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Adelkhanova A, Oli PR, Shrestha DB, Shtembari J, Jha V, Shantha G, Bodziock GM, Biswas M, Zaman MO, Patel NK. Safety and efficacy of direct oral anticoagulants in comparison to warfarin in obese patients with atrial fibrillation: A systematic review and meta-analysis. Health Sci Rep 2024; 7:e2044. [PMID: 38650729 PMCID: PMC11033493 DOI: 10.1002/hsr2.2044] [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: 09/13/2023] [Revised: 03/15/2024] [Accepted: 03/21/2024] [Indexed: 04/25/2024] Open
Abstract
Background and Aim Obesity affects nearly 650 million adults worldwide, and the prevalence is steadily rising. This condition has significant adverse effects on cardiovascular health, increasing the risk of hypertension, coronary artery disease, heart failure, and atrial fibrillation (AF). While anticoagulation for obese patients with AF is a well-established therapy for the prevention of thromboembolism, the safety and efficacy of different anticoagulants in this specific population are not well explored. This meta-analysis aimed to compare direct oral anticoagulants (DOAC) to vitamin K antagonists in obese populations with AF. Methods The PRISMA guidelines were followed for this meta-analysis, registered in PROSPERO (CRD42023392711). PubMed, PubMed Central, Embase, Cochrane Library, and Scopus databases were searched for relevant articles from inception through January 2023. Two independent authors screened titles and abstracts, followed by a full-text review in Covidence. Data were extracted in Microsoft Excel and analyzed using RevMan v5.4 using odds ratio as an effect measure. Results Two thousand two hundred fifty-nine studies were identified from the database search, and 18 were included in the analysis. There were statistically significant reductions in the odds of ischemic and hemorrhagic stroke in the DOAC group compared with the VKA group (OR 0.70, CI 0.66-0.75) and (OR 0.47, CI 0.35-0.62), respectively. In addition, the DOAC group exhibited lower odds of systemic embolism (OR 0.67, CI 0.54-0.83), major bleeding (OR 0.62, CI 0.54-0.72), and composite outcome (OR 0.72, CI 0.63-0.81). Conclusion Based on the findings from this meta-analysis, DOACs demonstrate superior safety and efficacy in obese patients with AF compared with VKAs. These results may have significant implications for guiding anticoagulation strategies in this patient population.
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Affiliation(s)
- Alla Adelkhanova
- Department of Internal MedicineMount Sinai HospitalChicagoIllinoisUSA
| | - Prakash Raj Oli
- Department of Internal MedicineProvince HospitalBirendranagarNepal
| | | | - Jurgen Shtembari
- Department of Internal MedicineMount Sinai HospitalChicagoIllinoisUSA
| | - Vivek Jha
- Department of Internal MedicineJohn H. Stroger, Jr. Hospital of Cook CountyChicagoIllinoisUSA
| | - Ghanshyam Shantha
- Department of Internal Medicine, Division of Cardiac ElectrophysiologyWake Forest University School of MedicineWinston SalemNorth CarolinaUSA
| | - George Michael Bodziock
- Department of Internal Medicine, Division of Cardiac ElectrophysiologyWake Forest University School of MedicineWinston SalemNorth CarolinaUSA
| | - Monodeep Biswas
- Department of Internal Medicine, Division of Cardiac ElectrophysiologyUniversity of Maryland Medical CenterBaltimoreMarylandUSA
| | - Muhammad Omer Zaman
- Department of Internal Medicine, Division of CardiologyRudd Heart HospitalLouisvilleKentuckyUSA
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Jaiswal V, Roy P, Ang SP, Shama N, Deb N, Taha AM, Rajak K, Sharma A, Halder A, Wajid Z, Agrawal V, Khela H, Biswas M. Association between rheumatoid arthritis and atrial fibrillation: A systematic review and meta-analysis. J Arrhythm 2024; 40:203-213. [PMID: 38586849 PMCID: PMC10995606 DOI: 10.1002/joa3.12995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 12/26/2023] [Accepted: 01/09/2024] [Indexed: 04/09/2024] Open
Abstract
Rheumatoid arthritis (RA) is an autoimmune disorder with a varying range of organs involved leading to adverse outcomes. However, very little is known, with conflicting results about the association between RA and atrial fibrillation (AF). We aim to evaluate the association between RA and AF, and other clinical outcomes. We performed a systematic literature search using PubMed, Embase, and Scopus for relevant articles from inception until September 10, 2023. Primary clinical outcomes were AF. Secondary outcomes were acute coronary syndrome (ACS), stroke, and all-cause mortality (ACM). A total of 4 679 930 patients were included in the analysis, with 81 677 patients in the RA group and 4 493 993 patients in the nonrheumatoid arthritis (NRA) group. The mean age of the patients was 57.2 years. Pooled analysis of primary outcomes shows that RA groups of patients had a significantly higher risk of AF (odds ratios [OR], 1.53; 95% confidence interval [CI]: [1.16-2.03], p < .001) compared with NRA groups. Secondary Outcomes show that the RA group of patients had significantly higher odds of ACS (OR, 1.39; 95% CI: [1.26-1.52], p < .001), and ACM (OR, 1.19; 95% CI: [1.03-1.37], p = .02) compared with the NRA groups. However, the likelihood of stroke (OR, 1.02; 95% CI: [0.94-1.11], p = .61) was comparable between both groups of patients. Our study shows that RA groups of patients are at increased risk of having AF, ACS, and ACM.
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Affiliation(s)
- Vikash Jaiswal
- Department of Cardiovascular ResearchLarkin Community HospitalSouth MiamiFloridaUSA
| | - Poulami Roy
- Department of Internal MedicineNorth Bengal Medical College and HospitalSiliguriIndia
| | - Song Peng Ang
- Department of Internal MedicineRutgers Health/Community Medical CenterToms RiverNew JerseyUSA
| | - Nishat Shama
- Department of Internal MedicineBangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic DisordersDhakaBangladesh
| | - Novonil Deb
- Department of Internal MedicineNorth Bengal Medical College and HospitalSiliguriIndia
| | | | - Kripa Rajak
- Department of Internal MedicineUPMC HarrisburgHarrisburgPennsylvaniaUSA
| | - Akanksha Sharma
- Department of Internal MedicineUPMC MercyPittsburghPennsylvaniaUSA
| | - Anupam Halder
- Department of Internal MedicineUPMC HarrisburgHarrisburgPennsylvaniaUSA
| | - Zarghoona Wajid
- Department of Internal Medicine, School of MedicineWayne State UniversityDetroitMichiganUSA
| | - Vibhor Agrawal
- Department of MedicineKing George's Medical UniversityLucknowIndia
| | - Harpriya Khela
- Department of MedicineRoyal College of Surgeons in IrelandDublinIreland
| | - Monodeep Biswas
- Department of ElectrophysiologyUniversity of MarylandBaltimoreMarylandUSA
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3
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Jaiswal A, Jaiswal V, Ang SP, Hanif M, Vadhera A, Agrawal V, Kumar T, Nair AM, Borra V, Garimella V, Ishak A, Wajid Z, Song D, Attia AM, Huang H, Aguilera Alvarez VH, Shrestha AB, Biswas M. SGLT2 inhibitors among patients with heart failure with preserved ejection fraction: A meta-analysis of randomised controlled trials. Medicine (Baltimore) 2023; 102:e34693. [PMID: 37773799 PMCID: PMC10545009 DOI: 10.1097/md.0000000000034693] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Accepted: 07/20/2023] [Indexed: 10/01/2023] Open
Abstract
BACKGROUND Sodium-glucose co-transporter 2 (SGLT2) inhibitors have been recommended in the practice guidelines for the treatment of patients with heart failure with reduced ejection fraction; however, their effects among patients with preserved ejection fraction have been debatable. OBJECTIVE We aim to evaluate the SGLT2 inhibitor effect among patients with heart failure with reduced ejection fraction, including DELIVER and EMPEROR-Preserved trials. METHODS We performed a systematic literature search using the PubMed, Embase, Scopus, and Cochrane libraries for relevant articles from inception until August 30th, 2022. Statistical analysis was performed by calculating hazard ratio (HR) using the random effect model with a 95% confidence interval (CI) and probability value (P). Statistical significance was met if 95% CI does not cross numeric "1" and P < .05. RESULTS Six studies with a total of 15,989 total patients were included in the final analysis. The mean age of patients enrolled in SGLT2 inhibitors and placebo was 69.13 and 69.37 years, respectively. The median follow-up duration was 2.24 years. SGLT2 inhibitors reduced composite cardiovascular mortality or first hospitalization for heart failure (HR, 0.80 [95% CI: 0.74-0.87], P < .001, I2 = 0%), heart failure hospitalization (HR, 0.74 [95% CI: 0.67-0.82], P < .001, I2 = 0%) compared with placebo. However, all-cause mortality (HR, 0.97 [95% CI: 0.89-1.06], P = .54, I2 = 0%) and cardiovascular mortality (HR, 0.96 [95% CI: 0.82-1.13), P = .66, I2 = 35.09%] were comparable between both groups. CONCLUSION Our study finding shows that SGLT2 inhibitors significantly reduced the risk of first HF hospitalization or cardiovascular death and HF hospitalization; however, all-cause mortality was comparable between the groups.
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Affiliation(s)
- Akash Jaiswal
- Department of Geriatric Medicine, All India Institute of Medical Science, New Delhi, India
| | - Vikash Jaiswal
- Department of Cardiovascular Research, Larkin Community Hospital, South Miami, FL
| | - Song Peng Ang
- Department of Internal Medicine, Rutgers Health/Community Medical Center, NJ
| | - Muhammad Hanif
- Department of Internal Medicine, SUNY Upstate Medical University
| | | | | | - Tushar Kumar
- Department of Radiology, Sikkim Manipal Institute of Medical Science, Sikkim, India
| | | | | | | | - Angela Ishak
- Department of Geriatric Medicine, All India Institute of Medical Science, New Delhi, India
| | - Zarghoona Wajid
- Department of Internal Medicine, Wayne State University School of Medicine, MI
| | - David Song
- Department of Internal Medicine, Ichan School of Medicine at Mount Sinai, NY
| | | | - Helen Huang
- Royal College of Surgeons in Ireland, University of Medicine and Health Science, Dublin, Ireland
| | | | | | - Monodeep Biswas
- Division of Cardiology, The University of Maryland, Baltimore, MD
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Ali MP, Clemente-Orta G, Kabir MMM, Haque SS, Biswas M, Landis DA. Landscape structure influences natural pest suppression in a rice agroecosystem. Sci Rep 2023; 13:15726. [PMID: 37735534 PMCID: PMC10514064 DOI: 10.1038/s41598-023-41786-y] [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: 02/25/2023] [Accepted: 08/31/2023] [Indexed: 09/23/2023] Open
Abstract
Agricultural landscapes are constantly changing as farmers adopt new production practices and respond to changing environmental conditions. Some of these changes alter landscape structure with impacts on natural pest control, pesticide use, and conservation of biodiversity. In rice agroecosystems the effect of landscape structure on natural enemies and pest suppression is often poorly understood. Here we investigate the effect of landscape composition and configuration on a key pest of rice, the brown planthopper (Nilaparvata lugens). Using N. lugens as sentinel prey coupled with predator exclusions, we investigated landscape effects on herbivore suppression and rice grain yield at multiple spatial scales in two regions of Bangladesh. Ladybird beetles and spiders were the most abundant natural enemies of N. lugens with landscape effects observed at all scales on ladybird beetles. Specifically, ladybird beetles were positively influenced by road edges, and fallow land, while spiders were strongly influenced only by rice phenology. Predator exclusion cages showed that N. lugens abundance significantly increased in caged plots, reducing rice gain yield. We also used an estimated biocontrol service index that showed a significant positive relationship with landscape diversity and a significant negative impact on pest density and yield loss. These results suggest that promoting fallow lands and fragmented patches between rice fields could lead to more sustainable insect pest management in rice agroecosystems, potentially reducing the practice of prophylactic insecticide use.
