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Gogoi BB, Yeasin M, Paul RK, Deka D, Malakar H, Saikia J, Rahman FH, Maiti CS, Sarkar A, Handique JG, Kanrar B, Singh AK, Karak T. Pollution indices of selected metals in tea (Camellia sinensis L.) growing soils of the Upper Assam region divulge a non-trifling menace of National Highway. Sci Total Environ 2024; 920:170737. [PMID: 38340860 DOI: 10.1016/j.scitotenv.2024.170737] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 02/01/2024] [Accepted: 02/03/2024] [Indexed: 02/12/2024]
Abstract
The study investigated the influence of a National Highway (NH) traversing tea estates (TEs) on heavy metal (HM) contamination in the top soils of Upper Assam, India. The dispersion and accumulation of six HMs, viz. cadmium (Cd), copper (Cu), iron (Fe), manganese (Mn), nickel (Ni), and zinc (Zn), within tea-growing soils were assessed using diverse indices: contamination factor (CF), degree of contamination (DC), enrichment factor (EF), geo-accumulation index (Igeo), modified degree of contamination (MDC), Nemerow pollution index (PINemerow), pollution load index (PLI), potential ecological risk factor (Eri), and potential ecological risk index (RI). The order of HM prevalence was Fe > Mn > Zn > Ni > Cu > Cd. Elevated Cd levels near the NH prompted immediate attention, while Cd and Zn showed moderate pollution in CF, EF, and RI. The remaining metals posed minimal individual risk (Eri< 40), resulting in an overall contamination range of "nil to shallow," signifying slight contamination from the studied metals. From MDC values for investigated metals, it was found to be "zero to very low degree of contamination" at all locations except the vicinity of NH. Soil pollution, as determined by PLI, indicated unpolluted soils in both districts, yet PINemerow values indicated slight pollution. The statistical analysis revealed that there is a significant decrease in most of the indices of HM as the distance from NH increases. The application of multivariate statistical techniques namely Principal Component Analysis and Cluster Analysis showed the presence of three distinct homogenous groups of distances based on different indices. This investigation underscores NH-associated anthropogenic effects on TE soil quality due to HM deposition, warranting proactive mitigation measures.
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Affiliation(s)
- Bidyot Bikash Gogoi
- Upper Assam Advisory Centre, Tea Research Association, Dikom, 786101 Dibrugarh, Assam, India; Department of Chemistry, D.H.S.K. College, Dibrugarh 786001, Assam, India; Department of Chemistry, Dibrugarh University, Dibrugarh 786004, Assam, India
| | - Md Yeasin
- ICAR-Indian Agricultural Statistics Research Institute, New Delhi 110012, India
| | - Ranjit Kumar Paul
- ICAR-Indian Agricultural Statistics Research Institute, New Delhi 110012, India
| | - Diganta Deka
- North Bank Advisory Centre, Tea Research Association, Thakurbari 784 503, Assam, India
| | - Harisadhan Malakar
- Tea Research Association, Tocklai Tea Research Institute, Cinnamara, 785008 Jorhat, Assam, India
| | - Jiban Saikia
- Department of Chemistry, Dibrugarh University, Dibrugarh 786004, Assam, India
| | - Feroze Hasan Rahman
- ICAR-NBSS and LUP, Regional Center Kolkata, Block DK, Sector II, Salt Lake, Kolkata 700091, India
| | - C S Maiti
- Department of Horticulture, School of Agricultural Sciences, Nagaland University, Medziphema Campus, Medziphema 797106, Nagaland, India
| | - Animesh Sarkar
- Department of Horticulture, School of Agricultural Sciences, Nagaland University, Medziphema Campus, Medziphema 797106, Nagaland, India
| | | | - Bappaditya Kanrar
- TLabs, Tea Research Association, Kolkata 700 016, West Bengal, India
| | - A K Singh
- Department of Soil Science, School of Agricultural Sciences, Nagaland University, Medziphema Campus, Medziphema 797106, Nagaland, India
| | - Tanmoy Karak
- Department of Soil Science, School of Agricultural Sciences, Nagaland University, Medziphema Campus, Medziphema 797106, Nagaland, India.
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Ray S, Kapoor N, Deshpande N, Chatterjee S, Kumar J, Tantia O, Goyal G, Mukherjee JJ, Singh AK. An overview of therapeutic options of obesity management in India: the Integrated Diabetes and Endocrinology Academy (IDEA) 2023 Congress update. Expert Rev Clin Pharmacol 2024; 17:349-362. [PMID: 38471973 DOI: 10.1080/17512433.2024.2330468] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 03/11/2024] [Indexed: 03/14/2024]
Abstract
INTRODUCTION With newer anti-obesity medications (AOMs) being introduced at a rapid pace, it is prudent to make a concise and updated clinical practice document that may help busy clinicians in daily clinical practice. A group of metabolic physicians, diabetologists, endocrinologists, and bariatric surgeons assembled during the Integrated Diabetes and Endocrine Academy 2023 Congress (IDEACON, July 2023, Kolkata, India) to compile an update of pharmacotherapeutic options for managing people with obesity in India. AREAS COVERED After an extensive review of the literature by experts in different domains, this update provides all available information on the management of obesity, with a special emphasis on both currently available and soon-to-be-available AOMs, in people with obesity. EXPERT OPINION Several newer AOMs have been shown to reduce body weight significantly, thus poised to make a paradigm shift in the management of obesity. While the tolerability and key adverse events associated with these AOMs appear to be acceptable in randomized controlled trials, pharmacovigilance is vital in real-world settings, given the absence of sufficiently long-term studies. The easy availability and affordability of these drugs is another area of concern, especially in developing countries like India.
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Affiliation(s)
- Subir Ray
- Department of Medicine, Division of Diabetes & Endocrinology, Apollo Multi-Speciality Hospitals, Kolkata, West Bengal, India
| | - Nitin Kapoor
- Department of Endocrinology, Diabetes and Metabolism Christian Medical College & Hospital, Vellore, Tamil Nadu, India
- Non-Communicable disease Unit, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Neeta Deshpande
- Belgaum Diabetes Centre and CentraCare Institute of Diabetes, Obesity and Metabolic Health (CIDOM), Belgaum, Karnataka, India
| | - Sanjay Chatterjee
- Department of Medicine, Division of Diabetes & Endocrinology, Apollo Multi-Speciality Hospitals, Kolkata, West Bengal, India
| | - Janardanan Kumar
- Department of Medicine, SRM Hospital & Research Centre, SRMIST, Kattankulathur, Tamil Nadu, India
| | - Om Tantia
- Department of Minimal Access and Bariatric Surgery, ILS Hospital, Kolkata, West Bengal, India
| | - Ghanshyam Goyal
- Department of Medicine, ILS Hospital, Salt Lake, Kolkata, West Bengal, India
| | - Jagat Jyoti Mukherjee
- Department of Medicine, Division of Diabetes & Endocrinology, Apollo Multi-Speciality Hospitals, Kolkata, West Bengal, India
| | - Awadhesh Kumar Singh
- Department of Diabetes & Endocrinology, G.D Hospital & Diabetes Institute, Kolkata, West Bengal, India
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Shah M, Noronha V, Patil V, Menon N, Singh AK, Shah A, Kumar P, Roychoudhary O, Peelay Z, Janu A, Purandare N, Chakrabarty N, Patil V, Kaushal R, Shetty O, Pai T, Chandrani P, Chougule A, Prabhash K. The Role of Systemic Therapy in Patients with Advanced Non-small Cell Lung Cancer and a Poor Eastern Cooperative Oncology Group Performance Status. Clin Oncol (R Coll Radiol) 2024; 36:128-129. [PMID: 38097463 DOI: 10.1016/j.clon.2023.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 11/29/2023] [Accepted: 12/06/2023] [Indexed: 01/12/2024]
Affiliation(s)
- M Shah
- Department of Medical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Parel, Mumbai, Maharashtra, India
| | - V Noronha
- Department of Medical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Parel, Mumbai, Maharashtra, India
| | - V Patil
- Department of Medical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Parel, Mumbai, Maharashtra, India
| | - N Menon
- Department of Medical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Parel, Mumbai, Maharashtra, India
| | - A K Singh
- Department of Medical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Parel, Mumbai, Maharashtra, India
| | - A Shah
- Department of Medical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Parel, Mumbai, Maharashtra, India
| | - P Kumar
- Department of Medical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Parel, Mumbai, Maharashtra, India
| | - O Roychoudhary
- Biostatistics, Department of Medical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Parel, Mumbai, Maharashtra, India
| | - Z Peelay
- Department of Medical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Parel, Mumbai, Maharashtra, India
| | - A Janu
- Department of Radiodiagnosis, Tata Memorial Hospital, Homi Bhabha National Institute, Parel, Mumbai, Maharashtra, India
| | - N Purandare
- Department of Nuclear Medicine, Tata Memorial Hospital, Homi Bhabha National Institute, Parel, Mumbai, Maharashtra, India
| | - N Chakrabarty
- Department of Radiodiagnosis, Tata Memorial Hospital, Homi Bhabha National Institute, Parel, Mumbai, Maharashtra, India
| | - V Patil
- Department of Radiodiagnosis, Tata Memorial Hospital, Homi Bhabha National Institute, Parel, Mumbai, Maharashtra, India
| | - R Kaushal
- Department of Pathology, Tata Memorial Hospital, Homi Bhabha National Institute, Parel, Mumbai, Maharashtra, India
| | - O Shetty
- Department of Molecular Pathology, Tata Memorial Hospital, Homi Bhabha National Institute, Parel, Mumbai, Maharashtra, India
| | - T Pai
- Department of Molecular Pathology, Tata Memorial Hospital, Homi Bhabha National Institute, Parel, Mumbai, Maharashtra, India
| | - P Chandrani
- Department of Medical Oncology Molecular Laboratory, Tata Memorial Hospital, Homi Bhabha National Institute, Parel, Mumbai, Maharashtra, India
| | - A Chougule
- Department of Molecular Pathology, Tata Memorial Hospital, Homi Bhabha National Institute, Parel, Mumbai, Maharashtra, India
| | - K Prabhash
- Department of Medical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Parel, Mumbai, Maharashtra, India
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Yadav LP, Gangadhara K, Apparao VV, Yadav V, Mishra DS, Singh AK, Rane J, Kaushik P, Janani P, Kumar R, Verma AK, Kumar S, Malhotra SK, Shekhawat N. Genetic diversity, morphological traits, quality traits and antioxidants potentiality of Coccinia grandis germplasm under rainfed semi-arid region. Sci Rep 2024; 14:868. [PMID: 38195737 PMCID: PMC10776759 DOI: 10.1038/s41598-023-49091-4] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Accepted: 12/04/2023] [Indexed: 01/11/2024] Open
Abstract
The present study was conducted to evaluate the genetic variability for morphological and qualitative traits of Coccinia for development of trait specific lines at ICAR-Central Horticultural Experiment Station (CIAH-RS), Panchmahals (Godhra), Gujarat during 2020-2022. In this study, we evaluated 26 gynoecious accessions to assess the genetic divergence through principal component and cluster analysis. The experiment was carried out in a randomized complete block design with three replications under rainfed semi-arid conditions. High values of PCV and GCV were observed for variables such as NFFP (25.13 and 22.20), PL (23.14 and 20.69), FD (24.01 and 21.46), AFW (22.98 and 20.13), NFPY (26.38 and 24.40), FYP (37.57 and 31.29), FY (35.55 and 33.20), AsC (28.65 and 27.73), Ac (24.32 and 21.06), TSS (37.23 and 35.94), DPPHL (20.71 and 20.38), FRAPL (21.08 and 20.92), TPF(20.81 and 20.45) respectively. High heritability coupled with high genetic advance as per cent of mean was observed for vine length (VL), internodal length (IL), number of female flowers per plant (NFFP), fruit length (FL), peduncle length (PL), fruit diameter (FD), average fruit weight (AFW), number of fruit per plant per year (NFPY), fruit yield per plant (FYP), fruit yield (FY), ascorbic acid (AsC), acidity (Ac), total soluble solids (TSS), total phenols in leaves TPL), total flavonoids in leaves TFL, CUPRAC in leaves (CUPRACL), DPPH in leaves (DPPHL), FRAP in leaves (FRAPL), Total phenols in fruits (TPF), Total flavonoids in fruits (TFF), CUPRAC in fruits (CUPRACF) and DPPH in fruits (DPPHF). The FYP exhibited a significant positive correlation with variables like VL (0.6833), IL (0.2991), NFFP (0.8107), FD (0.5245), AFW (0.6766), NFPY (0.7659), ASC (0.4611), TSS (0.5004) and TPF (0.4281). The estimates of genetic parameters revealed scope for further improvement of fruit yield by selection. Of the eight principal components, PC-I through PC-VIII had eigen values greater than 1 and it accounts 85.02% of the total variation for 26 gynoecious accessions of Ivy gourd. The eigen values of PC-I comprised 5.775% of total variation followed by PC-II (4.250%), PC-III (3.175%), PC-IV (2.588%), PC-V (1.828%), PC-VI (1.447%), PC-VII (1.179%) and PC-VIII (1.013%).The cluster VI and cluster I having highest mean values for most of traits under study. Thus, genotypes from the distinct cluster like cluster VI and I for should be used for selection of parents and varietal improvement for further breeding programme in ivy gourd.
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Affiliation(s)
- Lalu Prasad Yadav
- ICAR-Central Horicultulal Experiment Station (CIAH RS), Godhra, 389340, Gujarat, India.
| | - K Gangadhara
- ICAR-Central Horicultulal Experiment Station (CIAH RS), Godhra, 389340, Gujarat, India
| | - V V Apparao
- ICAR-Central Horicultulal Experiment Station (CIAH RS), Godhra, 389340, Gujarat, India
| | - Vikas Yadav
- ICAR-Central Horicultulal Experiment Station (CIAH RS), Godhra, 389340, Gujarat, India
| | - D S Mishra
- ICAR-Central Horicultulal Experiment Station (CIAH RS), Godhra, 389340, Gujarat, India
| | - A K Singh
- ICAR-Central Horicultulal Experiment Station (CIAH RS), Godhra, 389340, Gujarat, India
| | - Jagdish Rane
- ICAR-Central Institute for Arid Horticulture, Beechwal, Bikaner, 334006, Rajasthan, India
| | - Prashant Kaushik
- Chaudhary Charan Singh Haryana Agricultural University, Hisar, 125 004, Haryana, India
| | - P Janani
- ICAR-Central Potato Research Station, Shillong, 793 009, Meghalaya, India
| | - Raj Kumar
- ICAR-Central Institute for Arid Horticulture, Beechwal, Bikaner, 334006, Rajasthan, India
| | - A K Verma
- ICAR-Central Institute for Arid Horticulture, Beechwal, Bikaner, 334006, Rajasthan, India
| | - Sanjay Kumar
- Chaudhary Charan Singh Haryana Agricultural University, Hisar, 125 004, Haryana, India
| | - S K Malhotra
- ICAR-Directorate of Knowledge Management in Agriculture, Pusa, 110012, New Delhi, India
| | - Neelam Shekhawat
- ICAR-NBPGR Regional Station Jodhpur, C/o CAZRI, Jodhpur, 342003, Rajasthan, India
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Yadav S, Singh AK, Selvaraj RK, Applegate TJ, Bhattacharya P, Shinall SB, Fenn LS, Shanmugasundaram R, Kim WK. Research Note: Effect of dietary xylo-oligosaccharide on growth performance, intestinal histomorphology, and specific cecal bacteria in broiler chickens. Poult Sci 2024; 103:103189. [PMID: 37939588 PMCID: PMC10665916 DOI: 10.1016/j.psj.2023.103189] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 09/29/2023] [Accepted: 10/09/2023] [Indexed: 11/10/2023] Open
Abstract
This study was conducted to evaluate the prebiotic effect of xylo-oligosaccharide (XOS) supplemented in a corn-soybean meal (SBM) based conventional diet on growth performance, intestinal histomorphology, and quantification of specific bacteria in the ceca of broilers. A total of 240 d of hatch Cobb 500 male broiler chicks were randomly assigned to 4 dietary treatments (corn-SBM-based control diet) containing 0, 0.05, 0.1, and 0.2% XOS. The broilers were raised for 21 d in 6 replicate cages, each containing 10 birds. Growth performance parameters were obtained weekly. Additionally, small intestinal tissues were collected to evaluate histomorphometry and whole ceca were collected to quantify bacterial populations on D21. The results showed that inclusion of XOS has similar body weight (BW), body weight gain (BWG), feed intake (FI), and feed conversion ratio (FCR) as the control group during the 21-day study. The results further indicate a tendency for the jejunum villus to crypt ratio (VH:CD) to increase in birds given 0.05 and 0.2% XOS (P = 0.08). Cecal bacteria quantification showed a linear increase in Bifidobacterium with increasing XOS levels (P < 0.0001) and a decrease Clostridium perfringens levels compared to birds fed the control diet (P < 0.0001). However, there were no differences in the total counts of Lactobacillus and E. coli. Together these results showed that while there were no differences in growth parameters up to 21 d, the histomorphology findings and the increase in Bifidobacterium, along with the reduction in C. perfringens observed in the XOS groups, suggest a beneficial impact of XOS inclusion on gut health. Further research with longer feeding periods and higher XOS levels should be conducted to explore potential positive effects on both growth and gut health parameters.
