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Baruhee D, Ganapathy A, Singh S, Sarwar S, Banerjee A, Bhukya S, Quadri JA, Shariff A. Morphology of human fetal enteric neurons: A comparative study of different segments of the colon. Morphologie 2023; 107:38-46. [PMID: 35764504 DOI: 10.1016/j.morpho.2022.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 02/23/2022] [Accepted: 03/06/2022] [Indexed: 10/17/2022]
Abstract
OBJECTIVES The Enteric Nervous System (ENS) present in the wall of the gut is currently being explored because of its influence on the gut and beyond. In this context, the morphology of developing ENS has not been completely understood in humans due to lack of adequate literature. The aim of the present study was to observe the morphology of the enteric neurons in the human fetal colon and compare the findings in ascending colon a midgut derivative and descending colon a hindgut derivative at various weeks of gestation (WG). MATERIAL AND METHODS Tissue samples from 15 aborted fetuses (11 WG to 2 months postnatal) were processed for Cresyl violet, H & E staining, and NADPH Diaphorase histochemistry. The morphometric analysis was done by calculating the neuronal number density and neuronal fractional area. The Student t-test; Mann-Whitney test and Wilcoxon signed-rank test were used to analyze the data. RESULTS The muscularis externa with two distinct layers was visible as early as 13 WG and the muscularis mucosae was first observed at 18 WG. The size of the myenteric neurons appeared to be larger with increasing weeks of gestation suggesting a process of neuronal maturation. The neuronal number density and neuronal fractional area seemed to be reduced with advancing fetal age. There was no marked difference between the ascending and sigmoid colon. At 23 and 26 WG, a mature pattern of nitrergic innervation was observed. CONCLUSION This study is done on human fetal tissue samples unlike previous studies on animal samples to comprehend the morphology of developing ENS. It will aid in understanding the effect of ENS on various neurological disorders.
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Affiliation(s)
- D Baruhee
- Department of Obstretics and Gynaecology, ESI, PGIMSR, Basaidarapur, New Delhi, India
| | - A Ganapathy
- Department of Anatomy, All India Institute of Medical Sciences, Bhubaneswar, India
| | - S Singh
- Department of Anatomy, All India Institute of Medical Sciences, New Delhi, India.
| | - S Sarwar
- Department of Anatomy, All India Institute of Medical Sciences, New Delhi, India
| | - A Banerjee
- Department of Anaesthesiology and Critical care, Sanjay Gandhi post graduate institute, Lucknow, India
| | - S Bhukya
- Department of Anatomy, Armed forces medical college, Pune, India
| | - J A Quadri
- Department of Anatomy, All India Institute of Medical Sciences, New Delhi, India
| | - A Shariff
- Department of Anatomy, All India Institute of Medical Sciences, New Delhi, India
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Ganapathy A, Achappa B, Kulkarni V, Madi D, Holla R, Bhaskaran U, Rathi P, Mahalingam S, Dsouza NV. Association between Veterans Aging Cohort Study (VACS) index and neurocognitive function among people living with HIV-a cross sectional study in coastal South India. AIDS Res Ther 2021; 18:47. [PMID: 34348754 PMCID: PMC8336242 DOI: 10.1186/s12981-021-00368-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 07/09/2021] [Indexed: 11/10/2022] Open
Abstract
Background HIV is an infectious disease affecting 36.7 million people worldwide. In recent times, Antiretroviral Therapy (ART) has become accessible to the majority of People Living with HIV (PLHIV) and this has transformed the course of infection to one that is chronic, characterized by fewer diseases pathognomonic of AIDS. In view of this, there is a pressing need for better markers, apart from the routine HIV indicators, to detect comorbidities such as Neurocognitive Impairment (NCI). The aim of this study was to find out the association between Veterans Aging Cohort Study (VACS) index and Neurocognitive function in HIV positive patients. Methods In our study, we included 97 HIV positive patients and their Neurocognitive function was assessed using a combination of Montreal Cognitive Assessment and Grooved Pegboard Test, while VACS index was calculated using the most recent laboratory values. Binomial Logistics Regression analyses, adjusting for potential confounding variables, was performed to determine the association between VACS score and Neurocognitive Impairment. Results We found that a higher VACS Index was associated with global and domain-wise Neurocognitive impairment (p < 0.01), specifically in the domains of attention (p < 0.01) and fine motor skills (p = 0.01). Our study also showed that among all the VACS components, older age (p = 0.02) and lower hemoglobin (p < 0.01) values were associated with global NCI. After plotting an ROC curve, a VACS cut-off score of 11.00 was identified as it had good sensitivity (87.0%) and specificity (71.4%) in identifying Global NCI. Conclusion Our findings extend prior research on the use of VACS Index to predict global and domain-wise NCI in HIV-positive patients. However, further research with more comprehensive neurocognitive testing is required in our setting before VACS Index can be used as a tool to screen for neurocognitive dysfunction among PLHIV. Supplementary Information The online version contains supplementary material available at 10.1186/s12981-021-00368-6.