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Affiliation(s)
- M P Ali
- Entomology Division, Bangladesh Rice Research Institute (BRRI), Gazipur, 1701, Bangladesh.
| | - Gemma Clemente-Orta
- Department of Crop and Forest Sciences, AGROTECNIO Center, University of Lleida, Rovira Roure 191, 25198, Lleida, Spain.
| | - M M M Kabir
- Entomology Division, Bangladesh Rice Research Institute (BRRI), Gazipur, 1701, Bangladesh
| | - S S Haque
- Entomology Division, Bangladesh Rice Research Institute (BRRI), Gazipur, 1701, Bangladesh
| | - M Biswas
- Department of Geography, Presidency University, 86/1, College Street, Kolkata, West Bengal, 700073, India
| | - Douglas A Landis
- Department of Entomology, Michigan State University, East Lansing, MI, USA
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5
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Jaiswal V, Ang SP, Shrestha AB, Wajid Z, Endurance EO, Ayoobkhan FS, Khan S, Garimellla V, Huang H, Ghanim M, Song D, Sharma P, Alraies MC, Biswas M. Amplatzer amulet versus watchman device for percutaneous left atrial appendage closure: A systematic review and meta-analysis. Medicine (Baltimore) 2023; 102:e34185. [PMID: 37390240 PMCID: PMC10313297 DOI: 10.1097/md.0000000000034185] [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: 03/14/2023] [Accepted: 06/13/2023] [Indexed: 07/02/2023] Open
Abstract
BACKGROUND The Amplatzer Amulet (AA) and Watchman devices (WD) are the 2 most frequently used devices for percutaneous LAA closure globally. OBJECTIVE To evaluate the safety and clinical outcomes associated with these 2 devices in patients undergoing percutaneous LAA closure. METHOD We systematically searched all electronic databases from inception until February 21, 2023. The primary endpoint was procedure related complications. Secondary endpoints were device related thrombus, stroke, cardiovascular mortality, peri device leak, systemic embolism, and all-cause mortality. RESULTS A total of 3 randomized clinical trials with 2150 patients were included in this meta-analysis. The mean age was 75 and 76 years in the Amplatzer group and in the Watchman group, respectively. The odds of procedure-related complications (OR, 1.80 [95% CI: 1.21-2.67], P < .001) were significantly higher among patients with AA compared to the WD. However, the odds of all-cause mortality (OR, 0.75 (95% CI: 0.49-1.16), P = .20), stroke (OR, 0.79 [95% CI: 0.47-1.34], P = .39), systemic/pulmonary embolism (OR, 1.34 [95% CI: 0.30-6.04], P = .70), and major bleeding (OR, 1.10 [95% CI: 0.83-1.48], P = .50) were comparable between the two devices. The odds of device related thrombus (OR, 0.72 [95% CI: 0.46-1.14], P = .17) was comparable between both the group of patients, however the incidence of peri device leak was significantly lower in AA group (OR, 0.41 [95% CI: 0.26-0.66], P < .001) compared with WD group of patients. CONCLUSION The AA was not superior to the Watchman device in terms of safety and efficacy. However, the Amulet occluder was associated with a higher incidence of procedure-related complications, and lower peri device leak.
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Affiliation(s)
- Vikash Jaiswal
- Department of Cardiovascular Research, Larkin Community Hospital, South Miami, FL
| | - Song Peng Ang
- Division of Internal Medicine, Rutgers Health/Community Medical Center, NJ
| | | | - Zarghoona Wajid
- Department of Internal Medicine, Wayne State University School of Medicine, Detroit, MI
| | | | | | - Shazia Khan
- Department of Medicine, Shadan Institute of Medical Science, India
| | | | - Helen Huang
- Royal College of Surgeons in Ireland, University of Medicine and Health Science, Dublin, Ireland
| | | | - David Song
- Division of Internal Medicine, Icahn School of Medicine at Mount Sinai Elmhurst Hospital Center, Queens, NY
| | - Prachi Sharma
- Division of Cardiology, Department of Internal Medicine, King George’s Medical University, India
| | | | - Monodeep Biswas
- Division of Cardiac Electrophysiology, University of Maryland Medical Center, Baltimore, MD
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6
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Jaiswal V, Ang SP, Ishak A, Joshi A, Chia JE, Lnu K, Attia AM, Sharma P, Biswas M, Grubb KJ. Transcatheter versus Surgical Aortic Valve Replacement Outcomes among Solid Organ Transplant Patients: A Systematic Review and Meta-Analysis. Curr Probl Cardiol 2023; 48:101685. [PMID: 36931333 DOI: 10.1016/j.cpcardiol.2023.101685] [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: 02/19/2023] [Accepted: 03/02/2023] [Indexed: 03/17/2023]
Abstract
BACKGROUND The safety and clinical outcomes of transcatheter aortic valve replacement (TAVR) compared to surgical aortic valve replacement (SAVR) among patients with solid organ transplants (SOT) is not well understood. OBJECTIVE This study aimed to evaluate the clinical outcomes of TAVR and SAVR among patients with a history of solid organ transplantation. METHOD We performed a systematic literature search of databases for relevant articles from inception until May 1st, 2022. Unadjusted odds ratios (OR) were pooled using a random-effect model, and a p-value of <0.05 was considered statistically significant. RESULT A total of 3240 studies were identified of which 3 studies with a total of 2960 patients were included in the final analysis. For SOT patients, the odds of in-hospital mortality (OR 0.37, 95% CI 0.20 to 0.71, p<0.001), 30-day mortality (OR 0.51, 95% CI 0.35 to 0.74, p<0.001), acute kidney injury (OR 0.45, 95% CI 0.35 to 0.59, p<0.001), and bleeding (OR 0.35, 95% CI 0.27 to 0.46, p<0.001) were significantly lower in patients undergoing TAVR compared to SAVR. In contrast, the odds of pacemaker implantation (OR 2.60, 95% CI 0.36 to 18.90, p=0.34), post-procedural stroke (OR 0.36, 95% CI 0.13 to 1.03, p=0.06) were similar between both groups of patients. Length of hospital stay was significantly lower in TAVR compared to SAVR patients (SMD -0.82, 95% CI -0.95 to -0.70, p<0.001). CONCLUSION In solid organ transplant patients, TAVR appeared to be a safe procedure with fewer post-procedure complications, shorter length of hospital stay, and lower in hospital mortality compared with SAVR.
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Affiliation(s)
- Vikash Jaiswal
- Department of Cardiovascular Research, Larkin Community Hospital, South Miami, Fl, USA.
| | - Song Peng Ang
- Department of Internal Medicine, Rutgers Health/Community Medical Center, New Jersey, USA
| | - Angela Ishak
- Department of Research and Academic affairs, Larkin Community Hospital, South Miami, Fl, USA
| | - Amey Joshi
- Department of Cardiovascular Research, Larkin Community Hospital, South Miami, Fl, USA
| | - Jia Ee Chia
- Department of Medicine, International Medical University, Malaysia
| | - Kriti Lnu
- Department of Cardiology, Medstar Washington Hospital Center, WD, USA
| | | | - Prachi Sharma
- Department of Cardiology, King George's Medical University, Lucknow, India
| | - Monodeep Biswas
- General Cardiology & Advanced Heart Failure, Wellspan Cardiology, Lancaster, Pennsylvania, USA & University of Maryland Medical Center, Baltimore
| | - Kendra J Grubb
- Division of Cardiothoracic Surgery, Department of Surgery, Emory University School of Medicine, Atlanta, Georgia, USA.
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7
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Dickfeld T, Kagan CM, Amara R, Jaikumar L, Biswas M, Hong-Zohlman SN, Ananthram M, Hong CC, See VY, Shorofsky SR, Mohiuddin M, Griffith BP. REPOLARIZATION/ST SEGMENT CHARACTERISTICS IN SERIAL 12-LEAD EKGS IN THE WORLDWIDE FIRST GENETICALLY MODIFIED PORCINE-TO-HUMAN XENOTRANSPLANT. J Am Coll Cardiol 2023. [DOI: 10.1016/s0735-1097(23)00643-5] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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8
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Jaiswal VIKASH, Ang SONGP, Shrestha AB, Sharma PRACHI, Endurance EO, Khan SHAZIA, Mukherjee D, Jaiswal AKASH, Chia JIAEE, Huang HELEN, Alraies MC, Biswas M. Amplatzer amulet versus watchman device for percutaneous left atrial appendage closure: a systematic review and meta-analysis. Eur Heart J 2023. [DOI: 10.1093/eurheartj/ehac779.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
The Amplatzer Amulet and Watchman devices are the two most frequently used devices for percutaneous LAA closure globally.
Aim
To evaluate the safety and clinical outcomes associated with these two devices in patients undergoing percutaneous LAA closure.
Method
A systematic literature search was performed in PubMed, Scopus, Embase, and Cochrane databases for studies comparing the safety and outcomes of patients undergoing LAA closure using either Amulet or Watchman devices. The primary outcome was all-cause mortality. Secondary outcomes were incidence of ischemic stroke, systemic/pulmonary embolism, major bleeding, and procedure-related complications.
Results
A total of 3 randomized clinical trials with 2150 patients were included in this meta-analysis. The mean age was 75 years and 76 years in the Amplatzer group and in the Watchman group, respectively. The mean CHA2DS2-VASc score (4.2 vs. 4.34) and mean HAS-BLED score (3.46 vs. 3.56) were comparable between both groups. The odds of all-cause mortality (OR, 0.74 (95% CI: 0.48-1.13), p = 0.16), ischemic stroke (OR, 0.81 (95% CI: 0.27-2.49), p = 0.72), systemic/pulmonary embolism (OR, 1.33 (95% CI: 0.29-6.00), p = 0.71), and major bleeding (OR, 1.10 (95%CI: 0.82-1.48), p = 0.51) were comparable between the two devices. In contrast, procedure-related complications (OR, 2.11 (95%CI: 1.31-3.40), p = 0.002) were significantly higher among patients with Amplatzer Amulet compared to the Watchman device.
Conclusion
The Amplatzer Amulet was non-inferior to the Watchman device in terms of safety and efficacy. However, the Amulet occluder was associated with a higher incidence of procedure-related complications.
