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Parzyck CT, Gupta NK, Wu Y, Anil V, Bhatt L, Bouliane M, Gong R, Gregory BZ, Luo A, Sutarto R, He F, Chuang YD, Zhou T, Herranz G, Kourkoutis LF, Singer A, Schlom DG, Hawthorn DG, Shen KM. Absence of 3a 0 charge density wave order in the infinite-layer nickelate NdNiO 2. Nat Mater 2024; 23:486-491. [PMID: 38278983 PMCID: PMC10990928 DOI: 10.1038/s41563-024-01797-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 01/03/2024] [Indexed: 01/28/2024]
Abstract
A hallmark of many unconventional superconductors is the presence of many-body interactions that give rise to broken-symmetry states intertwined with superconductivity. Recent resonant soft X-ray scattering experiments report commensurate 3a0 charge density wave order in infinite-layer nickelates, which has important implications regarding the universal interplay between charge order and superconductivity in both cuprates and nickelates. Here we present X-ray scattering and spectroscopy measurements on a series of NdNiO2+x samples, which reveal that the signatures of charge density wave order are absent in fully reduced, single-phase NdNiO2. The 3a0 superlattice peak instead originates from a partially reduced impurity phase where excess apical oxygens form ordered rows with three-unit-cell periodicity. The absence of any observable charge density wave order in NdNiO2 highlights a crucial difference between the phase diagrams of cuprate and nickelate superconductors.
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Grants
- DE-SC0019414 U.S. Department of Energy (DOE)
- DE-AC02-05CH11231 U.S. Department of Energy (DOE)
- DE-AC02-06CH11357 U.S. Department of Energy (DOE)
- FA9550-21-1-0168 United States Department of Defense | United States Air Force | AFMC | Air Force Office of Scientific Research (AF Office of Scientific Research)
- DMR-2104427 National Science Foundation (NSF)
- NNCI-2025233 National Science Foundation (NSF)
- GBMF3850 Gordon and Betty Moore Foundation (Gordon E. and Betty I. Moore Foundation)
- GBMF9073 Gordon and Betty Moore Foundation (Gordon E. and Betty I. Moore Foundation)
- Part of the research described in this paper was performed at the Canadian Light Source, a national research facility of the University of Saskatchewan, which is supported by the Canada Foundation for Innovation (CFI), the Natural Sciences and Engineering Research Council (NSERC), the National Research Council (NRC), the Canadian Institutes of Health Research (CIHR), the Government of Saskatchewan, and the University of Saskatchewan.
- The microscopy work at Cornell was supported by the NSF PARADIM, with additional support from Cornell University, the Weill Institute, the Kavli Institute at Cornell, and the Packard Foundation.
- G.H. acknowledges support from Severo Ochoa FUNFUTURE (No. CEX2019-000917-S) of the Spanish Ministry of Science and Innovation and by the Generalitat de Catalunya (2021 SGR 00445).
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Affiliation(s)
- C T Parzyck
- Laboratory of Atomic and Solid State Physics, Department of Physics, Cornell University, Ithaca, NY, USA
| | - N K Gupta
- Department of Physics and Astronomy, University of Waterloo, Waterloo, Ontario, Canada
| | - Y Wu
- Laboratory of Atomic and Solid State Physics, Department of Physics, Cornell University, Ithaca, NY, USA
| | - V Anil
- Laboratory of Atomic and Solid State Physics, Department of Physics, Cornell University, Ithaca, NY, USA
| | - L Bhatt
- School of Applied and Engineering Physics, Cornell University, Ithaca, NY, USA
| | - M Bouliane
- Department of Physics and Astronomy, University of Waterloo, Waterloo, Ontario, Canada
| | - R Gong
- Department of Physics and Astronomy, University of Waterloo, Waterloo, Ontario, Canada
| | - B Z Gregory
- Laboratory of Atomic and Solid State Physics, Department of Physics, Cornell University, Ithaca, NY, USA
- Department of Materials Science and Engineering, Cornell University, Ithaca, NY, USA
| | - A Luo
- Department of Materials Science and Engineering, Cornell University, Ithaca, NY, USA
| | - R Sutarto
- Canadian Light Source, Saskatoon, Saskatchewan, Canada
| | - F He
- Canadian Light Source, Saskatoon, Saskatchewan, Canada
| | - Y-D Chuang
- Advanced Light Source, Lawrence Berkeley National Laboratory, Berkeley, CA, USA
| | - T Zhou
- Center for Nanoscale Materials, Argonne National Laboratory, Lemont, IL, USA
| | - G Herranz
- Institut de Ciència de Materials de Barcelona (ICMAB-CSIC), Bellaterra, Spain
| | - L F Kourkoutis
- School of Applied and Engineering Physics, Cornell University, Ithaca, NY, USA
- Kavli Institute at Cornell for Nanoscale Science, Cornell University, Ithaca, NY, USA
| | - A Singer
- Department of Materials Science and Engineering, Cornell University, Ithaca, NY, USA
| | - D G Schlom
- Department of Materials Science and Engineering, Cornell University, Ithaca, NY, USA
- Kavli Institute at Cornell for Nanoscale Science, Cornell University, Ithaca, NY, USA
- Leibniz-Institut für Kristallzüchtung, Berlin, Germany
| | - D G Hawthorn
- Department of Physics and Astronomy, University of Waterloo, Waterloo, Ontario, Canada
| | - K M Shen
- Laboratory of Atomic and Solid State Physics, Department of Physics, Cornell University, Ithaca, NY, USA.
- Institut de Ciència de Materials de Barcelona (ICMAB-CSIC), Bellaterra, Spain.
- Kavli Institute at Cornell for Nanoscale Science, Cornell University, Ithaca, NY, USA.
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Panda S, Arora A, Luthra K, Mohan A, Vikram NK, Kumar Gupta N, Singh A. Hyperglycemia modulates M1/M2 macrophage polarization in chronic diabetic patients with pulmonary tuberculosis infection. Immunobiology 2024; 229:152787. [PMID: 38271857 DOI: 10.1016/j.imbio.2024.152787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 01/05/2024] [Accepted: 01/12/2024] [Indexed: 01/27/2024]
Abstract
Increased susceptibility to bacterial infections like tuberculosis (TB) is one of the complications of type 2 diabetes, however the underlying mechanisms remains poorly characterized. To explore how chronic hyperglycemia in diabetes affects progression of active TB, we examined mRNA expression of M1 (proinflammatory) and M2 (anti-inflammatory) cytokines/markers, in monocyte-derived macrophages obtained from patients with PTB + DM (pulmonary TB + diabetes mellitus type 2), patients with DM alone, patients with PTB alone, and healthy individuals (controls). Our findings indicate a dysregulated cytokine response in patients with both PTB and DM, characterized by decreased expression levels of interferon-gamma (IFN-γ) and inducible nitric oxide synthase (iNOS), along with increased expression levels of interleukin-1 beta (IL-1β) and CD206. Furthermore, we observed a positive correlation of IL-1β and CD206 expression with levels of glycosylated hemoglobin (HbA1c) in both PTB + DM and DM groups, while IFN-γ showed a positive correlation with HbA1c levels, specifically in the PTB + DM group. Additionally, M1 cytokines/markers, IL-1β and iNOS were found to be significantly associated with the extent of sputum positivity in both PTB and PTB + DM groups, suggesting it to be a function of increased bacterial load and hence severity of infection. Our data demonstrates that tuberculosis in individuals with PTB + DM is characterized by altered M1/M2 cytokine responses, indicating that chronic inflammation associated with type 2 diabetes may contribute to increased immune pathology and inadequate control of tuberculosis infection.
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Affiliation(s)
- Sudhasini Panda
- Department of Biochemistry, All India Institute of Medical Sciences, New Delhi -110029, India
| | - Alisha Arora
- Department of Biochemistry, All India Institute of Medical Sciences, New Delhi -110029, India
| | - Kalpana Luthra
- Department of Biochemistry, All India Institute of Medical Sciences, New Delhi -110029, India
| | - Anant Mohan
- Department of Pulmonary Medicine, All India Institute of Medical Sciences, New Delhi -110029, India
| | - Naval K Vikram
- Department of Medicine, All India Institute of Medical Sciences, New Delhi -110029, India
| | - Neeraj Kumar Gupta
- Department of Pulmonary Medicine, VMMC and Safdarjung Hospital, New Delhi -110029, India
| | - Archana Singh
- Department of Biochemistry, All India Institute of Medical Sciences, New Delhi -110029, India.
