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Harikrishnan VS, Niyas VKM, Arjun R, Murlidharan P, Sasidharan M, Aswini Rajeswari R. Esophageal mucormycosis. QJM 2023; 116:547-548. [PMID: 36857591 DOI: 10.1093/qjmed/hcad031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 02/27/2023] [Indexed: 03/03/2023] Open
Affiliation(s)
- V S Harikrishnan
- Internal Medicine, KIMSHEALTH, Thiruvananthapuram, Kerala 695029, India
| | - V K M Niyas
- Infectious Diseases, KIMSHEALTH, Thiruvananthapuram, Kerala 695029, India
| | - R Arjun
- Infectious Diseases, KIMSHEALTH, Thiruvananthapuram, Kerala 695029, India
| | - P Murlidharan
- Nephrology, KIMSHEALTH, Thiruvananthapuram, Kerala 695029, India
| | - M Sasidharan
- Gastroenterology, KIMSHEALTH, Thiruvananthapuram, Kerala 695029, India
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Kareem H, Ali N, Sasidharan M. A (Not So) Rare Cause of Obscure Gastrointestinal Bleed in Elderly. Clin Gastroenterol Hepatol 2022; 21:A17. [PMID: 36402371 DOI: 10.1016/j.cgh.2022.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 11/05/2022] [Accepted: 11/08/2022] [Indexed: 11/18/2022]
Affiliation(s)
- Harish Kareem
- Medical Gastroenterology, KIMSHEALTH, Trivandrum, India
| | - Nihal Ali
- Medical Gastroenterology, KIMSHEALTH, Trivandrum, India
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Veerankutty FH, Jayan G, Yadav MK, Manoj KS, Yadav A, Nair SRS, Shabeerali TU, Yeldho V, Sasidharan M, Rather SA. Artificial Intelligence in hepatology, liver surgery and transplantation: Emerging applications and frontiers of research. World J Hepatol 2021; 13:1977-1990. [PMID: 35070002 PMCID: PMC8727218 DOI: 10.4254/wjh.v13.i12.1977] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 05/09/2021] [Accepted: 11/25/2021] [Indexed: 02/06/2023] Open
Abstract
The integration of artificial intelligence (AI) and augmented realities into the medical field is being attempted by various researchers across the globe. As a matter of fact, most of the advanced technologies utilized by medical providers today have been borrowed and extrapolated from other industries. The introduction of AI into the field of hepatology and liver surgery is relatively a recent phenomenon. The purpose of this narrative review is to highlight the different AI concepts which are currently being tried to improve the care of patients with liver diseases. We end with summarizing emerging trends and major challenges in the future development of AI in hepatology and liver surgery.
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Affiliation(s)
- Fadl H Veerankutty
- Comprehensive Liver Care, VPS Lakeshore Hospital, Cochin 682040, Kerala, India
| | - Govind Jayan
- Hepatobiliary Pancreatic and Liver Transplant Surgery, Kerala Institute of Medical Sciences, Trivandrum 695029, Kerala, India
| | - Manish Kumar Yadav
- Department of Radiodiagnosis, Kerala Institute of Medical Sciences, Trivandrum 695029, Kerala, India
| | - Krishnan Sarojam Manoj
- Department of Radiodiagnosis, Kerala Institute of Medical Sciences, Trivandrum 695029, Kerala, India
| | - Abhishek Yadav
- Comprehensive Liver Care, VPS Lakeshore Hospital, Cochin 682040, Kerala, India
| | - Sindhu Radha Sadasivan Nair
- Hepatobiliary Pancreatic and Liver Transplant Surgery, Kerala Institute of Medical Sciences, Trivandrum 695029, Kerala, India
| | - T U Shabeerali
- Hepatobiliary Pancreatic and Liver Transplant Surgery, Kerala Institute of Medical Sciences, Trivandrum 695029, Kerala, India
| | - Varghese Yeldho
- Hepatobiliary Pancreatic and Liver Transplant Surgery, Kerala Institute of Medical Sciences, Trivandrum 695029, Kerala, India
| | - Madhu Sasidharan
- Gastroenterology and Hepatology, Kerala Institute of Medical Sciences, Thiruvananthapuram 695029, India
| | - Shiraz Ahmad Rather
- Hepatobiliary Pancreatic and Liver Transplant Surgery, Kerala Institute of Medical Sciences, Trivandrum 695029, Kerala, India
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Kothakota SR, Kumar Nair A, Sasidharan M, Kareem H, Praveen Kumar C, Kanala J. Extrapulmonary Sarcoidosis Manifested as Cirrhosis with Portal Hypertension. Middle East J Dig Dis 2021; 13:160-162. [PMID: 34712455 PMCID: PMC8531926 DOI: 10.34172/mejdd.2021.220] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 01/17/2021] [Indexed: 11/23/2022] Open
Abstract
Hepatic involvement has been reported in 20-30% of patients with systemic sarcoidosis. However, isolated liver involvement is rare. We report a case of cirrhosis with portal hypertension, diagnosed as hepatic sarcoidosis based on high angiotensin-converting enzyme level and presence of multiple non-caseating granulomas in liver histopathology. She improved clinically after treatment with steroid and ursodeoxycholic acid.