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Affiliation(s)
| | - S O N G P Ang
- Rutgers Health/Community Medical Center, New Jersey, USA, Internal Medicine , New Jersey , United States of America
| | - A B Shrestha
- Larkin Community Hospital , Miami , United States of America
| | | | - E O Endurance
- St. Luke's Hospital, Internal Medicine , Missouri , United States of America
| | | | - D Mukherjee
- Larkin Community Hospital , Miami , United States of America
| | | | - J I A E E Chia
- Larkin Community Hospital , Miami , United States of America
| | | | - M C Alraies
- Detroit Medical Center , Detroit , United States of America
| | - M Biswas
- University of Maryland , Baltimore , United States of America
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Chen S, Biswas M, Scott M, Small M, Lee L, Ruiz S, Emmanuel B. Symptom burden and health-related quality of life in moderate to severe chronic rhinosinusitis with nasal polyposis. RHINOL 2022. [DOI: 10.4193/rhinol/22.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Background: Chronic rhinosinusitis with nasal polyposis (CRSwNP) affects up to 4% of individuals. Common symptoms include nasal congestion/obstruction, nasal discharge, facial pain, and reduced sense of smell. This study describes patient- and physician-reported CRSwNP symptom burden and health-related quality of life (HRQOL) in a real-world clinical setting. Methods: This multinational, geographically diverse, point-in-time survey invited physicians to evaluate 5 consecutive adults with confirmed bilateral moderate to severe CRSwNP (consecutive sampling) plus the next 2 patients with recurrent nasal polyps and ≥1 surgery for polyp removal (oversampling). Patients’ and physicians’ surveys were assessed in the entire consecutive sample and by categories of physician-determined CRSwNP severity, and by categories of asthma comorbidity (total sample). Patients’ and physicians’ responses were compared in a matched sample. Results: The total sample of 1,782 patients comprised 1,296 (72.7%) from consecutive sampling and 486 (27.3%) from oversampling. Among the consecutive sample (mean age, 46.9 years), 1,122 (86.6%) had moderate and 174 (13.4%) had severe CRSwNP. Of 1,697 patients from total sampling with known asthma status, 708 (41.7%) had asthma and 989 (58.3%) did not. Patients’ self-reported symptom frequency, severity, and burden on HRQOL worsened with increasing CRSwNP severity and comorbid asthma. Physicians underreported prevalence, severity, and impact of symptoms on daily activities compared with patients (matched sample). Conclusion: Patients and physicians from real-world settings both described a considerable burden of CRSwNP, but physicians consistently reported fewer and less severe symptoms than patients. This suggests a more patient-centric view is needed when assessing CRSwNP symptom burden and HRQOL.
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Shahin O, Shahin H, Heineke H, Biswas M. Predictors of ICU admission in patients with peripartum cardiomyopathy. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Peripartum cardiomyopathy (PPCM) is a dilated cardiomyopathy that affects women in the peripartum period. The incidence of PPCM in the United States is 1,100 women per year. We studied the admission of women diagnosed with PPCM to the intensive care unit (ICU) with the goal of identifying factors that increase risk for adverse outcomes.
Methods
This was a retrospective study of 2,286 patients with a diagnosis of PPCM admitted to a private hospital system across the United States between the years 2017 and 2021. Logistical regression analysis was utilized to identify specific patient characteristics and risk factors that were associated with admission to the ICU.
Results
The average age of patients was 32.13 years. The patient cohort was 39.76% black, 39.15% white, and 13.12% Hispanic. The average length of stay was 3.35 days. Preeclampsia was present in 342 (14.96%) patients, cerebral infarction in 31 (1.36%) patients, eclampsia in 48 (2.10%) patients, myocardial infarction (MI) in 52 (2.27%) patients, and HELLP (hemolysis, elevated liver enzymes, low platelets) syndrome in 24 (1.05%) patients. There was a total of 504 (22.05%) patients admitted to the ICU. Preeclampsia (adjusted odds ratio [adj. OR] 1.588, 95% confidence interval [CI] 1.215–2.074, p<0.001), eclampsia (adj. OR 3.131, 95% CI 1.718–5.708, p<0.001), cerebral infarction (adj. OR 4.381, 95% CI 2.028–9.463, p<0.001), age (adj. OR 0.967, 95% CI 0.953–0.982, p<0.001), MI (adj. OR 2.961, 95% CI 1.608–5.455, p<0.001), and HELLP syndrome (adj. OR 4.655, 95% CI 1.926–11.256, p<0.001) were all associated with increased odds of requiring ICU level of care. However, hypertension, d-dimer level, troponin level, active tobacco smoking, alcohol use, and diabetes mellitus were not associated with increased likelihood of admission to the ICU.
Conclusion
In our study of 2,286 women with PPCM, we found statistically significant predictors of ICU admission included age, HELLP syndrome, eclampsia, preeclampsia, MI, and cerebral infarction. This data may be useful for the early identification and triaging of patients with PPCM that require higher level of care. These results can be utilized in developing a risk score to assist in this goal.
Funding Acknowledgement
Type of funding sources: Private hospital(s). Main funding source(s): HCA-Riverside Community Hospital
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Affiliation(s)
- O Shahin
- Riverside Community Hospital , Riverside , United States of America
| | - H Shahin
- University of California, Riverside, School of Medicine , Riverside , United States of America
| | - H Heineke
- Riverside Community Hospital , Riverside , United States of America
| | - M Biswas
- Riverside Community Hospital , Riverside , United States of America
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Jaiswal V, Ang SP, Chia JE, Abdelazem EM, Jaiswal A, Biswas M, Gimelli A, Parwani P, Siller-Matula JM, Mamas MA. Echocardiographic predictors of presence of cardiac amyloidosis in aortic stenosis. Eur Heart J Cardiovasc Imaging 2022; 23:1290-1301. [PMID: 35925614 DOI: 10.1093/ehjci/jeac146] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 05/28/2022] [Accepted: 07/15/2022] [Indexed: 11/15/2022] Open
Abstract
AIMS Aortic stenosis (AS) and cardiac amyloidosis (CA) frequently coexist but the diagnosis of CA in AS patients remains a diagnostic challenge. We aim to evaluate the echocardiographic parameters that may aid in the detection of the presence of CA in AS patients. METHOD AND RESULTS We performed a systematic literature search of electronic databases for peer-reviewed articles from inception until 10 January 2022. Of the 1449 patients included, 160 patients had both AS-CA whereas the remaining 1289 patients had AS-only. The result of our meta-analyses showed that interventricular septal thickness [standardized mean difference (SMD): 0.74, 95% CI: 0.36-1.12, P = 0.0001), relative wall thickness (SMD: 0.74, 95% CI: 0.17-1.30, P < 0.0001), posterior wall thickness (SMD: 0.74, 95% CI 0.51 to 0.97, P = 0.0011), LV mass index (SMD: 1.62, 95% CI: 0.63-2.62, P = 0.0014), E/A ratio (SMD: 4.18, 95% CI: 1.91-6.46, P = 0.0003), and LA dimension (SMD: 0.73, 95% CI: 0.43-1.02, P < 0.0001)] were found to be significantly higher in patients with AS-CA as compared with AS-only patients. In contrast, myocardial contraction fraction (SMD: -2.88, 95% CI: -5.70 to -0.06, P = 0.045), average mitral annular S' (SMD: -1.14, 95% CI: -1.86 to -0.43, P = 0.0017), tricuspid annular plane systolic excursion (SMD: -0.36, 95% CI: -0.62 to -0.09, P = 0.0081), and tricuspid annular S' (SMD: -0.77, 95% CI: -1.13 to -0.42, P < 0.0001) were found to be significantly lower in AS-CA patients. CONCLUSION Parameters based on echocardiography showed great promise in detecting CA in patients with AS. Further studies should explore the optimal cut-offs for these echocardiographic variables for better diagnostic accuracy.
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Affiliation(s)
- Vikash Jaiswal
- Department of Cardiovascular Research, Larkin Community Hospital, South Miami, FL 33143, USA
| | - Song Peng Ang
- School of Medicine, International Medical University, Tawau 91000, Malaysia
| | - Jia Ee Chia
- School of Medicine, International Medical University, Tawau 91000, Malaysia
| | | | - Akash Jaiswal
- Department of Geriatric Medicine, All India Institute of Medical Science, New Delhi 110029, India
| | - Monodeep Biswas
- Division of Cardiology, Penn Medicine Lancaster General Health, Landisville, PA 17538, USA
| | - Alessia Gimelli
- Department of Imaging, Fondazione Toscana/CNR Gabriele Monasterio, Pisa 56124, Italy
| | - Purvi Parwani
- Division of Cardiology, Department of Medicine, Loma Linda University Health, Loma Linda, CA 92350, USA
| | - Jolanta M Siller-Matula
- Department of Cardiology, Medical University of Vienna, Vienna 1090, Austria.,Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Center for Preclinical Research and Technology CEPT, Warsaw 02-091, Poland
| | - Mamas A Mamas
- Keele Cardiovascular Research Group, Keele University, Keele ST5 5BG, UK
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Jaiswal V, Ang SP, Sarfraz Z, Butey S, Khandait HV, Song D, Chia JE, Maroo D, Hanif M, Ghanim M, Chand R, Biswas M. RETRACTED: Association between sarcoidosis and cardiovascular Outcomes: A systematic review and Meta-analysis. IJC Heart & Vasculature 2022; 41:101073. [PMID: 35800042 PMCID: PMC9253999 DOI: 10.1016/j.ijcha.2022.101073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 06/14/2022] [Accepted: 06/19/2022] [Indexed: 11/10/2022]
Abstract
What is known? Previous studies showed the prevalence of cardiovascular diseases with sarcoidosis. However, there is limited data quantifying the future risks of these adverse outcomes in patients with a diagnosis of sarcoidosis. What is New? To the best of our knowledge, this is the first meta-analysis assessed the adverse cardiovascular outcomes in patients with sarcoidosis. Our study analyzed 22,539,096 patients and found that the incidence of Atrial Arrhythmia, Ventricular Tachycardia and Heart Failure were significantly higher in patients with sarcoidosis. All-cause mortality appeared to be approximately 2-fold higher in patients with sarcoidosis. What are the clinical implications? In sarcoidosis with cardiac involvement, clinicians should be aware of the increased risk of adverse cardiovascular events in these patients. Additional studies are warranted to study the optimal management approach towards patients with cardiac sarcoidosis.
Background Sarcoidosis is a chronic inflammatory disorder of unknown etiology associated with high morbidity and mortality. Its association with cardiovascular outcomes is under-documented. Aim The aim of this study was to assess the adverse cardiovascular outcomes in patients with sarcoidosis compared with that of non-sarcoidosis. Methodology Online databases including PubMed, Embase and Scopus were queried from inception until March 2022. The outcomes assessed included all-cause mortality (ACM) and incidence of ventricular tachycardia (VT), heart failure (HF) and atrial arrhythmias (AA). Result A total of 6 studies with 22,539,096 participants (42,763 Sarcoidosis, 22,496,354 Non-Sarcoidosis) were included in this analysis. The pooled prevalence of sarcoidosis was 13.1% (95% CI 1% to 70%). The overall mean age was 47 years. The most common comorbidities were hypertension (12.7% vs 12.5%), and diabetes mellitus (5.5% vs 4%) respectively. The pooled analysis of primary endpoints showed that all-cause mortality (RR, 2.08; 95% CI: 1.17 to 3.08; p = 0.01) was significantly increased in sarcoidosis patients. The pooled analysis of secondary endpoints showed that the incidence of VT (RR, 15.3; 95% CI: 5.39 to 43.42); p < 0.001), HF (RR, 4.96; 95% CI: 2.02 to 12.14; p < 0.001) and AA (RR, 2.55; 95% CI: 1.47 to 4.44); p = 0.01) were significantly higher with sarcoidosis respectively compared to non-sarcoidosis. Conclusion Incidence of VT, HF and AA was significantly higher in patients with CS. Clinicians should be aware of these adverse cardiovascular events associated with sarcoidosis.