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Parzyck CT, Gupta NK, Wu Y, Anil V, Bhatt L, Bouliane M, Gong R, Gregory BZ, Luo A, Sutarto R, He F, Chuang YD, Zhou T, Herranz G, Kourkoutis LF, Singer A, Schlom DG, Hawthorn DG, Shen KM. Publisher Correction: Absence of 3a 0 charge density wave order in the infinite-layer nickelate NdNiO 2. Nat Mater 2024; 23:440. [PMID: 38347120 PMCID: PMC10917676 DOI: 10.1038/s41563-024-01832-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/15/2024]
Affiliation(s)
- C T Parzyck
- Laboratory of Atomic and Solid State Physics, Department of Physics, Cornell University, Ithaca, NY, USA
| | - N K Gupta
- Department of Physics and Astronomy, University of Waterloo, Waterloo, Ontario, Canada
| | - Y Wu
- Laboratory of Atomic and Solid State Physics, Department of Physics, Cornell University, Ithaca, NY, USA
| | - V Anil
- Laboratory of Atomic and Solid State Physics, Department of Physics, Cornell University, Ithaca, NY, USA
| | - L Bhatt
- School of Applied and Engineering Physics, Cornell University, Ithaca, NY, USA
| | - M Bouliane
- Department of Physics and Astronomy, University of Waterloo, Waterloo, Ontario, Canada
| | - R Gong
- Department of Physics and Astronomy, University of Waterloo, Waterloo, Ontario, Canada
| | - B Z Gregory
- Laboratory of Atomic and Solid State Physics, Department of Physics, Cornell University, Ithaca, NY, USA
- Department of Materials Science and Engineering, Cornell University, Ithaca, NY, USA
| | - A Luo
- Department of Materials Science and Engineering, Cornell University, Ithaca, NY, USA
| | - R Sutarto
- Canadian Light Source, Saskatoon, Saskatchewan, Canada
| | - F He
- Canadian Light Source, Saskatoon, Saskatchewan, Canada
| | - Y-D Chuang
- Advanced Light Source, Lawrence Berkeley National Laboratory, Berkeley, CA, USA
| | - T Zhou
- Center for Nanoscale Materials, Argonne National Laboratory, Lemont, IL, USA
| | - G Herranz
- Institut de Ciència de Materials de Barcelona (ICMAB-CSIC), Bellaterra, Spain
| | - L F Kourkoutis
- School of Applied and Engineering Physics, Cornell University, Ithaca, NY, USA
- Kavli Institute at Cornell for Nanoscale Science, Cornell University, Ithaca, NY, USA
| | - A Singer
- Department of Materials Science and Engineering, Cornell University, Ithaca, NY, USA
| | - D G Schlom
- Department of Materials Science and Engineering, Cornell University, Ithaca, NY, USA
- Kavli Institute at Cornell for Nanoscale Science, Cornell University, Ithaca, NY, USA
- Leibniz-Institut für Kristallzüchtung, Berlin, Germany
| | - D G Hawthorn
- Department of Physics and Astronomy, University of Waterloo, Waterloo, Ontario, Canada
| | - K M Shen
- Laboratory of Atomic and Solid State Physics, Department of Physics, Cornell University, Ithaca, NY, USA.
- Institut de Ciència de Materials de Barcelona (ICMAB-CSIC), Bellaterra, Spain.
- Kavli Institute at Cornell for Nanoscale Science, Cornell University, Ithaca, NY, USA.
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Madan M, Mahendran AJ, Kumar R, Kedia Y, Kaushik R, Ish P, Chakrabarti S, Gupta NK, Gupta N. Comparative yield of transbronchial cryo-nodal biopsy, transbronchial intra-nodal forceps biopsy, and transbronchial needle aspiration for mediastinal lesions at a tertiary care center in India (COLD-FORCEPS study). Monaldi Arch Chest Dis 2024. [PMID: 38226634 DOI: 10.4081/monaldi.2024.2813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 01/08/2024] [Indexed: 01/17/2024] Open
Abstract
Endobronchial ultrasound (EBUS) guided mediastinal cryobiopsy, and intranodal forceps biopsy are newer modalities for sampling mediastinal lymph nodes. The data regarding the diagnostic yield of both modalities is scarce. Patients were recruited retrospectively from our existing database. Patients who had undergone both an EBUS guided mediastinal cryobiopsy and an intranodal forceps biopsy were enrolled in the study. The final diagnosis was made with a clinical-pathological-radiological assessment and clinico-radiological follow-up after one month. A total of 34 patients were enrolled in the study who had undergone both EBUS guided mediastinal cryobiopsy and intranodal forceps biopsy and had complete data available, including 1-month follow-up data. The sample adequacy rate of EBUS-transbronchial needle aspiration (EBUS-TBNA), EBUS-TBNA with mediastinal cryobiopsy, and EBUS-TBNA with intranodal forceps biopsy was 94.11%, 97.05%, and 94.11%, respectively (p=0.56). The diagnostic yield achieved in EBUS-TBNA, EBUS-TBNA with mediastinal cryobiopsy, and EBUS-TBNA with intranodal forceps biopsy was 73.52%, 82.35%, and 79.41%, respectively (p=0.38). No major complications were seen in any patient. To conclude, adding EBUS guided mediastinal cryobiopsy and intranodal forceps biopsy to EBUS-TBNA may not be superior to routine EBUS-TBNA.
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Affiliation(s)
- Manu Madan
- Department of Pulmonary, Critical Care and Sleep Medicine, VMMC and Safdarjung Hospital, New Delhi.
| | - A J Mahendran
- Department of Pulmonary, Critical Care and Sleep Medicine, VMMC and Safdarjung Hospital, New Delhi.
| | - Rohit Kumar
- Department of Pulmonary, Critical Care and Sleep Medicine, VMMC and Safdarjung Hospital, New Delhi.
| | - Yash Kedia
- Department of Pulmonary, Critical Care and Sleep Medicine, VMMC and Safdarjung Hospital, New Delhi.
| | - Rajnish Kaushik
- Department of Pulmonary, Critical Care and Sleep Medicine, VMMC and Safdarjung Hospital, New Delhi.
| | - Pranav Ish
- Department of Pulmonary, Critical Care and Sleep Medicine, VMMC and Safdarjung Hospital, New Delhi.
| | - Shibdas Chakrabarti
- Department of Pulmonary, Critical Care and Sleep Medicine, VMMC and Safdarjung Hospital, New Delhi.
| | - Neeraj Kumar Gupta
- Department of Pulmonary, Critical Care and Sleep Medicine, VMMC and Safdarjung Hospital, New Delhi.
| | - Nitesh Gupta
- Department of Pulmonary, Critical Care and Sleep Medicine, VMMC and Safdarjung Hospital, New Delhi.
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Wadhwa K, Malik S, Balaji S, Thiruvengadam R, Bashyam MD, Bhattacharya PK, Behera B, Bhardwaj P, Biswas NK, Das A, Dey A, Dhotre D, Dias M, Dubey P, Dutta S, Gadepalli R, Gosain M, Goud KI, Gupta NK, Gupta N, Jana P, Jena D, John E, Karunanidhi A, Khan SMS, Khattar S, Paul APK, Kumar S, Maitra A, Modi N, Moorthy M, Nagaraj S, Palakodeti D, Pandey AK, Pandey A, Raghav SK, Ramasubban S, Raghavan S, Harikrishnan S, Krishnamoorthy S, Selvamurugan S, Sardana R, Shouche Y, Singh A, Singh AK, Ramasubramaniyan V, Yadav M, Zahoor D, Narreddy S, Bhatnagar S, Wadhwa N, Das B, Garg PK. Correlation of severity & clinical outcomes of COVID-19 with virus variants: A prospective, multicentre hospital network study. Indian J Med Res 2024; 159:91-101. [PMID: 38344919 PMCID: PMC10954099 DOI: 10.4103/ijmr.ijmr_1041_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Indexed: 03/06/2024] Open
Abstract
BACKGROUND OBJECTIVES The clinical course of COVID-19 and its prognosis are influenced by both viral and host factors. The objectives of this study were to develop a nationwide platform to investigate the molecular epidemiology of SARS-CoV-2 (Severe acute respiratory syndrome Corona virus 2) and correlate the severity and clinical outcomes of COVID-19 with virus variants. METHODS A nationwide, longitudinal, prospective cohort study was conducted from September 2021 to December 2022 at 14 hospitals across the country that were linked to a viral sequencing laboratory under the Indian SARS-CoV-2 Genomics Consortium. All participants (18 yr and above) who attended the hospital with a suspicion of SARS-CoV-2 infection and tested positive by the reverse transcription-PCR method were included. The participant population consisted of both hospitalized as well as outpatients. Their clinical course and outcomes were studied prospectively. Nasopharyngeal samples collected were subjected to whole genome sequencing to detect SARS-CoV-2 variants. RESULTS Of the 4972 participants enrolled, 3397 provided samples for viral sequencing and 2723 samples were successfully sequenced. From this, the evolution of virus variants of concern including Omicron subvariants which emerged over time was observed and the same reported here. The mean age of the study participants was 41 yr and overall 49.3 per cent were female. The common symptoms were fever and cough and 32.5 per cent had comorbidities. Infection with the Delta variant evidently increased the risk of severe COVID-19 (adjusted odds ratio: 2.53, 95% confidence interval: 1.52, 4.2), while Omicron was milder independent of vaccination status. The independent risk factors for mortality were age >65 yr, presence of comorbidities and no vaccination. INTERPRETATION CONCLUSIONS The authors believe that this is a first-of-its-kind study in the country that provides real-time data of virus evolution from a pan-India network of hospitals closely linked to the genome sequencing laboratories. The severity of COVID-19 could be correlated with virus variants with Omicron being the milder variant.