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Affiliation(s)
| | - Ajith Kumar Nair
- Department of Medical Sciences, Kerala Institute of Medical Sciences, Kerala, India
| | - Madhu Sasidharan
- Department of Medical Sciences, Kerala Institute of Medical Sciences, Kerala, India
| | - Harish Kareem
- Department of Medical Sciences, Kerala Institute of Medical Sciences, Kerala, India
| | - C Praveen Kumar
- Senior Resident, Kerala Institute of Medical Sciences, Kerala, India
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Khiangte B, Kothakota SR, Sasidharan M, Kareem H, Joshi S, Kumar VV, Kanala JR, Kumar C P, Nair AK. Prevalence and determinants of hepatopulmonary syndrome in decompensated chronic liver disease. Indian J Gastroenterol 2020; 39:362-369. [PMID: 32839954 DOI: 10.1007/s12664-020-01052-9] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Accepted: 05/07/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND One of the severe complications of liver disease is hepatopulmonary syndrome (HPS). There is paucity in literature regarding the various factors associated with the development of HPS. This study was conducted to analyze the prevalence and determinants of HPS among patients with decompensated chronic liver disease (CLD). METHODS This study was a cross-sectional-observational study conducted in a tertiary care center. Decompensated CLD patients admitted for pre-liver transplant workup were included in the study. Demographic data, clinical findings, and biochemical and hematologic parameters were collected. Pulse oximetry, arterial blood gas analysis, bubble contrast echocardiogram, diffusion capacity of the lungs for carbon monoxide (DLCO), and spirometry were done to get the needed parameters. All data were entered into a Microsoft Excel sheet and analyzed using the statistical software SPSS for Windows, version 22.0. RESULTS Among 64 subjects, 58 were men (90.6%). Mean age was 54.5 years. HPS was present in 26 (40.6%) patients. Platypnea and orthodeoxia were present more often in HPS patients. DLCO was significantly impaired among patients with HPS. Portopulmonary hypertension was seen in 8 (12.5%) subjects with no difference between HPS and non-HPS patients. Subjects with HPS had more severe liver disease. A model for end-stage liver disease (MELD)-Na score > 19 was associated with HPS (sensitivity 73.08%, specificity 65.79%, PPV 59.4%, and NPV 78.1%). Multivariate analysis (binary logistic regression) revealed that a higher MELD-Na score, hepatic encephalopathy, and impaired DLCO were independently associated with HPS. CONCLUSIONS HPS is associated with more severe liver disease (as per Child-Turcotte-Pugh [CTP] stage and MELD-Na score). There was no relation between HPS and causes of CLD. Higher MELD-Na score, hepatic encephalopathy, impaired DLCO, clubbing, and spider naevi were independently associated with HPS.
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Affiliation(s)
- Benjamine Khiangte
- Department of Gastroenterology, Kerala Institute of Medical Sciences (KIMS) Hospital, Anayara PO, Trivandrum, 695 029, India
| | - Sunil Raviraj Kothakota
- Department of Gastroenterology, Kerala Institute of Medical Sciences (KIMS) Hospital, Anayara PO, Trivandrum, 695 029, India.