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Holla R, Darshan BB, Unnikrishnan B, Kumar N, Sinha A, Thapar R, Mithra PP, Kulkarni V, Ganapathy A, Kotian H. Effectiveness of School-Based Interventions in Reducing Unintentional Childhood Injuries: A Cluster Randomized Trial. Indian Pediatr 2021; 58:537-541. [PMID: 33612490 PMCID: PMC8253681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 12/15/2020] [Accepted: 02/04/2021] [Indexed: 04/03/2024]
Abstract
OBJECTIVE To evaluate the effectiveness of school-based interventions in promoting child safety and reducing unintentional childhood injuries. METHODS This cluster randomized trial with 1:1 allocation of clusters to intervention and control arm was conducted in the public and private schools of Dakshina Kannada district, Karnataka, over a period of 10 months. Study participants included children from standard 5-7 in schools selected for the study. 10 schools that could accommodate 1100 students each, were randomly allocated to the interventional and control arm. A comprehensive child safety and injury prevention module was developed based on the opinions of school teachers through focus group discussions. This module was periodically taught to the students of intervention arm by the teachers. The children in control arm did not receive any intervention. Outcome was assessed by determining the incidence of unintentional injuries and type of injuries from the questionnaire used at the baseline, and at the end of three, six, and ten months. RESULTS Unintentional injuries declined progressively from baseline until the end of the study in both the interventional arm (from 52.9% to 2.5%) and control arm (from 44.7% to 32%) [AOR (95% CI) 0.458 (0.405-0.518); P value <0.001]. The decline in incidence of injuries in the interventional arm was higher than that in the control arm (50.4% vs 12.7%; P <0.001). CONCLUSIONS School based educational intervention using child safety and injury prevention modules is effective in reducing unintentional injuries among school children over a 10-month period.
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Affiliation(s)
- Ramesh Holla
- Department of Community Medicine, Kasturba Medical College, Mangalore (Manipal Academy of Higher Education), Karnataka. Correspondence to: Dr Ramesh Holla, Associate Professor, Department of Community Medicine, Kasturba Medical College, Mangalore (Manipal Academy of Higher Education), Karnataka, India.
| | - B B Darshan
- Department of Community Medicine, Kasturba Medical College, Mangalore (Manipal Academy of Higher Education), Karnataka
| | - Bhaskaran Unnikrishnan
- Department of Community Medicine, Kasturba Medical College, Mangalore (Manipal Academy of Higher Education), Karnataka
| | - Nithin Kumar
- Department of Community Medicine, Kasturba Medical College, Mangalore (Manipal Academy of Higher Education), Karnataka
| | - Anju Sinha
- Division of Reproductive, Maternal and Child Health, Indian Council of Medical Research, Ansari Nagar, New Delhi
| | - Rekha Thapar
- Department of Community Medicine, Kasturba Medical College, Mangalore (Manipal Academy of Higher Education), Karnataka
| | - P Prasanna Mithra
- Department of Community Medicine, Kasturba Medical College, Mangalore (Manipal Academy of Higher Education), Karnataka
| | - Vaman Kulkarni
- Department of Community Medicine, Kasturba Medical College, Mangalore (Manipal Academy of Higher Education), Karnataka
| | - Archana Ganapathy
- Department of Community Medicine, Kasturba Medical College, Mangalore (Manipal Academy of Higher Education), Karnataka
| | - Himani Kotian
- Department of Community Medicine, Kasturba Medical College, Mangalore (Manipal Academy of Higher Education), Karnataka
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Kasapuram D, Ganapathy A, Harisha K, Bhukya S, Rani N, Singh S. Neuromuscular variations in the gluteal region - Embryological basis and clinical significance. Clin Ter 2021; 172:91-93. [PMID: 33763684 DOI: 10.7417/ct.2021.2290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
ABSTRACT Piriformis, is a key muscle in the gluteal region. Under its lower border sciatic nerve and inferior gluteal nerves exit. During routine educational dissection of the lower limb, bilateral gluteal regions in fifteen cadavers (30 gluteal regions) focusing on the variations of inferior gluteal nerve and sciatic nerve with respect to piriformis muscle were observed in the department of anatomy, All India Institute of Medical Sciences, New Delhi, India. In one of the left sided specimens, inferior gluteal nerve had an abnormal course, piercing superior belly of piriformis muscle instead of emerging through the lower border of it along with variation of the sciatic nerve. The common peroneal component of the sciatic nerve was coming out between the two anomalous tendinous slips of the piriformis muscle, whereas the tibial component, emerged along lower border of the piriformis muscle bilaterally in the same cadaver. In the remaining cadavers, there were no variations of the inferior gluteal nerve with respect to the piriformis muscle. But in another cadaver, there was a similar variation of the sciatic nerve bilaterally. Inferior gluteal and sciatic nerves, when compressed by muscle belly or tendinous slips of the piriformis muscle, may cause lurching gait and sciatica respectively. Knowledge of the different variations of these peripheral nerves with respect to the piriformis muscle is important to clinicians and surgeons for the accurate diagnosis and intervention.
