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Padiyar S, Danda D, Goel R, Joseph E, Nair AM, Joseph G, Antonisamy B. Clinical and angiographic outcomes of mycophenolate versus methotrexate in South Asian patients of Takayasu arteritis: Results from an open-label, outcome-assessor blinded randomized controlled trial. Mod Rheumatol 2023; 34:175-181. [PMID: 36542822 DOI: 10.1093/mr/roac157] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 11/30/2022] [Accepted: 12/15/2022] [Indexed: 12/24/2023]
Abstract
OBJECTIVE To compare the clinical and angiographic responses of mycophenolate mofetil (MMF) versus methotrexate (MTX) in Takayasu arteritis (TAK). METHODS This was an open-label, outcome assessor-blinded trial. Adult patients with active TAK were randomized 1:1 to MMF 1 g twice daily or MTX 20 mg once weekly by a computer-generated program. All patients were started on 0.5 mg/kg of steroids with a predetermined tapering protocol. The primary outcome was the treatment response as defined by Indian Takayasu arteritis score at 9 months. The secondary end points included the time to first failure and angiographic progression. RESULTS A total of 52 patients (26 in each arm) were recruited. The rate of responders was 71.43% (15/21) in the MMF arm and 63.64% (14/22) in the MTX arm (P = .58). The median time to the first failure was 9 months (range: 3-9) and 4.5 months (range: 3-9) in the MMF and MTX arms, respectively (P = .052). In both groups, 15% of patients (n = 3) had a progressive disease in angiography. CONCLUSIONS The results showed numerically better outcomes favouring MMF, with a longer time to the first failure than MTX (9 months versus 4.5 months, P = .052). No significant difference was seen in the angiographic outcomes.
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Affiliation(s)
- Shivraj Padiyar
- Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India
| | - Debashish Danda
- Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India
| | - Ruchika Goel
- Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India
| | - Elizabeth Joseph
- Department of Radiology, Christian Medical College, Vellore, India
| | - Aswin M Nair
- Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India
| | - George Joseph
- Department of Cardiology, Christian Medical College, Vellore, India
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Antonisamy B, Shailesh H, Hani Y, Ahmed LHM, Noor S, Ahmed SY, Alfaki M, Muhayimana A, Jacob SS, Balayya SK, Soloviov O, Liu L, Mathew LS, Wang K, Tomei S, Al Massih A, Mathew R, Karim MY, Ramanjaneya M, Worgall S, Janahi IA. Sphingolipids in Childhood Asthma and Obesity (SOAP Study): A Protocol of a Cross-Sectional Study. Metabolites 2023; 13:1146. [PMID: 37999242 PMCID: PMC10673587 DOI: 10.3390/metabo13111146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 10/27/2023] [Accepted: 10/31/2023] [Indexed: 11/25/2023] Open
Abstract
Asthma and obesity are two of the most common chronic conditions in children and adolescents. There is increasing evidence that sphingolipid metabolism is altered in childhood asthma and is linked to airway hyperreactivity. Dysregulated sphingolipid metabolism is also reported in obesity. However, the functional link between sphingolipid metabolism, asthma, and obesity is not completely understood. This paper describes the protocol of an ongoing study on sphingolipids that aims to examine the pathophysiology of sphingolipids in childhood asthma and obesity. In addition, this study aims to explore the novel biomarkers through a comprehensive multi-omics approach including genomics, genome-wide DNA methylation, RNA-Seq, microRNA (miRNA) profiling, lipidomics, metabolomics, and cytokine profiling. This is a cross-sectional study aiming to recruit 440 children from different groups: children with asthma and normal weight (n = 100), asthma with overweight or obesity (n = 100), overweight or obesity (n = 100), normal weight (n = 70), and siblings of asthmatic children with normal weight, overweight, or obesity (n = 70). These participants will be recruited from the pediatric pulmonology, pediatric endocrinology, and general pediatric outpatient clinics at Sidra Medicine, Doha, Qatar. Information will be obtained from self-reported questionnaires on asthma, quality of life, food frequency (FFQ), and a 3-day food diary that are completed by the children and their parents. Clinical measurements will include anthropometry, blood pressure, biochemistry, bioelectrical impedance, and pulmonary function tests. Blood samples will be obtained for sphingolipid analysis, serine palmitoyltransferase (SPT) assay, whole-genome sequencing (WGS), genome-wide DNA methylation study, RNA-Seq, miRNA profiling, metabolomics, lipidomics, and cytokine analysis. Group comparisons of continuous outcome variables will be carried out by a one-way analysis of variance or the Kruskal-Wallis test using an appropriate pairwise multiple comparison test. The chi-squared test or a Fisher's exact test will be used to test the associations between categorical variables. Finally, multivariate analysis will be carried out to integrate the clinical data with multi-omics data. This study will help us to understand the role of dysregulated sphingolipid metabolism in obesity and asthma. In addition, the multi-omics data from the study will help to identify novel genetic and epigenetic signatures, inflammatory markers, and mechanistic pathways that link asthma and obesity in children. Furthermore, the integration of clinical and multi-omics data will help us to uncover the potential interactions between these diseases and to offer a new paradigm for the treatment of pediatric obesity-associated asthma.
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Affiliation(s)
- Belavendra Antonisamy
- Department of Pediatric Medicine, Sidra Medicine, Doha P.O. Box 26999, Qatar; (B.A.); (H.S.); (Y.H.); (L.H.M.A.); (S.N.); (S.Y.A.); (M.A.); (A.M.)
| | - Harshita Shailesh
- Department of Pediatric Medicine, Sidra Medicine, Doha P.O. Box 26999, Qatar; (B.A.); (H.S.); (Y.H.); (L.H.M.A.); (S.N.); (S.Y.A.); (M.A.); (A.M.)
| | - Yahya Hani
- Department of Pediatric Medicine, Sidra Medicine, Doha P.O. Box 26999, Qatar; (B.A.); (H.S.); (Y.H.); (L.H.M.A.); (S.N.); (S.Y.A.); (M.A.); (A.M.)
| | - Lina Hayati M. Ahmed
- Department of Pediatric Medicine, Sidra Medicine, Doha P.O. Box 26999, Qatar; (B.A.); (H.S.); (Y.H.); (L.H.M.A.); (S.N.); (S.Y.A.); (M.A.); (A.M.)
| | - Safa Noor
- Department of Pediatric Medicine, Sidra Medicine, Doha P.O. Box 26999, Qatar; (B.A.); (H.S.); (Y.H.); (L.H.M.A.); (S.N.); (S.Y.A.); (M.A.); (A.M.)
| | - Salma Yahya Ahmed
- Department of Pediatric Medicine, Sidra Medicine, Doha P.O. Box 26999, Qatar; (B.A.); (H.S.); (Y.H.); (L.H.M.A.); (S.N.); (S.Y.A.); (M.A.); (A.M.)
| | - Mohamed Alfaki
- Department of Pediatric Medicine, Sidra Medicine, Doha P.O. Box 26999, Qatar; (B.A.); (H.S.); (Y.H.); (L.H.M.A.); (S.N.); (S.Y.A.); (M.A.); (A.M.)
| | - Abidan Muhayimana
- Department of Pediatric Medicine, Sidra Medicine, Doha P.O. Box 26999, Qatar; (B.A.); (H.S.); (Y.H.); (L.H.M.A.); (S.N.); (S.Y.A.); (M.A.); (A.M.)
| | - Shana Sunny Jacob
- Analytical Chemistry Core, Advanced Diagnostic Core Facilities, Sidra Medicine, Doha P.O. Box 26999, Qatar; (S.S.J.); (S.K.B.)
| | - Saroja Kotegar Balayya
- Analytical Chemistry Core, Advanced Diagnostic Core Facilities, Sidra Medicine, Doha P.O. Box 26999, Qatar; (S.S.J.); (S.K.B.)
| | - Oleksandr Soloviov
- Clinical Genomics Laboratory, Integrated Genomics Services, Sidra Medicine, Doha P.O. Box 26999, Qatar; (O.S.); (L.L.); (L.S.M.); (K.W.)
| | - Li Liu
- Clinical Genomics Laboratory, Integrated Genomics Services, Sidra Medicine, Doha P.O. Box 26999, Qatar; (O.S.); (L.L.); (L.S.M.); (K.W.)
| | - Lisa Sara Mathew
- Clinical Genomics Laboratory, Integrated Genomics Services, Sidra Medicine, Doha P.O. Box 26999, Qatar; (O.S.); (L.L.); (L.S.M.); (K.W.)
| | - Kun Wang
- Clinical Genomics Laboratory, Integrated Genomics Services, Sidra Medicine, Doha P.O. Box 26999, Qatar; (O.S.); (L.L.); (L.S.M.); (K.W.)
| | - Sara Tomei
- Omics Core, Integrated Genomics Services, Sidra Medicine, Doha P.O. Box 26999, Qatar; (S.T.); (A.A.M.); (R.M.)
| | - Alia Al Massih
- Omics Core, Integrated Genomics Services, Sidra Medicine, Doha P.O. Box 26999, Qatar; (S.T.); (A.A.M.); (R.M.)
| | - Rebecca Mathew
- Omics Core, Integrated Genomics Services, Sidra Medicine, Doha P.O. Box 26999, Qatar; (S.T.); (A.A.M.); (R.M.)
| | - Mohammed Yousuf Karim
- Department of Pathology, Sidra Medicine, Doha P.O. Box 26999, Qatar;
- College of Medicine, Qatar University, Doha P.O. Box 2713, Qatar
| | - Manjunath Ramanjaneya
- Qatar Metabolic Institute, Hamad Medical Corporation, Doha P.O. Box 3050, Qatar;
- Translational Research Institute, Hamad Medical Corporation, Doha P.O. Box 3050, Qatar
| | - Stefan Worgall
- Department of Pediatrics, Weill Cornell Medicine, New York, NY 10021, USA;
| | - Ibrahim A. Janahi
- Department of Pediatric Medicine, Sidra Medicine, Doha P.O. Box 26999, Qatar; (B.A.); (H.S.); (Y.H.); (L.H.M.A.); (S.N.); (S.Y.A.); (M.A.); (A.M.)
- Department of Pediatrics, Weill Cornell Medicine-Qatar, Doha P.O. Box 24144, Qatar
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Vasan SK, Alex AG, Roy A, Gowri M, Sinha S, Suresh J, Philip RS, Kochumon J, Jaiswal N, Arulappan G, Ramakrishnan L, Sachdev HS, Tandon N, Thomas N, Jebasingh F, Osmond C, Karpe F, Bhargava SK, Antonisamy B, Prabhakaran D, Fall CH, Thomson VS. Echocardiography protocol and cardiometabolic phenotyping in Indian birth cohorts-the IndEcho study. Front Cardiovasc Med 2023; 10:1055454. [PMID: 37522075 PMCID: PMC10372793 DOI: 10.3389/fcvm.2023.1055454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 06/27/2023] [Indexed: 08/01/2023] Open
Abstract
Background Asian Indians are at higher risk of cardiometabolic disease compared to other ethnic groups, and the age of onset is typically younger. Cardiac structure and function are poorly characterized in this ethnic group. In this study, we describe image-acquisition methods and the reproducibility of measurements and detailed echocardiography characteristics in two large Indian population-based cohorts (the New Delhi and Vellore Birth Cohorts) from India. Methods The IndEcho study captured transthoracic echocardiographic measurements of cardiac structure and function from 2,322 men and women aged 43-50 years. M-mode measurements in the parasternal long axis (PLAX) and 2-dimensional (2D) short axis recordings at the mitral valve, mid-papillary and apical level were recorded. Apical 2D recordings of two- three- and four-chamber (2C, 3C and 4C) views and Doppler images (colour, pulsed and continuous) were recorded in cine-loop format. Left ventricular (LV) mass, LV hypertrophy, and indices of LV systolic and diastolic function were derived. Results Echocardiographic measurements showed good/excellent technical reproducibility. Hetero-geneity across sites, sex and rural/urban differences in cardiac structure and function were observed. Overall, this cohort of South Asian Indians had smaller LV mass and normal systolic and diastolic function when compared with published data on other Asian Indians and the West, (LV mass indexed for body surface area: Delhi men: 68 g/m2, women 63.9; Vellore men: 65.8, women 61.6) but were within ethnic-specific reference ranges. The higher prevalence of obesity, diabetes and hypertension is reflected by the higher proportion of LV remodelling and lesser hypertrophy. Conclusions Our study adds to scarce population-based echocardiographic data for mid-life Asian Indians. Compared to published literature on other ethnic groups, the Asian Indian heart is characterised by smaller cardiac dimensions and normal range systolic and diastolic function on a background of a high prevalence of hypertension, diabetes and cardiac disease at a relatively young age. This data will form the basis for further analyses of lifecourse, metabolic and body composition predictors of cardiac structure and function, and echocardiographic predictors of future mortality. ISRCTN registration number 13432279.
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Affiliation(s)
- Senthil K. Vasan
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
- Oxford Centre for Diabetes, Endocrinology and Metabolism, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | | | - Ambuj Roy
- Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India
- Centre for Chronic Disease Control, Gurgaon, India
| | - Mahasampath Gowri
- Department of Biostatistics, Christian Medical College, Vellore, India
| | - Sikha Sinha
- Department of Pediatrics, Sitaram Bhartia Institute of Science and Research Institute, New Delhi, India
| | - Jenifer Suresh
- Department of Cardiology, Christian Medical College, Vellore, India
| | | | | | | | | | - Lakshmy Ramakrishnan
- Department of Cardiac Biochemistry, All India Institute of Medical Sciences, New Delhi, India
| | - Harshpal Singh Sachdev
- Department of Pediatrics, Sitaram Bhartia Institute of Science and Research Institute, New Delhi, India
| | - Nikhil Tandon
- Department of Endocrinology, All India Institute of Medical Sciences, New Delhi, India
| | - Nihal Thomas
- Department of Endocrinology, Christian Medical College, Vellore, India
| | - Felix Jebasingh
- Department of Endocrinology, Christian Medical College, Vellore, India
| | - Clive Osmond
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
| | - Fredrik Karpe
- Oxford Centre for Diabetes, Endocrinology and Metabolism, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | | | | | - Dorairaj Prabhakaran
- Centre for Chronic Disease Control, Gurgaon, India
- Public Health Foundation of India, New Delhi, India
| | - Caroline H.D. Fall
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
| | - Viji S. Thomson
- Department of Cardiology, Christian Medical College, Vellore, India
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Chanda R, Singh S, Eapen A, David VG, Mukha RP, Pandian RM, Antonisamy B, Deborah MN, Eapen JJ, Thomas A, John EE, Yusuf S, Alexander S, Varughese S, Valson AT. Whole and cortical kidney volume predict 5-year post-nephrectomy eGFR in Indian living kidney donors. Nephrology (Carlton) 2023; 28:136-147. [PMID: 36342651 PMCID: PMC7615851 DOI: 10.1111/nep.14129] [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: 08/02/2022] [Revised: 09/24/2022] [Accepted: 11/02/2022] [Indexed: 11/09/2022]
Abstract
AIM To study the additional utility of pre-nephrectomy whole and cortical kidney volumes (WKV, CKV) in predicting long-term post-nephrectomy kidney function in Indian living kidney donors (LKDs). METHODS This retrospective cohort study included all LKDs who underwent nephrectomy between 1 January 2006 and 31 December 2015 at our centre, had pre-nephrectomy height, weight and computed tomography (CT) angiography with arterial and nephrographic phase documented, and 5-year post-nephrectomy creatinine values measured. Correlation between body surface area (BSA) adjusted pre-nephrectomy total CKV, WKV and pre-nephrectomy CKD EPI eGFR; BSA-adjusted remnant pre-nephrectomy CKV (rCKV), WKV (rWKV) and 5-year post-nephrectomy CKD EPI creatinine eGFR (5yeGFRCr ); predictors of 5yeGFRCr < 70% of pre-nephrectomy CKD EPI creatinine eGFR (pre-eGFRCr ), and an equation to predict 5yeGFRCr from pre-nephrectomy variables were calculated. RESULTS A total of 196 LKDs (74% female, mean age 41.7 ± 11.0 years) were included in the study. Total WKV showed higher correlation with pre-nephrectomy eGFR than CKV, the highest with CKD EPI cystatin eGFR. Remnant WKV showed higher correlation than rCKV with post-nephrectomy eGFRCr and this increased over time. Older age, lower rWKV or rCKV, higher BSA, and higher pre-eGFRCr identified LKDs with 5yeGFRCr < 70% of pre-eGFRCr , with rCKV identifying a higher proportion (4.5%) of such LKDs. A model including rWKV or rCKV predicted 5yeGFRCr better than one including age, gender, BSA and pre-eGFRCr alone. CONCLUSION Inclusion of pre-nephrectomy remnant CKV and WKV into models for 5yeGFRCr and sub-optimal post-nephrectomy adaptation in Indian LKDs improves their accuracy. CKD EPI cystatin eGFR correlates better with functional renal mass.
