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Koay KL, Mohd Zim MA, Botross NP, Thong YK, Nordin N, Ramachandran A, See PW, Pemasiri WDRH, Chai ST, Wong YYP, Kong JY, Lim SWS, Chia PLM, Gan GCR, Cai CZ, Kok YQ, Loh HY, Su EJE, Shamsuddin AR, Md Tarekh NA, Sood S. Appendectomy and asthma: a search for an association in older subjects. Med J Malaysia 2024; 79:47-51. [PMID: 38287757] [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] [Subscribe] [Scholar Register] [Indexed: 01/31/2024]
Abstract
INTRODUCTION Several risk factors found to be associated with postoperative complications and cancer surgery, which carry a significant morbidity risk to cancer patients. Therefore, prehabilitation is necessary to improve the functional capability and nutritional status of a patient prior to surgery, so that the patient can withstand any postoperative activity and associated deterioration. Thus, this study aims to assess the effectiveness of prehabilitation interventions on the functional status of patients with gastric and oesophageal cancer who underwent esophagectomy and gastrectomy. MATERIAL AND METHODS An interventional study was carried out among oesophageal and gastric cancer patients who had undergone surgery at the National Cancer Institute of Malaysia. The prehabilitation process took a maximum of two weeks, depending on the patient's optimisation before surgery. The prehabilitation is based on functional capacity (ECOG performance status), muscle function (handgrip strength), cardio-respiratory function (peak flow meter) and nutritional status (calorie and protein). Postoperative outcomes are measured based on the length of hospital stay, complications, and Clavien-Dindo Classification. RESULTS Thirty-one patients were recruited to undergo a prehabilitation intervention prior to gastrectomy (n=21) and esophagectomy (n=10). Demographically, most of the cancer patients were males (67.7%) with an ideal mean of BMI (23.5±6.0). Physically, the majority of them had physical class (ASA grade) Grade 2 (67.7%), ECOG performance status of 1 (61.3%) and SGA grade B (51.6%). The functional capacity and nutritional status showed a significant improvement after one week of prehabilitation interventions: peak expiratory flow meter (p<0.001), handgrip (p<0.001), ECOG performance (p<0.001), walking distance (p<0.001), incentive spirometry (p<0.001), total body calorie (p<0.001) and total body protein (p=0.004). However, those patients who required two weeks of prehabilitation for optimization showed only significant improvement in peak expiratory flow meter (p<0.001), handgrip (p<0.001), and incentive spirometry (p<0.001). Prehabilitation is significantly associated postoperatively with the length of hospital stay (p=0.028), complications (p=0.011) and Clavien-Dindo Classification (p=0.029). CONCLUSION Prehabilitation interventions significantly increase the functional capacity and nutritional status of cancer patients preoperatively; concurrently reducing hospital stays and complications postoperatively. However, certain cancer patients might require over two weeks of prehabilitation to improve the patient's functional capacity and reduce complications postoperatively.
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Affiliation(s)
- K L Koay
- Hospital Serdang, Department of General Surgery, Kajang, Selangor, Malaysia
| | - M A Mohd Zim
- Universiti Teknologi MARA, Faculty of Medicine, Medical Department and Respiratory Unit, Shah Alam, Selangor, Malaysia
| | - N P Botross
- Monash University Malaysia, Department of Medicine, Johor Bahru, Johor, Malaysia
| | - Y K Thong
- Klinik Kesihatan Sungai Besi, Sungai Besi, Kuala Lumpur, Malaysia
| | - N Nordin
- Universiti Teknologi MARA, Faculty of Medicine, Medical Department and Respiratory Unit, Shah Alam, Selangor, Malaysia
| | - A Ramachandran
- Lyell McEwin Hospital, Adelaide, South Australia, Australia
| | - P W See
- Hospital Sultanah Aminah, Johor Bahru, Johor, Malaysia
| | | | - S T Chai
- Hospital Shah Alam, Shah Alam, Selangor, Malaysia
| | - Y Y P Wong
- Sarawak General Hospital, Department of Anesthesiology, Kuching, Sarawak, Malaysia
| | - J Y Kong
- Hospital Sultan Ismail, Department of Medicine, Johor Bahru, Johor, Malaysia
| | - S W S Lim
- Western Health, Melbourne, Victoria, Australia
| | - P L M Chia
- Hospital Sultanah Aminah, Johor Bahru, Johor, Malaysia
| | - G C R Gan
- Hospital Tuanku Jaafar, Department of Orthopedics, Seremban, Negri Sembilan, Malaysia
| | - C Z Cai
- Hospital Sultanah Aminah, Johor Bahru, Johor, Malaysia
| | - Y Q Kok
- Hospital Sultanah Aminah, Johor Bahru, Johor, Malaysia
| | - H Y Loh
- Hospital Townsville, Townsville, Queensland, Australia
| | - E J E Su
- Hospital Sibu, Sibu, Sarawak, Malaysia
| | | | | | - S Sood
- International Medical University, Department of Surgery, Bukit Jalil, Kuala Lumpur, Malaysia.
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S R, Vaiyakkani G, S SK, Ramachandran A, Rajendran K, Krishnasamy N, Panneerselvam P, Pamarthi J, Rajaram M. Analysis of blood lead level and its clinical significance among occupational exposed painters in chennai based population: A cross sectional study. J Trace Elem Med Biol 2023; 79:127257. [PMID: 37437390 DOI: 10.1016/j.jtemb.2023.127257] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Revised: 06/07/2023] [Accepted: 06/28/2023] [Indexed: 07/14/2023]
Abstract
INTRODUCTION AND AIM Lead is a ubiquitous element found in the earth crust. There is no known physiologic role of lead in human body and hence any amount of lead present in human tissue considered as a contamination. Several studies on lead toxicity show that, occupational exposure remains the main source for lead toxicity and is emerging as important public health problem. Burden and severity of occupational exposure of lead and its clinical significance are gaining more interest in the field of toxicology. Only limited studies are available and there is scarcity of epidemiology data to assess the blood lead levels of workers and the contribution of common workplace practices to lead exposure in India especially from our region. So, the current study is designed to assess the blood lead levels (BLL) and its clinical significance among high risk workers especially painters working in the construction and public private sector in Chennai based population. MATERIALS AND METHODS This cross-sectional case control study included 122 painters and 122 healthy individuals. A detailed questionnaire about demographic details, personal habits, work related safety precautions, presenting symptoms of lead toxicity were given to painter followed by detailed medical examination and blood investigations including blood lead levels were collected and statistically analyzed. The t-test were used to compare mean blood lead levels and to investigate the associations between specific job type, use of self-protection device,sex, service years and occurrence of non-specific symptoms with BLLs. RESULTS The mean BLL of the painters were less than the recommended threshold level. Among painters 13.1% were categorized under BLL > 10 μg/dL. The higher BLL among the painters were directly proportional to year of experience and poor usage of personal protective materials. The levels of Hb, HCT and eosinophil were much correlated with lead toxicity. A marginal significance were observed in some parameters especially urea and creatinine when compared with control. The Cognitive dysfunction, hypertension and renal dysfunction were also observed among the painters. CONCLUSION The BLL in painters among our group were minimal compared to biological reference value. Duration of exposure and association of patient's clinical features like cognitive dysfunction, hypertension and renal dysfunction conditions were observed and this should be carefully monitored and study on huge population of painters with longitudinal aspect is recommended to rule out the clinical correlation of lead toxicity.
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Affiliation(s)
- Ragunanthanan S
- Poison Control, Training & Research Centre, Institute of Internal Medicine, Rajiv Gandhi Government General Hospital & Madras Medical College, 1st floor, Tower II Park Town, Chennai, Tamil Nadu 600003, India
| | - Govardhini Vaiyakkani
- Poison Control, Training & Research Centre, Institute of Internal Medicine, Rajiv Gandhi Government General Hospital & Madras Medical College, 1st floor, Tower II Park Town, Chennai, Tamil Nadu 600003, India.
| | - Senthil Kumar S
- Institute of Internal Medicine, K.A.P. Viswanatham Medical College is a medical, Periyamilaguparai, Colletor's office Road, Tamil Nadu 620001, India
| | - Arunkumar Ramachandran
- Multidisciplinary Research Unit, Madras Medical College, Park Town, Chennai, Tamil Nadu 600003, India.
| | - Karthick Rajendran
- Multidisciplinary Research Unit, Madras Medical College, Park Town, Chennai, Tamil Nadu 600003, India
| | - Narayanasamy Krishnasamy
- Institute of Hepatobilary Sciences, Madras Medical College & Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu 600 003, India
| | | | - Jayakrishna Pamarthi
- Multidisciplinary Research Unit, Madras Medical College, Park Town, Chennai, Tamil Nadu 600003, India
| | - Muthukumaran Rajaram
- Multidisciplinary Research Unit, Madras Medical College, Park Town, Chennai, Tamil Nadu 600003, India
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Brabon A, Labens R, Ramachandran A, Dart AJ, Dowling BA. Gastrojejunostomy as a treatment for gastric outflow disorders in four adult horses. Aust Vet J 2023. [PMID: 37253644 DOI: 10.1111/avj.13249] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 04/12/2023] [Accepted: 04/30/2023] [Indexed: 06/01/2023]
Abstract
Four adult horses with histories of moderate abdominal pain and inappetence were diagnosed with delayed gastric emptying and gastric impaction attributed to pyloroduodenal obstruction (three cases) or duodenitis (one case). A stapled side-to-side gastrojejunostomy was performed on all horses. Two horses returned to work and survived ≥3 years. One horse was euthanased 6 months post-surgery due to recurrent abdominal pain, and one was found dead 5 months postsurgery after an unattended foaling.
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Affiliation(s)
- A Brabon
- Faculty of Science, School of Agricultural, Environmental and Veterinary Sciences, Charles Sturt University, Wagga Wagga, New South Wales, Australia
| | - R Labens
- Faculty of Science, School of Agricultural, Environmental and Veterinary Sciences, Charles Sturt University, Wagga Wagga, New South Wales, Australia
| | - A Ramachandran
- Department of Veterinary Clinical Sciences, University Veterinary Centre, Camden, The University of Sydney, Werombi Road, 2570, Camden, New South Wales, Australia
| | - A J Dart
- Department of Veterinary Clinical Sciences, University Veterinary Centre, Camden, The University of Sydney, Werombi Road, 2570, Camden, New South Wales, Australia
| | - B A Dowling
- Department of Veterinary Clinical Sciences, University Veterinary Centre, Camden, The University of Sydney, Werombi Road, 2570, Camden, New South Wales, Australia
- Townsville Veterinary Clinic, 22 Anne Street, Aitkenvale, Queensland, Australia
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Nathan J, Shameera R, Ramachandran A. Impact of nutraceuticals on immunomodulation against viral infections-A review during COVID-19 pandemic in Indian scenario. J Biochem Mol Toxicol 2023; 37:e23320. [PMID: 36799127 DOI: 10.1002/jbt.23320] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 12/13/2022] [Accepted: 02/02/2023] [Indexed: 02/18/2023]
Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) originated in Wuhan, China, in early December 2019 is a censorious global emergency after World War II. Research on the coronavirus uncovered essential information that aided in the development of the vaccine, and specific coronavirus disease 2019 (COVID-19) vaccines were later developed and were approved for usage in humans. But then, mutations in the coronavirus gave rise to new variants and questioned the vaccine's efficacy against them. On the other hand, the investigation of traditional medicine was also on its path to find a novel outcome against COVID-19. On a comparative analysis between India and the United States, India had low death rate and high recovery rate than the latter. The dietary regulation of immunity may be the factor that makes the above difference. The immunity gained from the regular diet of Indian culture nourishes Indian people with essential phytochemicals that support immunity and metabolism. Dietary phytochemicals or nutraceuticals possess antioxidant, anti-inflammatory, and anticancer properties, out of which our concern will be on immune-boosting phytochemicals from our daily nutritional supplements. In several case studies, dietary substance like lemon, ginger, and spinach was reported in the recovery of COVID-19 patients. Thus in this review, we discuss coronavirus and its available variants, vaccines, and the effect of nutraceuticals against the coronavirus. Further, we denote that the immunity of the Indian population may be high because of their diet, which adds natural phytochemicals to boost their immunity and metabolism.
