1
|
Patwardhan S, Patwardhan M. M047 Smartphone photomicrocraphy bridge between analogue and digital pathology – Indian experience. Clin Chim Acta 2022. [DOI: 10.1016/j.cca.2022.04.359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
2
|
Gadve S, Chavanda S, Gogate Y, Harale V, Dasgupta A, Patwardhan M. Journey from EMPA-REG to CARMELINA to EMPEROR-Preserved: Empagliflozin/linagliptin in heart failure and diabetes. J Diabetol 2022. [DOI: 10.4103/jod.jod_24_22] [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: 03/19/2023] Open
|
3
|
Gadve SS, Chavanda S, Mukherjee AD, Aziz S, Joshi A, Patwardhan M. Risk of Developing Type 2 Diabetes Mellitus in South Asian Women with History of Gestational Diabetes Mellitus: A Systematic Review and Meta-Analysis. Indian J Endocrinol Metab 2021; 25:176-181. [PMID: 34760669 PMCID: PMC8547406 DOI: 10.4103/ijem.ijem_57_21] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 06/18/2021] [Accepted: 09/21/2021] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Gestational diabetes mellitus (GDM) and type 2 diabetes mellitus (T2DM) represent two different components of the spectrum of diabetes mellitus (DM). Women with GDM have a high chance of developing T2DM in later life and this relative risk depends on a number of factors including ethnicity. AIM To compare and estimate the risk of developing T2DM in South Asian women with a history of GDM compared to those without a history of GDM. METHODS This is a systematic review of PubMed and MEDLINE articles reporting the progression of GDM to T2DM that were published in English from 2000 to 2020. We performed meta-analysis to calculate risk ratios (RR). RESULTS We selected 6 studies considering the inclusion and exclusion criteria after sorting 25 full-text articles. Of the 44165 South Asian women assessed, 3095 had GDM and 41070 were without GDM. 995 women in GDM group and 1525 women in non-GDM group had developed T2DM. The RR of women with GDM over non-GDM in developing T2DM was 10.81 (95% confidence interval (CI): 7.61-15.35) suggesting that women with GDM are at 10.81 times more risk of developing T2DM than non-GDM. The cumulative incidence of T2DM in GDM group was 17.34% at 5 years of follow-up and 33% at more than 10 years of follow-up. CONCLUSION The risk of developing T2DM in later life is higher in South Asian women with GDM than without GDM. Therefore, lifestyle and pharmacological interventions, patient communication, timely screening, and long-term follow-up of GDM patients are important to reduce the risk.
Collapse
Affiliation(s)
- Sharvil S Gadve
- Endocrinologist, Excel Endocrine Centre, Rajarampuri, Kolhapur, Maharashtra, India
| | - Sneha Chavanda
- Department of Medicine, D. Y. Patil Medical College, Kolhapur, Maharashtra, India
| | | | - Sahid Aziz
- Demonstrator, Jorhat Medical College and Hospital, Assam, India
| | - Ameya Joshi
- Endocrinologist, Bhaktivedanta Hospital and Research Institute, Mira Road, Thane, India
| | - Milind Patwardhan
- Endocrinologist, Endocrine and Diabetes Research Centre, Miraj, Maharashtra, India
| |
Collapse
|
4
|
Chiuve S, Peloso P, Chand D, Patwardhan M, Snabes M, Kilpatrick R. Risk factors for low bone mineral density in premenopausal women with endometriosis in the national health and nutrition examination survey (NHANES). Fertil Steril 2018. [DOI: 10.1016/j.fertnstert.2018.07.1076] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
5
|
Shankarkumar U, Pradhan V, Patwardhan M, Pawar A, Almeida A, Ghosh K. HLA Alleles in Anti-Endothelial Cell Antibody Positive Indian SLE Patients. INT J HUM GENET 2017. [DOI: 10.1080/09723757.2009.11886067] [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: 10/18/2022]
Affiliation(s)
- U. Shankarkumar
- National Institute of Immunohaematology, Indian Council of Medical Research, 13th floor, King Edward Memorial Hospital, Parel, Mumbai 400 012, Maharashtra, India
| | - V.D. Pradhan
- National Institute of Immunohaematology, Indian Council of Medical Research, 13th floor, King Edward Memorial Hospital, Parel, Mumbai 400 012, Maharashtra, India
| | - M. Patwardhan
- National Institute of Immunohaematology, Indian Council of Medical Research, 13th floor, King Edward Memorial Hospital, Parel, Mumbai 400 012, Maharashtra, India
| | - A. Pawar
- National Institute of Immunohaematology, Indian Council of Medical Research, 13th floor, King Edward Memorial Hospital, Parel, Mumbai 400 012, Maharashtra, India
| | - A. Almeida