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Affiliation(s)
- Reettika Chanda
- Department of Radiodiagnosis, Christian Medical College, Vellore, Tamil Nadu, India
| | - Shweta Singh
- Department of Radiodiagnosis, Christian Medical College, Vellore, Tamil Nadu, India
| | - Anu Eapen
- Department of Radiodiagnosis, Christian Medical College, Vellore, Tamil Nadu, India
| | - Vinoi George David
- Department of Nephrology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Rajiv Paul Mukha
- Department of Urology, Christian Medical College, Vellore, Tamil Nadu, India
| | | | | | | | - Jeethu Joseph Eapen
- Department of Nephrology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Athul Thomas
- Department of Nephrology, Christian Medical College, Vellore, Tamil Nadu, India
| | | | - Sabina Yusuf
- Department of Nephrology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Suceena Alexander
- Department of Nephrology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Santosh Varughese
- Department of Nephrology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Anna T. Valson
- Department of Nephrology, Christian Medical College, Vellore, Tamil Nadu, India
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Kamath MS, Subramanian V, Antonisamy B, Sunkara SK. Endometriosis and oocyte quality: an analysis of 13 614 donor oocyte recipient and autologous IVF cycles. Hum Reprod Open 2022; 2022:hoac025. [PMID: 35747401 PMCID: PMC9211016 DOI: 10.1093/hropen/hoac025] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 05/31/2022] [Indexed: 11/30/2022] Open
Abstract
STUDY QUESTION Does endometriosis affect live birth following donor oocyte recipient versus autologous IVF? SUMMARY ANSWER There was no significant difference in the live birth rate (LBR) in women with endometriosis undergoing donor oocyte recipient cycles versus autologous IVF cycles. WHAT IS KNOWN ALREADY For infertile women with endometriosis, IVF is often considered as a treatment option. Lower implantation and pregnancy rates have been observed following IVF in women with endometriosis. It has been debated whether the lower pregnancy rate is due to the effect on oocyte quality or the endometrium, thus affecting implantation. To delineate whether endometriosis affects oocyte quality or the endometrium, we planned a study, using a donor oocyte recipient model, where the recipients were women diagnosed with endometriosis and compared their outcomes with women who underwent autologous IVF, who had also been diagnosed with endometriosis. STUDY DESIGN, SIZE, DURATION Human Fertilization and Embryology Authority (HFEA) anonymized data from 1996 to 2016 were analyzed. This comprised of a total of 758 donor oocyte recipients, where the recipients were women diagnosed with endometriosis, and 12 856 autologous IVF cycles where the women were diagnosed with endometriosis as the sole cause of infertility. PARTICIPANTS/MATERIALS, SETTING, METHODS Data on all women with endometriosis undergoing donor oocyte recipient and autologous IVF cycles were analyzed to compare live birth outcomes. Logistic regression analysis was performed adjusting for number of previous IVF cycles, previous live birth, period of treatment, day of embryo transfer, number of embryos transferred and fresh or frozen embryo transfer cycle. MAIN RESULTS AND THE ROLE OF CHANCE There was no significant difference in the LBR in women with endometriosis undergoing donor oocyte recipient fresh embryo transfer cycles compared to women undergoing autologous IVF fresh embryo transfer cycles (31.6% vs 31.0%; odds ratio (OR) 1.03, 99.5% CI 0.79–1.35). After adjusting for confounders, there was no significant difference in LBR in women with endometriosis undergoing donor oocyte recipient fresh embryo transfer cycles versus autologous fresh embryo transfer cycles (adjusted OR (aOR) 1.05, 99.5% CI 0.79–1.41). There was no significant difference in the LBR in women with endometriosis undergoing donor oocyte recipient frozen embryo transfer cycles compared to women undergoing autologous frozen embryo transfer cycles (19.6% vs 24.0%; OR 0.77, 99.5% CI 0.47–1.25). After adjusting for potential confounders, there was no significant difference in the LBR in women undergoing donor oocyte recipient frozen embryo transfer cycles compared with autologous frozen embryo transfer cycles (aOR 0.85, 99.5% CI 0.51–1.41). LIMITATIONS, REASONS FOR CAUTION Although the analysis was adjusted for potential confounders, there was no information on the extent and classification of endometriosis as well as oocyte number. Furthermore, adenomyosis is thought to co-exist in women with endometriosis and may have independent pathophysiological mechanisms affecting fertility, for which there was no information. WIDER IMPLICATIONS OF THE FINDINGS The study shows no difference in LBR between donor oocyte recipient cycles in which all recipients had endometriosis compared to autologous IVF cycles in women with endometriosis. Therefore, this study finding suggests that there may be a minimal or no effect of oocyte quality on IVF outcomes in women with endometriosis. STUDY FUNDING/COMPETING INTEREST(S) No funding was obtained. M.S.K. is an associate editor with Human Reproduction Open. He was not involved in the editorial or peer review process for the manuscript. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
| | - Venkatesh Subramanian
- Division of Women's Health, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | | | - Sesh Kamal Sunkara
- Division of Women's Health, Faculty of Life Sciences and Medicine, King's College London, London, UK
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Nandeibam Y, Joseph T, Antonisamy B, Kamath MS, Kunjummen AT. Effectiveness of music therapy as an adjuvant to conscious sedation in women undergoing transvaginal oocyte retrieval: A randomized controlled trial. J Obstet Gynaecol Res 2022; 48:1409-1417. [PMID: 35316858 DOI: 10.1111/jog.15216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 02/23/2022] [Accepted: 02/26/2022] [Indexed: 11/29/2022]
Abstract
AIM Assisted reproductive technique (ART) has emerged as the highest form of treatment for infertile couples. Transvaginal oocyte retrieval is currently performed under conscious sedation in most centers. Since it is a relatively painful procedure, a number of adjuvant therapies have been tried to improve pain relief during the procedure. Music therapy is a nonpharmacological technique that has been successfully used for pain relief in perioperative and chronic pain of malignancy. However, studies evaluating its usefulness in ART-related procedures are limited. We evaluated the effectiveness of music therapy as an adjuvant for pain relief during oocyte retrieval. METHODS This was a randomized controlled trial conducted at a tertiary level teaching hospital in South India from September 2020 to March 2021. All women undergoing transvaginal oocyte retrieval were randomized to receive either music therapy along with conscious sedation (Group A) or conscious sedation alone (Group B). The primary outcome was postprocedure pain score assessed by the visual analog scale. Secondary outcomes included anxiety score. RESULTS A total of 109 women were randomized into Group A (54 women) and Group B (55 women). The postprocedure pain score was comparable between the two study groups (6.0, interquartile range [IQR] 4 to 6 vs. 6.0, IQR 4 to 6; p = 0.69). However, anxiety levels were found to be significantly lower in women who were offered music therapy (3.0, IQR 1 to 5 vs. 4.0, IQR 3 to 6; p = 0.004). CONCLUSION The use of music therapy as an adjuvant to conscious sedation was found to have no significant benefit in pain relief during oocyte retrieval.
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Affiliation(s)
- Yohen Nandeibam
- Department of Reproductive Medicine and Surgery, Christian Medical College, Vellore, India
| | - Treasa Joseph
- Department of Reproductive Medicine and Surgery, Christian Medical College, Vellore, India
| | | | - Mohan S Kamath
- Department of Reproductive Medicine and Surgery, Christian Medical College, Vellore, India
| | - Aleyamma T Kunjummen
- Department of Reproductive Medicine and Surgery, Christian Medical College, Vellore, India
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Karuppusami R, Antonisamy B, Premkumar PS. Functional principal component analysis for identifying the child growth pattern using longitudinal birth cohort data. BMC Med Res Methodol 2022; 22:76. [PMID: 35313828 PMCID: PMC8935724 DOI: 10.1186/s12874-022-01566-0] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 02/25/2022] [Indexed: 12/02/2022] Open
Abstract
Background Longitudinal studies are important to understand patterns of growth in children and limited in India. It is important to identify an approach for characterising growth trajectories to distinguish between children who have healthy growth and those growth is poor. Many statistical approaches are available to assess the longitudinal growth data and which are difficult to recognize the pattern. In this research study, we employed functional principal component analysis (FPCA) as a statistical method to find the pattern of growth data. The purpose of this study is to describe the longitudinal child growth trajectory pattern under 3 years of age using functional principal component method. Methods Children born between March 2002 and August 2003 (n = 290) were followed until their third birthday in three neighbouring slums in Vellore, South India. Field workers visited homes to collect details of morbidity twice a week. Height and weight were measured monthly from 1 month of age in a study-run clinic. Longitudinal child growth trajectory pattern were extracted using Functional Principal Component analysis using B-spline basis functions with smoothing parameters. Functional linear model was used to assess the factors association with the growth functions. Results We have obtained four FPCs explained by 86.5, 3.9, 3.1 and 2.2% of the variation respectively for the height functions. For height, 38% of the children’s had poor growth trajectories. Similarly, three FPCs explained 76.2, 8.8, and 4.7% respectively for the weight functions and 44% of the children’s had poor growth in their weight trajectories. Results show that gender, socio-economic status, parent’s education, breast feeding, and gravida are associated and, influence the growth pattern in children. Conclusions The FPC approach deals with subjects’ dynamics of growth and not with specific values at given times. FPC could be a better alternate approach for both dimension reduction and pattern detection. FPC may be used to offer greater insight for classification. Supplementary Information The online version contains supplementary material available at 10.1186/s12874-022-01566-0.
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Affiliation(s)
- Reka Karuppusami
- Department of Biostatistics, Christian Medical College, Vellore, 632002, India
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Joseph LL, Boddu D, Srinivasan HN, Regi SS, Antonisamy B, John R, Mathew LG, Totadri S. Postchemotherapy tumor volume as a prognostic indicator in Wilms tumor: A single-center experience from South India. Pediatr Blood Cancer 2022; 69:e29454. [PMID: 34811921 DOI: 10.1002/pbc.29454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 10/17/2021] [Accepted: 10/25/2021] [Indexed: 11/06/2022]
Abstract
BACKGROUND Optimal risk stratification is the key to minimizing relapse and toxicity in children with Wilms tumor (WT). The study evaluated poor tumor volume response to chemotherapy as a risk factor that predicts relapse. PROCEDURE Children with WT who were treated between 2005 and 2020 at the center were analyzed. Tumor volumes at the time of diagnosis and after preoperative chemotherapy were calculated from cross-sectional imaging. The International Society of Paediatric Oncology (SIOP)-WT-2001 protocol was used for treatment. The area under a receiver operating characteristic curve was estimated to ascertain the ability of tumor volume to predict relapse. RESULTS Ninety-five patients with a median age of 40 months were included. A postchemotherapy tumor volume cutoff of 270 ml was ascertained to have the best predictive value for relapse. Patients with a tumor volume of <270 ml following preoperative chemotherapy had a better 3-year event-free survival (EFS) than those with a tumor volume of ≥270 ml (89.8% ± 4.0% vs. 57.4% ± 12.5%, p = .001). The data demonstrated that a tumor volume of ≥270 ml after chemotherapy was associated with an increased risk of relapse (hazard ratio [HR]: 5.3, p = .006). The EFS in patients with an epithelial or stromal type of histopathology was not affected by the tumor volume response (p = .437). Conversely, patients with other types of intermediate-risk histopathology who had a poor tumor volume response had an inferior survival (3-year EFS 51.4% ± 18.7%, p = .001). CONCLUSION A postchemotherapy tumor volume cutoff of ≥270 ml emerged as a strong predictor of relapse in a low- and middle-income country (LMIC) center study of WT treated with the SIOP protocol.
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Affiliation(s)
| | - Deepthi Boddu
- Paediatric Haematology-Oncology unit, Department of Paediatrics
| | | | | | | | - Rikki John
- Paediatric Haematology-Oncology unit, Department of Paediatrics
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Gowri S M, Antonisamy B, Geethanjali FS, Thomas N, Jebasingh F, Paul TV, Karpe F, Osmond C, Fall CHD, Vasan SK. Distinct opposing associations of upper and lower body fat depots with metabolic and cardiovascular disease risk markers. Int J Obes (Lond) 2021; 45:2490-2498. [PMID: 34331002 DOI: 10.1038/s41366-021-00923-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 07/03/2021] [Accepted: 07/21/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND To examine the associations of total and regional adiposity with metabolic and cardiovascular disease (CVD) risk markers. METHODS This cross-sectional study included 1080 (53.8% men, aged 39-44 years) individuals from South India. Anthropometry (height, weight, waist and hip circumference), body composition assessment using dual-energy X-ray absorptiometry (DXA), blood pressure (BP), and plasma glucose, insulin and lipids were measured. Regression analysis was used to examine associations of standardized fat measurements with type 2 diabetes (T2D), insulin resistance (IR), hypertension and hypertriglyceridemia and continuous measurements of BP, glucose, insulin, HOMA-IR and lipids. Contour plots were constructed to visualize the differential effect of upper and lower fat depots. RESULTS DXA-measured fat depots were positively associated with metabolic and CVD risk markers. After adjusting for fat mass index, upper body fat remained positively, while lower body fat was negatively associated with risk markers. A one standard deviation (SD) increase in android fat showed higher odds ratios (ORs) for T2D (6.59; 95% CI 3.17, 13.70), IR (4.68; 95% CI 2.31, 9.50), hypertension (2.57; 95% CI 1.56, 4.25) and hypertriglyceridemia (6.39; 95% CI 3.46, 11.90) in men. A 1 SD increase in leg fat showed a protective effect with ORs for T2D (0.42; 95% CI 0.24, 0.74), IR (0.31; 95% CI 0.17, 0.57) and hypertriglyceridemia (0.61; 95% CI 0.38, 0.98). The magnitude of the effect was greater with DXA-measured fat compared with anthropometry. CONCLUSION At any level of total body fat, upper and lower body fat depots demonstrate opposite risk associations with metabolic and CVD risk markers in Asian Indians.
