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Shruti S, Siraj F, Singh A, Ramesh V. Epidermodysplasia verruciformis: three case reports and a brief review. ACTA DERMATOVENEROLOGICA ALPINA PANNONICA ET ADRIATICA 2017; 26:59-61. [PMID: 28941263 DOI: 10.15570/actaapa.2017.19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Epidermodyplasia verruciformis (EV) is a rare heritable disease that is characterized by an increased susceptibility to infection with specific human papillomavirus (HPV) types due to a defect in cell-mediated immune response to HPV infection. Widespread infection with HPV is responsible for the development of wart-like lesions and pityriasis versicolor-like spots. These individuals have a lifelong risk of developing cutaneous malignancies, especially Bowen's disease and squamous cell carcinoma, mainly in sun-exposed parts. Being the first disease to correlate cancer and viral infection, EV serves as the cornerstone of the understanding of viral oncogenesis. We report three cases of EV, of which one patient subsequently developed Bowen's disease. The patients had multiple hypopigmented papules and plaques of varying sizes that started erupting in childhood and were mainly distributed over sun-exposed parts of the body. Histopathology of the skin biopsies was consistent with EV. One of these patients had started developing an ulcerated plaque over the left clavicle 2 years earlier. A biopsy from the clavicular region also showed histopathological features of Bowen's disease arising in EV. Hence, this clinical review discusses three cases of EV presenting in different age groups with detailed histopathological findings typical for EV.
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Singh VP, Sinha N, Ramesh V, Tewari S, Khan F, Agrawal S. Mutation in the Gene Encoding Sterol Regulatory Element Binding Protein (SREBP-2) in Hyper-Cholesterolaemic Subjects. INT J HUM GENET 2017. [DOI: 10.1080/09723757.2007.11886012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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78
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79
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Bharani V, Ramesh V, Rao RN, Tewari S. Evaluation of gamma glutamyl transferase as a marker of cardiovascular risk, in 200 angiographically proven coronary artery disease patients. Indian Heart J 2017. [PMID: 28648423 PMCID: PMC5485402 DOI: 10.1016/j.ihj.2017.03.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Gamma glutamyl transferase (GGT) is emerging as a promising marker for assessing cardiovascular risk. GGT predicts cardiovascular mortality in the population and is positively associated with traditional risk factors for coronary artery disease (CAD). This study was undertaken on 200 north Indian CAD patients diagnosed with coronary angiography to study relation of GGT with risk factors for CAD and severity of CAD. GGT values ranged from 5 to 69U/L and were divided in 4 quartiles. GGT was positively associated with triglyceride (p=0.008) and VLDL cholesterol (p=0.002) in our subjects. Also an increase in total cholesterol from GGT quartile I to quartile IV (p=0.28) was noted.
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80
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Verma S, Singh R, Sharma V, Bumb RA, Negi NS, Ramesh V, Salotra P. Development of a rapid loop-mediated isothermal amplification assay for diagnosis and assessment of cure of Leishmania infection. BMC Infect Dis 2017; 17:223. [PMID: 28335752 PMCID: PMC5363003 DOI: 10.1186/s12879-017-2318-8] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2016] [Accepted: 03/10/2017] [Indexed: 11/10/2022] Open
Abstract
Background Leishmaniasis is a spectrum of diseases with great relevance to public health. Conventional diagnostic methods are time consuming, needing trained personnel. A robust, rapid and cost effective diagnostic test is warranted for on-time diagnosis and field application. Methods We have developed a loop mediated isothermal amplification (LAMP) assay with primers (n = 6) based on Leishmania donovani kDNA for detection of Leishmania infection, using a closed tube to prevent cross-contamination. The assay was used to detect Leishmania infection in biological samples obtained from patients of visceral leishmaniasis (VL), post kala-azar dermal leishmaniasis (PKDL) and cutaneous leishmaniasis (CL). Results The assay was positive for L. donovani, L. tropica and L. major parasites, with the highest sensitivity towards L. donovani (1 fg DNA). The high sensitivity of the assay for detection of L. donovani was reflected in its ability to detect parasite DNA within 30 min of amplification time with a threshold detection limit of ≥25 copies per reaction. The assay detected parasite in 64 of 66 VL blood samples (sensitivity, 96.9%; 95% CI: 89.6-99.2%), 15 of 15 VL bone marrow aspirate samples (sensitivity, 100%; 95% CI:79.6-100%), 65 of 67 PKDL tissue biopsy samples (sensitivity, 97%; 95% CI:89.7-99.2%). The assay was evaluated in a few cases of CL wherein it was found positive in 8 of 10 tissue biopsies (sensitivity, 80%; 95% CI: 49-94.3%). The assay was negative in all control blood (n = 76) and tissue biopsy (n = 24) samples (specificity, 100%; 95% CI: 96.3-100%). Further, the assay was evaluated for its utility in assessment of cure in treated VL and PKDL patients. The assay detected parasite DNA in 2 of 20VL blood samples and 2 of 21 PKDL tissue samples. Out of 4 cases that were positive for parasite DNA at post treatment stage, 2 patients (1VL and 1 PKDL) returned with relapse. Conclusions The study demonstrated a Leishmania genus specific closed tube LAMP assay for reliable and rapid molecular diagnosis of VL and PKDL with potential for application in assessment of cure.