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Affiliation(s)
- S Yadav
- Department of Poultry Science, University of Georgia, Athens, GA 30602, USA
| | - A K Singh
- Department of Poultry Science, University of Georgia, Athens, GA 30602, USA
| | - R K Selvaraj
- Department of Poultry Science, University of Georgia, Athens, GA 30602, USA
| | - T J Applegate
- Department of Poultry Science, University of Georgia, Athens, GA 30602, USA
| | | | - S B Shinall
- Rayonier Advanced Materials, Inc., Jesup, GA 31545, USA
| | - L S Fenn
- Rayonier Advanced Materials, Inc., Jesup, GA 31545, USA
| | - R Shanmugasundaram
- Toxicology and Mycotoxin Research Unit, U.S. National Poultry Research Center, Agricultural Research Service, U.S. Department of Agriculture, Athens, GA 30605, USA
| | - W K Kim
- Department of Poultry Science, University of Georgia, Athens, GA 30602, USA.
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Mohan V, Misra A, Bhansali A, Singh AK, Makkar B, Krishnan D, Chadha M, Shah P, Samaddar R, Saraogi RK, Bhattacharya S, Salis S, Nagesh S, Khanna U. Role and Significance of Dietary Protein in the Management of Type 2 Diabetes and Its Complications in India: An Expert Opinion. J Assoc Physicians India 2023; 71:36-46. [PMID: 38736053 DOI: 10.59556/japi.71.0339] [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: 05/14/2024]
Abstract
BACKGROUND Obesity, prediabetes, and type 2 diabetes mellitus (T2DM) pose a triple burden in India. Almost two-thirds of people with diabetes (PWD) in India are found to have suboptimal glycemic, blood pressure, and lipid control. Medical nutrition therapy (MNT) in diabetes has emphasized on the amount and type of carbohydrates for years. However, protein, an important macronutrient in diabetes management, needs to be focused upon, especially in India, where the consumption is found to be lower than the recommendations provided by most guidelines. AIM An expert committee attempted to review the role of dietary protein in the management of T2DM, arrive at a consensus on the significance of increasing dietary protein for various benefits, and offer practical guidance on ways to improve protein intake among Indians. METHODOLOGY A total of 10 endocrinologists and diabetologists, one nephrologist, and three registered dietitians representing four zones of India formed the expert committee. An in-depth review of literature in the Indian context was carried out, and the draft document was shared with the expert committee, and their views were incorporated into the same. The expert committee then assembled virtually to deliberate on various aspects of the role of protein in T2DM management. The experts from various specialties gave their valuable inputs and suggestions from their extensive personal clinical experience and research work, which helped to reach a consensus on the role and significance of protein in the management of T2DM and its complications in India. RESULTS There is abundant evidence that MNT is essential for the prevention and management of T2DM and its complications. Experts agreed that increasing protein intake offers myriad health benefits, namely reducing glycemic variability, improving glycemic control, increasing insulin sensitivity, improvement in lipid profile and immunity, and helping in weight management and preservation of muscle mass in PWD. The expert committee suggested aiming for an increase in protein intake by at least 5-10% of the current intake in lieu of carbohydrates in PWD. Experts also highlighted the need for more data quantifying the unmet protein needs in the Indian PWD, especially among vegetarians. Randomized controlled trials to study the effect of protein in diabetes complications such as cardiovascular disease (CVD) and diabetic kidney disease (DKD) and comorbid conditions such as sarcopenia among the Indian population are also warranted. CONCLUSION Increasing protein quantity and quality in the diets of Indian PWD could significantly contribute to positive health outcomes. Increased protein intake, preferably through dietary sources to meet the requirements and, when required using diabetes-specific protein supplements (DSPS), is recommended in the prevention and control of T2DM.
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Affiliation(s)
- Viswanathan Mohan
- Chairman, Dr Mohan's Diabetes Specialities Centre (IDF Centre of Excellence in Diabetes Care); Madras Diabetes Research Foundation (ICMR Centre for Advanced Research on Diabetes), Chennai, Tamil Nadu, India
| | - Anoop Misra
- Chairman, Fortis CDOC Centre of Excellence for Diabetes Metabolic Diseases and Endocrinology; Director, National Diabetes, Obesity and Cholesterol Foundation and Diabetes Foundation, Delhi, India
| | - Anil Bhansali
- Endocrinologist and Medical Director, Gini Health, Mohali, Punjab, India
| | - Awadhesh Kumar Singh
- Consultant Endocrinologist and Diabetologist and Head, Department of Endocrinology, GD Hospital and Diabetes Institute, Kolkata, West Bengal, India
| | - Brij Makkar
- Senior Diabetes and Bariatric Physician and Director, Dr Makkar's Diabetes and Obesity Centre, Delhi, India
| | - Dharini Krishnan
- Director and Consultant Dietician, DV Living Science Enterprises Pvt Ltd, Chennai, Tamil Nadu, India
| | - Manoj Chadha
- Consultant Endocrinologist, PD Hinduja Hospital and Research Centre, Mumbai; Founder; Hope & Care Centre, Navi Mumbai, Maharashtra, India
| | - Parag Shah
- Endocrinologist, Gujarat Endocrine Centre, Ahmedabad, Gujarat, India
| | - Ritika Samaddar
- Regional Head, Department of Dietetics, Max Healthcare, Delhi, India
| | - Ravi Kant Saraogi
- Consultant Endocrinologist, Diabetes and Endocrine Clinic, Kolkata, West Bengal, India
| | | | - Sheryl Salis
- Registered Dietician and Founder, Nurture Health Solutions, Mumbai, Maharashtra, India, Corresponding Author
| | - Sri Nagesh
- Consultant Endocrinologist and Diabetologist, Srinagesh Diabetes Thyroid Endocrine Clinic, Hyderabad,Telengana, India
| | - Umesh Khanna
- Consultant Nephrologist and Transplant Physician, Lancelot Kidney and GI Centre, Mumbai, Maharashtra, India
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Singh AK, Misra A, Das AK, Behl A, Srivastava A, Paneerselvam A, Chidambaram B, Saboo B, Sethi B, Makkar BM, Bantwal G, Thacker H, Panda J, Kesavadev J, Seshadri KG, Tiwaskar M, Shunmugavelu M, Sahay R, Das S, Agarwal S, Shaikh S, Sharma SK, Gupta S, Bhattacharyya S, Mohan V, Gunupati VK. SGLT2i as a First-line Antihyperglycemic in the Management of Type 2 Diabetes in the Context of Indians: A Systematic Review and Consensus. J Assoc Physicians India 2023; 71:62-74. [PMID: 38736056 DOI: 10.59556/japi.71.0422] [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: 05/14/2024]
Abstract
BACKGROUND Sodium-glucose cotransporter-2 inhibitors (SGLT2i) have been used for almost a decade and have proven to be effective not only in managing Type 2 diabetes (T2D), but their cardio and renal protective features make them very useful in managing patients with risk of multiple comorbidities. This systematic review was undertaken by the authors because there is no evidence currently available in India that has studied the suitability of SGLT2i as a first-line agent in patients newly diagnosed with T2D in India. MATERIALS AND METHODS First, literature was searched to identify features that are considered important when deciding on a first-line agent for managing T2D. A total of 5 broad topics were identified-glycemic control, extra glycemic effects, antihyperglycemic combination therapy, safety, and cost-effectiveness. These domains had further subheadings, and a total of 16 domains were identified. Metformin is the drug of choice as a first-line agent in such situations and has been considered the gold standard for evaluating the effects of SGLT2i across these domains. A systematic literature review on each domain was conducted to compare SGLT2i with the gold standard in Indian patients newly diagnosed with T2D. Evidence was graded (levels of evidence (LoE)-A, B, and C), and recommendations (class of recommendation (CoR)-I, II, and III) were classified by the expert group as defined in the methodology. RESULTS According to the systematic reviews conducted, 11 domains had Level A evidence, 2 domains (impact on lipids and gut microbiome) had Level B, and 3 domains had Level C (β-cell function, renal protection, and glycemic variability) evidence. Based on evidence and expert opinion, the authors recommend SGLT2i as a first-line agent for managing newly diagnosed patients with T2D with a Class I recommendation for 13 domains and Class II for the remaining 3 (impact on lipids, gut microbiome, and β-cell function). Although a poorer level of evidence (Level C) was available for the glycemic variability domain, the authors still reported this as Class I recommendations according to their expert opinion and consensus. CONCLUSION This article advocates adopting SGLT2 inhibitors as the primary treatment choice for treating patients with newly diagnosed T2D in India.
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Affiliation(s)
- Awadhesh Kumar Singh
- Consultant Endocrinologist, Department of Diabetology, GD Hospital & Diabetes Institute, Kolkata, West Bengal, India, Corresponding Author
| | - Anoop Misra
- Consultant Endocrinologist, Department of Diabetes and Endocrinology, Fortis-C-DOC Hospital, Delhi, India
| | - Ashok Kumar Das
- Consultant Endocrinologist, Department of Endocrinology, Pondicherry Institute of Medical Sciences, Pondicherry, India
| | - Anish Behl
- Consultant Endocrinologist, Department of Endocrinology, Wellness Superspeciality Centre & Apollo BGS Hospitals, Mysuru, Karnataka, India
| | - Ankit Srivastava
- Consultant Endocrinologist, Department of Endocrinology, Arogya Diabetes & Endocrine Centre, Ranchi, Jharkhand, India
| | | | - Balaji Chidambaram
- Consultant Diabetologist, Department of Diabetology, Nithyashree Balaji Diabetes Centre, Kumbakonam, Tamil Nadu, India
| | - Banshi Saboo
- Chief Diabetologist, Department of Diabetology, Dia Care Hormone Clinic, Ahmedabad, Gujarat, India
| | - Bipin Sethi
- Consultant Endocrinologist, Department of Endocrinology, Care Hospitals, Hyderabad, Telangana, India
| | - Brij Mohan Makkar
- Senior Diabetologist and Obesity Specialist, Department of Diabetology, Dr Makkar's Diabetes and Obesity Centre, Delhi, India
| | - Ganapathi Bantwal
- Consultant Endocrinologist, Department of Endocrinology, St Johns Medical College, Bengaluru, Karnataka, India
| | - Hemant Thacker
- Consultant Physician, Cardio-Metabolic Specialist, Department of Internal Medicine, Bhatia Hospital (Tardeo), Breach Candy Hospital (Breach Candy), Mumbai, Maharashtra, India
| | - Jayant Panda
- Professor and Head, Department of Internal Medicine, SCB Medical College & Hospital, Cuttack, Odisha, India
| | - Jothydev Kesavadev
- Consultant Diabetologist, Department of Diabetology, Jothydev's Diabetes & Research Center, Trivandrum, Kerala, India
| | - Krishna G Seshadri
- Senior Consultant, American Board-Certified Endocrinology, Department of Diabetes and Metabolism, Diabetes and Endocrinology Clinic, Chennai, Tamil Nadu, India
| | - Mangesh Tiwaskar
- Consultant Diabetologist, Department of Diabetology, Shilpa Medical Research Centre, Mumbai, Maharashtra, India
| | - Minakshisundaram Shunmugavelu
- Consultant Endocrinologist, Department of Endocrinology, Trichy Diabetes Speciality Centre, Tiruchirappalli, Tamil Nadu, India
| | - Rakesh Sahay
- Professor and HOD, Department of Endocrinology, Osmania Medical College, Hyderabad, Telengana, India
| | - Sambit Das
- Consultant Endocrinologist, Department of Endocrinology, HiTech Medical College and Hospitals, Bhubaneswar, Odisha, India
| | - Sanjay Agarwal
- Consultant Endocrinologist, Department of Diabetes Care, Aegle Clinic; Department of Medicine and Diabetes, Ruby Hall Clinic, Pune, India
| | - Shehla Shaikh
- Consultant Endocrinologist, Department of Endocrinology, Saifee Hospital, Mumbai, Maharashtra, India
| | - Surendra Kumar Sharma
- Consultant Endocrinologist, Department of Endocrinology, Diabetes Thyroid and Endocrine Centre, Jaipur, Rajasthan, India
| | - Sunil Gupta
- Consultant Diabetologist, Department of Diabetology, Sunil's Diabetes Care & Research Centre, Nagpur, Maharashtra, India
| | - Supratik Bhattacharyya
- Consultant Endocrinologist, Department of Endocrinology, Apollo Clinic, Kolkata, West Bengal, India
| | - Viswanathan Mohan
- Chairman and Chief of Diabetology, Department of Diabetology, Dr Mohan's Diabetes Specialities Centre, Chennai, Tamil Nadu, India
| | - Vijaya Kumar Gunupati
- Consultant Diabetologist, Department of Diabetology, Diabetes Medicare Centre, Chennai, Tamil Nadu, India
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Sahu H, Patil VM, Menon N, Singh AK, Biswas S, Janu A, Chakraborty N, Prabhash K, Noronha V. Infections in Patients with Advanced-stage Epidermal Growth Factor Receptor-mutant Lung Cancer - a Post-hoc Analysis of a Randomised Trial. Clin Oncol (R Coll Radiol) 2023; 35:811-812. [PMID: 37838606 DOI: 10.1016/j.clon.2023.09.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 09/26/2023] [Indexed: 10/16/2023]
Affiliation(s)
- H Sahu
- Department of Medical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute (HBNI), Mumbai, Maharashtra, India
| | - V M Patil
- Department of Medical Oncology, Hinduja Hospital, Mumbai, Maharashtra, India
| | - N Menon
- Department of Medical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute (HBNI), Mumbai, Maharashtra, India
| | - A K Singh
- Department of Medical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute (HBNI), Mumbai, Maharashtra, India
| | - S Biswas
- Department of Microbiology, Tata Memorial Hospital, Homi Bhabha National Institute (HBNI), Mumbai, Maharashtra, India
| | - A Janu
- Department of Radiology, Tata Memorial Hospital, Homi Bhabha National Institute (HBNI), Mumbai, Maharashtra, India
| | - N Chakraborty
- Department of Microbiology, Tata Memorial Hospital, Homi Bhabha National Institute (HBNI), Mumbai, Maharashtra, India
| | - K Prabhash
- Department of Medical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute (HBNI), Mumbai, Maharashtra, India
| | - V Noronha
- Department of Medical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute (HBNI), Mumbai, Maharashtra, India
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9
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Biswas B, Thakur K, Pote TD, Sharma KD, Krishnan SG, Singh AK, Sharma TR, Rathour R. Genetic and molecular analysis of leaf blast resistance in Tetep derived line RIL4 and its relationship to genes at Pita/Pita 2 locus. Sci Rep 2023; 13:18683. [PMID: 37907574 PMCID: PMC10618204 DOI: 10.1038/s41598-023-46070-7] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Accepted: 10/27/2023] [Indexed: 11/02/2023] Open
Abstract
The Vietnamese indica landrace 'Tetep' is known worldwide for its durable and broad spectrum-resistance to blast. We performed genetic and molecular analyses of leaf blast resistance in a Tetep derived recombinant inbred line 'RIL4' which is resistant to both leaf and neck blast. Phenotypic analysis of segregating F2 progenies suggested that leaf blast resistance in RIL4 was controlled by a dominant gene tentatively designated as Pi-l(t). The gene was mapped to a 2.4 cm region close to the centromere of chromosome 12. The search for the gene content in the equivalent genomic region of reference cv. Nipponbare revealed the presence of five NBS-LRR genes, two of which corresponded to the alleles of Pita and Pi67 genes previously identified from Tetep. The two other genes, LOC_Os12g17090, and LOC_Os12g17490 represented the homologs of stripe rust resistance gene Yr10. The allelic tests with Pita2 and Pi67 lines suggested that the leaf blast resistance gene in RIL4 is either allelic or tightly linked to these genes. The genomic position of the leaf blast resistance gene in RIL4 perfectly coincided with the genomic position of a neck blast resistance gene Pb2 previously identified from this line suggesting that the same gene confers resistance to leaf and neck blast. The present results were discussed in juxtaposition with past studies on the genes of Pita/Pita2 resistance gene complex.