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Affiliation(s)
| | | | | | - Nihal Thomas
- Department of Endocrinology, Diabetes and Metabolism, Christian Medical College, Vellore, India
| | - Felix Jebasingh
- Department of Endocrinology, Diabetes and Metabolism, Christian Medical College, Vellore, India
| | - Thomas V Paul
- Department of Endocrinology, Diabetes and Metabolism, Christian Medical College, Vellore, India
| | - Fredrik Karpe
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Churchill Hospital, Oxford, UK
- NIHR Oxford Biomedical Research Centre, OUH Foundation Trust, Oxford, UK
| | - Clive Osmond
- MRC Environmental Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton, UK
| | - Caroline H D Fall
- MRC Environmental Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton, UK
| | - Senthil K Vasan
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Churchill Hospital, Oxford, UK.
- MRC Environmental Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton, UK.
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George R, Chandy VJ, Christudoss AI, Hariharan TD, ArunShankar A, Antonisamy B, Oommen AT, Poonnoose PM. Peri-operative Morbidity Associated with Bilateral Hip Arthroplasty for Inflammatory Arthritis: Results from a Consecutive Series of 168 Hips. Indian J Orthop 2021; 55:1232-1239. [PMID: 34824724 PMCID: PMC8586095 DOI: 10.1007/s43465-021-00474-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 07/31/2021] [Indexed: 02/04/2023]
Abstract
AIM This study aims to assess the risks and peri-operative morbidity associated with a single-stage sequential bilateral hip arthroplasty (SBHA) when performed in patients with arthritis secondary to inflammatory arthropathy. METHODS Data of patients who underwent SBHA between 2012 and 2018 for inflammatory arthritis were extracted from a database, for peri-operative complications and functional improvement. SBHA for other causes was excluded. RESULTS Data of 84 consecutive patients with a mean age of 34.5 years were analyzed. The mean follow-up was 2.4 years. 66% had ankylosing spondylitis, while 14% had rheumatoid arthritis. 50% of the patients had bilateral fusion of the hips, and 34% had flexion deformity > 30°.None of the patients had peri-operative cardiac or pulmonary complications. 2.4% had per-operative hypotension (MAP < 50 mmHg) and 1.2% had desaturation (SpO2 < 90%). The mean drop in hematocrit was 9.3%. While 31% did not require blood transfusion, 35% required more than 1 unit of blood. Patients with pre-operative PCV of > 36% had a significantly lower risk of being transfused > 1 unit of blood (p = 0.02). ICU admission was 6%-mostly for post-operative monitoring. While one patient had a local hematoma that needed a wash-out, there were no infections, dislocations, or mortality in these patients. The modified Harris hip score improved from a mean of 26.5-85. The mean hip flexion improved post-operatively from 32° to 92°. CONCLUSIONS SBHA for inflammatory arthritis can be performed with minimum complications in a multidisciplinary setting. Pre-operatively, PCV of > 36 is advised to reduce transfusion rates.
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Affiliation(s)
- Rahul George
- Department of Orthopaedics, Christian Medical College, Vellore, Tamil Nadu 632004 India
| | - V. J. Chandy
- Department of Orthopaedics, Christian Medical College, Vellore, Tamil Nadu 632004 India
| | - A. I. Christudoss
- Department of Orthopaedics, Christian Medical College, Vellore, Tamil Nadu 632004 India
| | - T. D. Hariharan
- Department of Orthopaedics, Christian Medical College, Vellore, Tamil Nadu 632004 India
| | - A. ArunShankar
- Department of Orthopaedics, Christian Medical College, Vellore, Tamil Nadu 632004 India
| | - B. Antonisamy
- Department of Biostatistics, Christian Medical College, Vellore, Tamil Nadu 632002 India
| | - A. T. Oommen
- Department of Orthopaedics, Christian Medical College, Vellore, Tamil Nadu 632004 India
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Kamath MS, Antonisamy B, Sunkara SK. P-295 Does endometriosis affect oocyte quality? An analysis of 13 627 donor oocyte recipient and autologous IVF cycles. Hum Reprod 2021. [DOI: 10.1093/humrep/deab127.073] [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: 11/12/2022] Open
Abstract
Abstract
Study question
Does endometriosis affect live birth following donor oocyte recipient versus autologous in vitro fertilisation (IVF) cycle.
Summary answer
There was no significant difference in the live birth rate (LBR) in women with endometriosis undergoing donor oocyte recipient versus autologous IVF cycle.
What is known already
For infertile women with endometriosis, IVF is often considered as a treatment option. Lower implantation and pregnancy rates have been observed following IVF in women with endometriosis when compared to tubal factor infertility. It has been debated that lower pregnancy rates following IVF in endometriosis is due to both oocyte quality and the endometrium. To delineate whether endometriosis affects oocyte quality or the endometrium, we planned a study using donor oocyte recipient model where the recipient were women with endometriosis. We compared the LBR after oocyte recipient cycle with autologous IVF in women with endometriosis
Study design, size, duration
We obtained anonymised dataset of all the IVF cycles performed in the UK since 19991 from the Human Fertilization and Embryology Authority (HFEA). Data from 1996 to 2016 comprising a total of 13 627 donor oocyte recipient and autologous IVF cycles with endometriosis and no other cause of infertility were analysed.
Participants/materials, setting, methods
Data on all women with endometriosis undergoing fresh or frozen IVF treatment cycles were analysed to compare the LBR between donor oocyte recipient and autologous treatment cycles. Logistic regression analysis was performed adjusting for number of previous IVF cycles, previous live birth, period of treatment, day of embryo transfer, number of embryo transferred, fresh and frozen cycle.
Main results and the role of chance
There was no significant difference in the LBR in women with endometriosis undergoing donor oocyte recipient fresh cycles compared to women undergoing fresh autologous IVF cycles (31.6% vs. 31.0%; odds ratio, OR 1.03, 99% CI 0.79 – 1.35). After adjusting for confounders listed above, there was no significant difference in LBR in women undergoing donor oocyte recipient fresh cycles versus fresh autologous ART cycles (aOR 1.06, 99% CI 0.79 – 1.42).
There was no significant difference in the LBR in women with endometriosis undergoing frozen donor oocyte recipient cycles compared to women undergoing autologous frozen embryo transfer cycles (19.6% vs. 24.0%; OR 0.77, 99% CI 0.47 - 1.25). After adjusting for potential confounders, there was no significant difference in the LBR in women undergoing frozen donor oocyte recipient cycles compared with autologous frozen embryo transfer cycles (aOR 0.84, 99% CI 0.50 - 1.41).
Limitations, reasons for caution
Although the analysis was adjusted for several potential confounders, there was no information on classification of endometriosis to allow adjustment.
Wider implications of the findings
The current study design does not indicate endometriosis has an impact on oocyte quality given that the outcomes in donor oocyte recipient cycles are comparable with autologous IVF cycles. These findings need to be further studied and validated.
Trial registration number
Not applicable
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Affiliation(s)
- M S Kamath
- Christian Medical College and Hospital, Department of Reproductive Medicine, Vellore, India
| | - B Antonisamy
- Christian Medical College- Vellore, Department of Biostatistics, Vellore, India
| | - S K Sunkara
- King’s College London, Division of Women’s Health- Faculty of Life Sciences and Medicine, London, United Kingdom
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Kamath MS, Antonisamy B, Sunkara SK. P–295 Does endometriosis affect oocyte quality? An analysis of 13 627 donor oocyte recipient and autologous IVF cycles. Hum Reprod 2021. [DOI: 10.1093/humrep/deab130.294] [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: 11/14/2022] Open
Abstract
Abstract
Study question
Does endometriosis affect live birth following donor oocyte recipient versus autologous in vitro fertilisation (IVF) cycle.
Summary answer
There was no significant difference in the live birth rate (LBR) in women with endometriosis undergoing donor oocyte recipient versus autologous IVF cycle.
What is known already
For infertile women with endometriosis, IVF is often considered as a treatment option. Lower implantation and pregnancy rates have been observed following IVF in women with endometriosis when compared to tubal factor infertility. It has been debated that lower pregnancy rates following IVF in endometriosis is due to both oocyte quality and the endometrium. To delineate whether endometriosis affects oocyte quality or the endometrium, we planned a study using donor oocyte recipient model where the recipient were women with endometriosis. We compared the LBR after oocyte recipient cycle with autologous IVF in women with endometriosis
Study design, size, duration
We obtained anonymised dataset of all the IVF cycles performed in the UK since 19991 from the Human Fertilization and Embryology Authority (HFEA). Data from 1996 to 2016 comprising a total of 13 627 donor oocyte recipient and autologous IVF cycles with endometriosis and no other cause of infertility were analysed.
Participants/materials, setting, methods
Data on all women with endometriosis undergoing fresh or frozen IVF treatment cycles were analysed to compare the LBR between donor oocyte recipient and autologous treatment cycles. Logistic regression analysis was performed adjusting for number of previous IVF cycles, previous live birth, period of treatment, day of embryo transfer, number of embryo transferred, fresh and frozen cycle.
Main results and the role of chance
There was no significant difference in the LBR in women with endometriosis undergoing donor oocyte recipient fresh cycles compared to women undergoing fresh autologous IVF cycles (31.6% vs. 31.0%; odds ratio, OR 1.03, 99% CI 0.79 – 1.35). After adjusting for confounders listed above, there was no significant difference in LBR in women undergoing donor oocyte recipient fresh cycles versus fresh autologous ART cycles (aOR 1.06, 99% CI 0.79 – 1.42).
There was no significant difference in the LBR in women with endometriosis undergoing frozen donor oocyte recipient cycles compared to women undergoing autologous frozen embryo transfer cycles (19.6% vs. 24.0%; OR 0.77, 99% CI 0.47 - 1.25). After adjusting for potential confounders, there was no significant difference in the LBR in women undergoing frozen donor oocyte recipient cycles compared with autologous frozen embryo transfer cycles (aOR 0.84, 99% CI 0.50 - 1.41).
Limitations, reasons for caution
Although the analysis was adjusted for several potential confounders, there was no information on classification of endometriosis to allow adjustment.
Wider implications of the findings: The current study design does not indicate endometriosis has an impact on oocyte quality given that the outcomes in donor oocyte recipient cycles are comparable with autologous IVF cycles. These findings need to be further studied and validated.
Trial registration number
Not applicable
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Affiliation(s)
- M S Kamath
- Christian Medical College and Hospital, Department of Reproductive Medicine, Vellore, India
| | - B Antonisamy
- Christian Medical College- Vellore, Department of Biostatistics, Vellore, India
| | - S K Sunkara
- King’s College London, Division of Women’s Health- Faculty of Life Sciences and Medicine, London, United Kingdom
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Sunkara SK, Antonisamy B, Redla AC, Kamath MS. Female causes of infertility are associated with higher risk of preterm birth and low birth weight: analysis of 117 401 singleton live births following IVF. Hum Reprod 2021; 36:676-682. [PMID: 33367914 DOI: 10.1093/humrep/deaa283] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 09/21/2020] [Indexed: 11/14/2022] Open
Abstract
STUDY QUESTION Does the cause of infertility affect the perinatal outcomes preterm birth (PTB) and low birth weight (LBW) following IVF treatment? SUMMARY ANSWER The risk of PTB and LBW was higher with female causes of infertility-ovulatory disorders, tubal disorders and endometriosis-compared to unexplained infertility but the absolute increase in risk was low. WHAT IS KNOWN ALREADY Infertility is associated with an increased risk of adverse perinatal outcomes. Risk of adverse perinatal outcomes is also higher following ART compared to spontaneous conceptions. Infertility can result from female and/or male factors or is unexplained when the cause cannot be delineated by standard investigations. Given that infertility and ART are contributory to the adverse perinatal outcomes, it is a matter of interest to delineate if the specific cause of infertility influences perinatal outcomes following IVF treatment. STUDY DESIGN, SIZE, DURATION Anonymous data were obtained from the Human Fertilization and Embryology Authority (HFEA). The HFEA has collected data prospectively on all ART cycles performed in the UK since 1991. Data from 1991 to 2016 comprising a total of 117 401 singleton live births following IVF with or without ICSI (IVF ± ICSI) for sole causes of infertility were analysed for PTB and LBW. Cycles having more than one cause of infertility and/or multiple births were excluded. PARTICIPANTS/MATERIALS, SETTING, METHODS Data on all women undergoing stimulated IVF ± ICSI treatment cycles were analysed to compare perinatal outcomes of PTB and LBW among singleton live births based on the cause of infertility (ovulatory disorders, tubal disorders, endometriosis, male factor, unexplained). Logistic regression analysis was performed, adjusting for female age category, period of treatment, previous live births, IVF or ICSI, number of embryos transferred and fresh or frozen embryo transfer cycles. MAIN RESULTS AND THE ROLE OF CHANCE Compared to unexplained infertility, the risk of PTB was significantly higher with ovulatory disorders (adjusted odds ratio (aOR) 1.31, 99.5% CI 1.17 to 1.46); tubal disorders (aOR 1.25, 99.5% CI 1.14 to 1.38) and endometriosis (aOR 1.17, 99.5% CI 1.01 to 1.35). There was no significant difference in the risk of PTB with male factor causes compared to unexplained infertility (aOR 1.01, 99.5% CI 0.93, 1.10). The risk of LBW was significantly higher with ovulatory disorders (aOR 1. 29, 99.5% CI 1.16 to 1.44) and tubal disorders (aOR 1.12, 99.5% CI 1.02 to 1.23) and there was no increase in the risk of LBW with endometriosis (aOR 1.11, 99.5% CI 0.96 to 1.30) and male factor causes (aOR 0.94, 99.5% CI 0.87, 1.03), compared to unexplained infertility. LIMITATIONS, REASONS FOR CAUTION Although the analysis was adjusted for several important confounders, there was no information on the medical history of women during pregnancy to allow adjustment. The limitations with observational data would apply to this study, including residual confounding. WIDER IMPLICATIONS OF THE FINDINGS This is the largest study to address the causes of infertility affecting perinatal outcomes of PTB and LBW. The information is important for the management of pregnancies and the underlying reasons for the associations observed need to be further understood. STUDY FUNDING/COMPETING INTEREST(S) No funding was obtained. There are no competing interests to declare. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- Sesh Kamal Sunkara
- Division of Women's Health, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | | | - Ankita C Redla
- Faculty of Life Sciences and Medicine, King's College London, London, UK
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Singh O, Mukherjee P, Sakthivel MS, Wann C, George AJP, Gopalakrishnan R, Antonisamy B, Devasia A, Kumar S, Kekre NS, Chandrasingh J. Satisfaction and genital perception after orchiectomy for prostate cancer: does the technique matter? A randomized trial. Int Urol Nephrol 2021; 53:1583-1589. [PMID: 33851360 DOI: 10.1007/s11255-021-02849-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Accepted: 03/25/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Bilateral extracapsular or total orchiectomy (BEO) for prostate cancer is presumed to have psychological consequences after the surgery due to perception of an empty scrotum. Bilateral subcapsular orchiectomy (BSO) was designed to preserve perception of palpable testes. We compared the patients' satisfaction and genital perception following BEO and BSO. MATERIALS AND METHODS Prostate cancer patients eligible for androgen deprivation therapy who opted for orchiectomy were enrolled in prospective randomized study. Patients with bleeding disorder or uncorrected coagulopathy, poor performance score, and psychiatric problems were excluded. Outlook to life and own health in-general, overall satisfaction to the procedure and genital perception was evaluated using modified Fugl-Meyer questionnaire (FMQ) which was administered before and after 3 months of the surgery. Patients were randomized to BEO and BSO groups at the time of surgery using block randomization. Primary outcome was to compare the genital perception of testicular loss and patients' satisfaction to BSO and BEO. Secondary outcomes included testosterone and PSA control, operative time, and complications. RESULTS Total 35 patients were enrolled in each group which was comparable. There was no difference in PSA control at 3 months. Mean operative time and blood loss were significantly lesser in BEO group. FMQ score at 3 months did not show significant difference. Majority of the patients in both groups were satisfied with procedure and the aesthetic value of scrotum after surgery. However, 84% in BSO group did not feel that testes were removed on self-examination, as compared to 28% in BEO group. Majority patients in both groups did not report physical or psychological discomfort from change in scrotal content. CONCLUSIONS Results showed that patients' satisfaction and genital perception following BSO and BEO were similar. Feeling of remaining intrascrotal contents after BSO did not had added psychological advantage in terms of perception of genitalia.