| | - Madhu Sasidharan
- Department of Gastroenterology, Kerala Institute of Medical Sciences (KIMS) Hospital, Anayara PO, Trivandrum, 695 029, India
| | - Harish Kareem
- Department of Gastroenterology, Kerala Institute of Medical Sciences (KIMS) Hospital, Anayara PO, Trivandrum, 695 029, India
| | - Subhashchandra Joshi
- Department of Gastroenterology, Kerala Institute of Medical Sciences (KIMS) Hospital, Anayara PO, Trivandrum, 695 029, India
| | - Vijosh V Kumar
- Department of Gastroenterology, Kerala Institute of Medical Sciences (KIMS) Hospital, Anayara PO, Trivandrum, 695 029, India
| | - Jagadeswara Reddy Kanala
- Department of Gastroenterology, Kerala Institute of Medical Sciences (KIMS) Hospital, Anayara PO, Trivandrum, 695 029, India
| | - Praveen Kumar C
- Department of Gastroenterology, Kerala Institute of Medical Sciences (KIMS) Hospital, Anayara PO, Trivandrum, 695 029, India
| | - Ajith K Nair
- Department of Gastroenterology, Kerala Institute of Medical Sciences (KIMS) Hospital, Anayara PO, Trivandrum, 695 029, India
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Kothakota SR, Sasidharan M, Kareem H, Nair AK. Small Bowel Angiodysplasia Managed with Novel Motorized Spiral Enteroscope: A Case Report. Journal of Digestive Endoscopy 2020. [DOI: 10.1055/s-0040-1713552] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
AbstractWe report a case of 72-year-old woman, who presented with complaints of melena associated with shortness of breath on exertion for more than 2 weeks. On evaluation, she was diagnosed to have severe anemia with evidence of occult blood in stool. After initial management, further workup was done to find out the source of bleeding. Upper and lower gastrointestinal endoscopy were normal. Computerized tomography enteroclysis showed no significant abnormality. Later small bowel enteroscopy was performed with the help of Novel Motorized Spiral Enteroscope in antegrade approach and scope passed through oral cavity up to cecum. Multiple angiodysplasia lesions seen in ileum. All the lesions were managed with argon plasma coagulation (APC). Postprocedure, patient improved well and hemoglobin also remained stable. Small bowel diseases always remain a diagnostic and therapeutic challenge, despite the introduction of various modalities for deep enteroscopy. Spiral enteroscopy is a recent advance which uses an overtube with a raised spiral at the distal end to pleat the small intestine. It consumes less time and suits for both diagnostic and therapeutic needs of small bowel diseases.
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Affiliation(s)
- Sunil Raviraj Kothakota
- Department of Gastroenterology, Kerala Institute of Medical Sciences Hospital, Trivandrum, Kerala, India
| | - Madhu Sasidharan
- Department of Gastroenterology, Kerala Institute of Medical Sciences Hospital, Trivandrum, Kerala, India
| | - Harish Kareem
- Department of Gastroenterology, Kerala Institute of Medical Sciences Hospital, Trivandrum, Kerala, India
| | - Ajith K. Nair
- Department of Gastroenterology, Kerala Institute of Medical Sciences Hospital, Trivandrum, Kerala, India
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Jadhav PV, Kothakota SR, Sasidharan M, Kareem H, Nair AK. Effect of Donor Hepatic Steatosis on Ischemia Reperfusion Injury in Liver Transplant Recipient. J Clin Exp Hepatol 2020; 10:236-244. [PMID: 32405180 PMCID: PMC7212288 DOI: 10.1016/j.jceh.2019.07.004] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Accepted: 07/05/2019] [Indexed: 01/02/2023] Open
Abstract
INTRODUCTION Ischemia reperfusion injury (IRI) is an important complication of liver transplant (LT). The donor risk index, which does not incorporate steatosis, includes several variables known to impact on allograft survival. The purpose of this study was to report on donor liver allograft steatosis and its association with severity of IRI. AIM The aim of this study was to determine the effect of type and grade of donor liver steatosis on the occurrence and severity of IRI in LT recipients. METHODS This was an observational study conducted at a single center over a period of 37 months from July 2013 to August 2016. Liver biopsy was performed twice, initially at the time of procurement before graft perfusion for steatosis assessment. Steatosis was classified as microsteatosis (MiS) or macrosteatosis (MaS) with mild, moderate, or severe grade. Second biopsy for IRI assessment was taken before skin closure in death donor LT (DDLT) and at the time of transaminitis in postoperative period (<72 hrs) in living donor LT (LDLT). IRI was graded as per neutrophil infiltrate, apoptosis, and hepatocyte cell dropout. Prevalence of IRI and association steatosis was studied along with other factors. RESULTS Among 53 subjects, 35 were DDLTs and 18 were LDLTs. All live donor grafts were restricted to <15% MaS and the deceased liver grafts had different type and degree of steatosis. In DDLTs, the association between occurrence of IRI and MaS was not statistically significant (P = 0.201). In DDLTs, the mild steatosis was not significantly associated with IRI. Death donor and ischemic time were significantly associated with IRI. Child's stage and MELD scores, gender, and age were not associated with risk of IRI. Severity of IRI is significantly associated with 3-month mortality (P = 0.001). CONCLUSION In patients with mild steatosis, IRI does not correlate with steatosis. However, more patients with moderate and severe steatosis are needed to define the relationship of the two in this group of patients.