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Affiliation(s)
- Komal Wadhwa
- Clinical Development Services Agency, Faridabad, Haryana, India
| | - Shilpa Malik
- Clinical Development Services Agency, Faridabad, Haryana, India
| | | | | | | | | | - Bijayini Behera
- Department of Microbilogy, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Pankaj Bhardwaj
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | | | - Asim Das
- ESIC Medical College & Hospital, Faridabad, Haryana, India
| | - Anindya Dey
- Department of Microbiology, Apollo Hospitals, Kolkata, West Bengal, India
| | - Dhiraj Dhotre
- National Centre for Cell Science, Pune, Maharashtra, India
| | - Mary Dias
- National Centre for Cell Science, Pune, Maharashtra, India
| | - Pankaj Dubey
- Department of Critical Care, Apollo Hospitals, Ahmedabad, Gujarat, India
| | | | - Ravisekhar Gadepalli
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Mudita Gosain
- Center for Maternal and Child Health, Faridabad, Haryana, India
| | - Kalal Iravaty Goud
- Molecular Biology and Cytogenetics, Apollo Hospitals, Hyderabad, Telangana, India
| | - Neeraj Kumar Gupta
- Department of Pulmonary Critical Care and Sleep Medicine, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, India
| | - Nitesh Gupta
- Department of Pulmonary Critical Care and Sleep Medicine, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, India
| | | | - Deepak Jena
- Department of Immunogenomics & Systems Biology Lab, Institute of Life Sciences, Bhubaneswar, Odisha, India
| | - Elizabeth John
- Institute for Stem Cell Science & Regenerative Medicine, Bengaluru, Karnataka, India
| | | | - S. Muhammad Salim Khan
- Department of Community Medicine, Government Medical College, Srinagar, Jammu & Kashmir, India
| | - Sahil Khattar
- Center for Data Management, Faridabad, Haryana, India
| | | | - Shakti Kumar
- Infection and Immunology, Faridabad, Haryana, India
| | - Arindam Maitra
- National Institute of Biomedical Genomics, Kalyani, India
| | - Nikhil Modi
- Department of Respiratory Critical Care and Sleep Medicine, Apollo Hospitals, New Delhi, India
| | - Mahesh Moorthy
- Department of Clinical Virology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Savitha Nagaraj
- Department of Microbiology, St. Johns Medical College & Hospital, Bengaluru, Karnataka, India
| | - Dasaradhi Palakodeti
- Institute for Stem Cell Science & Regenerative Medicine, Bengaluru, Karnataka, India
| | - Anil Kumar Pandey
- Medical Superindent, ESIC Medical College & Hospital, Faridabad, Haryana, India
| | - Aparna Pandey
- Department of Microbiology, ESIC Medical College & Hospital, Faridabad, Haryana, India
| | - Sunil Kumar Raghav
- Department of Immunogenomics & Systems Biology Lab, Institute of Life Sciences, Bhubaneswar, Odisha, India
| | - Suresh Ramasubban
- Department of Critical care, Apollo Hospitals, Kolkata, West Bengal, India
| | | | - S. Harikrishnan
- Department of Pulmonology, Apollo Hospitals, Madurai, Tamil Nadu, India
| | - S. Krishnamoorthy
- Department of Internal Medicine, Apollo Hospitals, Chennai, Tamil Nadu, India
| | | | - Raman Sardana
- Department of Microbiology, Apollo Hospitals, New Delhi, India
| | - Yogesh Shouche
- National Centre for Microbiol Resource, Pune, Maharashtra, India
| | - Akanksha Singh
- Clinical Development Services Agency, Faridabad, Haryana, India
| | - Arvind Kumar Singh
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - V. Ramasubramaniyan
- Department of Infectious Diseases and Tropical Medicine, Apollo Hospitals, Chennai, Tamil Nadu, India
| | - Monika Yadav
- Clinical Development Services Agency, Faridabad, Haryana, India
| | - Danish Zahoor
- Department of Microbiology, Government Medical College, Srinagar, Jammu & Kashmir, India
| | - Suneetha Narreddy
- Departments of Infectious Medicine, Apollo Hospitals, Hyderabad, Telangana, India
| | | | - Nitya Wadhwa
- Center for Maternal and Child Health, Faridabad, Haryana, India
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Purohit S, Madan M, Kumar R, Kaushik R, Ish P, Aj M, Chakrabarti S, Gupta NK, Gupta N. Comparison of immediate withdrawal and stepwise reduction in duration of non-invasive ventilation in chronic obstructive pulmonary disease patients presenting with acute hypercapnic respiratory failure. Monaldi Arch Chest Dis 2023. [PMID: 37823836 DOI: 10.4081/monaldi.2023.2755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Accepted: 09/27/2023] [Indexed: 10/13/2023] Open
Abstract
There is no universally acceptable protocol for the withdrawal of non-invasive ventilation (NIV) in chronic obstructive pulmonary disease (COPD) patients presenting with acute hypercapnic respiratory failure (AHcRF). This study was carried out to evaluate immediate against stepwise reduction in NIV. Sixty COPD patients with AHcRF who were managed with NIV were randomized into two groups - immediate NIV withdrawal (Group A), and stepwise reduction of NIV duration (Group B). The rate of successful NIV withdrawal, time to recurrence of hypercapnic respiratory failure, total duration of NIV use, and hospital length of stay (LOS), were compared among the 2 groups. NIV was successfully withdrawn in 51/60 (85%) patients. NIV was successfully withdrawn in 24/30 (80%) patients in Group A and 27/30 (90%) patients in Group B (p=0.472). The total duration of NIV use was significantly lower in Group A (38.97±17 hours) as compared to Group B (64.3±7.74 hours) (p<0.0001). The hospital LOS was significantly lower in group A (5.8±1.6 days) as compared to Group B (7.7±0.61 days) (p<0.0001). To conclude, immediate withdrawal of the NIV after recovery of respiratory failure among patients with exacerbation of COPD is feasible and does not increase the risk of weaning failure.
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Affiliation(s)
- Swetabh Purohit
- Department of Pulmonary, Critical Care and Sleep Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi.
| | - Manu Madan
- Department of Pulmonary, Critical Care and Sleep Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi.
| | - Rohit Kumar
- Department of Pulmonary, Critical Care and Sleep Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi.
| | - Rajnish Kaushik
- Department of Pulmonary, Critical Care and Sleep Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi.
| | - Pranav Ish
- Department of Pulmonary, Critical Care and Sleep Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi.
| | - Mahendran Aj
- Department of Pulmonary, Critical Care and Sleep Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi.
| | - Shibdas Chakrabarti
- Department of Pulmonary, Critical Care and Sleep Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi.
| | - Neeraj Kumar Gupta
- Department of Pulmonary, Critical Care and Sleep Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi.
| | - Nitesh Gupta
- Department of Pulmonary, Critical Care and Sleep Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi.
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7
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Ramaswamy A, Kumar R, Arul M, Ish P, Madan M, Gupta NK, Gupta N. Prediction of Weaning Outcome from Mechanical Ventilation Using Ultrasound Assessment of Parasternal Intercostal Muscle Thickness. Indian J Crit Care Med 2023; 27:704-708. [PMID: 37908421 PMCID: PMC10613859 DOI: 10.5005/jp-journals-10071-24548] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 09/06/2023] [Indexed: 11/02/2023] Open
Abstract
Background Monitoring the function of parasternal intercostal muscles provides information on respiratory load and capacity and thus can be a weaning monitoring tool. Objective The goal was to study the diagnostic accuracy of parasternal intercostal muscle thickness fraction (PICTF%) as a predictor of weaning. Materials and methods A prospective observational study on consecutively admitted patients who were intubated and mechanically ventilated for a duration of at least 48 hours was carried out. When an SBT was planned by the treating physician, the study examiner performed the ultrasound measurements of parasternal intercostal muscle thickness (inspiration and expiration) and thickening fraction using M-mode ultrasonography (USG). The PICTF% was calculated as "(peak inspiratory thickness - end-expiratory thickness)/end-expiratory thickness) × 100." Weaning failure was defined if the patient had a failed spontaneous breathing trial (SBT) or the need for a reintubation within 48 hours following extubation. The SBT failure was defined as the need to connect the patient back to the ventilator prior to its completion due to any reason as decided by the clinician. Results Of 81 screened patients, 60 patients met the inclusion criteria, of whom 49 patients had successful SBT, and 48 patients could be successfully extubated. The PMTF% cut-off value more than or equal to 15.38% was associated with the best sensitivity (75%) and specificity (87.8%) in predicting extubation failure. Conclusion The PICTF% has a good diagnostic accuracy in predicting weaning failure. How to cite this article Ramaswamy A, Kumar R, Arul M, Ish P, Madan M, Gupta NK, et al. Prediction of Weaning Outcome from Mechanical Ventilation Using Ultrasound Assessment of Parasternal Intercostal Muscle Thickness. Indian J Crit Care Med 2023;27(10):704-708.
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Affiliation(s)
- Arjun Ramaswamy
- Department of Pulmonary, Critical Care, and Sleep Medicine, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, India
| | - Rohit Kumar
- Department of Pulmonary, Critical Care, and Sleep Medicine, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, India
| | - Mahendran Arul
- Department of Pulmonary, Critical Care, and Sleep Medicine, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, India
| | - Pranav Ish
- Department of Pulmonary, Critical Care, and Sleep Medicine, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, India
| | - Manu Madan
- Department of Pulmonary, Critical Care, and Sleep Medicine, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, India
| | - Neeraj Kumar Gupta
- Department of Pulmonary, Critical Care, and Sleep Medicine, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, India
| | - Nitesh Gupta
- Department of Pulmonary, Critical Care, and Sleep Medicine, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, India
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Feyissa Z, Edossa GD, Gupta NK, Negera D. Development of double crosslinked sodium alginate/chitosan based hydrogels for controlled release of metronidazole and its antibacterial activity. Heliyon 2023; 9:e20144. [PMID: 37809897 PMCID: PMC10559936 DOI: 10.1016/j.heliyon.2023.e20144] [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: 06/05/2023] [Revised: 09/08/2023] [Accepted: 09/13/2023] [Indexed: 10/10/2023] Open
Abstract
Double network sodium alginate/chitosan hydrogels were prepared using calcium chloride (CaCl2) and glutaraldehyde as the crosslinking agents by the ionotropic interaction method for controlled metronidazole release. The effect of polymer ratios and CaCl2 amount is investigated by the developing porosity, gel fraction, and extent of swelling in simulated physiological fluids. Interaction between the polymers with the formation of crosslinked structures, good stability, phase nature, and morphology of the hydrogels is revealed by Fourier-transform infrared spectroscopy, thermogravimetric analysis, X-ray diffraction, and scanning electron microscopy. A sodium alginate/chitosan hydrogel (weight ratio of 75:25) crosslinked with two percent CaCl2 is chosen for the in-situ loading of 200 mg of metronidazole. The drug release kinetics using different models show that the best-fit Korsmeyer-Peppas model suggests metronidazole release from the matrix follows diffusion and swelling-controlled time-dependent non-Fickian transport related to hydrogel erosion. This composition displays enhanced antimicrobial activity against Staphylococcus aureus and Escherichia coli.