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Affiliation(s)
- Jhansi Nathan
- AUKBC Research Centre for Emerging Technologies, Anna University, Chennai, Tamil Nadu, India
| | - Rabiathul Shameera
- AUKBC Research Centre for Emerging Technologies, Anna University, Chennai, Tamil Nadu, India
| | - Arunkumar Ramachandran
- Multidisciplinary Research Unit (MRU), Madras Medical College, Chennai, Tamil Nadu, India
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Simpson S, Bettauer V, Ramachandran A, Kraemer S, Mahon S, Medina M, Vallès Y, Dumeaux V, Vallès H, Walsh D, Hallett MT. A metagenomic-based study of two sites from the Barbadian reef system. Coral Reefs 2023; 42:359-366. [PMID: 37009568 PMCID: PMC10060342 DOI: 10.1007/s00338-022-02330-y] [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] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Accepted: 11/05/2022] [Indexed: 06/19/2023]
Abstract
UNLABELLED We study the microbiome of sea water collected from two locations of the Barbadian coral reefs. The two sites differ in several environmental and ecological variables including their endogenous benthic community and their proximity to urban development and runoffs from inland watersheds. The composition of the microbial communities was estimated using whole genome DNA shotgun sequencing with adjuvant measurements of chemical and environmental qualities. Although both sites exhibit a similar degree of richness, the less urbanized site (Maycocks reef at Hangman's Bay) has a strong concentration of phototrophs whereas the more urbanized location (Bellairs reef at Folkstone) is enriched for copiotrophs, macroalgal symbionts and marine-related disease-bearing organisms from taxa scattered across the tree of life. Our results are concordant with previous profiles of warm ocean surface waters, suggesting our approach captures the state of each coral reef site, setting the stage for longitudinal studies of marine microbiome dynamics in Barbados. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s00338-022-02330-y.
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Affiliation(s)
- S. Simpson
- Department of Computer Science and Software Engineering, Concordia University, Montreal, Canada
| | - V. Bettauer
- Department of Computer Science and Software Engineering, Concordia University, Montreal, Canada
| | - A. Ramachandran
- Department of Biology, Concordia University, Montreal, Canada
| | - S. Kraemer
- Department of Biology, Concordia University, Montreal, Canada
| | - S. Mahon
- Coral Reef Restoration Alliance (CORALL), Bridgetown, Barbados
| | - M. Medina
- Department of Biology, Pennsylvania State University, University Park, PA USA
| | - Y. Vallès
- Department of Biology and Chemical Sciences, University of the West Indies, Cave Hill, Barbados
| | - V. Dumeaux
- Department of Anatomy and Cell Biology, University of Western Ontario, London, Canada
| | - H. Vallès
- Department of Biology and Chemical Sciences, University of the West Indies, Cave Hill, Barbados
| | - D. Walsh
- Department of Biology, Concordia University, Montreal, Canada
| | - M. T. Hallett
- Department of Biochemistry, University of Western Ontario, London, Canada
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Allan D, Chatzistergos PE, Mahadevan S, Healy A, Sundar L, Ramachandran A, Kumar S, Punnoose A, Chockalingam N, Naemi R. Increased exposure to loading is associated with decreased plantar soft tissue hardness in people with diabetes and neuropathy. Diabetes Res Clin Pract 2022; 187:109865. [PMID: 35398144 DOI: 10.1016/j.diabres.2022.109865] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 03/30/2022] [Accepted: 04/02/2022] [Indexed: 11/03/2022]
Abstract
AIMS Literature indicates that altered plantar loading in people with diabetes could trigger changes in plantar soft tissue biomechanics which, in turn, could affect the risk for ulceration. To stimulate more research in this area, this study uses in vivo testing to investigate the link between plantar loading and tissue hardness. METHODS Tissue hardness and plantar pressure distribution were measured for six plantar areas in 39 people with diabetes and peripheral neuropathy. RESULTS Spearman correlation analysis revealed that increased pressure time integral at the 1st metatarsal-head region (r = -0.354, n = 39, P = 0.027) or at the heel (r = -0.378, n = 39, P = 0.018) was associated with reduced hardness in the same regions. After accounting for confounding parameters, generalised estimating equations analysis also showed that 10% increase in pressure time integral at the heel was associated with ≈ 1 unit reduction in hardness in the same region. CONCLUSIONS For the first time, this study reveals that people with diabetes and neuropathy who tend to load their feet more heavily also tend to have plantar soft tissues with lower hardness. The observed difference in tissue hardness is likely to affect the tissue's vulnerability to overload injury. More research will be needed to explore the implications of the observed association for the risk of ulceration.
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Affiliation(s)
- D Allan
- Centre for Biomechanics and Rehabilitation Technologies, School of Health, Science and Wellbeing, Staffordshire University, Stoke-On-Trent, United Kingdom
| | - P E Chatzistergos
- Centre for Biomechanics and Rehabilitation Technologies, School of Health, Science and Wellbeing, Staffordshire University, Stoke-On-Trent, United Kingdom.
| | | | - A Healy
- Centre for Biomechanics and Rehabilitation Technologies, School of Health, Science and Wellbeing, Staffordshire University, Stoke-On-Trent, United Kingdom
| | - L Sundar
- India Diabetes Research Foundation, Chennai, India
| | | | - S Kumar
- Sri Ramachandra University, Chennai, India
| | - A Punnoose
- Sri Ramachandra University, Chennai, India
| | - N Chockalingam
- Centre for Biomechanics and Rehabilitation Technologies, School of Health, Science and Wellbeing, Staffordshire University, Stoke-On-Trent, United Kingdom
| | - R Naemi
- Centre for Biomechanics and Rehabilitation Technologies, School of Health, Science and Wellbeing, Staffordshire University, Stoke-On-Trent, United Kingdom
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Ramachandran A, Siddiqui E, Reyentovich A, Lonze B, Saraon T, Rao S, Katz S, Goldberg R, Kadosh B, DiVita M, Cruz J, Carillo J, Smith D, Moazami N, Gidea C. Transplant Outcomes in Hearts with Moderate to Severe Left Ventricular Hypertrophy After the 2018 OPTN/UNOS Allocation Changes. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1690] [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: 10/18/2022] Open
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Krishnasamy N, Rajendran K, Barua P, Ramachandran A, Panneerselvam P, Rajaram M. Elevated Liver Enzymes along with Comorbidity Is a High Risk Factor for COVID-19 Mortality: A South Indian Study on 1,512 Patients. J Clin Transl Hepatol 2022; 10:120-127. [PMID: 35233380 PMCID: PMC8845151 DOI: 10.14218/jcth.2020.00100] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 01/30/2021] [Accepted: 05/20/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND AND AIMS Liver enzyme abnormalities in coronavirus 2019 (COVID-19) are being addressed in the literature. The predictive risk of elevated liver enzymes has not been established for COVID-19 mortality. In this study, we hypothesized that elevated liver enzymes at admission can predict the outcome of COVID-19 disease with other known indicators, such as comorbidities. METHODS This retrospective study included all the consecutive hospitalized patients with confirmed COVID-19 disease from March 4th to May 31st, 2020. The study was conducted in Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India. We assessed demography, clinical variables, COVID-19 severity, laboratory parameters, and outcome. RESULTS We included 1,512 patients, and median age was 47 years (interquartile range: 34-60) with 36.9% being female. Liver enzyme level (aspartate aminotransferase and/or alanine aminotransferase) was elevated in 450/1,512 (29.76%) patients. Comorbidity was present in 713/1,512 (47.16%) patients. Patients with liver enzymes' elevation and presence of comorbidity were older, more frequently hospitalized in ICU and had more severe symptoms of COVID-19 at the time of admission. Presence of liver enzymes' elevation with comorbidity was a high risk factor for death (OR: 5.314, 95% CI: 2.278-12.393), as compared to patients with presence of comorbidity (OR: 4.096, 95% CI: 1.833-9.157). CONCLUSIONS Comorbidity combined with liver enzymes' elevation at presentation independently increased the risk of death in COVID-19 by at least 5-fold.
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Affiliation(s)
- Narayanasamy Krishnasamy
- Institute of Hepatobiliary Sciences, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India
- Correspondence to: Narayanasamy Krishnasamy, Institute of Hepatobiliary Sciences, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu 600003, India. Tel: +91-9841170145, Fax: +91-4425305115, E-mail: ; Karthick Rajendran, Multidisciplinary Research Unit, Madras Medical College, Chennai, Tamil Nadu 600003, India. ORCID: https://orcid.org/0000-0003-3938-3347. Tel: +91-9790787578, Fax: +91-4425305115, E-mail:
| | - Karthick Rajendran
- Multidisciplinary Research Unit (MRU), Madras Medical College, Chennai, Tamil Nadu, India
- Correspondence to: Narayanasamy Krishnasamy, Institute of Hepatobiliary Sciences, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu 600003, India. Tel: +91-9841170145, Fax: +91-4425305115, E-mail: ; Karthick Rajendran, Multidisciplinary Research Unit, Madras Medical College, Chennai, Tamil Nadu 600003, India. ORCID: https://orcid.org/0000-0003-3938-3347. Tel: +91-9790787578, Fax: +91-4425305115, E-mail:
| | - Parimita Barua
- Institute of Hepatobiliary Sciences, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India
| | - Arunkumar Ramachandran
- Multidisciplinary Research Unit (MRU), Madras Medical College, Chennai, Tamil Nadu, India
| | | | - Muthukumaran Rajaram
- Multidisciplinary Research Unit (MRU), Madras Medical College, Chennai, Tamil Nadu, India
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Jagannathan H, Ramachandran A, Subramanian V, Shanmugam A, Rajendran K. Effect of Haemoglobin and Iron Status of the Antenatal Mothers on their Newborns at Birth: A Cross-sectional Study. IJNMR 2022. [DOI: 10.7860/ijnmr/2022/57853.2360] [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] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Introduction: Iron deficiency (ID) anaemia in pregnant mothers can affect the iron reserves of their newborns and lead to anaemia later. The haematological indices and iron status of pregnant women and its correlation with their neonates is still unclear. Aim: To assess the correlation between maternal and cord blood Hb and iron status. Materials and Methods: The present cross-sectional study included 134 antenatal mothers, at term gestation without any significant antenatal complications. Complete haemogram, serum iron, ferritin, and iron binding capacity were assessed for these mothers before delivery and also from the cord blood samples of their newborns at birth. Statistical difference and correlation were observed using Chi-square test and Pearson’s correlation coefficient. Results: Maternal anaemia Hb <11 gm/dL) was observed in 62 (46.3%). The mean Hb and ferritin of the mothers were 11.06±1.02 gm/dL and 113.3±7.1 μg/L, respectively. The mean Hb and ferritin levels of the cord blood samples were 12.24±0.17 gm/dL and 214.3±20.1 μg/L, respectively. In univariate analysis, maternal Hb showed a significant correlation with cord blood Hb with Odds Ratio (OR) 0.508 and 95% Confidence Interval (CI): 0.428-0.603. The Pearson’s correlation showed a moderate correlation between mother and cord blood Packed Cell Volume (PCV) (r=0.344, p<0.001) and weak correlation between other maternal and cord blood iron indices and serum ferritin (r=0.191, p=0.027 and r=0.203, p=0.019). Conclusion: There is a significant correlation between maternal and cord blood Hb in term neonates. The study indicates that the haematological indices of pregnant women determine the neonatal Hb in term babies.
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Nathan J, Ramachandran A. Efficacy of marine biomolecules on angiogenesis by targeting hypoxia inducible factor/vascular endothelial growth factor signaling in zebrafish model. J Biochem Mol Toxicol 2021; 36:e22954. [PMID: 34783123 DOI: 10.1002/jbt.22954] [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: 05/27/2021] [Revised: 10/10/2021] [Accepted: 11/01/2021] [Indexed: 12/22/2022]
Abstract
Marine resources are notably explored for their unique biomolecules that have been designed to be drug targets for their immense potential against various pathologies. These biomolecules are mostly secondary metabolites from different species that include sponges, tunicates, echinoderms, ascidians, algae, and marine symbionts. Among the various biological activities of the marine biomolecules, antiangiogenic property has gained much significance in alternate therapy for treatment against cancer. Hypoxia inducible factor (HIF) and vascular endothelial growth factor (VEGF) are the prime signaling pathways related to angiogenesis that are exclusively designated as markers for critical selection of novel inhibitors. This is mainly due to their importance in tumor induction and regulatory control over other interlinked pathways involved in cancer. Small molecular drug screening using the zebrafish model has been an advantage in cancer research in recent times. This review addresses the importance of marine biomolecules and their antiangiogenic efficacy by targeting HIF/VEGF pathways experimented in the zebrafish model in the last decade. Thus, it would provide more clear insights into the role of biomolecules in alternative cancer therapy.