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Key Words
- ALT, alanine transferase
- AST, aspartate transferase
- CIT, cold ischemia time
- DDLT, death donor liver transplant
- DRI, donor risk index
- ECD, extended criteria donor
- EHBA, extrahepatic biliary atresia
- H&E, haematoxilin & eosin
- HBV, hepatitis B virus
- HCV, hepatitis C virus
- HPE, histopathological examination
- IRI, ischemia reperfusion injury
- LAI, liver attenuation index
- LDLT, living donor liver transplant
- LT, liver transplant
- MELD, model for end-stage liver disease
- MaS, macrosteatosis
- MiS, microsteatosis
- NAFLD, nonalcoholic fatty liver disease
- NASH, nonalcoholic steatohepatitis
- PNF, primary nonfunction (graft)
- WIT, warm ischemia time
- cold ischemic time
- ischemia reperfusion injury
- macrosteatosis
- microsteatosis
- warm ischemic time
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Affiliation(s)
- Prafulla V. Jadhav
- Department of Gastroenterology, KIMS Hospital, Trivandrum, Kerala, India
| | | | - Madhu Sasidharan
- Department of Gastroenterology, KIMS Hospital, Trivandrum, Kerala, India
| | - Harish Kareem
- Department of Gastroenterology, KIMS Hospital, Trivandrum, Kerala, India
| | - Ajith K. Nair
- Department of Gastroenterology, KIMS Hospital, Trivandrum, Kerala, India
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Khiangte B, Kothakota SR, Sasidharan M, Kareem H, Nair AK, Kumar VV, Kanala JR, Kumar PC. Hepatitis B Reactivation in Liver Transplant Recipients With Hepatitis B Virus Core Antibody Positive Grafts: a Retrospective Study. J Clin Exp Hepatol 2020; 10:548-554. [PMID: 33311891 PMCID: PMC7719971 DOI: 10.1016/j.jceh.2020.05.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 05/01/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Liver grafts from hepatitis B core antibody (anti-HBc) positive donors increase the risk of hepatitis B virus (HBV) reactivation in recipients due to posttransplant immunosuppressive therapy. AIM AND OBJECTIVE to study the HBV reactivation in liver transplant recipients with anti-HBc-positive donors. METHODS This was a retrospective study. Liver transplant recipients who received grafts from anti-HBc-positive donors between January 2013 and December 2017 were included in analysis. Hospital records of all subjects for a 2-year posttransplantation period were studied to observe reactivation of hepatitis B. As per our institute protocol, prophylaxis for HBV was given to subjects with either positive hepatitis B surface antigens or hepatitis B surface antibody (anti-HBs) titre <100 mIU/ml, after transplantation with anti-HBc-positive donor grafts. Recipients with anti-HBs titre >100 mIU/mL were exempted from prophylaxis and kept on regular monitoring for HBV markers. RESULTS Of 85 liver transplant recipients, 20 subjects who received anti-HBc-positive grafts were included in analysis. The mean age of the study population was 46 years (range 2-68 years). The most common aetiology of cirrhosis in our study population was cryptogenic followed by ethanol. Among the study population, 16 (80%) transplant recipients had anti-HBs titre less than 100 mu/ml and 4 (20%) subjects had anti-HBs > 100 miu/ml. HBV reactivation occurred in 6 (30%) subjects. Reactivation was seen even in those who received HBV prophylaxis, while none of the subjects with anti-HBs titre >100 miu/ml developed HBV reactivation despite absence of prophylaxis. CONCLUSION HBV reactivation can occur even in the presence of target anti-HBs titre (i.e. >10 miu/ml) and HBV prophylaxis during postliver transplantation. However, HBV reactivation is not seen in recipients with anti-HBs titre of >100 miu/ml.