- National Institute of Immunohaematology, Indian Council of Medical Research, 13th floor, King Edward Memorial Hospital, Parel, Mumbai 400 012, Maharashtra, India
| | - K. Ghosh
- National Institute of Immunohaematology, Indian Council of Medical Research, 13th floor, King Edward Memorial Hospital, Parel, Mumbai 400 012, Maharashtra, India
| |
Collapse
|
6
|
Doley D, Kakati S, Saikia L, Rajadhyaksha A, Nadkar M, Khadilkar P, Patwardhan M, Pradhan V. A Comparitive Study of Anticardiolipin Antibodies among Systemic Lupus Erythematosus Patients from Western and Eastern India. J Assoc Physicians India 2017; 65:14-19. [PMID: 28462538] [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: 06/07/2023]
Abstract
INTRODUCTION Anti-phospholipid antibodies (APA) like anticardiolipin antibodies (ACA) are important cause of venous and arterial thrombosis and other occlusive vascular diseases. Prevalence of these antibodies in SLE patients at the time of diagnosis is not known in Indian SLE patients. This study was conducted to evaluate the prevalence of ACA in SLE patients from Eastern and Western India and to correlate them with disease activity. MATERIAL AND METHODS Seventy SLE patients from Assam Medical College, Dibrugarh, Assam and 85 SLE patients from Rheumatology Department, KEM Hospital, Mumbai were studied. SLE disease activity was evaluated by SLE Disease Activity Index (SLEDAI) score at the time of evaluation. All patients studied were in an active stage of disease. RESULTS Demographic data showed significant variations in the clinical manifestations of SLE between two regions. Renal manifestations were higher (42.9%) among SLE patients from Eastern region as compared with 37.6% patients from Western region. These patients were categorized as Lupus Nephritis (LN) and patients that did not show any renal manifestations were categories as non-LN. ACA to IgG and IgM subclasses were tested by ELISA. IgGACA positivity was 20%, 12.9% and IgM-ACA positivity was 18.6%, 12.9% where asIgG + IgM ACA positivity as found in 12.9%, 3.5% patients respectively among SLE patients from Eastern and Western India. CONCLUSIONS ACA positivity was higher among LN patients from Eastern India whereas the same was higher among non-LN patients from Western India. Hence detection of ACA alongwith associated clinical manifestations were helpful to evaluate their possible association with disease severity in SLE patients. A long term follow up of patients having ACA antibodies without thrombotic event is needed to detect their possible thrombotic event in future along with their clinical presentation from these two different geographic regions from India.
Collapse
Affiliation(s)
- D Doley
- Department of Medicine, Assam Medical College, Dibrugarh, Assam
| | - S Kakati
- Department of Medicine, Assam Medical College, Dibrugarh, Assam
| | - L Saikia
- Department of Microbiology, AMCH, Dibrugarh, Assam
| | - A Rajadhyaksha
- Department of Medicine, King Edward Memorial Hospital, Mumbai, Maharashtra
| | - Milind Nadkar
- Department of Medicine, King Edward Memorial Hospital, Mumbai, Maharashtra
| | - P Khadilkar
- Department of Clinical and Experimental Immunology, National Institute of Immunohaematology, Indian Council of medical Resarch, Mumbai, Maharashtra
| | - M Patwardhan
- Department of Clinical and Experimental Immunology, National Institute of Immunohaematology, Indian Council of medical Resarch, Mumbai, Maharashtra
| | - V Pradhan
- Department of Clinical and Experimental Immunology, National Institute of Immunohaematology, Indian Council of medical Resarch, Mumbai, Maharashtra
| |
Collapse
|
7
|
Shah K, Atodaria G, Patwardhan M, Nene A. Mycobacteria Intracellulare Spondylodiscitis Presenting as Progressive Consecutive Vertebral Sclerosis: A Case Report. J Orthop Case Rep 2017; 7:89-92. [PMID: 29600220 PMCID: PMC5868894 DOI: 10.13107/jocr.2250-0685.964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Non-tuberculous mycobacteria (NTM) are slow-growing organisms affecting both immunocompromised and immunocompetent patients. As compared to tuberculosis, they pose formidable challenge in successful management beginning with diagnosis extending through its treatment. CASE REPORT Our case highlights unusual spinal presentation of NTM, intricacies in diagnosis, and successful management. CONCLUSION As the prevalence of NTM is rising, it is important as clinicians to understand unique aspects which differ from tuberculosis for appropriate and successful treatment.