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Affiliation(s)
- Jhansi Nathan
- Zebrafish Developmental Biology Laboratory, AUKBC Research Centre, Anna University, Chennai, India
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Jaeschke H, Akakpo J, Ramachandran A. Paracetamol hepatotoxicity: Discovering new drugs based on mechanistic insight from animal studies. Toxicol Lett 2021. [DOI: 10.1016/s0378-4274(21)00380-5] [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: 11/28/2022]
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Etherajan T, Zahir Hussain S, Rajendran K, Ramachandran A, Natrajan M, Venugopalan N, Elumalai K, Annamalai G, Mathiyalagan G, Panneerselvam P, Pamarthi J, Rajaram M, Anandan G, Natarajan G. Profile of COVID-19 Patients at Zero Delay COVID-19 Ward, Tertiary Care Hospital in South India. J Prim Care Community Health 2021; 12:21501327211035094. [PMID: 34315299 PMCID: PMC8323444 DOI: 10.1177/21501327211035094] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Introduction: Coronavirus disease 2019 (COVID-19) pandemic is a worldwide public health
crisis. During huge surge in COVID-19 cases, most of the patient arrived at
Rajiv Gandhi Government General Hospital, Chennai were severe due to late
presentation and also available evidence demonstrating that the delay in
treatment is directly associated with increased mortality or poor patient
outcome. As an innovative concept of Zero Delay COVID-19 Ward were set up to
provide the required critical care for all severe COVID-19 cases. The
experience of setting up of such Zero Delay COVID-19 Ward and profile of
admitted COVID-19 patients were described in this paper. Methods: A total of 4515 laboratory-confirmed COVID-19 patients admitted at Zero Delay
COVID-19 Ward was analyzed retrospectively from 7th July to 31st December
2020. Results: At the time of admission the frequency of dyspnea were 85.6% among them 99.1%
recovered from dyspnea after the oxygen therapy and other management at Zero
Delay COVID-19 Ward. Of the 4515 COVID-19 individuals, about 1829 (40.5%)
had comorbidity, 227 (5%) had died. Multivariable logistic regression
analysis, COVID-19 death was more likely to be associated with comorbidity
(OR: 18.687; 95% CI: 11.229-31.1) than other variables. Conclusions: Comorbidity is an independent high risk factor for mortality of COVID-19
patients. From our observation, it is strongly recommended that effective
zero delay covid-19 ward model will help for the prevention of mortality in
current/expected waves of COVID-19.
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Affiliation(s)
- Theranirajan Etherajan
- Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India
| | - S Zahir Hussain
- Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India
| | | | | | - Murugan Natrajan
- Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India
| | - Nisha Venugopalan
- Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India
| | - Kathiravan Elumalai
- Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India
| | - Ganesh Annamalai
- Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India
| | - Guhan Mathiyalagan
- Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India
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Ramachandran A, Sivakumar K, Shanmugasundharam A, Sangunathan U, Krishnamurthy R. Evaluation of potable groundwater zones identification based on WQI and GIS techniques in Adyar River basin, Chennai, Tamilnadu, India. ACTA ACUST UNITED AC 2021. [DOI: 10.1016/j.chnaes.2020.02.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Krishnasamy N, Natarajan M, Ramachandran A, Vivian Thangaraj JW, Etherajan T, Rengarajan J, Shanmugasundaram M, Kandasamy A, Ramamoorthy R, Velusamy A, Obla Lakshmanamoorthy NB, Kanagaraman P, Rahamathula MI, Devadas G, Sathyanathan BP, Rajaji P, Rajendran K, Panneerselvam P, Rajaram M, Panjacharam M. Clinical Outcomes among Asymptomatic or Mildly Symptomatic COVID-19 Patients in an Isolation Facility in Chennai, India. Am J Trop Med Hyg 2021; 104:85-90. [PMID: 33205749 PMCID: PMC7790092 DOI: 10.4269/ajtmh.20-1096] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Globally, India has reported the third highest number of COVID-19 cases. Chennai, the capital of Tamil Nadu state, witnessed a huge surge in COVID-19 cases, resulting in the establishment of isolation facilities named COVID Care Center (CCC). In our study, we describe the demographic, epidemiological, and clinical characteristics; clinical progression; and outcome of 1,263 asymptomatic/mildly symptomatic COVID-19 patients isolated in one such CCC between May 4, 2020 and June 4, 2020. Around 10.5% of the patients progressed to moderate/severe illness, requiring referral for tertiary care, and three died. Nearly half (49.5%) of the patients were symptomatic at the time of admission, 2.2% of the patients developed symptoms post-testing, and 48.5% patients remained asymptomatic during the entire course of illness. Most common presenting symptoms were fever (69.9%) and cough (29.6%), followed by generalized body pain, breathlessness, and loss of smell and taste. On multivariate analysis, we identified that symptomatic patients with comorbidities and higher neutrophil–lymphocyte ratio (NLR) were more likely to progress to severe illness warranting referral for tertiary care. COVID Care Center ensured case isolation and monitoring of asymptomatic/mildly symptomatic patients, thereby providing hospital beds for sick patients. COVID Care Center isolation facilities are safe alternatives for medical institutions to isolate and monitor COVID-19 patients. Older symptomatic patients with comorbidities and a high NLR admitted in an isolation facility must be frequently monitored for prompt identification of clinical progression and referral to higher center for advanced medical care.
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Affiliation(s)
| | - Murugan Natarajan
- 1Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, India
| | | | | | | | - Jayanthi Rengarajan
- 1Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, India
| | | | - Anuradha Kandasamy
- 1Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, India
| | - Ramesh Ramamoorthy
- 1Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, India
| | - Arul Velusamy
- 1Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, India
| | | | | | | | - Geetha Devadas
- 1Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, India
| | | | - Poonguzhali Rajaji
- 1Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, India
| | - Karthick Rajendran
- 1Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, India
| | | | - Muthukumaran Rajaram
- 1Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, India
| | - Mohan Panjacharam
- 1Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, India
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Ramachandran A, Wilbur GR, O'Neal S, Deppe DG, Hall KC. Suppression of decoherence tied to electron-phonon coupling in telecom-compatible quantum dots: low-threshold reappearance regime for quantum state inversion. Opt Lett 2020; 45:6498-6501. [PMID: 33258845 DOI: 10.1364/ol.403590] [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] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 10/01/2020] [Indexed: 06/12/2023]
Abstract
We demonstrate suppression of dephasing tied to deformation potential coupling of confined electrons to longitudinal acoustic (LA) phonons in optical control experiments on large semiconductor quantum dots (QDs) with emission compatible with the low-dispersion telecommunications band at 1.3 µm. By exploiting the sensitivity of the electron-phonon spectral density to the size and shape of the QD, we demonstrate a fourfold reduction in the threshold pulse area required to enter the decoupled regime for exciton inversion using adiabatic rapid passage (ARP). Our calculations of the quantum state dynamics indicate that the symmetry of the QD wave function provides an additional means to engineer the electron-phonon interaction. Our findings will support the development of solid-state quantum emitters in future distributed quantum networks using semiconductor QDs.
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Kumar A, Paulose R, Sadasivan S, Bajad C, Ramachandran A, Nair P. Sarcoidosis, steroids and Strongyloides-what's the catch? Clin Microbiol Infect 2020; 27:S1198-743X(20)30561-9. [PMID: 32950714 PMCID: PMC7497548 DOI: 10.1016/j.cmi.2020.09.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 09/02/2020] [Accepted: 09/06/2020] [Indexed: 10/29/2022]
Affiliation(s)
- A Kumar
- Department of Microbiology, Amrita Institute of Medical Sciences & Research Centre, Amrita Vishwa Vidyapeetham, Ponekara, Kochi 682041, Kerala, India.
| | - R Paulose
- Department of Pathology, Amrita Institute of Medical Sciences & Research Centre, Amrita Vishwa Vidyapeetham, Ponekara, Kochi 682041, Kerala, India
| | - S Sadasivan
- Department of Gastroenterology, Amrita Institute of Medical Sciences & Research Centre, Amrita Vishwa Vidyapeetham, Ponekara, Kochi 682041, Kerala, India
| | - C Bajad
- Department of Pathology, Amrita Institute of Medical Sciences & Research Centre, Amrita Vishwa Vidyapeetham, Ponekara, Kochi 682041, Kerala, India
| | - A Ramachandran
- Department of Microbiology, Amrita Institute of Medical Sciences & Research Centre, Amrita Vishwa Vidyapeetham, Ponekara, Kochi 682041, Kerala, India
| | - P Nair
- Department of Gastroenterology, Amrita Institute of Medical Sciences & Research Centre, Amrita Vishwa Vidyapeetham, Ponekara, Kochi 682041, Kerala, India
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Kumar A, Sathyapalan D, Ramachandran A, Subhash K, Biswas L, Beena KV. SARS-CoV-2 antibodies in healthcare workers in a large university hospital, Kerala, India. Clin Microbiol Infect 2020; 27:481-483. [PMID: 32949718 PMCID: PMC7493758 DOI: 10.1016/j.cmi.2020.09.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 09/02/2020] [Accepted: 09/06/2020] [Indexed: 11/01/2022]
Affiliation(s)
- A Kumar
- Department of Microbiology, Amrita Institute of Medical Sciences & Research Centre, Amrita Vishwa Vidyapeetham, Ponekkara, Kochi 682041, Kerala, India.
| | - D Sathyapalan
- Department of Medicine & Infectious Diseases, Amrita Institute of Medical Sciences & Research Centre, Amrita Vishwa Vidyapeetham, Ponekkara, Kochi 682041, Kerala, India
| | - A Ramachandran
- Department of Microbiology, Amrita Institute of Medical Sciences & Research Centre, Amrita Vishwa Vidyapeetham, Ponekkara, Kochi 682041, Kerala, India
| | - K Subhash
- Department of Microbiology, Amrita Institute of Medical Sciences & Research Centre, Amrita Vishwa Vidyapeetham, Ponekkara, Kochi 682041, Kerala, India
| | - L Biswas
- Centre for Nanoscience and Molecular Medicine, Amrita Institute of Medical Sciences & Research Centre, Amrita Vishwa Vidyapeetham, Ponekkara, Kochi 682041, Kerala, India
| | - K V Beena
- Medical Administration, Amrita Institute of Medical Sciences & Research Centre, Amrita Vishwa Vidyapeetham, Ponekkara, Kochi 682041, Kerala, India
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18
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Subhasree S, Anitha P, Kannan K, Ramachandran A, Sheri JJ, Jayavel R. Anticorrosion Behavior of ZnO Nanoparticles Coated on Mild Steel in NaCl Solution. J Nanosci Nanotechnol 2020; 20:4061-4068. [PMID: 31968421 DOI: 10.1166/jnn.2020.17526] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
This work focuses on the environment protected, ecological procedure by the combination of ZnO nanoparticles utilizing the extraction of Ocimum sanctum. The prepared nanoparticles are examined by different methods like Fourier-transform infrared spectroscopy (FTIR), X-ray Diffraction (XRD), Field emission scanning electron microscopy (FE-SEM), Energy Dispersive X-ray Analysis (EDAX). A systematic study has been made on the result of ZnO nano-coating for the corrosion behavior of mild steel. The ZnO nanoparticles of average diameter in the range 18-22 nm were coated on mild steel in nickel bath solution. The anticorrosion properties on the coated mild steel was carefully tested in 3.5% NaCl solution by performing potentio-dynamic polarization measurement and electrochemical impedance spectroscopy. Surface morphology of the coated mild steel immersed in corrosive solution was judged by using SEM with EDAX. The ZnO nano coating has shown a perfect protection against corrosion and the shielding capability is in the range between 86-95%. The incorporation of ZnO nanoparticles has upgraded the process of mild steel in all corrosion media are subjected to investigation.
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Affiliation(s)
- S Subhasree
- Department of Chemistry, Government College of Engineering, Salem 11, India
| | - P Anitha
- Department of Chemistry, Government College of Engineering, Salem 11, India
| | - K Kannan
- Department of Chemistry, Government College of Engineering, Salem 11, India
| | - A Ramachandran
- Department of Chemistry, Government College of Engineering, Salem 11, India
| | - J J Sheri
- Department of Biosciences, Mangalore University, Mangalagangotri 574199, India
| | - R Jayavel
- Centre for Nanoscience and Technology, Anna University, Chennai 600025, India
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Rajendran K, Krishnasamy N, Rangarajan J, Rathinam J, Natarajan M, Ramachandran A. Convalescent plasma transfusion for the treatment of COVID-19: Systematic review. J Med Virol 2020; 92:1475-1483. [PMID: 32356910 PMCID: PMC7267113 DOI: 10.1002/jmv.25961] [Citation(s) in RCA: 202] [Impact Index Per Article: 50.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 04/29/2020] [Indexed: 12/28/2022]
Abstract
The recent emergence of coronavirus disease 2019 (COVID‐19) pandemic has reassessed the usefulness of historic convalescent plasma transfusion (CPT). This review was conducted to evaluate the effectiveness of CPT therapy in COVID‐19 patients based on the publications reported till date. To our knowledge, this is the first systematic review on convalescent plasma on clinically relevant outcomes in individuals with COVID‐19. PubMed, EMBASE, and Medline databases were searched upto 19 April 2020. All records were screened as per the protocol eligibility criteria. We included five studies reporting CPT to COVID‐19 patients. The main findings from available data are as follows: (a) Convalescent plasma may reduce mortality in critically ill patients, (b) Increase in neutralizing antibody titers and disappearance of SARS‐CoV‐2 RNA was observed in almost all the patients after CPT therapy, and (c) Beneficial effect on clinical symptoms after administration of convalescent plasma. Based on the limited scientific data, CPT therapy in COVID‐19 patients appears safe, clinically effective, and reduces mortality. Well‐designed large multicenter clinical trial studies should be conducted urgently to establish the efficacy of CPT to COVID‐19 patients.