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Jaiswal V, Ang SP, Sarfraz Z, Butey S, Khandait HV, Song D, Chia JE, Maroo D, Hanif M, Ghanim M, Chand R, Biswas M. Retraction notice to “Association between sarcoidosis and cardiovascular Outcomes: A systematic review and meta-analysis” [IJC Heart Vasculat. 41 (2022) 101073]. IJC Heart & Vasculature 2022; 41:101112. [DOI: 10.1016/j.ijcha.2022.101112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Jaiswal V, Ang SP, Yaqoob S, Ishak A, Chia JE, Nasir YM, Anjum Z, Alraies MC, Jaiswal A, Biswas M. Cardioprotective effects of Influenza Vaccination among Patients with Established Cardiovascular Disease or at High Cardiovascular Risk: A Systematic Review and Meta-analysis. Eur J Prev Cardiol 2022; 29:1881-1892. [PMID: 35857821 DOI: 10.1093/eurjpc/zwac152] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [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: 05/24/2022] [Revised: 07/01/2022] [Accepted: 07/19/2022] [Indexed: 11/12/2022]
Abstract
BACKGROUND The clinical impact of the influenza vaccination on cardiovascular outcomes in people with established cardiovascular disease (CVD) is still debated. AIM The aim of this meta-analysis was to estimate the effect of influenza vaccination on cardiovascular and cerebrovascular outcomes among patients with established CVD. METHODS We systematically searched all electronic databases from inception until 15 April 2022. Primary clinical outcomes were all-cause mortality (ACM), and major adverse clinical events (MACE). Secondary endpoints were heart failure, myocardial infarction, CV mortality, and stroke. RESULTS Eighteen articles (five randomized trials and thirteen observational studies), with a total of 22,532,165 patients were included in the analysis. There were 217,072 participants included in the high cardiovascular risk or established CVD population (vaccinated n = 111,073 and unvaccinated n = 105,999). The mean age of the patients was 68 years old, without any difference between groups (69 vs 71) years. At mean follow-up of 1.5 years, vaccinated group was associated with lower risk for all-cause mortality [HR, 0.71(95%CI, 0.63-0.80), p < 0.001], MACE [HR, 0.83(95%CI:0.72-0.96), p = 0.01], CV mortality [HR, 0.78(95%CI:0.68-0.90), p < 0.001] and myocardial infarction [HR, 0.82(95%CI:0.74-0.92), p < 0.001] compared to unvaccinated group. While incidence of stroke [HR, 1.03 (95%CI, 0.92-1.06), p = 0.61] and heart failure [HR, 0.74 (95%CI, 0.51-1.08), p = 0.12] did not differ between the two groups. CONCLUSION Influenza vaccination reduced major adverse clinical events, all-cause mortality, CV mortality and myocardial infarction. These highlighted the importance of influenza vaccination in established CVD or high cardiovascular risk.
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Affiliation(s)
- Vikash Jaiswal
- Department of Research and Academic Affairs, Larkin Community Hospital, South Miami, Fl, USA
| | - Song Peng Ang
- Division of Internal Medicine, Rutgers Health/Community Medical Center, New Jersey, USA
| | | | - Angela Ishak
- Department of Research and Academic Affairs, Larkin Community Hospital, South Miami, Fl, USA.,European University Cyprus - School of Medicine, Nicosia, Cyprus
| | - Jia Ec Chia
- School of Medicine, International Medical University, Malaysia
| | | | - Zauraiz Anjum
- Department of Internal Medicine, Rochester General Hospital, USA
| | - M Chadi Alraies
- Detroit Medical Center, Wayne State University, Detroit, MI, USA
| | - Akash Jaiswal
- Department of Geriatrics Medicine, All India Institute of Medical Science, New Delhi, India
| | - Monodeep Biswas
- Division of General Cardiology and Advanced Heart Failure, Wellspan Cardiology, Lancaster, PA, USA
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Jaiswal V, Ang SP, Lnu K, Ishak A, Pokhrel NB, Chia JE, Hajra A, Biswas M, Matetic A, Dhatt R, Mamas MA. Effect of Pneumococcal Vaccine on Mortality and Cardiovascular Outcomes: A Systematic Review and Meta-Analysis. J Clin Med 2022; 11:jcm11133799. [PMID: 35807082 PMCID: PMC9267914 DOI: 10.3390/jcm11133799] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [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: 05/20/2022] [Revised: 06/27/2022] [Accepted: 06/27/2022] [Indexed: 11/24/2022] Open
Abstract
Various studies have suggested the possible cardiovascular (CV) protective effects of the pneumococcal vaccine (PV). Therefore, we conducted a meta-analysis to assess the association between recipients of PV with mortality and CV outcomes among patients with and without established cardiovascular disease. We performed a systematic literature search in PubMed, Embase, and Scopus for studies evaluating the effect of PV on mortality and CV outcomes. A total of 15 studies with 347,444 patients were included in the meta-analysis: 111,784 patients received PV (32%) and 235,660 patients were in the unvaccinated group (68%). Recipients of PV were associated with decreased all-cause mortality (HR, 0.76 (95% CI: 0.66 to 0.87), p < 0.001). PV was associated with a decrease in the incidence of myocardial infarction (MI) (HR, 0.73 (95% CI: 0.56−0.96), p = 0.02), without significant reduction in CV mortality (HR, 0.87 (95% CI: 0.72−1.07), p = 0.18) and stroke (HR, 1.01 (95% CI: 0.93−1.10), p = 0.82). Our study found PV was associated with decreased risk of all-cause mortality and MI. Future RCTs will be necessary to confirm benefits associated with receipt of PV.
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Affiliation(s)
- Vikash Jaiswal
- Department of Medicine, Larkin Community Hospital, South Miami, FL 33143, USA;
| | - Song Peng Ang
- Department of Internal Medicine, Rutgers Health/Community Medical Center, Toms River, NJ 08755, USA;
| | - Kriti Lnu
- Department of Internal Medicine, UPMC Harrisburg, Harrisburg, PA 17105, USA;
- Correspondence: (K.L.); (M.A.M.)
| | - Angela Ishak
- School of Medicine, European University Cyprus, Nicosia 2404, Cyprus;
| | | | - Jia Ee Chia
- School of Medicine, International Medical University, Kuala Lumpur 57000, Malaysia;
| | - Adrija Hajra
- Department of Internal Medicine, Jacobi Medical Center/Albert Einstein College of Medicine, The Bronx, NY 10461, USA;
| | - Monodeep Biswas
- Division of Cardiology, Wellspan Cardiology, Lancaster, PA 17602, USA;
| | - Andrija Matetic
- Department of Cardiology, University Hospital of Split, 21000 Split, Croatia;
- Keele Cardiovascular Research Group, Centre for Prognosis Research, Keele University, Keele ST5 5BG, UK
| | - Ravinder Dhatt
- Department of Internal Medicine, UPMC Harrisburg, Harrisburg, PA 17105, USA;
| | - Mamas A. Mamas
- Keele Cardiovascular Research Group, Centre for Prognosis Research, Keele University, Keele ST5 5BG, UK
- Correspondence: (K.L.); (M.A.M.)
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Sarkar D, Chandra AK, Chattopadyay S, Biswas M, Das S, Singh LH, Ray I. Possible mechanism of bamboo shoots ( Bambusa balcooa) induced thyroid disruption - An in vitro study. Hum Exp Toxicol 2021; 40:483-496. [PMID: 32909866 DOI: 10.1177/0960327120958037] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Endemic goitre and associated iodine deficiency disorders (IDDs) are a major concern in public health even in the period of post salt iodization in many regions. Among others the consumption of cyanogenic plants found responsible for the persistence of such diseases. Bamboo shoots (BS) is one such cyanogenic plant food that caused disruption of certain thyroid hormone synthesizing regulatory element as has already been reported in our earlier study. In this investigation the possible mechanism of thyrocytes disruption along with interruption of thyroid hormone biosynthesis by BS has been worked out. Commonly consumed BS, Bambusa Balcooa Roxb (BBR) water extract was analysed by GC MS; three doses below IC50 were administered to thyrocytes in culture with and without iodine. Expressions of thyroglobulin (Tg), pendrin (PDS) and monocarboxylate transporter 8 (MCT8) were evaluated in thyrocytes with cell cycle analysis, reactive oxygen species (ROS) generation, DNA oxidation and apoptotic regulation through Bax, Bcl-2 and p53. Phytochemical analysis of BBR extract revealed the presence of precursors and metabolic end products of cyanogenic glycosides. Dose dependent decrease in expression of Tg and PDS with concomitant decrease in gene expression of these with MCT8 were observed. Increased ROS, DNA oxidation and associated imbalance were found through increased Bax and p53 with decreased Bcl-2 that perturbed thyrocytes cell cycle. Cyanogenic constituents of BBR generates ROS associated oxidative changes in thyrocytes with DNA damage and oxidation and cell cycle disruption followed by inhibition of thyroid hormone synthesizing regulatory elements; addition of extra iodine showed partial prevention.
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Affiliation(s)
- D Sarkar
- Department of Physiology, 30163University of Calcutta, Kolkata, West Bengal, India
| | - A K Chandra
- Department of Physiology, 30163University of Calcutta, Kolkata, West Bengal, India
| | - S Chattopadyay
- Department of Physiology, 30163University of Calcutta, Kolkata, West Bengal, India
| | - M Biswas
- Department of Botany, 30163University of Calcutta, Kolkata, West Bengal, India
| | - S Das
- Department of Botany, 30163University of Calcutta, Kolkata, West Bengal, India
| | - L H Singh
- Department of Zoology, 179227DM College of Science (Govt. of Manipur), Imphal West, Manipur, India
| | - I Ray
- Department of Human Physiology, Ramkrishna Mahavidyalaya (Govt. of Tripura), Unakoti, Tripura, India
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Biswas M. Identifying geographical heterogeneity of under-five child nutritional status in districts of India. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
The nutritional status of under-five children often cited as a sensitive indicator of household living standards as well as the economic condition and also an important determinant of child survival. Despite India has already achieved remarkable progress in reducing child malnutrition, progress toward reducing the number of malnourished children has been sluggish. improvements in nutrition still represent a massive unfinished agenda. The objective of this study identified the place-specific spatial dependencies and heterogeneities in the associations between socioeconomic and demographic factors and nutritional status among under-five children in India. The study used a geocoded database from the fourth wave of the National Family Health Survey (NFHS-4 2015-16) data for 640 districts. The dependent variables were stunting, wasting and underweight. Moran's I and univariate LISA were used to confirm the spatial autocorrelation and clustering of nutritional status. Multivariate Ordinary least square (OLS), Geographically weighted regression (GWR), spatial (lag/error) models were employed to decrypt the determinants of under-five nutritional status. Overall, the prevalence and spatial clustering (Moran's I statistics) of stunting, wasting and underweight were 38% (0.634), 21% (0.488) and 36% (0.721), respectively. GWR results disclosed that the relationships between the outcomes and its covariates were significantly place-specific and spatially clustering in terms of their respective magnitude, direction and strength. Regarding model performance and prediction accuracy, GWR better fits compared to traditional OLS models. The findings of the present study identified district-level nutritional conditions (hotspots) in India, where children are under severe risk of malnutrition can help health professionals, planners and policymakers in designing and implementing effective place-specific health policies to improve district-level under-five nutrition status in India.
Key messages
To identify the place-specific spatial dependencies and heterogeneities in the associations between socio-economic and demographic factors and nutritional status among under-five children in India. This study helps health professionals, planners and policymakers in designing and implementing effective place-specific health policies to improve district-level under-five nutrition status in India.
