08/2012] [Indexed: 06/01/2023]
Abstract
The reefs in some islands of Andaman and Nicobar suffered severe damage following a tropical storm in the Bay of Bengal off Myanmar coast during 13-17 March 2011. Surveys were conducted at eight sites in Andaman, of which five were located in the Ritchie's Archipelago where maximum wind speeds of 11 m s(-1) was observed; and three around Port Blair which lay on the leeward side of the storm and had not experienced wind speeds of more than 9 m s(-1). Corals in the shallow inshore reefs were broken and dislodged by the thrust of the waves. Significant damage in the deeper regions and offshore reefs were caused by the settlement of debris and sand brought down from the shallower regions. The fragile branching corals (Acropora sp.) were reduced to rubbles and the larger boulder corals (Porites sp.) were toppled over or scarred by falling debris. The reefs on the windward side and directly in the path of the storm winds were the worst affected. The investigation exposes the vulnerability of the reefs in Andaman to the oceanographic features which generally remain unnoticed unless the damage is caused to the coastal habitats.
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Krishnan P, Gayathri K, Sivakumar N, Gunasekaran B, Anbalagan G. Bis(2,3-dimeth-oxy-10-oxostrychni-din-ium) phthalate nonahydrate. Acta Crystallogr Sect E Struct Rep Online 2013; 69:o870. [PMID: 23795049 PMCID: PMC3685030 DOI: 10.1107/s160053681301204x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2013] [Accepted: 05/02/2013] [Indexed: 11/11/2022]
Abstract
The asymmetric unit of the title compound 2C23H27N2O4+·C8H4O42−·9H2O, contains a cation, an anionon a twofold axis and four and half molecules of water, one of which is located on the twofold axis. In the cation, both fused pyrrolidine rings exhibit twisted conformations, while the piperidine rings adopt screw–boat and boat conformations. In the crystal, the components are linked by N—H⋯O and O—H⋯O hydrogen bonds. The brucinium cations form typical undulating head-to-tail ribbon structuresalong the a-axis direction, which associate with the carboxy phthalate and the water molecules.
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Su IC, Krishnan P, Rawal S, Krings T. Magnetic Resonance Evolution of De Novo Formation of a Cavernoma in a Thrombosed Developmental Venous Anomaly. Neurosurgery 2013; 73:E739-44; discussion E745. [DOI: 10.1227/neu.0000000000000002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Abstract
BACKGROUND AND IMPORTANCE:
Mechanisms that lead to de novo formations of nonfamilial-type cavernomas are not well understood. One of the interesting hypotheses is the causative relationship between developmental venous anomaly (DVA) and cavernoma formation. We report a unique case in which serial imaging demonstrated the evolution of de novo formation of a cavernoma in association with a thrombosed DVA. A detailed review of the causal hypothesis between a DVA and cavernoma is also provided.
CLINICAL PRESENTATION:
We report a 37-year-old female patient in whom a cavernoma-like lesion arose 1 year after the progressive thrombosis of a medullary (or caput medusa) vein of a DVA. The presence of an acute angulation in the draining vein may have prompted an intrinsic outflow restriction. Possible worsening of venous disequilibrium led to subsequent thrombus progression, venous congestion, and occlusion of the vein with venous dilation and signs of stasis on follow-up magnetic resonance imaging. Finally, this developed into a lobulated lesion with salt-and-pepper appearance at the converging region of medullary tributaries, which typified the classic features of a cavernoma.
CONCLUSION:
Compared with other published cases of de novo cavernoma formation in relation to a DVA, our case, for the first time, allows us to witness the temporal evolution from a thrombosed DVA to the birth of a cavernoma around it. This supports the hypothesis that the cavernoma can be an acquired disease that arises from a DVA.
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Balm MND, La MV, Krishnan P, Jureen R, Lin RTP, Teo JWP. Emergence of Klebsiella pneumoniae co-producing NDM-type and OXA-181 carbapenemases. Clin Microbiol Infect 2013; 19:E421-3. [PMID: 23668475 DOI: 10.1111/1469-0691.12247] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2013] [Revised: 04/01/2013] [Accepted: 04/07/2013] [Indexed: 11/28/2022]
Abstract
The emergence of carbapenemase-producing Enterobacteriaceae is a rapidly evolving threat worldwide. Here, we report the molecular characterization of two Klebsiella pneumoniae isolates carrying both bla(OXA -181) and bla(NDM -1) or bla(NDM -5) isolated from epidemiologically unrelated patients in Singapore. The bla(OXA -181) genes were found existing in different genetic environments.
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Krishnan P, Gayathri K, Sivakumar N, Chakkaravarthi G, Anbalagan G. 2,3-Dimeth-oxy-10-oxostrychnidinium hydrogen oxalate dihydrate. Acta Crystallogr Sect E Struct Rep Online 2013; 69:o659. [PMID: 23723821 PMCID: PMC3647855 DOI: 10.1107/s1600536813008623] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2013] [Accepted: 03/28/2013] [Indexed: 11/10/2022]
Abstract
In the cation of the title salt, C23H27N2O4 (+)·C2HO4 (-)·2H2O, both fused pyrrolidine rings exhibit twisted conformations, while the piperidine rings adopt screw-boat and boat conformations. In the crystal, the three components are linked via O-H⋯O and N-H⋯O inter-actions, forming a tape along the b axis. The tapes are further linked by weak C-H⋯O hydrogen bonds. forming a three-dimensional network.