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Affiliation(s)
- B Biswas
- CSK Himachal Pradesh Agricultural University, Palampur, 176062, India
| | - K Thakur
- College of Horticulture and Forestry, Dr YSP University of Horticulture and Forestry, Thunag, 175048, India
| | - T D Pote
- CSK Himachal Pradesh Agricultural University, Palampur, 176062, India
| | - K D Sharma
- CSK Himachal Pradesh Agricultural University, Palampur, 176062, India
| | - S Gopala Krishnan
- Division of Genetics, Indian Agricultural Research Institute, New Delhi, 110012, India
| | - A K Singh
- Division of Genetics, Indian Agricultural Research Institute, New Delhi, 110012, India
| | - T R Sharma
- Indian Council of Agricultural Research, Krishi Bhawan, New Delhi, 110001, India
| | - R Rathour
- CSK Himachal Pradesh Agricultural University, Palampur, 176062, India.
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10
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Iovoli AJ, Stephans KL, Bogart JA, Tian L, Videtic GM, Singh AK. Change in Quality of Life after Stereotactic Body Radiation Therapy (SBRT) on a Prospective Trial of Peripheral Stage I or II Non-Small Cell Lung Cancer Predicts Survival. Int J Radiat Oncol Biol Phys 2023; 117:e26-e27. [PMID: 37784997 DOI: 10.1016/j.ijrobp.2023.06.706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) We previously reported the results of a randomized, multi-institutional phase II clinical trial evaluating one versus three fractions of SBRT for peripheral Stage I to II non-small cell lung cancer (NSCLC). A secondary objective to compare quality of life (QOL) data and its association with survival outcomes is reported. MATERIALS/METHODS Medically inoperable patients with biopsy-proven peripheral T1-2N0M0 NSCLC were enrolled. Patients were randomized to 30 Gy in 1 fraction (arm 1) or 60 Gy in 3 fractions (arm 2) and stratified by performance status. QOL scores from the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30) and EORTC QLQ Lung Cancer-Specific Module (EORTC QLQ-LC13) questionnaires were required at baseline and each follow-up visit. Univariate models were generated to evaluate associations between QOL scores and survival with 95% confidence intervals (CI) calculated at each time point. RESULTS Among 98 patients enrolled (49 in each arm), 88 patients had data available for QOL analysis. At 6 month follow up, patients with stable or decreased (n = 49) versus those with increased global QOL scores (n = 27) had worse progression-free survival (HR [Hazards' Ratio] 2.32 [CI, 1.14-4.73], p = 0.021) and overall survival (HR 2.13 [CI, 1.01-4.51], p = 0.048). Similar results persisted at the 12 month follow up for progression-free survival (HR 3.90 [CI, 1.52-10.04], p = 0.016) and overall survival (HR 3.25 [CI, 1.25-8.43], p = 0.016). Median overall survival for patients with stable or decreased global QOL versus increased global QOL at 6 month follow up was 39.0 vs 60.3 months (p = 0.032). CONCLUSION Change in QOL is an early predictor of survival following SBRT for patients with peripheral early-stage NSCLC.
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Affiliation(s)
- A J Iovoli
- Roswell Park Comprehensive Cancer Center, Buffalo, NY
| | - K L Stephans
- Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH
| | - J A Bogart
- SUNY Upstate Medical Center, Syracuse, NY
| | - L Tian
- University at Buffalo, Buffalo, NY
| | - G M Videtic
- Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH
| | - A K Singh
- Roswell Park Comprehensive Cancer Center, Buffalo, NY
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Iovoli AJ, Yu H, Advani PG, Malhotra H, Fung-Kee-Fung S, Malik NK, Singh AK, Farrugia MK. Sinoatrial Node Irradiation in Patients Undergoing Definitive Stereotactic Body Radiation Therapy (SBRT) for Central Lung Cancers. Int J Radiat Oncol Biol Phys 2023; 117:e27. [PMID: 37785020 DOI: 10.1016/j.ijrobp.2023.06.707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) The clinical consequences of sinoatrial node (SAN) and atrioventricular node (AVN) irradiation in patients undergoing thoracic stereotactic body radiation therapy (SBRT) remains unclear. We examined the relationship between SAN and AVN dose with survival outcomes in patients with central non-small cell lung cancer (NSCLC) tumors. MATERIALS/METHODS A single-institutional retrospective review of patients with primary NSCLC undergoing definitive SBRT for centrally located tumors from February 2007 to December 2021 was performed. Central tumors were defined as within 2 cm of the proximal airway, mediastinum, great vessels, or spinal cord whereas ultracentral tumors were directly abutting any of the above structures. All patients underwent five-fraction SBRT to a total dose of 50 to 60 Gy. The SAN and AVN were contoured in accordance with a published contouring atlas and the maximum dose (Dmax) and mean dose (Dmean) for each structure were calculated. Sequential log rank testing between the 50th and 90th percentiles was used to identify potential cutoff values for the corresponding dosimetric parameters and non-cancer associated survival. RESULTS Among 93 eligible patients, the median age was 72.5 years (Inter-Quartile Range [IQR], 66.6-78.3), median follow up was 32.4 months (IQR, 13.0-49.6), and 48 patients were female (52%). There were 49 ultracentral tumors (53%) and the median planning target volume (PTV) was 31.0 cc (IQR, 18.0-53.3). The median SAN Dmax and Dmean were 95 cGy (IQR, 37-1,072) and 58 cGy (IQR, 26-641), respectively. The median AVN Dmax and Dmean were 45 cGy (IQR, 19-506) and 34 cGy (IQR, 15-160), respectively. Candidate cutoff values for SAN Dmax and Dmean were 1,309 cGy and 814 cGy, respectively. No significant cutoff values were identified for either AVN parameter. Kaplan-Meier analysis for the proposed SAN Dmean constraint was significantly associated with overall (p = 0.016) and non-cancer associated survival (p = 0.028). The SAN Dmax constraint was significantly associated with only overall survival (p = 0.029). In a multivariate model, the SAN Dmean cutoff significantly correlated with both overall (Hazard Ratio [HR] 2.1 [1.13-3.78], p = 0.019) and non-cancer associated survival (HR 2.39 [1.12-5.10], p = 0.025) whereas the SAN Dmax cutoff was only significantly associated with overall survival (HR 1.95 [1.03-3.68], p = 0.041). CONCLUSION SAN Dmax and Dmean were associated with significantly worse overall survival using cut-off values of 1,309 cGy and 814 cGy, respectively. SAN dose should be considered in radiation planning and further study on the consequence of SAN irradiation during SBRT is warranted.
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Affiliation(s)
- A J Iovoli
- Roswell Park Comprehensive Cancer Center, Buffalo, NY
| | - H Yu
- Roswell Park Comprehensive Cancer Center, Buffalo, NY
| | - P G Advani
- Roswell Park Comprehensive Cancer Center, Buffalo, NY
| | - H Malhotra
- Roswell Park Comprehensive Cancer Center, Buffalo, NY
| | | | - N K Malik
- Roswell Park Comprehensive Cancer Center, Buffalo, NY
| | - A K Singh
- Roswell Park Comprehensive Cancer Center, Buffalo, NY
| | - M K Farrugia
- Roswell Park Comprehensive Cancer Center, Buffalo, NY
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Garg A, Nathawat R, Singh AK, Dixit S, Acharya M. Corrective and preventive actions (CAPAs) in eye bank. Indian J Ophthalmol 2023; 71:3128-3130. [PMID: 37602597 PMCID: PMC10565914 DOI: 10.4103/ijo.ijo_1994_23] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 08/07/2023] [Indexed: 08/22/2023] Open
Abstract
This case series highlights the challenges in eye banking and the importance of a quality assurance program. Three cases triggered corrective and preventive actions (CAPAs) to improve the processes. Case 1 emphasized training to prevent retrieval failures. Case 2 stressed the need for blood samples and comprehensive documentation. In Case 3, mishandling led to policy revisions and staff training. CAPA involved identifying concerns, root cause analysis, action plans, implementation, checks, and closure. Errors can occur in man, machinery, process, and policies. Continuous CAPA ensures continuous quality improvement and safe corneal tissue transplantation, benefiting patients in need.
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Affiliation(s)
- Aastha Garg
- Department of Cornea and Anterior Segment, Dr. Shroff’s Charity Eye Hospital, New Delhi, India
| | - Rakhi Nathawat
- Department of Eye Bank, Dr. Shroff’s Charity Eye Hospital, New Delhi, India
| | - A K Singh
- Department of Quality Control, Dr. Shroff’s Charity Eye Hospital, New Delhi, India
| | - Surender Dixit
- Department of Eye Bank, Dr. Shroff’s Charity Eye Hospital, New Delhi, India
| | - Manisha Acharya
- Department of Cornea and Anterior Segment, Dr. Shroff’s Charity Eye Hospital, New Delhi, India
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Singh AK, Singh R, Gangopadhyay KK. Letter to the Editor regarding articles on lobeglitazone. Diabetes Metab Syndr 2023; 17:102727. [PMID: 36934031 DOI: 10.1016/j.dsx.2023.102727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Accepted: 02/06/2023] [Indexed: 03/06/2023]
Affiliation(s)
| | - Ritu Singh
- G. D Hospital & Diabetes Institute, Kolkata, 13, India
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Singh AK, Singh A, Singh R, Joshi SR, Misra A. Non-sugar sweeteners and health outcomes in adults without diabetes: deciphering the WHO recommendations in the Indian context. Diabetes Metab Syndr 2023; 17:102829. [PMID: 37451112 DOI: 10.1016/j.dsx.2023.102829] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 06/30/2023] [Accepted: 07/02/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND AND AIMS A systematic review and meta-analysis conducted by the World Health Organization (WHO) assessed the health outcomes of non-sugar sweeteners (NSS) in randomized controlled trials (RCTs) and prospective cohort studies (PCSs) and reported conflicting findings. We aim to decipher these conflicting findings in RCTs and PCSs by critically reviewing their results, comparing them with previous meta-analyses, and providing a simplified interpretation including the Indian perspective. METHODS We critically reviewed the 210-page dossier of WHO including the full text of most of the key studies of NSS included in this meta-analysis and subsequently compared it with previous meta-analyses to identify similarities and differences to address a few key questions pertaining to health outcomes associated with NSS use in adults. RESULTS Poor health outcomes are often associated with excess sugar intake. While NSS are typically consumed as a sugar replacement, benefits are conflicting. While RCTs found some benefits in the short term, PCSs found harm associated with NSS use in the long term. CONCLUSION The 2022 WHO meta-analysis that assessed the health outcomes of NSS is the most robust and critically analyzed document available to date. Despite the absence of any strong conclusion that suggests NSS consumption increases the risk of cardio-metabolic disorders, no firm evidence also rejects this statement. NSS could be an attractive replacement for sugar in overweight/obese people in the short term, but long-term harm cannot be fully ruled out. We suggest avoiding consuming sugar and restricting NSS intake wherever possible until long-term studies confirm or refute these findings.
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Affiliation(s)
- Awadhesh Kumar Singh
- G. D Hospital & Diabetes Institute, Kolkata, West Bengal, India; Sun Valley Hospital & Diabetes Research Centre, Guwahati, Assam, India; Horizon Lifeline Multi-specialty Hospital, Kolkata, West Bengal, India.
| | - Akriti Singh
- Jawaharlal Nehru Medical College & Hospital, Kalyani, West Bengal, India
| | - Ritu Singh
- G. D Hospital & Diabetes Institute, Kolkata, West Bengal, India; Horizon Lifeline Multi-specialty Hospital, Kolkata, West Bengal, India
| | | | - Anoop Misra
- Fortis C-DOC Hospital for Diabetes & Allied Sciences, New Delhi, India; National Diabetes, Obesity and Cholesterol Foundation, New Delhi, India; Diabetes Foundation (India), New Delhi, India
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15
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Namgial T, Singh AK, Singh NP, Francis A, Chattopadhyay D, Voloudakis A, Chakraborty S. Correction to: Differential expression of genes during recovery of Nicotiana tabacum from tomato leaf curl Gujarat virus infection. Planta 2023; 258:51. [PMID: 37490148 PMCID: PMC10368538 DOI: 10.1007/s00425-023-04206-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/26/2023]
Affiliation(s)
- T Namgial
- Laboratory of Plant Breeding and Biometry, Department of Crop Science, Agricultural University of Athens, Athens, 11855, Greece
- Molecular Virology Laboratory, School of Life Sciences, Jawaharlal Nehru University, New Delhi, 110067, India
| | - A K Singh
- Molecular Virology Laboratory, School of Life Sciences, Jawaharlal Nehru University, New Delhi, 110067, India
| | - N P Singh
- Laboratory of Plant Molecular Biology, National Institute of Plant Genome Research, New Delhi, 110067, India
| | - A Francis
- Laboratory of Plant Molecular Biology, National Institute of Plant Genome Research, New Delhi, 110067, India
| | - D Chattopadhyay
- Laboratory of Plant Molecular Biology, National Institute of Plant Genome Research, New Delhi, 110067, India
| | - A Voloudakis
- Laboratory of Plant Breeding and Biometry, Department of Crop Science, Agricultural University of Athens, Athens, 11855, Greece.
| | - S Chakraborty
- Molecular Virology Laboratory, School of Life Sciences, Jawaharlal Nehru University, New Delhi, 110067, India.
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Namgial T, Singh AK, Singh NP, Francis A, Chattopadhyay D, Voloudakis A, Chakraborty S. Differential expression of genes during recovery of Nicotiana tabacum from tomato leaf curl Gujarat virus infection. Planta 2023; 258:37. [PMID: 37405593 PMCID: PMC10322791 DOI: 10.1007/s00425-023-04182-4] [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] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 06/10/2023] [Indexed: 07/06/2023]
Abstract
MAIN CONCLUSION Nicotiana tabacum exhibits recovery response towards tomato leaf curl Gujarat virus. Transcriptome analysis revealed the differential expression of defense-related genes. Genes encoding for cysteine protease inhibitor, hormonal- and stress-related to DNA repair mechanism are found to be involved in the recovery process. Elucidating the role of host factors in response to viral infection is crucial in understanding the plant host-virus interaction. Begomovirus, a genus in the family Geminiviridae, is reported throughout the globe and is known to cause serious crop diseases. Tomato leaf curl Gujarat virus (ToLCGV) infection in Nicotiana tabacum resulted in initial symptom expression followed by a quick recovery in the systemic leaves. Transcriptome analysis using next-generation sequencing (NGS) revealed a large number of differentially expressed genes both in symptomatic as well as recovered leaves when compared to mock-inoculated plants. The virus infected N. tabacum results in alteration of various metabolic pathways, phytohormone signaling pathway, defense related protein, protease inhibitor, and DNA repair pathway. RT-qPCR results indicated that Germin-like protein subfamily T member 2 (NtGLPST), Cysteine protease inhibitor 1-like (NtCPI), Thaumatin-like protein (NtTLP), Kirola-like (NtKL), and Ethylene-responsive transcription factor ERF109-like (NtERTFL) were down-regulated in symptomatic leaves when compared to recovered leaves of ToLCGV-infected plants. In contrast, the Auxin-responsive protein SAUR71-like (NtARPSL) was found to be differentially down-regulated in recovered leaves when compared to symptomatic leaves and the mock-inoculated plants. Lastly, Histone 2X protein like (NtHH2L) gene was found to be down-regulated, whereas Uncharacterized (NtUNCD) was up-regulated in both symptomatic as well as recovered leaves compared to the mock-inoculated plants. Taken together, the present study suggests potential roles of the differentially expressed genes that might govern tobacco's susceptibility and/or recovery response towards ToLCGV infection.
