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Zhao W, Rose SF, Blake R, Godicelj A, Cullen AE, Stenning J, Beevors L, Gehrung M, Kumar S, Kishore K, Sawle A, Eldridge M, Giorgi FM, Bridge KS, Markowetz F, Holding AN. ZMIZ1 enhances ERα-dependent expression of E2F2 in breast cancer. J Mol Endocrinol 2024; 73:e230133. [PMID: 38564418 DOI: 10.1530/jme-23-0133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 04/02/2024] [Indexed: 04/04/2024]
Abstract
The estrogen receptor-α (ER) drives 75% of breast cancers. On activation, the ER recruits and assembles a 1-2 MDa transcriptionally active complex. These complexes can modulate tumour growth, and understanding the roles of individual proteins within these complexes can help identify new therapeutic targets. Here, we present the discovery of ER and ZMIZ1 within the same multi-protein assembly by quantitative proteomics, and validated by proximity ligation assay. We characterise ZMIZ1 function by demonstrating a significant decrease in the proliferation of ER-positive cancer cell lines. To establish a role for the ER-ZMIZ1 interaction, we measured the transcriptional changes in the estrogen response post-ZMIZ1 knockdown using an RNA-seq time-course over 24 h. Gene set enrichment analysis of the ZMIZ1-knockdown data identified a specific delay in the response of estradiol-induced cell cycle genes. Integration of ENCODE data with our RNA-seq results identified that ER and ZMIZ1 both bind the promoter of E2F2. We therefore propose that ER and ZMIZ1 interact to enable the efficient estrogenic response at subset of cell cycle genes via a novel ZMIZ1-ER-E2F2 signalling axis. Finally, we show that high ZMIZ1 expression is predictive of worse patient outcome, ER and ZMIZ1 are co-expressed in breast cancer patients in TCGA and METABRIC, and the proteins are co-localised within the nuclei of tumour cell in patient biopsies. In conclusion, we establish that ZMIZ1 is a regulator of the estrogenic cell cycle response and provide evidence of the biological importance of the ER-ZMIZ1 interaction in ER-positive patient tumours, supporting potential clinical relevance.
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Affiliation(s)
- Weiye Zhao
- Department of Biology, University of York, York, UK
| | | | - Ryan Blake
- CRUK Cambridge Institute, University of Cambridge, Cambridge, UK
| | - Aňze Godicelj
- Department of Cancer Immunology and Virology, Dana-Farber Cancer Institute, Smith Building, Boston, Massachusetts, USA
| | - Amy E Cullen
- CRUK Cambridge Institute, University of Cambridge, Cambridge, UK
| | | | - Lucy Beevors
- The Institute of Metabolism and Systems Research (IMSR), University of Birmingham, College of Medical and Dental Sciences, Birmingham, UK
| | - Marcel Gehrung
- CRUK Cambridge Institute, University of Cambridge, Cambridge, UK
| | - Sanjeev Kumar
- Chris O'Brien Lifehouse, Sydney, New South Wales, Australia
| | - Kamal Kishore
- CRUK Cambridge Institute, University of Cambridge, Cambridge, UK
| | - Ashley Sawle
- CRUK Cambridge Institute, University of Cambridge, Cambridge, UK
| | - Matthew Eldridge
- CRUK Cambridge Institute, University of Cambridge, Cambridge, UK
| | - Federico M Giorgi
- Department of Pharmacy and Biotechnology, University of Bologna, Bologna, Italy
| | - Katherine S Bridge
- Department of Biology, University of York, York, UK
- York Biomedical Research Institute, University of York, York, UK
| | | | - Andrew N Holding
- Department of Biology, University of York, York, UK
- York Biomedical Research Institute, University of York, York, UK
- The Alan Turing Institute, Kings Cross, London, UK
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Corcoran SR, Phelan JD, Choi J, Shevchenko G, Fenner RE, Yu X, Scheich S, Hsiao T, Morris VM, Papachristou EK, Kishore K, D'Santos CS, Ji Y, Pittaluga S, Wright GW, Urlaub H, Pan KT, Oellerich T, Muppidi J, Hodson DJ, Staudt LM. Molecular Determinants of Sensitivity to Polatuzumab Vedotin in Diffuse Large B Cell Lymphoma. Cancer Discov 2024:745052. [PMID: 38683128 DOI: 10.1158/2159-8290.cd-23-0802] [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] [Received: 07/15/2023] [Revised: 03/12/2024] [Accepted: 04/23/2024] [Indexed: 05/01/2024]
Abstract
Polatuzumab Vedotin (Pola-V) is an antibody-drug conjugate directed to the CD79B subunit of the B cell receptor (BCR). When combined with conventional immunochemotherapy, Pola-V improves outcomes in DLBCL. To identify determinants of Pola-V sensitivity, we used CRISPR-Cas9 screening for genes that modulated Pola-V toxicity for lymphomas or the surface expression of its target, CD79B. Our results reveal the striking impact of CD79B glycosylation on Pola-V epitope availability on the lymphoma cell surface and on Pola-V toxicity. Genetic, pharmacological, and enzymatic approaches that remove sialic acid from N-linked glycans enhanced lymphoma killing by Pola-V. Pola-V toxicity was also modulated by KLHL6, an E3 ubiquitin ligase that is recurrently inactivated in germinal center derived lymphomas. We reveal how KLHL6 targets CD79B for degradation in normal and malignant germinal center B cells, thereby determining expression of the surface BCR complex. Our findings suggest precision medicine strategies to optimize Pola-V as a lymphoma therapeutic.
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Affiliation(s)
| | | | - Jaewoo Choi
- National Cancer Institute, Bethesda, United States
| | | | | | - Xin Yu
- National Cancer Institute, Bethesa, MD, United States
| | | | - Tony Hsiao
- National Institutes of Health, United States
| | | | | | - Kamal Kishore
- Cancer Research UK Cambridge Institute, United Kingdom
| | - Clive S D'Santos
- Cancer Research UK Cambridge Research Institute, Cambridge, United Kingdom
| | - Yanlong Ji
- Max-Planck-Institute for Multidisciplinary Sciences, Goettingen, Germany
| | | | | | - Henning Urlaub
- Max Planck Institute for Multidisciplinary Sciences, Göttingen, Germany
| | - Kuan-Ting Pan
- University Hospital Frankfurt, Frankfurt am Main, Germany
| | | | - Jagan Muppidi
- National Institutes of Health, Bethesda, MD, United States
| | - Daniel J Hodson
- Wellcome/MRC Cambridge Stem Cell Institute, Cambridge, United Kingdom
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Khanna SK, Kishore K, Panchal G. Transcutaneous Hitching Sutures in Paediatric Minimally Invasive Surgery: A Novel Technique of "Assistant Without Port". Afr J Paediatr Surg 2024; 21:81-84. [PMID: 38546243 PMCID: PMC11003575 DOI: 10.4103/ajps.ajps_103_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 09/30/2022] [Accepted: 10/10/2022] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Transcutaneous hitching sutures in paediatric minimally invasive surgery (MIS) is a unique and rare technique. This technique has been used previously in adult patients undergoing gastric resections and laparoscopic cholecystectomy; however, its use in paediatric population has never been reported in the world literature. The primary objective of this study was to bring out the advantages and feasibility of this technique in minimally invasive gastrointestinal, hepatobiliary, urological and thoracoscopic surgeries on paediatric patients. MATERIALS AND METHODS This retrospective observational study was conducted on 167 paediatric patients who underwent MIS surgery for different indications between April 2016 and March 2020 at two paediatric surgery tertiary care centres. RESULTS A total of 167 patients, including 91 boys and 76 girl patients between the age group of new-born period to 12 years were operated. The mean hospital stay was 4 days. Five out of 167 cases (3%) had post-operative surgical emphysema, which resolved spontaneously. At 6-month follow-up, parental satisfaction was 100%, and in 99% of patients, scars were imperceptible. CONCLUSION This versatile technique is of exemplary utility, especially in paediatric patients where there is a paucity of working space at low intra-abdominal pressure, and eases the dissection even in narrow and closed spaces with a better functional and cosmetic outcome.
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Affiliation(s)
- Sanat Kumar Khanna
- Department of Paediatric Surgery, Army Hospital Research and Referral Hospital, New Delhi, India
| | - Kamal Kishore
- Department of Paediatric Surgery, Army Hospital Research and Referral Hospital, New Delhi, India
| | - Gaurav Panchal
- Department of Paediatric Surgery, Military Hospital, Meerut, Uttar Pradesh, India
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Khanna SK, Khanna N, Sharma A, Bayad HC, Kishore K, Tewari VV. Ten Years Analysis of Parental Counselling-in-Continuum in Paediatric Surgery: Psychosocial and Medico-legal Outcome. Afr J Paediatr Surg 2024; 21:90-96. [PMID: 38546245 PMCID: PMC11003569 DOI: 10.4103/ajps.ajps_110_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 11/01/2022] [Accepted: 11/21/2022] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Parents are anxious and apprehensive about the health of their children. A standardised, reproducible and meticulous parental counselling is helpful to both the parents and the treating doctors, as well as markedly reduces instances of scrimmage and medico-legal litigations. The aim of this study is to assess the psychosocial and medico-legal outcomes of parental counselling-in-continuum (PCiC) in paediatric surgery. MATERIALS AND METHODS The study was conducted at two government-run Tertiary Healthcare Centres in North India. The study design involves prospective feedback-based study. It included all the admitted paediatric surgery patients. Periodic multisession PCiC was done for each patient by three paediatric surgery teams from 2011 to 2021. At the time of discharge, feedback was taken to assess the psychosocial outcome of PCiC, and the medico-legal outcome was calculated based on the number of litigations. RESULTS A total of 22,353 admissions were done in paediatric wards at these institutes. 1574 cases were managed conservatively and 20,779 patients who underwent surgeries were included in the study. 4758 (22.89%) were emergency procedures and 16,021 (77.11%) were elective procedures. Parents rated the counselling efforts excellent in 18,285 (81.80%), good in 3162 (14.14%), satisfactory in 876 (3.91%) and poor in 30 (0.13%) cases with zero medico-legal litigations and 12 incidents of scrimmage. CONCLUSIONS PCiC, being a novel concept, should form a centerpiece of paediatric surgical management as it maximally enhances the patient satisfaction level and protects the treating paediatric surgical team from scrimmage and medico-legal litigations.
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Affiliation(s)
- Sanat Kumar Khanna
- Department of Paediatric Surgery, Command Hospital (Western Command), Chandi Mandir, Haryana, India
| | - Neelu Khanna
- Department of Paediatric Surgery, Command Hospital (Western Command), Chandi Mandir, Haryana, India
| | - Avinash Sharma
- Department of Surgery, Military Hospital, Shimla, Himachal Pradesh, India
| | - Himanshu Chhagan Bayad
- Department of Otorhinolaryngology (ENT), Military Hospital, Shimla, Himachal Pradesh, India
| | - Kamal Kishore
- Department of Paediatric Surgery, Army Hospital Research and Referral, New Delhi, India
| | - Vishal Vishnu Tewari
- Department of Paediatrics, Command Hospital (Western Command), Chandi Mandir, Haryana, India
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Kaur I, Kishore K, Suri V, Sahni N, Rana SV, Singh A. Determinants of polycystic ovary syndrome: A matched case-control study. J Hum Nutr Diet 2024; 37:583-592. [PMID: 38234173 DOI: 10.1111/jhn.13282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Accepted: 01/02/2024] [Indexed: 01/19/2024]
Abstract
BACKGROUND Polycystic ovarian syndrome (PCOS) is a multifaceted endocrine disorder of women of reproductive age with a multifactorial aetiology. Despite much research, there is still inconclusive data on the impact of dietary, lifestyle and socio-economic factors on PCOS aetiology. Thus, the present study explored the association of PCOS with diet, eating behaviour, other lifestyle and socio-economic factors. METHODS A matched-pair case-control study was conducted on 150 women with PCOS and 150 healthy controls. Information on diet, eating behaviour and physical activity, and also anthropometric and socio-economic data were collected through standard questionnaires. The adjusted odds ratios (AmOR) were calculated and reported using conditional multivariable logistic regression. RESULTS The results showed low education level (AmOR = 8.44; 95% confidence interval [CI] = 1.63-43.68), high sugar consumption (AmOR = 11.61; 95% CI = 2.05-65.72) along with higher body mass index (BMI) and inactivity to be significantly associated with PCOS. Also, a significant protective effect was found for cognitive dietary restraint (AmOR = 0.79; 95% CI = 0.66-0.93), crude fibre (AmOR = 0.61; 95% CI = 0.45-0.82) and protein intake. CONCLUSIONS Low education status may contribute to higher receptiveness to choosing unhealthy diets and lifestyles, resulting in adiposity and an increased risk of PCOS.
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Affiliation(s)
- Ishwarpreet Kaur
- Department of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Kamal Kishore
- Department of Biostatistics, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Vanita Suri
- Department of Obstetrics & Gynecology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Nancy Sahni
- Department of Dietetics, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Satya Vati Rana
- Department of Gastroenterology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Amarjeet Singh
- Department of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
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Jain A, Jandial A, Mani T, Kishore K, Singh C, Lad D, Prakash G, Khadwal A, Das R, Varma N, Varma S, Malhotra P. Comparable outcomes with low-dose and standard-dose horse anti-thymocyte globulin in the treatment of severe aplastic anemia. Blood Res 2024; 59:6. [PMID: 38485832 PMCID: PMC10903521 DOI: 10.1007/s44313-024-00003-z] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 01/10/2024] [Indexed: 03/18/2024] Open
Abstract
BACKGROUND The standard dose (SD) of horse anti-thymocyte globulin (hATG) ATGAM (Pfizer, USA) or its biosimilar thymogam (Bharat Serum, India) for the treatment of Aplastic Anemia (AA) is 40 mg/kg/day for 4 days in combination with cyclosporine. Data on the impact of hATG dose on long-term outcomes are limited. Here, we describe our comparative experience using 25 mg/kg/day (low-dose [LD]) hATG for 4 days with SD for the treatment of AA. METHODS We retrospectively studied patients with AA (age > 12 years) who received two doses of hATG combined with cyclosporine. Among 93 AA patients who received hATG, 62 (66.7%) and 31 (33.3%) patients received LD and SD hATG with cyclosporine, respectively. Among these,seventeen(18.2%) patients also received eltrombopag with hATG and cyclosporine. Overall response rates [complete response (CR) and partial response (PR)] of LD and SD hATG groups at 3 months (50% vs. 48.4%; p = 0.88), 6 months (63.8% vs. 71.4%; p = 0.67), and 12 months (69.6% vs. 79.2%; p = 0.167) were comparable. The mean (Standard Deviation) 5-year Kaplan-Meier estimate of overall survival and event-free survival was 82.1 (4.6)% and 70.9 (5.5)% for the study population. The mean (standard deviation) 5-year Kaplan-Meier estimate of overall survival and event-free survival of those who received LD hATG versus SD hATG dose was 82.9 (5·3)% versus 74.8 (10·3)% (P = 0·439), and 75.2 (6.2)% versus 61.4(11.2)% (P = 0·441). CONCLUSION Our study revealed that the response rates of patients with AA and LD were similar to those of patients with SD to hATG combined with cyclosporine in a real-world setting.