Collapse
Affiliation(s)
- Kunal Shah
- Department of Spine, “We Are Spine “, Ghatkopar, Mumbai, Maharashtra, India,Address of Correspondence: Dr. Kunal Shah, Consultant Spine Surgeon, We Are Spine Centre, Aarav Polyclinic LBS Road, Opposite Telephone Exchange, Ghatkopar (West), Mumbai -86, Maharashtra, India. E-mail:
| | - Gaurang Atodaria
- Department of Spine, Wockhardt Hospital, Mumbai, Maharashtra, India
| | | | - Abhay Nene
- Department of Spine, Wockhardt Hospital, Mumbai, Maharashtra, India
| |
Collapse
|
8
|
Patwardhan M, Eckert LO, Spiegel H, Pourmalek F, Cutland C, Kochhar S, Gonik B. Maternal death: Case definition and guidelines for data collection, analysis, and presentation of immunization safety data. Vaccine 2016; 34:6077-6083. [PMID: 27426627 PMCID: PMC5139803 DOI: 10.1016/j.vaccine.2016.03.042] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Accepted: 03/15/2016] [Indexed: 11/02/2022]
Affiliation(s)
- M Patwardhan
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA.
| | - L O Eckert
- Department of Obstetrics and Gynecology, University of Washington, Seattle, WA, USA
| | - H Spiegel
- Henry Jackson Foundation, Bethesda, MD, USA
| | - F Pourmalek
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - C Cutland
- Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, Johannesburg, Department of Science and Technology National Research Foundation, Vaccine Preventable Diseases, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | | | - B Gonik
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA
| | | |
Collapse
|
9
|
Pradhan V, Patwardhan M, Rajadhyksha A, Umare V, Khadilkar P, Kaveri SV, Ghosh K. Association of clinical presentation with anti-nuclear antibody specificities among patients with systemic lupus erythematosus. Indian J Nephrol 2015; 25:391-2. [PMID: 26664225 PMCID: PMC4663787 DOI: 10.4103/0971-4065.160338] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- V Pradhan
- Clinical and Experimental Immunology, National Institute of Immunohaematology, Indian Council of Medical Research, King Edward Memorial Hospital, Parel, Mumbai, Maharashtra, India
| | - M Patwardhan
- Clinical and Experimental Immunology, National Institute of Immunohaematology, Indian Council of Medical Research, King Edward Memorial Hospital, Parel, Mumbai, Maharashtra, India
| | - A Rajadhyksha
- Department of Medicine, King Edward Memorial Hospital, Parel, Mumbai, Maharashtra, India
| | - V Umare
- Clinical and Experimental Immunology, National Institute of Immunohaematology, Indian Council of Medical Research, King Edward Memorial Hospital, Parel, Mumbai, Maharashtra, India
| | - P Khadilkar
- Clinical and Experimental Immunology, National Institute of Immunohaematology, Indian Council of Medical Research, King Edward Memorial Hospital, Parel, Mumbai, Maharashtra, India
| | - S V Kaveri
- INSERM, UMR-S 1138, Centre de Recherche des Cordeliers, Université Pierre et Marie Curie, Paris 6, F-75006, France
| | - K Ghosh
- Clinical and Experimental Immunology, National Institute of Immunohaematology, Indian Council of Medical Research, King Edward Memorial Hospital, Parel, Mumbai, Maharashtra, India
| |
Collapse
|
10
|
Patwardhan M, Ponce E, Driscoll CR, Gonik B. 24: Global diversity in vaccine acceptance during pregnancy. Am J Obstet Gynecol 2015. [DOI: 10.1016/j.ajog.2015.09.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
11
|
Pradhan V, Kemp EH, Nadkar M, Rajadhyaksha A, Lokhandwala K, Patwardhan M, Weetman AP, Nadkarni A, Ghosh K. Association between the angiotensin-converting enzyme gene insertion/deletion polymorphism and susceptibility to systemic lupus erythematosus in an Indian population. Scand J Rheumatol 2015; 44:425-7. [DOI: 10.3109/03009742.2015.1022214] [Citation(s) in RCA: 7] [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: 11/13/2022]
|
12
|