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Affiliation(s)
- Karthick Rajendran
- Multidisciplinary Research Unit (MRU), Madras Medical College, Chennai, Tamil Nadu, India
| | | | - Jayanthi Rangarajan
- Institute of Internal Medicine, Madras Medical College, Chennai, Tamil Nadu, India
| | - Jeyalalitha Rathinam
- Institute of Internal Medicine, Madras Medical College, Chennai, Tamil Nadu, India
| | - Murugan Natarajan
- Institute of Internal Medicine, Madras Medical College, Chennai, Tamil Nadu, India
| | - Arunkumar Ramachandran
- Multidisciplinary Research Unit (MRU), Madras Medical College, Chennai, Tamil Nadu, India
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20
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Rajendran K, Krishnasamy N, Rangarajan J, Rathinam J, Natarajan M, Ramachandran A. Convalescent plasma transfusion for the treatment of COVID-19: Systematic review. J Med Virol 2020. [PMID: 32356910 DOI: 10.1002/jmv.25961.] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The recent emergence of coronavirus disease 2019 (COVID-19) pandemic has reassessed the usefulness of historic convalescent plasma transfusion (CPT). This review was conducted to evaluate the effectiveness of CPT therapy in COVID-19 patients based on the publications reported till date. To our knowledge, this is the first systematic review on convalescent plasma on clinically relevant outcomes in individuals with COVID-19. PubMed, EMBASE, and Medline databases were searched upto 19 April 2020. All records were screened as per the protocol eligibility criteria. We included five studies reporting CPT to COVID-19 patients. The main findings from available data are as follows: (a) Convalescent plasma may reduce mortality in critically ill patients, (b) Increase in neutralizing antibody titers and disappearance of SARS-CoV-2 RNA was observed in almost all the patients after CPT therapy, and (c) Beneficial effect on clinical symptoms after administration of convalescent plasma. Based on the limited scientific data, CPT therapy in COVID-19 patients appears safe, clinically effective, and reduces mortality. Well-designed large multicenter clinical trial studies should be conducted urgently to establish the efficacy of CPT to COVID-19 patients.
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Affiliation(s)
- Karthick Rajendran
- Multidisciplinary Research Unit (MRU), Madras Medical College, Chennai, Tamil Nadu, India
| | | | - Jayanthi Rangarajan
- Institute of Internal Medicine, Madras Medical College, Chennai, Tamil Nadu, India
| | - Jeyalalitha Rathinam
- Institute of Internal Medicine, Madras Medical College, Chennai, Tamil Nadu, India
| | - Murugan Natarajan
- Institute of Internal Medicine, Madras Medical College, Chennai, Tamil Nadu, India
| | - Arunkumar Ramachandran
- Multidisciplinary Research Unit (MRU), Madras Medical College, Chennai, Tamil Nadu, India
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21
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Narayanasamy K, Karthick R, Panneerselvam P, Mohan N, Ramachandran A, Prakash R, Rajaram M. Association of metabolic syndrome and patatin-like phospholipase 3 - rs738409 gene variant in non-alcoholic fatty liver disease among a Chennai-based south Indian population. J Gene Med 2020; 22:e3160. [PMID: 31945251 DOI: 10.1002/jgm.3160] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 06/21/2019] [Revised: 12/12/2019] [Accepted: 01/09/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Non-alcoholic fatty liver disease (NAFLD) is commonly diagnosed in patients presenting with metabolic syndrome (MetS) and has been associated with single nucleotide polymorphisms of rs738409 in the patatin-like phospholipase domain containing 3 (PNPLA3) gene. This association remains to be investigated in the South Indian population. We aimed to determine the association of the PNPLA3 rs738409 gene polymorphism with MetS and NAFLD among a Chennai-based population. METHODS The study comprised 105 NAFLD cases and 102 controls. All subjects were genotyped for the PNPLA3 rs738409 variant and MetS was defined according to the National Cholesterol Education Program - Adult Treatment Panel III criteria. Our case-control study showed the association of the variant with NAFLD and MetS. RESULTS The PNPLA3 rs738409 variant was associated with NAFLD and the genotype frequencies (CC/CG/GG) were 19 (18.1%), 50 (47.6%) and 36 (34.3%) in the NAFLD group and 59 (57.8%), 29 (28.4%) and 14 (13.7%) in the control group respectively. We also confirmed the interaction between the PNPLA3 rs738409 polymorphism and MetS with respect tto elevated triglyceride levels. However, an association with elevated waist circumference, fasting glucose, blood pressure and decreased high-density lipoprotein cholesterol was not observed in the present study. CONCLUSIONS The PNPLA3 rs738409 gene polymorphism increases the risk of NAFLD by up to four-fold in subjects with an elevated level of triglyceride independent of other features of MetS.
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Affiliation(s)
| | - Rajendran Karthick
- Multidisciplinary Research Unit (MRU), Madras Medical College, Chennai, Tamil Nadu, India
| | | | - Nithya Mohan
- Multidisciplinary Research Unit (MRU), Madras Medical College, Chennai, Tamil Nadu, India
| | - Arunkumar Ramachandran
- Multidisciplinary Research Unit (MRU), Madras Medical College, Chennai, Tamil Nadu, India
| | - Radhika Prakash
- Institute of Hepatobiliary Sciences, Madras Medical College, Chennai, Tamil Nadu, India
| | - Muthukumaran Rajaram
- Multidisciplinary Research Unit (MRU), Madras Medical College, Chennai, Tamil Nadu, India
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Zhang K, Liu X, Samuel Ravi SOA, Ramachandran A, Aziz Ibrahim IA, M Nassir A, Yao J. Synthesis of silver nanoparticles (AgNPs) from leaf extract of Salvia miltiorrhiza and its anticancer potential in human prostate cancer LNCaP cell lines. Artif Cells Nanomed Biotechnol 2019; 47:2846-2854. [PMID: 31299869 DOI: 10.1080/21691401.2019.1638792] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Biosynthesis of silver nanoparticles (AgNPs) from the medicinal plants has been considered as a remarkable approach of several therapeutic innovations and successful drug delivery. Silver nanoparticles were biosynthesized with Salvia miltiorrhiza, Chinese medicinal herb and assessed for its anticarcinogenic property. Synthesis of AgNPs was characterized by several studies such as UV-absorbance and it shows peak values in the range of 425-445 nm. The sizes of the nanoparticles are confirmed by dynamic light scattering analysis and it shows 100 nm. Furthermore, transmission electron microscopy (TEM) and energy dispersive X-ray analysis (EDX) was to confirm the shape and Ag particles are present in the synthesized materials. FTIR analysis to find out the active biomolecules located in the surface of the synthesized particles. This AgNPs from S. miltiorrhiza inhibits the growth of Bacillus subtillis, Staphylococcus aureus, Escherichia coli, and Klebsiella pneumonia. Furthermore, the anticancer potential of AgNPs is examined in prostate adenocarcinoma (LNCaP) cell lines. In this study, we found the AgNPs effectively induces cytotoxicity, ROS and apoptosis by modulation of intrinsic apoptoic Bcl2, Bclxl, Bax and Caspase 3 protein expressions in LNCap cell lines. Based on the study, synthesis of AgNPs from S. miltiorrhiza shows eco-friendly and it exhibits antimicrobial and anticarcinogenic effects.
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Affiliation(s)
- Ke Zhang
- a Department of Urology, The First People's Hospital of Yunnan Province, the Affiliated Hospital of Kunming University of Science and Technology, Kunming , Yunnan , China
| | - Xiaodong Liu
- b Department of Urology, The Second People's Hospital of Yunnan Province , Kunming , Yunnan , China
| | | | | | - Ibrahim Abdel Aziz Ibrahim
- e Department of Pharmacology and Toxicology, Faculty of Medicine, Umm Al-Qura University , Makkah , Saudi Arabia
| | - Anmar M Nassir
- f Department of Surgery, Faculty of Medicine, Umm Al-Qura University , Makkah , Saudi Arabia
| | - Jiapei Yao
- g Department of Urological Surgery No.2, The First Affiliated Hospital of Kunming Medical University , Kunming , Yunnan , China
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Chawla R, Makkar BM, Aggarwal S, Bajaj S, Das AK, Ghosh S, Gupta A, Gupta S, Jaggi S, Jana J, Keswadev J, Kalra S, Keswani P, Kumar V, Maheshwari A, Moses A, Nawal CL, Panda J, Panikar V, Ramchandani GD, Rao PV, Saboo B, Sahay R, Setty KR, Viswanathan V, Aravind SR, Banarjee S, Bhansali A, Chandalia HB, Das S, Gupta OP, Joshi S, Kumar A, Kumar KM, Madhu SV, Mittal A, Mohan V, Munichhoodappa C, Ramachandran A, Sahay BK, Sai J, Seshiah V, Zargar AH. RSSDI consensus recommendations on insulin therapy in the management of diabetes. Int J Diabetes Dev Ctries 2019. [DOI: 10.1007/s13410-019-00783-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
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Matt C, Ramachandran A, Allison R, Wall C, Dieterly A, Brandão J. LISTERIA MONOCYTOGENES IN AN INLAND BEARDED DRAGON (POGONA VITTICEPS). J Exot Pet Med 2019. [DOI: 10.1053/j.jepm.2018.12.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Tabesh M, Magliano DJ, Tanamas SK, Surmont F, Bahendeka S, Chiang C, Elgart JF, Gagliardino JJ, Kalra S, Krishnamoorthy S, Luk A, Maegawa H, Motala AA, Pirie F, Ramachandran A, Tayeb K, Vikulova O, Wong J, Shaw JE. Cardiovascular disease management in people with diabetes outside North America and Western Europe in 2006 and 2015. Diabet Med 2019; 36:878-887. [PMID: 30402961 PMCID: PMC6618273 DOI: 10.1111/dme.13858] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/02/2018] [Indexed: 01/07/2023]
Abstract
AIM Optimal treatment of cardiovascular disease is essential to decrease mortality among people with diabetes, but information is limited on how actual treatment relates to guidelines. We analysed changes in therapeutic approaches to anti-hypertensive and lipid-lowering medications in people with Type 2 diabetes from 2006 and 2015. METHODS Summary data from clinical services in seven countries outside North America and Western Europe were collected for 39 684 people. Each site summarized individual-level data from outpatient medical records for 2006 and 2015. Data included: demographic information, blood pressure (BP), total cholesterol levels and percentage of people taking statins, anti-hypertensive medication (angiotensin-converting enzyme inhibitors, calcium channel blockers, angiotensin II receptor blockers, thiazide diuretics) and antiplatelet drugs. RESULTS From 2006 to 2015, mean cholesterol levels decreased in six of eight sites (range: -0.5 to -0.2), whereas the proportion with BP levels > 140/90 mmHg increased in seven of eight sites. Decreases in cholesterol paralleled increases in statin use (range: 3.1 to 47.0 percentage points). Overall, utilization of anti-hypertensive medication did not change. However, there was an increase in the use of angiotensin II receptor blockers and a decrease in angiotensin-converting enzyme inhibitors. The percentage of individuals receiving calcium channel blockers and aspirin remained unchanged. CONCLUSIONS Our findings indicate that control of cholesterol levels improved and coincided with increased use of statins. The percentage of people with BP > 140/90 mmHg was higher in 2015 than in 2006. Hypertension treatment shifted from using angiotensin-converting enzyme inhibitors to angiotensin II receptor blockers. Despite the potentially greater tolerability of angiotensin II receptor blockers, there was no associated improvement in BP levels.