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Affiliation(s)
- Onkar Singh
- Department of Urology, Christian Medical College and Hospital, Vellore, Tamil Nadu, 632004, India. .,Consultant Department of Urology and Renal Transplantation, Shrimann Superspeciality Hospital, Jalandhar, 144012, India.
| | - Partho Mukherjee
- Department of Urology, Christian Medical College and Hospital, Vellore, Tamil Nadu, 632004, India
| | - M S Sakthivel
- Department of Urology, Christian Medical College and Hospital, Vellore, Tamil Nadu, 632004, India
| | - Cornerstone Wann
- Department of Urology, Christian Medical College and Hospital, Vellore, Tamil Nadu, 632004, India
| | - A J P George
- Department of Urology, Christian Medical College and Hospital, Vellore, Tamil Nadu, 632004, India
| | - Rajesh Gopalakrishnan
- Department of Psychiatry, Christian Medical College, Bagayam Campus, Vellore, 632004, Tamil Nadu, India
| | - Belavendra Antonisamy
- Department of Biostatistics, Christian Medical College, Bagayam Campus, Vellore, 632004, Tamil Nadu, India
| | - Antony Devasia
- Department of Urology, Christian Medical College and Hospital, Vellore, Tamil Nadu, 632004, India
| | - Santosh Kumar
- Department of Urology, Christian Medical College and Hospital, Vellore, Tamil Nadu, 632004, India
| | - Nitin S Kekre
- Department of Urology, Christian Medical College and Hospital, Vellore, Tamil Nadu, 632004, India
| | - J Chandrasingh
- Department of Urology, Christian Medical College and Hospital, Vellore, Tamil Nadu, 632004, India
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Chinta P, Antonisamy B, Mangalaraj AM, Kunjummen AT, Kamath MS. POSEIDON classification and the proposed treatment options for groups 1 and 2: time to revisit? A retrospective analysis of 1425 ART cycles. Hum Reprod Open 2021; 2021:hoaa070. [PMID: 33614989 PMCID: PMC7882041 DOI: 10.1093/hropen/hoaa070] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 12/20/2020] [Indexed: 11/14/2022] Open
Abstract
STUDY QUESTION Do live birth outcomes differ when Patient-Oriented Strategy Encompassing IndividualizeD Oocyte Number (POSEIDON) stratified groups are compared with women with good prognosis (non-POSEIDON group) undergoing ART? SUMMARY ANSWER The current study showed no significant difference in the live birth rates (LBRs) per embryo transfer between POSEIDON groups 1 and 2 when compared with women in the non-POSEIDON group undergoing ART. WHAT IS KNOWN ALREADY Recently, there has been a lot of focus on the POSEIDON classification for low prognosis women undergoing ART and various management options have been advocated. For POSEIDON groups 1 and 2, low starting dose and gonadotrophin receptor polymorphism have been suggested as possible reasons for a hyporesponse, and increasing the starting gonadotrophin dose, the addition of recombinant LH and dual stimulation have been suggested as treatment options. Most of these treatment options are hypothetical in nature and need validation. STUDY DESIGN SIZE DURATION In the current cohort study, a total of 1425 cycles were analyzed retrospectively following a single cycle fresh embryo transfer. The study period was from January 2013 to June 2018. PARTICIPANTS/MATERIALS SETTING METHODS Women undergoing ART at a tertiary level infertility clinic were included. Clinical and treatment-related details were obtained from the hospital's electronic medical records. The ART outcomes in a non-POSEIDON group (women with an adequate ovarian reserve and/or optimal ovarian response i.e. >9 oocytes retrieved in the previous ART cycle) and a low prognosis group stratified by POSEIDON criteria were compared. We also examined the effectiveness of the modifications made in the current ART treatment protocols among women with an adequate ovarian reserve who had a history of poor/suboptimal response (POSEIDON 1 and 2). MAIN RESULTS AND THE ROLE OF CHANCE There was no statistically significant difference in the LBR per embryo transfer in POSEIDON group 1 (32/109, 29%) and group 2 (17/58, 29%) when compared with the non-POSEIDON group (340/1041, 33%) (adjusted odds ratio (aOR) 0.69; 95% CI 0.37-1.27 and aOR 0.93, 95% CI 0.43-1.97, respectively), while significantly lower LBR were observed in POSEIDON groups 3 (17/97, 17.5%) and 4 (12/120, 10%) (aOR 0.49; 95% CI 0.28-0.89 and aOR 0.38, 95% CI 0.19-0.74, respectively). The gonadotrophin dose alone was increased in one-quarter of the cycles and in another 27% the dose was increased along with the protocol change among POSEIDON group 1. In POSEIDON group 2, a change in the dose alone and in combination with protocol change was performed in 5 and 41% of cycles, respectively. LIMITATIONS REASONS FOR CAUTION A limitation of our study is the retrospective nature of the study with an inherent risk of unknown confounders influencing the outcomes. Other limitations are the lack of cumulative live birth data and the relatively small sample within POSEIDON group 2, which could lead to a type II error. WIDER IMPLICATIONS OF THE FINDINGS The current study showed no significant difference in the LBR between the POSEIDON groups 1 and 2 when compared with the non-POSEIDON group of women, while groups 3 and 4 had significantly lower LBR. The simple gonadotrophin/protocol changes in groups 1 and 2 resulted in LBRs comparable to women with good prognosis. These findings call for revisiting the proposed treatment strategies for POSEIDON groups 1 and 2. STUDY FUNDING/COMPETING INTERESTS No funding was obtained. There are no competing interests to declare.
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Affiliation(s)
- Parimala Chinta
- Department of Reproductive Medicine, Christian Medical College, Vellore, India
| | | | - Ann M Mangalaraj
- Department of Reproductive Medicine, Christian Medical College, Vellore, India
| | | | - Mohan S Kamath
- Department of Reproductive Medicine, Christian Medical College, Vellore, India
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Chinta P, Antonisamy N, Reddy N, Waanbah B, Samadhiya R, Aleyamma TK, Antonisamy B, Kamath M. Role of hysterosalpingography in diagnosing tubal blockage – A prospective diagnostic study. J Hum Reprod Sci 2021; 14:386-391. [PMID: 35197684 PMCID: PMC8812393 DOI: 10.4103/jhrs.jhrs_92_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 08/13/2021] [Accepted: 10/26/2021] [Indexed: 11/04/2022] Open
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Vasan SK, Antonisamy B, Gowri M, Selliah HY, Geethanjali FS, Jebasingh FS, Paul TV, Thomas N, Karpe F, Johnson M, Osmond C, Fall CHD. Prevalence, incidence and predictors of cardiovascular risk factors: longitudinal data from rural and urban South India and comparison with global data. BMJ Open Diabetes Res Care 2020; 8:8/1/e001782. [PMID: 33093130 PMCID: PMC7583064 DOI: 10.1136/bmjdrc-2020-001782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 09/12/2020] [Accepted: 09/15/2020] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION India has high mortality rates from cardiovascular disease (CVD). Understanding the trends and identifying modifiable determinants of CVD risk factors will guide preventive strategies and policy making. RESEARCH DESIGN AND METHODS CVD risk factors (obesity, central obesity, and type 2 diabetes (T2D), hypertension, hypercholesterolemia and hypertriglyceridemia) prevalence and incidence were estimated in 962 (male 519) non-migrant adults from Vellore, South India, studied in: (1) 1998-2002 (mean age 28.2 years) and (2) 2013-2014 (mean age 41.7 years). Prevalence was compared with the Non-Communicable Disease Risk Collaboration (global) data. Incidence was compared with another Indian cohort from New Delhi Birth Cohort (NDBC). Regression analysis was used to test baseline predictors of incident CVD risk factors. RESULTS The prevalence at 28 and 42 years was 17% (95% CI 14% to 19%) and 51% (95% CI 48% to 55%) for overweight/obesity, 19% (95% CI 17% to 22%) and 59% (95% CI 56% to 62%) for central obesity, 3% (95% CI 2% to 4%) and 16% (95% CI 14% to 19%) for T2D, 2% (95% CI 1% to 3%) and 19% (95% CI 17% to 22%) for hypertension and 15% (95% CI 13% to 18%) and 30% (95% CI 27% to 33%) for hypertriglyceridemia. The prevalence of T2D at baseline and follow-up and hypertension at follow-up was comparable with or exceeded that in high-income countries despite lower obesity rates. The incidence of most risk factors was lower in Vellore than in the NDBC. Waist circumference strongly predicted incident T2D, hypertension and hypertriglyceridemia. CONCLUSIONS A high prevalence of CVD risk factors was evident at a young age among Indians compared with high and upper middle income countries, with rural rates catching up with urban estimates. Adiposity predicted higher incident CVD risk, but the prevalence of hypertension and T2D was higher given a relatively low obesity prevalence. Preventive efforts should target both rural and urban India and should start young.
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Affiliation(s)
- Senthil K Vasan
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford, UK
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, Hampshire, UK
| | - Belavendra Antonisamy
- Department of Biostatistics, Christian Medical College and Hospital Vellore, Vellore, Tamil Nadu, India
| | - Mahasampath Gowri
- Department of Biostatistics, Christian Medical College and Hospital Vellore, Vellore, Tamil Nadu, India
| | - Hepsy Y Selliah
- Department of Biostatistics, Christian Medical College and Hospital Vellore, Vellore, Tamil Nadu, India
| | - Finney S Geethanjali
- Department of Clinical Biochemistry, Christian Medical College and Hospital Vellore, Vellore, Tamil Nadu, India
| | - Felix S Jebasingh
- Department of Endocrinology, Diabetes and Metabolism, Christian Medical College and Hospital Vellore, Vellore, Tamil Nadu, India
| | - Thomas V Paul
- Department of Endocrinology, Diabetes and Metabolism, Christian Medical College and Hospital Vellore, Vellore, Tamil Nadu, India
| | - Nihal Thomas
- Department of Endocrinology, Diabetes and Metabolism, Christian Medical College and Hospital Vellore, Vellore, Tamil Nadu, India
| | - Fredrik Karpe
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford, UK
| | - Matthew Johnson
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, Hampshire, UK
| | - Clive Osmond
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, Hampshire, UK
| | - Caroline H D Fall
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, Hampshire, UK
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Nagasubramanian S, John NT, Antonisamy B, Mukha RP, Jeyachandra Berry CS, Kumar S, Devasia A, Kekre NS. Tamsulosin and placebo vs tamsulosin and tadalafil in male lower urinary tract symptoms: a double-blinded, randomised controlled trial. BJU Int 2020; 125:718-724. [PMID: 32012409 DOI: 10.1111/bju.15027] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To compare the efficacy and safety of tamsulosin vs the combination of tamsulosin and tadalafil in male lower urinary tract symptoms (LUTS). PATIENTS AND METHODS This was a double-blinded, parallel-arm randomised controlled trial. Men aged >45 years with moderate LUTS and a maximum urinary flow rate (Qmax ) of 5-15 mL/s were included. One arm received 0.4 mg tamsulosin only (Group-A), while the second received 5 mg tadalafil with tamsulosin (Group-B). The primary outcome was the International Prostate Symptom Score (IPSS). Secondary outcomes were IPSS quality of life (QoL) score, five-item version of the International Index of Erectile Function (IIEF-5) score, Qmax , and post-void residual urine (PVR). Block randomisation was used. Placebo was used for blinding and allocation concealment. Intention-to-treat analysis was used for outcome measures. RESULTS Of the 183 men screened, 140 were randomised (71 in Group-A, 69 in Group-B); 116 (82.85%) (61 in Group-A, 55 in Group-B) completed the study. Baseline characteristics were comparable. The improvements in the IPSS, IPSS QoL score, IIEF score and Qmax were -1.69 (95% confidence interval [CI] -1.4 to -2.0), -0.70 (95% CI -0.60 to -0.80), 3.8 (95% CI 3.4-4.2) and 1.8 mL/s (95% CI 1.1-2.4) respectively, in favour of the combination group. The difference in PVR was not significant. There were no serious adverse events (AEs). The dropout rate due to AEs was 2.85%. Myalgia (five patients) was the commonest AE in the combination group. CONCLUSION The combination of tamsulosin and tadalafil produced significantly better improvements in LUTS, QoL, erectile function and Qmax compared to monotherapy with tamsulosin, without an increase in AEs.
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Affiliation(s)
| | - Nirmal Thampi John
- Departments of, Department of, Urology, Christian Medical College, Vellore, India
| | | | - Rajiv Paul Mukha
- Departments of, Department of, Urology, Christian Medical College, Vellore, India
| | | | - Santosh Kumar
- Departments of, Department of, Urology, Christian Medical College, Vellore, India
| | - Antony Devasia
- Departments of, Department of, Urology, Christian Medical College, Vellore, India
| | - Nitin Sudhakar Kekre
- Departments of, Department of, Urology, Christian Medical College, Vellore, India
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Danda D, Ganapati A, Kabeerdoss J, Gowri M, Antonisamy B. Myeloid-related proteins 8/14 failed to act as theragnostic biomarker in axial spondyloarthritis patients on combination disease-modifying anti-rheumatic drugs therapy. Indian J Rheumatol 2020. [DOI: 10.4103/injr.injr_223_20] [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: 11/04/2022] Open
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Radhakrishnan RC, Varughese S, Chandran A, Jacob S, David VG, Alexander S, Mohapatra A, Valson AT, Gopal B, Palani C, Jose A, Antonisamy B, Tamilarasi V. Effects of Individualized Dialysate Sodium Prescription in Hemodialysis - Results from a Prospective Interventional Trial. Indian J Nephrol 2020; 30:3-7. [PMID: 32015592 PMCID: PMC6977377 DOI: 10.4103/ijn.ijn_391_18] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Revised: 03/03/2019] [Accepted: 05/07/2019] [Indexed: 12/04/2022] Open
Abstract
INTRODUCTION Individualized dialysate sodium prescription does affect weight gain, blood pressure (BP), and intradialytic complications. A prospective interventional trial (Dialysate Individualised Sodium (DISO) trial) was conducted to study this issue in Indian patients. METHODS Forty patients on thrice-weekly maintenance hemodialysis (HD) for at least 6 weeks were enrolled. The study was performed in two different phases. In the first phase, 12 consecutive HD sessions were done with a standard dialysate sodium concentration of 140 mEq/L. In the second phase, 12 consecutive HD sessions were done with dialysate sodium concentration set to individualized value (mean of pre-HD sodium concentration multiplied by Donnan coefficient of 0.95). Differences in pre- and post-HD sodium, interdialytic weight gain (IDWG), pre- and post-HD BP, thirst scores, and intradialytic adverse events during both phases were assessed. RESULTS The mean age of patients was 45.65 years (24 males, 16 females). The mean serum pre-HD sodium level was 138.7 ± 1.7 meq/L in the standard phase and 138.2 ± 2.6meq/L in the individualized phase (P = 0.229). In the standard phase, the mean IDWG was 2.64 ± 1.56 kg and 2.13 ± 0.99 kg in the individualized phase (P = 0.008). The mean pre-HD systolic BP was 138 ± 18 mmHg and 134 ± 17 mmHg in the standard and individualized phases (P = 0.008). There was no difference in intradialytic symptoms, hypotensive episodes or requirement of interventions. Hypertension episodes occurred at a mean value of 2.2 and 1.2 in the standard and individualized phases, respectively (P = 0.010). CONCLUSION The use of individualized dialysate sodium level is safe and results in lower IDWG, pre-HD systolic BP, and intradialytic hypertension in patients on HD.