Patwardhan M, Pradhan V, Taylor LH, Thakkar V, Kharkar V, Khopkar U, Ghosh K, Gawkrodger DJ, Teare MD, Weetman AP, Kemp EH. The angiotensin-converting enzyme gene insertion/deletion polymorphism in Indian patients with vitiligo: a case-control study and meta-analysis. Br J Dermatol 2014; 168:1195-204. [PMID: 23278772 DOI: 10.1111/bjd.12177] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND Vitiligo is a common, acquired, idiopathic depigmenting skin disorder. Although the exact pathogenesis remains unknown, genetic susceptibility and autoimmune responses play a role in vitiligo development. Previous studies have suggested that the D allele of the insertion/deletion (I/D) polymorphism of the angiotensin-converting enzyme (ACE) gene is associated with vitiligo in Indians and Koreans. Furthermore, significantly higher serum ACE levels have been demonstrated in patients with some autoimmune and autoinflammatory disorders. OBJECTIVES The objectives were to investigate any association between the ACE I/D polymorphism and vitiligo susceptibility in an Indian population, and to compare serum ACE levels in patients with vitiligo and healthy subjects. METHODS The ACE I/D genotypes of 79 patients with vitiligo and 100 normal individuals were determined by polymerase chain reaction amplification. A meta-analysis was done to compare the distribution of the ACE I/D alleles and genotypes in the current and three previous studies. Serum ACE levels were evaluated by enzyme-linked immunosorbent assay. RESULTS A significant increase in the frequency of the ACE I/D D allele was evident in patients with vitiligo in both the case-control study [P=0·005; odds ratio (OR) 1·87; 95% confidence intervals (CI) 1·22-2·85] and the meta-analysis (P=0·044; OR 1·44; 95% CI 1·01-2·06). Serum ACE levels were significantly increased in patients with vitiligo compared with healthy subjects (P<0·0001). CONCLUSIONS In agreement with earlier reports, the ACE I/D D allele is associated with vitiligo susceptibility in the Indian population. The significantly elevated serum ACE levels in our cohort of patients with vitiligo concur with those previously found in patients with some other autoimmune diseases.
Collapse
Affiliation(s)
- M Patwardhan
- Department of Clinical and Experimental Immunology, National Institute of Immunohaematology, Indian Council of Medical Research, Mumbai 400012, India
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
13
|
Pradhan V, Rajadhyaksha A, Yadav K, Surve P, Patwardhan M, Dhavale N, Pandit P, Ghosh K. Anti-C reactive protein antibodies in Indian patients with systemic lupus erythematosus. Indian J Nephrol 2013; 23:434-7. [PMID: 24339522 PMCID: PMC3841512 DOI: 10.4103/0971-4065.120341] [Citation(s) in RCA: 6] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Systemic lupus erythematosus (SLE) is characterized by over production of autoantibodies. C-reactive protein (CRP) is a phylogenetically highly conserved plasma protein that participates in the systemic response to inflammation. Anti-CRP antibodies might have biological functions of pathogenetic interest in SLE. We evaluated anti-CRP antibodies in Indian SLE patients and their association with anti-dsDNA antibodies and complement levels (C3 and C4). One hundred SLE patients diagnosed according to the American College of Rheumatology criteria were included. Disease activity was assessed using SLE disease activity index (SLEDAI). Anti-CRP autoantibodies were detected by enzyme linked immunosorbent assay. Anti-dsDNA antibodies were detected by indirect immunofluroscence test (Euroimmun Lubeck, Germany). High sensitivity CRP and complement levels (C3, C4) were detected using a Nephelometer. (BN ProSpec, Dade Behring, Germany). Anti-CRP antibodies were detected in 26% of SLE patients. Mean age of disease onset among anti-CRP positives was 22.4 ± 7.5, and 26.6 ± 9.3 years among anti-CRP negatives (P > 0.05). Anti-dsDNA positivity was significantly higher among anti-CRP positives (32.7%) as compared to anti-CRP negatives (16%) (P = 0.00519). No statistically significant difference was observed in SLEDAI scores of anti-CRP positive group and anti-CRP negative group (P > 0.05). We observed a positive correlation between anti-CRP antibodies and anti-dsDNA antibodies.