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Affiliation(s)
- Arihant Jain
- Department of Clinical Hematology and Medical Oncology, PGIMER, Chandigarh, 160012, India
| | - Aditya Jandial
- Department of Clinical Hematology and Medical Oncology, PGIMER, Chandigarh, 160012, India
| | - Thenmozhi Mani
- Department of Biostatistics, CMC, Vellore, Hematology, India
| | - Kamal Kishore
- Department of Biostatistics, PGIMER, Chandigarh, India
| | - Charanpreet Singh
- Department of Clinical Hematology and Medical Oncology, PGIMER, Chandigarh, 160012, India
| | - Deepesh Lad
- Department of Clinical Hematology and Medical Oncology, PGIMER, Chandigarh, 160012, India
| | - Gaurav Prakash
- Department of Clinical Hematology and Medical Oncology, PGIMER, Chandigarh, 160012, India
| | - Alka Khadwal
- Department of Clinical Hematology and Medical Oncology, PGIMER, Chandigarh, 160012, India
| | - Reena Das
- Department of Hematology, PGIMER, Chandigarh, India
| | - Neelam Varma
- Department of Hematology, PGIMER, Chandigarh, India
| | | | - Pankaj Malhotra
- Department of Clinical Hematology and Medical Oncology, PGIMER, Chandigarh, 160012, India.
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Canizela CC, Kishore K. Comment on: Visual Recovery in 2 Cases of Central Retinal Artery Occlusion Treated With Prompt Intraophthalmic Artery Fibrinolysis. J Neuroophthalmol 2024:00041327-990000000-00565. [PMID: 38315984 DOI: 10.1097/wno.0000000000002097] [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: 02/07/2024]
Affiliation(s)
- Cecilia C Canizela
- Department of Surgery (CCC), University of Illinois College of Medicine-Peoria Campus, Peoria, Illinois; and Illinois Retina and Eye Associates (CCC, KK), Peoria, Illinois
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Saseedharan S, Dubey D, Singh RK, Zirpe K, Choudhuri AH, Mukherjee DN, Gupta N, Sahasrabudhe S, Soni S, Kulkarni S, Walse P, Vora AC, Thomas J, Tayade A, Bhadarke G, Kishore K, Paliwal Y, Patil P, Reddy PK, Nagvekar V, Veeraraghavan B. Treatment challenges in the management of difficult-to-treat gram-positive infections: A consensus view apropos therapeutic role of novel anti-MRSA antibiotics, levonadifloxacin (IV) and alalevonadifloxacin (oral). Indian J Med Microbiol 2024; 47:100528. [PMID: 38228227 DOI: 10.1016/j.ijmmb.2024.100528] [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: 09/29/2023] [Revised: 10/22/2023] [Accepted: 01/13/2024] [Indexed: 01/18/2024]
Abstract
PURPOSE Treatment of antibiotic-resistant Gram-positive infections (GPIs), including methicillin-resistant Staphylococcus aureus (MRSA) is becoming increasingly difficult, particularly in patients with multiple co-morbidities who require antibiotics with greater safety and a consistent pharmacokinetic/pharmacodynamic (PK/PD) profile. Such difficult-to-treat GPIs are often associated with poor outcomes, extended hospital stay and increased expenditure. This can be partly attributed to the limited safety and aberrant PK/PD profile of existing anti-MRSA antibiotics. In this context, intravenous levonadifloxacin and its oral prodrug alalevonadifloxacin are novel anti-MRSA antibiotics that have significant advantages over conventional anti-Gram-positive antibiotics. The purpose of this paper was to generate a consensus on the optimal use of levonadifloxacin and alalevonadifloxacin for tackling resistant Gram-positive infections in patients with multiple co-morbidities. METHOD Using a modified Delphi approach that combines critical appraisal of evidence and expert opinion, therapeutic use of levonadifloxacin and alalevonadifloxacin in various clinical scenarios and specific unmet conditions was deliberated. Fifteen expert members from medicine, critical-care, emergency, microbiology, and intensive-care disciplines participated and voted on 11 pre-conceived statements. When there was at least 70 % agreement, a consensus was reached. RESULTS Following the voting, agreements were reached on 10 out of the 11 statements. Broadly, a consensus was reached in defining the therapeutic role of levonadifloxacin and alalevonadifloxacin in the treatment of various clinical indications involving resistant Gram-positive pathogens, including MRSA, in patients with co-morbidities, such as co-existing or increased risk for kidney dysfunction or hepatic disease and/or immunosuppression; also, in therapeutically challenging conditions caused by Gram-positive bacteria such as bacteraemia, bone and joint infection, diabetic foot infection, febrile neutropenia, and hospital-acquired pneumonia. CONCLUSIONS This consensus supports the therapeutic use of levonadifloxacin and alalevonadifloxacin in the treatment of antibiotic-resistant GPIs, including those caused by MRSA and certain polymicrobial infections, in patients with multiple co-morbidities requiring drug with adequate safety and consistent efficacy.
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Affiliation(s)
| | - Dilip Dubey
- Department of Critical Care, Medanta Hospital, Lucknow, India
| | | | - Kapil Zirpe
- Department of Neuro Critical Care, Ruby Hall Clinic, Grant Medical Foundation, Pune, India.
| | | | - Dip Narayan Mukherjee
- Department of Clinical Microbiology & ID, Woodlands, CMRI Hospitals and Belluview Clinic, Kolkata, India
| | - Neha Gupta
- Department of Infectious Diseases, Medanta-The Medicity & Fortis Memorial Research Institute, Gurgaon, India
| | - Shrikant Sahasrabudhe
- Department of Pulmonology and Critical Care Medicine, Medicover Hospitals, Aurangabad, India
| | - Sachin Soni
- Department of Nephrology, Dialysis and Kidney Transplantation, Medicover Hospitals, Aurangabad, India
| | - Sudhir Kulkarni
- Department of Nephrology, MGM Medical College, Aurangabad, India
| | - Prashant Walse
- Department of Critical Care, Asian Hospital, Aurangabad, India
| | | | - Jessy Thomas
- Department of Paediatrics, L H Hiranandani Hospital, Mumbai, India
| | - Ashwini Tayade
- Department of Infectious Diseases, Kingsway Hospital, Nagpur, India
| | - Girish Bhadarke
- Department of Haematology, Sankalp Specialty Hospital, Nashik, India
| | - Kamal Kishore
- Department of Pulmonary & Critical Care, Yashoda Super Speciality Hospital Kaushambi, Ghaziabad, India
| | | | - Pratik Patil
- Department of Infectious Diseases, KIMS, Secunderabad, Telangana, India
| | - Pavan Kumar Reddy
- Department of Critical Care Medicine, Care Hospitals, Banjara Hills, Hyderabad, India
| | - Vasant Nagvekar
- Department of Internal Medicine, Infectious Diseases, Lilavati Hospital & Research Centre, Bandra (W), Mumbai, India
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De D, Shilpa S, Kumar S, Drenovska K, Mehta H, van Beek N, Sachdeva N, Fleva A, Shahid M, Handa S, Giannakou A, Naumova E, Mahajan R, Kyriakou A, Lesichkova S, Lazaridou E, Radotra BD, Kishore K, Schmidt E, Vassileva S, Patsatsi A. Differences among Indian and European pemphigus patients based on demographics, clinical parameters and propensity for relapse: results of a prospective bicontinental cohort study. Eur J Dermatol 2023; 33:642-647. [PMID: 38465545 DOI: 10.1684/ejd.2023.4631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Abstract
Limited studies have explored pemphigus variations among different ethnic groups residing in their respective geographical locations. This bicontinental study aimed to compare clinical and immunological parameters in Indian and European pemphigus patients in complete remission, off therapy, or on minimal therapy. 105 patients (India, n= 75; Bulgaria, n=15; Greece, n=15) with pemphigus vulgaris (PV) or pemphigus foliaceous (PF) in complete remission on minimal therapy (n=64) or complete remission off therapy (n=41) were recruited. Demographic, clinical, and immunological parameters were compared. Indian patients were significantly younger, the maximal disease severity during the preceding active disease phase was significantly lower, and treatment duration until complete remission was significantly shorter, compared to European patients. European patients had significantly higher anti-Dsg3 serum levels and higher IgG positivity rate based on direct immunofluorescence microscopy at baseline. Furthermore, European patients revealed higher CD19, CD19+ CD27+ cell counts, compared with patients from India. Of note, none of the European patients (n=30) relapsed within the study period, in contrast to 29/75 (38.6%) Indian patients. Treatment strategies differed significantly between the two cohorts, with more frequent utilization of rituximab to achieve remission in the Indian cohort, while prednisolone was more widely used for maintaining remission in the European cohort. The observed heterogeneity of pemphigus among patients of different ethnicities in terms of demographics, clinical parameters, and propensity for relapse may be due to genetic background or different treatment strategies.
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Affiliation(s)
- Dipankar De
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Shilpa Shilpa
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Sheetanshu Kumar
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Kossara Drenovska
- Department of Dermatology and Venereology, Faculty of Medicine, Medical University - Sofia, Bulgaria
| | - Hitaishi Mehta
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Nina van Beek
- Department of Dermatology, University of Lübeck, Lübeck, Germany
| | - Naresh Sachdeva
- Department of Endocrinology (Immunology Division), Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Alexandra Fleva
- Department of Immunology-Histocompatibility, Papageorgiou General Hospital, Thessaloniki, Greece
| | - Martin Shahid
- Department of Dermatology and Venereology, Faculty of Medicine, Medical University - Sofia, Bulgaria
| | - Sanjeev Handa
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Anastasia Giannakou
- Department of Immunology-Histocompatibility, Papageorgiou General Hospital, Thessaloniki, Greece
| | - Elissaveta Naumova
- Department of Clinical Immunology, Faculty of Medicine, Medical University - Sofia, Sofia, Bulgaria
| | - Rahul Mahajan
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Aikaterini Kyriakou
- 2nd University Dermatology Department, Aristotle University School of Medicine, Thessaloniki, Greece
| | - Spaska Lesichkova
- Department of Clinical Immunology, Faculty of Medicine, Medical University - Sofia, Sofia, Bulgaria
| | - Elisabeth Lazaridou
- 2nd University Dermatology Department, Aristotle University School of Medicine, Thessaloniki, Greece
| | - Bishan Dass Radotra
- Department Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Kamal Kishore
- Department of Biostatistics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Enno Schmidt
- Department of Dermatology, University of Lübeck, Lübeck, Germany, Lübeck Institute of Experimental Dermatology (LIED), University of Lübeck, Lübeck, Germany
| | - Snejina Vassileva
- Department of Dermatology and Venereology, Faculty of Medicine, Medical University - Sofia, Bulgaria
| | - Aikaterini Patsatsi
- 2nd University Dermatology Department, Aristotle University School of Medicine, Thessaloniki, Greece
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10
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Carden S, Vitiello E, Rosa E Silva I, Holder J, Quarantotti V, Kishore K, Roamio Franklin VN, D'Santos C, Ochi T, van Breugel M, Gergely F. Proteomic profiling of centrosomes across multiple mammalian cell and tissue types by an affinity capture method. Dev Cell 2023; 58:2393-2410.e9. [PMID: 37852252 DOI: 10.1016/j.devcel.2023.09.008] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 07/27/2023] [Accepted: 09/25/2023] [Indexed: 10/20/2023]
Abstract
Centrosomes are the major microtubule-organizing centers in animals and play fundamental roles in many cellular processes. Understanding how their composition varies across diverse cell types and how it is altered in disease are major unresolved questions, yet currently available centrosome isolation protocols are cumbersome and time-consuming, and they lack scalability. Here, we report the development of centrosome affinity capture (CAPture)-mass spectrometry (MS), a powerful one-step purification method to obtain high-resolution centrosome proteomes from mammalian cells. Utilizing a synthetic peptide derived from CCDC61 protein, CAPture specifically isolates intact centrosomes. Importantly, as a bead-based affinity method, it enables rapid sample processing and multiplexing unlike conventional approaches. Our study demonstrates the power of CAPture-MS to elucidate cell-type-dependent heterogeneity in centrosome composition, dissect hierarchical interactions, and identify previously unknown centrosome components. Overall, CAPture-MS represents a transformative tool to unveil temporal, regulatory, cell-type- and tissue-specific changes in centrosome proteomes in health and disease.
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Affiliation(s)
- Sarah Carden
- CRUK Cambridge Institute, Li Ka Shing Centre, University of Cambridge, Cambridge, UK
| | - Elisa Vitiello
- Department of Biochemistry, University of Oxford, Oxford, UK
| | | | - James Holder
- Department of Biochemistry, University of Oxford, Oxford, UK
| | - Valentina Quarantotti
- CRUK Cambridge Institute, Li Ka Shing Centre, University of Cambridge, Cambridge, UK
| | - Kamal Kishore
- CRUK Cambridge Institute, Li Ka Shing Centre, University of Cambridge, Cambridge, UK
| | | | - Clive D'Santos
- CRUK Cambridge Institute, Li Ka Shing Centre, University of Cambridge, Cambridge, UK
| | - Takashi Ochi
- MRC Laboratory of Molecular Biology, Cambridge, UK; The Astbury Centre for Structural Molecular Biology, School of Molecular and Cellular Biology, University of Leeds, Leeds, UK.
| | - Mark van Breugel
- MRC Laboratory of Molecular Biology, Cambridge, UK; School of Biological & Behavioural Sciences, Queen Mary University of London, London, UK.
| | - Fanni Gergely
- CRUK Cambridge Institute, Li Ka Shing Centre, University of Cambridge, Cambridge, UK; Department of Biochemistry, University of Oxford, Oxford, UK.