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Affiliation(s)
- D Kasapuram
- MBBS, MD Anatomy Assistant professor, Department of anatomy, MNR Medical College, Faisalwadi, Sangareddy
| | - A Ganapathy
- MBBS, MD Anatomy Senior resident, Department of anatomy, AIIMS, New Delhi, India. - 110029
| | - K Harisha
- MBBS, MD,Assistant professor, Department of anatomy, AIIMS, New Delhi, India. - 110029
| | - S Bhukya
- MBBS,MD Anatomy Assistant professor, Department of Anatomy, AFMC, Pune, India
| | - N Rani
- Msc, PhD, Associate professor, Department of anatomy, AIIMS, New Delhi, India. - 110029
| | - S Singh
- Department of anatomy, AIIMS, New Delhi, India
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Holla R, Darshan BB, Unnikrishnan B, Kumar N, Sinha A, Thapar R, Mithra PP, Kulkarni V, Ganapathy A, Kotian H. Effectiveness of School-Based Interventions in Reducing Unintentional Childhood Injuries: A Cluster Randomized Trial. Indian Pediatr 2021. [PMID: 33612490 PMCID: PMC8253681 DOI: 10.1007/s13312-021-2236-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Objective To evaluate the effectiveness of school-based interventions in promoting child safety and reducing unintentional childhood injuries. Methods This cluster randomized trial with 1:1 allocation of clusters to intervention and control arm was conducted in the public and private schools of Dakshina Kannada district, Karnataka, over a period of 10 months. Study participants included children from standard 5–7 in schools selected for the study. 10 schools that could accommodate 1100 students each, were randomly allocated to the interventional and control arm. A comprehensive child safety and injury prevention module was developed based on the opinions of school teachers through focus group discussions. This module was periodically taught to the students of intervention arm by the teachers. The children in control arm did not receive any intervention. Outcome was assessed by determining the incidence of unintentional injuries and type of injuries from the questionnaire used at the baseline, and at the end of three, six, and ten months. Results Unintentional injuries declined progressively from baseline until the end of the study in both the interventional arm (from 52.9% to 2.5%) and control arm (from 44.7% to 32%) [AOR (95% CI) 0.458 (0.405–0.518); P value <0.001]. The decline in incidence of injuries in the interventional arm was higher than that in the control arm (50.4% vs 12.7%; P <0.001). Conclusion School based educational intervention using child safety and injury prevention modules is effective in reducing unintentional injuries among school children over a 10-month period.
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Jaiswal M, Ganapathy A, Singh S, Sarwar S, Quadri JA, Rani N, Das P, Pal S, Shariff A. Morphology of enteric glia in colorectal carcinoma: A comparative study of tumor site and its proximal normal margin. Morphologie 2020; 105:267-274. [PMID: 33309198 DOI: 10.1016/j.morpho.2020.11.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 10/19/2020] [Accepted: 11/05/2020] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Colorectal carcinoma (CRC) is the third most common cancer in the world and fifth most common cancer in India. To understand the extent of perineural invasion (PNI) in CRC it is essential to study the morphology of enteric glial cells (EGCs). The aim of the study was to analyze the numerical density of EGCs and area of myenteric ganglia (MG) in the colonic tissue samples collected from CRC patients. MATERIAL AND METHODS Fifteen intraoperative tissue specimens were collected from the tumor site and 2cm proximal to the upper extent of tumor. The samples were divided into four groups: group 1 (n=15): proximal tumor free colonic tissue; group 2 (n=3): well-differentiated; group 3 (n=8): moderately differentiated; group 4 (n=4): poorly differentiated adenocarcinoma. After processing the tissues were subjected to hematoxylin and eosin staining. The anti-S100β and anti-GFAP antibodies were used to observe the EGCs. RESULTS In the H&E stained sections the number of myenteric ganglia appeared to be decreasing with increasing grade of adenocarcinoma. Immunostaining showed significant decreasing pattern in the numerical density of EGCs per myenteric ganglion and mean area of myenteric ganglia in relation to the thickness of circular muscle, corresponding to the increasing grades of adenocarcinoma. The morphology of the EGCs remained unaltered in the colonic tissue adjacent to the tumor site. CONCLUSION Significant loss of EGCs and neurodegeneration corresponded with the grade of tumor emphasizing on its prognostic value. The PNI was not seen in the clear margin proximal to the tumor site.