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Affiliation(s)
- T Namgial
- Laboratory of Plant Breeding and Biometry, Department of Crop Science, Agricultural University of Athens, Athens, 11855, Greece
- Molecular Virology Laboratory, School of Life Sciences, Jawaharlal Nehru University, New Delhi, 110067, India
| | - A K Singh
- Molecular Virology Laboratory, School of Life Sciences, Jawaharlal Nehru University, New Delhi, 110067, India
| | - N P Singh
- Laboratory of Plant Molecular Biology, National Institute of Plant Genome Research, New Delhi, 110067, India
| | - A Francis
- Laboratory of Plant Molecular Biology, National Institute of Plant Genome Research, New Delhi, 110067, India
| | - D Chattopadhyay
- Laboratory of Plant Molecular Biology, National Institute of Plant Genome Research, New Delhi, 110067, India
| | - A Voloudakis
- Laboratory of Plant Breeding and Biometry, Department of Crop Science, Agricultural University of Athens, Athens, 11855, Greece.
| | - S Chakraborty
- Molecular Virology Laboratory, School of Life Sciences, Jawaharlal Nehru University, New Delhi, 110067, India
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17
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Singh AK, Singh A, Singh R. New-onset diabetes with sodium-glucose cotransporter-2 inhibitors in prediabetes: An updated meta-analysis and possible mechanisms. Diabetes Metab Syndr 2023; 17:102789. [PMID: 37257223 DOI: 10.1016/j.dsx.2023.102789] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 05/23/2023] [Accepted: 05/24/2023] [Indexed: 06/02/2023]
Abstract
BACKGROUND AND AIMS A recent systematic review and meta-analysis studied the effect of sodium-glucose cotransporter-2 inhibitors (SGLT2i) on new-onset diabetes (NOD) in adults with prediabetes having chronic kidney disease and heart failure. In light of other large randomized controlled trials (RCTs) of SGLT2i published after this meta-analysis that also reported the NOD outcome in adults with prediabetes, it is of interest to update the NOD outcome with SGLT2i. METHODS A systemic search in the PubMed and Embase electronic database was made until March 31, 2023, using specific MeSH keywords following PRISMA protocol. Subsequently, we conducted a meta-analysis using the random effects model while applying the inverse variance-weighted averages of pooled logarithmic hazard ratio (HR). Heterogeneity was measured using Higgins I2 and Cochrane Q statistics and publication bias was evaluated by applying funnel plots. A sensitivity exclusion analysis was additionally made. RESULTS This meta-analysis of five RCTs (N = 6752) found a significant reduction in NOD (HR 0.81; 95% CI, 0.69-0.94; P = 0.005) with SGLT2i in adults with prediabetes without any heterogeneity (I2 = 0%). CONCLUSIONS SGLT2i has the potential to reduce NOD in adults with prediabetes. Since no effect on HbA1c reduction was seen in adults with prediabetes in all five RCTs included in this meta-analysis, it is conceivable that reduction in NOD is not related to the masking of blood glucose exerted by SGLT2i. However, only an adequately powered trial of SGLT2i in people with prediabetes with a sufficient wash-out period will confirm these findings.
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Affiliation(s)
- Awadhesh Kumar Singh
- G. D Hospital & Diabetes Institute, Kolkata, West Bengal, India; Sun Valley Hospital & Diabetes Research Center, Guwahati, Assam, India; Horizon Life Line Multispecialty Hospital, Kolkata, West Bengal, India.
| | - Akriti Singh
- Jawaharlal Nehru Medical College & Hospital, Kalyani, West Bengal, India
| | - Ritu Singh
- G. D Hospital & Diabetes Institute, Kolkata, West Bengal, India; Horizon Life Line Multispecialty Hospital, Kolkata, West Bengal, India
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Ray S, Singh AK, Mukherjee JJ, Ramachandran R, Sengupta U, Virmani AK, Dutta AR, Sharma SK, Srivastava SL, Batin M. Protein restriction in adults with chronic kidney disease, with or without diabetes: Integrated Diabetes and Endocrine Academy (IDEA) consensus statement for Indian patients. Diabetes Metab Syndr 2023; 17:102785. [PMID: 37210963 DOI: 10.1016/j.dsx.2023.102785] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 05/05/2023] [Accepted: 05/08/2023] [Indexed: 05/23/2023]
Abstract
BACKGROUND AND AIMS Most guidelines recommend protein restriction in adults with chronic kidney disease (CKD), with or without diabetes. However, advising protein restriction for every person with CKD is controversial. We aim to arrive at a consensus on this topic, especially among Indian adults with CKD. METHODS A systematic literature search in the PubMed electronic database was undertaken using specific keywords and MeSH terms until May 1, 2022. All the retrieved literature was circulated and rigorously deliberated upon by the panel members. RESULTS Seventeen meta-analyses that evaluated the outcomes of protein restriction in adults with CKD, with or without diabetes, met our inclusion criteria and were analyzed. A low-protein diet (LPD) in people with stages 3-5 of CKD (who are not on haemodialysis [HD]) reduces the severity of uremic symptoms and the rate of decline in glomerular filtration rate, leading to a delay in dialysis initiation. However, LPD in patients on maintenance HD may not be desirable because HD-induced protein catabolism may lead to protein-energy malnutrition. Since the average protein intake among Indians is much lower than recommended, this must be taken into consideration before recommending LPD for all Indian adults with CKD, particularly those on maintenance HD. CONCLUSION It is essential to assess the nutritional status of people with CKD, particularly in countries like India where average daily protein intake is poor, before recommending guideline-directed protein restriction. The prescribed diet, including the quantity and quality of proteins, should be tailored to the person's habits, tastes, and needs.
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Affiliation(s)
- Subir Ray
- Apollo Multi-speciality Hospitals, Kolkata, West Bengal, India
| | | | | | - Raja Ramachandran
- Post Graduate Institute of Medical Education and Research, Chandigarh, India
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Singh AK, Singh A, Singh R. Cardiovascular and Renal Outcomes with SGLT-2 inhibitors and DPP-4 inhibitors Combination Therapy: A Meta-analysis of Randomized Cardiovascular Outcome Trials. Endocr Pract 2023:S1530-891X(23)00367-1. [PMID: 37037286 DOI: 10.1016/j.eprac.2023.04.001] [Citation(s) in RCA: 1] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 03/31/2023] [Accepted: 04/02/2023] [Indexed: 04/12/2023]
Abstract
OBJECTIVE The cardiovascular (CV) and renal benefits of SGLT-2 inhibitors (SGLT2i) in people with type 2 diabetes (T2D) are well known. However, similar beneficial effects of SGLT2i in combination with DPP-4 inhibitors (DPP4i) are not known. It is of interest to explore a trial-level meta-analysis to find out this knowledge gap. METHODS A literature search was carried out in PubMed and Embase databases until January 31, 2023. All CV outcome trials (CVOTs) reporting the CV and renal outcomes of SGLT2i with or without background DPP4i therapy against the placebo were retrieved. A meta-analysis was subsequently conducted by applying the inverse variance-weighted averages of pooled logarithmic hazard ratio using random effects analysis, primarily. RESULTS This meta-analysis showed that the beneficial three-point major adverse cardiovascular events (3P-MACE) composite (three CVOTs; N = 32,418), the composite of CV death or heart failure hospitalization (hHF) (four CVOTs; N = 37,687), hHF (three CVOTs; N = 27,545), CV death (four CVOTs; N = 34,565), and renal outcomes (two CVOTs; N = 25,406) with SGLT2i are similar with or without background DPP4i therapy against the placebo (Pheterogeneity = 0.71, 0.07, 0.87, 0.72, and 0.25; respectively). However, against the placebo, the summary estimates for 3P-MACE composite, hHF, and renal outcomes were stronger with SGLT2i alone whilst the summary estimates for CV death or hHF composite were larger with SGLT2i with background DPP4i therapy. CONCLUSION Beneficial CV and renal effects of SGLT2i are similar against placebo regardless of background DPP4i therapy.
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Affiliation(s)
- Awadhesh Kumar Singh
- G. D Hospital & Diabetes Institute, Kolkata, West Bengal, India; Sun Valley Hospital & Diabetes Research center, Guwahati, Assam, India; Horizon Life Line Multispecialty Hospital, Kolkata, West Bengal India.
| | - Akriti Singh
- Jawaharlal Nehru Medical College & Hospital, Kalyani, West Bengal, India
| | - Ritu Singh
- G. D Hospital & Diabetes Institute, Kolkata, West Bengal, India; Horizon Life Line Multispecialty Hospital, Kolkata, West Bengal India
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Tomar P, Rajoriya JS, Ojha BK, Singh AK, Deshpande D, Choubey P, Raje A, Mishra GK, Perumal P. Tinospora cordifolia modulates the seminal parameters, leakage of intracellular enzymes and seminal antioxidants in equilibrated and cryopreserved semen of Sahiwal bulls. Reprod Domest Anim 2023. [PMID: 37009827 DOI: 10.1111/rda.14352] [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: 01/18/2023] [Revised: 03/05/2023] [Accepted: 03/24/2023] [Indexed: 04/04/2023]
Abstract
The present study was undertaken to assess the effects of stem extract of Tinospora cordifolia (Giloy or Guduchi) in the semen extender on seminal parameters, leakage of intracellular enzymes and antioxidants in semen of Sahiwal bull. A total of 48 ejaculates from four bulls were selected for the study. Spermatozoa of 25×106 were incubated in 100, 300 and 500 μg of stem extract of Guduchi as Gr II, III and IV, respectively and pre-freeze and post-thaw semen samples were analysed for seminal parameters (motility, viability, total sperm abnormality; TSA, plasma membrane integrity; PMI, and acrosomal integrity; AcI), intracellular enzymes (aspartate aminotransferase; AST and lactate dehydrogenase; LDH) and seminal antioxidants (superoxide dismutase; SOD and catalase) in comparison with an untreated control group (Gr I). The results revealed that stem extract treated semen had significantly (p<0.05) higher motility, viability, PMI, AcI, SOD and catalase and had significantly (p<0.05) lower TSA, AST and LDH compared to those in untreated control group at pre-freeze and post-thaw stages. Semen treated with 100 μg stem extract /25×106 spermatozoa had significantly (p<0.05) higher motility, viability, PMI, AcI, SOD and catalase and had significantly (p<0.05) lower TSA, AST and LDH compared to those in control, 300, and 500 μg treated groups at pre-freeze and post-thaw stages. Further, these seminal parameters and antioxidants were showing decreasing trend and TSA and leakage of intra-cellular enzymes were showing increasing trend from Gr II to Gr IV at pre-freeze and post-thaw stages. Thus, 100 μg/25×106 spermatozoa were optimum or suitable dose for cryopreservation of Sahiwal bull semen. The study concluded that T. cordifolia stem extract 100 μg/25×106 spermatozoa in the semen extender can be effectively utilized to reduce the oxidative stress and improve the pre-freeze and post-thaw seminal parameters in Sahiwal bull. However, further studies on effects of different concentrations of stem extract on in-vitro or in-vivo fertility trials are to be conducted to assess the impact of the stem extract supplementation in the semen extender on field pregnancy outcome in bovine species.
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Affiliation(s)
- P Tomar
- NDVSU-College of Veterinary Science & Animal Husbandry, Rewa, Madhya Pradesh, India
| | - J S Rajoriya
- NDVSU-College of Veterinary Science & Animal Husbandry, Rewa, Madhya Pradesh, India
| | - B K Ojha
- NDVSU-College of Veterinary Science & Animal Husbandry, Rewa, Madhya Pradesh, India
| | - A K Singh
- NDVSU-College of Veterinary Science & Animal Husbandry, Rewa, Madhya Pradesh, India
| | - D Deshpande
- Central Semen Station, Bhadbhada, Bhopal, Madhya Pradesh, India
| | - P Choubey
- Central Semen Station, Bhadbhada, Bhopal, Madhya Pradesh, India
| | - A Raje
- NDVSU-College of Veterinary Science & Animal Husbandry, Rewa, Madhya Pradesh, India
| | - G K Mishra
- NDVSU-College of Veterinary Science & Animal Husbandry, Rewa, Madhya Pradesh, India
| | - P Perumal
- ICAR-Central, Island Agricultural Research Institute, Port Blair, Andaman and Nicobar Islands
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Gangopadhyay KK, Singh AK. Will lobeglitazone rival pioglitazone? A systematic review and critical appraisal. Diabetes Metab Syndr 2023; 17:102747. [PMID: 36966544 DOI: 10.1016/j.dsx.2023.102747] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 03/11/2023] [Accepted: 03/17/2023] [Indexed: 03/28/2023]
Abstract
BACKGROUND AND AIMS Lobeglitazone (LGZ), a newly researched thiazolidinedione (TZD) thought to have lesser side effects compared with pioglitazone (PGZ), has been recently approved for the treatment of type 2 diabetes (T2D) in India. We aim to conduct an updated systematic review of LGZ to critically appraise its efficacy and safety in the context of PGZ. METHODS A systematic literature search was carried out in the electronic database of PubMed until Jan 15, 2023, using specific keywords and MeSH terms. All studies which evaluated LGZ in people with T2D were retrieved and data were synthesized with regard to its efficacy and safety. A comparative critical appraisal was additionally made in the context of PGZ in T2D. RESULTS Four randomized controlled, one prospective observational, and two real-world studies have evaluated the safety and efficacy of LGZ against placebo or active comparators either as monotherapy or in combination therapy. HbA1c reduction with LGZ 0.5 mg was superior to the placebo but similar to PGZ 15 mg and sitagliptin (SITA) 100 mg. Weight gain with LGZ was significantly higher compared to placebo and SITA but similar to PGZ. Edema was more frequently observed with LGZ compared to placebo, PGZ, and SITA. CONCLUSION No substantial evidence is yet available that suggests LGZ could be a better alternative to PGZ both in the context of glycemic or extra-glycemic effects. At least in the short-term, adverse events of LGZ are indifferent from PGZ. More data is additionally needed to claim any advantage of LGZ over PGZ.
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Kumar G, Singh AK, Agarwal D. Structural and functional characterization of RNA dependent RNA polymerase of Macrobrachium rosenbergii nodavirus (MnRdRp). J Biomol Struct Dyn 2023; 41:12825-12837. [PMID: 36757137 DOI: 10.1080/07391102.2023.2175384] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 01/07/2023] [Indexed: 02/10/2023]
Abstract
Macrobrachium rosenbergii is a highly valued farmed freshwater species and its production has been affected globally by white tail disease caused by M. rosenbergii nodavirus (MrNV). MrNV is a single stranded positive sense RNA virus encoding RNA-dependent RNA polymerase (RdRp) for genome replication. Due to its essentiality for pathogenesis, it is an important drug target. The domain prediction of the complete sequence revealed the presence of two enzymatic regions namely methyl transferase and RdRp separated by transmembrane region. The predicted three-dimensional (3D) structure of MnRdRp using AlphaFold 2 shows that the structure is composed of three major sub-domains common for other polymerases namely fingers, palm and thumb. Structural similarity search revealed its similarity with other flaviviridea members especially with BVDV RdRp (BvdvRdRp). The structure of fingers and palm sub-domains is more conserved than the thumb sub-domain. A small α-helix named 'priming helix' having conserve Tyr was identified at position 829-833 with a potential role in de novo initiation. Analysis of electrostatic potential revealed that nucleotide and template channels are electropositive. Metal binding residues were identified as Asp599, Asp704 and Asp705. The α and β phosphates of incoming nucleotide interact with two Mn2+, Arg455 and Arg537. For recognition of 2'-OH of incoming rNTP, Asp604, Ser661 and Asn670 were identified which can form H-bond network with 2'-OH group. Docking study revealed that Dasabuvir can potentially inhibit MnRdRp. The study concluded that the overall structure and function of MnRdRp are similar to Flaviviridae polymerases and their inhibitors can work against this enzyme.Communicated by Ramaswamy H. Sarma.