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81
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Molpariya A, Ramesh V. Lichen scrofulosorum: importance of early recognition. Clin Exp Dermatol 2017; 42:369-373. [DOI: 10.1111/ced.13050] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/14/2016] [Indexed: 11/28/2022]
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82
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Raj J, Bahuleyan H, Ramesh V, Vanajakshi LD. Soft Computing-Based Traffic Density Estimation Using Automated Traffic Sensor Data under Indian Conditions. CURR SCI INDIA 2017. [DOI: 10.18520/cs/v112/i05/954-964] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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83
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Jha A, Khunger N, Malarvizhi K, Ramesh V, Singh A. Familial Disseminated Cutaneous Glomuvenous Malformation: Treatment with Polidocanol Sclerotherapy. J Cutan Aesthet Surg 2017; 9:266-269. [PMID: 28163461 PMCID: PMC5227083 DOI: 10.4103/0974-2077.197083] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Glomuvenous malformations (GVMs) present as asymptomatic multiple pink-to-blue nodules or plaques. Disseminated lesions are rare, representing 10% of all the cases. Familial cases are caused by mutations in the glomulin gene. A young male presented with multiple bluish-to-dusky red-coloured nodules 10-15 in numbers over the trunk, limbs and buttocks since 12 years of age. They ranged in size from 1 to 3 cm, partially to non-compressible and tender on palpation. There was no history of any systemic complaint. His sister and mother had similar lesions but in a limited distribution. Biopsy showed multiple ectatic dilated vascular channels lined by multiple layers of glomus cells consistent with the diagnosis of GVM. The biopsy of the lesions from the mother and sister also showed similar features. Mutation analysis for glomulin gene could not be done because of the unavailability of the facility at our setting. He underwent sclerotherapy with 3% polidocanol every 2 weeks, and there was significant improvement in the lesions after six sessions of sclerotherapy. The patient is under follow-up and there is no recurrence of the lesions over treated sites after 6 months.
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84
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Nitin M, Ramesh V, Radhakrishnan M. Hemodynamic changes in cervical myelopathy with prone position using non invasive cardiac output monitor. JOURNAL OF NEUROANAESTHESIOLOGY AND CRITICAL CARE 2017. [DOI: 10.1055/s-0038-1646241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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85
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Sharma B, Singh PK, Pandey K, Mittal G, Ramesh V, Deb M. Subcutaneous Cyst due to Medicopsis romeroi in a Diabetic Lepromatous Leprosy Patient: An Interesting Case Report and Review from India. J Clin Diagn Res 2017. [DOI: 10.7860/jcdr/2017/30102.10718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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86
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Shruti S, Singh A, Ramesh V, Siraj F. Phaeohyphomycosis of the Face Masquerading as Basal Cell Carcinoma in an Immunocompetent Patient. Indian Dermatol Online J 2017; 8:271-273. [PMID: 28761846 PMCID: PMC5518581 DOI: 10.4103/idoj.idoj_294_16] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Pheohyphomycosis is a rare heterogeneous group of mycotic infections caused by dermatiaceous (phaeoid) fungi affecting the skin, subcutaneous tissue, and the central nervous system.Involvement of the face is extremely rare, and very few cases have been reported in India so far. We reporta case of phaeohyphomycosisin a 45-year-old female with 1-year history of a well- defined hypertrophic plaque over the right cheek advancing towards the forehead. The lesion was ulcerated with rolled-up margins; a provisional clinical diagnosis of basal cell carcinoma was given. Histopathology of the skin biopsy revealed numerous multinucleated giant cells and fungal hyphae with in and in between the giant cells. Various histochemical stains were used toconfirm the presence of fungal hyphae. Melanin pigment in the fungus was demonstrated with Masson's Fontana stain. Based on the histopathological and histochemical findings, a diagnosis of phaeohyphomycosis was given and it was concluded that the disease was more of a histopathological than clinical diagnosis. This case is being reported due to its unusual presentation and it also highlights the importance of histopathology in the diagnosis of this rare disease.