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Affiliation(s)
- Zerihun Feyissa
- Department of Applied Chemistry, School of Applied Natural Science, Adama Science and Technology University, P.O. Box 1888, Adama, Ethiopia
| | - Gemechu Deressa Edossa
- Department of Applied Chemistry, School of Applied Natural Science, Adama Science and Technology University, P.O. Box 1888, Adama, Ethiopia
| | - Neeraj Kumar Gupta
- Department of Applied Chemistry, School of Applied Natural Science, Adama Science and Technology University, P.O. Box 1888, Adama, Ethiopia
| | - Defaru Negera
- Department of Applied Chemistry, School of Applied Natural Science, Adama Science and Technology University, P.O. Box 1888, Adama, Ethiopia
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Ketan PS, Kumar R, Aj M, Ish P, Chakrabarti S, Gupta NK, Gupta N. Post-extubation high-flow nasal cannula oxygen therapy <em>versus</em> non-invasive ventilation in chronic obstructive pulmonary disease with hypercapnic respiratory failure. Monaldi Arch Chest Dis 2023. [PMID: 37522869 DOI: 10.4081/monaldi.2023.2576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 07/04/2023] [Indexed: 08/01/2023] Open
Abstract
The sequential use of non-invasive ventilation (NIV) for weaning in hypercapnic respiratory failure patients is a recommended practice. However, the effectiveness of weaning on High flow nasal cannula (HFNC) is unclear. Chronic obstructive pulmonary disease patients with hypercapnic respiratory failure who received invasive ventilation were screened for enrolment. This study was a single-centre, prospective, randomized comparative study. The primary outcome was treatment failure within 72 hours after extubation. Patients who were screened positive for extubation were enrolled in the study and randomized into the HFNC group and NIV group using a computer-generated simple randomization chart. The treatment failure was defined as a return to invasive mechanical ventilation, or a switch in respiratory support modality (i.e., changing from HFNC to NIV or from NIV to HFNC). Of 72 patients, 62 patients were included in the study. Treatment failure occurred in 8 patients (26.67 %) in HFNC group and 8 patients in NIV group (25%) (p=0.881). The mean duration of ICU stay in HFNC group was 5.47±2.26 days and 6.56±3.39 in NIV group (p=0.376). In the current study, HFNC was non-inferior to NIV in preventing post-extubation respiratory failure in COPD patients, while HFNC had better treatment tolerance.
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Affiliation(s)
- Pankti Sheth Ketan
- Department of Pulmonary, Critical Care and Sleep Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi.
| | - Rohit Kumar
- Department of Pulmonary, Critical Care and Sleep Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi.
| | - Mahendran Aj
- Department of Pulmonary, Critical Care and Sleep Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi.
| | - Pranav Ish
- Department of Pulmonary, Critical Care and Sleep Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi.
| | - Shibdas Chakrabarti
- Department of Pulmonary, Critical Care and Sleep Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi.
| | - Neeraj Kumar Gupta
- Department of Pulmonary, Critical Care and Sleep Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi.
| | - Nitesh Gupta
- Department of Pulmonary, Critical Care and Sleep Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi.
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Yeap S, Gupta NK, Gill S, Dinesh A, Woodman RJ. Seizure EEG Quality in Right Unilateral Ultrabrief ECT. J ECT 2023; 39:106-110. [PMID: 36318226 DOI: 10.1097/yct.0000000000000887] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE The aims of this study were to compare threshold and suprathreshold ictal electroencephalograms (EEGs) in right unilateral (RUL) ultrabrief (UB) electroconvulsive therapy (ECT) and to identify the differences between these EEGs. METHODS This study is a retrospective review of 125 pairs EEGs from titration and subsequent sessions across a 2-year period. All EEGs were independently rated for by 2 assessors using a scale based on qualities of an EEG used to guide ECT treatment dose adequacy, for example, midictal amplitude, regularity, interhemispheric coherence, seizure end point, and postictal suppression. The scores of threshold and suprathreshold EEGs were compared within and between groups based on 2 ECT types, that is, RUL UB ECT and RUL brief pulse (BP) ECT. RESULTS Paired t tests showed a statistically significant difference in between threshold and suprathreshold EEG scores in RUL UB ECT. There were no statistically significant differences between corresponding scores for RUL UB ECT and RUL BP ECT threshold and suprathreshold EEGs. CONCLUSIONS There is a significant difference between the quality of threshold and suprathreshold EEGs in RUL UB ECT when measured with an EEG rating scale. Visual rating of ictal EEGs is as reliable in discriminating between threshold and suprathreshold seizure in RUL UB ECT as it is in RUL BP ECT.
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Affiliation(s)
| | | | - Shane Gill
- South Australian Psychiatry Training Committee, Glenside
| | | | - Richard John Woodman
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia
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Singh SP, Khokhar A, Gupta NK. Enrolment under of Nikshay Poshan Yojana among tuberculosis patients in a tertiary care hospital of Delhi. Indian J Tuberc 2022; 69:546-551. [PMID: 36460387 DOI: 10.1016/j.ijtb.2021.08.032] [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: 04/12/2021] [Revised: 08/02/2021] [Accepted: 08/25/2021] [Indexed: 06/17/2023]
Abstract
UNLABELLED To mitigate malnutrition among tuberculosis burden, Government of India launched Nikshay Poshan Yojana in 2018, providing incentive of INR500 per month to each enrolled patient. Our study tried to find out the status of the scheme and its target benefits amongst the beneficiaries in a tertiary care hospital in Delhi, and also the facilitating factors and barriers towards enrolment, and their knowledge, attitude and practice towards nutrition in TB. METHODS A cross-sectional study was undertaken at a tertiary care hospital involving a calculated sample of 188 patients. The subjects were interviewed on a pre-designed, semi-structured, validated questionnaire and data was analysed on SPSS v.21. RESULTS Enrolment rate for the scheme was 81.4%, of which only 10% of the participants received any benefit. Of the 35 participants who were not enrolled or were not aware of their enrolment status, 22 were interested in enrolment. The reason for non-enrolment by the 21 participants who were not enrolled were lack of awareness, lack of time or lack of a bank account. CONCLUSION The study found that most of the patients attending DOTS treatment were enrolled under the scheme, but 90% were not receiving any incentive promised under it.
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Affiliation(s)
- Suraj Prakash Singh
- Department of Community Medicine, VMMC & Safdarjung Hospital, New Delhi, India.
| | - Anita Khokhar
- Department of Community Medicine, VMMC & Safdarjung Hospital, New Delhi, India
| | - Neeraj Kumar Gupta
- Department of Pulmonary, Critical Care and Sleep Medicine, VMMC & Safdarjung Hospital, New Delhi, India
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12
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Panda S, Seelan DM, Faisal S, Arora A, Luthra K, Palanichamy JK, Mohan A, Vikram NK, Gupta NK, Ramakrishnan L, Singh A. Chronic hyperglycemia drives alterations in macrophage effector function in pulmonary tuberculosis. Eur J Immunol 2022; 52:1595-1609. [PMID: 36066992 DOI: 10.1002/eji.202249839] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 07/05/2022] [Accepted: 09/05/2022] [Indexed: 12/14/2022]
Abstract
Diabetes mellitus (DM) alters immune responses and given the rising prevalence of DM in tuberculosis (TB) endemic countries; hyperglycemia can be a potential risk factor for active TB development. However, the impact of hyperglycemia on TB-specific innate immune response in terms of macrophage functions remains poorly addressed. We assessed macrophage effector functions in uncontrolled DM patients with or without TB infection (PTB+DM and DM), non-diabetic TB patients (PTB), and non-diabetic-uninfected controls. Phagocytic capacity against BCG and surface expression of different pattern recognition receptors (PRRs) (CD11b, CD14, CD206, MARCO, and TLR-2) were measured via flow cytometry. Effector molecules (ROS and NO) required for bacterial killing were assessed via DCFDA and Griess reaction respectively. A systematic dysregulation in phagocytic capacity with concurrent alterations in the expression pattern of key PRRs (CD11b, MARCO, and CD206) was observed in PTB+DM. These altered PRR expressions were associated with decreased phagocytic capacity of macrophages. Similarly, ROS was aberrantly higher while NO was lower in PTB+DM. These altered macrophage functions were positively correlated with increasing disease severity. Our results highlight several key patterns of immune dysregulation against TB infection under hyperglycemic conditions and highlight a negative impact of hyperglycemia with etiology and progression of TB.
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Affiliation(s)
- Sudhasini Panda
- Department of Biochemistry, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Diravya M Seelan
- Department of Biochemistry, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Shah Faisal
- Department of Biochemistry, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Alisha Arora
- Department of Biochemistry, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Kalpana Luthra
- Department of Biochemistry, All India Institute of Medical Sciences, New Delhi, 110029, India
| | | | - Anant Mohan
- Department of Pulmonary Medicine, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Naval K Vikram
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Neeraj Kumar Gupta
- Department of Pulmonary Medicine, VMMC and Safdarjung Hospital, New Delhi, 110029, India
| | - Lakshmy Ramakrishnan
- Department of Cardiac Biochemistry, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Archana Singh
- Department of Biochemistry, All India Institute of Medical Sciences, New Delhi, 110029, India
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13
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Agrawal S, Nath R, Ish P, Gupta NK, Gaind R, Kale S, Gera R, Dabral A, Gupta N, Covid Working Group OMOTSH. Clinico-epidemiological profile of COVID-19 patients admitted during third wave of pandemic in a tertiary care hospital in New Delhi, India. Monaldi Arch Chest Dis 2022; 93. [PMID: 36062989 DOI: 10.4081/monaldi.2022.2324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 08/11/2022] [Indexed: 11/23/2022] Open
Abstract
Even nearly two years after the first reported case, the novel coronavirus (SARS-CoV-2) continues to ebb and flow around the world. A retrospective cohort study was carried out to determine the clinico-epidemiological profile and outcome of the cases. The study analyzed secondary data from 827 patients who presented to our center with COVID-19-related illnesses between December 15, 2021, and February 15, 2022 (third wave in India). There was a significant difference in the vaccination status of patients treated at home and those admitted, with 87.9% having received two doses compared to 74% in the second group being unvaccinated. Patients who were isolated at home recovered at a rate of 99.4%, while hospitalized patients died at a rate of 26.5%. Vaccination reduces the severity of COVID-19; however, constant vigilance for new variants, precautionary measures, and increased vaccination drives are critical moving forward. *Other members of the Safdarjung Hospital COVID-19 working group: B. Lal (Medicine), Harish Sachdeva (Anaesthesiology), Santvana Kohli (Anaesthesiology), Amandeep Jaswal (Anaesthesiology), Sumitra Bachani (Obstetrics and Gynecology), Ajay Kumar (Pediatrics), Rohit Kumar (Pulmonary Medicine), Vidya Sagar Chaturvedi (Surgery), Vinod Chaitanya (Medicine).