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11
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Baldrighi M, Doreth C, Li Y, Zhao X, Warner E, Chenoweth H, Kishore K, Umrania Y, Minde DP, Thome S, Yu X, Lu Y, Knapton A, Harrison J, Clarke M, Latz E, de Cárcer G, Malumbres M, Ryffel B, Bryant C, Liu J, Lilley KS, Mallat Z, Li X. PLK1 inhibition dampens NLRP3 inflammasome-elicited response in inflammatory disease models. J Clin Invest 2023; 133:e162129. [PMID: 37698938 PMCID: PMC10617773 DOI: 10.1172/jci162129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 09/06/2023] [Indexed: 09/14/2023] Open
Abstract
Unabated activation of the NLR family pyrin domain-containing 3 (NLRP3) inflammasome is linked with the pathogenesis of various inflammatory disorders. Polo-like kinase 1 (PLK1) has been widely studied for its role in mitosis. Here, using both pharmacological and genetic approaches, we demonstrate that PLK1 promoted NLRP3 inflammasome activation at cell interphase. Using an unbiased proximity-dependent biotin identification (Bio-ID) screen for the PLK1 interactome in macrophages, we show an enhanced proximal association of NLRP3 with PLK1 upon NLRP3 inflammasome activation. We further confirmed the interaction between PLK1 and NLRP3 and identified the interacting domains. Mechanistically, we show that PLK1 orchestrated the microtubule-organizing center (MTOC) structure and NLRP3 subcellular positioning upon inflammasome activation. Treatment with a selective PLK1 kinase inhibitor suppressed IL-1β production in in vivo inflammatory models, including LPS-induced endotoxemia and monosodium urate-induced peritonitis in mice. Our results uncover a role of PLK1 in regulating NLRP3 inflammasome activation during interphase and identify pharmacological inhibition of PLK1 as a potential therapeutic strategy for inflammatory diseases with excessive NLRP3 inflammasome activation.
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Affiliation(s)
- Marta Baldrighi
- The Victor Phillip Dahdaleh Heart and Lung Research Institute, Department of Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Christian Doreth
- The Victor Phillip Dahdaleh Heart and Lung Research Institute, Department of Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Yang Li
- Department of Cardiovascular Surgery, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Xiaohui Zhao
- The Victor Phillip Dahdaleh Heart and Lung Research Institute, Department of Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Emily Warner
- The Victor Phillip Dahdaleh Heart and Lung Research Institute, Department of Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Hannah Chenoweth
- The Victor Phillip Dahdaleh Heart and Lung Research Institute, Department of Medicine, University of Cambridge, Cambridge, United Kingdom
| | | | - Yagnesh Umrania
- Department of Biochemistry, Cambridge Centre for Proteomics, University of Cambridge, Cambridge, United Kingdom
| | - David-Paul Minde
- Department of Biochemistry, Cambridge Centre for Proteomics, University of Cambridge, Cambridge, United Kingdom
| | - Sarah Thome
- The Victor Phillip Dahdaleh Heart and Lung Research Institute, Department of Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Xian Yu
- The Victor Phillip Dahdaleh Heart and Lung Research Institute, Department of Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Yuning Lu
- The Victor Phillip Dahdaleh Heart and Lung Research Institute, Department of Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Alice Knapton
- The Victor Phillip Dahdaleh Heart and Lung Research Institute, Department of Medicine, University of Cambridge, Cambridge, United Kingdom
| | - James Harrison
- The Victor Phillip Dahdaleh Heart and Lung Research Institute, Department of Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Murray Clarke
- The Victor Phillip Dahdaleh Heart and Lung Research Institute, Department of Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Eicke Latz
- Institute of Innate Immunity, University Hospital, University of Bonn, Bonn, Germany
| | - Guillermo de Cárcer
- Cell Division and Cancer Group, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
- Cell Cycle and Cancer Biomarkers Group, “Alberto Sols” Biomedical Research Institute (IIBM-CSIC), Madrid, Spain
| | - Marcos Malumbres
- Cell Division and Cancer Group, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
| | - Bernhard Ryffel
- UMR7355 INEM, Experimental and Molecular Immunology and Neurogenetics CNRS and Université d’Orleans, Orleans, France
| | - Clare Bryant
- Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Jinping Liu
- Department of Cardiovascular Surgery, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Kathryn S. Lilley
- Department of Biochemistry, Cambridge Centre for Proteomics, University of Cambridge, Cambridge, United Kingdom
| | - Ziad Mallat
- The Victor Phillip Dahdaleh Heart and Lung Research Institute, Department of Medicine, University of Cambridge, Cambridge, United Kingdom
- Université Paris Cité, PARCC, INSERM, Paris, France
| | - Xuan Li
- The Victor Phillip Dahdaleh Heart and Lung Research Institute, Department of Medicine, University of Cambridge, Cambridge, United Kingdom
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12
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Gupta K, Bansal M, Kishore K, Goyal D. Successful use of tadalafil in oligohydramnios associated with lupus pregnancy. Reumatologia 2023; 61:219-220. [PMID: 37522141 PMCID: PMC10373169 DOI: 10.5114/reum/167432] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Accepted: 06/05/2023] [Indexed: 08/01/2023] Open
Affiliation(s)
- Kushagra Gupta
- Joint and Autoimmune Clinic, Gupta Medical Centre, Hisar, India
| | - Meenakshi Bansal
- Department of Obstetrics and Gynaecology, Lifeline Hospital, Hisar, India
| | - Kamal Kishore
- Department of Internal Medicine, Geetanjali Hospital, Hisar, India
| | - Divya Goyal
- Critical Care Department, Gupta Medical Centre, Hisar, India
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13
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Kaur I, Singh A, Suri V, Kishore K, Rana SV, Sahni N, Bhattacharya S. Assessment of quality of life in patients having Poly-Cystic Ovarian Syndrome: A cross-sectional facility-based study. J Educ Health Promot 2023; 12:190. [PMID: 37545991 PMCID: PMC10402774 DOI: 10.4103/jehp.jehp_21_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 04/12/2023] [Indexed: 08/08/2023]
Abstract
BACKGROUND Polycystic ovarian syndrome (PCOS) is a complex and heterogeneous disorder affecting various body organs. Menstrual irregularity, anovulation, and many cosmetic issues faced by PCOS patients endanger the essence of being a woman and may have a deleterious impact on their health-related quality of life (HRQOL). This study aimed to assess HRQOL in patients with PCOS and to identify the clinical and socio-demographic factors that might predict poor HRQOL. MATERIALS AND METHODS This cross-sectional study was carried out in the tertiary care hospital in India. A total of 275 women visiting the same setting and diagnosed with PCOS were included. The participants' quality of life was studied using a disease-specific HRQOL questionnaire. Information regarding clinical and socio-demographics was collected using the interviewer schedule. For evaluating the predictors of HRQOL in PCOS subjects, analysis of variance and independent t-test was applied. For subgroup analysis, the post hoc (Gabriel) test was applied. RESULTS The average total score of HRQOL of the study participants was 125.41 ± 29.1. The lowest weighted mean score was for menstrual problems. Among the socio-demographic variables, age and educational level influenced the HRQOL scores. Highly educated women reported the poorest HRQOL. The analysis of variance also indicated a significant variation in HRQOL scores among body mass index categories [F (4,270) = 5.09, P = <.001] and hirsutism status [F (2,272) = 14.222, P =<.001]. CONCLUSIONS Menstrual irregularity, hirsutism, increased body mass index, educational status, and age are critical in altering HRQOL in PCOS cases. Clinicians should inquire about the HRQOL of patients with severe clinical manifestations and appropriate support must be provided during patient care.
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Affiliation(s)
- Ishwarpreet Kaur
- Department of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Amarjeet Singh
- Department of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Vanita Suri
- Department of Obstetrics and Gynecology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Kamal Kishore
- Department of Biostatistics, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Satya Vati Rana
- Department of Gastroenterology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Nancy Sahni
- Department of Dietetics, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Sudip Bhattacharya
- Department of Community and Family Medicine, All India Institute of Medical Sciences (AIIMS), Deoghar, Jharkhand, India
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14
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Kaur I, Singh A, Suri V, Kishore K, Rana SV, Sahni N, Bhattacharya S. Treatment seeking behavior among patients with polycystic ovarian syndrome (PCOS)-A cross-sectional study from Northern India. J Educ Health Promot 2023; 12:194. [PMID: 37546021 PMCID: PMC10402790 DOI: 10.4103/jehp.jehp_102_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 04/12/2023] [Indexed: 08/08/2023]
Abstract
BACKGROUND Polycystic ovarian syndrome (PCOS) has now become a common problem among adolescent girls and young women in India. However, little is known about the treatment and satisfaction incurred from it. Our study aimed to assess the treatment-seeking behaviour among patients with PCOS. MATERIALS AND METHODS The cross-sectional study was carried out in gynecology OPD of PGIMER, Chandigarh. Women with PCOS, 275, visiting the gynecology OPD were included. The treatment-seeking behavior for PCOS was elucidated among cases using a questionnaire. This included parameters like healthcare consulted, preferred system of medicine, referral pattern, treatment efficacy, and expenses incurred. Univariate descriptive analysis was used to present the results. RESULTS The majority (68%) of the study participants were less than 25 years of age. The average weight was 66.78 (±13.0) Kg. Half of the participants were students. More than 70% belonged to the upper or upper-middle class. The study participants were diagnosed with PCOS at an average age of 21.4 (±4.7) years. The minimum age reported at diagnosis was 11 years, and the maximum age of diagnosis was 36 years. Most respondents preferred Allopathic treatment followed by homeopathy and Ayurveda. Few also opted for other treatment choices like diet therapy, yoga & meditation, weight loss supplements, and home remedies. Treatment efficacy ranged between 17.3%-34.2%. The majority of respondents reported the treatment to be moderately expensive. Most respondents (58.91%) were hardly influenced, while 16% were quite influenced by PCOS medicine or treatment advertisements. CONCLUSION PCOS patients opt for different treatment options but generally find the treatment less effective and expensive.
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Affiliation(s)
- Ishwarpreet Kaur
- Department of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Amarjeet Singh
- Department of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Vanita Suri
- Department of Obstetrics and Gynecology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Kamal Kishore
- Department of Biostatistics, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Satya Vati Rana
- Department of Gastroenterology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Nancy Sahni
- Department of Dietetics, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Sudip Bhattacharya
- Department of Community and Family Medicine, All India Institute of Medical Sciences (AIIMS), Deoghar, Jharkhand, India
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15
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Hansen AB, Kishore K, Klein KL. Hyperacute Central Retinal Artery Occlusion With Normal Fundus: A Diagnostic and Therapeutic Challenge. J Neuroophthalmol 2023; Publish Ahead of Print:00041327-990000000-00368. [PMID: 37267040 DOI: 10.1097/wno.0000000000001893] [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: 06/04/2023]
Affiliation(s)
- Allison B Hansen
- Department of Surgery (ABH, KK), University of Illinois College of Medicine-Peoria Campus, Peoria, Illinois; Illinois Retina and Eye Associates (KK), Peoria, Illinois; and KSB Lawless Eye and Vision Center (KLK), Dixon, Illinois
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16
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Maralakunte M, Gupta V, Grover S, Ahuja CK, Sahoo S, Kishore K, Vyas S, Garg G, Singh P, Govind V. Cross-sectional analysis of whole-brain microstructural changes in adult patients with bipolar and unipolar depression by diffusion kurtosis imaging. Neuroradiol J 2023; 36:176-181. [PMID: 35817080 PMCID: PMC10034704 DOI: 10.1177/19714009221114446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
RATIONALE AND OBJECTIVES More than half of the bipolar depression (BD) subjects are misdiagnosed as unipolar depression (UD) due to lack of objective diagnostic criteria. We aimed to identify microstructural neuronal changes differentiating BD from UD groups using diffusion kurtosis imaging (DKI). The objective of the study is to identify an objective neuro-imaging marker to differentiate BD from UD. MATERIALS AND METHODS A prospective, cross-sectional study included total of 62 subjects with diagnosis of bipolar depression (n = 21), unipolar depression (n = 21), and healthy controls (n = 20). All subjects underwent diffusion-weighted imaging (b = 0,1000,2000) of the whole brain on 3-Tesla MR scanner. DKI data was analyzed using 189 region whole-brain atlas. Eight diffusion and kurtosis metrics including mean diffusivity (MD), axial diffusivity (AD), radial diffusivity (RD), fractional anisotropy (FA), mean kurtosis (MK), axial kurtosis (AK), radial kurtosis (RK), and kurtosis fractional anisotropy (FKA) were measured against these 189 regions. Principle component analysis (PCA) was utilized to identify the most significant regions of the brain. ANOVA with post hoc tests was used for analyzing these regions. RESULTS BD group showed increased MD, RD, decreased AK at the left amygdala and decreased MK and RK at the right hemi-cerebellum. UD group showed increased MK and RK at the right external capsule; and increased AK, MK, and RK at the right amygdala. CONCLUSION The right and left amygdala, right external capsule, and right hemi-cerebellum showed microstructural abnormalities capable of differentiating BD and UD groups. Diffusion imaging especially DKI can aid in management of depression patients.