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Affiliation(s)
- M. Tabesh
- Baker Heart and Diabetes InstituteMelbourneAustralia
- Department of Epidemiology and Preventive MedicineSchool of Public Health and Preventive MedicineMonash UniversityMelbourneAustralia
| | - D. J. Magliano
- Baker Heart and Diabetes InstituteMelbourneAustralia
- Department of Epidemiology and Preventive MedicineSchool of Public Health and Preventive MedicineMonash UniversityMelbourneAustralia
| | - S. K. Tanamas
- Baker Heart and Diabetes InstituteMelbourneAustralia
| | | | - S. Bahendeka
- MKPGMS‐Uganda Martyrs University & St. Francis Hospital NsambyaKampalaUganda
| | - C.‐E. Chiang
- General Clinical Research CenterTaipei Veterans General HospitalTaipeiTaiwan
| | - J. F. Elgart
- CENEXA. Centro de Endocrinología Experimental y Aplicada (UNLP‐CONICET)La PlataArgentina
| | - J. J. Gagliardino
- CENEXA. Centro de Endocrinología Experimental y Aplicada (UNLP‐CONICET)La PlataArgentina
| | - S. Kalra
- Bharti Research Institute of Diabetes & EndocrinologyBharti HospitalKarnalHaryanaIndia
| | | | - A. Luk
- Department of Medicine and TherapeuticsPrince of Wales HospitalHong Kong SARChina
| | - H. Maegawa
- Shiga University of Medical ScienceShigaJapan
| | - A. A. Motala
- Department of Diabetes and EndocrinologyUniversity of KwaZulu NatalDurbanSouth Africa
| | - F. Pirie
- Department of Diabetes and EndocrinologyUniversity of KwaZulu NatalDurbanSouth Africa
| | | | - K. Tayeb
- Diabetes Center at AlNoor Specialist HospitalMakkahSaudi Arabia
| | - O. Vikulova
- FGBU ‘Endocrinology Research Center’Ministry of HealthMoscowRussia
| | - J. Wong
- Royal Prince Alfred Hospital Diabetes Centre and the University of SydneySydneyAustralia
| | - J. E. Shaw
- Baker Heart and Diabetes InstituteMelbourneAustralia
- Department of Epidemiology and Preventive MedicineSchool of Public Health and Preventive MedicineMonash UniversityMelbourneAustralia
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Akakpo JY, Ramachandran A, Kandel SE, Ni HM, Kumer SC, Rumack BH, Jaeschke H. 4-Methylpyrazole protects against acetaminophen hepatotoxicity in mice and in primary human hepatocytes. Hum Exp Toxicol 2018; 37:1310-1322. [PMID: 29739258 DOI: 10.1177/0960327118774902] [Citation(s) in RCA: 67] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Liver injury due to acetaminophen (APAP) overdose is the major cause of acute liver failure in the United States. While treatment with N-acetylcysteine is the current standard of care for APAP overdose, anecdotal evidence suggests that administration of 4-methylpyrazole (4MP) may be beneficial in the clinic. The objective of the current study was to examine the protective effect of 4MP and its mechanism of action. Male C57BL/6J mice were co-treated with 300 mg/kg of APAP and 50 mg/kg of 4MP. The severe liver injury induced by APAP at 6 h as indicated by elevated plasma alanine aminotransferase activities, centrilobular necrosis, and nuclear DNA fragmentation was almost completely eliminated by 4MP. In addition, 4MP largely prevented APAP-induced activation of c-Jun N-terminal kinase (JNK), mitochondrial translocation of phospho-JNK and Bax, and the release of mitochondrial intermembrane proteins. Importantly, 4MP inhibited the generation of APAP protein adducts and formation of APAP-glutathione (GSH) conjugates and attenuated the depletion of the hepatic GSH content. These findings are relevant to humans because 4MP also prevented APAP-induced cell death in primary human hepatocytes. In conclusion, early treatment with 4MP can completely prevent liver injury after APAP overdose by inhibiting cytochrome P450 and preventing generation of the reactive metabolite.
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Affiliation(s)
- J Y Akakpo
- 1 Department of Pharmacology, Toxicology and Therapeutics, University of Kansas Medical Center, Kansas City, KS, USA
| | - A Ramachandran
- 1 Department of Pharmacology, Toxicology and Therapeutics, University of Kansas Medical Center, Kansas City, KS, USA
| | - S E Kandel
- 1 Department of Pharmacology, Toxicology and Therapeutics, University of Kansas Medical Center, Kansas City, KS, USA
| | - H M Ni
- 1 Department of Pharmacology, Toxicology and Therapeutics, University of Kansas Medical Center, Kansas City, KS, USA
| | - S C Kumer
- 2 Department of Surgery, University of Kansas Medical Center, Kansas City, KS, USA
| | - B H Rumack
- 3 Department of Emergency Medicine and Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA
| | - H Jaeschke
- 1 Department of Pharmacology, Toxicology and Therapeutics, University of Kansas Medical Center, Kansas City, KS, USA
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Ghosh S, Unnikrishnan AG, Saboo B, Kesavadev J, Aravind SR, Bajaj S, Rajput R, Seshadri K, Verma N, Gupta A, Makkar BM, Saikia M, Kale S, Damodaran S, Dengra A, Eashwar TKM, Maheshwari A, Pendsey S, Phatak SR, Sharma SK, Singh SK, Ramachandran A, Zargar AH, Joshi SR, Sadikot SM. Evidence-based recommendations for insulin intensification strategies after basal insulin in type 2 diabetes. Diabetes Metab Syndr 2017; 11 Suppl 1:S507-S521. [PMID: 28433618 DOI: 10.1016/j.dsx.2017.03.045] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Indexed: 01/27/2023]
Abstract
Over the time due to progressive nature of diabetes, proactive intensification of the existing insulin therapy becomes imminent as it minimizes patients' exposure to chronic hypo/hyperglycaemia and reduces weight gain while achieving individualized glycaemic targets. This review focuses on the strength of evidence behind various options for intensification, primarily the insulins as also the GLP-1 analogues. The recommendations presented here are meant to serve as a guide for the physician managing type 2 diabetes patients requiring insulin intensification upon failing of basal insulin therapy.
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Affiliation(s)
- Sujoy Ghosh
- Department of Endocrinology and Metabolism, Institute of Post-Graduate Medical Education and Research, Kolkata, India.
| | | | | | | | | | - Sarita Bajaj
- Department of Medicine, Motilal Nehru Medical College, Allahabad, India
| | - Rajesh Rajput
- Department of Endocrinology, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, India
| | - Krishna Seshadri
- Department of Endocrinology and Metabolism, Shri Rama Chandra University, Chennai, India
| | | | | | | | | | | | | | - Ashish Dengra
- Mahi Diabetes & Thyroid Care and Research Center, Jabalpur, India
| | | | - Anuj Maheshwari
- Department of Medicine, Babu Banarasi Das University, Lucknow, India
| | | | | | | | - Surya Kumar Singh
- Department of Endocrinology and Metabolism, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
| | | | - Abdul H Zargar
- Advanced Center for Diabetes and Endocrine Care, Srinagar, India
| | - Shashank R Joshi
- Lilavati and Bhatia Hospital and Grant Medical College, Mumbai, India
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Naemi R, Chatzistergos P, Suresh S, Sundar L, Chockalingam N, Ramachandran A. Can plantar soft tissue mechanics enhance prognosis of diabetic foot ulcer? Diabetes Res Clin Pract 2017; 126:182-191. [PMID: 28259007 DOI: 10.1016/j.diabres.2017.02.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Revised: 01/16/2017] [Accepted: 02/02/2017] [Indexed: 10/20/2022]
Abstract
AIM To investigate if the assessment of the mechanical properties of plantar soft tissue can increase the accuracy of predicting Diabetic Foot Ulceration (DFU). METHODS 40 patients with diabetic neuropathy and no DFU were recruited. Commonly assessed clinical parameters along with plantar soft tissue stiffness and thickness were measured at baseline using ultrasound elastography technique. 7 patients developed foot ulceration during a 12months follow-up. Logistic regression was used to identify parameters that contribute to predicting the DFU incidence. The effect of using parameters related to the mechanical behaviour of plantar soft tissue on the specificity, sensitivity, prediction strength and accuracy of the predicting models for DFU was assessed. RESULTS Patients with higher plantar soft tissue thickness and lower stiffness at the 1st Metatarsal head area showed an increased risk of DFU. Adding plantar soft tissue stiffness and thickness to the model improved its specificity (by 3%), sensitivity (by 14%), prediction accuracy (by 5%) and prognosis strength (by 1%). The model containing all predictors was able to effectively (χ2 (8, N=40)=17.55, P<0.05) distinguish between the patients with and without DFU incidence. CONCLUSION The mechanical properties of plantar soft tissue can be used to improve the predictability of DFU in moderate/high risk patients.
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Affiliation(s)
- R Naemi
- School of Life Sciences and Education, Staffordshire University, Stoke on Trent, United Kingdom.
| | - P Chatzistergos
- School of Life Sciences and Education, Staffordshire University, Stoke on Trent, United Kingdom
| | - S Suresh
- India Diabetes Research Foundation, Chennai, India
| | - L Sundar
- India Diabetes Research Foundation, Chennai, India
| | - N Chockalingam
- School of Life Sciences and Education, Staffordshire University, Stoke on Trent, United Kingdom
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Nanditha A, Snehalatha C, Ram J, Selvam S, Vijaya L, Shetty SA, Arun R, Ramachandran A. Impact of lifestyle intervention in primary prevention of Type 2 diabetes did not differ by baseline age and BMI among Asian-Indian people with impaired glucose tolerance. Diabet Med 2016; 33:1700-1704. [PMID: 26773871 DOI: 10.1111/dme.13071] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Revised: 11/11/2015] [Accepted: 01/11/2016] [Indexed: 01/28/2023]
Abstract
AIM To investigate whether the effectiveness of lifestyle interventions on the incidence of diabetes was influenced by the baseline age and BMI of the Asian-Indian participants with prediabetes. METHODS Pooled data, obtained from two of our Indian Diabetes Prevention Programmes (2006, n=236 and 2013, n=473; total N=709) which had similar baseline characteristics and intervention principles, were analysed. For the present secondary analysis we dichotomously categorized the participants' baseline age (<45 and ≥45 years) and BMI (<25.0 and ≥ 25.0 kg/m2 ). Glycaemic status was ascertained at 6-monthly intervals by oral glucose tolerance tests. The incidence rates of diabetes and relative risk reduction in both the intervention and the control group were calculated for categories of baseline age and BMI. Interactions between the intervention and baseline age and BMI on diabetes risk were also analysed. RESULTS Incident diabetes was diagnosed in 227 of the total 709 participants (32.0%) [control group 139 participants (38.8%) vs intervention group 88 participants (24.2%)] during the median follow-up period of 2 years. The overall relative risk reduction was 35.4% (95% CI 19.3-48.3). Lifestyle intervention was equally effective in both age groups [relative risk reduction in those aged <45 years: 43.7% (95% CI 19.8-60.5) and in those aged ≥ 45 years: 28.9% (95% CI 5.3-46.6) P for interaction = 0.52] and in categories of BMI [BMI <25 kg/m2 : 36.1% (95% CI 9.5-54.9); and BMI ≥ 25 kg/m2 : 34.8% (95% CI 12.9-51.2); P for interaction = 0.95]. CONCLUSIONS In Asian-Indian individuals with prediabetes, the effectiveness of lifestyle intervention was not modified by baseline age and BMI.
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Affiliation(s)
- A Nanditha
- India Diabetes Research Foundation, Chennai, India
- Dr. A. Ramachandran's Diabetes Hospitals, Chennai, India
| | - C Snehalatha
- India Diabetes Research Foundation, Chennai, India
- Dr. A. Ramachandran's Diabetes Hospitals, Chennai, India
| | - J Ram
- India Diabetes Research Foundation, Chennai, India
| | - S Selvam
- India Diabetes Research Foundation, Chennai, India
| | - L Vijaya
- India Diabetes Research Foundation, Chennai, India
| | - S A Shetty
- India Diabetes Research Foundation, Chennai, India
- Dr. A. Ramachandran's Diabetes Hospitals, Chennai, India
| | - R Arun
- India Diabetes Research Foundation, Chennai, India
- Dr. A. Ramachandran's Diabetes Hospitals, Chennai, India
| | - A Ramachandran
- India Diabetes Research Foundation, Chennai, India
- Dr. A. Ramachandran's Diabetes Hospitals, Chennai, India
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Khunti K, Alsifri S, Aronson R, Cigrovski Berković M, Enters‐Weijnen C, Forsén T, Galstyan G, Geelhoed‐Duijvestijn P, Goldfracht M, Gydesen H, Kapur R, Lalic N, Ludvik B, Moberg E, Pedersen‐Bjergaard U, Ramachandran A. Rates and predictors of hypoglycaemia in 27 585 people from 24 countries with insulin-treated type 1 and type 2 diabetes: the global HAT study. Diabetes Obes Metab 2016; 18:907-15. [PMID: 27161418 PMCID: PMC5031206 DOI: 10.1111/dom.12689] [Citation(s) in RCA: 164] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Revised: 04/22/2016] [Accepted: 05/04/2016] [Indexed: 12/16/2022]
Abstract
AIMS To determine the global extent of hypoglycaemia experienced by patients with diabetes using insulin, as there is a lack of data on the prevalence of hypoglycaemia in developed and developing countries. METHODS This non-interventional, multicentre, 6-month retrospective and 4-week prospective study using self-assessment questionnaire and patient diaries included 27 585 patients, aged ≥18 years, with type 1 diabetes (T1D; n = 8022) or type 2 diabetes (T2D; n = 19 563) treated with insulin for >12 months, at 2004 sites in 24 countries worldwide. The primary endpoint was the proportion of patients experiencing at least one hypoglycaemic event during the observational period. RESULTS During the prospective period, 83.0% of patients with T1D and 46.5% of patients with T2D reported hypoglycaemia. Rates of any, nocturnal and severe hypoglycaemia were 73.3 [95% confidence interval (CI) 72.6-74.0], 11.3 (95% CI 11.0-11.6) and 4.9 (95% CI 4.7-5.1) events/patient-year for T1D and 19.3 (95% CI 19.1-19.6), 3.7 (95% CI 3.6-3.8) and 2.5 events/patient-year (95% CI 2.4-2.5) for T2D, respectively. The highest rates of any hypoglycaemia were observed in Latin America for T1D and Russia for T2D. Glycated haemoglobin level was not a significant predictor of hypoglycaemia. CONCLUSIONS We report hypoglycaemia rates in a global population, including those in countries without previous data. Overall hypoglycaemia rates were high, with large variations between geographical regions. Further investigation into these differences may help to optimize therapy and reduce the risk of hypoglycaemia.