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Affiliation(s)
| | - Sunil R. Kothakota
- Address for correspondence. Sunil Raviraj K, Senior Resident, Department of Gastroenterology, KIMS hospital, Postal code/ P.O. Box: Anayara PO., Trivandrum, Kerala, 695029, India.
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Kesavan T, Boopathi S, Kundu M, Maduraiveeran G, Sasidharan M. Morphology-dependent electrochemical performance of spinel-cobalt oxide nanomaterials towards lithium-ion batteries. Electrochim Acta 2018. [DOI: 10.1016/j.electacta.2018.07.084] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Kumaran R, Boopathi S, Kundu M, Sasidharan M, Maduraiveeran G. The morphology-dependent electrocatalytic activities of spinel-cobalt oxide nanomaterials for direct hydrazine fuel cell application. NEW J CHEM 2018. [DOI: 10.1039/c8nj01622d] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Morphologically-tuned spinel-cobalt oxide nanomaterials such as pellet-, flower-, cube- and sheet-like structures as an anode for an enhanced hydrazine oxidation reaction (HOR) is demonstrated.
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Affiliation(s)
- R. Kumaran
- Department of Chemistry & Research Institute
- SRM Institute of Science and Technology
- Chennai
- India
| | - S. Boopathi
- Electrochemical Technology Centre
- Department of Chemistry
- University of Guelph
- Guelph
- Canada
| | - M. Kundu
- Department of Chemistry & Research Institute
- SRM Institute of Science and Technology
- Chennai
- India
| | - M. Sasidharan
- Department of Chemistry & Research Institute
- SRM Institute of Science and Technology
- Chennai
- India
| | - G. Maduraiveeran
- Department of Chemistry & Research Institute
- SRM Institute of Science and Technology
- Chennai
- India
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Elavarasan S, Baskar B, Senthil C, Bhanja P, Bhaumik A, Selvam P, Sasidharan M. An efficient mesoporous carbon nitride (g-C3N4) functionalized Pd catalyst for carbon–carbon bond formation reactions. RSC Adv 2016. [DOI: 10.1039/c6ra04170a] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Pd-nanoparticles on mesoporous nitrogen-rich carbon nitride (MCN) serves as an efficient heterogeneous catalyst for Sonogashira cross-coupling reactions.
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Affiliation(s)
- S. Elavarasan
- SRM Research Institute and Department of Chemistry
- SRM University
- Chennai
- India
| | - B. Baskar
- SRM Research Institute and Department of Chemistry
- SRM University
- Chennai
- India
| | - C. Senthil
- SRM Research Institute and Department of Chemistry
- SRM University
- Chennai
- India
| | - Piyali Bhanja
- Department of Material Science
- Indian Association for the Cultivation of Science
- Kolkata 700 032
- India
| | - A. Bhaumik
- Department of Material Science
- Indian Association for the Cultivation of Science
- Kolkata 700 032
- India
| | - P. Selvam
- National Center for Catalysis Research and Department of Chemistry
- IIT – Madras
- Chennai
- India
| | - M. Sasidharan
- SRM Research Institute and Department of Chemistry
- SRM University
- Chennai
- India
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Mallaiyappan M, Sawalakhe NR, Sasidharan M, Shah DK, Rathi PM, Bhatia SJ. Retrospective and prospective validation of model for end-stage liver disease (MELD) score in predicting mortality in patients of alcoholic liver disease. ACTA ACUST UNITED AC 2014; 34:252-8. [PMID: 25046888 DOI: 10.7869/tg.143] [Citation(s) in RCA: 7] [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] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND AIM Patients with alcoholic hepatitis and alcoholic cirrhosis have significant morbidity and mortality. The model for end-stage liver disease (MELD) score is used to predict mortality in patients with liver disease. Our study aimed to validate the utility of MELD score versus Child Pugh Turcotte (CPT) and modified CPT (CPT+creatinine; CPTC) scores in predicting mortality among alcoholic liver disease (ALD) patients. METHODS We examineda retrospective (n=110; mean age 44.5years; 109 men) and a prospective (n=96; mean age 45 years; 92 men) cohort of patients suffering from ALD, with varying disease severity, and compared the ability of MELD, CTP and CPTC scores to predict the 1-, 3- and 6-month mortality using concordance (c-) statistics. RESULTS The median MELD, CPT and CPTC scores were 21, 10 and 11 in the retrospective group and 21, 10 and 10 in prospective groups, respectively. The 1-month, 3-month and 6-month mortality was 41 (37.3%), 59 (53.6%) and 81 (73.6%) in the retrospective group and 27 (28.1%), 41 (42.7%) and 65 (67.7%) in the prospective group. The predictive ability of MELD, CPT and CPTC was 0.72, 0.67, 0.68 for 1-month mortality, 0.73, 0.70, 0.68 for 3-month mortality and 0.83, 0.75, 0.73 for 6-month mortality in retrospective group and 0.86, 0.56, 0.63 for 1-month mortality, 0.80, 0.57, and 0.60 for 3-month mortality, and 0.88, 0.51, and 0.64 for 6-month mortality in the prospective cohort, respectively. The predictive accuracy of MELD was significantly better than CPT and CPTC scores in the prospective group. CONCLUSIONS MELD is a valid prognostic score compared to CPT and CPTC scores for predicting short-term mortality in patients of alcoholic liver disease.