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Affiliation(s)
- M Biswas
- Center for the Study of Regional Development, Jawaharlal Nehru University, New Delhi, India
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18
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Biswas M. Exploring district-level geographical variance of complete immunization coverage in India. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.956] [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: 11/13/2022] Open
Abstract
Abstract
India has been significantly progressed in full immunization care over the last few decades. Existing literature has not been unaddressed the potential spatial variations in relationships between full immunization coverage and its influence on socio-economic factors. The study aims to explore place-specific spatial dependencies and heterogeneities in the relationships of various factors on the district-level full immunization coverage in India. The study used a geocoded database for 640 districts of India, drawn from the 4th wave of the National Family Health Survey (NFHS) in 2015-16. Univariate Moran's I and LISA maps were used to confirm the spatial autocorrelation and geographical hotspots of the district-level full immunization coverage. Multivariate Ordinary Least Squares (OLS) and Geographically Weighted Regression (GWR) models were employed to examine spatial relationships and decrypt location-based district-level analysis. The prevalence of full immunization care was 62 percent as per the national figure. The GWR results revealed that the relationships between the outcome and set of cofactors were significantly place-specific and spatially clustering in terms of their respective magnitude, direction, and differences in due to local characteristics across India. In terms of model performance and prediction accuracy, the GWR model was performing better over OLS estimates through comparisons of R2 and Akaike Information Criterion (AICC) in both models. Furthermore, the GWR model also improves the reliabilities of the relationships by reducing spatial autocorrelations. The findings suggest that the local GWR model has the potential to explain complexities in place-specific variations that could be ignored by OLS on the local causes of immunization coverage. Thus, appropriate intervention should be devised to safeguard child from vaccine-preventable diseases reduce the geographical heterogeneity of full immunization coverage across India.
Key messages
This study aims to explore place-specific spatial dependencies and heterogeneities in the relationships of various factors on the district-level full immunization coverage in India. To explain local complexities in place-specific variations that could be ignored by the traditional model on the local causes of full immunization coverage across India.
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Affiliation(s)
- M Biswas
- Center for the Study of Regional Development, Jawaharlal Nehru University, New Delhi, India
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Sreedharan S, Biswas M, Thiyagarajan S, Basak N, Basu A, Ghosh P. Spatio-temporal separation of tumor infiltrating CD8+ T-cells and HER2/neu+ tumor cells in tumor-immune milieu of infiltrating ductal carcinoma of the breast. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz269.025] [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: 11/13/2022] Open
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Cotter C, Biswas M, Rao N, Selim A, Walsh S. Vanishing bile duct syndrome with eruptive xanthomas. Clin Exp Dermatol 2019; 45:364-366. [PMID: 31385321 DOI: 10.1111/ced.14043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/14/2019] [Indexed: 11/27/2022]
Affiliation(s)
- C Cotter
- Departments of, Dermatology, Kings College Hospital, London, UK
| | - M Biswas
- Metabolic Medicine and Chemical Pathology, Kings College Hospital, London, UK
| | - N Rao
- Metabolic Medicine and Chemical Pathology, Kings College Hospital, London, UK
| | - A Selim
- Histopathology, Kings College Hospital, London, UK
| | - S Walsh
- Departments of, Dermatology, Kings College Hospital, London, UK
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Ranasinghe R, Chen B, Zeng H, Biswas M, Chandra R, Rao N. The Use Of Carotid Plaques To Compliment Simon Broome Criteria And Dutch Lipid Clinic Network Score In Familial Hypercholesteroleamia (Fh). Atherosclerosis 2019. [DOI: 10.1016/j.atherosclerosis.2019.06.778] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Abstract
AIMS A major component of the National Health Service (NHS) Health Check in England is to provide lifestyle advice to eligible participants. The aims of the study were to explore the variations (in terms of uptake) in the NHS Health Check in Leicester and to determine its association with a healthy lifestyle. METHODS This cross-sectional study used data from the Leicester Health and Wellbeing Survey (2015). RESULTS The odds of having an NHS Health Check were found to be higher in Black and minority ethnic groups and in people of other religions. The odds were lower in people without a religion, residing in the fourth index of multiple deprivation quintile and in ex-smokers. No associations were found between having an NHS Health Check and describing a healthy lifestyle, following a healthy lifestyle, thinking of making lifestyle changes in the next 6 months, cutting down on/stopping smoking among current smokers, or amount of alcohol current drinkers would like to drink. CONCLUSIONS In Leicester, a few variations in having an NHS Health Check were found among different socio-economic, demographic and behavioural groups. No association was found between the NHS Health Check and a healthy lifestyle. Thus, the improvement work should focus on reducing these variations in having the NHS Health Check and bringing its benefits on promoting a healthy lifestyle.
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Affiliation(s)
- K Chattopadhyay
- Assistant Professor in Evidence Based Healthcare, Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK; Clinical Sciences Building, Nottingham City Hospital, Nottingham, UK
| | - M Biswas
- Research Fellow in Health Economics, Centre for Reviews and Dissemination, University of York, York, UK
| | - R Moore
- Consultant in Public Health, Leicester City Council, Leicester, UK; Honorary Senior Lecturer, Department of Health Sciences, University of Leicester, Leicester, UK
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Chattopadhyay K, Akagwire U, Biswas M, Moore R, Rajania G, Lewis S. Role of lifestyle behaviours in the ethnic pattern of poor health outcomes in Leicester, England: analysis of a survey data set. Public Health 2019; 170:122-128. [PMID: 31029834 DOI: 10.1016/j.puhe.2019.03.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 02/10/2019] [Accepted: 03/11/2019] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Mediation analyses were conducted to explore the contribution of lifestyle behaviours in the ethnic pattern of poor health outcomes in Leicester, England. STUDY DESIGN Cross-sectional study. METHODS The study used data on 1959 participants from the Leicester Health and Well-being Survey (2015). Lifestyle behaviours were physical activity, diet, smoking and alcohol drinking. Poor health outcomes were the presence of long-term illness and poor self-reported health. RESULTS Poor health outcomes were less common in Black and Minority Ethnic groups (BMEs) than Whites. Smoking was less common in BMEs than Whites. Poor health outcomes were more common in ex-smokers and current smokers than never smokers. Health outcomes were associated with smoking even after adjusting for ethnicity. The association of ethnicity and health outcomes reduced after adjusting for smoking, suggesting that the effect was mediated by smoking. CONCLUSIONS In Leicester, Whites had poorer health outcomes than BMEs, which were not mediated by physical activity, diet and alcohol drinking but were mediated by smoking.
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Affiliation(s)
- Kaushik Chattopadhyay
- Division of Epidemiology and Public Health, The University of Nottingham, Nottingham, UK.
| | - U Akagwire
- Division of Epidemiology and Public Health, The University of Nottingham, Nottingham, UK
| | - M Biswas
- Centre for Reviews and Dissemination, University of York, York, UK
| | - R Moore
- Leicester City Council, Leicester, UK; Health Sciences, University of Leicester, Leicester, UK
| | - G Rajania
- Leicester City Council, Leicester, UK
| | - S Lewis
- Division of Epidemiology and Public Health, The University of Nottingham, Nottingham, UK
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Roy S, Roy B, Gangopadhayay M, Basu S, Guha S, Manir K, Ahmed M, Biswas M. Open technique of intraperitoneal chemotherapy in advanced ovarian cancer- how feasible is it. Eur J Surg Oncol 2019. [DOI: 10.1016/j.ejso.2018.10.234] [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: 10/27/2022] Open
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Abstract
BACKGROUND Occupational injuries are a major problem in agriculture worldwide. In the Northeast region of India, most of the farm operations are carried out manually with hand operated tools and equipment. These tools also cause some nonfatal accidents. In the absence of reliable data on accidents in this region, injury prevention policy cannot be madeOBJECTIVE:The aim of this study was to survey injury causing agricultural accidents occurring during 2010 to 2013 in Arunachal Pradesh of the northeast region to know their magnitude, causes and severity. PARTICIPANTS In this study, four districts of Arunachal Pradesh namely Papum Pare, Lower Subansiri, West Siang and East Siang were chosen using purposive sampling. From each district, 15 villages were selected. In these villages, a total of 50614 agricultural workers participated and 174 and 48 injuries were found for male and female workers respectively. METHOD A case-control study was carried out in Arunachal Pradesh. The questionnaire-based approach was used for data collection. The questionnaire contains detailed information on the demographic and injury characteristics. The Demographic information included gender, age, educational background, etc. and injury characteristics included the nature of the injury, the body part injured, and type of tools and equipment that caused the injury. RESULTS The results showed that farm tools and equipment-related accidents were maximum i.e. 144 (60%) caused due to dao followed by 19 from spade (8%), 18 from sickle (7%) and 8 from axe (3%). The foot and legs were the most frequently injured body parts. From this study, it was also revealed that male agricultural workers are more affected as compared to their female counterparts. CONCLUSIONS Agricultural accident incident rate (AIR) was found to be 589 per 1,00,000 workers per year. The AIR for males is 462 per 100,000 workers per year which is 3.6 times higher than female workers. The root causes of accidents are the use of traditional tools and equipment in various agricultural activities. Therefore, any ergonomic interventions in designing tools and equipment will significantly improve the occupational health and safety of workers.
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Affiliation(s)
- Thaneswer Patel
- Department of Agricultural Engineering, North Eastern Regional Institute of Science and Technology (NERIST), Nirjuli, Arunachal Pradesh, India
| | - P K Pranav
- Department of Agricultural Engineering, North Eastern Regional Institute of Science and Technology (NERIST), Nirjuli, Arunachal Pradesh, India
| | - M Biswas
- Department of Agricultural Engineering, North Eastern Regional Institute of Science and Technology (NERIST), Nirjuli, Arunachal Pradesh, India
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Majumder P, Babu G, Rajagowda C, Thiyagarajan S, Biswas M, Radhakrishnan P, Chaudhuri P, Chatterjee A. Identification of the rational combination of two epigenetic inhibitors therapy in refractory AML using patient tumor derived ex vivo platform. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy303.026] [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: 11/14/2022] Open
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Babu G, Deepak K, Balakrishnan B, Biswas M, Prasath A, Radhakrishnan P, Chatterjee A, Thiyagarajan S, Chaudhuri P, Majumder P. CANscript™ as a patient-derived predictive platform for individualizing treatment in lung cancer. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy303.008] [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: 11/12/2022] Open
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Smalley M, Shanthappa BU, Gertje H, Lawson M, Ulaganathan B, Thayakumar A, Maciejko L, Radhakrishnan P, Biswas M, Thiyagarajan S, Majumder B, Gopinath KS, K GB, Goldman A. Abstract P5-11-04: Therapy-induced priming of natural killer cells predicts patient-specific tumor rejection in multiple breast cancer indications. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p5-11-04] [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: 11/16/2022]
Abstract
Abstract
Background: Predicting patient-specific clinical response to anticancer therapy is the holy grail of treatment-selection. It is now clear that response or resistance to therapy depends on the heterogeneous tumor microenvironment, which is comprised of malignant cells, normal stroma, soluble ligands, and tumor-immune contexture; attributes that are unique to each individual patient. This is particularly true for emerging anticancer drugs, such as immune checkpoint inhibitors, which recalibrate the body's own immune defense largely by modulating exhaustion of cytotoxic lymphocytes including T cells and natural killer (NK) cells. However, clinical response to therapy varies enormously. There is a critical gap in our understanding for the mechanisms that drive response or resistance to conventional drugs and immunotherapies at the individual patient level.
Methods: Here, we used a fully patient-autologous, clinically-validated ex-vivo tumor model that recreates and preserves the native, patient tumor microenvironment (CANscriptTM), which incorporates an algorithm-driven method to predict clinical response to therapy (M-Score). Utilizing tissue from patients diagnosed with luminal, HER2 positive, and triple-negative (ER- PR- HER2-) breast cancers (N=10), we studied phenotypic alterations to the tumor-immune contexture under pressure of conventional standard-of-care regimens and immunotherapies including immune-checkpoint inhibitors, ex-vivo. To do this, we used a comprehensive panel of immunological assays to evaluate changes in cytotoxic lymphocytes by flow cytometry and multiplex immunohistochemistry (i.e. CD56, MHC class 1A/B, NKG2D/C, CD8, CD3, PD-1, CTLA-4, TIM-3, LAG-3, 4-1BB, granzyme A/B). In addition, we used multiplex cytokine analysis to study the soluble components of the tumor microenvironment.