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Affiliation(s)
- Shreyash Agrawal
- Department of Pulmonary, Critical Care and Sleep Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi.
| | - Ravindra Nath
- Department of Preventive and Social Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi.
| | - Pranav Ish
- Department of Pulmonary, Critical Care and Sleep Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi.
| | - Neeraj Kumar Gupta
- Department of Pulmonary, Critical Care and Sleep Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi.
| | - Rajni Gaind
- Department of Microbiology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi.
| | - Suniti Kale
- Department of Anesthesia and Intensive Care, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi.
| | - Rani Gera
- Department of Pediatrics, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi.
| | - Anjali Dabral
- Department of Obstetrics and Gynecology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi.
| | - Nitesh Gupta
- Department of Pulmonary, Critical Care and Sleep Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi.
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Shamil PK, Gupta NK, Ish P, Sen MK, Kumar R, Chakrabarti S, Gupta N. Prediction of Weaning Outcome from Mechanical Ventilation using Diaphragmatic Rapid Shallow Breathing Index. Indian J Crit Care Med 2022; 26:1000-1005. [PMID: 36213711 PMCID: PMC9492741 DOI: 10.5005/jp-journals-10071-24316] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 08/09/2022] [Indexed: 11/23/2022] Open
Affiliation(s)
- PK Shamil
- Department of Pulmonary and Critical Care Medicine, VMMC and Safdarjung Hospital, New Delhi, India
| | - NK Gupta
- Department of Pulmonary and Critical Care Medicine, VMMC and Safdarjung Hospital, New Delhi, India
| | - Pranav Ish
- Department of Pulmonary and Critical Care Medicine, VMMC and Safdarjung Hospital, New Delhi, India
| | - MK Sen
- Department of Pulmonary and Critical Care Medicine, VMMC and Safdarjung Hospital, New Delhi, India
| | - Rohit Kumar
- Department of Pulmonary and Critical Care Medicine, VMMC and Safdarjung Hospital, New Delhi, India
| | - Shibdas Chakrabarti
- Department of Pulmonary and Critical Care Medicine, VMMC and Safdarjung Hospital, New Delhi, India
| | - Nitesh Gupta
- Department of Pulmonary and Critical Care Medicine, VMMC and Safdarjung Hospital, New Delhi, India
- Nitesh Gupta, Department of Pulmonary and Critical Care Medicine, VMMC and Safdarjung Hospital, New Delhi, India, Phone: +91 98730963364, e-mail:
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15
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Nath R, Gupta NK, Gupta N, Tiwari P, Kishore J, Ish P. Effect of COVID-19 pandemic on tuberculosis notification. Indian J Tuberc 2022; 69:364-365. [PMID: 35760488 PMCID: PMC8358081 DOI: 10.1016/j.ijtb.2021.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Accepted: 08/04/2021] [Indexed: 10/27/2022]
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16
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Ahluwalia B, Gupta NK, Singh A, Ish P, Dev N, Kohli S, Kumar R, Marwein F, Gupta N. Effect of COVID-19 vaccination status on outcome of adult patients admitted at a tertiary care centre in India. Monaldi Arch Chest Dis 2022; 93. [PMID: 35443571 DOI: 10.4081/monaldi.2022.2135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Accepted: 04/13/2022] [Indexed: 12/27/2022] Open
Abstract
COVID-19 vaccination was initially started in India on 16th January 2021 after approval from national authorities. This study was carried out to assess the effect of vaccination status on the severity and clinical outcome among patients infected with COVID-19. The study included all adult COVID-19 patients admitted to our hospital from 1st April to 30th June 2021. A total of 819 patients were enrolled in the study out of which only 183 (22.3%) were vaccinated. The study documented a statistically significant reduction in the severity of illness among the vaccinated (single/double dose) (33% severe COVID-19) against the unvaccinated (43% severe COVID-19) groups; along with a reduction in mortality. On univariate and multivariate analysis, age, severity of illness and lack of COVID-19 vaccination status were associated with a statistically significant increased mortality. To conclude, this study demonstrates the role of vaccination in decreasing the severity and mortality of COVID-19 infection.
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Affiliation(s)
- Bineet Ahluwalia
- Department of Pulmonary and Critical Care Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi .
| | - Neeraj Kumar Gupta
- Department of Pulmonary and Critical Care Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi .
| | - Amitabh Singh
- Department of Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi.
| | - Pranav Ish
- Department of Pulmonary and Critical Care Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi .
| | - Nishanth Dev
- Department of Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi.
| | - Santvana Kohli
- Department of Anesthesiology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi.
| | - Rohit Kumar
- Department of Pulmonary and Critical Care Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi .
| | - Fellisha Marwein
- Department of Pulmonary and Critical Care Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi .
| | - Nitesh Gupta
- Department of Pulmonary and Critical Care Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi .
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Gupta V, Rathore NS, Arora AK, Gupta S, Kanungo A, Salim N, Gupta NK. Electrocardiogram signal pattern recognition using PCA and ICA on different databases for improved health management. IJAPR 2022. [DOI: 10.1504/ijapr.2022.122273] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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18
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Gupta NK, Ish P. Tuberculosis with discordant drug resistance patterns- A diagnostic dilemma. Indian J Tuberc 2022; 69:8-11. [PMID: 35074156 DOI: 10.1016/j.ijtb.2021.05.003] [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: 03/27/2021] [Accepted: 05/22/2021] [Indexed: 06/14/2023]
Abstract
Programmatic management of drug-resistant tuberculosis (PMDT) guidelines in India specify the use of cartridge based nucleic acid amplification test (CBNAAT) and Line probe assay (LPA) for early diagnosis of drug-resistant Tuberculosis. However, discrepancy among these genotypic tests (CBNAAT and LPA) or with the phenotypic DST in real practice poses a clinical dilemma. The usual solutions are to rely on methods with short turnaround times like CBNAAT and LPA to start an initial regimen. The culture and DST results, that are typically available after at least a few weeks, are used to modify the regimen if required. This practice is based on the fact that culture and DST based sensitivity patterns are considered the gold standard for diagnosing and drug resistance. DNA sequencing by pyrosequencing, Sanger sequencing and next generation sequencing (NGS) are being evaluated; their future availability may help in early clarifications in discordant drug resistance patterns. Such tests are costly and have limited availability, however, in view of immense benefit to detect TB Drug-resistant phenotypes, national guidelines plan to scale up their use in national and well-performing intermediate TB reference laboratories.
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Affiliation(s)
- Neeraj Kumar Gupta
- Department of Pulmonary, Critical Care and Sleep Medicine and Nodal Officer for DOTS, VMMC and Safdarjung Hospital, New Delhi, India
| | - Pranav Ish
- Department of Pulmonary, Critical Care and Sleep Medicine, VMMC and Safdarjung Hospital, New Delhi, India.
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Muhammud AM, Gupta NK. Nanostructured SiO 2 material: synthesis advances and applications in rubber reinforcement. RSC Adv 2022; 12:18524-18546. [PMID: 35799930 PMCID: PMC9218877 DOI: 10.1039/d2ra02747j] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Accepted: 05/31/2022] [Indexed: 11/21/2022] Open
Abstract
Silica is a commercially significant material due to its extensive use in widespread applications and products. Synthetic amorphous silica (SAS) is a form of SiO2 that is intentionally manufactured and has been produced and marketed for decades without significant changes in its physico-chemical properties. The industrial production of nanostructured SiO2 is nowadays challenged by the expensive raw material use and high energy consumption. The search for non-petroleum-based fillers such as nanostructured SiO2, which are environmentally friendly, cheap, abundant, renewable, and efficient, has been initiated nowadays. Therefore, a large number of research activities have been carried out so far for the preparation of SAS from potential alternate precursors, i.e., synthetic chemicals, biogenic, and mineral ore resources. Reinforcement of rubbers with nanostructured SiO2 fillers is a process of great practical and technological importance for improving their mechanical, dynamic, and thermal properties. The efficiencies of SiO2 reinforcement correlate with different factors such as filler structure, surface area, rubber–filler interactions, and filler–filler interactions with their effects. This review paper discusses the recent synthesis advances of nanostructured SiO2 from synthetic chemicals, biogenic and mineral ore resources, their physical characteristics, and applications in rubber reinforcement, overcoming challenges. Finally, summary and future work recommendations have been mentioned well for future researchers. This review discusses recent advances in the synthesis of nanostructured SiO2 from synthetic chemicals, and biogenic and mineral ore resources, its physical characteristics, and its applications in rubber reinforcement.![]()
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Affiliation(s)
- Agraw Mulat Muhammud
- Department of Applied Chemistry, Adama Science and Technology University, Ethiopia
| | - Neeraj Kumar Gupta
- Department of Applied Chemistry, Adama Science and Technology University, Ethiopia
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Gupta NK, Gupta SK, Kanungo A, Gupta S, Arora AK, Gupta V, Rathore NS. Electrocardiogram signal pattern recognition using PCA and ICA on different databases for improved health management. IJAPR 2022. [DOI: 10.1504/ijapr.2022.10046194] [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: 11/21/2022]
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21
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Panda S, Faisal S, Kumar K, Seelan DM, Sharma A, Gupta NK, Datta S, Singh A. Role of Regulatory Proteins Involved in Iron Homeostasis in Pulmonary Tuberculosis Patients and Their Household Contacts. Indian J Clin Biochem 2022; 37:77-84. [PMID: 35125696 PMCID: PMC8799833 DOI: 10.1007/s12291-020-00947-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 12/08/2020] [Indexed: 01/03/2023]
Abstract
Early identification and treatment of active tuberculosis disease among high risk household contacts could limit new transmission and better clinical outcome, thus decreasing TB burden. Host iron homeostasis is an important yet underevaluated factor in pathophysiology of tuberculosis (TB). One such protein is hepcidin which internalizes ferroportin (membrane iron transporter), thus inhibiting iron export from macrophages which is utilised by bacteria leading to disease severity. Iron homeostasis markers were evaluated in 50 pulmonary tuberculosis patients (PTB) and their household contacts to assess their utility as biomarkers for TB development. Altered iron homeostasis with significantly lower haemoglobin levels despite optimum serum iron levels was observed in PTB compared to household contacts and healthy controls pointing towards anaemia of inflammation. Higher serum hepcidin with lower ferroportin expression and hence higher ferritin levels was seen in PTB compared to both household contacts and healthy controls due to IL-6 induced hepcidin production in TB. Transferrin levels were found to be significantly lower in PTB and household contacts as compared to healthy controls owing to higher ferritin levels in PTB group. Upon infection, regulation of iron absorption is disturbed via increased hepcidin levels leading to ferroportin internalization and thus inhibition of iron export from macrophages which may lead to favourable M.tb. survival and multiplication leading to tuberculosis. Some of these markers could be assessed for early identification and treatment of active tuberculosis among high risk household contacts limiting new transmission and better clinical outcome, thus decreasing TB burden.