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Anandhakumar S, Sasidharan M, Tsao CW, Raichur AM. Tailor-made hollow silver nanoparticle cages assembled with silver nanoparticles: an efficient catalyst for epoxidation. ACS Appl Mater Interfaces 2014; 6:3275-81. [PMID: 24552178 DOI: 10.1021/am500229v] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
A novel approach toward the synthesis of hollow silver nanoparticle (NP) cages built with building blocks of silver NPs by layer-by-layer (LbL) assembly is demonstrated. The size of the NP cage depends on the size of template used for the LbL assembly. The microcages showed a uniform distribution of spherical silver nanoparticles with an average diameter of 20 ± 5 nm, which increased to 40 ± 5 nm when the AgNO3 concentration was increased from 25 to 50 mM. Heat treatment of the polyelectrolyte capsules at 80 °C near their pKa values yielded intact nano/micro cages. These cages produced a higher conversion for the epoxidation of olefins and maintained their catalytic activity even after four successive uses. The nanocages exhibited unique and attractive characteristics for metal catalytic systems, thus offering the scope for further development as heterogeneous catalysts.
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Affiliation(s)
- S Anandhakumar
- SRM Research Institute, SRM University , Kattankulathur, Chennai 603 203, Tamil Nadu, India
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15
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Sasidharan M, Nistala S, Narendhran RT, Murugesh M, Bhatia SJ, Rathi PM. Nutritional status and prognosis in cirrhotic patients. Trop Gastroenterol 2012; 33:257-264. [PMID: 23923351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
BACKGROUND AND AIMS Malnutrition is commonly associated with chronic liver disease. The presence of protein-calorie malnutrition has been shown to be associated with increased short- and long-term mortality in patients with acute and chronic liver disease. We undertook this study to assess the prognostic value of nutritional status in predicting survival in cirrhotic patients. The aim of our study was to determine whether assessment of nutritional status using the RFH-SGA score adds significantly to CP (Child-Pugh) and MELD scores in predicting patient prognosis and survival in cirrhotic patients. METHODS Diagnosed cases of cirrhosis were enrolled and their nutritional assessment was done using the RFH-SGA score. All patients were followed up for a period of 6 months. The mortality rates in the various groups were compared with respect to their nutritional status. Multivariate analysis was used to determine the factors associated with mortality. RESULTS A total of 73 cirrhotic patients were taken up for this study. Of these, 23 patients (31.5%) were well nourished, 21 (28.8%) had mild to moderate malnourishment and 29 (39.7%) were severely malnourished. Multivariate analyses of various parameters identified poor nutritional status, increased CP grade, increased creatinine, lower sodium levels and longer prothrombin time as being independently associated with poorer survival. CONCLUSIONS RFH-SGA is a simple and inexpensive tool for assessing the nutritional status in cirrhotic patients and can reliably predict their disease prognosis and survival.