Results: We identified that tumor response, predicted by M-Score, correlates to increased infiltration of NK cells, which associated a pro-inflammatory cytokine signature from the tumor microenvironment. Interestingly, these evidences were concordant with induction of the tumor-expressing biomarker MICA/B, which is known to attract and recruit active NK cells. Furthermore, we determined that therapy-induced expression of protein biomarkers associated with NK cell exhaustion inversely correlated to the expression of cytotoxic granzyme B in the tumor microenvironment.
Conclusions: Taken together, these data demonstrate an integral role that NK cells contribute to the antitumor effect of therapy including conventional and immuno-modulatory drugs. It further demonstrates how a novel ex-vivo platform can be harnessed to study the mechanisms of response and resistance, which couldn't otherwise be known in a drug naïve state. Such an advance in our preclinical methods to study anticancer drugs at the individual patient level can help guide treatment decisions for clinicians while simultaneously functioning as a platform to study clinical efficacy of novel and emerging agents.
Citation Format: Smalley M, Shanthappa BU, Gertje H, Lawson M, Ulaganathan B, Thayakumar A, Maciejko L, Radhakrishnan P, Biswas M, Thiyagarajan S, Majumder B, Gopinath KS, K GB, Goldman A. Therapy-induced priming of natural killer cells predicts patient-specific tumor rejection in multiple breast cancer indications [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P5-11-04.
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Affiliation(s)
- M Smalley
- Integrative Immuno-Oncology Center Mitra RxDx Inc., Woburn, MA; Mitra RxDx, Bangalore, Karnataka, India; Bangalore Institute of Oncology, Bangalore, Karnataka, India; Kidwai Memorial Institute of Oncology, Bangalore, Karnataka, India
| | - BU Shanthappa
- Integrative Immuno-Oncology Center Mitra RxDx Inc., Woburn, MA; Mitra RxDx, Bangalore, Karnataka, India; Bangalore Institute of Oncology, Bangalore, Karnataka, India; Kidwai Memorial Institute of Oncology, Bangalore, Karnataka, India
| | - H Gertje
- Integrative Immuno-Oncology Center Mitra RxDx Inc., Woburn, MA; Mitra RxDx, Bangalore, Karnataka, India; Bangalore Institute of Oncology, Bangalore, Karnataka, India; Kidwai Memorial Institute of Oncology, Bangalore, Karnataka, India
| | - M Lawson
- Integrative Immuno-Oncology Center Mitra RxDx Inc., Woburn, MA; Mitra RxDx, Bangalore, Karnataka, India; Bangalore Institute of Oncology, Bangalore, Karnataka, India; Kidwai Memorial Institute of Oncology, Bangalore, Karnataka, India
| | - B Ulaganathan
- Integrative Immuno-Oncology Center Mitra RxDx Inc., Woburn, MA; Mitra RxDx, Bangalore, Karnataka, India; Bangalore Institute of Oncology, Bangalore, Karnataka, India; Kidwai Memorial Institute of Oncology, Bangalore, Karnataka, India
| | - A Thayakumar
- Integrative Immuno-Oncology Center Mitra RxDx Inc., Woburn, MA; Mitra RxDx, Bangalore, Karnataka, India; Bangalore Institute of Oncology, Bangalore, Karnataka, India; Kidwai Memorial Institute of Oncology, Bangalore, Karnataka, India
| | - L Maciejko
- Integrative Immuno-Oncology Center Mitra RxDx Inc., Woburn, MA; Mitra RxDx, Bangalore, Karnataka, India; Bangalore Institute of Oncology, Bangalore, Karnataka, India; Kidwai Memorial Institute of Oncology, Bangalore, Karnataka, India
| | - P Radhakrishnan
- Integrative Immuno-Oncology Center Mitra RxDx Inc., Woburn, MA; Mitra RxDx, Bangalore, Karnataka, India; Bangalore Institute of Oncology, Bangalore, Karnataka, India; Kidwai Memorial Institute of Oncology, Bangalore, Karnataka, India
| | - M Biswas
- Integrative Immuno-Oncology Center Mitra RxDx Inc., Woburn, MA; Mitra RxDx, Bangalore, Karnataka, India; Bangalore Institute of Oncology, Bangalore, Karnataka, India; Kidwai Memorial Institute of Oncology, Bangalore, Karnataka, India
| | - S Thiyagarajan
- Integrative Immuno-Oncology Center Mitra RxDx Inc., Woburn, MA; Mitra RxDx, Bangalore, Karnataka, India; Bangalore Institute of Oncology, Bangalore, Karnataka, India; Kidwai Memorial Institute of Oncology, Bangalore, Karnataka, India
| | - B Majumder
- Integrative Immuno-Oncology Center Mitra RxDx Inc., Woburn, MA; Mitra RxDx, Bangalore, Karnataka, India; Bangalore Institute of Oncology, Bangalore, Karnataka, India; Kidwai Memorial Institute of Oncology, Bangalore, Karnataka, India
| | - KS Gopinath
- Integrative Immuno-Oncology Center Mitra RxDx Inc., Woburn, MA; Mitra RxDx, Bangalore, Karnataka, India; Bangalore Institute of Oncology, Bangalore, Karnataka, India; Kidwai Memorial Institute of Oncology, Bangalore, Karnataka, India
| | - GB K
- Integrative Immuno-Oncology Center Mitra RxDx Inc., Woburn, MA; Mitra RxDx, Bangalore, Karnataka, India; Bangalore Institute of Oncology, Bangalore, Karnataka, India; Kidwai Memorial Institute of Oncology, Bangalore, Karnataka, India
| | - A Goldman
- Integrative Immuno-Oncology Center Mitra RxDx Inc., Woburn, MA; Mitra RxDx, Bangalore, Karnataka, India; Bangalore Institute of Oncology, Bangalore, Karnataka, India; Kidwai Memorial Institute of Oncology, Bangalore, Karnataka, India
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Biswas M, Brijwani N, Balakrishnan B, Muthusamy O, Thiyagarajan S, Mehrotra D, Majumder B, Radhakrishnan P, Majumder P. Mechanistic divergence of immune checkpoint inhibition by an ex vivo platform derived from patient tumors where tumor and immune microenvironment is preserved. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx711.066] [Citation(s) in RCA: 1] [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: 11/12/2022] Open
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Smalley M, Shanthappa B, Gertje H, Lawson M, Ulaganathan B, Thayakumar A, Maciejko L, Radhakrishnan P, Biswas M, Thiyagarajan S, Majumder B, Gopinath K, Babu G, Goldman A. Therapy-induced priming of natural killer cells predicts patient-specific tumor rejection in multiple breast cancer indications. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx711.010] [Citation(s) in RCA: 1] [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: 11/13/2022] Open
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Majumder P, Radhakrishnan P, Thiagarajan S, Biswas M, Malhotra D, Ulaganathan B, Majumder B, Babu G. Deciphering the antitumor efficacy and mechanistic delineation of epigenetic inhibitors in AML using patient tumor derived ex vivo phenotypic assay based platform. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx390.066] [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: 11/13/2022] Open
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Vaidya S, Biswas M, Rai K. Traumatic Diaphragmatic Hernia: Diagnostic Dilemma. Kathmandu Univ Med J (KUMJ) 2017; 15:265-267. [PMID: 30353906] [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: 06/08/2023]
Abstract
Traumatic rupture of the diaphragm is an uncommon condition. The prevalence of diaphragmatic rupture among blunt trauma victim ranges from 0.8 to 8%. The etiologic factors are blunt trauma (for example, in motor vehicle accidents) and penetrating trauma. The diagnosis is often missed because of non-specific clinical signs, and the absence of additional intra-abdominal and thoracic injuries. We present a case which was misdiagnosed as a case of left sided hemopneumothorax and treated with tube thoracotomy in other center.
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Affiliation(s)
- S Vaidya
- Department of CardioVascular and Thoracic Surgery, Banghabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh
| | - M Biswas
- Department of Thoracic Surgery, National Institute of Diseases of Chest Hospital, Dhaka, Bangladesh
| | - K Rai
- Department of CardioVascular and Thoracic Surgery, Banghabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh
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Biswas M, Murray J. The effects of cognitive biases and imperfectness in long-term robot-human interactions: Case studies using five cognitive biases on three robots. COGN SYST RES 2017. [DOI: 10.1016/j.cogsys.2016.07.007] [Citation(s) in RCA: 5] [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: 10/21/2022]
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Tiwana MS, Ni LH, Saini S, Verma SK, Doddamani D, Jain N, Biswas M, Gupta M, Gupta M, Saini M, Chauhan N. Radiation therapy outcomes in muscle invasive urinary bladder cancer: A single institution experience. Indian J Cancer 2017; 53:143-6. [PMID: 27146766 DOI: 10.4103/0019-509x.180842] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION To audit the survival outcomes and loco-regional control in muscle invasive urinary bladder cancer patients treated with external beam radiation therapy (RT). MATERIALS AND METHODS From November 2008 through December 2011, 50 consecutively diagnosed muscle invasive urinary bladder carcinoma (T2-4a N0-2, M0) patients were included in this retrospective study. All these patients received external beam RT to a median dose of 60 Gy (range 30-66 Gy), and were not suitable for radical surgery due to patients' preference or medical comorbidities. A stepwise procedure using proportional hazard regression was used to identify prognostic factors with respect to survival. RESULTS Completion trans-urethral resection of bladder tumor was done in 38 (76%) patients of the cohort and 47 (94%) had transitional cell carcinoma on histopathology. Clinical stage T2 was diagnosed in 40 (80%) patients. The median follow-up for the entire cohort was 14 ± 8.9 months (range 1-36 months). In conclusion, 24 patients (48%) were free of disease, 5 patients (10%) had residual disease, and 13 patients (26%) had died of disease. Two-year and 3 year overall survival of intact bladder for the entire cohort was 58% and 43.6%, respectively. Cox regression modeling strongly suggested clinical stage (P = 0.01) and RT dose (P = 0.001) as being predictors for overall survival. CONCLUSION RT shows reliable outcomes and excellent compliance in this advanced disease. Prescribing a higher RT dose could potentially correlate to better intact bladder control rates while maintaining good quality of life in selected patients.
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Affiliation(s)
| | - L H Ni
- Department of Radiation Oncology, STM Cancer Research Institute, Himalayan Institute Hospital Trust, Swami Ram Nagar, Jolly Grant, Dehradun, India
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Shewade HD, Chadha SS, Gupta V, Tripathy JP, Satyanarayana S, Sagili K, Mohanty S, Bera OP, Pandey P, Rajeswaran P, Jayaraman G, Santhappan A, Bajpai UN, Mamatha AM, Maiser R, Naqvi AJ, Pandurangan S, Nath S, Ghule VH, Das A, Prasad BM, Biswas M, Singh G, Mallick G, Jeyakumar Jaisingh AJ, Rao R, Kumar AMV. Data collection using open access technology in multicentre operational research involving patient interviews. Public Health Action 2017; 7:74-77. [PMID: 28744430 DOI: 10.5588/pha.15.0079] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [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: 09/19/2016] [Accepted: 11/19/2016] [Indexed: 11/10/2022] Open
Abstract
Conducting multicentre operational research is challenging due to issues related to the logistics of travel, training, supervision, monitoring and troubleshooting support. This is even more burdensome in resource-constrained settings and if the research includes patient interviews. In this article, we describe an innovative model that uses open access tools such as Dropbox, TeamViewer and CamScanner for efficient, quality-assured data collection in an ongoing multicentre operational research study involving record review and patient interviews. The tools used for data collection have been shared for adaptation and use by other researchers.