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Affiliation(s)
- Sudhasini Panda
- Department of Biochemistry, All India Institute of Medical Sciences, New Delhi, 110029 India
| | - Shah Faisal
- Department of Biochemistry, All India Institute of Medical Sciences, New Delhi, 110029 India
| | - Krishna Kumar
- Department of Biochemistry, All India Institute of Medical Sciences, New Delhi, 110029 India
| | - Diravya M. Seelan
- Department of Biochemistry, All India Institute of Medical Sciences, New Delhi, 110029 India
| | - Alpana Sharma
- Department of Biochemistry, All India Institute of Medical Sciences, New Delhi, 110029 India
| | - Neeraj Kumar Gupta
- Department of Pulmonary Medicine, VMMC and Safdarjung Hospital, New Delhi, 110029 India
| | - Sudip Datta
- Department of Laboratory Medicine, All India Institute of Medical Sciences, New Delhi, 110029 India
| | - Archana Singh
- Department of Biochemistry, All India Institute of Medical Sciences, New Delhi, 110029 India
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Garg N, Gandhi V, Gupta NK. Impact of COVID-19 lockdown on ambient noise levels in seven metropolitan cities of India. Appl Acoust 2022; 188:108582. [PMID: 36530553 PMCID: PMC9746987 DOI: 10.1016/j.apacoust.2021.108582] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Revised: 11/18/2021] [Accepted: 12/05/2021] [Indexed: 05/23/2023]
Abstract
The paper analyzed the impact of lockdown on the ambient noise levels in the seventy sites in the seven major cities of India and ascertained the noise scenario in lockdown period, and on the Janta Curfew day in comparison to the pre-lock down period and year 2019 annual average values. It was observed that the majority of the noise monitoring sites exhibited a decrement in ambient day and night equivalent noise levels on the national Janta Curfew day and Lockdown period as compared with the normal working days attributed to the restricted social, economical, industrial, urbanization activity and reduced human mobility. A mixed pattern was observed at a few sites, wherein the ambient day and night equivalent noise levels during Janta curfew day and Lockdown period had been reported to be higher than that on the normal working days. The study depicts the noise scenario during the lockdown and pre-lockdown period for seventy sites in India and shall be instrumental in analyzing the consequences and implications of imposing lockdowns in future on the environmental noise pollution in Indian cities.
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Affiliation(s)
- N Garg
- CSIR-National Physical Laboratory, New Delhi 110 012, India
| | - V Gandhi
- Central Pollution Control Board, Delhi 110 032, India
| | - N K Gupta
- Central Pollution Control Board, Delhi 110 032, India
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Mahendran AJ, Gupta NK, Gupta N, Kumar R, Ish P. COVID-19 - deliberating beyond steroids in 2021. Adv Respir Med 2021; 89:612-614. [PMID: 34966989 DOI: 10.5603/arm.a2021.0114] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 08/18/2021] [Indexed: 11/25/2022]
Affiliation(s)
- Arul J Mahendran
- Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, India
| | - Neeraj Kumar Gupta
- Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, India
| | - Nitesh Gupta
- Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, India
| | - Rohit Kumar
- Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, India
| | - Pranav Ish
- Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, India.
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Sheth P, Chakrabarti S, Gupta NK, Ish P, Kumar R, Gupta N. A middle-aged lady with near-fatal respiratory failure. Monaldi Arch Chest Dis 2021; 92. [PMID: 34964576 DOI: 10.4081/monaldi.2021.2103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 12/20/2021] [Indexed: 11/22/2022] Open
Abstract
Tuberculosis is an uncommon cause of acute hypoxemic respiratory failure. We present a case of a middle-aged women with near-fatal respiratory failure due to underlying tuberculosis with favorable clinical recovery. Early diagnosis and treatment are imperative to prevent morbidity, mortality, and disease transmission.
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Affiliation(s)
- Pankti Sheth
- Department of Pulmonary and Critical Care Medicine, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi.
| | - Shibdas Chakrabarti
- Department of Pulmonary and Critical Care Medicine, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi.
| | - Neeraj Kumar Gupta
- Department of Pulmonary and Critical Care Medicine, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi.
| | - Pranav Ish
- Department of Pulmonary and Critical Care Medicine, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi.
| | - Rohit Kumar
- Department of Pulmonary and Critical Care Medicine, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi.
| | - Nitesh Gupta
- Department of Pulmonary and Critical Care Medicine, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi.
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Kapur M, Gupta N, Gupta NK, Chakrabarti S, Kumar R, Ish P. Antitubercular therapy - an uncommon side effect. Adv Respir Med 2021; 89:544-545. [PMID: 34725810 DOI: 10.5603/arm.a2021.0097] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 05/08/2021] [Accepted: 05/20/2021] [Indexed: 11/25/2022]
Affiliation(s)
- Mayank Kapur
- Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, India
| | - Nitesh Gupta
- Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, India
| | - Neeraj Kumar Gupta
- Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, India
| | | | - Rohit Kumar
- Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, India
| | - Pranav Ish
- Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, India.
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Nath R, Gupta NK, Jaswal A, Gupta S, Kaur N, Kohli S, Saxena A, Ish P, Kumar R, Tiwari P, Kumar M, Kishore J, Yadav G, Marwein F, Gupta N. Mortality among adult hospitalized patients during the first wave and second wave of COVID-19 pandemic at a tertiary care center in India. Monaldi Arch Chest Dis 2021; 92. [PMID: 34634900 DOI: 10.4081/monaldi.2021.2034] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 09/10/2021] [Indexed: 11/23/2022] Open
Abstract
The similarities and differences between the mortality patterns of the two waves in India remain largely unknown. This was a retrospective study of medical records conducted in the COVID data center of our hospital This study analyzed data of patients who died in the month of August, 2020 to October 2020 (one month before and after the peak of first wave i.e., 16th September, 2020) & April 2021 to June 2021 (one month before and after the peak of second wave i.e., 6th May, 2021), corresponding to an equal part of the pandemic during first (2020) and second (2021) wave. Out of 1893 patients in the study, 764 patients were admitted during the first wave and 1129 patients during the second wave of pandemic. In total, 420 patients died during the entire study period. Of those, 147 (35%) deaths occurred during the first wave and 273 (65%) during the second wave, reflecting a case fatality rate (CFR) of 19.2% during the first wave and a CFR of 24.18%. There were no significant differences in the Age Group, Gender, Presenting Complaints, Duration of Stay and Comorbidities. However, the deceased COVID-19 patients had an increase in Case Fatality Rate, average duration of symptoms from onset to Hospital Admission (DOSHA) and a major shift from MODS to ARDS being the Cause of Death during the second wave of Pandemic. This study demonstrates increased CFR, average DOSHA and a paradigm shift to ARDS as cause of mortality during the second peak of the Pandemic. It is necessary to remain vigilant of newer COVID-19 variants of concern, follow COVID-19 appropriate behaviors and keep emphasizing on care of high-risk groups including patients with comorbidities and elderly population to prevent mortality.
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Affiliation(s)
- Ravindra Nath
- Department of Community Medicine, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi.
| | - Neeraj Kumar Gupta
- Department of Pulmonary and Critical Care Medicine, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi.
| | - Amandeep Jaswal
- Department of Anaesthesiology, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi.
| | - Sparsh Gupta
- Department of Pharmacology, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi.
| | - Navjot Kaur
- Department of Pharmacology, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi.
| | - Santvana Kohli
- Department of Anaesthesiology, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi.
| | - Anirudh Saxena
- Department of Community Medicine, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi.
| | - Pranav Ish
- Department of Pulmonary and Critical Care Medicine, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi.
| | - Rohit Kumar
- Department of Pulmonary and Critical Care Medicine, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi.
| | - Poornima Tiwari
- Department of Community Medicine, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi.
| | - Mukesh Kumar
- Department of Community Medicine, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi.
| | - Jugal Kishore
- Department of Community Medicine, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi.
| | - Geeta Yadav
- Department of Community Medicine, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi.
| | - Fellisha Marwein
- Department of Pulmonary and Critical Care Medicine, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi.
| | - Nitesh Gupta
- Department of Pulmonary and Critical Care Medicine, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi.