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Affiliation(s)
- M Jaiswal
- Department of anatomy, All India Institute of Medical Sciences, 110029 New Delhi, India
| | - A Ganapathy
- Department of anatomy, All India Institute of Medical Sciences, 110029 New Delhi, India
| | - S Singh
- Department of anatomy, All India Institute of Medical Sciences, 110029 New Delhi, India.
| | - S Sarwar
- Department of anatomy, All India Institute of Medical Sciences, 110029 New Delhi, India
| | - J A Quadri
- Department of anatomy, All India Institute of Medical Sciences, 110029 New Delhi, India
| | - N Rani
- Department of anatomy, All India Institute of Medical Sciences, 110029 New Delhi, India
| | - P Das
- Department of pathology, All India Institute of Medical Sciences, New Delhi, India
| | - S Pal
- Department of gastrointestinal surgery, All India Institute of Medical Sciences, New Delhi, India
| | - A Shariff
- Department of anatomy, All India Institute of Medical Sciences, 110029 New Delhi, India
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Ganapathy A, Kumar V, Prathapamchandra V, Jessy JP, Rani N, Kaler S, Singh S. Topographic Localization of Nerve to Masseter Muscle to determine the Primary Nerve- Muscle Relation, an Aid to Facial Sculpting Techniques. Muscles Ligaments Tendons J 2020. [DOI: 10.32098/mltj.01.2020.17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
| | - V. Kumar
- Department of Anatomy, AIIMS, New Delhi, India
| | | | - JP Jessy
- Department of Anatomy, AIIMS, New Delhi, India
| | - N. Rani
- Department of Anatomy, AIIMS, New Delhi, India
| | - S. Kaler
- Department of Anatomy, AIIMS, New Delhi, India
| | - S. Singh
- Department of Anatomy, AIIMS, New Delhi, India
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Ganapathy A, Banerjee A, Jhajhria K. Anomalous origin of bilateral testicular arteries – an anatomical and developmental overview. J ANAT SOC INDIA 2018. [DOI: 10.1016/j.jasi.2018.06.158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Duggal A, Ganapathy A, Ratnapalan M, Adhikari NK. Pharmacological treatments for acute respiratory distress syndrome: systematic review. Minerva Anestesiol 2015; 81:567-588. [PMID: 24937499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND Our objective was to systematically review the effect of pharmacological therapies on mortality in patients with acute respiratory distress syndrome (ARDS), focusing on randomized controlled trials (RCTs) published since a previous review in 2004. METHODS We updated previous searches and searched OVID versions of MEDLINE, EMBASE and CENTRAL (to January 2013) and proceedings from conferences and bibliographies of included studies. We included RCTs of pharmacologic therapies compared with placebo or no therapy for adult patients with ARDS, using authors' definitions, which reported on mortality (≤ 3 months after randomization). We excluded subgroups of patients with ARDS reported in RCTs enrolling other populations and RCTs of therapies to prevent ARDS, nutritional or fluid interventions, inhaled nitric oxide, therapies coupled to a mechanical ventilation strategy, or oxygen. Two reviewers independently screened citations, selected articles for inclusion, and abstracted clinical and methodological data from included studies with disagreements resolved by a third reviewer. Mortality data were pooled using random-effects models. RESULTS From 13461 citations, 58 trials (6635 patients) of 21 classes of medications met selection criteria; 26 trials (3880 patients) were published after 2003. Meta-analyses showed reduced 28-day mortality with a 48-hour infusion of cis-atracurium in early ARDS (relative risk 0.66, 95% confidence interval 0.50 to 0.87; 431 patients, 138 deaths). There was no effect on mortality with granulocyte-macrophage colony stimulating factor, late low-dose methylprednisolone, neutrophil elastase inhibitors, intravenous salbutamol, surfactant, or N-acetylcysteine; each meta-analysis included ≥ 1 trial published after 2003. Seven single trials of other treatments published after 2003 showed no effect. Meta-analysis of older trials of prostaglandin E1 also showed no effect. CONCLUSION Effective pharmacotherapy for ARDS remains extremely limited. Cis-atracurium is a promising treatment for early moderate-severe ARDS (using Berlin definition nomenclature) and merits further investigation in a large RCT.
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Affiliation(s)
- A Duggal
- Medical Intensive Care Unit, Respiratory Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
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