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87
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Ramesh V. The molecular phylogeny and taxonomy of endophytic fungal species from the leaves of Vitex negundo L. STUDIES IN FUNGI 2017. [DOI: 10.5943/sif/2/1/4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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88
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Dalal V, Kaur M, Rai C, Singh A, Ramesh V. Histopathological spectrum of lichen sclerosus Et atrophicus. INDIAN JOURNAL OF DERMATOPATHOLOGY AND DIAGNOSTIC DERMATOLOGY 2017. [DOI: 10.4103/ijdpdd.ijdpdd_66_16] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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89
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Sheetal, Ramesh V, Balamurali PD, Premalatha B, Chaudhary M. Cystadenoma in Retromolar Region: A Case Report. J Clin Diagn Res 2016; 10:ZD17-ZD18. [PMID: 27891483 DOI: 10.7860/jcdr/2016/20149.8679] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Accepted: 05/25/2016] [Indexed: 11/24/2022]
Abstract
Cystadenoma is a rare benign salivary gland epithelial tumor that is characterized by intraluminal papillary projection. Majority of the tumors are located in minor salivary glands and usually occur in palatal and buccal mucosa, but rarely found in retromolar area. Clinically it is difficult to differentiate it from other minor salivary gland tumors, and diagnosis is chiefly based on characteristic clinical features and immunohistochemistry. We present a case of Cystadenoma arising from the minor salivary gland in retromolar area of a 44 year old female patient with a special emphasis on the immunohistochemistry to rule out the metastatic follicular carcinoma of thyroid.
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90
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Gupta V, Ramesh V. Understanding cutaneous tuberculosis in children. Int J Dermatol 2016; 56:242-244. [DOI: 10.1111/ijd.13441] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Accepted: 07/11/2016] [Indexed: 11/27/2022]
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91
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Ramesh V. Alopecias: Practical evaluation and management. Indian J Med Res 2016. [PMCID: PMC5345317 DOI: 10.4103/0971-5916.200879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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92
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Reka SS, Ramesh V. Demand side management scheme in smart grid with cloud computing approach using stochastic dynamic programming. ACTA ACUST UNITED AC 2016. [DOI: 10.1016/j.pisc.2016.04.024] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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93
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Sarojini S, Ramesh V, Senthilkumaar P. Cytotoxicity effect of ethanolic extract of Mikania glomerata against A549 human lung cancer cell line. ACTA ACUST UNITED AC 2016. [DOI: 10.7439/ijasr.v2i7.3512] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The genus Mikania is the largest of its kind in the family Eupatorieae (Asteraceae), with more than 430 species concentrated mainly in the tropical regions, among which, Mikania glomerata is a most common herb generally employed in the treatment of respiratory disorders. The Milania glomerata plant leaf extracts were used for anticancer study against A549 human lung cancer cell line. The solid liquid extraction method has been employed to prepare the ethanol extract of Mikania glomerata through soxhelt apparatus method. To check the anti-proliferative effect of this extract, the extract chosen was tested for cell viability on the lung cancer cells A549 in different concentrations. Cell viability was evaluated by MTT assay for 24 hour and 48 hours. The LD50 value was calculated for the level of cell death and its effectiveness. The dose-dependent manner plays an important role in the treatment of lung cancer cell lines. The present study suggests that Mikania glomerata may be used as an alternative anticancer agent and further research is needed to improve the effectiveness.