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Affiliation(s)
- Madhu Sasidharan
- Department of Gastroenterology and Hepatology, TNMC-BYL Nair Hospital, Mumbai, India
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Sawalakhe NR, Nistala S, Sasidharan M, Narendran RT, Amrapurkar AD, Joshi RM, Rathi PM. Solitary type III gastric carcinoid causing upper gastrointestinal bleeding and severe anaemia. Trop Gastroenterol 2010; 31:43-44. [PMID: 20860226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Affiliation(s)
- N R Sawalakhe
- Department of Gastroenterology, B.Y.L Charitable Hospital and T.N. M.C Mumbai Central, Maharashtra, India
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Murugesh M, Sandur V, Sawalake N, Sasidharan M, Altekar S, Rathi UU, Ramadwar MR, Rathi PM. Mantle cell lymphoma (multiple lymphomatous polyposis) of gastrointestinal tract. Indian J Gastroenterol 2008; 26:300-1. [PMID: 18431022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Banait VS, Sandur V, Parikh F, Murugesh M, Ranka P, Ramesh VS, Sasidharan M, Sattar A, Kamat S, Dalal A, Bhatia SJ. Outcome of acute liver failure due to acute hepatitis E in pregnant women. Indian J Gastroenterol 2007; 26:6-10. [PMID: 17401226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Acute liver failure due to acute hepatitis E carries a high mortality. METHODS Clinical and laboratory parameters of 42 pregnant women (median age 25.5 years) with acute liver failure due to acute hepatitis E were retrospectively analyzed. RESULTS 22 women delivered, whereas pregnancy continued in 20 women. The maternal mortality in these two groups was similar (9/22 [41%] versus 14/20 [70%], p=0.056). However, in patients with grade I, II or III hepatic encephalopathy, delivery of fetus was associated with reduced mortality in those who delivered as against those who continued pregnancy (5/16 (31%) vs. 13/20 (65%), p=0.046). On multivariate analysis, higher grade of encephalopathy at admission was associated with risk of death (p=0.005). CONCLUSION Mortality in pregnant women with acute liver failure with acute hepatitis E is high, especially in patients who present with higher grades of encephalopathy.
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Affiliation(s)
- Vaibhav S Banait
- Department of Gastroenterology, T N Medical College and BYL Nair Ch. Hospital, Mumbai 400 008, India
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Sasidharan M, Mal NK, Bhaumik A. In-situ polymerization of grafted aniline in the channels of mesoporous silica SBA-15. ACTA ACUST UNITED AC 2007. [DOI: 10.1039/b610392h] [Citation(s) in RCA: 77] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Anbazhagan M, Kumaran G, Sasidharan M. Selective Conversion of Nitroalcohols into Nitroolefinsover Zeolite under Heterogeneous Conditions†. J Chem Res 1997. [DOI: 10.1039/a702347b] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Barhate N, Sasidharan M, Sudalai A, Wakharkar R. Selective catalytic oxidation of benzylic alcohols to the corresponding carbonyl compounds with TBHP over CrS-2. Tetrahedron Lett 1996. [DOI: 10.1016/0040-4039(96)00193-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Sasidharan M, Raju SVN, Srinivasan KV, Paul V, Kumar R. Titanium silicate molecular sieve, TS-1, catalysed C–C bond formation in Mukaiyama type aldol reactions. Chem Commun (Camb) 1996. [DOI: 10.1039/cc9960000129] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Sasidharan M, Kumar R. Synthesis, characterization and catalytic properties of ferri- and gallo-silicate analogues of zeolite NCL-1. Catal Letters 1996. [DOI: 10.1007/bf00806576] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Balaji BS, Sasidharan M, Kumar R, Chanda B. A facile and selective synthesis of β-keto esters via zeolite catalysed transesterification. Chem Commun (Camb) 1996. [DOI: 10.1039/cc9960000707] [Citation(s) in RCA: 52] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Joseph R, Sasidharan M, Kumar R, Sudalai A, Ravindranathan T. Chromium silicalite-2 (CrS-2): an efficient catalyst for the chemoselective epoxidation of alkenes with TBHP. ACTA ACUST UNITED AC 1995. [DOI: 10.1039/c39950001341] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Jayachandran B, Sasidharan M, Sudalai A, Ravindranathan T. Chromium silicalite-2 (CrS-2): an efficient catalyst for the direct oxidation of primary amines to nitro compounds with TBHP. ACTA ACUST UNITED AC 1995. [DOI: 10.1039/c39950001523] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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