Collapse
Affiliation(s)
- V Pradhan
- Department of Clinical and Experimental Immunology, National Institute of Immunohematology, Indian Council of Medical Research, King Edward Memorial Hospital, Mumbai, Maharashtra, India
| | | | | | | | | | | | | | | |
Collapse
|
14
|
Kelkar DS, Patwardhan M, Joshi VD. Prevalence and causalities of tobacco consumption (TC) among adolescents: a cross sectional study at Pune. J Assoc Physicians India 2013; 61:174-178. [PMID: 24475679] [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: 06/03/2023]
Abstract
BACKGROUND AND OBJECTIVES Health risks associated with tobacco consumption (TC) are well known. The aim of this study was to assess the prevalence and causality of tobacco consumption among adolescents. METHODS A cross-sectional study was conducted with 6577 participants aged 12 to 20 years from 21 schools and colleges in Pune during year 2005/6. Data on socio demographic profile, family members' tobacco habits and respondents' tobacco consumption habits were collected by self-administered questionnaire. Convenience sampling method was used for data collection. RESULTS Complete information on age, gender and participants' consumption of tobacco was available for 6119 students. This data was used for analysis. Average age of the students was 16.9 +/- 1.79 years. 51% were boys. 9% lived in the hostels. Prevalence of TC was 4.2% (256). Prevalence increased from 2.1% at < 14 years to 9.8% at 18 to 20 years of age. Respondents aged < 14 years spent about Rs. 110 per month on tobacco while those over 18 years of age spent about Rs.142 per month (P < 0.05). Significantly (p < 0.0001) more boys (85.2%) consumed tobacco compared to girls (14.8%). Hostel residents consumed tobacco more than those not living in hostel (13% Vs 8.6%). Significantly more (p < 0.0001) number of fathers and brothers of TCs consumed tobacco than non TCs. (Fathers: 53.1% Vs 29.7%), (Brothers: 5.7% Vs 1.1%). CONCLUSION Tobacco consumption among adolescents in Pune is low. However to reduce it further, intervention should start prior to teenage before they form their opinion and start consuming tobacco.
Collapse
Affiliation(s)
- D S Kelkar
- Department of Oncology, Deenanath Mangeshkar Hospital and Research Centre, Erandawane, Pune 411004
| | - M Patwardhan
- Department of Research, Deenanath Mangeshkar Hospital and Research Centre, Erandawane, Pune 411004
| | - V D Joshi
- Department of Research, Deenanath Mangeshkar Hospital and Research Centre, Erandawane, Pune 411004
| |
Collapse
|
15
|
Pradhan V, Rajadhyaksha A, Mahant G, Surve P, Patwardhan M, Dighe S, Ghosh K. Anti-C1q antibodies and their association with complement components in Indian systemic lupus erythematosus patients. Indian J Nephrol 2012; 22:353-7. [PMID: 23326045 PMCID: PMC3544056 DOI: 10.4103/0971-4065.103911] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Systemic lupus erythematosus (SLE) is a prototype autoimmune disease, characterized by immune complex formation and systemic inflammation. Complement components such as C1q and mannose-binding lectin (MBL) play an important role in the clearance of immune complexes. Anti-C1q antibodies are associated with lupus nephritis and reduced levels of the complement components. The objective of this study was to detect anti-C1q antibodies in SLE patients and to evaluate their association with the complement components. Sixty SLE patients were included, of whom 75% had lupus nephritis (LN) and 25% were without renal manifestations (non-LN). The disease activity was assessed at the time of evaluation by the systemic lupus erythematosus disease activity index (SLEDAI). Anti-C1q antibodies, circulating immune complexes, and serum MBL levels were detected by enzyme-linked immunosorbent assay. The anti-C1q antibody prevalence was 58.3%. The LN patients showed 60% anti-C1q positivity with a higher percentage in membranoproliferative glomerulonephritis patients (51.9%). Anti-dsDNA positivity was slightly higher among the anti-C1q positives than in the anti-C1q negatives (65.7% vs. 60%). A higher percentage of reduced C3 and C4 levels was noted among the anti-C1q positives. The LN patients showed a higher percentage of low MBL levels among anti-C1q negatives than in the anti-C1q positives (61.1% vs. 55.6%). Non-LN patients showed a higher percentage of low MBL levels among anti-C1q positives than among anti-C1q negatives (87.5% vs. 57.1%). Anti-C1q antibodies were found in both LN and non-LN patients, but there was no correlation with the clinical severity of the disease.