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Affiliation(s)
- K. Khunti
- Diabetes Research CentreUniversity of LeicesterLeicesterUK
| | - S. Alsifri
- Al Hada Military HospitalTaifSaudi Arabia
| | - R. Aronson
- LMC Diabetes and EndocrinologyTorontoCanada
| | | | | | - T. Forsén
- Department of General Practice and Primary Health CareUniversity of HelsinkiHelsinkiFinland
| | - G. Galstyan
- Endocrinology Research CenterMoscowRussian Federation
| | | | - M. Goldfracht
- Clalit Health ServicesTel AvivIsrael
- The TechnionHaifaIsrael
| | | | | | - N. Lalic
- Faculty of Medicine, Clinic for Endocrinology, Diabetes and Metabolic Diseases, Clinical Center of SerbiaUniversity of BelgradeBelgradeSerbia
| | - B. Ludvik
- Rudolfstiftung Hospital and Medical University of ViennaViennaAustria
| | - E. Moberg
- Karolinska InstitutetStockholmSweden
| | | | - A. Ramachandran
- India Diabetes Research Foundation and Dr A Ramachandran's Diabetes HospitalsChennaiIndia
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Rushendra Revathy TD, Palanivelu K, Ramachandran A. Direct mineral carbonation of steelmaking slag for CO2 sequestration at room temperature. Environ Sci Pollut Res Int 2016; 23:7349-7359. [PMID: 26681331 DOI: 10.1007/s11356-015-5893-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Accepted: 11/27/2015] [Indexed: 06/05/2023]
Abstract
Rapid increase of CO2 concentration in the atmosphere has forced the international community towards adopting actions to restrain from the impacts of climate change. Moreover, in India, the dependence on fossil fuels is projected to increase in the future, implying the necessity of capturing CO2 in a safe manner. Alkaline solid wastes can be utilized for CO2 sequestration by which its disposal issues in the country could also be met. The present work focuses to study direct mineral carbonation of steelmaking slag (SS) at room temperature and low-pressure conditions (<10 bar). Direct mineral carbonation of SS was carried out in a batch reactor with pure CO2 gas. The process parameters that may influence the carbonation of SS, namely, CO2 gas pressure, liquid to solid ratio (L/S) and reaction time were also studied. The results showed that maximum sequestration of SS was attained in the aqueous route with a capacity of 82 g of CO2/kg (6 bar, L/S ratio of 10 and 3 h). In the gas-solid route, maximum sequestration capacity of about 11.1 g of CO2/kg of SS (3 bar and 3 h) was achieved indicating that aqueous route is the better one under the conditions studied. These findings demonstrate that SS is a promising resource and this approach could be further developed and used for CO2 sequestration in the country. The carbonation process was evidenced using FT-IR, XRD, SEM and TG analysis.
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Affiliation(s)
- T D Rushendra Revathy
- Centre for Climate Change and Adaptation Research, Anna University, Chennai, 600 025, India.
| | - K Palanivelu
- Centre for Climate Change and Adaptation Research, Anna University, Chennai, 600 025, India
- Centre for Environmental Studies, Anna University, Chennai, 600 025, India
| | - A Ramachandran
- Centre for Climate Change and Adaptation Research, Anna University, Chennai, 600 025, India
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Reddy YNV, Abraham G, Sundaram V, Reddy PP, Mathew M, Nagarajan P, Mehra N, Ramachandran A, Ali AAM, Reddy YNV. Is there a genetic predisposition to new-onset diabetes after kidney transplantation? Saudi J Kidney Dis Transpl 2016; 26:1113-20. [PMID: 26586047 DOI: 10.4103/1319-2442.168558] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Kidney transplant recipients may develop new-onset diabetes after transplantation (NODAT) and transplant-associated hyperglycemia (TAH) (NODAT or new-onset impaired glucose tolerance-IGT). We studied 251 consecutive renal transplant South Asian recipients for incidence of NODAT and its risk factors between June 2004 and January 2009. Pre-transplant glucose tolerance test (GTT) identified non-diabetics (n = 102, IGT-24, NGT-78) for analysis. Baseline immunosuppression along with either cyclosporine (CsA) (n = 70) or tacrolimus (Tac) (n = 32) was given. Patients underwent GTT 20 days (mean) post-transplant to identify NODAT, normal (N) or IGT. TAH was observed in 40.2% of the patients (40% in CsA and 40.6% in Tac) (P = 0.5). NODAT developed in 13.7% of the patients (12.9% in CsA and 15.6% in Tac) (P = 0.5). Overall, Hepatitis C (P = 0.007), human leukocyte antigen (HLA) B52 (P = 0.03) and lack of HLA A28 (A68/69) (P = 0.03) were associated with TAH. In the Tac group, higher Day 1 dosage (P <0.001), HLA A1 (P = 0.04), B13 (P = 0.03) and lack of DR2 (P = 0.004) increased the risk of TAH. In the CsA group, HLA A10 (P = 0.03), failure of triglyceride (P = 0.001) or low-density lipoprotein (LDL) (P = 0.03) to lower or high-density lipoprotein to rise (P = 0.001), and higher post-transplant LDL (P <0.001) and cholesterol levels (P = 0.02) were associated with NODAT or TAH. Post-transplant fasting plasma glucose on Day 1 had sensitivity-54.5%, specificity-50.1%, positive predictive value-18.1% and negative predictive value-84.8% for detecting NODAT. In conclusion, there is a genetic predisposition to NODAT and TAH in South Asia as seen by the HLA associations, and a predisposition exists to the individual diabetogenic effects of Tac and CsA based on HLA type. This could lead to more careful selection of calcineurin inhibitors based on HLA types in the South Asian population.
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Affiliation(s)
- Yogesh N V Reddy
- Madras Medical Mission Hospital, Chennai, India; Division of Cardiovascular Disease, Mayo Clinic, Rochester, Minnesota, USA,
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Ramachandran A, Praveen D, Jaganathan R, Palanivelu K. Projected and Observed Aridity and Climate Change in the East Coast of South India under RCP 4.5. ScientificWorldJournal 2015; 2015:169761. [PMID: 26771002 PMCID: PMC4681802 DOI: 10.1155/2015/169761] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Revised: 11/03/2015] [Accepted: 11/08/2015] [Indexed: 12/03/2022] Open
Abstract
In the purview of global warming, the present study attempts to project changes in climate and quantify the changes in aridity of two coastal districts in south India under the RCP 4.5 trajectory. Projected climate change output generated by RegCM 4.4 model, pertaining to 14 grid points located within the study area, was analyzed and processed for this purpose. The meteorological parameters temperature and precipitations were used to create De Martonne Aridity Index, to assess the spatial distribution of aridity. The original index values ranged from 13.7 to 16.4 mm/°C, characterizing this area as a semidry climate. The outcome from the changed scenario analysis under RCP 4.5 showed that, during the end of the 21st century, the aridity may be increased more as the index values tend to reduce. The increasing trend in the drying phenomenon may be attributed to the rising of mean annual temperatures.
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Affiliation(s)
- A. Ramachandran
- Centre for Climate Change and Adaptation Research, Anna University, Guindy, Chennai 600025, India
| | - Dhanya Praveen
- Centre for Climate Change and Adaptation Research, Anna University, Guindy, Chennai 600025, India
| | - R. Jaganathan
- Tamil Nadu Agricultural University, Coimbatore, Tamil Nadu 641003, India
| | - K. Palanivelu
- Centre for Climate Change and Adaptation Research, Anna University, Guindy, Chennai 600025, India
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Abstract
The craniofacial skeleton is derived from both neural crest cells and mesodermal cells; however, the majority of the bone, cartilage, and connective tissue is derived from the neural crest. Dentin sialophosphoprotein (DSPP) is a precursor protein that is expressed by the connective tissues of the craniofacial skeleton, namely, bone and dentin with high expression levels in the dentin matrix. Gene ablation studies have shown severe dental defects in DSPP-null mutant mice. Therefore, to elucidate the role of DSPP on the developing dental-craniofacial complex, we evaluated phenotypic changes in the structure of intramembranous bone and dentin mineralization using 3 different age groups of DSPP-null and wild-type mice. Results from micro-computed tomographic, radiographic, and optical microscopic analyses showed defective dentin, alveolar and calvarial bones, and sutures during development. The impaired mineralization of the cranial bone correlated well with low expression levels of Runx2, Col1, and OPN identified using calvarial cells from DSPP-null and wild-type mice in an in vitro culture system. However, the upregulation of MMP9, MMP2, FN, and BSP was observed. Interestingly, the null mice also displayed low serum phosphate levels, while calcium levels remained unchanged. Alizarin red and von Kossa staining confirmed the dysfunction in the terminal differentiation of osteoblasts obtained from the developing calvaria of DSPP-null mice. Immunohistochemical analysis of the developing molars showed changes in Runx2, Gli1, Numb, and Notch expression in the dental pulp cells and odontoblasts of DSPP-null mice when compared with wild-type mice. Overall, these observations provide insight into the role of DSPP in the normal development of the calvaria, alveolar bone, and dentin-pulp complex.
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Affiliation(s)
- Y Chen
- Brodie Tooth Development Genetics and Regenerative Medicine Research Laboratory, Department of Oral Biology, University of Illinois at Chicago, Chicago, IL, USA
| | - Y Zhang
- Brodie Tooth Development Genetics and Regenerative Medicine Research Laboratory, Department of Oral Biology, University of Illinois at Chicago, Chicago, IL, USA
| | - A Ramachandran
- Brodie Tooth Development Genetics and Regenerative Medicine Research Laboratory, Department of Oral Biology, University of Illinois at Chicago, Chicago, IL, USA
| | - A George
- Brodie Tooth Development Genetics and Regenerative Medicine Research Laboratory, Department of Oral Biology, University of Illinois at Chicago, Chicago, IL, USA
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Blick C, Ramachandran A, McCormick R, Wigfield S, Cranston D, Catto J, Harris AL. Identification of a hypoxia-regulated miRNA signature in bladder cancer and a role for miR-145 in hypoxia-dependent apoptosis. Br J Cancer 2015; 113:634-44. [PMID: 26196183 PMCID: PMC4647685 DOI: 10.1038/bjc.2015.203] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Revised: 04/27/2015] [Accepted: 05/06/2015] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Hypoxia leads to the stabilisation of the hypoxia-inducible factor (HIF) transcription factor that drives the expression of target genes including microRNAs (miRNAs). MicroRNAs are known to regulate many genes involved in tumourigenesis. The aim of this study was to identify hypoxia-regulated miRNAs (HRMs) in bladder cancer and investigate their functional significance. METHODS Bladder cancer cell lines were exposed to normoxic and hypoxic conditions and interrogated for the expression of 384 miRNAs by qPCR. Functional studies were carried out using siRNA-mediated gene knockdown and chromatin immunoprecipitations. Apoptosis was quantified by annexin V staining and flow cytometry. RESULTS The HRM signature for NMI bladder cancer lines includes miR-210, miR-193b, miR-145, miR-125-3p, miR-708 and miR-517a. The most hypoxia-upregulated miRNA was miR-145. The miR-145 was a direct target of HIF-1α and two hypoxia response elements were identified within the promoter region of the gene. Finally, the hypoxic upregulation of miR-145 contributed to increased apoptosis in RT4 cells. CONCLUSIONS We have demonstrated the hypoxic regulation of a number of miRNAs in bladder cancer. We have shown that miR-145 is a novel, robust and direct HIF target gene that in turn leads to increased cell death in NMI bladder cancer cell lines.