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Srikanth JK, Kumar R, Gupta NK, Ish P, Yadav SR, Chakrabarti S, Gupta N. A Prospective Study Evaluating Sleep Quality and Disorders in Post-ARDS Patients. ACTA ACUST UNITED AC 2021; 5:267-274. [PMID: 34368616 PMCID: PMC8324182 DOI: 10.1007/s41782-021-00158-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 04/27/2021] [Accepted: 07/25/2021] [Indexed: 12/17/2022]
Abstract
Introduction Critically ill patients are predisposed to developing sleep disorders due to multiple factors like pre-existing sleep disorders, severe acute illness, sleep-altering medical interventions, and the disturbing intensive care unit (ICU) environment. In the current study, a multi-modality approach has been attempted to capture the different aspects of sleep disturbances, including insomnia (using ISI), daytime sleepiness (using ESS), sleep quality (using PSQI), sleep architecture, and SDB (using PSG). Materials and Methods The eligible ARDS survivor patients were updated about the study's design prior to hospital discharge. At admission, data regarding demographic details, clinical history, etiology of ARDS, and PaO2/FiO2 (P/F) ratio at presentation, Acute Physiology and Chronic Health Evaluation II (APACHE II) and Sequential Organ Failure Assessment (SOFA) scores was collected. All enrolled patients were evaluated twice (early-within 7 days of admission and late-after 6 weeks of discharge) by the Richards-Campbell Sleep Questionnaire (RCSQ), Insomnia severity index (ISI), and level 1 PSG. Additionally, ESS questionnaire and the Pittsburgh Sleep Quality Index (PSQI) were also recorded in late evaluation. Abnormal sleep was defined if one or more of the following characteristics met: ISI > 15, ESS > 10, global PSQI > 5, AHI ≥ 5 events/h. Results Thirty patients were recruited out of the total of 88 ARDS patients screened at admission. The median (IQR) PaO2/FiO2 ratio and APACHE II scores were 176 (151-191.5) and 14 (14-16), respectively. The median (IQR) duration of stay in the ICU was 10 (7.3-19.5) days. The median RCSQ score in the early and late evaluation was 42 and 69, respectively. The mean ISI score in the early evaluation was 16.67 ± 4.72, which decreased to 11.70 ± 5.03 in late evaluation (p < 0.05). ISI score > 15 (clinical insomnia) was found in 18 out of 30 subjects (60%) in early evaluation and 11 out of 30 (36%) in late evaluation. During the early evaluation, sleep efficiency was low (median 59.9% and predominantly N1 and N2) which improved in late evaluation (median 80.6%). Of the 30 patients, only 4 had AHI > 5 in early evaluation and none in late evaluation. Neither of P/F ratio, SOFA, and APACHE II scores did correlate with ICU events in the early and late evaluations. Regression analysis showed subjects with ICU stay more than 10 days, duration of IMV more than 7 days, Fentanyl more than 7 mg, duration of sedative use more than 7 days was independently associated with poor objective sleep quality (low sleep efficiency, low TST and high arousal index) during the early and late evaluations after ICU discharge compared to counterparts (p value < 0.05). Conclusion We conclude that sleep quality in ARDS survivors was poor within 7 days of ICU discharge, characterized by severe disruption of sleep architecture and sleep-disordered breathing. After 6 weeks of ICU discharge sleep quality showed significant improvement in the N3 stage and AHI, however persistent insomnia was observed even at 6 weeks. Therefore, prior identification of risk factors and early diagnosis of sleep quality disorders in post-ARDS patients is essential.
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Affiliation(s)
- Juvva Kishan Srikanth
- Office of Department of Pulmonary, Critical Care and Sleep Medicine, VMMC and Safdarjung Hospital, Room Number 638, Superspeciality Block, New Delhi, 110029 India
| | - Rohit Kumar
- Office of Department of Pulmonary, Critical Care and Sleep Medicine, VMMC and Safdarjung Hospital, Room Number 638, Superspeciality Block, New Delhi, 110029 India
| | - Neeraj Kumar Gupta
- Office of Department of Pulmonary, Critical Care and Sleep Medicine, VMMC and Safdarjung Hospital, Room Number 638, Superspeciality Block, New Delhi, 110029 India
| | - Pranav Ish
- Office of Department of Pulmonary, Critical Care and Sleep Medicine, VMMC and Safdarjung Hospital, Room Number 638, Superspeciality Block, New Delhi, 110029 India
| | - Siddharth Raj Yadav
- Office of Department of Pulmonary, Critical Care and Sleep Medicine, VMMC and Safdarjung Hospital, Room Number 638, Superspeciality Block, New Delhi, 110029 India
| | - Shibdas Chakrabarti
- Office of Department of Pulmonary, Critical Care and Sleep Medicine, VMMC and Safdarjung Hospital, Room Number 638, Superspeciality Block, New Delhi, 110029 India
| | - Nitesh Gupta
- Office of Department of Pulmonary, Critical Care and Sleep Medicine, VMMC and Safdarjung Hospital, Room Number 638, Superspeciality Block, New Delhi, 110029 India
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Srikanth JK, Kumar R, Gupta N, Ish P, Kumar R, Gupta NK. An unusual origin of Ewing sarcoma. Adv Respir Med 2021; 89:466-467. [PMID: 34269409 DOI: 10.5603/arm.a2021.0044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 02/07/2021] [Accepted: 02/27/2021] [Indexed: 11/25/2022]
Affiliation(s)
| | - Rajendra Kumar
- Rangaraya Medical College, Kakinada, Andhra Pradesh, India
| | - Nitesh Gupta
- Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, India
| | - Pranav Ish
- Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, India.
| | - Rohit Kumar
- Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, India
| | - Neeraj Kumar Gupta
- Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, India
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Gupta N, Agstam S, Malhotra N, Ish P, Virk BS, Gupta NK. A left hilar mass with an uncommon etiology. Adv Respir Med 2021; 89:336-337. [PMID: 33881159 DOI: 10.5603/arm.a2021.0006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 11/18/2020] [Indexed: 11/25/2022]
Affiliation(s)
- Nitesh Gupta
- Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, India
| | - Sourabh Agstam
- Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, India
| | - Nipun Malhotra
- Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, India
| | - Pranav Ish
- Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, India.
| | - Baljeet Singh Virk
- Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, India
| | - Neeraj Kumar Gupta
- Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, India
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Gupta N, Ish P, Gupta A, Malhotra N, Caminero JA, Singla R, Kumar R, Yadav SR, Dev N, Agrawal S, Kohli S, Sen MK, Chakrabarti S, Gupta NK. A profile of a retrospective cohort of 22 patients with COVID-19 and active/treated tuberculosis. Eur Respir J 2020; 56:13993003.03408-2020. [PMID: 33093125 PMCID: PMC7674774 DOI: 10.1183/13993003.03408-2020] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Accepted: 10/13/2020] [Indexed: 11/18/2022]
Abstract
We read with interest the two articles by Tadoliniet al. [1] and Stochinoet al. [2], which described recent cohorts of either current or former tuberculosis (TB) patients with coronavirus disease 2019 (COVID-19) and studied their clinical course. India has the majority of global burden of TB, along with highest rising number of daily COVID-19 cases in the world [3, 4]. The information about COVID-19 and active/former TB co-infection reported so far is sparse, but it can be assumed that person with TB, when co-infected with COVID-19, may be at more risk of poor outcomes [1, 5]. The present study describes the first-ever cohort of current or treated TB patients co-infected with COVID-19 from a high TB burden country, recruited by a tertiary care hospital in India. Both tuberculosis and COVID-19 being communicable and prevalent diseases in India, the co-existence can lead to worse outcomes, as seen in this study, where there was high mortality among active as well as treated TB patients with COVID-19 co-infectionhttps://bit.ly/3jHcGbQ
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Affiliation(s)
- Nitesh Gupta
- Pulmonary Medicine, Safdarjung Hospital, New Delhi, India
| | - Pranav Ish
- Pulmonary Medicine, Safdarjung Hospital, New Delhi, India
| | - Amitesh Gupta
- National Institute of Tuberculosis and Respiratory Diseases, New Delhi, India
| | - Nipun Malhotra
- Pulmonary Medicine, Safdarjung Hospital, New Delhi, India
| | - Jose Antonio Caminero
- Dept of Pneumology, Dr Negrín University Hospital of Gran Canaria, Las Palmas de Gran Canaria, Spain.,MDR-TB Unit, Tuberculosis Division, International Union against Tuberculosis and Lung Disease, Paris, France
| | - Rupak Singla
- Dept of Tuberculosis and Respiratory Diseases, National Institute of Tuberculosis and Respiratory Diseases, New Delhi, India
| | - Rohit Kumar
- Pulmonary Medicine, Safdarjung Hospital, New Delhi, India
| | | | | | | | | | - M K Sen
- Pulmonary Medicine, Safdarjung Hospital, New Delhi, India
| | | | - N K Gupta
- Pulmonary Medicine, Safdarjung Hospital, New Delhi, India
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Gupta NK, Kumar R, Puri HV, Gupta N, Yadav SR, Ish P. Chest percussion, a common yet underutilized art. Monaldi Arch Chest Dis 2020; 90. [PMID: 32885933 DOI: 10.4081/monaldi.2020.1387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Accepted: 06/18/2020] [Indexed: 11/22/2022] Open
Abstract
Dear Editor Long years of respiratory medicine practice lets one develop a clinical instinct which certainly aids in diagnostic acumen...
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Affiliation(s)
- Neeraj Kumar Gupta
- Department of Pulmonary, Critical Care and Sleep Medicine, Vardhaman Mahavir Medical College and Safdarjung Hospital, New Delhi.
| | - Rohit Kumar
- Department of Pulmonary, Critical Care and Sleep Medicine, Vardhaman Mahavir Medical College and Safdarjung Hospital, New Delhi.
| | | | - Nitesh Gupta
- Department of Pulmonary, Critical Care and Sleep Medicine, Vardhaman Mahavir Medical College and Safdarjung Hospital, New Delhi.
| | - Siddharth Raj Yadav
- Department of Pulmonary, Critical Care and Sleep Medicine, Vardhaman Mahavir Medical College and Safdarjung Hospital, New Delhi.
| | - Pranav Ish
- Department of Pulmonary, Critical Care and Sleep Medicine, Vardhaman Mahavir Medical College and Safdarjung Hospital, New Delhi.