Collapse
Affiliation(s)
- V Pradhan
- Department of Autoimmune Disorders, National Institute of Immunohematology, Indian Council of Medical Research, Mumbai, India
| | | | | | | | | | | | | |
Collapse
|
16
|
Pradhan V, Patwardhan M, Thakkar V, Kharkar V, Khopkar U, Ghosh K, Weetman AP, Gawkrodger DJ, Kemp EH. Vitiligo patients from India (Mumbai) show differences in clinical, demographic and autoantibody profiles compared to patients in western countries. J Eur Acad Dermatol Venereol 2011; 27:279-86. [PMID: 22122088 DOI: 10.1111/j.1468-3083.2011.04367.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Vitiligo is a common, idiopathic skin disorder characterized by depigmented skin due to the loss of cutaneous melanocytes. Several studies have reported the clinical and demographic characteristics of Indian vitiligo patients, however, none has characterized their antibody profiles. OBJECTIVE To establish the clinical, demographic and serological details of a population of vitiligo patients from Mumbai, India, and to evaluate the data for any associations between clinical presentations and the occurrence of antibody responses. METHODS Vitiligo patients (n = 79) were recruited to the study and their clinical and demographic details recorded. Serum antibodies, including those against melanocyte-specific antigens, thyroid antigens and keratinocytes, were evaluated. RESULTS The prevalence of vitiligo was independent of sex, and non-segmental vitiligo was the most common form of the disease occurring in 65% of the patients. Patients with segmental vitiligo (mean age = 14.4 ± 4.6 years) presented at a younger age than those with non-segmental disease (mean age = 32.5 ± 17.8 years). Personal and family histories of other autoimmune diseases occurred in 3% and 8% of patients, respectively. Antibodies were detected against tyrosinase, tyrosine hydroxylase, thyroid peroxidase, thyroglobulin and keratinocytes at frequencies of 11%, 22%, 18%, 24% and 27%, respectively. Overall, antibodies were more common in patients with non-segmental vitiligo (50-67%) than in those with segmental disease (0-17%), and were detected more frequently in patients with shorter disease durations (<10 years). CONCLUSION Our study provides novel information relative to the clinical details, demographic features and serological parameters of a population of vitiligo patients from Mumbai, India. Important distinctions from similar surveys conducted in European patients were evident such as an infrequency of family history, a low prevalence of clinical autoimmune disease, and an absence of particular antibody specificities. These differences may have a bearing on the pathogenesis and course of the disease in Indian patients.
Collapse
Affiliation(s)
- V Pradhan
- Department of Autoimmune Disorders, National Institute of Immunohaematology, Indian Council of Medical Research, King Edward Memorial Hospital, Parel, Mumbai India Department of Dermatology, King Edward Memorial Hospital, Parel, Mumbai, India Department of Human Metabolism, The Medical School, University of Sheffield, Sheffield, UK Department of Dermatology, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | | | | | | | | | | | | | | | | |
Collapse
|
17
|
Deshmukh CD, Patwardhan M, Bakshi AV, Parasnis AS, Kelkar DS. Anxiety in cancer caregivers: A pilot study in the Indian population. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e19652] [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: 11/20/2022] Open
|
18
|
Zafar Y, Abernethy AP, Abbott DH, Herndon JE, Rowe K, Kolimaga J, Conner L, Patwardhan M, Grambow S, Provenzale D. Comorbidity, age and stage at diagnosis in colorectal cancer (CRC). J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.6554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
6554 Background: Stage at diagnosis is a crucial predictor of outcome in CRC. The purpose of this study is to determine if comorbidity and age affect the stage at which CRC is diagnosed. Identifying variables that influence stage might improve outcomes in CRC. Due to frequent contact with the health care system, we hypothesize that patients with greater comorbidity and older age are more likely to be diagnosed with early-stage disease. Methods: We present data from two distinct patient populations: using the Cancer Care Outcomes Research and Surveillance Consortium (CanCORS) database, we identified CRC patients treated at 15 Veterans Administration (VA) hospitals from 2003-present. We also identified CRC patients treated from 2003-present at 10 non-VA, fee-for-service (FFS) practices in North and South Carolina. Data were abstracted by retrospective chart review. Comorbidity was calculated by the Charlson comorbidity index (CCI) with high comorbidity defined as CCI =3. Older age was defined as age =70 years. Data were analyzed using logistic regression where the odds of late stage at diagnosis were modeled as influenced by older age, high CCI, and race. The analysis included estimation of adjusted and unadjusted odds ratios. Results: 347 VA and 282 FFS patients were included. 98% VA vs 50% FFS were male; 43% VA vs 27% FFS were aged =70; 56% VA vs 70% FFS were white; 26% VA vs 44% FFS presented with metastatic CRC; and 21% VA vs 6% FFS had a CCI =3. In both patient populations, regression analysis showed that older age, high CCI and white race were not significant predictors of stage at diagnosis. VA 95% confidence intervals (CI's) were 0.52–1.41 (age =70), 0.50–1.75 (CCI =3), and 0.42–1.11 (white race). FFS 95% CI's were 0.52–1.53 (age =70), 0.36–2.78 (CCI =3), and 0.74–2.11 (white race). Broader 95% CI's in the FFS analysis were due to smaller sample size. Conclusions: In CRC patients, age and comorbidity were not related to stage at diagnosis. The findings are similar whether the patients were treated in a fee-for-service or VA health system. While older age and greater illness might provide more contact with the health care system, this exposure did not result in earlier diagnosis of CRC. Future studies will examine the impact of comorbidity on CRC treatment and survival. No significant financial relationships to disclose.