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Krishnan P, Gayathri K, Bhagavannarayana G, Gunasekaran S, Anbalagan G. Growth, nonlinear optical, thermal, dielectric and laser damage threshold studies of semiorganic crystal: monohydrate piperazine hydrogen phosphate. SPECTROCHIMICA ACTA. PART A, MOLECULAR AND BIOMOLECULAR SPECTROSCOPY 2013; 102:379-385. [PMID: 23220681 DOI: 10.1016/j.saa.2012.10.004] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2012] [Revised: 09/22/2012] [Accepted: 10/04/2012] [Indexed: 06/01/2023]
Abstract
Monohydrate piperazine hydrogen phosphate (MPHP), a semi organic nonlinear optical material has been synthesized and single crystals were grown from aqueous solution by slow evaporation technique. Single crystal X-ray diffraction study on grown crystal reveals that they belong to monoclinic crystal system with space group P2(1)/c; (a=6.39Å; b=12.22Å; c=11.16Å; β=97.14°; V=864Å(3)). The structural perfection of the grown crystal was analyzed by high-resolution X-ray diffraction (HRXRD) rocking curve measurements. FTIR spectrum confirms the presence of the functional groups in synthesized material. UV-Vis spectrum indicates that the crystal is transparent in the entire visible region with a lower cut off wavelength of 387 nm. The variation of dielectric properties of the grown crystal with respect to frequency has been investigated at different temperatures. Thermal analysis carried out on the MPHP crystal shows that the crystal is stable up to 135°C. Relative powder second harmonic generation efficiency tested by Kurtz-Perry powder technique, which was about 0.638 times that of Potassium dihydrogen phosphate.
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97
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Kanagathara N, Renganathan NG, Marchewka MK, Sivakumar N, Gayathri K, Krishnan P, Gunasekaran S, Anbalagan G. Growth and characterization of Melaminium bis (trichloroacetate) dihydrate. SPECTROCHIMICA ACTA. PART A, MOLECULAR AND BIOMOLECULAR SPECTROSCOPY 2013; 101:112-118. [PMID: 23099168 DOI: 10.1016/j.saa.2012.09.057] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2012] [Revised: 08/30/2012] [Accepted: 09/20/2012] [Indexed: 06/01/2023]
Abstract
Single crystals of melaminium bis (trichloroacetate) dihydrate have been grown successfully by slow evaporation solution growth technique at room temperature. Single crystal X-ray diffraction analysis reveals that the compound crystallizes in monoclinic system with non -centrosymmetric space group C2 with lattice parameters a=17.70 Å, b=8.44 Å, c=6.09 Å, α=90°, β=100.24°, γ=90° and V=900 (Å)3. The UV-Vis transmittance spectrum shows that the crystal has a good optical transmittance in the entire visible region with lower cutoff wavelength of 351 nm. The vibrational frequencies of various functional groups present in the crystal have been derived from FI-IR, FT-Raman and Confocal Raman analyses. The chemical structure of the compound was established by 1H and 13C NMR spectrum. TGA-DTA analysis reveals that the materials have good thermal stability and the melting point of the crystal is found to be 195°C. The dielectric response of the crystals was studied in the frequency range 50 Hz to 5 MHz at different temperatures and the results are discussed. Etching studies show the growth pattern of the crystals. The second harmonic generation efficiency was measured in comparison with KDP by employing powder Kurtz method.
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98
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Krishnan P, Frew Q, Green A, Martin R, Dziewulski P. Cause of death and correlation with autopsy findings in burns patients. Burns 2012; 39:583-8. [PMID: 23137628 DOI: 10.1016/j.burns.2012.09.017] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2012] [Revised: 09/18/2012] [Accepted: 09/26/2012] [Indexed: 10/27/2022]
Abstract
OBJECTIVE Global mortality from burns is decreasing however there is a relative paucity of mortality data in the literature from burns units in the United Kingdom. We present an analysis of burns deaths and correlation with coroners' autopsy findings from a large regional burns unit. DESIGN Retrospective medical note review of patients who died over a 7 year period (January 2005 to April 2011) was undertaken. Patient demographics were recorded in addition to: burn size, depth, length of stay, presence of inhalational injury, organs failing and diagnosis of sepsis. In order to evaluate the accuracy of our pre-mortem clinical diagnosis, we compared post-mortem cause of death with clinical cause of death. RESULTS There were 92 deaths out of 4745 admissions for acute burn (crude mortality 1.9%). 37 patients were immediately given comfort care and excluded from analysis. Average age was 52.9 years±19.4, average percentage burn 43.7%±26.8, and length of stay 26.4±45 days. 80% of deaths were attributable to flame burn (44/55), and 51% (28/55) suffered inhalational injury. Multi-organ failure was the primary cause of death (39/55), with sepsis being the primary trigger (20/39, 51%). Pseudomonas was the most common organism isolated in septic patients. There were significant difficulties in obtaining post-mortem reports and an obvious lack of correlation between coroners' reports and clinical cause of death. CONCLUSIONS The principal cause of mortality in our unit was multi-organ failure due to sepsis, which concurs with current literature. Autopsy has previously been shown to be a useful retrospective diagnostic tool, however we challenge its reliability as a result of our study.
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Krishnan P, Bhat R, Kush A, Ravikumar P. Isolation and functional characterization of bacterial endophytes from Carica papaya fruits. J Appl Microbiol 2012; 113:308-17. [DOI: 10.1111/j.1365-2672.2012.05340.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2011] [Revised: 05/04/2012] [Accepted: 05/07/2012] [Indexed: 11/29/2022]
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100
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Ang B, Ho Y, Marimuthu K, Poh B, Yung CF, Krishnan P. The impact of Universal Active Surveillance for MRSA and cohorting on MRSA infections. Int J Infect Dis 2012. [DOI: 10.1016/j.ijid.2012.05.465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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