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Affiliation(s)
| | - H D Shewade
- International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Office, New Delhi, India
| | - S S Chadha
- International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Office, New Delhi, India
| | - V Gupta
- International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Office, New Delhi, India.,All India Institute of Medical Sciences, New Delhi, India
| | - J P Tripathy
- International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Office, New Delhi, India
| | - S Satyanarayana
- International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Office, New Delhi, India
| | - K Sagili
- International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Office, New Delhi, India
| | - S Mohanty
- International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Office, New Delhi, India
| | - O P Bera
- International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Office, New Delhi, India
| | - P Pandey
- International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Office, New Delhi, India
| | - P Rajeswaran
- Resource Group for Education and Advocacy for Community Health, Chennai, India
| | - G Jayaraman
- Resource Group for Education and Advocacy for Community Health, Chennai, India
| | - A Santhappan
- Catholic Health Association of India, Secunderabad, India
| | - U N Bajpai
- Voluntary Health Association of India, New Delhi, India
| | - A M Mamatha
- Catholic Health Association of India, Secunderabad, India
| | - R Maiser
- Catholic Health Association of India, Secunderabad, India
| | - A J Naqvi
- MAMTA Health Institute for Mother and Child, New Delhi, India
| | - S Pandurangan
- International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Office, New Delhi, India
| | - S Nath
- International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Office, New Delhi, India
| | - V H Ghule
- International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Office, New Delhi, India
| | - A Das
- International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Office, New Delhi, India
| | - B M Prasad
- International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Office, New Delhi, India
| | - M Biswas
- International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Office, New Delhi, India
| | - G Singh
- International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Office, New Delhi, India
| | - G Mallick
- International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Office, New Delhi, India
| | | | - R Rao
- Central TB Division, Revised National Tuberculosis Control Programme, Ministry of Health and Family Welfare, New Delhi, India
| | - A M V Kumar
- International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Office, New Delhi, India.,The Union, Paris, France
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Biswas M, Tewary B, Mehrotra D, Majumder B, Majumder P. Immune profiling of colorectal cancer in CANScript™ platform deciphers heterogeneity of tumor microenvironment and immune check point phenotype status. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw525.28] [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: 11/12/2022] Open
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Biswas M, Patel R, German C, Kharod A, Mohamed A, Dod HS, Kapoor PM, Nanda NC. Simulation-based training in echocardiography. Echocardiography 2016; 33:1581-1588. [PMID: 27587344 DOI: 10.1111/echo.13352] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [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: 11/27/2022] Open
Abstract
The knowledge gained from echocardiography is paramount for the clinician in diagnosing, interpreting, and treating various forms of disease. While cardiologists traditionally have undergone training in this imaging modality during their fellowship, many other specialties are beginning to show interest as well, including intensive care, anesthesia, and primary care trainees, in both transesophageal and transthoracic echocardiography. Advances in technology have led to the development of simulation programs accessible to trainees to help gain proficiency in the nuances of obtaining quality images, in a low stress, pressure free environment, often with a functioning ultrasound probe and mannequin that can mimic many of the pathologies seen in living patients. Although there are various training simulation programs each with their own benefits and drawbacks, it is clear that these programs are a powerful tool in educating the trainee and likely will lead to improved patient outcomes.
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Affiliation(s)
- Monodeep Biswas
- Wright Center for Graduate Medical Education and The Commonwealth Medical College, Scranton, Pennsylvania
| | | | - Charles German
- Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, Alabama
| | - Anant Kharod
- Department of Cardiovascular Medicine, University of South Florida, Tampa, Florida
| | - Ahmed Mohamed
- Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, Alabama
| | - Harvinder S Dod
- The Heart and Vascular Center at Medical Center of South Arkansas, El Dorado, Arkansas
| | | | - Navin C Nanda
- Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, Alabama.
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Ghatak A, Singh V, Shantha GPS, Badheka A, Patel N, Alfonso CE, Biswas M, Pancholy SB, Grines C, O'Neill WW, de Marchena E, Cohen MG. Aspiration Thrombectomy in Patients Undergoing Primary Angioplasty for ST Elevation Myocardial Infarction: An Updated Meta-Analysis. J Interv Cardiol 2016; 28:503-13. [PMID: 26642999 DOI: 10.1111/joic.12249] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND The Trial of Routine Aspiration Thrombectomy with PCI versus PCI alone in patients with STEMI (TOTAL trial) refuted the salutary effect of routine aspiration thrombectomy (AT) in PPCI for patients with ST-elevation myocardial infarction (STEMI). OBJECTIVES We performed an updated meta-analysis to assess clinical outcomes with AT prior to PPCI compared with conventional PPCI alone including the additional trial data. METHODS AND RESULTS Clinical trials (n = 20) that randomized patients (n = 21,281) with STEMI between Routine AT (n = 10,619) and PPCI (n = 10,662) were pooled. There was no difference in all-cause mortality between the 2 groups (RR: 0.89, 95%CI: 0.78-1.01, P = 0.08). Stratifying by follow up at 1-month (RR: 0.87, 95%CI: 0.69-1.10, P = 0.25), up to 6 months (RR: 0.91, 95%CI: 0.74-1.13, P = 0.39 and beyond 6 months (RR: 0.88, 95%CI: 0.74-1.05, P = 0.16) yielded similar results. There was a statistically significant increase risk of stoke rate in the AT arm (RR: 1.51, 95%CI: 1.01-2.25, P = 0.04). The 2 groups were similar with regards to target vessel revascularization (0.94, 95%CI: 0.83-1.06, P = 0.28) recurrent MI (RR: 0.96, 95%CI: 0.80-1.16, P = 0.68, MACE events (RR: 0.91 95%CI: 0.81-1.02, P = 0.11), early (0.59, 95%CI: 0.23-1.50, P = 0.27) and late (RR: 0.91, 95%CI: 0.69-1.18, P = 0.47) stent thrombosis and net clinical benefit (RR 0.99, 95%CI: 0.91-1.07, P = 0.76). CONCLUSION Routine AT prior to PPCI in STEMI is associated with higher risk of stroke. There is no statistical difference in clinical outcome parameters of mortality, major adverse cardiac events, target vessel revascularization, stent thrombosis, and net clinical benefit between AT and PCI alone.
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Affiliation(s)
- Abhijit Ghatak
- Cardiovascular Division, University of Miami Miller School of Medicine, Miami, Florida
| | - Vikas Singh
- Cardiovascular Division, University of Miami Miller School of Medicine, Miami, Florida
| | - Ghanshyam Palamaner Subash Shantha
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, and University of Iowa Hospitals and Clinics, Iowa City, Iowa.,The Wright Center for Graduate Medical Education, Scranton, Pennsylvania
| | | | - Nilesh Patel
- Cardiovascular Division, University of Miami Miller School of Medicine, Miami, Florida
| | - Carlos E Alfonso
- Cardiovascular Division, University of Miami Miller School of Medicine, Miami, Florida
| | - Monodeep Biswas
- The Wright Center for Graduate Medical Education, Scranton, Pennsylvania
| | | | | | | | - Eduardo de Marchena
- Cardiovascular Division, University of Miami Miller School of Medicine, Miami, Florida
| | - Mauricio G Cohen
- Cardiovascular Division, University of Miami Miller School of Medicine, Miami, Florida
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Ghosh RK, Bandyopadhyay D, Hajra A, Biswas M, Gupta A. Cardiovascular outcomes of sodium-glucose cotransporter 2 inhibitors: A comprehensive review of clinical and preclinical studies. Int J Cardiol 2016; 212:29-36. [DOI: 10.1016/j.ijcard.2016.02.134] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Revised: 02/09/2016] [Accepted: 02/28/2016] [Indexed: 12/23/2022]
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Ovhal A, Sonarkhan D, Mujahid AM, Biswas M, Zargar R. Bilateral double belly of gracilis muscle in a male cadaver: A rare case report. J ANAT SOC INDIA 2015. [DOI: 10.1016/j.jasi.2015.07.159] [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: 10/23/2022]
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Damery S, Biswas M, Billingham L, Barton P, Al-Janabi H, Grimer R. Patient preferences for clinical follow-up after primary treatment for soft tissue sarcoma: a cross-sectional survey and discrete choice experiment. Eur J Surg Oncol 2014; 40:1655-61. [PMID: 25108811 DOI: 10.1016/j.ejso.2014.04.020] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [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: 03/06/2014] [Accepted: 04/15/2014] [Indexed: 11/23/2022]
Abstract
BACKGROUND Patients treated for soft tissue sarcoma (STS) require long-term follow-up to detect recurrent or metastatic disease, yet marked differences exist in clinical approaches to the length of follow-up, frequency of consultations and investigations undertaken at follow-up visits. There has been no published work assessing patient expectations or the acceptability of post-treatment follow-up strategies. This study aimed to assess the patient acceptability of different follow-up strategies following curative surgery for soft tissue sarcoma and to investigate the hypothetical levels of recurrence risk at which different follow-up regimes were acceptable. METHODS Patients were recruited from the Royal Orthopaedic Hospital in Birmingham. The study used a cross-sectional survey incorporating a best-worst scaling discrete choice experiment to assess patient preferences regarding different aspects of follow-up. RESULTS 132 patients participated (47% response). The nature of investigations undertaken during follow-up was the most important aspect of post-surgical care. Patients typically preferred appointments routinely consisting of clinical examination and chest X-ray, and for follow-up to remain in secondary care rather than general practice. CONCLUSION Clear protocols for STS patient follow-up can improve consistency and equity of care. In determining the optimum follow-up plan for STS patients from the patient perspective, this study provides valuable information that should be considered alongside the clinical effectiveness of follow-up strategies to maximise patient outcomes and use NHS resources appropriately.
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Affiliation(s)
- S Damery
- Primary Care Clinical Sciences, School of Health and Population Sciences, University of Birmingham, Edgbaston, West Midlands B15 2TT, United Kingdom.
| | - M Biswas
- Cancer Research UK Clinical Trials Unit and MRC Midland Hub for Trials Methodology Research, University of Birmingham, Edgbaston, West Midlands B15 2TT, United Kingdom.
| | - L Billingham
- Cancer Research UK Clinical Trials Unit and MRC Midland Hub for Trials Methodology Research, University of Birmingham, Edgbaston, West Midlands B15 2TT, United Kingdom.
| | - P Barton
- Health Economics Unit, School of Health and Population Sciences, University of Birmingham, Edgbaston, West Midlands B15 2TT, United Kingdom.
| | - H Al-Janabi
- Health Economics Unit, School of Health and Population Sciences, University of Birmingham, Edgbaston, West Midlands B15 2TT, United Kingdom.
| | - R Grimer
- Royal Orthopaedic Hospital NHS Foundation Trust, Bristol Road South, Northfield, Birmingham B31 2AP, United Kingdom.