Collapse
Affiliation(s)
- Y. Zafar
- Duke University Medical Center, Durham, NC; Durham Veterans Administration Medical Center, Durham, NC
| | - A. P. Abernethy
- Duke University Medical Center, Durham, NC; Durham Veterans Administration Medical Center, Durham, NC
| | - D. H. Abbott
- Duke University Medical Center, Durham, NC; Durham Veterans Administration Medical Center, Durham, NC
| | - J. E. Herndon
- Duke University Medical Center, Durham, NC; Durham Veterans Administration Medical Center, Durham, NC
| | - K. Rowe
- Duke University Medical Center, Durham, NC; Durham Veterans Administration Medical Center, Durham, NC
| | - J. Kolimaga
- Duke University Medical Center, Durham, NC; Durham Veterans Administration Medical Center, Durham, NC
| | - L. Conner
- Duke University Medical Center, Durham, NC; Durham Veterans Administration Medical Center, Durham, NC
| | - M. Patwardhan
- Duke University Medical Center, Durham, NC; Durham Veterans Administration Medical Center, Durham, NC
| | - S. Grambow
- Duke University Medical Center, Durham, NC; Durham Veterans Administration Medical Center, Durham, NC
| | - D. Provenzale
- Duke University Medical Center, Durham, NC; Durham Veterans Administration Medical Center, Durham, NC
| |
Collapse
|
19
|
Rowe K, Patwardhan M, Herndon JE, Martin MG, Zafar Y, Morse M, Abernethy AP. Choice of adjuvant and first-line metastatic chemotherapy (CT) for colorectal cancer (CRC) treated in the Carolinas. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.17039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
17039 Background: CT choice is influenced by many factors including published evidence, guidelines, cost, reimbursement, patient considerations, key opinion leaders, and anecdote. Substantial locoregional variation in practice patterns can exist, and therefore studies of locoregional practice provide important information on local drivers of care. Methods: Using a population-based strategy, we identified CRC patients who developed metastatic disease since 6/1/03 from 9 Duke Oncology Network community practices and 1 academic practice in North and South Carolina. Demographic, comorbidity, diagnostic, stage, initial treatment, and metastatic treatment data were abstracted by retrospective chart review, double-entered and verified for accuracy. Results: Of the first 743 charts screened, 306 were eligible (mean age 61 (SD 13), 49% male; 65% white; 22% black; 77% colon cancer and 19% rectal; stages II 8%, III 16%, IV 64%). 26 earlier stage rectal cancer patients received neoadjuvant treatment, 50% infusional fluorouracil (5FU) and 42% capecitabine (Cap). 46 colon cancer patients received adjuvant CT, including 5FU/leucovorin (LVN; 54%), 5FU/LVN/oxaliplatin (21%), Cap (9%), and 5FU/LVN/irinotecan (7%). First-line CT for metastatic colon cancer (n=149) included FOLFOX+-bevacizumab (Bev; 42%), Cap/oxaliplatin +- Bev (23%), 5FU/LVN + Bev (9%), FOLFIRI +- Bev (7%), IFL +- Bev (7%), clinical trial (7%), Cap (3%), and unknown (1%). 54% of patients received Bev overall, reflecting 49% usage before 6/05 and 69% after 6/05. CT was not offered for 25 (8%) at initial diagnosis. Conclusion: Locoregional practice patterns in the Carolinas suggest that for adjuvant treatment of CRC, oxaliplatin has been used in 21% of adjuvant and 75% of first-line metastatic colon CT regimens, and that bevacizumab use has increased to 69% of first-line metastatic CRC patients. No significant financial relationships to disclose.