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Affiliation(s)
- Radhika C. Radhakrishnan
- Department of Nephrology, Christian Medical College, (Current Affiliation: Department of Pediatric Nephrology, Government Medical College, Thiruvananthapuram, Kerala), India
| | - Santosh Varughese
- Department of Nephrology, Christian Medical College, The Alfred Hospital, Melbourne, Australia), Australia
| | - Abitha Chandran
- Department of Nephrology, Christian Medical College, The Alfred Hospital, Melbourne, Australia), Australia
| | - Shibu Jacob
- Department of Nephrology, Christian Medical College, The Alfred Hospital, Melbourne, Australia), Australia
| | - Vinoi G. David
- Department of Nephrology, Christian Medical College, The Alfred Hospital, Melbourne, Australia), Australia
| | - Suceena Alexander
- Department of Nephrology, Christian Medical College, The Alfred Hospital, Melbourne, Australia), Australia
| | - Anjali Mohapatra
- Department of Nephrology, Christian Medical College, The Alfred Hospital, Melbourne, Australia), Australia
| | - Anna T. Valson
- Department of Nephrology, Christian Medical College, The Alfred Hospital, Melbourne, Australia), Australia
| | - Basu Gopal
- Department of Nephrology, Christian Medical College, (Current Affiliation: Department of Renal Medicine, The Alfred Hospital, Melbourne, Australia), Australia
| | - C. Palani
- Department of Nephrology, Christian Medical College, The Alfred Hospital, Melbourne, Australia), Australia
| | - Arun Jose
- Department of Biochemistry, Christian Medical College, Vellore, Tamil Nadu, India
| | - B. Antonisamy
- Department of Biostatistics, Christian Medical College, Vellore, Tamil Nadu, India
| | - V. Tamilarasi
- Department of Nephrology, Christian Medical College, The Alfred Hospital, Melbourne, Australia), Australia
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Kamath MS, Antonisamy B, Sunkara SK. Zygotic splitting following embryo biopsy: a cohort study of 207 697 single-embryo transfers following IVF treatment. BJOG 2019; 127:562-569. [PMID: 31828906 DOI: 10.1111/1471-0528.16045] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/04/2019] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To evaluate the risk of monozygotic splitting with embryo biopsy during in vitro fertilisation (IVF). DESIGN A cohort study. SETTING Anonymised assisted reproductive technology national data from the Human Fertilisation and Embryology Authority, UK. POPULATION Women undergoing single-embryo transfer (SET) following either pre-implantation genetic testing (PGT) involving embryo biopsy or IVF without PGT. METHODS Data on women undergoing SET either following PGT and non-PGT IVF treatment in 2000-2016 were analysed to compare the risk of zygotic splitting and monozygotic twining. Logistic regression analysis was performed adjusting for potential confounders. MAIN OUTCOMES Monozygotic spitting, monozygotic twin birth. RESULTS Data comprising a total of 207 697 SET cycles (4544 following PGT and 203 153 following non-PGT IVF) were analysed. The live birth rate per embryo transfer was 31.9% (95% confidence interval [CI] 30.5-33.2%) following PGT and 26.9% (95% CI 26.7-27.1%) following non-PGT IVF. The incidence of zygotic splitting following PGT was 2.4% (95% CI 1.7-3.3%) versus 1.5% (95% CI 1.4-1.6%) following non-PGT IVF. There was a significantly higher risk of zygotic splitting with PGT versus non-PGT IVF cycles (odds ratio [OR] 1.64, 95% CI 1.19-2.27). The higher risk of zygotic splitting with PGT cycles remained significant after adjusting for potential confounders (adjusted OR 1.51, 95% CI 1.06-2.15). CONCLUSIONS The present study demonstrated an increased risk of monozygotic splitting with embryo biopsy. Given the current sparse literature, it is important to accumulate further evidence to validate the findings. TWEETABLE ABSTRACT A likely increased risk of monozygotic splitting following embryo biopsy.
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Affiliation(s)
- M S Kamath
- Department of Reproductive Medicine, Christian Medical College, Vellore, India
| | - B Antonisamy
- Department of Biostatistics, Christian Medical College, Vellore, India
| | - S K Sunkara
- Division of Women's Health, Faculty of Life Sciences and Medicine, King's College London, London, UK
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Chiramel MJ, George R, Daniel D, Sam Arul Das R, Mani V, Antonisamy B, Muliyil JP. Case-control study measuring the association between HLA-B*13:01 and dapsone hypersensitivity syndrome in Indian patients. LEPROSY REV 2019. [DOI: 10.47276/lr.90.4.371] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Kamath MS, Antonisamy B, Selliah HY, Sunkara SK. Perinatal outcomes of singleton live births with and without vanishing twin following transfer of multiple embryos: analysis of 113 784 singleton live births. Hum Reprod 2019; 33:2018-2022. [PMID: 30219900 DOI: 10.1093/humrep/dey284] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 08/24/2018] [Indexed: 11/13/2022] Open
Abstract
STUDY QUESTION Does transfer of multiple embryos affect perinatal outcomes of resulting singleton live births following ART? SUMMARY ANSWER There is a higher risk of preterm birth (PTB) and low birthweight (LBW) in singleton live births associated with spontaneous reduction of an initial multiple to singleton gestation following transfer of multiple embryos. WHAT IS KNOWN ALREADY Singleton pregnancies following ART are at a higher risk of adverse perinatal outcomes compared to spontaneous conceptions. Earlier studies have found an increased risk of PTB and LBW in singletons following transfer of multiple embryos versus single embryo transfer (SET). However, these studies did not address the specific role of vanishing twin, i.e. spontaneous reduction of an initial multiple to singleton gestation. STUDY DESIGN, SIZE, DURATION Anonymised data on all ART cycles performed in the UK were obtained from the Human Fertilization and Embryology Authority. Data from 1991 to 2011 involving 508 410 fresh and 131 157 frozen autologous ART cycles resulting in 95 779 and 18 005 singleton live births, respectively, were analyzed. PARTICIPANTS/MATERIALS, SETTING, METHODS Fresh and frozen ART cycles were analyzed separately to compare perinatal outcomes of PTB and LBW of singleton live births resulting from transfer of multiple (≥2) embryos versus SET. Logistic regression analysis was performed adjusting for confounders. Subgroup analyses were carried out for perinatal outcomes of singleton live births with initial multiple or initial single gestational sacs following transfer of multiple embryos versus singleton live births following SET. MAIN RESULTS AND THE ROLE OF CHANCE In fresh cycles, there was a significantly higher risk of PTB (adjusted odds ratio (aOR) 2.70, CI 2.37-3.05) and LBW (aOR 2.76, CI 2.44-3.13) in singleton live births with initial multiple gestational sacs but there was no significant difference in the risk of PTB (aOR 1.08, CI 1.00-1.16) or LBW (aOR 1.08, CI 1.00-1.16) in singleton live births with an initial single gestational sac following transfer of ≥2 embryos compared to those following SET. In frozen cycles, there was a significantly higher risk of PTB (aOR 2.13, CI: 1.55-2.93) and LBW (aOR 2.61, CI: 1.87-3.64) in singleton live births with initial multiple gestational sacs but there was no significant difference in the risk of PTB (aOR 1.02, CI: 0.88-1.18) or LBW (aOR 0.91, CI: 0.77-1.07) in the singleton live births with an initial single gestational sac following transfer of ≥2 embryos compared to those following SET. LIMITATIONS, REASONS FOR CAUTION While the analysis was adjusted for a number of known confounders, the dataset had no information for confounders such as smoking, BMI, previous obstetric history and comorbid medical conditions during pregnancy. The lack of information about the timing of occurrence of the vanishing phenomenon is another limitation because poorer perinatal outcomes of a surviving twin have been reported following second trimester fetal demise compared to the first trimester. WIDER IMPLICATIONS OF THE FINDINGS The study results suggest that the vanishing twin phenomenon is associated with increased risk of PTB and LBW in the resulting singleton live births and there was no increased risk when there was a single gestational sac from the outset following transfer of multiple embryos. STUDY FUNDING/COMPETING INTERESTS Nil.
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Affiliation(s)
- Mohan S Kamath
- Department of Reproductive Medicine, Christian Medical College, Vellore, India
| | | | - Hepsy Y Selliah
- Department of Biostatistics, Christian Medical College, Vellore, India
| | - Sesh Kamal Sunkara
- Queen's Hospital, Barking Havering Redbridge University Hospitals NHS Trust, Essex, UK
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Nirmal B, Antonisamy B, Peter CVD, George L, George AA, Dinesh GM. Cross-Sectional Study of Dermatoscopic Findings in Relation to Activity in Vitiligo: BPLeFoSK Criteria for Stability. J Cutan Aesthet Surg 2019; 12:36-41. [PMID: 31057267 PMCID: PMC6484572 DOI: 10.4103/jcas.jcas_75_18] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background: Stability in vitiligo is an important concept in guiding patient management and a vital prerequisite before vitiligo surgery. Disease activity of vitiligo based on patient’s history is imprecise. It is practically impossible to perform biopsy from all lesions of vitiligo to ascertain stability. Dermatoscopy can be used to examine all clinical lesions in a patient of vitiligo. There is a need to validate many reported dermatoscopic findings for universal use. Aims: To analyze the significance of dermatoscopic findings in the activity of vitiligo and to devise a cutoff score for stable vitiligo. Materials and Methods: Dermatoscopic examination was performed in 85 patients clinically diagnosed with vitiligo. Six dermatoscopic parameters, namely, border, pigment network, perilesional hyperpigmentation, perifollicular pigmentation, satellite lesions, and micro-Koebner phenomenon (acronym: BPLeFoSK) were evaluated against Wood’s lamp findings as standard. Chi-square test was used to test association between categorical variables. Cutoff values for stability for these six parameters were plotted in receiver operating curve. Results: A total of 131 vitiligo lesions were analyzed with dermatoscopy. Absence of satellite lesions and absence of micro-Koebner phenomenon were the most sensitive parameters (96.7% and 100%, respectively). Sharp border and absent or reticulate pigment network within the vitiligo patch were the most specific findings (100% and 91.5%, respectively). Conclusion: A cutoff score of more than or equal to 1.5 using the “BPLeFoSK criteria” indicates stability in the vitiligo lesion.
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Affiliation(s)
- Balakrishnan Nirmal
- Department of Dermatology, Christian Medical College, Vellore, Tamil Nadu, India
| | | | - C V Dincy Peter
- Department of Dermatology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Leni George
- Department of Dermatology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Anu A George
- Department of Dermatology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Gauri M Dinesh
- Department of Dermatology, Christian Medical College, Vellore, Tamil Nadu, India
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Kamath MS, Antonisamy B, Selliah HY, La Marca A, Sunkara SK. Perinatal outcomes following IVF with use of donor versus partner sperm. Reprod Biomed Online 2018; 36:705-710. [DOI: 10.1016/j.rbmo.2018.03.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2017] [Revised: 03/09/2018] [Accepted: 03/14/2018] [Indexed: 12/15/2022]
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Vasan SK, Roy A, Samuel VT, Antonisamy B, Bhargava SK, Alex AG, Singh B, Osmond C, Geethanjali FS, Karpe F, Sachdev H, Agrawal K, Ramakrishnan L, Tandon N, Thomas N, Premkumar PS, Asaithambi P, Princy SFX, Sinha S, Paul TV, Prabhakaran D, Fall CHD. IndEcho study: cohort study investigating birth size, childhood growth and young adult cardiovascular risk factors as predictors of midlife myocardial structure and function in South Asians. BMJ Open 2018; 8:e019675. [PMID: 29643156 PMCID: PMC5898335 DOI: 10.1136/bmjopen-2017-019675] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
INTRODUCTION South Asians have high rates of cardiovascular disease (CVD) and its risk factors (hypertension, diabetes, dyslipidaemia and central obesity). Left ventricular (LV) hypertrophy and dysfunction are features of these disorders and important predictors of CVD mortality. Lower birth and infant weight and greater childhood weight gain are associated with increased adult CVD mortality, but there are few data on their relationship to LV function. The IndEcho study will examine associations of birth size, growth during infancy, childhood and adolescence and CVD risk factors in young adulthood with midlife cardiac structure and function in South Asian Indians. METHODS AND ANALYSIS We propose to study approximately 3000 men and women aged 43-50 years from two birth cohorts established in 1969-1973: the New Delhi Birth Cohort (n=1508) and Vellore Birth Cohort (n=2156). They had serial measurements of weight and height from birth to early adulthood. CVD risk markers (body composition, blood pressure, glucose tolerance and lipids) and lifestyle characteristics (tobacco and alcohol consumption, physical activity, socioeconomic status) were assessed at age ~30 years. Clinical measurements in IndEcho will include anthropometry, blood pressure, biochemistry (glucose, fasting insulin and lipids, urinary albumin/creatinine ratio) and body composition by dual energy X-ray absorptiometry and bioelectrical impedance. Outcomes are LV mass and indices of LV systolic and diastolic function assessed by two-dimensional and Doppler echocardiography, carotid intimal-media thickness and ECG indicators of ischaemia. Regression and conditional growth models, adjusted for potential confounders, will be used to study associations of childhood and young adult exposures with these cardiovascular outcomes. ETHICS AND DISSEMINATION The study has been approved by the Health Ministry Steering Committee, Government of India and institutional ethics committees of participating centres in India and the University of Southampton, UK. Results will be disseminated through scientific meetings and peer-reviewed journals. TRIAL REGISTRATION NUMBER ISRCTN13432279; Pre-results.