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Affiliation(s)
| | - Vivek Gupta
- Interventional Neuroradiology, Fortis Hospital, India
| | | | | | | | | | - Sameer Vyas
- Department of Radiodiagnosis and
Imaging, PGIMER, India
| | - Gaurav Garg
- Department of Radiodiagnosis and
Imaging, PGIMER, India
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17
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Pavlou S, Foskolou S, Patikas N, Field SF, Papachristou EK, Santos CD, Edwards AR, Kishore K, Ansari R, Rajan SS, Fernandes HJR, Metzakopian E. CRISPR-Cas9 genetic screen leads to the discovery of L-Moses, a KAT2B inhibitor that attenuates Tunicamycin-mediated neuronal cell death. Sci Rep 2023; 13:3934. [PMID: 36894612 PMCID: PMC9998435 DOI: 10.1038/s41598-023-31141-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Accepted: 03/07/2023] [Indexed: 03/11/2023] Open
Abstract
Accumulation of aggregated and misfolded proteins, leading to endoplasmic reticulum stress and activation of the unfolded protein response, is a hallmark of several neurodegenerative disorders, including Alzheimer's and Parkinson's disease. Genetic screens are powerful tools that are proving invaluable in identifying novel modulators of disease associated processes. Here, we performed a loss-of-function genetic screen using a human druggable genome library, followed by an arrayed-screen validation, in human iPSC-derived cortical neurons. We identified and genetically validated 13 genes, whose knockout was neuroprotective against Tunicamycin, a glycoprotein synthesis inhibitor widely used to induce endoplasmic reticulum stress. We also demonstrated that pharmacological inhibition of KAT2B, a lysine acetyltransferase identified by our genetic screens, by L-Moses, attenuates Tunicamycin-mediated neuronal cell death and activation of CHOP, a key pro-apoptotic member of the unfolded protein response in both cortical and dopaminergic neurons. Follow-up transcriptional analysis suggested that L-Moses provided neuroprotection by partly reversing the transcriptional changes caused by Tunicamycin. Finally, L-Moses treatment attenuated total protein levels affected by Tunicamycin, without affecting their acetylation profile. In summary, using an unbiased approach, we identified KAT2B and its inhibitor, L-Moses, as potential therapeutic targets for neurodegenerative diseases.
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Affiliation(s)
- Sofia Pavlou
- UK Dementia Research Institute, Department of Clinical Neurosciences, Cambridge Biomedical Campus, University of Cambridge, Cambridge, CB2 0AH, UK.
- Open Targets, Wellcome Genome Campus, Hinxton, Cambridge, CB10 1SA, UK.
| | - Stefanie Foskolou
- UK Dementia Research Institute, Department of Clinical Neurosciences, Cambridge Biomedical Campus, University of Cambridge, Cambridge, CB2 0AH, UK
- Open Targets, Wellcome Genome Campus, Hinxton, Cambridge, CB10 1SA, UK
| | - Nikolaos Patikas
- UK Dementia Research Institute, Department of Clinical Neurosciences, Cambridge Biomedical Campus, University of Cambridge, Cambridge, CB2 0AH, UK
| | - Sarah F Field
- UK Dementia Research Institute, Department of Clinical Neurosciences, Cambridge Biomedical Campus, University of Cambridge, Cambridge, CB2 0AH, UK
- Open Targets, Wellcome Genome Campus, Hinxton, Cambridge, CB10 1SA, UK
| | - Evangelia K Papachristou
- Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, UK
| | - Clive D' Santos
- Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, UK
| | - Abigail R Edwards
- Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, UK
| | - Kamal Kishore
- Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, UK
| | - Rizwan Ansari
- UK Dementia Research Institute, Department of Clinical Neurosciences, Cambridge Biomedical Campus, University of Cambridge, Cambridge, CB2 0AH, UK
| | - Sandeep S Rajan
- UK Dementia Research Institute, Department of Clinical Neurosciences, Cambridge Biomedical Campus, University of Cambridge, Cambridge, CB2 0AH, UK
- Open Targets, Wellcome Genome Campus, Hinxton, Cambridge, CB10 1SA, UK
| | - Hugo J R Fernandes
- UK Dementia Research Institute, Department of Clinical Neurosciences, Cambridge Biomedical Campus, University of Cambridge, Cambridge, CB2 0AH, UK
- Open Targets, Wellcome Genome Campus, Hinxton, Cambridge, CB10 1SA, UK
| | - Emmanouil Metzakopian
- UK Dementia Research Institute, Department of Clinical Neurosciences, Cambridge Biomedical Campus, University of Cambridge, Cambridge, CB2 0AH, UK.
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18
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MAGAL A, Kishore K, Mallapura Maheswarappa H, Sripad Bhat R. WCN23-0418 ASSOCIATION OF RED CELL DISTRIBUTION WIDTH (RDW) AND NEUTROPHIL LYMPHOCYTE RATIO (NLR) WITH OUTCOMES AMONG PATIENTS WITH ACUTE KIDNEY INJURY (AKI) IN CRITICAL CARE SETTING. Kidney Int Rep 2023. [DOI: 10.1016/j.ekir.2023.02.014] [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: 03/22/2023] Open
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19
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Demond H, Hanna CW, Castillo-Fernandez J, Santos F, Papachristou EK, Segonds-Pichon A, Kishore K, Andrews S, D'Santos CS, Kelsey G. Multi-omics analyses demonstrate a critical role for EHMT1 methyltransferase in transcriptional repression during oogenesis. Genome Res 2023; 33:18-31. [PMID: 36690445 PMCID: PMC9977154 DOI: 10.1101/gr.277046.122] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 12/22/2022] [Indexed: 01/25/2023]
Abstract
EHMT1 (also known as GLP) is a multifunctional protein, best known for its role as an H3K9me1 and H3K9me2 methyltransferase through its reportedly obligatory dimerization with EHMT2 (also known as G9A). Here, we investigated the role of EHMT1 in the oocyte in comparison to EHMT2 using oocyte-specific conditional knockout mouse models (Ehmt2 cKO, Ehmt1 cKO, Ehmt1/2 cDKO), with ablation from the early phase of oocyte growth. Loss of EHMT1 in Ehmt1 cKO and Ehmt1/2 cDKO oocytes recapitulated meiotic defects observed in the Ehmt2 cKO; however, there was a significant impairment in oocyte maturation and developmental competence in Ehmt1 cKO and Ehmt1/2 cDKO oocytes beyond that observed in the Ehmt2 cKO. Consequently, loss of EHMT1 in oogenesis results, upon fertilization, in mid-gestation embryonic lethality. To identify H3K9 methylation and other meaningful biological changes in each mutant to explore the molecular functions of EHMT1 and EHMT2, we performed immunofluorescence imaging, multi-omics sequencing, and mass spectrometry (MS)-based proteome analyses in cKO oocytes. Although H3K9me1 was depleted only upon loss of EHMT1, H3K9me2 was decreased, and H3K9me2-enriched domains were eliminated equally upon loss of EHMT1 or EHMT2. Furthermore, there were more significant changes in the transcriptome, DNA methylome, and proteome in Ehmt1/2 cDKO than Ehmt2 cKO oocytes, with transcriptional derepression leading to increased protein abundance and local changes in genic DNA methylation in Ehmt1/2 cDKO oocytes. Together, our findings suggest that EHMT1 contributes to local transcriptional repression in the oocyte, partially independent of EHMT2, and is critical for oogenesis and oocyte developmental competence.
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Affiliation(s)
- Hannah Demond
- Epigenetics Programme, Babraham Institute, Cambridge CB22 3AT, United Kingdom;,Millennium Institute on Immunology and Immunotherapy, Laboratory of Integrative Biology (LIBi), Centro de Excelencia en Medicina Traslacional (CEMT), Scientific and Technological Bioresource Nucleus (BIOREN), Universidad de La Frontera, 4810296, Temuco, Chile
| | - Courtney W. Hanna
- Epigenetics Programme, Babraham Institute, Cambridge CB22 3AT, United Kingdom;,Centre for Trophoblast Research, University of Cambridge, Cambridge CB2 3EG, United Kingdom;,Department of Physiology, Development, and Neuroscience, University of Cambridge, Cambridge CB2 3EG, United Kingdom
| | | | - Fátima Santos
- Epigenetics Programme, Babraham Institute, Cambridge CB22 3AT, United Kingdom;,Centre for Trophoblast Research, University of Cambridge, Cambridge CB2 3EG, United Kingdom
| | - Evangelia K. Papachristou
- Cancer Research UK Cambridge Institute, Li Ka Shing Centre, University of Cambridge, Cambridge CB2 0RE, United Kingdom
| | - Anne Segonds-Pichon
- Bioinformatics Group, Babraham Institute, Cambridge CB22 3AT, United Kingdom
| | - Kamal Kishore
- Cancer Research UK Cambridge Institute, Li Ka Shing Centre, University of Cambridge, Cambridge CB2 0RE, United Kingdom
| | - Simon Andrews
- Bioinformatics Group, Babraham Institute, Cambridge CB22 3AT, United Kingdom
| | - Clive S. D'Santos
- Cancer Research UK Cambridge Institute, Li Ka Shing Centre, University of Cambridge, Cambridge CB2 0RE, United Kingdom
| | - Gavin Kelsey
- Epigenetics Programme, Babraham Institute, Cambridge CB22 3AT, United Kingdom;,Centre for Trophoblast Research, University of Cambridge, Cambridge CB2 3EG, United Kingdom;,Wellcome-MRC Institute of Metabolic Science–Metabolic Research Laboratories, Cambridge CB2 0QQ, United Kingdom
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20
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Davera S, Chand K, Kishore K, Singh V. Glial Choristoma of the Tongue: a Rare Cause of Congenital Macroglossia. Indian J Surg 2022. [DOI: 10.1007/s12262-022-03606-x] [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: 11/06/2022] Open
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21
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Kishore K. Interrelationship of deposits and borrowings with capital adequacy ratio empirical analysis of Indian banks. Journal of Information and Optimization Sciences 2022. [DOI: 10.1080/02522667.2022.2128520] [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: 12/04/2022]
Affiliation(s)
- Kamal Kishore
- Department of Finance, Apeejay School of Management, Sector 8, Institution Area, Dwarka, New Delhi 110077, India
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Ahmad R, Saraf A, Kishore K, Kalsotra P. Relation of Superior Laryngeal Nerve and Superior Thyroid Artery with Superior Pole of Thyroid During Thyroid Surgery. Indian J Otolaryngol Head Neck Surg 2022; 74:2095-2098. [PMID: 36452603 PMCID: PMC9702245 DOI: 10.1007/s12070-020-01949-z] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 07/03/2020] [Indexed: 11/30/2022] Open
Abstract
The purpose of this study was to evaluate relation between superior thyroid vessels, external branch of superior laryngeal nerve and superior pole of thyroid based on Cernea classification in Jammu population. The present study was conducted on 50 patients in Department of ENT & Head and Neck Surgery, SMGS Hospital, Government Medical College Jammu during a time period of January 2018 to March 2020. Patients undergoing selective thyroid surgeries for various pathologies were included in the study. Patients with preoperative vocal cord palsy and patients with malignant thyroid neoplasms were excluded from the study. All patients were operated under general anaesthesia, with supine neck extended position. The bifurcation and the branches of STA were meticulously dissected preserving all the branches and any anastomoses if present. Once visualization of the nerve was attained, various measurements were taken to assess Cernea classification type. Depending on extent of lesion appropriate surgical procedure was done so as remove all the diseased tissue. Out of total 62 lobes, Cernea's Type 1 pattern was seen in 33 (53.2%) of patients, Cernea's Type 2a was seen in 11 patients (17.7%) and Cernea's Type 2b was seen in 14 patients (22.5%). No specific pattern was seen in 4 (6.4%) of patients. Cernea classification system is a simple and reliable guide to identify and preserve the nerve.
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Affiliation(s)
- Raies Ahmad
- Department of ENT & Head and Neck Surgery, SMGS Hospital, Government Medical College, Jammu, Jammu, Jammu and Kashmir 180 001 India
| | - Aditiya Saraf
- Department of ENT & Head and Neck Surgery, SMGS Hospital, Government Medical College, Jammu, Jammu, Jammu and Kashmir 180 001 India
| | - Kamal Kishore
- Department of ENT & Head and Neck Surgery, SMGS Hospital, Government Medical College, Jammu, Jammu, Jammu and Kashmir 180 001 India
| | - Parmod Kalsotra
- Department of ENT & Head and Neck Surgery, SMGS Hospital, Government Medical College, Jammu, Jammu, Jammu and Kashmir 180 001 India
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Hanna J, Beke F, O'Brien LM, Kapeni C, Chen HC, Carbonaro V, Kim AB, Kishore K, Adolph TE, Skjoedt MO, Skjoedt K, de la Roche M, de la Roche M. Cell-autonomous Hedgehog signaling controls Th17 polarization and pathogenicity. Nat Commun 2022; 13:4075. [PMID: 35835905 PMCID: PMC9281293 DOI: 10.1038/s41467-022-31722-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 06/30/2022] [Indexed: 11/17/2022] Open
Abstract
Th17 cells are key drivers of autoimmune disease. However, the signaling pathways regulating Th17 polarization are poorly understood. Hedgehog signaling regulates cell fate decisions during embryogenesis and adult tissue patterning. Here we find that cell-autonomous Hedgehog signaling, independent of exogenous ligands, selectively drives the polarization of Th17 cells but not other T helper cell subsets. We show that endogenous Hedgehog ligand, Ihh, signals to activate both canonical and non-canonical Hedgehog pathways through Gli3 and AMPK. We demonstrate that Hedgehog pathway inhibition with either the clinically-approved small molecule inhibitor vismodegib or genetic ablation of Ihh in CD4+ T cells greatly diminishes disease severity in two mouse models of intestinal inflammation. We confirm that Hedgehog pathway expression is upregulated in tissue from human ulcerative colitis patients and correlates with Th17 marker expression. This work implicates Hedgehog signaling in Th17 polarization and intestinal immunopathology and indicates the potential therapeutic use of Hedgehog inhibitors in the treatment of inflammatory bowel disease.
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Affiliation(s)
- Joachim Hanna
- Cancer Research UK Cambridge Institute, University of Cambridge, Robinson Way, Cambridge, CB2 0RE, UK
| | - Flavio Beke
- Cancer Research UK Cambridge Institute, University of Cambridge, Robinson Way, Cambridge, CB2 0RE, UK
| | - Louise M O'Brien
- Cancer Research UK Cambridge Institute, University of Cambridge, Robinson Way, Cambridge, CB2 0RE, UK
| | - Chrysa Kapeni
- Cancer Research UK Cambridge Institute, University of Cambridge, Robinson Way, Cambridge, CB2 0RE, UK
| | - Hung-Chang Chen
- Cancer Research UK Cambridge Institute, University of Cambridge, Robinson Way, Cambridge, CB2 0RE, UK
| | - Valentina Carbonaro
- Cancer Research UK Cambridge Institute, University of Cambridge, Robinson Way, Cambridge, CB2 0RE, UK
| | - Alexander B Kim
- Cancer Research UK Cambridge Institute, University of Cambridge, Robinson Way, Cambridge, CB2 0RE, UK
| | - Kamal Kishore
- Cancer Research UK Cambridge Institute, University of Cambridge, Robinson Way, Cambridge, CB2 0RE, UK
| | - Timon E Adolph
- Department of Internal Medicine I, Gastroenterology, Hepatology & Endocrinology, Medical University Innsbruck, Innsbruck, Austria
| | - Mikkel-Ole Skjoedt
- Rigshospitalet - University Hospital Copenhagen, Blegdamsvej 9, 2100, Copenhagen, Denmark
- Institute of Immunology and Microbiology, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen, Denmark
| | - Karsten Skjoedt
- University of Southern Denmark, J.B.Winslows Vej, 5000, Odense C, Denmark
| | - Marc de la Roche
- Department of Biochemistry, University of Cambridge, 80 Tennis Court Road, Cambridge, CB2 1GA, UK
| | - Maike de la Roche
- Cancer Research UK Cambridge Institute, University of Cambridge, Robinson Way, Cambridge, CB2 0RE, UK.