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Mukherjee S, Jagadeeshaprasad MG, Banerjee T, Ghosh SK, Biswas M, Dutta S, Kulkarni MJ, Pattari S, Bandyopadhyay A. Proteomic analysis of human plasma in chronic rheumatic mitral stenosis reveals proteins involved in the complement and coagulation cascade. Clin Proteomics 2014; 11:35. [PMID: 25379033 PMCID: PMC4193131 DOI: 10.1186/1559-0275-11-35] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2014] [Accepted: 08/14/2014] [Indexed: 12/31/2022] Open
Abstract
Background Rheumatic fever in childhood is the most common cause of Mitral Stenosis in developing countries. The disease is characterized by damaged and deformed mitral valves predisposing them to scarring and narrowing (stenosis) that results in left atrial hypertrophy followed by heart failure. Presently, echocardiography is the main imaging technique used to diagnose Mitral Stenosis. Despite the high prevalence and increased morbidity, no biochemical indicators are available for prediction, diagnosis and management of the disease. Adopting a proteomic approach to study Rheumatic Mitral Stenosis may therefore throw some light in this direction. In our study, we undertook plasma proteomics of human subjects suffering from Rheumatic Mitral Stenosis (n = 6) and Control subjects (n = 6). Six plasma samples, three each from the control and patient groups were pooled and subjected to low abundance protein enrichment. Pooled plasma samples (crude and equalized) were then subjected to in-solution trypsin digestion separately. Digests were analyzed using nano LC-MSE. Data was acquired with the Protein Lynx Global Server v2.5.2 software and searches made against reviewed Homo sapiens database (UniProtKB) for protein identification. Label-free protein quantification was performed in crude plasma only. Results A total of 130 proteins spanning 9–192 kDa were identified. Of these 83 proteins were common to both groups and 34 were differentially regulated. Functional annotation of overlapping and differential proteins revealed that more than 50% proteins are involved in inflammation and immune response. This was corroborated by findings from pathway analysis and histopathological studies on excised tissue sections of stenotic mitral valves. Verification of selected protein candidates by immunotechniques in crude plasma corroborated our findings from label-free protein quantification. Conclusions We propose that this protein profile of blood plasma, or any of the individual proteins, could serve as a focal point for future mechanistic studies on Mitral Stenosis. In addition, some of the proteins associated with this disorder may be candidate biomarkers for disease diagnosis and prognosis. Our findings might help to enrich existing knowledge on the molecular mechanisms involved in Mitral Stenosis and improve the current diagnostic tools in the long run. Electronic supplementary material The online version of this article (doi:10.1186/1559-0275-11-35) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Somaditya Mukherjee
- Cell Biology and Physiology Division, CSIR-Indian Institute of Chemical Biology, 4 Raja S. C. Mullick Road, Kolkata, 700032 India
| | | | - Tanima Banerjee
- Cell Biology and Physiology Division, CSIR-Indian Institute of Chemical Biology, 4 Raja S. C. Mullick Road, Kolkata, 700032 India
| | - Sudip K Ghosh
- General Medicine Department, Medical College, Kolkata, India
| | - Monodeep Biswas
- Department of Cardiology, Geisinger Community Medical Center & Wright Center for graduate medical education, Scranton, PA 18510 USA
| | - Santanu Dutta
- Department of Cardio-thoracic and Vascular Surgery, Institute of Post Graduate Medical Education and Research, SSKM Hospital, Kolkata, 700020 India
| | - Mahesh J Kulkarni
- Proteomics Facility, Division of Biochemical Sciences, CSIR-National Chemical Laboratory, Pune, 411008 India
| | - Sanjib Pattari
- Rabindranath Tagore International Institute of Cardiac Sciences, Kolkata, 700099 India
| | - Arun Bandyopadhyay
- Cell Biology and Physiology Division, CSIR-Indian Institute of Chemical Biology, 4 Raja S. C. Mullick Road, Kolkata, 700032 India
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Banerjee T, Mukherjee S, Ghosh S, Biswas M, Dutta S, Pattari S, Chatterjee S, Bandyopadhyay A. Clinical significance of markers of collagen metabolism in rheumatic mitral valve disease. PLoS One 2014; 9:e90527. [PMID: 24603967 PMCID: PMC3948343 DOI: 10.1371/journal.pone.0090527] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2013] [Accepted: 01/31/2014] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Rheumatic Heart Disease (RHD), a chronic acquired heart disorder results from Acute Rheumatic Fever. It is a major public health concern in developing countries. In RHD, mostly the valves get affected. The present study investigated whether extracellular matrix remodelling in rheumatic valve leads to altered levels of collagen metabolism markers and if such markers can be clinically used to diagnose or monitor disease progression. METHODOLOGY This is a case control study comprising 118 subjects. It included 77 cases and 41 healthy controls. Cases were classified into two groups- Mitral Stenosis (MS) and Mitral Regurgitation (MR). Carboxy-terminal propeptide of type I procollagen (PICP), amino-terminal propeptide of type III procollagen (PIIINP), total Matrix Metalloproteinase-1(MMP-1) and Tissue Inhibitor of Metalloproteinase-1 (TIMP-1) were assessed. Histopathology studies were performed on excised mitral valve leaflets. A p value <0.05 was considered statistically significant. RESULTS Plasma PICP and PIIINP concentrations increased significantly (p<0.01) in MS and MR subjects compared to controls but decreased gradually over a one year period post mitral valve replacement (p<0.05). In MS, PICP level and MMP-1/TIMP-1 ratio strongly correlated with mitral valve area (r = -0.40; r = 0.49 respectively) and pulmonary artery systolic pressure (r = 0.49; r = -0.49 respectively); while in MR they correlated with left ventricular internal diastolic (r = 0.68; r = -0.48 respectively) and systolic diameters (r = 0.65; r = -0.55 respectively). Receiver operating characteristic curve analysis established PICP as a better marker (AUC = 0.95; 95% CI = 0.91-0.99; p<0.0001). A cut-off >459 ng/mL for PICP provided 91% sensitivity, 90% specificity and a likelihood ratio of 9 in diagnosing RHD. Histopathology analysis revealed inflammation, scarring, neovascularisation and extensive leaflet fibrosis in diseased mitral valve. CONCLUSIONS Levels of collagen metabolism markers correlated with echocardiographic parameters for RHD diagnosis.
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Affiliation(s)
- Tanima Banerjee
- Department of Cell Biology and Physiology, CSIR-Indian Institute of Chemical Biology, Kolkata, WB, India
| | - Somaditya Mukherjee
- Department of Cell Biology and Physiology, CSIR-Indian Institute of Chemical Biology, Kolkata, WB, India
| | - Sudip Ghosh
- Department of Cell Biology and Physiology, CSIR-Indian Institute of Chemical Biology, Kolkata, WB, India
| | - Monodeep Biswas
- Department of Cardiology, Geisinger Community Medical Center and Wright Center for Graduate Medical Education, Scranton, Pennsylvania, United States of America
| | - Santanu Dutta
- Department of Cardio-thoracic and Vascular Surgery, Institute of Post Graduate Medical Education and Research, SSKM Hospital, Kolkata, WB, India
| | - Sanjib Pattari
- Department of Pathology, Rabindra Nath Tagore International Institute of Cardiac Sciences, Kolkata, WB, India
| | - Shelly Chatterjee
- Department of Cell Biology and Physiology, CSIR-Indian Institute of Chemical Biology, Kolkata, WB, India
| | - Arun Bandyopadhyay
- Department of Cell Biology and Physiology, CSIR-Indian Institute of Chemical Biology, Kolkata, WB, India
- * E-mail:
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Rana TK, Bhattacharya C, Bhattacharya S, Kundu S, Banerjee K, Ghosh TK, Mukherjee G, Pandey R, Gohil M, Dey A, Meena JK, Prajapati G, Roy P, Pai H, Biswas M. Search for rotational state of Hoyle state in complete kinematic experiment 12C(α, α′) 3α. EPJ Web of Conferences 2014. [DOI: 10.1051/epjconf/20146603010] [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: 11/14/2022] Open
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Abstract
Underlying ischaemic disease should be excluded in patients with delayed wound healing. Contrast angiography is a useful imaging method for assessing the specific cause of wound chronicity and may also be helpful in assessing the aetiology of unexplained pain symptoms. Angioplasty provides a practical alternative to more invasive techniques in addressing peripheral ischaemia. Our patient suffered claudication-type pain in his thigh and a non-healing stump wound following below-knee amputation. Magnetic resonance angiography confirmed the presence of arterial stenoses and an angioplasty was successfully performed to improve patency of the profunda femoris vessel. Following the operation, the claudication pain symptoms were significantly reduced and the stump wound went on to heal.
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Chatterjee S, Sarkate P, Ghosh S, Biswas M, Ghosh A. Early, structured disease modifying anti-rheumatic drug (DMARD) therapy reduces cardiovascular risk in rheumatoid arthritis--a single centre study using non-biologic drugs. J Assoc Physicians India 2013; 61:531-534. [PMID: 24818335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND Rheumatoid arthritis, being a chronic disease requires long-term management of patients with drugs. The increasing cost of biologics in this era of disease management led us to devise a treatment regime, optimal for use in a developing country like India, which was economical as well as effective in controlling disease activity. OBJECTIVE To investigate if combination therapy with DMARDs can reduce cardiovascular risk in early Rheumatoid Arthritis, besides controlling disease activity. METHODS A small cohort of early Rheumatoid subjects with disease duration less than 1 year were treated with a structured DMARD regime and were followed up over a year. Disease activity score, C-reactive protein (CRP) and cardiac risk markers like lipid panel and carotid intima-medial thickness were monitored at 6 months and 1 year. RESULTS A significant reduction (p < 0.001) of disease activity as well as cardiac risk parameters were observed. CONCLUSION Our study showed that treatment of early rheumatoid arthritis with a combination regime of traditional DMARDs is highly effective in controlling disease activity as well as cardiovascular risk.
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Biswas M, Sudhakar S, Nanda NC, Buckberg G, Pradhan M, Roomi AU, Gorissen W, Houle H. Two- and three-dimensional speckle tracking echocardiography: clinical applications and future directions. Echocardiography 2013; 30:88-105. [PMID: 23297852 DOI: 10.1111/echo.12079] [Citation(s) in RCA: 147] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Two-dimensional speckle tracking echocardiography (2D STE) is a novel technique of cardiac imaging for quantifying complex cardiac motion based on frame-to-frame tracking of ultrasonic speckles in gray scale 2D images. Two-dimensional STE is a relatively angle independent technology that can measure global and regional strain, strain rate, displacement, and velocity in longitudinal, radial, and circumferential directions. It can also quantify rotational movements such as rotation, twist, and torsion of the myocardium. Two-dimensional STE has been validated against hemodynamics, tissue Doppler, tagged magnetic resonance imaging, and sonomicrometry studies. Two-dimensional STE has been found clinically useful in the assessment of cardiac systolic and diastolic function as well as providing new insights in deciphering cardiac physiology and mechanics in cardiomyopathies, and identifying early subclinical changes in various pathologies. A large number of studies have evaluated the role of 2D STE in predicting response to cardiac resynchronization therapy in patients with severe heart failure. However, the clinical utility of 2D STE in the above mentioned conditions remains controversial because of conflicting reports from different studies. Emerging areas of application include prediction of rejection in heart transplant patients, early detection of cardiotoxicity in patients receiving chemotherapy for cancer, and effect of intracoronary injection of bone marrow stem cells on left ventricular function in patients with acute myocardial infarction. The emerging technique of three-dimensional STE may further extend its clinical usefulness.
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Affiliation(s)
- Monodeep Biswas
- Division of Cardiovascular Disease, University of Alabama at Birmingham, Alabama 35249, USA
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Abstract
Spontaneous coronary artery dissection (SCAD) is an unusual cause of acute coronary syndrome or sudden cardiac death. SCAD has most frequently been described as presenting as an acute coronary syndrome in females during the peripartum period. It may also be associated with autoimmune and collagen vascular diseases, Marfan's syndrome, chest trauma, and intense physical exercise. The most common presentation of SCAD is the acute onset of severe chest pain associated with autonomic symptoms. This condition has a high mortality rate if not identified and treated promptly. Here, we present a case of SCAD presenting with stroke, followed by a brief review.
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Affiliation(s)
- Monodeep Biswas
- Department of Internal Medicine and Cardiology, Community Medical Center, Pennsylvania, USA ; The Wright Center for Graduate Medical Education, Pennsylvania, USA
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