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Affiliation(s)
- Senthil K Vasan
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
- Oxford Center for Diabetes, Endocrinology and Metabolism, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Ambuj Roy
- Centre for Chronic Disease Control, New Delhi, India
- Department of Cardiology, All-India Institute of Medical Sciences, New Delhi, India
| | - Viji Thomson Samuel
- Departments of Cardiology, Biostatistics, Endocrinology and Clinical Biochemistry, Christian Medical College, Vellore, Tamil Nadu, India
| | - Belavendra Antonisamy
- Departments of Cardiology, Biostatistics, Endocrinology and Clinical Biochemistry, Christian Medical College, Vellore, Tamil Nadu, India
| | | | - Anoop George Alex
- Departments of Cardiology, Biostatistics, Endocrinology and Clinical Biochemistry, Christian Medical College, Vellore, Tamil Nadu, India
| | - Bhaskar Singh
- Department of Paediatrics, Sunder Lal Jain Hospital, New Delhi, India
| | - Clive Osmond
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
| | - Finney S Geethanjali
- Departments of Cardiology, Biostatistics, Endocrinology and Clinical Biochemistry, Christian Medical College, Vellore, Tamil Nadu, India
| | - Fredrik Karpe
- Oxford Center for Diabetes, Endocrinology and Metabolism, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Harshpal Sachdev
- Department of Paediatrics, Sitaram Bhartia Institute of Science and Research, New Delhi, India
| | - Kanhaiya Agrawal
- Departments of Cardiology, Biostatistics, Endocrinology and Clinical Biochemistry, Christian Medical College, Vellore, Tamil Nadu, India
| | - Lakshmy Ramakrishnan
- Department of Cardiology, All-India Institute of Medical Sciences, New Delhi, India
| | - Nikhil Tandon
- Department of Cardiology, All-India Institute of Medical Sciences, New Delhi, India
| | - Nihal Thomas
- Departments of Cardiology, Biostatistics, Endocrinology and Clinical Biochemistry, Christian Medical College, Vellore, Tamil Nadu, India
| | - Prasanna S Premkumar
- Departments of Cardiology, Biostatistics, Endocrinology and Clinical Biochemistry, Christian Medical College, Vellore, Tamil Nadu, India
| | - Prrathepa Asaithambi
- Departments of Cardiology, Biostatistics, Endocrinology and Clinical Biochemistry, Christian Medical College, Vellore, Tamil Nadu, India
| | - Sneha F X Princy
- Departments of Cardiology, Biostatistics, Endocrinology and Clinical Biochemistry, Christian Medical College, Vellore, Tamil Nadu, India
| | - Sikha Sinha
- Department of Paediatrics, Sitaram Bhartia Institute of Science and Research, New Delhi, India
| | - Thomas Vizhalil Paul
- Departments of Cardiology, Biostatistics, Endocrinology and Clinical Biochemistry, Christian Medical College, Vellore, Tamil Nadu, India
| | - Dorairaj Prabhakaran
- Centre for Chronic Disease Control, New Delhi, India
- Public Health Foundation of India, New Delhi, India
| | - Caroline H D Fall
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
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Nagasubramanian S, Thampi John N, Antonisamy B, J C, Kumar S, Devasia A, Sudhakar Kekre N. PD59-04 A DOUBLE BLINDED, RANDOMIZED CONTROLLED TRIAL COMPARING TAMSULOSIN AND PLACEBO VERSUS TAMSULOSIN AND TADALAFIL IN MALE LOWER URINARY TRACT SYMPTOMS. J Urol 2018. [DOI: 10.1016/j.juro.2018.02.2804] [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: 11/29/2022]
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George T, Rajan SJ, Peter JV, Hansdak SG, Prakash JAJ, Iyyadurai R, Mathuram A, Antonisamy B, Ramanathan K, Sudarsanam TD. Risk Factors for Acquiring Scrub Typhus among the Adults. J Glob Infect Dis 2018; 10:147-151. [PMID: 30166814 PMCID: PMC6100342 DOI: 10.4103/jgid.jgid_63_17] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Background: Behavioral and geographical factors may play a role in the acquisition of scrub typhus infection. In this prospective case–control study, we studied the factors associated with infection. Patients and Methods: Consecutive adult patients admitted with scrub typhus infection over 10 months were recruited. For every case, a geographical control from the same area and a gender-matched clinical control admitted with acute febrile illness were enrolled. The risk factors, which included sanitation, environment, activity, and protective measures, were compared between cases and controls using univariable and multivariable conditional logistic regression analysis and expressed as odds ratio (OR) with 95% confidence interval (CI). Results: The study cohort (n = 225; 132 female) aged 44 ± 17 years comprised of 75 cases and 150 controls from mid to low socioeconomic background. When compared with clinical controls, on univariable conditional regression analysis, cases were more likely to be involved in farming or gardening and less likely to have a toilet within the house. On multivariate regression analysis, only involvement in farming or gardening was associated with infection (OR: 4.2, 95% CI: 1.5–11.5). When compared with geographical controls, on univariable conditional regression analysis, cases were less likely to change undergarments or clothes before sleeping (OR: 3.5, 95% CI: 1.3–9.5) and more likely to have rodents in their house (OR: 2.5, 95% CI: 1–6.4) and rest on grass/mud without a mat (OR: 2.4, 95% CI: 1.1–5.3). On multivariate regression analysis, not changing undergarments or clothes tended to be associated with infection (OR: 2.7, 95% CI: 0.98–7.3). Conclusion: Certain behavioral factors predisposed our cohort to develop scrub typhus infection. Lifestyle changes may reduce the burden of scrub typhus in South India.
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Affiliation(s)
- Tina George
- Department of Medicine, Christian Medical College, Vellore, Tamil Nadu, India
| | - Sudha Jasmine Rajan
- Department of Medicine, Christian Medical College, Vellore, Tamil Nadu, India
| | - John Victor Peter
- Department of Medical Intensive Care Unit, Christian Medical College, Vellore, Tamil Nadu, India
| | | | | | - Ramya Iyyadurai
- Department of Medicine, Christian Medical College, Vellore, Tamil Nadu, India
| | - Alice Mathuram
- Department of Medicine, Christian Medical College, Vellore, Tamil Nadu, India
| | | | - Kavitha Ramanathan
- Department of Biostatistics, Christian Medical College, Vellore, Tamil Nadu, India
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Sunkara SK, Antonisamy B, Selliah HY, Kamath MS. Perinatal outcomes after gestational surrogacy versus autologous IVF: analysis of national data. Reprod Biomed Online 2017; 35:708-714. [DOI: 10.1016/j.rbmo.2017.08.024] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Revised: 08/24/2017] [Accepted: 08/30/2017] [Indexed: 11/28/2022]
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Pandian RM, John NT, Eapen A, Antonisamy B, Devasia A, Kekre N. Does MRI help in the pre - operative evaluation of pelvic fracture urethral distraction defect? - A pilot study. Int Braz J Urol 2017; 43:127-133. [PMID: 28124535 PMCID: PMC5293393 DOI: 10.1590/s1677-5538.ibju.2016.0252] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [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: 04/28/2016] [Accepted: 06/29/2016] [Indexed: 11/22/2022] Open
Abstract
Objectives To study the usefulness of MRI in preoperative evaluation of PFUDD. Can MRI provide additional information on urethral distraction defect (UDD) and cause of erectile dysfunction (ED)? Materials and Methods In this prospective study, consecutive male patients presenting with PFUDD were included from Feb 2011 till Dec 2012. Those with traumatic spinal cord injury and pre-existing ED were excluded. Patients were assessed using IIEF questionnaire, retrograde urethrogram and micturating cystourethrogram (RGU+MCU) and MRI pelvis. Primary end point was erectile function and secondary end point was surgical outcome. Results Twenty patients were included in this study. Fourteen patients (70%) were ≤40years; fifteen patients (75%) had ED, seven patients (35%) had severe ED. MRI findings associated with ED were longer median UDD (23mm vs. 15mm, p=0.07), cavernosal injury (100%, p=0.53), rectal injury (100%, p=0.53), retropubic scarring (60%, p=0.62) and prostatic displacement (60%, p=0.99). Twelve patients (60%) had a good surgical outcome, five (25%) had an acceptable outcome, three (15%) had a poor outcome. Poor surgical outcome was associated with rectal injury (66.7%, p=0.08), cavernosal injury (25%, p=0.19), retropubic scarring (18.1%, p=0.99) and prostatic displacement (16.7%, p=0.99). Five patients with normal erections had good surgical outcome. Three patients with ED had poor outcome (20%, p=0.20). Conclusions MRI did not offer significant advantage over MCU in the subgroup of men with normal erections. Cavernosal injury noted on MRI strongly correlated with ED. Role of MRI may be limited to the subgroup with ED or an inconclusive MCU.
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Affiliation(s)
| | - Nirmal Thampi John
- Department of Urology, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| | - Anu Eapen
- Department of Radiology, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| | - B Antonisamy
- Department of Biostatistics, Christian Medical College and Hospital, Tamil Nadu, India
| | - Antony Devasia
- Department of Urology, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| | - Nitin Kekre
- Department of Urology, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
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Arora R, Abrol N, Antonisamy B, Vanitha S, Chandrasingh J, Kumar S, Kekre N, Devasia A. Urine and serum fetuin-A levels in patients with urolithiasis. Indian J Urol 2017; 33:291-293. [PMID: 29021652 PMCID: PMC5635669 DOI: 10.4103/iju.iju_340_16] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Introduction: Fetuin-A is a glycoprotein secreted by liver and has been shown to inhibit extraosseous mineralization. Urolithiasis may be a manifestation in the urinary tract due to fetuin deficiency in urine. The objective of this study was to compare the 24-h urine and serum fetuin-A levels of patients with and without urolithiasis. Methods: Serum and 24-h urine fetuin-A levels were measured in 41 patients with bilateral, multiple, or recurrent urinary tract calculi (Group A) and 41 matched controls with no calculi (Group B). Fetuin levels were measured by enzyme linked immunosorbent assay. Serum and urine fetuin-A levels in the two groups were compared. Results: The median (range) 24-h urine fetuin-A value in Group A was 11.9 (1.12–221) mg/day and in Group B was 37.7 (1.28–125) mg/day. This difference was statistically significant (Mann–Whitney test, P = 0.0169). The median (range) serum fetuin-A in Group A was 0.67 (0.05–2.68) g/L and in Group B was 0.99 (0.01–5.5) g/L. The difference between serum values in the two arms was not statistically significant (Mann–Whitney test, P = 0.1817). However, the serum creatinine-adjusted mean log serum fetuin and urine fetuin were significantly different in the two arms (P = 0.003). The mean ± standard deviation (range) serum creatinine in Group A was 0.98 ± 0.25 (0.56–1.58) mg% and in Group B was 0.83 ± 0.16 (0.58–1.18) mg% (two sample t-test, P = 0.0031). Conclusions: Patients with urolithiasis have lower urine fetuin-A and creatinine-adjusted serum fetuin-A levels.
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Affiliation(s)
- Rajat Arora
- Department of Urology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Nitin Abrol
- Department of Urology, Christian Medical College, Vellore, Tamil Nadu, India
| | - B Antonisamy
- Department of Biostatistics, Christian Medical College, Vellore, Tamil Nadu, India
| | - S Vanitha
- Department of Clinical Biochemistry, Christian Medical College, Vellore, Tamil Nadu, India
| | - J Chandrasingh
- Department of Urology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Santosh Kumar
- Department of Urology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Nitin Kekre
- Department of Urology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Antony Devasia
- Department of Urology, Christian Medical College, Vellore, Tamil Nadu, India
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Antonisamy B, Vasan SK, Geethanjali FS, Gowri M, Hepsy YS, Richard J, Raghupathy P, Karpe F, Osmond C, Fall CHD. Weight Gain and Height Growth during Infancy, Childhood, and Adolescence as Predictors of Adult Cardiovascular Risk. J Pediatr 2017; 180:53-61.e3. [PMID: 27823768 PMCID: PMC5179199 DOI: 10.1016/j.jpeds.2016.09.059] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Revised: 07/29/2016] [Accepted: 09/28/2016] [Indexed: 01/03/2023]
Abstract
OBJECTIVES To investigate independent relationships of childhood linear growth (height gain) and relative weight gain to adult cardiovascular disease (CVD) risk traits in Asian Indians. STUDY DESIGN Data from 2218 adults from the Vellore Birth Cohort were examined for associations of cross-sectional height and body mass index (BMI) and longitudinal growth (independent conditional measures of height and weight gain) in infancy, childhood, adolescence, and adulthood with adult waist circumference (WC), blood pressure (BP), insulin resistance (homeostatic model assessment-insulin resistance [HOMA-IR]), and plasma glucose and lipid concentrations. RESULTS Higher BMI/greater conditional relative weight gain at all ages was associated with higher adult WC, after 3 months with higher adult BP, HOMA-IR, and lipids, and after 15 years with higher glucose concentrations. Taller adult height was associated with higher WC (men β = 2.32 cm per SD, women β = 1.63, both P < .001), BP (men β = 2.10 mm Hg per SD, women β = 1.21, both P ≤ .001), and HOMA-IR (men β = 0.08 log units per SD, women β = 0.12, both P ≤ .05) but lower glucose concentrations (women β = -0.03 log mmol/L per SD P = .003). Greater height or height gain at all earlier ages were associated with higher adult CVD risk traits. These positive associations were attenuated when adjusted for adult BMI and height. Shorter length and lower BMI at birth were associated with higher glucose concentration in women. CONCLUSIONS Greater height or weight gain relative to height during childhood or adolescence was associated with a more adverse adult CVD risk marker profile, and this was mostly attributable to larger adult size.
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Affiliation(s)
| | - Senthil K Vasan
- Oxford Center for Diabetes, Endocrinology, and Metabolism, University of Oxford, Oxford, United Kingdom.
| | | | - Mahasampath Gowri
- Department of Biostatistics, Christian Medical College, Vellore, India
| | - Y S Hepsy
- Department of Biostatistics, Christian Medical College, Vellore, India
| | - Joseph Richard
- Department of Biostatistics, Christian Medical College, Vellore, India
| | - P Raghupathy
- Department of Child Health, Christian Medical College, Vellore, India
| | - Fredrik Karpe
- Oxford Center for Diabetes, Endocrinology, and Metabolism, University of Oxford, Oxford, United Kingdom; National Institute for Health Research Oxford Biomedical Research Centre, Oxford University Hospital, Oxford, United Kingdom
| | - Clive Osmond
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom
| | - Caroline H D Fall
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom
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Sunkara SK, Antonisamy B, Selliah HY, Kamath MS. Pre-term birth and low birth weight following preimplantation genetic diagnosis: analysis of 88 010 singleton live births following PGD and IVF cycles. Hum Reprod 2016; 32:432-438. [DOI: 10.1093/humrep/dew317] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Revised: 11/10/2016] [Accepted: 11/21/2016] [Indexed: 12/13/2022] Open
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Shetty S, Kapoor N, Dian Bondu J, Antonisamy B, Thomas N, Paul TV. Bone turnover markers and bone mineral density in healthy mother-daughter pairs from South India. Clin Endocrinol (Oxf) 2016; 85:725-732. [PMID: 27497063 DOI: 10.1111/cen.13173] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Revised: 05/02/2016] [Accepted: 07/29/2016] [Indexed: 11/29/2022]
Abstract
UNLABELLED Bone turnover markers (BTMs) provide important insights into the dynamics of bone remodelling and are subjected to preanalytical and ethnic variations in addition to influence of genetic and environmental factors. AIM/OBJECTIVES To derive ethnicity specific reference range for BTMs and to study their correlation with Bone Mineral Density (BMD) in a cohort of healthy postmenopausal women and their premenopausal daughters and to look at the impact of maternal bone mineral status on daughters bone health. MATERIAL AND METHODS This community based cross sectional study included 300 subjects (150 mother-daughter pairs). Demographic details were collected. Fasting blood and a second void morning urine samples were obtained for measurement of BTMs (sCTX, sPTNP1, sOC and urine DPD respectively) and bone mineral parameters. BMD was measured by DXA scan. RESULTS Osteoporosis was seen in 44·7% of the postmenopausal women. Ethnicity specific reference ranges of BTMs were derived for the study population. Significant inverse correlation was found between all BTMs (except urine DPD) and BMD(P < 0·05). Daughters of mothers with osteoporosis at spine and femoral neck had lower BMD, compared to daughters of mothers without osteoporosis(P = 0·03 & 0·05). CONCLUSION Apart from deriving the ethnicity specific reference range for BTMs and finding a significant inverse correlation between BTM and BMD, this study found significantly lower BMD in daughters of mothers with osteoporosis at spine and femoral neck implicating the probable interplay of genetic, epigenetic and similar environmental factors.
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Affiliation(s)
- Sahana Shetty
- Department of Endocrinology, Diabetes & Metabolism, Christian Medical College, Vellore, India
| | - Nitin Kapoor
- Department of Endocrinology, Diabetes & Metabolism, Christian Medical College, Vellore, India
| | - Joseph Dian Bondu
- Department of Clinical Biochemistry, Christian Medical College, Vellore, India
| | | | - Nihal Thomas
- Department of Endocrinology, Diabetes & Metabolism, Christian Medical College, Vellore, India
| | - Thomas Vizhalil Paul
- Department of Endocrinology, Diabetes & Metabolism, Christian Medical College, Vellore, India.