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Joseph J, Varghese A, Vijay VR, Grover S, Sharma S, Dhandapani M, Khakha DC, Arya S, Mahendia N, Varkey BP, Kishore K. The prevalence of alcohol use disorders using alcohol use disorders identification test (AUDIT) in the Indian setting: - a systematic review and meta-analysis. J Ethn Subst Abuse 2022; 23:2-20. [PMID: 35404781 DOI: 10.1080/15332640.2022.2056105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
There is a wide discrepancy in the epidemiology of alcohol use disorders (AUDs) due to diverse scales and survey approaches. We estimated the prevalence of AUDs by comparing the pooled prevalence based on the alcohol use disorders identification test (AUDIT) Vs. non-AUDIT (all scales other than AUDIT). This review searched the community-based prevalence of AUDs in PubMed, Web of Science, PsycINFO, Scopus, Ovid, and Google Scholar. Articles published during the years from 2000 to 2020 were included. The methodological quality of each study was scored, and data were extracted from the published reports. Pooled prevalence was estimated, and the publication bias was evaluated. Twenty-one studies conducted in different states of India included 73997 community-based respondents, which estimated the overall prevalence of AUDs as 12.5% (95% CI: 9 to 17.3%). The pooled prevalence based on AUDIT was 12.4% (AUDIT ≥8; 95% CI: 8.8 to 17.1%) in which the magnitude of hazardous and harmful alcohol use (8.6%; 95% CI: 5.7 to 12.8%; AUDIT 8-19) was significantly higher than dependent alcohol use (2.3%; 95% CI: 1.1 to 4.8%; AUDIT ≥ 20). The pooled prevalence using the non-AUDIT tool was 14.2(95%; CI: 6-30%). Our findings further reveal that about one in twelve of the population of India have AUDs, and there is a gross variation in the patterns of alcohol use across the country. The high prevalence of AUDs suggests developing a national policy to benefit alcohol use, justifying regional variations.Supplemental data for this article is available online at https://doi.org/10.1080/15332640.2022.2056105 .
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Affiliation(s)
- Jaison Joseph
- Pandit Bhagwat Dayal Sharma University of Health Sciences, Rohtak, India
| | - Abin Varghese
- All India Institute of Medical Sciences, Nagpur, India
| | - V R Vijay
- AIl India Institute of Medical Sciences (AIIMS), Bhubaneswar, India
| | - Sandeep Grover
- Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Suresh Sharma
- All India Institute of Medical Sciences (AIIMS), Jodhpur, India
| | - Manju Dhandapani
- Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Deepika C Khakha
- All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Sidharth Arya
- Institute of Mental Health, Pandit Bhagwat Dayal Sharma University of Health Sciences, Rohtak, India
| | - Neeraj Mahendia
- All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Biji P Varkey
- Pandit Bhagwat Dayal Sharma University of Health Sciences, Rohtak, India
| | - Kamal Kishore
- Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
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25
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Kishore K, Bhat PV, Venkatesh P, Canizela CC. Dexamethasone Intravitreal Implant for the Treatment of Macular Edema and Uveitis: A Comprehensive Narrative Review. Clin Ophthalmol 2022; 16:1019-1045. [PMID: 35418744 PMCID: PMC8995179 DOI: 10.2147/opth.s209395] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 03/10/2022] [Indexed: 01/09/2023] Open
Abstract
Purpose The purpose of this review article is to provide a comprehensive review of the current applications of intravitreal DEX implant (Ozurdex®, Allergan Inc, Irvine, CA) for a variety of ophthalmic conditions – ranging from FDA approved indications to off-label uses. We have attempted to provide relevant evidence from the literature to help a reader develop an understanding of the biological and pharmacokinetic properties of DEX implant, its uses, and potential side effects. Methods PubMed searches were performed using the terms “Ozurdex”, or “intravitreal DEX implant”, AND “retinal vein occlusion”, or “diabetic macular edema”, or “uveitis”. The search was performed in July of 2021, with an additional search in October 2021. All original English language articles were considered for this review. Results DEX implant has evidence of efficacy in a variety of clinical situations including macular edema associated with retinal vein occlusion, diabetes, uveitis, and others. Safety concerns include cataract formation and progression, intraocular pressure elevation, complications related to intravitreal injection, and opportunistic infections secondary to steroid-induced immune suppression. Conclusion DEX implant is a useful tool in the management of several retinal disorders. Further studies are needed for head-to-head comparison with other treatment modalities and to determine its precise place in clinical practice.
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Affiliation(s)
- Kamal Kishore
- Illinois Retina and Eye Associates, Peoria, IL, USA
- Department of Surgery, University of Illinois College of Medicine, Peoria, IL, USA
- Correspondence: Kamal Kishore, Illinois Retina and Eye Associates, 4505 N Rockwood Drive, Suite 1, Peoria, IL, 61615, USA, Tel +1 3095891880, Fax +1 3095891885, Email
| | - Pooja V Bhat
- Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, University of Illinois at Chicago, Chicago, IL, 60612, USA
| | - Pradeep Venkatesh
- Department of Ophthalmology, Dr. Rajendra Prasad Center for Ophthalmic Sciences, AIIMS, Ansari Nagar, New Delhi, 110029, India
| | - Cecilia C Canizela
- Department of Surgery, University of Illinois College of Medicine, Peoria, IL, USA
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Collier AJ, Bendall A, Fabian C, Malcolm AA, Tilgner K, Semprich CI, Wojdyla K, Nisi PS, Kishore K, Roamio Franklin VN, Mirshekar-Syahkal B, D’Santos C, Plath K, Yusa K, Rugg-Gunn PJ. Genome-wide screening identifies Polycomb repressive complex 1.3 as an essential regulator of human naïve pluripotent cell reprogramming. Sci Adv 2022; 8:eabk0013. [PMID: 35333572 PMCID: PMC8956265 DOI: 10.1126/sciadv.abk0013] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 02/02/2022] [Indexed: 06/14/2023]
Abstract
Uncovering the mechanisms that establish naïve pluripotency in humans is crucial for the future applications of pluripotent stem cells including the production of human blastoids. However, the regulatory pathways that control the establishment of naïve pluripotency by reprogramming are largely unknown. Here, we use genome-wide screening to identify essential regulators as well as major impediments of human primed to naïve pluripotent stem cell reprogramming. We discover that factors essential for cell state change do not typically undergo changes at the level of gene expression but rather are repurposed with new functions. Mechanistically, we establish that the variant Polycomb complex PRC1.3 and PRDM14 jointly repress developmental and gene regulatory factors to ensure naïve cell reprogramming. In addition, small-molecule inhibitors of reprogramming impediments improve naïve cell reprogramming beyond current methods. Collectively, this work defines the principles controlling the establishment of human naïve pluripotency and also provides new insights into mechanisms that destabilize and reconfigure cell identity during cell state transitions.
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Affiliation(s)
- Amanda J. Collier
- Epigenetics Programme, Babraham Institute, Cambridge, UK
- Department of Biological Chemistry, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
| | - Adam Bendall
- Epigenetics Programme, Babraham Institute, Cambridge, UK
| | | | - Andrew A. Malcolm
- Epigenetics Programme, Babraham Institute, Cambridge, UK
- Wellcome–MRC Cambridge Stem Cell Institute, Jeffrey Cheah Biomedical Centre, University of Cambridge, Cambridge, UK
| | - Katarzyna Tilgner
- Stem Cell Genetics, Wellcome Sanger Institute, Hinxton, Cambridge, UK
| | | | | | | | - Kamal Kishore
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
| | | | | | - Clive D’Santos
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
| | - Kathrin Plath
- Department of Biological Chemistry, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
| | - Kosuke Yusa
- Stem Cell Genetics, Wellcome Sanger Institute, Hinxton, Cambridge, UK
- Stem Cell Genetics, Institute for Frontier Life and Medical Sciences, Kyoto University, Kyoto, Japan
| | - Peter J. Rugg-Gunn
- Epigenetics Programme, Babraham Institute, Cambridge, UK
- Wellcome–MRC Cambridge Stem Cell Institute, Jeffrey Cheah Biomedical Centre, University of Cambridge, Cambridge, UK
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Kishore K, Chan VW, Neekhra A. Comment on Chan W, Flowers AM, Meyer BI, et al. acute central retinal artery occlusion seen within 24 hours at a tertiary institution. J Stroke Cerebrovasc Dis 2021; 30:105988. J Stroke Cerebrovasc Dis 2022; 31:106392. [PMID: 35221226 DOI: 10.1016/j.jstrokecerebrovasdis.2022.106392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Accepted: 02/01/2022] [Indexed: 11/17/2022] Open
Affiliation(s)
- Kamal Kishore
- Illinois Retina and Eye Associates, 4505 N. Rockwood Drive, Suite 1, Peoria, IL 61615, USA; Dept of Surgery, University of Illinois College of Medicine, Peoria Campus, Peoria, IL 61615, USA.
| | - Victor W Chan
- Chief, Emergency Services, OSF Healthcare Saint Francis Medical Center, Peoria, IL 61615, USA; Clinical Assistant Professor, University of Illinois College of Medicine, Peoria, IL 61615, USA.
| | - Aneesh Neekhra
- Illinois Retina and Eye Associates, 4505 N. Rockwood Drive, Suite 1, Peoria, IL 61615, USA; Department of Neurology, UnityPoint Hospitals, Peoria, IL 61615, USA.
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Kishore K, Hariprasad SM, Mungee S. Perioperative Antiplatelet Agents and Anticoagulants in Vitreoretinal Surgery. Ophthalmic Surg Lasers Imaging Retina 2022; 53:71-78. [PMID: 35148217 DOI: 10.3928/23258160-20220128-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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29
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Mahajan R, Kishore K, Jaswal V. The challenges of interpreting ANOVA by dermatologists. Indian Dermatol Online J 2022; 13:109-113. [PMID: 35198479 PMCID: PMC8809174 DOI: 10.4103/idoj.idoj_307_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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 07/28/2021] [Accepted: 07/29/2021] [Indexed: 11/04/2022] Open
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Sharma S, Gohil R, Patel S, Kishore K, Singh A, Rajnish RK, Dhillon MS. Impact of the COVID-19 Lockdown and Confinement Measures on the Musculoskeletal Health of the Urban Geriatric Population. Cureus 2021; 13:e19212. [PMID: 34873541 PMCID: PMC8638804 DOI: 10.7759/cureus.19212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/02/2021] [Indexed: 11/25/2022] Open
Abstract
Background Owing to the coronavirus disease 2019 (COVID-19) pandemic, a nationwide lockdown was imposed in India, with strict confinement measures imposed on the elderly. Because mobility and regular physical activity are considered to be the key determinants of musculoskeletal health, this study aimed to investigate the effect of lockdown and confinement measures on the musculoskeletal health and activities of daily living of the urban geriatric population. Methodology A cross-sectional survey was conducted among the elderly aged ≥60 years. The survey instrument consisted of a questionnaire, a modified Nordic Musculoskeletal Questionnaire (mNMQ), and the Barthel activities of daily living (ADL) index. The net mNMQ score and Barthel ADL index were compared before and during the lockdown. Univariate and multivariate analyses were performed to determine which factors could result in the worsening of the net mNMQ score. In addition, floor and ceiling effects of the net mNMQ score were determined. Results In this study, a total of 105 out of 150 eligible participants were enrolled. A significant decline in physical activity status was noted during the lockdown. Overall, 54.3% of the respondents reported that their medical services were impacted during the lockdown. The net mNMQ score showed a significant worsening during the lockdown (P < 0.0001). A statistically significant increase in the modified NMQ score was noted for the lower limb (P < 0.0001) and spine (P = 0.002), but not for the upper limb (P = 0.052). Elderly whose medical services were impacted during lockdown had significantly worse net mNMQ scores than those whose services were not impacted (odds ratio = 6.16; 95% confidence interval = 2.51-15.08; P = 0.0001). Age, gender, ambulatory status, increase in body weight, and indulgence in exercise before and during lockdown had no effect on the change in the net mNMQ score. A significant ceiling effect was noted in the mNMQ score; however, no floor effect was noted. Conclusions Lockdown and confinement measures resulted in a significant decline in physical activity as well as the overall musculoskeletal health of the urban geriatric population in the present study. Hence, policymakers should ensure uninterrupted medical care to the elderly during extended periods of confinement and develop optimal home-based physical activity programs to counter the problems associated with sedentarism.