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Affiliation(s)
- Gulshan Kumar
- College of Fisheries Science Gunla, Birsa Agricultural University, Ranchi, Jharkhand, India
| | - A K Singh
- College of Fisheries Science Gunla, Birsa Agricultural University, Ranchi, Jharkhand, India
| | - Deepak Agarwal
- TNJFU, Institute of Fisheries Post Graduate Studies, OMR, Chennai, Tamil Nadu, India
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Sasidharan JK, Patra MK, Khan JA, Singh AK, Karikalan M, De UK, Saxena AC, Dubal ZB, Singh SK, Kumar H, Krishnaswamy N. Differential expression of inflammatory cytokines, prostaglandin synthases and secretory leukocyte protease inhibitor in the endometrium and circulation in different graded CEH-pyometra in bitch. Theriogenology 2023; 197:139-149. [PMID: 36516536 DOI: 10.1016/j.theriogenology.2022.11.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 11/05/2022] [Accepted: 11/09/2022] [Indexed: 11/24/2022]
Abstract
Cystic endometrial hyperplasia (CEH)-pyometra (CEH-P) is one of the most common reproductive disorders in bitches, posing a risk to both future fertility and life. The aims of the current study were to elucidate the differential expression patterns of inflammatory mediators at transcript and protein levels in the endometrium and to assess the concentrations of key inflammatory mediators in the peripheral circulation of bitches with different graded CEH-P. A total of 25 client-owned intact mixed breed bitches of 3-10 years presented to the outpatient department of RVP-TVCC of the institute were considered for the study. Of which, 22 cases suggestive of pyometra and 3 cases of CEH obtained during routine elective ovariohysterectomy were subjected to histopathological examination. Uteri were categorized into CEH (n = 3), moderate CEH-P (mCEH-P, n = 9), severe CEH-P (sCEH-P, n = 6) and atrophic pyometra (AT-P, n = 7). A group of age matched (n = 12) bitches without pyometra served as control. Endometrial transcripts such as IL6, IL8, PTGS2, PGFS, and SLPI were expressed differentially in the CEH and CEH-P bitch. In addition, a strong immunoreactivity (IR) of IL6, IL8, PTGS2, and mPGES1 was recorded in the sCEH-P uterus, while expression of IL10 was noticed in AT-P. In circulation, serum IL6 was the most relevant marker with high sensitivity of 96.2% and specificity of 84.6% at a cut off concentration 8.5 pg/mL followed by SLPI with 95.2% sensitivity, and 84.6% specificity at cut off concentration of 1.3 ng/mL. Serum IL10, PGFM and SLPI concentration in the peripheral circulation were 1.5-2.23 fold higher in mCEH-P, 0.87-2.5 fold higher in sCEH-P and 2.9-3.5 fold higher in AT-P than that of control. It is concluded that monitoring the serum concentration of IL6, IL10 and SLPI would be useful adjunct to the established hematobiochemical parameters in the management of pyometra in the bitch with critical illness.
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Affiliation(s)
- J K Sasidharan
- Animal Reproduction Division, ICAR-Indian Veterinary Research Institute, Izatnagar, Uttar Pradesh, 243 122, India
| | - M K Patra
- Animal Reproduction Division, ICAR-Indian Veterinary Research Institute, Izatnagar, Uttar Pradesh, 243 122, India.
| | - J A Khan
- Animal Reproduction Division, ICAR-Indian Veterinary Research Institute, Izatnagar, Uttar Pradesh, 243 122, India
| | - A K Singh
- Animal Reproduction Division, ICAR-Indian Veterinary Research Institute, Izatnagar, Uttar Pradesh, 243 122, India
| | - M Karikalan
- Centre for Wildlife Conservation, Management and Disease Surveillance, ICAR-Indian Veterinary Research Institute, Izatnagar, Uttar Pradesh, 243 122, India
| | - U K De
- Division of Veterinary Medicine, ICAR-Indian Veterinary Research Institute, Izatnagar, Uttar Pradesh, 243 122, India; Referral Veterinary Polyclinic, ICAR-Indian Veterinary Research Institute, Izatnagar, Uttar Pradesh, 243 122, India
| | - A C Saxena
- Referral Veterinary Polyclinic, ICAR-Indian Veterinary Research Institute, Izatnagar, Uttar Pradesh, 243 122, India
| | - Z B Dubal
- Division of Veterinary Public Health, ICAR-Indian Veterinary Research Institute, Izatnagar, Uttar Pradesh, 243 122, India
| | - S K Singh
- Animal Reproduction Division, ICAR-Indian Veterinary Research Institute, Izatnagar, Uttar Pradesh, 243 122, India
| | - H Kumar
- Animal Reproduction Division, ICAR-Indian Veterinary Research Institute, Izatnagar, Uttar Pradesh, 243 122, India
| | - N Krishnaswamy
- Indian Veterinary Research Institute, Hebbal, Bengaluru, 560 024, India
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Singh AK, Singh A, Singh R, Misra A. Efficacy and safety of imeglimin in type 2 diabetes: A systematic review and meta-analysis of randomized placebo-controlled trials. Diabetes Metab Syndr 2023; 17:102710. [PMID: 36702046 DOI: 10.1016/j.dsx.2023.102710] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 12/26/2022] [Revised: 01/09/2023] [Accepted: 01/11/2023] [Indexed: 01/22/2023]
Abstract
BACKGROUND & AIMS Imeglimin is a novel new oral compound recently approved for treating type 2 diabetes (T2D) in India. We conducted a systematic review and meta-analysis to evaluate the efficacy of imeglimin in people with T2D in the approved dose of 1000 mg twice daily (BID). METHODS We systematically searched the database of PubMed until December 20, 2022, and retrieved all published double-blind, randomized, placebo-controlled trials (RCTs) conducted with imeglimin 1000 mg BID, using appropriate keywords and MeSH terms. A meta-analysis was conducted to study the HbA1c lowering effect of imeglimin 1000 mg BID in people with T2D using the Comprehensive meta-analysis (CMA) software Version 3, Biostat Inc. Englewood, NJ, USA. RESULTS Of the seven Phase 2 studies and three Phase 3 studies conducted so far, only three published double-blind RCTs have reported the efficacy and safety of imeglimin 1000 mg BID against the placebo. Our meta-analysis using the random-effects model from two monotherapy studies (n = 360) showed imeglimin 1000 mg BID reduce HbA1c significantly (Δ -0.9%, 95% Confidence Interval [CI], -1.1 to -0.74%; P < 0.0001) against the placebo, without any heterogeneity (I2 = 0%). The pooled meta-analysis from all three RCTs (n = 574) found a significant reduction in HbA1c with imeglimin 1000 mg BID (Δ -0.79%; 95% CI, -1.00 to -0.59%; P < 0.0001) compared to placebo with high heterogeneity. CONCLUSIONS This meta-analysis found a significant HbA1c lowering effect of imeglimin in people with T2D with an acceptable tolerability profile. Still, larger and longer studies are needed.
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Affiliation(s)
| | - Akriti Singh
- Jawaharlal Nehru Medical College & Hospital, Kalyani, West Bengal, India
| | - Ritu Singh
- G. D Hospital & Diabetes Institute, Kolkata, West Bengal, India
| | - Anoop Misra
- Fortis C-DOC Hospital for Diabetes & Allied Sciences, New Delhi, India; National Diabetes, Obesity and Cholesterol Foundation, New Delhi, India; Diabetes Foundation (India), New Delhi, India
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Nassar M, Abosheaishaa H, Singh AK, Misra A, Bloomgarden Z. Noninsulin-based antihyperglycemic medications in patients with diabetes and COVID-19: A systematic review and meta-analysis. J Diabetes 2023; 15:86-96. [PMID: 36690377 PMCID: PMC9934962 DOI: 10.1111/1753-0407.13359] [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] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 12/12/2022] [Accepted: 01/05/2023] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Patients with diabetes are more likely to suffer COVID-19 complications. Using noninsulin antihyperglycemic medications (AGMs) during COVID-19 infection has proved challenging. In this study, we evaluate different noninsulin AGMs in patients with COVID-19. METHODS We searched Medline, Embase, Web of Science, and Cochrane on 24 January 2022. We used the following keywords (COVID-19) AND (diabetes mellitus) AND (antihyperglycemic agent). The inclusion criteria were studies reporting one or more of the outcomes. We excluded non-English articles, case reports, and literature reviews. Study outcomes were mortality, hospitalization, and intensive care unit (ICU) admission. RESULTS The use of metformin rather than other glucose-lowering medications was associated with statistically significant lower mortality (risk ratio [RR]: 0.60, 95% confidence interval [CI]: 0.47, 0.77, p < .001). Dipeptidyl peptidase-4 inhibitor (DPP-4i) use was associated with statistically significantly higher hospitalization risk (RR: 1.44, 95% CI: 1.23, 1.68, p < .001) and higher risk of ICU admissions and/or mechanical ventilation vs nonusers (RR: 1.24, 95% CI: 1.04, 1.48, p < .02). There was a statistically significant decrease in hospitalization for SGLT-2i users vs nonusers (RR: 0.89, 95% CI: 0.84-0.95, p < .001). Glucagon-like peptide-1 receptor agonist (GLP-1RA) use was associated with a statistically significant decrease in mortality (RR: 0.56, 95% CI: 0.42, 073, p < 0.001), ICU admission, and/or mechanical ventilation (RR: 0.79, 95% CI: 0.69-0.89, p < .001), and hospitalization (RR: 0.73, 95% CI: 0.54, 0.98, p = .04). CONCLUSIONS AGM use was not associated with increased mortality. However, metformin and GLP-1RA use reduced mortality risk statistically significantly. DPP-4i use was associated with a statistically significant increase in the risk of hospitalization and admission to the ICU.
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Affiliation(s)
- Mahmoud Nassar
- Department of MedicineIcahn School of Medicine at Mount Sinai/NYC Health+Hospitals/QueensNew York CityNew YorkUSA
| | - Hazem Abosheaishaa
- Department of MedicineIcahn School of Medicine at Mount Sinai/NYC Health+Hospitals/QueensNew York CityNew YorkUSA
| | - Awadhesh Kumar Singh
- Department of Diabetes & EndocrinologyGD Hospital & Diabetes InstituteKolkataIndia
| | - Anoop Misra
- Chairman, Fortis‐C‐DOC Centre of Excellence for Diabetes, Metabolic Diseases and Endocrinology, Diabetes Foundation (India), and National Diabetes Obesity and Cholesterol Foundation (NDOC)New DelhiIndia
| | - Zachary Bloomgarden
- Department of Medicine, Division of Endocrinology, Diabetes and Bone DiseaseIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
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Quamara S, Singh AK. An In-depth Security and Performance Investigation in Hyperledger Fabric-configured Distributed Computing Systems. IJCDS 2023. [DOI: 10.12785/ijcds/130115] [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: 02/13/2023] Open
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Baidya A, Basu AK, Bhattacharjee R, Biswas D, Biswas K, Chakraborty PP, Chatterjee P, Chowdhury S, Dasgupta R, Ghosh A, Ghosh S, Giri D, Goswami S, Maisnam I, Maiti A, Mondal S, Mukhopadhyay P, Mukhopadhyay S, Mukhopadhyay S, Pal SK, Pandit K, Ray S, Chowdhury BR, Raychaudhuri M, Raychaudhuri P, Roy A, Sahana PK, Sanyal D, Sanyal T, Saraogi RK, Sarkar D, Sengupta N, Singh AK, Sinha A. Diagnostic approach in 46, XY DSD: an endocrine society of bengal (ESB) consensus statement. J Pediatr Endocrinol Metab 2023; 36:4-18. [PMID: 36424806 DOI: 10.1515/jpem-2022-0515] [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: 05/30/2022] [Accepted: 10/31/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVES 46, XY difference/disorder of sex development (DSD) is a relatively uncommon group of heterogeneous disorders with varying degree of underandrogenization of male genitalia. Such patients should be approached systematically to reach an aetiological diagnosis. However, we lack, at present, a clinical practice guideline on diagnostic approach in 46, XY DSD from this part of the globe. Moreover, debate persists regarding the timing and cut-offs of different hormonal tests, performed in these cases. The consensus committee consisting of 34 highly experienced endocrinologists with interest and experience in managing DSD discussed and drafted a consensus statement on the diagnostic approach to 46, XY DSD focussing on relevant history, clinical examination, biochemical evaluation, imaging and genetic analysis. CONTENT The consensus was guided by systematic reviews of existing literature followed by discussion. An initial draft was prepared and distributed among the members. The members provided their scientific inputs, and all the relevant suggestions were incorporated. The final draft was approved by the committee members. SUMMARY The diagnostic approach in 46, XY DSD should be multidisciplinary although coordinated by an experienced endocrinologist. We recommend formal Karyotyping, even if Y chromosome material has been detected by other methods. Meticulous history taking and thorough head-to-toe examination should initially be performed with focus on external genitalia, including location of gonads. Decision regarding hormonal and other biochemical investigations should be made according to the age and interpreted according to age-appropriate norms Although LC-MS/MS is the preferred mode of steroid hormone measurements, immunoassays, which are widely available and less expensive, are acceptable alternatives. All patients with 46, XY DSD should undergo abdominopelvic ultrasonography by a trained radiologist. MRI of the abdomen and/or laparoscopy may be used to demonstrate the Mullerian structure and/or to localize the gonads. Genetic studies, which include copy number variation (CNV) or molecular testing of a candidate gene or next generation sequencing then should be ordered in a stepwise manner depending on the clinical, biochemical, hormonal, and radiological findings. OUTLOOK The members of the committee believe that patients with 46, XY DSD need to be approached systematically. The proposed diagnostic algorithm, provided in the consensus statement, is cost effective and when supplemented with appropriate genetic studies, may help to reach an aetiological diagnosis in majority of such cases.
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Affiliation(s)
- Arjun Baidya
- Department of Endocrinology, Nil Ratan Sircar Medical College and Hospital, Kolkata, India
| | - Asish Kumar Basu
- Department of Endocrinology & Metabolism, Medical College, Kolkata, West Bengal, India
| | - Rana Bhattacharjee
- Department of Endocrinology & Metabolism, Medical College, Kolkata, West Bengal, India
| | - Dibakar Biswas
- Department of Endocrinology & Metabolism, IPGME&R/SSKM Hospital, Kolkata, India
| | | | | | | | - Subhankar Chowdhury
- Department of Endocrinology & Metabolism, IPGME&R/SSKM Hospital, Kolkata, India
| | - Ranen Dasgupta
- Department of Endocrinology, Nil Ratan Sircar Medical College and Hospital, Kolkata, India
| | - Amritava Ghosh
- Department of Endocrinology, All India Institute of Medical Sciences, Raipur, India
| | - Sujoy Ghosh
- Department of Endocrinology & Metabolism, IPGME&R/SSKM Hospital, Kolkata, India
| | | | - Soumik Goswami
- Department of Endocrinology, Nil Ratan Sircar Medical College and Hospital, Kolkata, India
| | - Indira Maisnam
- Department of Endocrinology & Metabolism, IPGME&R/SSKM Hospital, Kolkata, India
| | - Animesh Maiti
- Department of Endocrinology & Metabolism, Medical College, Kolkata, West Bengal, India
| | - Sunetra Mondal
- Department of Endocrinology & Metabolism, IPGME&R/SSKM Hospital, Kolkata, India
| | - Pradip Mukhopadhyay
- Department of Endocrinology & Metabolism, IPGME&R/SSKM Hospital, Kolkata, India
| | | | | | - Salil Kumar Pal
- Department of Medicine, Calcutta National Medical College, Kolkata, India
| | - Kaushik Pandit
- Department of Endocrinology & Metabolism, IPGME&R/SSKM Hospital, Kolkata, India
| | - Sayantan Ray
- Department of Endocrinology, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Bibek Roy Chowdhury
- Department of Endocrinology & Metabolism, IPGME&R/SSKM Hospital, Kolkata, India
| | | | - Pradip Raychaudhuri
- Department of Endocrinology & Metabolism, Medical College, Kolkata, West Bengal, India
| | - Ajitesh Roy
- Department of Endocrinology, Vivekananda Institute of Medical Sciences, Kolkata, India
| | - Pranab Kumar Sahana
- Department of Endocrinology & Metabolism, IPGME&R/SSKM Hospital, Kolkata, India
| | - Debmalya Sanyal
- Department of Endocrinology, KPC Medical College, Kolkata, India
| | - Trinanjan Sanyal
- Department of Biochemistry, Malda Medical College & Hospital, Malda, India
| | | | - Dasarathi Sarkar
- Department of Endocrinology, G.D Hospital & Diabetes Institute, Kolkata, India
| | - Nilanjan Sengupta
- Department of Endocrinology, Nil Ratan Sircar Medical College and Hospital, Kolkata, India
| | | | - Anirban Sinha
- Department of Endocrinology & Metabolism, Medical College, Kolkata, West Bengal, India
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Lokwani P, Gupta N, Choudhary SK, Singh AK. Noise survey of neonatal intensive care unit at a government tertiary-care centre. J Neonatal Perinatal Med 2023; 16:619-625. [PMID: 38043020 DOI: 10.3233/npm-230031] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2023]
Abstract
BACKGROUND With technological advancement, Neonatal Intensive Care Units (NICU) have become noisier than ever. Studies have shown the detrimental effects of increasing noise in NICU on growing pre-term and sick neonates. The present study aimed to survey the amount of noise in one of the NICU blocks of a government tertiary care centre and explore ways to control it when dealing with these sick babies. METHODS A detailed noise survey was carried out, for February 2023, in one of the two blocks of NICU in a government tertiary-care centre. The noise measurements were performed using two "Sound Ear 3" noise meters. The analyses were done in Leq (equivalent continuous sound levels) A-weighted decibels (dBA). RESULTS The extracted data analysis revealed that the NICU block was exposed to a mean Leq of 67.78 dBA noise with a maximum of 89.0 dBA. There was a significant difference between the values noted in devices at different locations and across different periods. There were certain instances (57 and 42 for two devices) when there were sudden spikes in the noise levels beyond 80 dBA. It was also seen that noise was more than 65 dBA most of the time (72% and 66% for the two devices). CONCLUSION The noise survey carried out over one month revealed a considerable amount of noise in the NICU of a government tertiary-care centre. The study also explored ways such as environmental modification, human behavior modification, awareness programs, and neonatal-centered modifications to reduce the noise and lower its detrimental effects on the growth of neonates.