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Madhuri V, Mathew SE, Rajagopal K, Ramesh S, Antonisamy B. Does pamidronate enhance the osteogenesis in mesenchymal stem cells derived from fibrous hamartoma in congenital pseudarthrosis of the tibia? Bone Rep 2016; 5:292-298. [PMID: 28580399 PMCID: PMC5440779 DOI: 10.1016/j.bonr.2016.10.003] [Citation(s) in RCA: 8] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Revised: 10/12/2016] [Accepted: 10/13/2016] [Indexed: 12/29/2022] Open
Abstract
Neurofibromatosis type 1 (NF1) is a commonly occurring genetic disorder in children. Mutation in the NF1 gene has its implication in poor osteoblastic capabilities. We hypothesised that pamidronate will enhance the osteoblastic potential of the mesenchymal stem cells (MSCs) derived from lipofibromatosis tissue of children with congenital pseudarthrosis tibia (CPT) associated with NF1. In this study, bone marrow MSCs (BM MSCs) and CPT MSCs were obtained from three patients undergoing salvage surgeries/bone grafting (healthy controls) and those undergoing excision of the hamartoma and corrective surgeries respectively. The effects of pamidronate (0, 10 nM, 100 nM and 1 μM) on cell proliferation, toxicity and differentiation potential were assessed and the outcome was measured by staining and gene expression. Our outcome showed that CPT MSCs had more proliferation rate as compared to BM MSCs. All 3 doses of pamidronate did not cause any toxicity to the cells in both the groups. The CPT MSCs showed less differentiation with pamidronate compared to the healthy control MSCs. This was quantitated by staining and gene expression analysis. Therefore, supplementation with pamidronate alone will not aid in bone formation in patients diagnosed with CPT. An additional stimulus is required to enhance bone formation. First study demonstrating the differentiation potential of MSCs derived from the hamartoma using pamidronate The CPT MSCs have lower osteogenic potential as compared to BM MSCs. The osteoblastic response does not improve with the addition of pamidronate (1 μM) in CPT MSCs. Pamidronate enhances osteogenic differentiation in normal BM MSCs.
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Affiliation(s)
- Vrisha Madhuri
- Paediatric Orthopaedics Unit, Department of Orthopaedics, Christian Medical College, Vellore 632004, Tamil Nadu, India.,Centre for Stem Cell Research, a unit of inStem, Bengaluru, Christian Medical College Campus, Vellore 632002, Tamil Nadu, India
| | - Smitha Elizabeth Mathew
- Paediatric Orthopaedics Unit, Department of Orthopaedics, Christian Medical College, Vellore 632004, Tamil Nadu, India
| | - Karthikeyan Rajagopal
- Paediatric Orthopaedics Unit, Department of Orthopaedics, Christian Medical College, Vellore 632004, Tamil Nadu, India.,Centre for Stem Cell Research, a unit of inStem, Bengaluru, Christian Medical College Campus, Vellore 632002, Tamil Nadu, India
| | - Sowmya Ramesh
- Paediatric Orthopaedics Unit, Department of Orthopaedics, Christian Medical College, Vellore 632004, Tamil Nadu, India.,Centre for Stem Cell Research, a unit of inStem, Bengaluru, Christian Medical College Campus, Vellore 632002, Tamil Nadu, India
| | - B Antonisamy
- Department of Biostatistics, Christian Medical College, Vellore 632004, Tamil Nadu, India
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Petnikota H, Madhuri V, Gangadharan S, Agarwal I, Antonisamy B. Retrospective cohort study comparing the efficacy of prednisolone and deflazacort in children with muscular dystrophy: A 6 years' experience in a South Indian teaching hospital. Indian J Orthop 2016; 50:551-557. [PMID: 27746500 PMCID: PMC5017179 DOI: 10.4103/0019-5413.189609] [Citation(s) in RCA: 4] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Muscular dystrophies are inherited myogenic disorders characterized by progressive muscle wasting and weakness of variable distribution and severity. They are a heterogeneous group characterized by variable degree of skeletal and cardiac muscle involvement. The most common and the most severe form of muscular dystrophy is DMD. Currently, there is no curative treatment for muscular dystrophies. Several drugs have been studied to retard the progression of the muscle weakness. There is much controversy about steroid usage in muscular dystrophy with respect to regimen, adverse effects, and whether long term benefits outweigh side effects. This study is to assess steroid efficacy in children with muscular dystrophy. MATERIALS AND METHODS All children with diagnosed muscular dystrophy by muscle biopsy, immunohistochemistry and/or genetic test were enrolled in the study. They were started on either prednisolone (0.75 mg/kg/day) or deflazacort 0.9 mg/kg/day based on affordability. All were followed up every 6 months with clinical assessment, quality of life questionnaire and clinical and laboratory assessment of side effects. Outcome measures of children on deflazacort and prednisolone at 1 year followup were summarized as numbers and percentages and were compared using Fisher's exact test. RESULTS Twenty two children with muscular dystrophy were included (prednisolone group: 10 and deflazacort group: 12). The mean age was 7.7 years at an average followup of 26.4 months. Twenty children were diagnosed to have Duchenne's; one had Becker's muscular dystrophy while one had sarcoglycanopathy by Type 2C. All children from prednisolone group maintained their ambulatory status at 2 and 4 years followups while three on deflazacort lost their ability to walk at an average age of 11.3 years. All activities of daily living were found to be better in prednisolone group. Muscle function and time taken to walk improved in prednisolone group. Weight gain in children on prednisolone was three times more. CONCLUSIONS Prednisolone is more beneficial than deflazacort at doses of 0.75 mg/kg/day and 0.9 mg/kg/day, respectively, however it is associated with adverse effects.
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Affiliation(s)
- Harish Petnikota
- Department of Paediatric Orthopaedics, CMC, Vellore, Tamil Nadu, India
| | - Vrisha Madhuri
- Department of Paediatric Orthopaedics, CMC, Vellore, Tamil Nadu, India,Address for correspondence: Dr. Vrisha Madhuri, Department of Paediatric Orthopaedics, Paul Brand Building, Christian Medical College, Vellore - 632 004, Tamil Nadu, India. E-mail:
| | | | - Indira Agarwal
- Department of Child Health, CMC, Vellore, Tamil Nadu, India
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Kamath MS, Pradhan S, Edison ES, Velayudhan SR, Antonisamy B, Karthikeyan M, Mangalaraj AM, Kunjummen A, George K. Chorionic villous sampling through transvaginal ultrasound approach: A retrospective analysis of 1138 cases. J Obstet Gynaecol Res 2016; 42:1229-1235. [PMID: 27352773 DOI: 10.1111/jog.13070] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2016] [Revised: 03/29/2016] [Accepted: 05/02/2016] [Indexed: 11/27/2022]
Abstract
AIM The aim of this study was to evaluate the effectiveness and safety of a transvaginal approach for chorionic villous sampling (CVS). METHODS We carried out a retrospective data analysis of all the transvaginal CVS procedures performed for the purpose of prenatal diagnosis in a university-level referral center between January 2000 and December 2014. Women underwent the prenatal testing between 10 and 17 weeks of gestation mainly for hematological disorders involving single gene defects. The main outcomes were successful sampling rate, maternal contamination rate, post-procedure complications rates, and immediate fetal loss rate (<14 days post-procedure). RESULTS A total of 1138 transvaginal CVS were performed during the study period and were available for analysis. The sampling success rate after the first attempt was 98.5% (1121/1138) and the overall success rate was 99.6% (1133/1138). The maternal contamination rate was 0.4% (5/1138). While two patients had vaginal bleeding (0.2%), fresh retroplacental collection was noted in four patients (0.4%) post-procedure. None of the patients developed ascending uterine infection following CVS. The immediate fetal loss rate was 0.2% (2/1138). CONCLUSION Transvaginal approach is associated with high sampling success, along with low rates of maternal contamination and post-procedure complications; hence, it can be offered as an effective alternative method of CVS.
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Affiliation(s)
- Mohan S Kamath
- Reproductive Medicine Unit, Christian Medical College, Vellore, India
| | - Sujata Pradhan
- Reproductive Medicine Unit, Christian Medical College, Vellore, India
| | | | | | | | | | - Ann M Mangalaraj
- Reproductive Medicine Unit, Christian Medical College, Vellore, India
| | | | - Korula George
- Reproductive Medicine Unit, Bangalore Baptist Hospital, Bangalore, India.
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Premkumar P, Antonisamy B, Mathews J, Benjamin S, Regi A, Jose R, Kuruvilla A, Mathai M. Birth weight centiles by gestational age for twins born in south India. BMC Pregnancy Childbirth 2016; 16:64. [PMID: 27012538 PMCID: PMC4806424 DOI: 10.1186/s12884-016-0850-y] [Citation(s) in RCA: 8] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2014] [Accepted: 03/16/2016] [Indexed: 11/23/2022] Open
Abstract
Background Birth weight centile curves are commonly used as a screening tool and to assess the position of a newborn on a given reference distribution. Birth weight of twins are known to be less than those of comparable singletons and twin-specific birth weight centile curves are recommended for use. In this study, we aim to construct gestational age specific birth weight centile curves for twins born in south India. Methods The study was conducted at the Christian Medical College, Vellore, south India. The birth records of all consecutive pregnancies resulting in twin births between 1991 and 2005 were reviewed. Only live twin births between 24 and 42 weeks of gestation were included. Birth weight centiles for gestational age were obtained using the methodology of generalized additive models for location, scale and shape (GAMLSS). Centiles curves were obtained separately for monochorionic and dichorionic twins. Results Of 1530 twin pregnancies delivered during the study period (1991–2005), 1304 were included in the analysis. The median gestational age at birth was 36 weeks (1st quartile 34, 3rd quartile 38 weeks). Smoothed percentile curves for birth weight by gestational age increased progressively till 38 weeks and levels off thereafter. Compared with dichorionic twins, monochorionic twins had lower birth weight for gestational age from after 27 weeks. Conclusions We provide centile values of birth weight at 24 to 42 completed weeks of gestation for twins born in south India. These charts could be used both in routine clinical assessments and epidemiological studies.
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Affiliation(s)
- Prasanna Premkumar
- Departments of Biostatistics, Christian Medical College, Vellore, 632 002, India.
| | | | - Jiji Mathews
- Obstetrics and Gynaecology, Christian Medical College, Vellore, 632 002, India
| | - Santhosh Benjamin
- Obstetrics and Gynaecology, Christian Medical College, Vellore, 632 002, India
| | - Annie Regi
- Obstetrics and Gynaecology, Christian Medical College, Vellore, 632 002, India
| | - Ruby Jose
- Obstetrics and Gynaecology, Christian Medical College, Vellore, 632 002, India
| | - Anil Kuruvilla
- Neonatology, Christian Medical College, Vellore, 632 002, India
| | - Mathews Mathai
- Making Pregnancy Safer Department, World Health Organization, Geneva, Switzerland
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Livingstone RS, Grunnet LG, Thomas N, Eapen A, Antonisamy B, Mohan VR, Spurgeon R, Frank ID, Bygbjerg IC, Vaag A. Are hepatic and soleus lipid content, assessed by magnetic resonance spectroscopy, associated with low birth weight or insulin resistance in a rural Indian population of healthy young men? Diabet Med 2016; 33:365-70. [PMID: 26172248 DOI: 10.1111/dme.12852] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/03/2015] [Indexed: 12/22/2022]
Abstract
AIMS To assess young healthy men from rural India, who had normal or low birth weights, using magnetic resonance spectroscopy to determine the potential differences in ectopic fat storage between birth weight groups, and to determine if ectopic fat storage was associated with insulin resistance in this population. METHODS A total of 54 lean men with normal birth weight and 49 lean men with low birth weight (age range 18-22 years) from rural India were recruited. All the men underwent anthropometry, magnetic resonance spectroscopy, a hyperinsulinaemic-euglycaemic clamp and a dual-energy X-ray absorptiometry. RESULTS The median (interquartile range) values for hepatic cellular lipids, intramyocellular lipids and extramyocellular lipids, measured using magnetic resonance spectroscopy were 0.76 (0.1-1.8)%, 1.27 (1.0-2.3)% and 1.89 (1.3-3.2)%, respectively, for the normal birth weight group and 0.4 (0.1-1.3)%, 1.38 (0.9-2.2)% and 2.07 (1.2-2.8)%, respectively, for the low birth weight group (P > 0.05). No difference in ectopic fat storage was observed between the low and normal birth weight groups, with or without adjustment for age and total fat percentage. Homeostatic model assessment of insulin resistance values were not associated with hepatic cellular, intramyocellular or extramyocellular lipid content in any of the groups. Total fat percentage was the only independent predictor of intramyocellular and extramyocellular lipid content. CONCLUSION Young and lean men from rural India with low birth weight were not observed to have ectopic fat storage in the liver or muscle, and the amount of liver and muscle fat was unrelated to insulin resistance. Older age and/or an urban affluent lifestyle may be required to show a potential role of ectopic fat storage on insulin resistance in Indian people with low or normal birth weight.
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Affiliation(s)
- R S Livingstone
- Department of Radiology, Christian Medical College and Hospital, Vellore, India
| | - L G Grunnet
- Diabetes and Metabolism, Copenhagen University Hospital (Rigshospitalet), Denmark
| | - N Thomas
- Department of Endocrinology, Diabetes and Metabolism, Christian Medical College and Hospital, Vellore, India
| | - A Eapen
- Department of Radiology, Christian Medical College and Hospital, Vellore, India
| | - B Antonisamy
- Department of Biostatistics, Christian Medical College and Hospital, Vellore, India
| | - V R Mohan
- Department of Community Health, Christian Medical College and Hospital, Vellore, India
| | - R Spurgeon
- Department of Endocrinology, Diabetes and Metabolism, Christian Medical College and Hospital, Vellore, India
| | - I D Frank
- Department of Endocrinology, Diabetes and Metabolism, Christian Medical College and Hospital, Vellore, India
| | - I C Bygbjerg
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - A Vaag
- Diabetes and Metabolism, Copenhagen University Hospital (Rigshospitalet), Denmark
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Bhargav J, Ram T, Selvamani B, Chandramohan A, Antonisamy B. Correlation of Dose to Bone Marrow With Hematological Toxicity and MRI Based Estimation of Conversion of Active to Inactive Bone Marrow in Long Course Neo adjuvant Chemoradiation for Locally Advanced Rectal Cancer. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Sebastian A, Vijayaselvi R, Nandeibam Y, Natarajan M, Paul TV, Antonisamy B, Mathews JE. A Case Control Study to Evaluate the Association between Primary Cesarean Section for Dystocia and Vitamin D Deficiency. J Clin Diagn Res 2015; 9:QC05-8. [PMID: 26500960 PMCID: PMC4606289 DOI: 10.7860/jcdr/2015/14029.6502] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Accepted: 07/12/2015] [Indexed: 11/24/2022]
Abstract
BACKGROUND Milder forms of vitamin D deficiency could be responsible for poor muscular performance causing dysfunctional labor. The aim of our research was to study the association between vitamin D deficiency and primary cesarean section. MATERIALS AND METHODS This was a case control study. Forty six women who delivered by primary cesarean section with dystocia as primary or secondary indication after 37 weeks of gestation were taken as cases and a similar number of women who delivered vaginally were taken as controls. Vitamin D deficiency was diagnosed when the serum 25(OH)D level was ≤20 ng/ml and this was compared between cases and controls. RESULTS Median serum (OH) vitamin D levels was 23.3ng/ml among women who delivered by cesarean section and 26.2ng/ml among controls (p=0.196). Baseline characteristics were similar in both groups except for a strong association between Body Mass Index (BMI) and cesarean section, (29.7kg/m(2) in cases and 25.9kg/m(2) in controls p=0.001) seen in multivariate analysis. Vitamin D deficiency was seen in 34.8% of cases and 21.7% of controls (p=0.165). CONCLUSION This small case control study did not show a significant association between vitamin D deficiency and primary cesarean section.