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Affiliation(s)
- Siddhartha Sharma
- Orthopaedics, Postgraduate Institute of Medical Education and Research Chandigarh, Chandigarh, IND
| | - Riddhi Gohil
- Orthopaedics, Postgraduate Institute of Medical Education and Research Chandigarh, Chandigarh, IND
| | - Sandeep Patel
- Orthopaedics, Postgraduate Institute of Medical Education and Research Chandigarh, Chandigarh, IND
| | - Kamal Kishore
- Biostatistics, Postgraduate Institute of Medical Education and Research Chandigarh, Chandigarh, IND
| | - Amarjeet Singh
- School of Public Health, Postgraduate Institute of Medical Education and Research Chandigarh, Chandigarh, IND
| | - Rajesh K Rajnish
- Orthopaedics, Postgraduate Institute of Medical Education and Research Chandigarh, Chandigarh, IND
| | - Mandeep S Dhillon
- Orthopaedics, Postgraduate Institute of Medical Education and Research Chandigarh, Chandigarh, IND
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Kishore K, Chan VW, Neekhra A. Comment on Vangipuram G, Yang L, Weigle MP, et al. Workup following retinal artery occlusion-experience from an outpatient retina clinic and the delay in workup. Graefes Arch Clin Exp Ophthalmol 2021; 259:2625-2632. Graefes Arch Clin Exp Ophthalmol 2021; 260:2075-2076. [PMID: 34751817 DOI: 10.1007/s00417-021-05488-3] [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] [Received: 10/08/2021] [Revised: 10/08/2021] [Accepted: 11/04/2021] [Indexed: 10/19/2022] Open
Affiliation(s)
- Kamal Kishore
- Illinois Retina and Eye Associates, 4505 N. Rockwood Drive, Suite 1, Peoria, IL, 61615, USA. .,Department of Surgery, University of Illinois College of Medicine, Peoria Campus, Peoria, IL, USA.
| | - Victor W Chan
- Emergency Services, OSF Healthcare Saint Francis Medical Center, Peoria, IL, USA.,University of Illinois College of Medicine, Peoria, IL, USA
| | - Aneesh Neekhra
- Illinois Retina and Eye Associates, 4505 N. Rockwood Drive, Suite 1, Peoria, IL, 61615, USA.,Department of Neurology, UnityPoint Hospitals, Peoria, IL, USA
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Rana SS, Sharma R, Kishore K, Dhalaria L, Gupta R. Safety and Efficacy of Early (<4 Weeks of Illness) Endoscopic Transmural Drainage of Post-acute Pancreatic Necrosis Predominantly Located in the Body of the Pancreas. J Gastrointest Surg 2021; 25:2328-2335. [PMID: 33547585 DOI: 10.1007/s11605-021-04945-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 01/21/2021] [Indexed: 01/31/2023]
Abstract
BACKGROUND Endoscopic transmural drainage is usually not performed for pancreatic necrotic collection (PNC) < 4 weeks after onset of acute necrotizing pancreatitis (ANP) because of lack of encapsulating wall and increased risk of complications. OBJECTIVE Study safety and efficacy of early (<4 weeks) endoscopic transluminal drainage in patients with symptomatic PNC. METHODS Retrospective analysis of data base of patients with PNC treated with endoscopic transmural drainage within 4 weeks of onset of ANP (early drainage) was done. The outcomes and complications were compared with patients with PNC who underwent delayed endoscopic drainage (≥4 weeks of onset of ANP). RESULTS Thirty-four patients (26 males; mean age: 35.9 ± 8.6 years) underwent early and 136 patients (115 males; mean age: 37.9 ± 9.4 years) underwent delayed endoscopic drainage. The PNC was significantly larger (12.3 ± 2.1 cm vs 10.5 ± 2.7 cm, p <0.001) with increased solid component (47.7 ± 8.9% vs 28.3 ± 11.7%, p <0.001) in the early group. Clinical success was achieved in 94% patients in the early group and all patients in the delayed group. Direct endoscopic necrosectomy was performed more frequently in the early group (50% vs 7.4%; p<0.001). There was increased mortality (5.7% vs 0%), need for rescue surgical necrosectomy (5.7% vs 0%), and clinically significant bleeding (20% vs 1.5%, p<0.001) in the early group as compared to the delayed group. CONCLUSION Early endoscopic drainage of PNC is feasible and seems to be safe as well as effective but is associated with increased risk of complications as compared to delayed drainage.
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Affiliation(s)
- Surinder Singh Rana
- Department of Gastroenterology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India.
| | - Ravi Sharma
- Department of Gastroenterology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India
| | - Kamal Kishore
- Department of Biostatistics, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India
| | - Lovneet Dhalaria
- Department of Gastroenterology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India
| | - Rajesh Gupta
- Department of Surgical Gastroenterology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India
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Kishore K, Jaswal V, Verma M, Koushal V. Exploring the Utility of Google Mobility Data During the COVID-19 Pandemic in India: Digital Epidemiological Analysis. JMIR Public Health Surveill 2021; 7:e29957. [PMID: 34174780 PMCID: PMC8407437 DOI: 10.2196/29957] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 06/10/2021] [Accepted: 06/17/2021] [Indexed: 12/23/2022] Open
Abstract
Background Association between human mobility and disease transmission has been established for COVID-19, but quantifying the levels of mobility over large geographical areas is difficult. Google has released Community Mobility Reports (CMRs) containing data about the movement of people, collated from mobile devices. Objective The aim of this study is to explore the use of CMRs to assess the role of mobility in spreading COVID-19 infection in India. Methods In this ecological study, we analyzed CMRs to determine human mobility between March and October 2020. The data were compared for the phases before the lockdown (between March 14 and 25, 2020), during lockdown (March 25-June 7, 2020), and after the lockdown (June 8-October 15, 2020) with the reference periods (ie, January 3-February 6, 2020). Another data set depicting the burden of COVID-19 as per various disease severity indicators was derived from a crowdsourced API. The relationship between the two data sets was investigated using the Kendall tau correlation to depict the correlation between mobility and disease severity. Results At the national level, mobility decreased from –38% to –77% for all areas but residential (which showed an increase of 24.6%) during the lockdown compared to the reference period. At the beginning of the unlock phase, the state of Sikkim (minimum cases: 7) with a –60% reduction in mobility depicted more mobility compared to –82% in Maharashtra (maximum cases: 1.59 million). Residential mobility was negatively correlated (–0.05 to –0.91) with all other measures of mobility. The magnitude of the correlations for intramobility indicators was comparatively low for the lockdown phase (correlation ≥0.5 for 12 indicators) compared to the other phases (correlation ≥0.5 for 45 and 18 indicators in the prelockdown and unlock phases, respectively). A high correlation coefficient between epidemiological and mobility indicators was observed for the lockdown and unlock phases compared to the prelockdown phase. Conclusions Mobile-based open-source mobility data can be used to assess the effectiveness of social distancing in mitigating disease spread. CMR data depicted an association between mobility and disease severity, and we suggest using this technique to supplement future COVID-19 surveillance.
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Affiliation(s)
- Kamal Kishore
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | | | - Madhur Verma
- All India Institute of Medical Sciences, Bathinda, India
| | - Vipin Koushal
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Bishnoi A, Manjunath S, Kishore K, De D, Handa S, Murrell DF, Mahajan R. Hindi translation and validation of quality of life score in Indian patients with epidermolysis bullosa; and its correlation with the clinical severity assessment scores: A cross-sectional study. Indian J Dermatol Venereol Leprol 2021; 88:177-183. [PMID: 34491666 DOI: 10.25259/ijdvl_31_20] [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: 01/01/2020] [Accepted: 05/01/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND Quality of life (QoL) has not been evaluated in Indian patients having epidermolysis bullosa (EB). AIMS The aims of the study were to measure health-related QoL in Indian patients having EB using the quality of life in epidermolysis bullosa (QoLEB) questionnaire, and to find its correlation with clinically measured disease severity. METHODS In this observational cross-sectional study, the QoLEB questionnaire was translated from English to Hindi (QoLEB-Hin) and culturally adapted without a change in concept following standard guidelines. QoLEB-Hin and three clinical scores that have been independently validated in EB, that is, Birmingham Epidermolysis Bullosa severity score (BEBs), Instrument for Scoring Clinical Outcomes of Research for Epidermolysis Bullosa (iscorEB) and Epidermolysis Bullosa Disease Activity and Scarring Index (EBDASI), were administered to EB patients/their parents in the presence of an expert. This was followed by validity and correlation studies. RESULTS Fifty-four patients were recruited (19-females, 35-males; median age 5 years, range 0.025-36 years and 12 patients with an age >13 years). The parents answered the questions for 42 patients (age <13 years). Dystrophic epidermolysis bullosa was diagnosed in 32 (59.2%) patients (dominant dystrophic epidermolysis bullosa [DDEB]-19 [35.2%] and recessive dystrophic epidermolysis bullosa [RDEB]-13 [24.1%]). Junctional epidermolysis bullosa (JEB) and epidermolysis bullosa simplex (EBS) were each diagnosed in 11 (20.4%) patients. The mean ± standard deviation (SD) of QoLEB-Hin score of all epidermolysis bullosa patients was 11.3 ± 7.6 (range 0-28; median and interquartile range [IQR], 10, 10) and reflected an overall moderate degree of affliction on QoL of patients. Mean ± SD of QoLEB-Hin scores for EBS, JEB, DDEB and RDEB were 5.4 ± 3.7 (range, 1-13; median and IQR, 6, 6), 11 ± 6.2 (range, 1-22; median and IQR, 10, 6), 9 ± 5.7 (range, 0-19; median and IQR, 10, 10) and 20.1 ± 6.4 (range, 12-28; median and IQR, 19, 12.5), respectively (P < 0.001, Kruskal-Wallis analysis of variance). Cronbach's alpha coefficient of 0.946 was obtained for all items indicating excellent internal consistency and reliability. Mean sample adequacy was 0.91; absolute fit based off diagonal values was 0.99; indices root mean square error of approximation and root mean square residual were 0.04 and 0.05, respectively, and Tucker Lewis index was >1 indicating overfit. The mean time taken to complete the questionnaire was 6.1 min (range, 6-8 min). QoLEB-Hin correlated significantly (P < 0.001) with BEBs (ρ = 0.79), iscorEB (ρ= 0.63) and EBDASI (ρ = 0.77). Three multiple linear regression models were used to ascertain the strength of relationship between QoL-Hin, and BEBs, iSCOREB and EBDASI, respectively, after adjusting for age, gender and disease subtype. The EBDASI clinical score accounted for approximately 74% (R2 = 0.736, P < 0.001) of the variability in QOL-Hin, as compared to 73% and 55% by BEBs (R2 = 0.731, P < 0.001) and iscorEB (R2 = 0.545, P < 0.001), respectively. LIMITATIONS Parents filled out the questionnaires for many patients and probably led to an overall moderate degree of affliction of QoL. Comparison with Dermatology Life Quality Index and other QoL scores were not done in this study. Furthermore, the scoring was done at one point in time, and test-retest measurements could not be performed. CONCLUSION This study validated QoLEB-Hin in an Indian population finding an overall moderate reduction in QoL due to EB. Maximally affected QoL was seen in patients with RDEB. Furthermore, QoLEB-Hin had a variable positive correlation and association with all clinical severity assessment scores.
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Affiliation(s)
- Anuradha Bishnoi
- Department of Dermatology, Venereology, and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Seema Manjunath
- Department of Dermatology, Venereology, and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Kamal Kishore
- Department of Biostatistics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Dipankar De
- Department of Dermatology, Venereology, and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Sanjeev Handa
- Department of Dermatology, Venereology, and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Dedee F Murrell
- Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Rahul Mahajan
- Department of Dermatology, Venereology, and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Bhagat H, Sharma T, Mahajan S, Kumar M, Saharan P, Bhardwaj A, Sachdeva N, Gandhi K, Jangra K, Panda NB, Singla N, Kishore K, Singh N. Intravenous versus inhalational anesthesia trial for outcome following intracranial aneurysm surgery: A prospective randomized controlled study. Surg Neurol Int 2021; 12:300. [PMID: 34221630 PMCID: PMC8247687 DOI: 10.25259/sni_342_2021] [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] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 05/04/2021] [Indexed: 11/04/2022] Open
Abstract
Background For maintenance of anesthesia for intracranial aneurysmal neck clipping, both intravenous and inhalational anesthetics are in vogue. We aimed to evaluate the superiority of one agent over the other for long-term neurological outcomes in these patients. Methods This prospective assessor-blind randomized study was conducted in 106 patients of 18-65 years of age with World Federation of Neurosurgeons Grade I-II of subarachnoid hemorrhage. After written informed consent, the patients were randomized into - intravenous group (Propofol) and inhalational group (Desflurane). The primary outcome was to study neurological outcome using Glasgow outcome scale (GOS) at 3 months following discharge while secondary outcomes included intraoperative brain condition, intraoperative hemodynamics, duration of hospital stay, Modified Rankin Score (MRS) at discharge, MRS, and Barthel's index at 3 months following discharge and estimation of perioperative biomarkers of brain injury. Results The GOS at 3 months was 5 (5.00-5.00) in the propofol group and 5 (4.00-5.00) in the desflurane group (P = 0.24). Both the anesthetics were similar in terms of intraoperative hemodynamics, brain relaxation, duration of hospital stay, MRS at discharge and 3 months, and Barthel Index at 3 months (P > 0.05). The perioperative serum interleukin-6 and S100B were comparable among the groups (P > 0.05). Conclusion The long-term neurological outcome of good grade aneurysm patients undergoing craniotomy and clipping remains comparable with the use of either propofol or desflurane. The effect of the two anesthetic agents on the various clinical parameters and the biomarkers of brain injury is also similar.
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Affiliation(s)
- Hemant Bhagat
- Department of Anesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh
| | - Tanavi Sharma
- Department of Anesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh
| | - Shalvi Mahajan
- Department of Anesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh
| | - Munish Kumar
- Department of Anesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh
| | - Poonam Saharan
- Department of Anesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh
| | - Avanish Bhardwaj
- Department of Anesthesia and Critical Care, Command Hospital (Airforce), Bengaluru, Karnataka, India
| | - Naresh Sachdeva
- Department of Endocrinology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Komal Gandhi
- Department of Anesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh
| | - Kiran Jangra
- Department of Anesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh
| | - Nidhi Bidyut Panda
- Department of Anesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh
| | - Navneet Singla
- Department of Neurosurgery Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Kamal Kishore
- Department of Biostatistics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Nidhi Singh
- Department of Anesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh
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Sharma S, John R, Patel S, Neradi D, Kishore K, Dhillon MS. Bioaerosols in orthopedic surgical procedures and implications for clinical practice in the times of COVID-19: A systematic review and meta-analysis. J Clin Orthop Trauma 2021; 17:239-253. [PMID: 33814859 PMCID: PMC8005256 DOI: 10.1016/j.jcot.2021.03.016] [Citation(s) in RCA: 3] [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: 03/05/2021] [Accepted: 03/18/2021] [Indexed: 12/11/2022] Open
Abstract
INTRODUCTION Orthopedic surgical procedures (OSPs) are known to generate bioaerosols, which could result in transmission of infectious diseases. Hence, this review was undertaken to analyse the available evidence on bioaerosols in OSPs, and their significance in COVID-19 transmission. METHODS A systematic review was conducted by searching the PubMed, EMBASE, Scopus, Cochrane Library, medRxiv, bioRxiv and Lancet preprint databases for studies on bioaerosols in OSPs. Random-effects metanalysis was conducted to determine pooled estimates of key bioaerosol characteristics. Risk of bias was assessed by the RoB-SPEO tool; overall strength of evidence was assessed by the GRADE approach. RESULTS 17 studies were included in the systematic review, and 6 in different sets of meta-analyses. The pooled estimate of particle density was 390.74 μg/m3, Total Particle Count, 6.08 × 106/m3, and Microbial Air Contamination, 8.08 CFU/m3. Small sized particles ( = 0.5 μm) were found to be 37 and 1604 times more frequent in the aerosol cloud in comparison to medium and large sized particles respectively. 4 studies reported that haemoglobin could be detected in aerosols, and one study showed that HIV could be transmitted by blood aerosolized by electric saw and burr. The risk of bias for all studies in the review was determined to be high, and the quality of evidence, low. CONCLUSION Whereas there is evidence to suggest that OSPs generate large amounts of bioaerosols, their potential to transmit infectious diseases like COVID-19 is questionable. High-quality research, as well as consensus minimum reporting guidelines for bioaerosol research in OSPs is the need of the hour.