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Affiliation(s)
- P Lokwani
- Audiologist, Model Early Intervention Centre, Department of Neonatology, All India Institute of Medical Sciences, Jodhpur, India
| | - N Gupta
- Department of Neonatology, All India Institute of Medical Sciences, Jodhpur, India
| | - S K Choudhary
- Department of Neonatology, All India Institute of Medical Sciences, Jodhpur, India
| | - A K Singh
- Department of Neonatology, All India Institute of Medical Sciences, Jodhpur, India
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Sharma M, Marodia Y, Singh AK, Kurdia K, Gupta K, Sandhu MS. Gastrointestinal: An unusual cause of biliary obstruction in a case of Peutz-Jeghers syndrome. J Gastroenterol Hepatol 2023; 38:8. [PMID: 35643980 DOI: 10.1111/jgh.15890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 05/07/2022] [Indexed: 01/19/2023]
Affiliation(s)
- M Sharma
- Department of Radiodiagnosis, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Y Marodia
- Department of Radiodiagnosis, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - A K Singh
- Department of Gastroenterology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - K Kurdia
- Department of General Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - K Gupta
- Department of Histopathology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - M S Sandhu
- Department of Radiodiagnosis, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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Halli HM, Govindasamy P, Choudhary M, Srinivasan R, Prasad M, Wasnik VK, Yadav VK, Singh AK, Kumar S, Vijay D, Pathak H. Range grasses to improve soil properties, carbon sustainability, and fodder security in degraded lands of semi-arid regions. Sci Total Environ 2022; 851:158211. [PMID: 36029814 DOI: 10.1016/j.scitotenv.2022.158211] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [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: 05/17/2022] [Revised: 08/14/2022] [Accepted: 08/18/2022] [Indexed: 06/15/2023]
Abstract
Tropical grasses are the primary source of forage for livestock and a valuable resource for improving soil health and environmental sustainability in semi-arid regions. A study was carried out in a semi-arid region of central India to determine the short-term (6-year) impact of nine range grasses on soil physio-chemical and biological properties, carbon stock, and forage security. The experiment was carried out in a randomized block design with three replications. Results show that the majority of the grass roots were distributed in the upper soil layer (0-10 cm, 63.5-76.5 %), and then in the middle (10-20 cm, 21.3-25 %) and lower (20-30 cm, 2.2-11.5 %) layers. Perennial tussock grass (Heteropogon contortus (L.) P. Beauv. ex Roem. & Schult) had a higher root volume (2219 mm3), followed by Guinea grass [Megathyrsus maximus (Jacq.) B.K. Simon & S.W.L. Jacobs] (1860 mm3). A lower soil bulk density (BD, 1.11-1.23 g cm-3), higher gravimetric water content (GMW, 14.0-17.8 %), and soil organic carbon (0.38-0.73 %) were recorded for grass-cultivated plots compared to the barren land (1.38 g cm-3, 13.0 %, and 0.28 %, respectively). The perennial tussock grass and Guinea grass resulted in the highest soil microbial biomass carbon (SMBC, 70.1 mg kg-1 soil) and enzyme activities (dehydrogenase, 17.09 μg TPF g-1 day-1 and fluorescein diacetate activity 4.94 μg fluorescein g-1 h-1). The considerable improvement in soil properties with minimal inputs resulted in a higher sustainable yield index and carbon sustainability index in plots planted with Guinea grass (0.9 and 89.29) and perennial tussock grass (0.89 and 71.61). Therefore, the cultivation of either Guinea grass or perennial tussock grass as an intercrop or sole crop in the semi-arid environment can be an ecologically sound strategy to improve soil health, C sequestration, and fodder supply.
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Affiliation(s)
- Hanamant M Halli
- Division of Seed Technology, ICAR-Indian Grassland and Fodder Research Institute, Jhansi 284 003, India; School of Soil Stress Management, ICAR-National Institute of Abiotic Stress Management, Pune 413 115, India
| | - Prabhu Govindasamy
- Division of Crop Production, ICAR-Indian Grassland and Fodder Research Institute, Jhansi 284 003, India; Division of Agronomy, ICAR-Indian Agricultural Research Institute, New Delhi 110 012, India.
| | - Mukesh Choudhary
- Division of Crop Production, ICAR-Indian Grassland and Fodder Research Institute, Jhansi 284 003, India
| | - R Srinivasan
- Division of Crop Production, ICAR-Indian Grassland and Fodder Research Institute, Jhansi 284 003, India
| | - Mahendra Prasad
- Division of Crop Production, ICAR-Indian Grassland and Fodder Research Institute, Jhansi 284 003, India
| | - V K Wasnik
- Division of Seed Technology, ICAR-Indian Grassland and Fodder Research Institute, Jhansi 284 003, India
| | - V K Yadav
- Division of Seed Technology, ICAR-Indian Grassland and Fodder Research Institute, Jhansi 284 003, India
| | - A K Singh
- Division of Seed Technology, ICAR-Indian Grassland and Fodder Research Institute, Jhansi 284 003, India
| | - Sunil Kumar
- Division of Crop Production, ICAR-Indian Grassland and Fodder Research Institute, Jhansi 284 003, India
| | - D Vijay
- Division of Seed Technology, ICAR-Indian Agricultural Research Institute, New Delhi 110 012, India
| | - Himanshu Pathak
- School of Soil Stress Management, ICAR-National Institute of Abiotic Stress Management, Pune 413 115, India
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Mohan V, Singh AK, Zargar AH, Almeida A, Bhalla AK, Mohan JC, Dalal J, Sahay M, Mohanan PP, Maitra S, Ghosh S, Jeloka T, Kaul U, Sakhuja V, Das MK. Cardiorenal disease management in type 2 diabetes: An expert consensus. Diabetes Metab Syndr 2022; 16:102661. [PMID: 36375366 DOI: 10.1016/j.dsx.2022.102661] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 09/28/2022] [Accepted: 10/29/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND AND AIM The interplay between cardiovascular disease (CVD), chronic kidney disease (CKD) and type 2 diabetes (T2D) is well established. We aim at providing an evidence-based expert opinion regarding the prevention and treatment of both heart failure (HF) and renal complications in people with T2D. METHOD ology: The consensus recommendations were developed by subject experts in endocrinology, cardiology, and nephrology. The criteria for consensus were set to statements with ≥80% of agreement among clinicians specialized in endocrinology, cardiology, and nephrology. Key expert opinions were formulated based on scientific evidence and clinical judgment. RESULTS Assessing the risk factors of CVD or CKD in people with diabetes and taking measures to prevent HF or kidney disease are essential. Known CVD or CKD among people with diabetes confers a very high risk for recurrent CVD. Metformin plus lifestyle modification should be the first-line therapy (unless contraindicated) for the management of T2D. Glucagon-like peptide 1 (GLP-1) agonists can be preferred in people with atherosclerotic cardiovascular disease (ASCVD) or with high-risk indicators, along with sodium-glucose cotransporter-2 inhibitors (SGLT2i), whereas SGLT2i are the first choice in HF and CKD. The GLP-1 agonists can be used in people with CKD if SGLT2i are not tolerated. CONCLUSION Current evidence suggests SGLT2i as preferred agents among people with T2D and HF, and for those with T2D and ASCVD. SGLT2i and GLP-1RA also lower CV outcomes in those with diabetes and ASCVD, and the treatment choice should depend on the patient profile.
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Affiliation(s)
- Viswanathan Mohan
- Madras Diabetes Research Foundation & Dr.Mohan's Diabetes Specialities Centre, Chennai, India. http://www.drmohans.com
| | - Awadhesh Kumar Singh
- Department of Endocrinology, G.D. Hospital and Diabetes Institute, Kolkata, India
| | | | - Alan Almeida
- Department of Nephrology, P. D. Hinduja Hospital and Medical Research Centre, Mumbai, India
| | | | | | - Jamshed Dalal
- Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute, Mumbai, India
| | - Manisha Sahay
- Department of Nephrology, Osmania General Hospital & Osmania Medical College, Hyderabad, India
| | | | - Sanjay Maitra
- Department of Nephrology, Apollo Hospitals, Hyderabad, India
| | - Sujoy Ghosh
- Department of Endocrinology, IPGME&R and SSKM Hospital, Kolkata, India
| | | | | | - Vinay Sakhuja
- Department of Cardiology and Dean, Academics and Research, Batra Hospital and Medical Research Center, New Delhi, India
| | - Mrinal Kanti Das
- Department of Cardiology, C.K. Birla Hospitals (BMB/CMRI), Kolkata, India
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Ajay A, Craufurd P, Kumar V, Samaddar A, Malik RK, Sharma S, Ranjan H, Singh AK, Paudel G, Pundir AK, Poonia S, Kumar A, Kumar P, Singh DK, Singh M, Iftikar W, Ignatius M, Banik N, Mohapatra B, Sagwal P, Yadav AK, Munshi S, Panneerselvam P, McDonald A. Large survey dataset of rice production practices applied by farmers on their largest farm plot during 2018 in India. Data Brief 2022; 45:108625. [DOI: 10.1016/j.dib.2022.108625] [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] [Received: 07/04/2022] [Revised: 08/26/2022] [Accepted: 09/16/2022] [Indexed: 11/26/2022] Open
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Singh P, Anam, Chaurasia S, Kumar D, Singh AK, Singh P. Sugarcane Blanching at Specific Temperature and Time Combination Preserves Juice Physio‐biochemical, Microbial and Sensory Attributes. Int J Food Sci Technol 2022. [DOI: 10.1111/ijfs.16205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Priyanka Singh
- ICAR‐ Indian Institute of Sugarcane Research Lucknow 226002
| | - Anam
- ICAR‐ Indian Institute of Sugarcane Research Lucknow 226002
| | | | - Dilip Kumar
- ICAR‐ Indian Institute of Sugarcane Research Lucknow 226002
| | - AK Singh
- ICAR‐ Indian Institute of Sugarcane Research Lucknow 226002
| | - Pushpa Singh
- ICAR‐ Indian Institute of Sugarcane Research Lucknow 226002
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Singh AK, Acharya A, Carroll K, Lopes RD, McCausland FR, Mulloy L, Perkovic V, Solomon S, Waikar SS, Wanner C, Wong MG, Cobitz AR, Mallett SA, Shaddinger BC, McMurray JJV. Causes of death in patients with chronic kidney disease: insights from the ASCEND-D and ASCEND-ND cardiovascular outcomes trials. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
There are limited contemporary data available regarding adjudicated causes of death in patients with chronic kidney disease (CKD). Prior studies have indicated that cardiovascular (CV) events are one of the most common causes of death among patients with CKD, with previous reports stating approximately 30% of patients died from CV causes [1]. Here, we report the adjudicated causes of death in two recently completed large-scale randomised controlled trials (RCTs) with ∼14,200 person years of follow-up: ASCEND-D [2] (median follow-up: 2.5 years; NCT02879305) and ASCEND-ND [3] (median follow-up: 1.9 years; NCT02876835). These trials investigated the safety and efficacy of daprodustat, a hypoxia-inducible factor prolyl hydroxylase inhibitor (HIF-PHI), in correcting anaemia in patients with CKD.
Purpose
This study assessed the causes of death in patients with CKD in the ASCEND-D and ASCEND-ND trials.
Methods
ASCEND-D and ASCEND-ND were global, randomised, open-label, CV outcome trials in adult patients with CKD-related anaemia undergoing maintenance dialysis (ASCEND-D) or with pre-dialysis CKD (ASCEND-ND) who received daily oral daprodustat or conventional erythropoiesis-stimulating agents (ESAs). Cause of death was systematically and centrally adjudicated in a blinded fashion to the study treatment assignment by an independent committee.
Results
In ASCEND-D and ASCEND-ND, respectively, 2964 and 3872 patients were randomised, of which 92% and 97% completed the study. Baseline characteristics were well-balanced across treatment groups within each trial. Adjudicated causes of death for the ASCEND-D and -ND trials are shown in the Table. All-cause mortality was similar in patients treated with daprodustat as compared with those treated with conventional ESA in both the ASCEND-D and -ND trials. Overall mortality in the ASCEND-D and -ND trials was 20.0% and 15.5%, respectively, and CV causes accounted for approximately 30–40% of all deaths and infection accounted for 25–30% of all deaths in both trials.
Conclusion
Although CV events were the most common cause of death in the ASCEND-D and ASCEND-ND trials (30–40% of cases), the risk of death due to infection was also high, accounting for approximately 25–30% of all deaths across all study arms. Sudden death accounted for most CV deaths, particularly in the ASCEND-D trial. Infection as a cause of death was more frequent than previously reported in other RCTs or disease registries. Causes of death did not differ significantly between ASCEND-D and ASCEND-ND, or between treatments. However, as this is a selected population for a CV trial, it may not be representative of a real-life CKD population. Our results provide important data to inform the design of future studies in this population.
Funding Acknowledgement
Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): This study was funded by GlaxoSmithKline. Medical writing support was provided Natasha Tracey, PhD (Ashfield MedComms, Macclesfield, UK) and was funded by GlaxoSmithKline.
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Affiliation(s)
- A K Singh
- Brigham and Women's Hospital , Boston , United States of America
| | - A Acharya
- Albert Einstein College of Medicine , New York , United States of America
| | - K Carroll
- KJC Statistics , Macclesfield , United Kingdom
| | - R D Lopes
- Duke Clinical Research Institute , Durham , United States of America
| | - F R McCausland
- Brigham and Women's Hospital , Boston , United States of America
| | - L Mulloy
- Medical College of Georgia , Augusta , United States of America
| | - V Perkovic
- University of New South Wales , Sydney , Australia
| | - S Solomon
- Brigham and Women's Hospital , Boston , United States of America
| | - S S Waikar
- Boston Medical Center , Boston , United States of America
| | - C Wanner
- University Hospital Würzburg , Würzburg , Germany
| | - M G Wong
- Concord Repatriation General Hospital, Sydney, Australia and University of Sydney , Sydney , Australia
| | - A R Cobitz
- GlaxoSmithKline plc. , Collegeville , United States of America
| | - S A Mallett
- GlaxoSmithKline plc. , London , United Kingdom
| | - B C Shaddinger
- GlaxoSmithKline plc. , Collegeville , United States of America
| | - J J V McMurray
- BHF Glasgow Cardiovascular Research Centre , Glasgow , United Kingdom
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Singh AK, Singh A, Singh R, Misra A. Finerenone in diabetic kidney disease: A systematic review and critical appraisal. Diabetes Metab Syndr 2022; 16:102638. [PMID: 36223666 DOI: 10.1016/j.dsx.2022.102638] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 09/27/2022] [Accepted: 09/29/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND & AIMS Finerenone is a novel non-steroidal mineralocorticoid antagonist (MRA) recently approved for the treatment of chronic kidney disease (CKD) in people with type 2 diabetes (T2D). We aim to conduct a systematic review of finerenone to know the efficacy and safety of finerenone in CKD with or without T2D. METHODS A systematic search in the electronic database of PubMed and Google Scholar was made from inception until September 09, 2022, using several MeSH keywords related to finerenone. Ongoing trials were additionally searched from ClinicalTrials.Gov. RESULTS Five phase 2 and three phase 3, randomized, double-blind, placebo- or active-controlled studies of finerenone have been published to date and several other randomized and real-world studies of finerenone are currently undergoing. CONCLUSIONS In short-term studies in patients with CKD and reduced ejection heart failure, with or without T2D, finerenone 20 mg appears to have a better renal outcome compared with spironolactone and a better mortality outcome compared with eplerenone, with significantly lesser hyperkalemia compared to both spironolactone and finerenone. In long-term studies in patients with CKD and T2D, finerenone 10/20 mg significantly reduces the progression of renal disease and reduced CV endpoints (especially heart failure hospitalization) compared to placebo. Finerenone has no effect on HbA1c, body weight, and sexual side effects including gynecomastia, and has only a modest effect on blood pressure. However, hyperkalemia leading to drug withdrawal was significantly higher with finerenone compared to placebo. Safety data in real-world settings is a pressing priority.