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Kaushal H, Bras‐Gonçalves R, Avishek K, Kumar Deep D, Petitdidier E, Lemesre J, Papierok G, Kumar S, Ramesh V, Salotra P. Evaluation of cellular immunological responses in mono- and polymorphic clinical forms of post-kala-azar dermal leishmaniasis in India. Clin Exp Immunol 2016; 185:50-60. [PMID: 26948150 PMCID: PMC4908291 DOI: 10.1111/cei.12787] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/02/2016] [Indexed: 11/28/2022] Open
Abstract
Post-kala-azar dermal leishmaniasis (PKDL) is a chronic dermal complication that occurs usually after recovery from visceral leishmaniasis (VL). The disease manifests into macular, papular and/or nodular clinical types with mono- or polymorphic presentations. Here, we investigated differences in immunological response between these two distinct clinical forms in Indian PKDL patients. Peripheral blood mononuclear cells of PKDL and naive individuals were exposed in vitro to total soluble Leishmania antigen (TSLA). The proliferation index was evaluated using an enzyme-linked immunosorbent assay (ELISA)-based lymphoproliferative assay. Cytokines and granzyme B levels were determined by cytometric bead array. Parasite load in tissue biopsy samples of PKDL was quantified by quantitative polymerase chain reaction (qPCR). The proportion of different lymphoid subsets in peripheral blood and the activated T cell population were estimated using flow cytometry. The study demonstrated heightened cellular immune responses in the polymorphic PKDL group compared to the naive group. The polymorphic group showed significantly higher lymphoproliferation, increased cytokines and granzyme B levels upon TSLA stimulation, and a raised proportion of circulating natural killer (NK) T cells against naive controls. Furthermore, the polymorphic group showed a significantly elevated proportion of activated CD4(+) and CD8(+) T cells upon in-vitro TSLA stimulation. Thus, the polymorphic variants showed pronounced cellular immunity while the monomorphic form demonstrated a comparatively lower cellular response. Additionally, the elevated level of both activated CD4(+) and CD8(+) T cells, coupled with high granzyme B secretion upon in-vitro TSLA stimulation, indicated the role of cytotoxic cells in resistance to L. donovani infection in polymorphic PKDL.
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MESH Headings
- Adolescent
- Adult
- Antigens, Protozoan/pharmacology
- CD4-Positive T-Lymphocytes/immunology
- CD4-Positive T-Lymphocytes/parasitology
- CD4-Positive T-Lymphocytes/pathology
- CD8-Positive T-Lymphocytes/immunology
- CD8-Positive T-Lymphocytes/parasitology
- CD8-Positive T-Lymphocytes/pathology
- Cell Proliferation
- Cytokines/genetics
- Cytokines/immunology
- Cytotoxicity, Immunologic
- Female
- Flow Cytometry
- Gene Expression
- Granzymes/genetics
- Granzymes/immunology
- Humans
- Immunophenotyping
- India
- Killer Cells, Natural/immunology
- Killer Cells, Natural/parasitology
- Killer Cells, Natural/pathology
- Leishmania donovani/immunology
- Leishmania donovani/pathogenicity
- Leishmaniasis, Cutaneous/diagnosis
- Leishmaniasis, Cutaneous/immunology
- Leishmaniasis, Cutaneous/parasitology
- Leishmaniasis, Cutaneous/pathology
- Leishmaniasis, Visceral/diagnosis
- Leishmaniasis, Visceral/immunology
- Leishmaniasis, Visceral/parasitology
- Leishmaniasis, Visceral/pathology
- Leukocytes, Mononuclear/immunology
- Leukocytes, Mononuclear/parasitology
- Leukocytes, Mononuclear/pathology
- Lymphocyte Activation
- Male
- Parasite Load
- Primary Cell Culture
- Skin/immunology
- Skin/parasitology
- Skin/pathology
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95
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Jain S, Ramesh V, Singh A, Yadav A, Ramam M, Khandpur S. Clinical and histopathological features of paucibacillary leprosy before and after multidrug therapy: a prospective study. Trans R Soc Trop Med Hyg 2016; 110:350-8. [PMID: 27317754 DOI: 10.1093/trstmh/trw039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Accepted: 05/16/2016] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Leprosy often heals with residual skin lesions after completion of treatment. WHO recommends fixed duration multidrug therapy (MDT) irrespective of whether lesions clear or persist after treatment. Patients with residual lesions are often unsatisfied and may undergo repeat biopsy and re-treatment. This study was conducted to compare the clinicohistopathological features in paucibacillary leprosy before and after MDT from September 2012 to February 2014. METHODS Sixty-one untreated cases of paucibacillary leprosy were investigated and given standard WHO paucibacillary-MDT for 6 months. Scoring of clinical activity was done; histopathological activity was graded according to granuloma fraction. Forty-four patients who completed the treatment were subjected to post-treatment biopsy. Clinical response to therapy was graded as active, resolving and inactive and histopathological changes were compared in all patients. RESULTS Among the 44 patients, the lesions were inactive, resolving and active in 39% (17/44), 39% (17/44) and 23% (10/44) of patients respectively. Histologically, disease was inactive, resolving and active in 30% (13/44), 9% (4/44) and 61% (27/44). But histomorphological features suggesting regression: loose granulomas (59%, 26/44); lymphocyte predominance (66%, 29/44); vacuolar change in epithelioid cell cytoplasm (59%, 26/44), were statistically significant in post-treatment compared to pre-treatment. CONCLUSIONS Although histological resolution is slower than clinical resolution, qualitative histomorphological changes in correlation with clinical inactivity can offer a fair suggestion to the clinician to terminate therapy.