Collapse
Affiliation(s)
- K. Rowe
- Duke University Medical Center, Durham, NC
| | | | | | | | - Y. Zafar
- Duke University Medical Center, Durham, NC
| | - M. Morse
- Duke University Medical Center, Durham, NC
| | | |
Collapse
|
20
|
Joshi SR, Ambhore S, Butala N, Patwardhan M, Kulkarni M, Pai B, Karne R. Paget's disease from Western India. J Assoc Physicians India 2006; 54:535-8. [PMID: 17089901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
AIM AND OBJECTIVE To prospectively study prevalence of Paget's disease from Western India. METHODS AND MATERIALS Seventeen consecutive cases from Western India from 1998 to 2005 are analysed for the clinical, biochemical, skeletal profile. Seventeen cases (15 males & 2 females) with mean age of 62 were diagnosed RESULTS The Western Indian cohort of Paget's disease has male preponderance with a mean age of 62 years at onset. Its clinical features are pain, fracture and typical skeletal involvement. It is a non-familial, polyostotic disease with pelvis, skull, spine and femur being the commonly affected bone sites. Elevated alkaline phosphatase is typical which responds well to bisphosphonate therapy in 6 months. Most cases do well with low dose alendronate (10-20mg/day). CONCLUSIONS Paget's disease in western India is rare with classical clinical, radiological and biochemical features and responds well to low dose alendronate therapy. In eight years, seventeen cases of Paget's disease were seen from Western India indicating though still rare is present in this population of Western India.
Collapse
|
21
|
Morse M, Prosnitz R, Mantyh C, Fisher D, Samsa G, McCrory D, Cline K, Gray R, Patwardhan M. Measurement of quality of care for adjuvant chemotherapy of colorectal cancer. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.6071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
6071 Background: Although adjuvant chemotherapy (CT) is a crucial component of the therapy for stage III colon cancer and stage II and III rectal cancer patients, little is known about how best to measure whether quality care is being delivered. We sought to provide policy-makers and stake-holders with an inventory of the available measures and their usefulness. Methods: The MEDLINE and Cochrane databases were searched for all publications which might contain quality measures (QMs) pertaining to the diagnosis and treatment of patients with colorectal cancer (CRC). Our analysis was confined to QMs pertaining to adjuvant CT for CRC, based on US data, and published after 1990. Identified QMs were quantitatively rated based on the concepts of importance/usability, scientific acceptability, and validity or how well they had been tested. Results: 3,429 abstracts were reviewed, of which 843 articles underwent full text evaluation. Ultimately 74 articles met the established inclusion criteria for containing QMs, 32 of which pertained to adjuvant CT. These 32 articles contained 10 QMs, 8 of which had major flaws limiting their applicability. The two most ideal measures are presented in the table . Among the reasons some measures did not rate highly was the failure to utilize standard staging definitions or reliance on administrative inpatient databases, which do not account for chemotherapy administered on an out-patient basis. Conclusions: Very few measures of the quality of adjuvant CT for CRC have been published to date and fewer rate highly with regard to the concepts of importance/usability, scientific acceptability, and validity. Future research should focus on refining existing QMs and on developing new QMs which target important leverage points with respect to the provision of adjuvant therapy for CRC. [Table: see text] [Table: see text]
Collapse
Affiliation(s)
- M. Morse
- Duke University Medical Center, Durham, NC
| | | | - C. Mantyh
- Duke University Medical Center, Durham, NC
| | - D. Fisher
- Duke University Medical Center, Durham, NC
| | - G. Samsa
- Duke University Medical Center, Durham, NC
| | - D. McCrory
- Duke University Medical Center, Durham, NC
| | - K. Cline
- Duke University Medical Center, Durham, NC
| | - R. Gray
- Duke University Medical Center, Durham, NC
| | | |
Collapse
|
22
|
Iyer YS, Vasantha K, Joshi SR, Patwardhan M, Pujari V, Jadhav S, Mohanty D. A bicarbonate anion-dependent anti-'N' MoAb. Immunohematology 2004; 20:59-62. [PMID: 15373670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
While studying the serologic characteristics of certain monoclonal blood group antibodies, we observed a hybridoma clone (5A-11E10) with anti-N-like serologic specificity that was dependent on the presence of the bicarbonate anion. The diluted cell culture supernatant preferentially agglutinated M-N+ RBCs by immediate spin. This supernatant also agglutinated M-N+ RBCs that had been treated with trypsin or sialidase (to remove N-reactivity), suggesting anti-'N' activity. Anti-'N' specificity was confirmed by the supernatant's non-reactivity with N+ RBCs treated with papain (to remove 'N' reactivity) or with ('N'-negative) M+N-U- RBCs. The requirement for bicarbonate in the MoAb's formulation was not a function of pH. Both sodium and ammonium bicarbonate supported agglutination, but neither sulfate nor carbonate was effective.
Collapse
Affiliation(s)
- Y S Iyer
- Institute of Immunohaematology, 13th floor, New Multistorey-Building, KEM hospital compound, Parel, Mumbai-400 012, India
| | | | | | | | | | | | | |
Collapse
|