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Affiliation(s)
- Siddhartha Sharma
- Department of Orthopaedics, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - Rakesh John
- Department of Orthopaedics, Hull and Yorkshire Royal Infirmary, Hull, United Kingdom
| | - Sandeep Patel
- Department of Orthopaedics, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - Deepak Neradi
- Department of Orthopaedics, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - Kamal Kishore
- Department of Biostatistics, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - Mandeep S. Dhillon
- Department of Orthopaedics, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India
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Gupta A, Kulshrestha R, Kishore K, Micke O, Kumar R, Garg K, Sharma D, Pandey R. Identifying Patterns of Failure and Risk Factors for Recurrence in Patients of Paratesticular Sarcomas: Protocol of a Systematic Review and Meta-Analysis. Int J Surg Protoc 2021; 25:84-91. [PMID: 34113745 PMCID: PMC8162288 DOI: 10.29337/ijsp.145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Introduction: Para testicular sarcomas are rare mesenchymal tumors that affect patients of all ages. Unlike other sites of sarcoma, they tend to be of lower grade and have a higher propensity for lymphatic spread. Management is hampered by the small number of patients who differ in terms of tumor grade and histology. Current treatment approaches are based on case reports, small case series and literature reviews, resulting in a number of unresolved issues. The consensus on the type of surgery and adjuvant treatment is yet to be determined. The local relapse rates in the scrotum and groin after orchidectomy comes out to be 25%–37%, indicating the need for either aggressive surgery or adjuvant treatment. There is a paucity of data identifying the patterns of failure and risk factors for recurrence, which will help clinicians tailor appropriate treatment. Methods: We aim to perform a systematic review and meta-analysis of the available data in the last 50 years in a methodologically rigorous and transparent manner to identify patterns of failure and high-risk factors for recurrence. The protocol is prepared in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA-P) 2015 guidelines. The protocol is registered in the International Prospective Register of Systematic Reviews (CRD42021237134). Highlights Para testicular sarcomas are rare mesenchymal tumors that affects patients of all ages. Current treatment approaches are based on case reports, small case series and literature reviews, resulting in a number of unresolved issues. A systemic review was performed in 2013 based on survival rates, prognostic factors, and relapse sites on paratesticular sarcomas. However, it lacks a comprehensive review that can guide radiation oncologists to select in which patient’s postoperative radiotherapy is warranted and define the target volume based on histopathological type, stage, and grade of the tumor. After 2013, new case series with improved methodology and sample size are published, which adds new information to the literature. In one case series, 22 patients with spermatic cord sarcoma were discussed, while in another study, long-term outcome analysis of 51 patients was discussed, and another study discussed eight patients.
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Affiliation(s)
- Anil Gupta
- Department of Radiotherapy, All India Institute of Medical Sciences, New Delhi, IN
| | - Rashi Kulshrestha
- Clinical Radiation Oncology fellowship program, Department of Radiation Oncology, BC Cancer Agency, Abbotsford, BC, CA
| | - Kamal Kishore
- Department of Biostatistics, Post Graduate Institute of Medical Education and Research, Chandigarh, IN
| | - Oliver Micke
- Prof. Dr. med, Klinik für Strahlentherapie und Radioonkologie, Franziskus Hospital, Kiskerstrasse, Bielefeld, DE
| | - Rishabh Kumar
- Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi, IN
| | - Kanika Garg
- Department of Anaesthesiology, Employee's State Insurance Corporation, Noida, IN
| | - Dayanand Sharma
- Department of Radiotherapy, All India Institute of Medical Sciences, New Delhi & National Cancer Institute, Jhajjar, Haryana, IN
| | - Rambha Pandey
- Department of Radiotherapy, All India Institute of Medical Sciences, New Delhi, IN
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Guliani A, De D, Handa S, Mahajan R, Sachdeva N, Radotra BD, Kishore K. Response to a reader's query on CD19+ B cell as predictor of relapse in pemphigus vulgaris. Indian J Dermatol Venereol Leprol 2021; 87:238-239. [PMID: 33769744 DOI: 10.25259/ijdvl_758_20] [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] [Received: 05/01/2020] [Accepted: 07/01/2020] [Indexed: 11/04/2022]
Affiliation(s)
- Ankur Guliani
- Department of Dermatology, Venereology and Leprology, Institute of Medical Education and Research, Chandigarh, India
| | - Dipankar De
- Department of Dermatology, Venereology and Leprology, Institute of Medical Education and Research, Chandigarh, India
| | - Sanjeev Handa
- Department of Dermatology, Venereology and Leprology, Institute of Medical Education and Research, Chandigarh, India
| | - Rahul Mahajan
- Department of Dermatology, Venereology and Leprology, Institute of Medical Education and Research, Chandigarh, India
| | - Naresh Sachdeva
- Department of Endocrinology (Immunology Division), Institute of Medical Education and Research, Chandigarh, India
| | - Bishan Das Radotra
- Department of Histopathology Institute of Medical Education and Research, Chandigarh, India
| | - Kamal Kishore
- Biostatistics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Laroiya I, Irrinki S, Subbhiah Nagaraj S, Sakaray YR, Bal A, Kishore K, Singh T, Singh G. Triple-negative breast cancer and factors affecting disease-free survival-Experience from a tertiary care center in India. Breast J 2021; 27:556-558. [PMID: 33749057 DOI: 10.1111/tbj.14227] [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] [Received: 01/04/2021] [Revised: 02/28/2021] [Accepted: 03/01/2021] [Indexed: 11/25/2022]
Affiliation(s)
- Ishita Laroiya
- Department of Surgery, Post Graduate Institute of Medical Education & Research (P.G.I.M.E.R.), Chandigarh, India
| | - Santhosh Irrinki
- Department of Surgery, Post Graduate Institute of Medical Education & Research (P.G.I.M.E.R.), Chandigarh, India
| | - Satish Subbhiah Nagaraj
- Department of Surgery, Post Graduate Institute of Medical Education & Research (P.G.I.M.E.R.), Chandigarh, India
| | - Yashwant Raj Sakaray
- Department of Surgery, Post Graduate Institute of Medical Education & Research (P.G.I.M.E.R.), Chandigarh, India
| | - Amanjit Bal
- Department of Pathology, Post Graduate Institute of Medical Education & Research (P.G.I.M.E.R.), Chandigarh, India
| | - Kamal Kishore
- Department of Biostatistics, Post Graduate Institute of Medical Education & Research (P.G.I.M.E.R.), Chandigarh, India
| | - Tulika Singh
- Department of Radiodiagnosis, Post Graduate Institute of Medical Education & Research (P.G.I.M.E.R.), Chandigarh, India
| | - Gurpreet Singh
- Department of Surgery, Post Graduate Institute of Medical Education & Research (P.G.I.M.E.R.), Chandigarh, India
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Begh RA, Kishore K, Kalsotra G, Saraf A, Kalsotra P. Impact of Site, Size and Duration of Tympanic Membrane Perforation on Hearing Loss and Postsurgical Outcome. Indian J Otolaryngol Head Neck Surg 2021; 74:699-706. [PMID: 36032819 PMCID: PMC9411414 DOI: 10.1007/s12070-021-02487-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 02/22/2021] [Indexed: 10/21/2022] Open
Abstract
This paper aims to assess correlation of site, size and duration of tympanic membrane perforation with hearing loss using pure tone audiogram and surgical outcome in terms of above parameters. The present study was conducted on 100 patients in Department of ENT and HNS, SMGS Hospital, Government Medical College Jammu during a time period of November 2018 to October 2019. All the patients with age 15-60 years who presented with tympanic membrane (pars tensa) perforation were included in the study. According to the size of perforation, mean pure tone threshold in group I was 20.87 ± 3.86 dB, in group II was 26.45 ± 6.08 dB and in group III was 32.6 ± 5.56 dB. The difference in hearing threshold between all the three groups was significant statistically. In terms of site, group E had maximum hearing threshold (34.67 ± 4.20 dB), followed by group B (32.71 ± 5.88 dB). Group A had the lowest hearing threshold of 24.99 ± 6.21 dB. The difference between hearing thresholds of group B perforations and group A perforations was statistically significant (p < 0.05). However, the difference between group E and group B was insignificant. This study has shown significant correlation between the size and the site of the perforation to the degree of hearing loss. The bigger the perforation, the greater the hearing loss. The central perforations were associated with more hearing loss than posterior perforations, thus refuting the hypothesis that site and size of a tympanic membrane perforation does not affect the degree of conductive hearing loss. This study did not show any correlation between duration of disease and degree of hearing loss. Surgical and audiometric results obtained in this study can be accepted as satisfactory and as expected by the literature.
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Sachdev S, Kishore K, Singh L, Lamba DS, Hans R, Dhawan HK, Grover S, Sharma RR. Exploration of COVID-19 related fears deterring from blood donation in India. ACTA ACUST UNITED AC 2021; 16:147-157. [PMID: 34149866 PMCID: PMC8206832 DOI: 10.1111/voxs.12623] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [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: 12/11/2020] [Revised: 01/22/2021] [Accepted: 02/03/2021] [Indexed: 01/28/2023]
Abstract
Introduction The coronavirus pandemic (COVID‐19) has impacted and pushed the healthcare settings to extremes across the globe. It was extremely challenging to sustain blood donation, and strategies could be formulated on knowing fears hindering blood donation. Methods A cross‐sectional survey using Google Forms® through WhatsApp and email after obtaining the ethical clearance. The survey questionnaire was validated for content using the Delphi technique, and pilot tested for finalization. Results The survey was attempted by 1066 participants, and 749 participants who had not donated since pandemic were included in the study. A little more than half, 415 (55%) reported either one or more than one fear during the pandemic which hindered blood donation. They reported lack of confidence in the safety measures at the hospitals and fear of transmitting infection to family, in 415 (55%) of the participants each, respectively. The fear of COVID‐19 hospital infection risk and hospital entry was statistically significant across the age groups that are eligible for blood donation. Conclusions The clear and dedicated confidence building measures to sustain blood donation using all communication modalities clearly emerge as the most important strategies to augment blood donation in the COVID‐19 pandemic. The measures should include information about implementation of safety measures to mitigate COVID‐19 transmission at the blood centres and that the act of blood donation does not increase risk of COVID‐19 and therefore the risk of transmission of infection to family.
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Affiliation(s)
- Suchet Sachdev
- Department of Transfusion Medicine Postgraduate Institute of Medical Education & Research Chandigarh India
| | - Kamal Kishore
- Department of Biostatistics Postgraduate Institute of Medical Education & Research Chandigarh India
| | - Lakhvinder Singh
- Department of Transfusion Medicine Postgraduate Institute of Medical Education & Research Chandigarh India
| | - Divjot Singh Lamba
- Department of Transfusion Medicine Postgraduate Institute of Medical Education & Research Chandigarh India
| | - Rekha Hans
- Department of Transfusion Medicine Postgraduate Institute of Medical Education & Research Chandigarh India
| | - Hari Krishan Dhawan
- Department of Transfusion Medicine Postgraduate Institute of Medical Education & Research Chandigarh India
| | - Sandeep Grover
- Department of Psychiatry Postgraduate Institute of Medical Education & Research Chandigarh India
| | - Ratti Ram Sharma
- Department of Transfusion Medicine Postgraduate Institute of Medical Education & Research Chandigarh India
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Kishore K, Jaswal V, Kulkarni V, De D. Practical Guidelines to Develop and Evaluate a Questionnaire. Indian Dermatol Online J 2021; 12:266-275. [PMID: 33959523 PMCID: PMC8088187 DOI: 10.4103/idoj.idoj_674_20] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 12/11/2020] [Accepted: 01/25/2021] [Indexed: 11/14/2022] Open
Abstract
Life expectancy is gradually increasing due to continuously improving medical and nonmedical interventions. The increasing life expectancy is desirable but brings in issues such as impairment of quality of life, disease perception, cognitive health, and mental health. Thus, questionnaire building and data collection through the questionnaires have become an active area of research. However, questionnaire development can be challenging and suboptimal in the absence of careful planning and user-friendly literature guide. Keeping in mind the intricacies of constructing a questionnaire, researchers need to carefully plan, document, and follow systematic steps to build a reliable and valid questionnaire. Additionally, questionnaire development is technical, jargon-filled, and is not a part of most of the graduate and postgraduate training. Therefore, this article is an attempt to initiate an understanding of the complexities of the questionnaire fundamentals, technical challenges, and sequential flow of steps to build a reliable and valid questionnaire.
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Affiliation(s)
- Kamal Kishore
- Department of Biostatistics, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Vidushi Jaswal
- Department of Psychology, MCM DAV College for Women, Chandigarh, India
| | - Vinay Kulkarni
- Department of Dermatology, PRAYAS Health Group, Amrita Clinic, Karve Road, Pune, Maharashtra, India
| | - Dipankar De
- Department of Dermatology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
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Broome R, Chernukhin I, Jamieson S, Kishore K, Papachristou EK, Mao SQ, Tejedo CG, Mahtey A, Theodorou V, Groen AJ, D'Santos C, Balasubramanian S, Farcas AM, Siersbæk R, Carroll JS. TET2 is a component of the estrogen receptor complex and controls 5mC to 5hmC conversion at estrogen receptor cis-regulatory regions. Cell Rep 2021; 34:108776. [PMID: 33626359 PMCID: PMC7921846 DOI: 10.1016/j.celrep.2021.108776] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 01/05/2021] [Accepted: 01/29/2021] [Indexed: 01/10/2023] Open
Abstract
Estrogen receptor-α (ER) drives tumor development in ER-positive (ER+) breast cancer. The transcription factor GATA3 has been closely linked to ER function, but its precise role in this setting remains unclear. Quantitative proteomics was used to assess changes to the ER complex in response to GATA3 depletion. Unexpectedly, few proteins were lost from the ER complex in the absence of GATA3, with the only major change being depletion of the dioxygenase TET2. TET2 binding constituted a near-total subset of ER binding in multiple breast cancer models, with loss of TET2 associated with reduced activation of proliferative pathways. TET2 knockdown did not appear to change global methylated cytosine (5mC) levels; however, oxidation of 5mC to 5-hydroxymethylcytosine (5hmC) was significantly reduced, and these events occurred at ER enhancers. These findings implicate TET2 in the maintenance of 5hmC at ER sites, providing a potential mechanism for TET2-mediated regulation of ER target genes.