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Kaur M, Dalal V, Ramesh V, Singh A. Multinucleated giant cells in angiolymphoid hyperplasia with eosinophilia. Indian J Dermatol Venereol Leprol 2016; 82:567-9. [PMID: 27241504 DOI: 10.4103/0378-6323.182977] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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97
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Kasivisvanathan R, Ramesh V, Rao Baikady R, Nadaraja S. Preoperative anaemia is associated with increased allogeneic pack red cell transfusion in revision hip and knee joint arthroplasty: a retrospective analysis of 5387 patients over a 10-year period at a single high volume centre. Transfus Med 2016; 26:271-7. [DOI: 10.1111/tme.12322] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2015] [Revised: 05/01/2016] [Accepted: 05/03/2016] [Indexed: 11/30/2022]
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98
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Kandhari R, Sharma V, Ramesh V, Singh A. Familial reactive perforating collagenosis in three siblings. Indian J Dermatol Venereol Leprol 2016; 80:86-7. [PMID: 24448140 DOI: 10.4103/0378-6323.125488] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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99
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Ramesh V. Post kala-azar dermal leishmaniasis: Burden, diagnosis and treatment challenges. Int J Infect Dis 2016. [DOI: 10.1016/j.ijid.2016.02.165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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100
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Gill HK, Yadav SB, Ramesh V, Bhatia E. A prospective study of prevalence and association of peripheral neuropathy in Indian patients with newly diagnosed type 2 diabetes mellitus. J Postgrad Med 2016; 60:270-5. [PMID: 25121366 DOI: 10.4103/0022-3859.138750] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Diabetic peripheral neuropathy (DPN) predisposes to foot ulceration and gangrene. It has been reported that DPN is lower in Indians relative to Caucasians. Studies among recent onset patients with type 2 diabetes mellitus (T2DM) are very few. We studied the prevalence and risk factors of DPN in patients with newly diagnosed T2DM. MATERIALS AND METHODS We prospectively studied 195 consecutive patients over age 30 with a duration of diabetes ≤6 months. All underwent a clinical and biochemical evaluation and were screened for DPN using Neuropathy Symptom Score (NSS) and Neuropathy Disability Score (NDS) as well as the vibration perception threshold using a biothesiometer. We compared the prevalence of peripheral neuropathy (PN) in 75 age- and sex-matched healthy controls. RESULTS The cases had a mean age of 47.6 ± 10.2 years (59% males) and duration of symptoms of 5.9 ± 8.2 months prior to presentation. The overall prevalence of DPN was 29.2% [95% CI 22.8-35.7]. PN among matched control was 10.7% (95% CI 3.5-17.8). The prevalence of DPN showed an increasing trend with age (trend chi-square 11.8, P = 0.001). Abnormal vibration perception threshold was present in 43.3% (95% CI 36.3-50.3) of cases and had a significant correlation with NDS (P = 0.000). Abnormal monofilament testing was present in 6.1% of cases (95% CI 2.7- 9.5). A logistic regression analysis showed that DPN was independently associated with age (P = 0.002) and duration of diabetes prior to presentation (P = 0.02) but not with body mass index, plasma glucose, or HbA1c. CONCLUSIONS Our study showed high prevalence of PN in recently diagnosed patients with T2DM, which was independently associated with age and duration of symptoms of diabetes prior to the diagnosis. Screening for DPN at diagnosis of diabetes is warranted, especially among older subjects.
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