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Affiliation(s)
| | - Akriti Singh
- Jawaharlal Nehru Medical College & Hospital, Kalyani, West Bengal, India
| | - Ritu Singh
- G. D Hospital & Diabetes Institute, Kolkata, West Bengal, India
| | - Anoop Misra
- Fortis C-DOC Hospital for Diabetes & Allied Sciences, New Delhi, India; National Diabetes, Obesity and Cholesterol Foundation, New Delhi, India; Diabetes Foundation (India), New Delhi, India
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Karmacharya RM, Singh AK, Vaidya S, Tuladhar SM, Devbhandari M, Lama B, Kharel BB, Basnet S. Analysis of Lung Cancer Cases Presenting in Outpatient Department of University Hospital of Nepal. Kathmandu Univ Med J (KUMJ) 2022; 20:452-455. [PMID: 37795723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/06/2023]
Abstract
Background Lung cancer is one of the leading cause of cancer related death. Most common histopathology of lung cancer is non-small cell carcinoma of which adenocarcinoma is the most common. There are limited number of studies done in Nepal to know different aspects of lung cancer. Objective To know demographic parameters of patients diagnosed as lung cancer in a university hospital. The study also aims to know the different histopathological diagnosis of lung cancer. Method All the patients presenting to outpatient department (Cardio Thoracic and Vascular unit) of Dhulikhel Hospital, if are diagnosed as cancer of lung/bronchus will be included in the study. The duration of the study was January 2017 to December 2021. The details on age, gender, presenting symptoms, histopathology of lung cancer, operability will be included in database and will be analyzed. Result There were total of 127 patients diagnosed as lung cancer. Male:female ratio was 1.7:1. Overall mean age was 63.23 years (SD 13.5 years, Range 19-89 years). Non small cell carcinoma was the most common type of lung cancer with 83.7%. In non small cell carcinoma, most common type was Squamous cell carcinoma followed by undifferentiated and Adenocarcinoma. Only five (3.93%) cases were in operable stage. Conclusion Despite the fact that lung cancer is one of the most common cancer, patients usually present late and moslty are not in operable stage. This study shows that squamous cell carcinoma is the most common histopathology in lung cancer cases.
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Affiliation(s)
- R M Karmacharya
- Department of Surgery (Cardio Thoracic and Vascular Surgery Unit), Dhulikhel Hospital, Kathmandu University Hospital, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal
| | - A K Singh
- Department of Surgery (Cardio Thoracic and Vascular Surgery Unit), Dhulikhel Hospital, Kathmandu University Hospital, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal
| | - S Vaidya
- Department of Surgery (Cardio Thoracic and Vascular Surgery Unit), Dhulikhel Hospital, Kathmandu University Hospital, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal
| | - S M Tuladhar
- Department of Surgery (Cardio Thoracic and Vascular Surgery Unit), Dhulikhel Hospital, Kathmandu University Hospital, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal
| | - M Devbhandari
- Department of Surgery (Cardio Thoracic and Vascular Surgery Unit), Dhulikhel Hospital, Kathmandu University Hospital, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal
| | - B Lama
- Department of Surgery (Cardio Thoracic and Vascular Surgery Unit), Dhulikhel Hospital, Kathmandu University Hospital, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal
| | - B B Kharel
- Department of Surgery (Cardio Thoracic and Vascular Surgery Unit), Dhulikhel Hospital, Kathmandu University Hospital, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal
| | - S Basnet
- Department of Surgery (Cardio Thoracic and Vascular Surgery Unit), Dhulikhel Hospital, Kathmandu University Hospital, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal
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Singh AK, Singh R. Mortality Outcomes With Different Sodium-glucose Cotransporter-2 Inhibitors: Are They Dissimilar? Endocr Pract 2022; 28:1107-1108. [PMID: 35820610 DOI: 10.1016/j.eprac.2022.07.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Revised: 07/05/2022] [Accepted: 07/05/2022] [Indexed: 12/28/2022]
Affiliation(s)
- Awadhesh Kumar Singh
- Department of Diabetes & Endocrinology, G.D Hospital & Diabetes Institute, 139A, Lenin Sarani, Kolkata 700013, West Bengal, India.
| | - Ritu Singh
- Department of Diabetes & Endocrinology, G.D Hospital & Diabetes Institute, 139A, Lenin Sarani, Kolkata 700013, West Bengal, India
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Singh AK, Singh A, Singh R, Misra A. Once-weekly basal insulin icodec: Looking ONWARDS from pharmacology to clinical trials. Diabetes Metab Syndr 2022; 16:102615. [PMID: 36108418 DOI: 10.1016/j.dsx.2022.102615] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [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: 08/25/2022] [Revised: 08/30/2022] [Accepted: 09/02/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND AND AIMS Insulin icodec is currently the most advanced candidate insulin suitable for once-weekly administration. We aim to conduct a systematic review of the literature to find out the efficacy and safety of insulin icodec in patients with diabetes mellitus. METHODS We systematically searched the electronic database of PubMed, and Google Scholar from inception until August 20, 2022, using MeSH keywords. Ongoing trials of insulin icodec were additionally searched from the ClinicalTrials.Gov. We retrieved all the available granular details of phase 1 to phase 3 studies of insulin icodec in both type 1 and type 2 diabetes. RESULTS Phase 1 study showed insulin icodec having a half-life of 196 h (>1 week) while a steady state is achieved after 3 to 4 weekly injections. Phase 2 studies compared once-weekly icodec to insulin glargine (U-100) and found a similar glucose control with no significantly greater hypoglycemia risks. Top-line results from the five phase 3 studies reported better glucose control with once-weekly icodec compared to both once-daily insulin glargine (ONWARDS 1) and once-daily degludec (in both ONWARDS 2 and 4) with similar rates of hypoglycemia in type 2 diabetes, although there was a higher hypoglycemic event with insulin icodec in type 1 diabetes (ONWARDS 6) compared to once-daily degludec despite a similar glycemic control. CONCLUSION A brighter prospect of once-weekly insulin icodec is on the card in particular in type 2 diabetes in terms of reducing injection pricks by >85% vs. once-daily basal insulin analogs, although few unknowns still exist.
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Affiliation(s)
| | - Akriti Singh
- Jawaharlal Nehru Medical College & Hospital, Kalyani, West Bengal, India
| | - Ritu Singh
- G. D Hospital & Diabetes Institute, Kolkata, West Bengal, India
| | - Anoop Misra
- Fortis C-DOC Hospital for Diabetes & Allied Sciences, New Delhi, India; National Diabetes, Obesity and Cholesterol Foundation, New Delhi, India; Diabetes Foundation (India), New Delhi, India
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Singh AK, Shah VN. Cardio-Renal Benefits of GLP-1 Receptor Agonists vs. SGLT-2 Inhibitors in Type 2 Diabetes: Are They Juxtaposed? Clinical Diabetology 2022. [DOI: 10.5603/dk.a2022.0037] [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: 11/25/2022] Open
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Malik A, Kumar A, Ellur RK, Krishnan S G, Dixit D, Bollinedi H, Vinod KK, Nagarajan M, Bhowmick PK, Singh NK, Singh AK. Molecular mapping of QTLs for grain dimension traits in Basmati rice. Front Genet 2022; 13:932166. [PMID: 35983411 PMCID: PMC9379801 DOI: 10.3389/fgene.2022.932166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 04/29/2022] [Accepted: 06/28/2022] [Indexed: 11/13/2022] Open
Abstract
Basmati rice is known for its extra-long slender grains, exceptional kernel dimensions after cooking, high volume expansion, and strong aroma. Developing high yielding Basmati rice varieties with good cooking quality is a gigantic task. Therefore, identifying the genomic regions governing the grain and cooked kernel dimension traits is of utmost importance for its use in marker-assisted breeding. Although several QTLs governing grain dimension traits have been reported, limited attempts have been made to map QTLs for grain and cooked kernel dimension traits of Basmati rice. In the current study, a population of recombinant inbred lines (RIL) was generated from a cross of Sonasal and Pusa Basmati 1121 (PB1121). In the RIL population, there was a significant positive correlation among the length (RRL: rough rice length, MRL: milled rice length, CKL: cooked kernel length) and breadth (RRB: rough rice breadth, MRB: milled rice breadth and CKB: cooked kernel breadth) of the related traits, while there was significant negative correlation between them. QTL mapping has led to the identification of four major genomic regions governing MRL and CKL. Two QTLs co-localize with the earlier reported major gene GS3 and a QTL qGRL7.1, while the remaining two QTLs viz., qCKL3.2 (qMRL3.2) and qCKL4.1 (qMRL4.1) were novel. The QTL qCKL3.2 has been bracketed to a genomic region of 0.78 Mb between the markers RM15247 and RM15281. Annotation of this region identified 18 gene models, of which the genes predicted to encode pentatricopeptides and brassinosteroid insensitive 1-associated receptor kinase 1 precursor may be the putative candidate genes. Furthermore, we identified a novel QTL qKER2.1 governing kernel elongation ratio (KER) in Basmati rice.
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Affiliation(s)
- Ankit Malik
- Division of Genetics, ICAR-Indian Agricultural Research Institute (ICAR-IARI), New Delhi, India
- Amity Institute of Biotechnology, Amity University, Noida, India
| | - Aruna Kumar
- Amity Institute of Biotechnology, Amity University, Noida, India
| | - Ranjith Kumar Ellur
- Division of Genetics, ICAR-Indian Agricultural Research Institute (ICAR-IARI), New Delhi, India
| | - Gopala Krishnan S
- Division of Genetics, ICAR-Indian Agricultural Research Institute (ICAR-IARI), New Delhi, India
| | - Deepshikha Dixit
- Division of Genetics, ICAR-Indian Agricultural Research Institute (ICAR-IARI), New Delhi, India
| | - Haritha Bollinedi
- Division of Genetics, ICAR-Indian Agricultural Research Institute (ICAR-IARI), New Delhi, India
| | - KK Vinod
- Division of Genetics, ICAR-Indian Agricultural Research Institute (ICAR-IARI), New Delhi, India
| | - M Nagarajan
- Rice Breeding and Genetics Research Centre, ICAR-IARI, Aduthurai, India
| | - PK Bhowmick
- Division of Genetics, ICAR-Indian Agricultural Research Institute (ICAR-IARI), New Delhi, India
| | - NK Singh
- ICAR-National Institute for Plant Biotechnology, IARI, New Delhi, India
| | - AK Singh
- Division of Genetics, ICAR-Indian Agricultural Research Institute (ICAR-IARI), New Delhi, India
- *Correspondence: AK Singh,
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Singh AK. "Risk assessment for periodontal disease associated tooth loss among rural and urban population of 35-44, 45-54, 55-64 and 65-74 years age groups of Barabanki district, Uttar Pradesh, India: An epidemiological study. Natl J Maxillofac Surg 2022; 13:S70-S75. [PMID: 36393949 PMCID: PMC9651215 DOI: 10.4103/njms.njms_62_19] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 12/12/2019] [Accepted: 07/08/2020] [Indexed: 11/24/2022] Open
Abstract
AIM The aim of the study was to assess the risk for periodontal disease-associated tooth loss among rural and urban population of Barabanki district, Uttar Pradesh, India. MATERIALS AND METHODS A cross-sectional study was done on 1200 urban and rural adults (632 males and 568 females) aged 35-74 years. Data were collected, followed by clinical examination for missing teeth. One-way analysis of variance with Bonferroni post hoc test, Chi-square test, and Student's t-test were used for statistical analysis. Statistical significance was set at P ≤ 0.05. RESULTS The mean number of periodontal disease-associated tooth loss in the study population was 4.2 ± 7.4. A significant association was found between the place of residence and tooth loss (3.5 ± 6.8 urban; 4.7 ± 7.8 rural), with rural adults showing greater tooth loss compared to urban adults (P < 0.01). Tooth loss increased significantly with age, ranging from mean number of 1.2 teeth in 35-44 years old to 11.5 teeth among 65-74 years old (P < 0.001). Gender showed a significant difference (P < 0.01) in tooth loss between males (4.7 ± 7.7) and females (3.6 ± 6.9). A significant association for tooth loss was also found with respect to the level of education and socioeconomic status (P < 0.001). A decrease in the mean number of missing teeth with increasing education and better socioeconomic status was observed, which was statistically significant (P < 0.001). CONCLUSION The insights gained illustrate that tooth loss was 57% in rural and urban Barabanki district population, and the significant risks identified were age, illiterate, marital status, and low socioeconomic status.
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Affiliation(s)
- Awadhesh Kumar Singh
- Department of Periodontology, Chandra Dental College and Hospital, Barabanki, Uttar Pradesh, India,Address for correspondence: Prof. Awadhesh Kumar Singh, 2/108, Vibhav Khand, Gomtinagar, Lucknow - 226 010, Uttar Pradesh, India. E-mail:
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Singh AK, Singh R. Renin-angiotensin system blockers-SGLT2 inhibitors-mineralocorticoid receptor antagonists in diabetic kidney disease: A tale of the past two decades! World J Diabetes 2022; 13:471-481. [PMID: 36051422 PMCID: PMC9329844 DOI: 10.4239/wjd.v13.i7.471] [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: 03/11/2022] [Revised: 04/19/2022] [Accepted: 06/17/2022] [Indexed: 02/06/2023] Open
Abstract
Several pharmacological agents to prevent the progression of diabetic kidney disease (DKD) have been tested in patients with type 2 diabetes mellitus (T2DM) in the past two decades. With the exception of renin-angiotensin system blockers that have shown a significant reduction in the progression of DKD in 2001, no other pharmacological agent tested in the past two decades have shown any clinically meaningful result. Recently, the sodium-glucose cotransporter-2 inhibitor (SGLT-2i), canagliflozin, has shown a significant reduction in the composite of hard renal and cardiovascular (CV) endpoints including progression of end-stage kidney disease in patients with DKD with T2DM at the top of renin-angiotensin system blocker use. Another SGLT-2i, dapagliflozin, has also shown a significant reduction in the composite of renal and CV endpoints including death in patients with chronic kidney disease (CKD), regardless of T2DM status. Similar positive findings on renal outcomes were recently reported as a top-line result of the empagliflozin trial in patients with CKD regardless of T2DM. However, the full results of this trial have not yet been published. While the use of older steroidal mineralocorticoid receptor antagonists (MRAs) such as spironolactone in DKD is associated with a significant reduction in albuminuria outcomes, a novel non-steroidal MRA finerenone has additionally shown a significant reduction in the composite of hard renal and CV endpoints in patients with DKD and T2DM, with reasonably acceptable side effects.