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Affiliation(s)
- Rebecca Broome
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge CB2 0RE, UK
| | - Igor Chernukhin
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge CB2 0RE, UK
| | - Stacey Jamieson
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge CB2 0RE, UK; Merck Sharp & Dohme (UK) Limited, 120 Moorgate, London EC2M 6UR, UK
| | - Kamal Kishore
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge CB2 0RE, UK
| | | | - Shi-Qing Mao
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge CB2 0RE, UK
| | | | - Areeb Mahtey
- Department of Chemistry, University of Cambridge, Lensfield Road, Cambridge CB2 1EW, UK
| | - Vasiliki Theodorou
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge CB2 0RE, UK; Institute of Molecular Biology & Biotechnology, Foundation for Research & Technology - Hellas Nikolaou Plastira 100, 70013 Heraklion, Crete, Greece
| | - Arnoud J Groen
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge CB2 0RE, UK
| | - Clive D'Santos
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge CB2 0RE, UK
| | - Shankar Balasubramanian
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge CB2 0RE, UK; Department of Chemistry, University of Cambridge, Lensfield Road, Cambridge CB2 1EW, UK
| | - Anca Madalina Farcas
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge CB2 0RE, UK; Bioscience, Oncology R&D, AstraZeneca, Cambridge CB2 0RE, UK.
| | - Rasmus Siersbæk
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge CB2 0RE, UK; University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark.
| | - Jason S Carroll
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge CB2 0RE, UK.
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Kishore K, McGowan DS, Hanebrink KA. Iatrogenic Retinal Penetration from Intravitreal Injections. Case Rep Ophthalmol 2021; 12:248-253. [PMID: 33976691 PMCID: PMC8077486 DOI: 10.1159/000512695] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 10/30/2020] [Indexed: 11/19/2022] Open
Abstract
We present 2 cases of iatrogenic retinal penetration from intravitreal (IVT) injections in a retrospective noncomparative case series of 2 patients. The first patient, an 81-year-old Caucasian male, developed dense vitreous hemorrhage soon after receiving an IVT bevacizumab injection for macular edema from central retinal vein occlusion. A 25-g vitrectomy 1 week later showed a retinal hole surrounded by fresh hemorrhages in the same quadrant as the IVT injection. The second patient, an 87-years-old male, developed a retinal detachment after 28 injections of anti-VEGF medications for neovascular AMD. A peripheral round hole was observed during vitrectomy without any lattice degeneration in the same quadrant as prior IVT injections. Both eyes were pseudophakic, had normal axial lengths, and received injections without measuring the injection site. Retinal penetration from IVT injections can result in serious sight-threatening complications. Measuring the injection site from the limbus should be part of safe IVT injection technique.
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Affiliation(s)
- Kamal Kishore
- Illinois Retina and Eye Associates, Peoria, Illinois, USA
- Department of Surgery, University of Illinois College of Medicine, Peoria, Illinois, USA
| | - Daniel S. McGowan
- Department of Surgery, University of Illinois College of Medicine, Peoria, Illinois, USA
| | - Kurt A. Hanebrink
- Department of Surgery, University of Illinois College of Medicine, Peoria, Illinois, USA
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Kishore K, McGowan DS, Pode RP. Successful Treatment of Acute Endophthalmitis after Cat Bite: A Case Report and Review of the Literature. Case Rep Ophthalmol 2020; 11:574-581. [PMID: 33250758 PMCID: PMC7670322 DOI: 10.1159/000510631] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 08/01/2020] [Indexed: 11/22/2022] Open
Abstract
Endophthalmitis after cat bite has poor outcome particularly those associated with scleral injury. A 33-year-old Caucasian female was seen by her ophthalmologist 4 days after cat bite to her right eye with hand motion vision and obvious signs of acute endophthalmitis. She was treated with exploration and repair of scleral puncture wound, anterior chamber and vitreous cultures and intravitreal injections of vancomycin and ceftazidime. Cultures were positive for alpha hemolytic Streptococcus. She underwent a pars plana vitrectomy, cultures and repeat injection of the same antibiotics and intravitreal dexamethasone 2 days later. Cultures grew Bacillus. Endophthalmitis resolved and she regained 20/20 vision after cataract surgery 3 months later. Successful outcome of acute endophthalmitis following a cat bite to the sclera in this case was most likely due to prompt intravitreal antibiotics and early vitrectomy combined with supplemental intravitreal antibiotics and steroid therapy.
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Affiliation(s)
- Kamal Kishore
- Illinois Retina and Eye Associates, Peoria, Illinois, USA.,Department of Surgery, University of Illinois College of Medicine, Peoria, Illinois, USA
| | - Daniel S McGowan
- Department of Surgery, University of Illinois College of Medicine, Peoria, Illinois, USA
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Kishore K, McGowan DS, Chatterjee T, Hassanzadeh B. A Case of Bilateral Endogenous Candida dubliniensis Endophthalmitis Treated with Aggressive Local and Systemic Therapy. Case Rep Ophthalmol 2020; 11:561-573. [PMID: 33250757 PMCID: PMC7670387 DOI: 10.1159/000510500] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 07/25/2020] [Indexed: 11/19/2022] Open
Abstract
Candida dubliniensis is an emerging pathogen implicated in a variety of infections in immunocompromised hosts. A 79-year-old male with autoimmune pancytopenia on chronic oral steroid therapy was admitted for suspected sepsis and started on empirical antibiotics and micafungin. He developed floaters and decreased vision while on this regimen and was diagnosed with bilateral candida endophthalmitis. Blood cultures grew C. dubliniensis.Intravenous therapy was switched to voriconazole and amphotericin B. He also received aggressive intravitreal antifungal therapy consisting of 100 μg/0.1 mL voriconazole (4 OD, 3 OS) and 5 μg/0.1 mL amphotericin B (3 OD, 1 OS) over 2 weeks that resulted in local control of infection. The right eye developed a retinal detachment 1 month after initial presentation that was repaired by 25-gauge pars plana vitrectomy, scleral buckle, laser and silicone oil. At the 15-month follow-up exam, subsequent to silicone oil removal, membrane peel and cataract surgery, OD visual acuity had improved to 20/80. OS was phakic and 20/25. Aggressive intravitreal antifungal therapy combined with intravenous therapy may control endophthalmitis and avoid the risks associated with pars plana vitrectomy during acute infection.
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Affiliation(s)
- Kamal Kishore
- Illinois Retina and Eye Associates, Peoria, Illinois, USA.,Department of Surgery, University of Illinois College of Medicine, Peoria, Illinois, USA
| | - Daniel S McGowan
- Department of Surgery, University of Illinois College of Medicine, Peoria, Illinois, USA
| | - Tulika Chatterjee
- Department of Internal Medicine, UIC-Peoria Campus, Peoria, Illinois, USA.,Department of Internal Medicine, OSF St Francis Medical Center, Peoria, Illinois, USA
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Mahajan R, Bishnoi A, Manjunath S, Kishore K, De D, Murrell DF, Handa S. 17891 Quality of life score in Indian patients with epidermolysis bullosa and its correlation with clinical severity assessment scores. J Am Acad Dermatol 2020. [DOI: 10.1016/j.jaad.2020.06.896] [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: 11/15/2022]
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Guliani A, De D, Handa S, Mahajan R, Sachdeva N, Radotra BD, Kishore K. Identification of clinical and immunological factors associated with clinical relapse of pemphigus vulgaris in remission. Indian J Dermatol Venereol Leprol 2020; 86:233-239. [PMID: 31898637 DOI: 10.4103/ijdvl.ijdvl_89_19] [Citation(s) in RCA: 5] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Background Pemphigus vulgaris is a potentially fatal autoimmune epidermal blistering disease with a chronic and relapsing course. It is difficult to predict clinical relapse. Identification of clinical and immunological factors that are associated with early clinical relapse in a prospective study design may help in planning treatment for better maintenance of clinical remission. Aim The aim of our study was to identify clinical and immunological factors associated with clinical relapse within 9 months of study inclusion in patients with pemphigus vulgaris in clinical remission. Methods Forty consecutive consenting patients who had been diagnosed to have pemphigus vulgaris and were in clinical remission on minimal therapy or off therapy were included. The patients were followed up every 3 months until 9 months. Clinical factors considered relevant were recorded at the beginning of the study. Immunological factors such as CD19+ B-cell count and CD19+CD27+ memory B cells/plasma cell count in peripheral blood were assessed at baseline [anti-desmoglein (Dsg) 1 and 3 titers were first assessed at 3 months, not at baseline] and repeated every 3 months, until 9 months or clinical relapse whichever was earlier. Direct immunofluorescence (DIF) of skin biopsy specimen was performed at study initiation and again at the time of clinical relapse or study completion, whichever occurred earlier. All patients completed the study. Results Of 40 patients, 11 (27.5%) experienced relapse as per definition, while 29 (72.5%) remained in complete remission. Clinical relapse during study duration was significantly more common in those who had onset of disease in oral mucosa [odds ratio (OR), 10.71; 95% confidence interval (CI) 1.21-94.86, P = 0.02], pruritus (OR 8.4; 95% CI 1.76-40.02, P = 0.01), and extensive cutaneous involvement during previous disease activity (OR 7.36; 95% CI 1.34-40.55, P = 0.03) and also pruritus during remission (P = 0.004). Immunological factors found to be significantly associated with early clinical relapse were raised CD19+ B-cell count at baseline (OR 7.84; 95% CI 1.39 - 53.41, P = 0.01), immunoglobulin G (OR 4.85; 95% CI 1.09-23.44, P = 0.04), and C3 (OR 20.33; 95% CI 3.02-199.5, P < 0.001) positivity in the intercellular space of the epidermis on DIF at study onset and rising anti-Dsg 3 antibody titers (OR 19.96; 95% CI 1.85- 310.9, P = 0.03). Limitations Limited sample size, short follow-up duration, and inability to perform anti-Dsg enzyme linked immunosorbent assay for all the patients at all the time points of assessment are limitations of this study. Conclusion Immunological relapse can be determined before clinical relapse, so that treatment can be restarted/modified and clinical remission can be maintained.
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Affiliation(s)
- Ankur Guliani
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Dipankar De
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Sanjeev Handa
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Rahul Mahajan
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Naresh Sachdeva
- Department of Endocrinology (Division of Immunology), Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Bishan Dass Radotra
- Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Kamal Kishore
- Department of Biostatistics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Jaswal V, Kishore K, Muniraju M, Jaswal N, Kapoor R. Understanding the determinants of happiness through Gallup World Poll. J Family Med Prim Care 2020; 9:4826-4832. [PMID: 33209808 PMCID: PMC7652195 DOI: 10.4103/jfmpc.jfmpc_156_20] [Citation(s) in RCA: 2] [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: 01/24/2020] [Revised: 03/13/2020] [Accepted: 04/07/2020] [Indexed: 11/04/2022] Open
Abstract
Background The idea of happiness is as old as civilization, but breakthrough is achieved only in 20th century. Happiness can be broadly segmented into biological and behavioural component. The sufferings from illnesses hamper happiness. Happiness correlates negatively with morbidity, mortality, stress and anxiety in contrast to a positive correlation with motivation, healthy behaviours and longevity. In this article, an attempt has been made to understand the relationship between happiness and its important contributory factors. Material and Methods The current study used data from the Gallup World Poll available under license CC0. Data analysis was performed using R studio version 1.0.136. Initially, descriptive analysis in the form of mean (standard deviation), violin plot, correlation matrix, and scatter plots were reported. Subsequently, robust regression estimates along with bootstrap standard errors and confidence intervals were used to report inferential statistics. Results Norway, with a happiness score of 7.537 ranked first followed by Denmark with a score of 7.522. Burundi with a score of 2.905 is at the bottom of ranking for happiness. Freedom (CI; 0.95-2.22) and Family (CI; 0.92 - 1.57) are the strongest predictors of happiness. The trust variable does not have a significant (CI; -0.27 - 1.94) relationship with happiness. Conclusions The values and norms in society are changing at a fast pace. Therefore, the measures of happiness require consistent and innovative approaches to measure it.
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Affiliation(s)
- Vidushi Jaswal
- Department of Psychology, MCM DAV College for Women, Chandigarh, India
| | - Kamal Kishore
- Department of Biostatistics, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - M Muniraju
- Department of Radio Diagnosis and Imaging, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Nidhi Jaswal
- Department of Community Medicine, School of Public Health, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Rakesh Kapoor
- Department of Radiotherapy, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
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Kishore K, Mahajan R. Understanding Superiority, Noninferiority, and Equivalence for Clinical Trials. Indian Dermatol Online J 2020; 11:890-894. [PMID: 33344335 PMCID: PMC7734976 DOI: 10.4103/idoj.idoj_130_20] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 05/09/2020] [Accepted: 07/20/2020] [Indexed: 02/05/2023] Open
Abstract
Randomized control trialsare the gold standard for testing the efficacy of new interventions. Historically, superiority trials were methods of choice as reference (standard) interventions were not established for many disease conditions. However currently, reference interventions are available for most of adverse conditions. Despite this, many investigators are using superiority trials in comparison to more suitable noninferiority and equivalence trials. The application of noninferiority and equivalence trials is on the rise, but by and large, these trials are poorly understood, ill-conceived, inappropriately analyzed, and reported and misinterpreted.
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Affiliation(s)
- Kamal Kishore
- Department of Biostatistics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Rahul Mahajan
- Department of Dermatology, Venereology, and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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