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Affiliation(s)
- Ajit Sebastian
- Registrar, Department of Obstetrics and Gynaecology, Christian Medical College, Vellore, Tamilnadu, India
| | - Reeta Vijayaselvi
- Associate Professor, Department of Obstetrics and Gynaecology, Christian Medical College, Vellore, Tamilnadu, India
| | - Yohen Nandeibam
- Assistant Professor, Department of Obstetrics and Gynaecology, Christian Medical College, Vellore, Tamilnadu, India
| | - Madhupriya Natarajan
- Assistant Professor, Department of Obstetrics and Gynaecology, Christian Medical College, Vellore, Tamilnadu, India
| | - Thomas Vizhalil Paul
- Professor, Department of Endocrinology, Christian Medical College, Vellore, Tamilnadu, India
| | - B. Antonisamy
- Professor, Department of Biostatistics, Christian Medical College, Vellore, Tamilnadu, India
| | - Jiji Elizabeth Mathews
- Professor, Department of Obstetrics and Gynaecology Unit V, Christian Medical College, Ida Scudder Road, Vellore, South India
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Vasan SK, Ramachandran P, Mathew M, Natraj CV, Antonisamy B, Thomas N. Post-absorptive glucose lowering in normal healthy individuals: an epidemiological observation. Diabetes Res Clin Pract 2014; 104:e5-7. [PMID: 24565212 DOI: 10.1016/j.diabres.2014.01.023] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2013] [Revised: 01/17/2014] [Accepted: 01/18/2014] [Indexed: 11/18/2022]
Abstract
Post-absorptive glucose lowering (PALG) is observed in individuals with glucose intolerance and in healthy individuals. We report a prevalence of about 23% among healthy Asian Indians. Individuals with PALG are characterized by leaner phenotype, low body fat percentage, increased insulin sensitivity and higher fasting glucose levels.
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Affiliation(s)
- Senthil K Vasan
- Rolf Luft Centre for Diabetes, Department of Molecular Medicine & Surgery, Karolinska Institutet, Stockholm, Sweden; Department of Endocrinology, Diabetes & Metabolism, Christian Medical College, Vellore, India
| | | | - Mary Mathew
- Indian Institute of Science, Bangalore, India
| | - C V Natraj
- Indian Institute of Science, Bangalore, India
| | | | - Nihal Thomas
- Department of Endocrinology, Diabetes & Metabolism, Christian Medical College, Vellore, India.
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Abstract
Estimation of appropriate sample size for prevalence surveys presents many challenges, particularly when the condition is very rare or has a tendency for geographical clustering. Sample size estimate for prevalence studies is a function of expected prevalence and precision for a given level of confidence expressed by the z statistic. Choice of the appropriate values for these variables is sometimes not straight-forward. Certain other situations do not fulfil the assumptions made in the conventional equation and present a special challenge. These situations include, but are not limited to, smaller population size in relation to sample size, sampling technique or missing data. This paper discusses practical issues in sample size estimation for prevalence studies with an objective to help clinicians and healthcare researchers make more informed decisions whether reviewing or conducting such a study.
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Affiliation(s)
- Ravindra Arya
- Comprehensive Epilepsy Centre, Division of Neurology, Cincinnati Children's Hospital Medical Centre, Cincinnati, OH, USA.
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Vasan SK, Fall T, Neville MJ, Antonisamy B, Fall CH, Geethanjali FS, Gu HF, Raghupathy P, Samuel P, Thomas N, Brismar K, Ingelsson E, Karpe F. Associations of variants in FTO and near MC4R with obesity traits in South Asian Indians. Obesity (Silver Spring) 2012; 20:2268-77. [PMID: 22421923 DOI: 10.1038/oby.2012.64] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Recent genome-wide association studies show that loci in FTO and melanocortin 4 receptor (MC4R) associate with obesity-related traits. Outside Western populations the associations between these variants have not always been consistent and in Indians it has been suggested that FTO relates to diabetes without an obvious intermediary obesity phenotype. We investigated the association between genetic variants in FTO (rs9939609) and near MC4R (rs17782313) with obesity- and type 2 diabetes (T2DM)-related traits in a longitudinal birth cohort of 2,151 healthy individuals from the Vellore birth cohort in South India. The FTO locus displayed significant associations with several conventional obesity-related anthropometric traits. The per allele increase is about 1% for BMI, waist circumference (WC), hip circumference (HC), and waist-hip ratio. Consistent associations were observed for adipose tissue-specific measurements such as skinfold thickness reinforcing the association with obesity-related traits. Obesity associations for the MC4R locus were weak or nonsignificant but a signal for height (P < 0.001) was observed. The effect on obesity-related traits for FTO was seen in adulthood, but not at younger ages. The loci also showed nominal associations with increased blood glucose but these associations were lost on BMI adjustment. The effect of FTO on obesity-related traits was driven by an urban environmental influence. We conclude that rs9939609 variant in the FTO locus is associated with measures of adiposity and metabolic consequences in South Indians with an enhanced effect associated with urban living. The detection of these associations in Indians is challenging because conventional anthropometric obesity measures work poorly in the Indian "thin-fat" phenotype.
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Affiliation(s)
- Senthil K Vasan
- Rolf Luft Research Center for Diabetes and Endocrinology, Department of Molecular Medicine & Surgery, Karolinska Institutet, Stockholm, Sweden
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Chandy SJ, Thomas K, Mathai E, Antonisamy B, Holloway KA, Stalsby Lundborg C. Patterns of antibiotic use in the community and challenges of antibiotic surveillance in a lower-middle-income country setting: a repeated cross-sectional study in Vellore, south India. J Antimicrob Chemother 2012; 68:229-36. [DOI: 10.1093/jac/dks355] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Thomas N, Grunnet LG, Poulsen P, Christopher S, Spurgeon R, Inbakumari M, Livingstone R, Alex R, Mohan VR, Antonisamy B, Geethanjali FS, Karol R, Vaag A, Bygbjerg IC. Born with low birth weight in rural Southern India: what are the metabolic consequences 20 years later? Eur J Endocrinol 2012; 166:647-55. [PMID: 22250073 DOI: 10.1530/eje-11-0870] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [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] [Indexed: 01/19/2023]
Abstract
OBJECTIVE Low birth weight (LBW) is common in the Indian population and may represent an important predisposing factor for type 2 diabetes (T2D) and the metabolic syndrome. Intensive metabolic examinations in ethnic LBW Asian Indians have been almost exclusively performed in immigrants living outside India. Therefore, we aimed to study the metabolic impact of being born with LBW in a rural non-migrant Indian population. SUBJECTS AND METHODS One hundred and seventeen non-migrant, young healthy men were recruited from a birth cohort in a rural part of south India. The subjects comprised 61 LBW and 56 normal birth weight (NBW) men, with NBW men acting as controls. Subjects underwent a hyperinsulinaemic euglycaemic clamp, i.v. and oral glucose tolerance tests and a dual-energy X-ray absorptiometry scan. The parents' anthropometric status and metabolic parameters were assessed. RESULTS Men with LBW were shorter (167±6.4 vs 172±6.0 cm, P<0.0001), lighter (51.9±9 vs 55.4±7 kg, P=0.02) and had a reduced lean body mass (42.1±5.4 vs 45.0±4.5 kg, P=0.002) compared with NBW controls. After adjustment for height and weight, the LBW subjects had increased diastolic blood pressure (77±6 vs 75±6 mmHg, P=0.01). Five LBW subjects had impaired glucose tolerance. In vivo insulin secretion and peripheral insulin action were similar in both the groups. Mothers of the LBW subjects were 3 cm shorter than the control mothers. CONCLUSION Only subtle features of the metabolic syndrome and changes in body composition among LBW rural Indians were found. Whether other factors such as urbanisation and ageing may unmask more severe metabolic abnormalities may require a long-term follow-up.
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Affiliation(s)
- Nihal Thomas
- Department of Endocrinology, Diabetes and Metabolism, Christian Medical College, Vellore (CMC), India
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Samuel P, Antonisamy B, Raghupathy P, Richard J, Fall CHD. Socio-economic status and cardiovascular risk factors in rural and urban areas of Vellore, Tamilnadu, South India. Int J Epidemiol 2012; 41:1315-27. [PMID: 22366083 DOI: 10.1093/ije/dys001] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND We examined associations between socio-economic status (SES) indicators and cardiovascular disease (CVD) risk factors among urban and rural South Indians. METHODS Data from a population-based birth cohort of 2218 men and women aged 26-32 years from Vellore, Tamilnadu were used. SES indicators included a household possessions score, attained education and paternal education. CVD risk factors included obesity, hypertension, impaired glucose tolerance or diabetes, plasma total cholesterol to high density lipoprotein (HDL) ratio and triglyceride levels and consumption of tobacco and alcohol. Multiple logistic regression analysis was used to assess associations between SES indicators and risk factors. RESULTS Most risk factors were positively associated with possessions score in urban and rural men and women, except for tobacco use, which was negatively associated. Trends were similar with the participants' own education and paternal education, though weaker and less consistent. In a concurrent analysis of all the three SES indicators, adjusted for gender and urban/rural residence, independent associations were observed only for the possessions score. Compared with those in the lowest fifth of the score, participants in the highest fifth had a higher risk of abdominal obesity [odds ratio (OR) =6.4, 95% CI 3.4-11.6], high total cholesterol to HDL ratio (OR=2.4, 95% CI 1.6-3.5) and glucose intolerance (OR=2.8, 95% CI 1.9-4.1). Their tobacco use (OR=0.4, 95% CI 0.2-0.6) was lower. Except for hypertension and glucose intolerance, risk factors were higher in urban than rural participants independently of SES. CONCLUSION In this young cohort of rural and urban south Indians, higher SES was associated with a more adverse CVD risk factor profile but lower tobacco use.
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Affiliation(s)
- Prasanna Samuel
- Department of Biostatistics, Christian Medical College, Vellore, Tamilnadu, India
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Vasan SK, Neville MJ, Antonisamy B, Samuel P, Fall CH, Geethanjali FS, Thomas N, Raghupathy P, Brismar K, Karpe F. Absence of birth-weight lowering effect of ADCY5 and near CCNL, but association of impaired glucose-insulin homeostasis with ADCY5 in Asian Indians. PLoS One 2011; 6:e21331. [PMID: 21712988 PMCID: PMC3119677 DOI: 10.1371/journal.pone.0021331] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2011] [Accepted: 05/26/2011] [Indexed: 01/21/2023] Open
Abstract
Background A feature of the Asian Indian phenotype is low birth weight with increased adult type 2 diabetes risk. Most populations show consistent associations between low birth weight and adult type 2 diabetes. Recently, two birth weight-lowering loci on chromosome 3 (near CCNL1 and ADCY5) were identified in a genome-wide association study, the latter of which is also a type 2 diabetes locus. We therefore tested the impact of these genetic variants on birth weight and adult glucose/insulin homeostasis in a large Indian birth cohort. Methodology/Principal Findings Adults (n = 2,151) enrolled in a birth cohort (established 1969-73) were genotyped for rs900400 (near CCNL1) and rs9883204 (ADCY5). Associations were tested for birth weight, anthropometry from infancy to adulthood, and type 2 diabetes related glycemic traits. The average birth weight in this population was 2.79±0.47 kg and was not associated with genetic variation in CCNL1 (p = 0.87) or ADCY5 (p = 0.54). Allele frequencies for the ‘birth weight-lowering’ variants were similar compared with Western populations. There were no significant associations with growth or adult weight. However, the ‘birth weight-lowering’ variant of ADCY5 was associated with modest increase in fasting glucose (β 0.041, p = 0.027), 2-hours glucose (β 0.127, p = 0.019), and reduced insulinogenic index (β -0.106, p = 0.050) and 2-hour insulin (β -0.058, p = 0.010). Conclusions The low birth weight in Asian Indians is not even partly explained by genetic variants near CCNL1 and ADCY5 which implies that non-genetic factors may predominate. However, the ‘birth-weight-lowering’ variant of ADCY5 was associated with elevated glucose and decreased insulin response in early adulthood which argues for a common genetic cause of low birth weight and risk of type 2 diabetes.
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Affiliation(s)
- Senthil K. Vasan
- Department of Molecular Medicine & Surgery, Karolinska Institutet, Stockholm, Sweden
- Department of Endocrinology, Diabetes & Metabolism, Christian Medical College, Vellore, India
- * E-mail: (FK); (SKV)
| | - Matt J. Neville
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford, United Kingdom
| | | | - Prasanna Samuel
- Department of Biostatistics, Christian Medical College, Vellore, Tamil Nadu, India
| | - Caroline H. Fall
- Medical Research Council (MRC) Epidemiology Resource Centre, Southampton, United Kingdom
| | - Finney S. Geethanjali
- Department of Clinical Biochemistry, Christian Medical College, Vellore, Tamil Nadu, India
| | - Nihal Thomas
- Department of Endocrinology, Diabetes & Metabolism, Christian Medical College, Vellore, India
| | - Palany Raghupathy
- Department of Child Health, Christian Medical College, Vellore, Tami Nadu, India
| | - Kerstin Brismar
- Department of Molecular Medicine & Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Fredrik Karpe
- Department of Endocrinology, Diabetes & Metabolism, Christian Medical College, Vellore, India
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford, United Kingdom
- National Institute for Health Research (NIHR) Oxford Biomedical Research Centre, Oxford Radcliffe Hospitals (ORH) Trust, Oxford, United Kingdom
- * E-mail: (FK); (SKV)
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Antonisamy B, Christopher S, Samuel P, Zelterman D. Book Review Biostatistics: Principles and Practice By B. Antonisamy , Solomon Christopher , and P. Prasanna Samuel New Delhi, India: Tata McGraw Hill, 2010. 349 pp. Illustrated. Rs 350 (softcover). Clin Infect Dis 2010. [DOI: 10.1086/656626] [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: 11/03/2022] Open
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Masilamani V, Vijmasi T, Al Salhi M, Govindaraj K, Vijaya-Raghavan AP, Antonisamy B. Cancer detection by native fluorescence of urine. J Biomed Opt 2010; 15:057003. [PMID: 21054119 DOI: 10.1117/1.3486553] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Because cancer is a dreaded disease, a number of techniques such as biomarker evaluation, mammograms, colposcopy, and computed tomography scan are currently employed for early diagnosis. Many of these are specific to a particular site, invasive, and often expensive. Hence, there is a definite need for a simple, generic, noninvasive protocol for cancer detection, comparable to blood and urine tests for diabetes. Our objective is to show the results of a novel study in the diagnosis of several cancer types from the native or intrinsic fluorescence of urine. We use fluorescence emission spectra (FES) and stokes shift spectra (SSS) to analyze the native fluorescence of the first voided urine samples of healthy controls (N=100) and those of cancer patients (N=50) of different etiology. We show that flavoproteins and porphyrins released into urine can act as generic biomarkers of cancer with a specificity of 92%, a sensitivity of 76%, and an overall accuracy of 86.7%. We employ FES and SSS for rapid and cost-effective quantification of certain intrinsic biomarkers in urine for screening and diagnosis of most common cancer types with an overall accuracy of 86.7%.
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Affiliation(s)
- Vadivel Masilamani
- King Saud University, College of Science, Department of Physics, P.O. Box 2455, Riyadh, Saudi Arabia 11451.
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