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Affiliation(s)
- Awadhesh Kumar Singh
- Department of Diabetes & Endocrinology, G.D Hospital & Diabetes Institute, Kolkata 700013, West Bengal, India
| | - Ritu Singh
- Department of Diabetes & Endocrinology, G.D Hospital & Diabetes Institute, Kolkata 700013, West Bengal, India
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Singh AK, Karmacharya RM, Vaidya S, Shrestha I, Siwakoti S. The Cut-off Value of Great Saphenous Vein Diameter at the Level of Femoral Condyle to Predict the Sapheno-Femoral Junction Incompetence. Kathmandu Univ Med J (KUMJ) 2022; 20:280-283. [PMID: 37042366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2023]
Abstract
Background Varicose vein is one of the commonest problems that patients visit to a vascular out patient services (OPD). It causes a great deal of morbidity in today's population. Objective To see the correlation between the size of great saphenous and Saphenofemoral junction incompetence. Method From January 2019 till January 2020, 396 patients with symptomatic or clinically diagnosed varicose veins were screened for Saphenofemoral junction reflux. The diameter of the saphenous vein was measured with B-mode imaging, and reflux was quantified based on valve closure time using Doppler spectral measurements. Best saphenous vein diameter cutoff for predicting reflux was determined using receiver operating characteristics curve analysis. Result Out of 792 limbs, the Great Saphenous Venous System was involved in 452 limbs, the Short Saphenous Venous System was involved in 151 limbs and significant perforators were present in 240 limbs. Mean great Saphenous Vein diameter of diseased limb (Reflux Positive) was 5.68 mm and 4.0 mm in control group (Reflux Negative). Mean Saphenofemoral junction diameter was 8.23 mm in diseased limbs and 6.16 mm in control limbs. Receiver operating characteristics curve showed great saphenous vein diameter at femoral condyle of 4.5 mm as best cut-off value for diagnosis of sapheno femoral junction reflux. Conclusion Great Saphenous Vein diameter at femoral condyle of 4.5 mm is the best cut-off value for diagnosis Saphenofemoral junction reflux. The Sensitivity and specificity of this cut off value is 81.8% and 71% respectively.
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Affiliation(s)
- A K Singh
- National Consultant, WHO, Kathmandu, Nepal
| | - R M Karmacharya
- Department of Department of General Surgery (CTVS Unit), Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel, Kavre, Nepal
| | - S Vaidya
- Department of Department of General Surgery (CTVS Unit), Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel, Kavre, Nepal
| | - I Shrestha
- Department of Department of General Surgery (CTVS Unit), Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel, Kavre, Nepal
| | - S Siwakoti
- Department of Department of General Surgery (CTVS Unit), Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel, Kavre, Nepal
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McDonald AJ, Keil A, Srivastava A, Craufurd P, Kishore A, Kumar V, Paudel G, Singh S, Singh AK, Sohane RK, Malik RK. Time management governs climate resilience and productivity in the coupled rice-wheat cropping systems of eastern India. Nat Food 2022; 3:542-551. [PMID: 37117949 DOI: 10.1038/s43016-022-00549-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 06/12/2022] [Indexed: 04/30/2023]
Abstract
India will need to produce 30% more wheat by 2050, and these gains must principally come from intensification in eastern India where low productivity is common. Through a dense network of on-farm surveys for the rice-wheat system in this region, we show that contemporary wheat sowing dates have a central influence on achieved and attainable yields, superseding all other crop management, soil and varietal factors. We estimate that untapped wheat production potential will increase by 69% with achievable adjustments to wheat sowing dates without incurring undesirable trade-offs with rice productivity, irrigation requirements or profitability. Our findings also indicate that transformative gains in wheat yields are only possible in eastern India if rice and wheat are managed as a coupled system. Steps taken to 'keep time' through better management of the annual cropping calendar will pay dividends for food security, profitability and climate resilience now and as a foundation for adaptation to progressive climate change.
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Affiliation(s)
- Andrew J McDonald
- Soil and Crops Sciences-School of Integrative Plant Science, Cornell University, Ithaca, NY, USA
| | | | - Amit Srivastava
- International Rice Research Institute (IRRI)-South Asia Regional Centre (ISARC), Varanasi, India
| | - Peter Craufurd
- International Maize and Wheat Improvement Center (CIMMYT), South Asia Regional Office, Lalitpur District, Nepal
| | - Avinash Kishore
- International Food Policy Research Institute (IFPRI), National Agricultural Science Complex (NASC), New Delhi, India
| | - Virender Kumar
- International Rice Research Institute (IRRI), Los Baños, Philippines
| | - Gokul Paudel
- International Maize and Wheat Improvement Center (CIMMYT), South Asia Regional Office, Lalitpur District, Nepal
| | - Sudhanshu Singh
- International Rice Research Institute (IRRI)-South Asia Regional Centre (ISARC), Varanasi, India
| | - A K Singh
- Indian Council of Agricultural Research (ICAR), New Delhi, India
| | - R K Sohane
- Bihar Agricultural University (BAU), Sabour, India
| | - R K Malik
- International Maize and Wheat Improvement Center (CIMMYT), National Agricultural Science Complex (NASC), New Delhi, India
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Singh AK. Sojourn of Gemigliptin: A Hidden Gem? Clinical Diabetology 2022. [DOI: 10.5603/dk.a2022.0027] [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: 11/25/2022] Open
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Singh AK, Singh R. Metabolic and cardiovascular benefits with combination therapy of SGLT-2 inhibitors and GLP-1 receptor agonists in type 2 diabetes. World J Cardiol 2022; 14:329-342. [PMID: 35979179 PMCID: PMC9258221 DOI: 10.4330/wjc.v14.i6.329] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 12/26/2021] [Revised: 03/17/2022] [Accepted: 05/23/2022] [Indexed: 02/06/2023] Open
Abstract
Both GLP-1 receptor agonists (GLP-1RA) and SGLT-2 inhibitors (SGLT-2I) are newer classes of anti-diabetic agents that lower HbA1c moderately and decrease body weight and systolic blood pressure (SBP) modestly. Combination therapy with GLP-1RA plus SGLT-2I have shown a greater reduction in HbA1c, body weight, and SBP compared to either agent alone without any significant increase in hypoglycemia or other side effects. Since several agents from each class of these drugs have shown an improvement in cardiovascular (CV) and renal outcomes in their respective cardiovascular outcome trials (CVOT), combination therapy is theoretically expected to have additional CV and renal benefits. In this comprehensive opinion review, we found HbA1c lowering with GLP-1RA plus SGLT-2I to be less than additive compared to the sum of HbA1c lowering with either agent alone, although body weight lowering was nearly additive and the SBP lowering was more than additive. Our additional meta-analysis of CV outcomes with GLP-1RA plus SGLT-2I combination therapy from the pooled data of five CVOT found a similar reduction in three-point major adverse cardiovascular events compared to GLP-1RA or SGLT-2I alone, against placebo. Interestingly, a greater benefit in reduction of heart failure hospitalization with GLP-1RA plus SGLT-2I combination therapy was noted in the pooled meta-analysis of two randomized controlled trials. Future adequately powered trials can confirm whether additional CV or renal benefit is truly exerted by GLP-1RA plus SGLT-2I combination therapy.
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Affiliation(s)
- Awadhesh Kumar Singh
- Department of Diabetes and Endocrinology, G.D Hospital and Diabetes Institute, Kolkata 700013, India
| | - Ritu Singh
- Department of Reproductive Endocrinology, G.D Hospital and Diabetes Institute, Kolkata 700013, India
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Ravikiran KT, Gopala Krishnan S, Abhijith KP, Bollinedi H, Nagarajan M, Vinod KK, Bhowmick PK, Pal M, Ellur RK, Singh AK. Genome-Wide Association Mapping Reveals Novel Putative Gene Candidates Governing Reproductive Stage Heat Stress Tolerance in Rice. Front Genet 2022; 13:876522. [PMID: 35734422 PMCID: PMC9208292 DOI: 10.3389/fgene.2022.876522] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 03/25/2022] [Indexed: 11/14/2022] Open
Abstract
Temperature rise predicted for the future will severely affect rice productivity because the crop is highly sensitive to heat stress at the reproductive stage. Breeding tolerant varieties is an economically viable option to combat heat stress, for which the knowledge of target genomic regions associated with the reproductive stage heat stress tolerance (RSHT) is essential. A set of 192 rice genotypes of diverse origins were evaluated under natural field conditions through staggered sowings for RSHT using two surrogate traits, spikelet fertility and grain yield, which showed significant reduction under heat stress. These genotypes were genotyped using a 50 k SNP array, and the association analysis identified 10 quantitative trait nucleotides (QTNs) for grain yield, of which one QTN (qHTGY8.1) was consistent across the different models used. Only two out of 10 MTAs coincided with the previously reported QTLs, making the remaing eight novel. A total of 22 QTNs were observed for spikelet fertility, among which qHTSF5.1 was consistently found across three models. Of the QTNs identified, seven coincided with previous reports, while the remaining QTNs were new. The genes near the QTNs were found associated with the protein–protein interaction, protein ubiquitination, stress signal transduction, and so forth, qualifying them to be putative for RSHT. An in silico expression analysis revealed the predominant expression of genes identified for spikelet fertility in reproductive organs. Further validation of the biological relevance of QTNs in conferring heat stress tolerance will enable their utilization in improving the reproductive stage heat stress tolerance in rice.
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Affiliation(s)
- K T Ravikiran
- Division of Genetics, ICAR-Indian Agricultural Research Institute, New Delhi, India
| | - S Gopala Krishnan
- Division of Genetics, ICAR-Indian Agricultural Research Institute, New Delhi, India
| | - K P Abhijith
- Division of Genetics, ICAR-Indian Agricultural Research Institute, New Delhi, India
| | - H Bollinedi
- Division of Genetics, ICAR-Indian Agricultural Research Institute, New Delhi, India
| | - M Nagarajan
- Rice Breeding and Genetics Research Centre, ICAR-IARI, Aduthurai, India
| | - K K Vinod
- Division of Genetics, ICAR-Indian Agricultural Research Institute, New Delhi, India
| | - P K Bhowmick
- Division of Genetics, ICAR-Indian Agricultural Research Institute, New Delhi, India
| | - Madan Pal
- Division of Plant Physiology, ICAR-Indian Agricultural Research Institute, New Delhi, India
| | - R K Ellur
- Division of Genetics, ICAR-Indian Agricultural Research Institute, New Delhi, India
| | - A K Singh
- Division of Genetics, ICAR-Indian Agricultural Research Institute, New Delhi, India
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VK A, Vairat AD, Minz PS, Singh AK, Chitranayak M, Juneja AK, Jayswal D. Whey removal characteristics during conventional production of chhana. Indian J Dairy Sci 2022. [DOI: 10.33785/ijds.2022.v75i03.002] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Whey removal phenomena generally studied in terms of whey removal rate, chhana weight and moisture content during chhana production process. Despite all these above factors, moisture content concerned to be the important one to maintain its soft texture and suitability for manufacturing of diversified products. The present study was undertaken to identify best model to express whey draining process so as to predict the relevant characteristics such as moisture ratio, moisture content and moisture removal rate. Whey removal rate was pursued for different cow milk quantities (5, 10, 15 and 20 kg) using delayed straining technique for gravimetric removal of whey from the chhana mass. Among the mathematical models, Logarithmic model was found best in describing the whey draining characteristics and predicting the moisture ratio of chhana. Whey removal characteristics provides important insights for the development of equipments for chhana production, downstream processing equipments for whey and online sensors for monitoring the process that regulates the moisture content and final quality of chhana and chhana based products. The novelty of the work lied on the incorporation of mathematical modeling to the chhana production process.
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Singh AK, Singh R. Relook at DPP-4 inhibitors in the era of SGLT-2 inhibitors. World J Diabetes 2022; 13:466-470. [PMID: 35800411 PMCID: PMC9210541 DOI: 10.4239/wjd.v13.i6.466] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 04/19/2022] [Accepted: 05/23/2022] [Indexed: 02/06/2023] Open
Abstract
SGLT-2 inhibitors (SGLT-2Is) have significantly improved cardio-renal outcomes and are preferred agents in people with cardiovascular diseases, heart failure, and diabetic kidney disease. Similarly, GLP-1 receptor agonists (GLP-1RAs) have significantly improved atherosclerotic cardiovascular outcomes. To this end, DPP-4 inhibitors (DPP-4Is) are cardiac-neutral drugs. While long-acting GLP-1RAs have shown a favorable HbA1c lowering compared to DPP-4Is, there is no clinically meaningful HbA1c lowering difference between SGLT-2Is vs DPP-4Is. Moreover, the glucose-lowering potential of SGLT-2Is gets compromised with a progressive decline in renal functions, unlike DPP-4Is. Furthermore, the HbA1c lowering potential of DPP-4Is is favorable in people with T2DM having a modest baseline HbA1c (8.0%-8.5%) compared with SGLT-2Is which lowers HbA1c larger in a background of higher baseline HbA1c (> 8.5%-9.0%). These findings suggest that the role of DPP-4Is in the management of type 2 diabetes mellitus cannot be completely ignored even in the era of SGLT-2Is.
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Affiliation(s)
- Awadhesh Kumar Singh
- Department of Diabetes & Endocrinology, G.D Hospital & Diabetes Institute, Kolkata 700013, West Bengal, India
| | - Ritu Singh
- Department of Diabetes & Endocrinology, G.D Hospital & Diabetes Institute, Kolkata 700013, West Bengal, India
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50
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Jena B, Bajish CC, Turner J, Ravichandran M, Kshitija S, Anilkumar N, Singh AK, Pradhan PK, Ray Y, Saini S. Mechanisms associated with the rapid decline in sea ice cover around a stranded ship in the Lazarev Sea, Antarctica. Sci Total Environ 2022; 821:153379. [PMID: 35085627 DOI: 10.1016/j.scitotenv.2022.153379] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 01/07/2022] [Accepted: 01/20/2022] [Indexed: 06/14/2023]
Abstract
In the satellite data era starting from 1979, the extent of Antarctic sea ice increased moderately for the first 37 years. However, the extent decreased to record low levels from 2016 to 2020, with the drop being greatest in the Weddell and Lazarev Seas of the Southern Ocean. An important question for the scientific fraternity and policymakers is to understand what ocean-atmospheric processes triggered such a rapid decline in sea ice. We employ in-situ, satellite, and atmospheric reanalysis data to examine the causative mechanism of anomalous sea ice variability in the Lazarev Sea at a time of ice growth in the annual cycle (March-April 2019), when a cargo ship was stuck in extensive ice cover and freed following the unusual decline in sea ice. High-resolution Sentinel-1 synthetic aperture radar captured a distinct view of the ship location and track within extensive ice cover of fast sea ice, dense pack ice, and icebergs in the Lazarev Sea on 27 March 2019. Subsequently, the sea ice cover declined and reached the fourth lowest extent in the entire satellite record during April 2019 which was 25.6% lower than the long-term mean value of 2.65 × 106 km2. We show that the anomalous sea ice variability was due to the occurrence of eastward-moving polar cyclones, including a quasi-stationary explosive development that impacted sea ice through extreme changes in ocean-atmospheric conditions. The cyclone-induced dynamic (poleward propagation of ocean waves and ice motion) and thermodynamic (heat and moisture plumes from midlatitudes, ocean mixed layer warming) processes coupled with high tides provided a conducive environment for an exceptional decline in sea ice over the region of ship movement.
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Affiliation(s)
- B Jena
- National Centre for Polar and Ocean Research, Ministry of Earth Sciences, Government of India, Vasco-da-Gama, India.
| | - C C Bajish
- National Centre for Polar and Ocean Research, Ministry of Earth Sciences, Government of India, Vasco-da-Gama, India
| | - J Turner
- British Antarctic Survey, Natural Environment Research Council, Cambridge, UK
| | - M Ravichandran
- National Centre for Polar and Ocean Research, Ministry of Earth Sciences, Government of India, Vasco-da-Gama, India
| | - S Kshitija
- National Centre for Polar and Ocean Research, Ministry of Earth Sciences, Government of India, Vasco-da-Gama, India
| | - N Anilkumar
- National Centre for Polar and Ocean Research, Ministry of Earth Sciences, Government of India, Vasco-da-Gama, India
| | - A K Singh
- National Centre for Polar and Ocean Research, Ministry of Earth Sciences, Government of India, Vasco-da-Gama, India
| | - P K Pradhan
- Department of Physics, Sri Venkateswara University, Tirupati, India
| | - Y Ray
- National Centre for Polar and Ocean Research, Ministry of Earth Sciences, Government of India, Vasco-da-Gama, India
| | - S Saini
- National Centre for Polar and Ocean Research, Ministry of Earth Sciences, Government of India, Vasco-da-Gama, India
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