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Affiliation(s)
- C Blick
- Molecular Oncology Laboratories, Weatherall Institute of Molecular Medicine, University of Oxford, John Radcliffe Hospital, Oxford OX3 9DS, UK
- Department of Urology, Churchill Hospital, Oxford OX3 7LE, UK
| | - A Ramachandran
- Molecular Oncology Laboratories, Weatherall Institute of Molecular Medicine, University of Oxford, John Radcliffe Hospital, Oxford OX3 9DS, UK
- Cancer Research UK London Research Institute, Lincoln's Inn Fields Laboratories, London WC2A 3LY, UK
| | - R McCormick
- Molecular Oncology Laboratories, Weatherall Institute of Molecular Medicine, University of Oxford, John Radcliffe Hospital, Oxford OX3 9DS, UK
| | - S Wigfield
- Molecular Oncology Laboratories, Weatherall Institute of Molecular Medicine, University of Oxford, John Radcliffe Hospital, Oxford OX3 9DS, UK
| | - D Cranston
- Department of Urology, Churchill Hospital, Oxford OX3 7LE, UK
| | - J Catto
- The Academic Department of Urology and Institute for Cancer Studies, University of Sheffield, Sheffield S10 2RX, UK
| | - A L Harris
- Molecular Oncology Laboratories, Weatherall Institute of Molecular Medicine, University of Oxford, John Radcliffe Hospital, Oxford OX3 9DS, UK
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Oya J, Vistisen D, Christensen DL, Faurholt-Jepsen D, Mohan V, Ramachandran A, Chew SKH, Shaw JE, Jørgensen ME. Geographic differences in the associations between impaired glucose regulation and cardiovascular risk factors among young adults. Diabet Med 2015; 32:497-504. [PMID: 25523878 DOI: 10.1111/dme.12674] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/11/2014] [Indexed: 01/26/2023]
Abstract
AIMS To assess geographic differences in the association between BMI, blood pressure and lipid levels with impaired glucose regulation among young adults from various geographical regions. METHODS This was a cross-sectional study including data from 6987 participants aged ≤ 30 years from India, Singapore, Australia, Greenland, Kenya and Tanzania. Impaired glucose regulation was determined by the 75-g oral glucose tolerance test. For each geographical region, BMI, blood pressure and lipids were examined and compared between participants with normal glucose tolerance and those with impaired glucose regulation. Multiple logistic regression models were used to assess the association between risk factors and impaired glucose regulation. RESULTS Indian and East African people had a higher prevalence of impaired glucose regulation compared with participants from other regions, despite their lower BMI. Compared with the other regions, blood pressure was lower among Indian and Singaporean people but higher in those from Greenland. Greenlanders had the highest, while Indian and East-African people, had the lowest level of HDL cholesterol. BMI was positively associated with impaired glucose regulation in all regions, and there were no statistically significant geographic differences. In the Indian, Singaporean and Australian participants, there was a positive association between blood pressure and impaired glucose regulation. Triglycerides were positively associated with and HDL cholesterol had no association with impaired glucose regulation in all geographical regions. CONCLUSIONS Higher BMI and triglyceride levels were positively associated with prevalent impaired glucose regulation in all geographical regions. There were geographic differences in the association between impaired glucose regulation and blood pressure and lipids, probably reflecting environmental and genetic factors.
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Affiliation(s)
- J Oya
- Steno Diabetes Center, Gentofte, Denmark
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Padovano JD, Ravindran S, Snee PT, Ramachandran A, Bedran-Russo AK, George A. DMP1-derived peptides promote remineralization of human dentin. J Dent Res 2015; 94:608-14. [PMID: 25694469 DOI: 10.1177/0022034515572441] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Remineralization of dentin during dental caries is of considerable clinical interest. Dentin matrix protein 1 (DMP1) is a non-collagenous calcium-binding protein that plays a critical role in biomineralization. In the present study, we tested if peptides derived from DMP1 can be used for dentin remineralization. Peptide pA (pA, MW = 1.726 kDa) and peptide pB (pB, MW = 2.185), containing common collagen-binding domains and unique calcium-binding domains, were synthesized by solid-phase chemistry. An extreme caries lesion scenario was created by collagenase digestion, and the biomineral-nucleating potential of these peptides was ascertained when coated on collagenase-treated dentin matrix and control, native human dentin matrix under physiological levels of calcium and phosphate. Scanning electron microscopy analysis suggests that peptide pB was an effective nucleator when compared with pA. However, a 1:4 ratio of pA to pB was determined to be ideal for dentin remineralization, based on hydroxyapatite (HA) morphology and calcium/phosphorus ratios. Interestingly, HA was nucleated on collagenase-challenged dentin with as little as 20 min of 1:4 peptide incubation. Electron diffraction confirmed the presence of large HA crystals that produced a diffraction pattern indicative of a rod-like crystal structure. These findings suggest that DMP1-derived peptides may be useful to modulate mineral deposition and subsequent formation of HA when exposed to physiological concentrations of calcium and phosphate.
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Affiliation(s)
- J D Padovano
- Brodie Tooth Development Genetics & Regenerative Medicine Research Laboratory, Department of Oral Biology, University of Illinois at Chicago, Chicago, IL, USA
| | - S Ravindran
- Brodie Tooth Development Genetics & Regenerative Medicine Research Laboratory, Department of Oral Biology, University of Illinois at Chicago, Chicago, IL, USA
| | - P T Snee
- Department of Chemistry, College of Liberal Arts and Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - A Ramachandran
- Brodie Tooth Development Genetics & Regenerative Medicine Research Laboratory, Department of Oral Biology, University of Illinois at Chicago, Chicago, IL, USA
| | - A K Bedran-Russo
- Department of Restorative Dentistry, College of Dentistry, University of Illinois at Chicago, Chicago, IL, USA
| | - A George
- Brodie Tooth Development Genetics & Regenerative Medicine Research Laboratory, Department of Oral Biology, University of Illinois at Chicago, Chicago, IL, USA
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Ram J, Snehalatha C, Nanditha A, Selvam S, Shetty SA, Godsland IF, Johnston DG, Ramachandran A. Hypertriglyceridaemic waist phenotype as a simple predictive marker of incident diabetes in Asian-Indian men with prediabetes. Diabet Med 2014; 31:1542-9. [PMID: 24910196 DOI: 10.1111/dme.12517] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2013] [Revised: 04/04/2014] [Accepted: 06/03/2014] [Indexed: 02/02/2023]
Abstract
AIM To determine prospectively the association of baseline hypertriglyceridaemic waist phenotype with incident diabetes in Asian-Indian men with impaired glucose tolerance. METHODS In a randomized 2-year diabetes prevention trial in 517 men with impaired glucose tolerance, 123 (23.8%) developed diabetes. Baseline anthropometric, metabolic and clinical variables were estimated. Associations of hypertriglyceridaemic waist phenotype (waist circumference ≥ 90cm and a serum triglyceride level of ≥ 1.7 mmol/l) with insulin resistance and incident diabetes were assessed using multiple linear regression and Cox's proportional hazard models, respectively. RESULTS Men with an isolated enlarged waistline and hypertriglyceridaemic waist phenotype had significantly higher BMI and percentage of total body fat compared with the group with normal waistline and triglyceride levels and the group with isolated hypertriglyceridaemia. The men with hypertriglyceridaemic waist phenotype had higher insulin resistance (mean ± sd homeostasis model assessment of insulin resistance value: 3.6 ± 1.5) compared with those in the isolated enlarged waistline, the isolated hypertriglyceridaemia or the normal waistline and triglyceride level groups (3.1 ± 1.4, 2.7 ± 1.0 and 2.5 ± 1.1, respectively, all P < 0.05 compared with hypertriglyceridaemic waist phenotype). Multiple linear regression analyses showed that hypertriglyceridaemic waist phenotype was significantly associated with insulin resistance after adjusting for age, BMI, family history, percentage of total body fat, smoking, alcohol intake, 2-h plasma glucose and HDL cholesterol level. Hypertriglyceridaemic waist phenotype was independently associated with incident diabetes after adjusting for the above confounders and gamma-glutamyl transferase (hazard ratio 1.49, 95% CI 1.01-2.21; P = 0.047). The association of hypertriglyceridaemic waist phenotype with incident diabetes was abolished when insulin resistance was introduced into the model (hazard ratio 1.39, 95% CI 0.092-2.10; P=0.12). CONCLUSIONS Hypertriglyceridaemic waist phenotype is a simple clinical proxy measurement for insulin resistance and is strongly associated with incident diabetes in Asian-Indian men with impaired glucose tolerance.
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Affiliation(s)
- J Ram
- India Diabetes Research Foundation and Dr A. Ramachandran's Diabetes Hospitals, Chennai, India
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Ramachandran A. Know the signs and symptoms of diabetes. Indian J Med Res 2014; 140:579-81. [PMID: 25579136 PMCID: PMC4311308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Affiliation(s)
- A. Ramachandran
- India Diabetes Research Foundation & Dr. A. Ramachandran's Diabetes Hospitals 28, Marshalls Road, Egmore Chennai 600 008, Tamil Nadu, India
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Radhapriya P, Ramachandran A, Dhanya P, Remya K, Malini P. An appraisal of physico-chemical and microbiological characteristics of Nanmangalam Reserve Forest soil. J Environ Biol 2014; 35:1137-1144. [PMID: 25522517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
A detailed evaluation was performed on the soils of Nanmangalam Reserve Forest (NRF) in order to understand its physico-chemical, microbiological and enzymatic characteristics. The results of analysis showed that soil pH was directly proportional to the soil depth and the soil moisture content was irreversibly related to varying soil depth. Soil organic carbon was positively correlated with (p < 0.01) with total nitrogen, total bacterial count, cellulytic microbes, nitrogen-fixing bacteria, microbial biomass carbon, dehydrogenase activity and soil respiration. During summer, microbial population in the organic layer was more diverse than in the deepest layer. Analysis showed that NRF had low organic carbon content (less than 1%), microbial biomass, nutrient and functional microbes. The overall results of the analysis reinstate that Nanmangalam forest soil is undergoing degradation.
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Abstract
Background: Cut-off values for endometrial thickness (ET) in asymptomatic postmenopausal woman have been standardized. However, there are no comprehensive studies to document how various factors can influence the ET after the age of menopause. Aim: To study the various factors influencing the ET in postmenopausal women. Subjects and Methods: This was a prospective observational study. A total of 110 postmenopausal women underwent detailed history taking, clinical examination, and transvaginal scan for uterine volume and ovarian volume. The volumes were calculated by using ellipsoid formula: Width × thickness × height × 0.523. The variation in ET with respect to the influencing factors such as age, duration of menopause, parity, body mass index (BMI), medical illness like diabetes/hypertension, drugs like tamoxifen, presence of myoma, uterine volume, ovarian volume, and serum estradiol (in selected patients) were measured. Descriptive analysis was performed using SPSS software (version 16, Chicago II, USA) to obtain mean, standard deviation (SD), 95% confidence intervals (CIs) and inter quartile ranges. Comparison of means was carried out using analysis of variance. Results: The mean (SD) age of the patients was 55.4 (6.91) years (95% CI, 54.1, 56.7). The mean (SD) age at menopause was 47.95 (3.90) years (95% CI, 47.2, 48.7) and the mean (SD) duration of menopause was 7.27 (6.65) years (95% CI, 6.01, 8.53). The mean (SD) ET was 3.8 (2.3) mm (95% CI, 3.36, 4.23). Medical illness like diabetes and hypertension did not alter the ET. ET increased as BMI increased and it was statistically significant. The presence of myoma increased uterine volume significantly and was associated with thick endometrial stripe. Similarly, whenever the ovaries were visualized and as the ovarian volume increased, there was an increase in ET. When ET was > 4 mm (n = 37), they were offered endocel, of which 16 agreed to undergo the procedure. None were found to have endometrial cancer. Conclusion: This study suggests that parity, BMI, presence of myoma, tamoxifen usage, uterine volume, ovarian volume and serum estradiol influence the ET in postmenopausal women.
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Affiliation(s)
- S Hebbar
- Department of Obstetrics and Gynecology, Kasturba Medical College, Manipal University, Manipal, Udupi District, Karnataka, India
| | - V Chaya
- Department of Obstetrics and Gynecology, Kasturba Medical College, Manipal University, Manipal, Udupi District, Karnataka, India
| | - L Rai
- Department of Obstetrics and Gynecology, Kasturba Medical College, Manipal University, Manipal, Udupi District, Karnataka, India
| | - A Ramachandran
- Department of Obstetrics and Gynecology, Kasturba Medical College, Manipal University, Manipal, Udupi District, Karnataka, India
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Ramachandran A, Gupta V, Kesavadev J, Kalra S. Understanding the safety of the new ultra long acting basal insulin. J Assoc Physicians India 2014; 62:35-42. [PMID: 25330630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Hypoglycaemia is a key safety concern in diabetes management. It is potentially dangerous and the fear of hypoglycaemia may lead to sub-optimal dosing and inadequate glycaemic control. On the other hand, hypoglycaemia may generate adverse effects and disease complications, will compromise the quality of life and will substantially increase the economic burden of treatment budged. Today, treat to target clinical trial designs are mandate for clinical development of any newer anti-diabetic medication. While similar glycaemic targets are expected to be achieved by test and comparator, the newer molecules are definitely expected to show advantage over standard comparator in terms of reduction in frequency and severity of hypoglycaemia. An ultra-long acting basal analogue insulin degludec (IDeg), has been recently approved for the treatment of type 2 and type 1 diabetes mellitus (T2DM and T1DM). The pooled patient-level data for self-reported hypoglycaemia from seven phase 3a trials with IDeg has shown significantly lower episodes of nocturnal confirmed and numerical low overall confirmed hypoglycaemia with IDeg, compared to Insulin glargine (IGlar), which was more pronounced during maintenance phase of treatment in all populations. The most plausible explanation being that, the flat peakless profile of IDeg with least glycaemic variability leads to less hypoglycaemia and adds to the safety profile of this ultra-long acting insulin. The real life practice will further validate the findings of clinical trials.
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Zhang Y, Song Y, Ravindran S, Gao Q, Huang CC, Ramachandran A, Kulkarni A, George A. DSPP contains an IRES element responsible for the translation of dentin phosphophoryn. J Dent Res 2013; 93:155-61. [PMID: 24352500 DOI: 10.1177/0022034513516631] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
The major phosphoprotein in dentin is the aspartic acid and serine-rich protein called dentin phosphophoryn (DPP). DPP appears to be synthesized as a part of a larger compound protein, dentin sialophosphoprotein (DSPP). DSPP has never been isolated or detected in dentin extracts. It is now evident that DSPP is a chimeric protein composed of 3 parts: dentin sialoprotein (DSP), DPP, and dentin glycoprotein (DGP). Previous reports have suggested that the BMP1 protease is responsible for processing DSPP. However, unequal amounts of these products are present in the dentin matrix. Here, we provide evidence for an internal ribosome entry site in the DSPP gene that directs the synthesis of DPP. This mechanism would account for unequal amounts of intracellular DSP and DPP. The internal ribosomal entry site (IRES) activity varied in different cell types, suggesting the presence of additional regulatory elements during the translational regulation of DPP. Further, we provide evidence that DPP is transported to the extracellular matrix (ECM) through exosomes. Using tissue recombination and lentivirus-mediated gain-of-function approaches, we also demonstrate that DPP is essential for the formation of well-defined tooth structures with mineralized dentin matrix.
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Affiliation(s)
- Y Zhang
- Brodie Tooth Development Genetics & Regenerative Medicine Research Laboratory, Department of Oral Biology, University of Illinois at Chicago, Chicago, IL 60612, USA
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Abraham S, Ramachandran A. Estimation of quality of life in haemodialysis patients. Indian J Pharm Sci 2013; 74:583-7. [PMID: 23798788 PMCID: PMC3687932 DOI: 10.4103/0250-474x.110624] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2011] [Revised: 12/10/2012] [Accepted: 12/16/2012] [Indexed: 12/26/2022] Open
Abstract
Since haemodialysis is an expensive treatment modality for chronic renal failure patients, it is very essential to assess the outcome of therapy in terms of quality of life. The primary objective of the study was to estimate the effect of patient counselling in quality of life of end stage renal disease patients opting haemodialysis using World Health Organisation Quality of life scale and to assess the variables affecting the quality of life of these patients. Quality of life was determined by World Health Organisation Quality of life scale questionnaire comprised of 26 items which measures four domains: physical, psychological, social and environmental domain. A total of 81 patients were selected and divided into test and control group and the test group patients received counselling regarding their disease, use of medications, importance of adherence and the complications experienced during and after dialysis. The quality of life data was collected at the interval of 1, 2, 3, 6 and 12 months and the patients were counselled at each interval. The demographic profiles revealed that majority of the patients were in the age group of 31-50 and there exists a male predominance. About the socioeconomic status, upper middle class people were mostly affected. Assessment of impact of patient counselling in the quality of life of haemodialysis indicated a significant improvement in each domain after counselling. And also found that the psychological domain showed a significant increase in the score compared to others. Patient counselling helped to gain benefits in terms of improvement in quality of life and delayed progression of renal failure. Early recognition and prevention is necessary to improve the quality of life of chronic renal failure patients. Patient counselling should be made mandatory by incorporating clinical pharmacist in the nephrology team to make the patient understand his illness and modifications in lifestyle also create a positive environment and result in better quality of life.
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Affiliation(s)
- S Abraham
- Department of Pharmacy Practice, Amrita School of Pharmacy, Amrita Viswavidyapeetham University, AIMS Healthscience Campus, Kochi-682 026, India
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Abstract
Preventing diabetes is of enormous value, particularly for the South Asian countries, which have a huge healthcare burden from the onslaught of the disease. Type 2 diabetes has been proved to be preventable using lifestyle changes, even in South Asians despite their heightened risk profile. Strategies to improve awareness about diabetes and translation of preventive measures by innovative, culturally specific programmes have to be implemented at national levels. Integrated involvement of the government, community, media, healthcare and education services, and financial support from national and international organizations, are required. South Asian countries have initiated national programmes for diabetes prevention and management. It is also encouraging to note that joint ventures between developed countries such as the USA, UK and other European countries and centres of excellence in South Asia have been initiated to develop large-scale, community-oriented, pragmatic intervention strategies.
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Affiliation(s)
- A Ramachandran
- India Diabetes Research Foundation and Dr A Ramachandran's Diabetes Hospitals, Chennai, India
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Padovano J, Ravindran S, Ramachandran A, Bedran-Russo A, George A. Dentin mineralization using DMP1-derived synthetic peptides. Dent Mater 2013. [DOI: 10.1016/j.dental.2013.08.194] [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: 11/30/2022]
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Zimmerman E, Hu S, Orwick S, Berk J, Li L, Drenberg C, Roberts M, Ramachandran A, Stewart C, Baker S. 386 Evaluation of Crenolanib (CP-868,596) for the Treatment of FLT3-ITD-positive AML. Eur J Cancer 2012. [DOI: 10.1016/s0959-8049(12)72184-6] [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: 10/27/2022]
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Wetmore C, Broniscer A, Wright K, Pai-Panandiker A, Patay Z, Onar-Thomas A, Ramachandran A, Gajjar A, Turner D, Stewart C. 346 First in Pediatrics Phase I Study of Crenolanib Besylate (CP-868, 596–26) Administered During and After Radiation Therapy (RT) in Newly-diagnosed Diffuse Intrinsic Pontine Glioma (DIPG) and Recurrent High Grade Glioma, Including DIPG (HGG). Eur J Cancer 2012. [DOI: 10.1016/s0959-8049(12)72144-5] [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: 11/26/2022]
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Stevens RJ, Ali R, Bankhead CR, Bethel MA, Cairns BJ, Camisasca RP, Crowe FL, Farmer AJ, Harrison S, Hirst JA, Home P, Kahn SE, McLellan JH, Perera R, Plüddemann A, Ramachandran A, Roberts NW, Rose PW, Schweizer A, Viberti G, Holman RR. Cancer outcomes and all-cause mortality in adults allocated to metformin: systematic review and collaborative meta-analysis of randomised clinical trials. Diabetologia 2012; 55:2593-2603. [PMID: 22875195 DOI: 10.1007/s00125-012-2653-7] [Citation(s) in RCA: 133] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2012] [Accepted: 06/12/2012] [Indexed: 12/31/2022]
Abstract
AIMS/HYPOTHESIS Observational studies suggest that metformin may reduce cancer risk by approximately one-third. We examined cancer outcomes and all-cause mortality in published randomised controlled trials (RCTs). METHODS RCTs comparing metformin with active glucose-lowering therapy or placebo/usual care, with minimum 500 participants and 1-year follow-up, were identified by systematic review. Data on cancer incidence and all-cause mortality were obtained from publications or by contacting investigators. For two trials, cancer incidence data were not available; cancer mortality was used as a surrogate. Summary RRs, 95% CIs and I (2)statistics for heterogeneity were calculated by fixed effects meta-analysis. RESULTS Of 4,039 abstracts identified, 94 publications described 14 eligible studies. RRs for cancer were available from 11 RCTs with 398 cancers during 51,681 person-years. RRs for all-cause mortality were available from 13 RCTs with 552 deaths during 66,447 person-years. Summary RRs for cancer outcomes in people randomised to metformin compared with any comparator were 1.02 (95% CI 0.82, 1.26) across all trials, 0.98 (95% CI 0.77, 1.23) in a subgroup analysis of active-comparator trials and 1.36 (95% CI 0.74, 2.49) in a subgroup analysis of placebo/usual care comparator trials. The summary RR for all-cause mortality was 0.94 (95% CI 0.79, 1.12) across all trials. CONCLUSIONS/INTERPRETATION Meta-analysis of currently available RCT data does not support the hypothesis that metformin lowers cancer risk by one-third. Eligible trials also showed no significant effect of metformin on all-cause mortality. However, limitations include heterogeneous comparator types, absent cancer data from two trials, and short follow-up, especially for mortality.
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Affiliation(s)
- R J Stevens
- Department of Primary Care Health Sciences, University of Oxford, Woodstock Road, Oxford, OX2 6GG, UK.
| | - R Ali
- Cancer Epidemiology Unit, University of Oxford, Oxford, UK
| | - C R Bankhead
- Department of Primary Care Health Sciences, University of Oxford, Woodstock Road, Oxford, OX2 6GG, UK
| | - M A Bethel
- Diabetes Trials Unit, Oxford Centre for Diabetes Endocrinology and Metabolism, University of Oxford, Oxford, UK
| | - B J Cairns
- Cancer Epidemiology Unit, University of Oxford, Oxford, UK
| | - R P Camisasca
- TGRD Europe, Takeda Pharmaceutical Company, London, UK
| | - F L Crowe
- Cancer Epidemiology Unit, University of Oxford, Oxford, UK
| | - A J Farmer
- Department of Primary Care Health Sciences, University of Oxford, Woodstock Road, Oxford, OX2 6GG, UK
| | - S Harrison
- Department of Primary Care Health Sciences, University of Oxford, Woodstock Road, Oxford, OX2 6GG, UK
| | - J A Hirst
- Department of Primary Care Health Sciences, University of Oxford, Woodstock Road, Oxford, OX2 6GG, UK
| | - P Home
- ICM-Diabetes, The Medical School, Newcastle University, Newcastle upon Tyne, UK
| | - S E Kahn
- Division of Metabolism, Endocrinology and Nutrition, Department of Medicine, Veterans Affairs Puget Sound Health Care System and University of Washington, Seattle, WA, USA
| | - J H McLellan
- Department of Primary Care Health Sciences, University of Oxford, Woodstock Road, Oxford, OX2 6GG, UK
| | - R Perera
- Department of Primary Care Health Sciences, University of Oxford, Woodstock Road, Oxford, OX2 6GG, UK
| | - A Plüddemann
- Department of Primary Care Health Sciences, University of Oxford, Woodstock Road, Oxford, OX2 6GG, UK
| | - A Ramachandran
- India Diabetes Research Foundation, Dr A. Ramachandran's Diabetes Hospitals, Egmore, Chennai, India
| | - N W Roberts
- Department of Primary Care Health Sciences, University of Oxford, Woodstock Road, Oxford, OX2 6GG, UK
| | - P W Rose
- Department of Primary Care Health Sciences, University of Oxford, Woodstock Road, Oxford, OX2 6GG, UK
| | | | - G Viberti
- Unit for Metabolic Medicine, School of Medicine, King's College London, London, UK
| | - R R Holman
- Diabetes Trials Unit, Oxford Centre for Diabetes Endocrinology and Metabolism, University of Oxford, Oxford, UK
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Karpagavalli MS, Malini P, Ramachandran A. Analysis of heavy metals in dying wetland Pallikaranai, Tamil Nadu, India. J Environ Biol 2012; 33:757-761. [PMID: 23360004] [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] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Pallikaranai wetland has high ecological significance as it has been a home for other associated biodiversities. This wetland is highly polluted due to the rapid industrialization, urbanization and dumping of solid waste. The water quality of the Pallikaranai wetland has been studied with reference to toxic metals. The metals analyzed include lead, chromium, iron, copper, nickel, zinc and cadmium. The heavy metal analysis in surface waters were in the following range; Cd: BDL--0.019 mg l(-1), Fe: BDL--1.52 mg l(-1), Cu: BDL--0.02 mg l(-1), Ni: BDL-0.60 mg l(-1), Pb: 0.03-1.13 mg l(-1), Zn: 0.002-0.14 mg l(-1) and Cr: 0.10-1.52 mg l(-1) respectively. The dominance of various heavy metals in the surface water of the Pallikaranai wetland followed the sequence: Pb > Cr > Fe > Ni > Zn > Cd > Cu. The quality of water has deterioted due to the various anthropogenic activities. Most of the metal ions were in higherconcentration compared to the standards. It has been observed that the quality of the surface water is not safe for aquatic and domestic life, hence necessary management actions should be taken to control the quality of the surface water.
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Affiliation(s)
- M Sridevi Karpagavalli
- Centre for Climate Change and Adaptation Research, Anna University, Chennai--600 025, India
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