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Lindahl JF, Vrentas CE, Deka RP, Hazarika RA, Rahman H, Bambal RG, Bedi JS, Bhattacharya C, Chaduhuri P, Fairoze NM, Gandhi RS, Gill JPS, Gupta NK, Kumar M, Londhe S, Rahi M, Sharma PK, Shome R, Singh R, Srinivas K, Swain BB. Brucellosis in India: results of a collaborative workshop to define One Health priorities. Trop Anim Health Prod 2019; 52:387-396. [PMID: 31620958 DOI: 10.1007/s11250-019-02029-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Accepted: 07/24/2019] [Indexed: 01/25/2023]
Abstract
Brucellosis is an important zoonosis worldwide. In livestock, it frequently causes chronic disease with reproductive failures that contribute to production losses, and in humans, it causes an often-chronic febrile illness that is frequently underdiagnosed in many low- and middle-income countries, including India. India has one of the largest ruminant populations in the world, and brucellosis is endemic in the country in both humans and animals. In November 2017, the International Livestock Research Institute invited experts from government, national research institutes, universities, and different international organizations to a one-day meeting to set priorities towards a "One Health" control strategy for brucellosis in India. Using a risk prioritization exercise followed by discussions, the meeting agreed on the following priorities: collaboration (transboundary and transdisciplinary); collection of more epidemiological evidence in humans, cattle, and in small ruminants (which have been neglected in past research); Economic impact studies, including cost effectiveness of control programmes; livestock vaccination, including national facilities for securing vaccines for the cattle population; management of infected animals (with the ban on bovine slaughter, alternatives such as sanctuaries must be explored); laboratory capacities and diagnostics (quality must be assured and better rapid tests developed); and increased awareness, making farmers, health workers, and the general public more aware of risks of brucellosis and zoonoses in general. Overall, the meeting participants agreed that brucellosis control will be challenging in India, but with collaboration to address the priority areas listed here, it could be possible.
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Affiliation(s)
- Johanna F Lindahl
- Department of Biosciences, International Livestock Research Institute, Regional Office, 298 Kim Ma Street, Ba Dinh District, Hanoi, 100000, Vietnam.,Department of Clinical Sciences, Swedish University of Agricultural Sciences, P.O Box 7054, SE-750 07, Uppsala, Sweden.,Zoonosis Science Centre, Uppsala University, P.O Box 582, SE-751 23, Uppsala, Sweden
| | - Catherine E Vrentas
- National Animal Disease Center, U.S. Department of Agriculture, Ames, IA, 50010, USA. .,The Engaged Scientist, Richmond, VA, USA.
| | - Ram P Deka
- International Livestock Research Institute, Guwahati Office, Guwahati, 781022, India
| | - Razibuddin A Hazarika
- Department of Veterinary Public Health, Assam Agricultural University, Khanapara Campus, Guwahati, 781022, India
| | - H Rahman
- South Asia Regional Office, NASC Complex, International Livestock Research Institute, Pusa, New Delhi, 110012, India
| | - R G Bambal
- Department of Animal Husbandry, Dairying & Fisheries, Ministry of Agriculture & Farmers Welfare, Government of India, Krishi Bhavan, New Delhi, 110001, India
| | - J S Bedi
- Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana, Punjab, 141004, India
| | - C Bhattacharya
- Department of Animal Husbandry, Government of National Capital Territory (NCT), Delhi, India
| | - Pallab Chaduhuri
- Division of Bacteriology, Indian Veterinary Research Institute, Izatnagar, 243122, India
| | - Nadeem Mohamed Fairoze
- Department of LPT, Veterinary College, Karnataka Veterinary Animal & Fisheries Sciences University Bangalore, Bangalore, 560024, India
| | - R S Gandhi
- Indian Council of Agricultural Research (ICAR), Krishi Bhavan, New Delhi, 110001, India
| | - J P S Gill
- Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana, Punjab, 141004, India
| | - N K Gupta
- National Centre for Disease Control, 22 Shamnath Marg, Delhi, 110054, India
| | - M Kumar
- Department of Veterinary Microbiology, Bihar Veterinary College, Patna, 800014, India
| | - S Londhe
- South Asia Regional Programme, World Agroforestry Center (ICRAF), DPS Marg, Pusa Campus, New Delhi, 110012, India
| | - M Rahi
- Division of Epidemiology and Communicable Diseases, Indian Council of Medical Research, New Delhi, 110029, India
| | - P K Sharma
- ICAR-National Dairy Research Institute, Karnal, Haryana, 132001, India
| | - R Shome
- ICAR-National Institute for Veterinary Epidemiology and Disease Informatics, Yelahanka, Bengaluru, 560064, India
| | - R Singh
- Bihar Animal Sciences University, Patna, 800014, India
| | - K Srinivas
- Indian Immunologicals Ltd., Hyderabad, 500030, India
| | - B B Swain
- South Asia Regional Office, NASC Complex, International Livestock Research Institute, Pusa, New Delhi, 110012, India
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Madeshwaran SR, Jayaganthan R, Velmurugan R, Gupta NK, Manzhirov AV. Mechanical and thermal properties of MoS2 reinforced epoxy nanocomposites. ACTA ACUST UNITED AC 2018. [DOI: 10.1088/1742-6596/991/1/012054] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Gupta NK, Joshi P, Srivastava V, Quraishi M. Chitosan: A macromolecule as green corrosion inhibitor for mild steel in sulfamic acid useful for sugar industry. Int J Biol Macromol 2018; 106:704-711. [DOI: 10.1016/j.ijbiomac.2017.08.064] [Citation(s) in RCA: 79] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2017] [Revised: 07/20/2017] [Accepted: 08/09/2017] [Indexed: 11/15/2022]
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35
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Gupta S, Tarannum F, Gupta NK, Upadhyay M, Abdullah A. Effect of head posture on tooth contacts in dentate and complete denture wearers using computerized occlusal analysis system. J Indian Prosthodont Soc 2017; 17:250-254. [PMID: 28936038 PMCID: PMC5601498 DOI: 10.4103/jips.jips_321_16] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Accepted: 04/18/2017] [Indexed: 11/04/2022] Open
Abstract
Purpose: The purpose of the study was to assess and compare the occlusal contacts in dentate and edentulous patients wearing complete denture with varying head posture. Materials and Methods: Ad hoc sampling of 30 subjects (15 dentate and 15 edentulous) based on inclusion and exclusion criteria was done. Subjects were divided into two groups: dentate and edentulous. Each group was further divided into two subgroups based on two head postures-upright 90° and ventroflexed 30°. For recording of every posture, a new sensor was used, and the subject was asked to clench on the sensor in maximum intercuspation position at the two head postures. Results: Data were summarized as mean ± standard error and compared by Student's t-test using SPSS software (windows version 17.0 IBM corporation, New York, USA). A statistically significant correlation between head posture and contact area was found in dentate and denture wearers, i.e., tooth contact area varies with head posture. Conclusion: It was concluded that the occlusal contacts vary at different head posture in dentate as well as in denture wearers. With ventroflexion, the number of tooth contact decreased as compared to upright-erect position in both groups. Clinical implication - since the number of tooth contacts varies with varying head postures, it is recommended that the balancing of the contacts should be done at varying head postures.
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Affiliation(s)
- Swati Gupta
- Department of Prosthodontics, Babu Banarasi Das College of Dental Sciences, Babu Banarasi Das University, Lucknow, Uttar Pradesh, India
| | - Fauzia Tarannum
- Department of Prosthodontics, Career Postgraduate Institute of Dental Sciences and Hospital, Lucknow, Uttar Pradesh, India
| | - N K Gupta
- Department of Prosthodontics, Babu Banarasi Das College of Dental Sciences, Babu Banarasi Das University, Lucknow, Uttar Pradesh, India
| | - Manoj Upadhyay
- Department of Prosthodontics, Babu Banarasi Das College of Dental Sciences, Babu Banarasi Das University, Lucknow, Uttar Pradesh, India
| | - Ahsan Abdullah
- Department of Pedodontics and Preventive Dentistry, Career Post Graduate Institute of Dental Science, Lucknow, Uttar Pradesh, India
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Gupta NK, Verma C, Salghi R, Lgaz H, Mukherjee AK, Quraishi MA. New phosphonate based corrosion inhibitors for mild steel in hydrochloric acid useful for industrial pickling processes: experimental and theoretical approach. NEW J CHEM 2017. [DOI: 10.1039/c7nj01431g] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Phosphorus containing compounds have been evaluated by experimental and theoretical techniques and more than 96% corrosion inhibition efficiency was observed at 200 ppm concentration.
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Affiliation(s)
- Neeraj Kumar Gupta
- Department of Chemistry
- Indian Institute of Technology (Banaras Hindu University)
- Varanasi-221005
- India
| | - Chandrabhan Verma
- Department of Chemistry
- Indian Institute of Technology (Banaras Hindu University)
- Varanasi-221005
- India
- Department of Chemistry
| | - R. Salghi
- Laboratory of Applied Chemistry and Environment
- ENSA, Universite Ibn Zohr
- PO Box 1136
- 80000 Agadir
- Morocco
| | - H. Lgaz
- Laboratory of Applied Chemistry and Environment
- ENSA, Universite Ibn Zohr
- PO Box 1136
- 80000 Agadir
- Morocco
| | - A. K. Mukherjee
- Department of Chemistry
- Indian Institute of Technology (Banaras Hindu University)
- Varanasi-221005
- India
| | - M. A. Quraishi
- Department of Chemistry
- Indian Institute of Technology (Banaras Hindu University)
- Varanasi-221005
- India
- Center of Research Excellence in Corrosion
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Abstract
The technique of thrombelastography was used to assess whether the phenomenon of hypercoagulability (accelerated coagulation) occurred in adult patients (n = 20) undergoing consecutive open-heart surgical procedures. Standard haematological investigations (pre- and 2 hours postop) were also performed and comparisons made with thrombelastographic parameters. Thrombelastographic hypercoagulability was identified in 12/20 (60%) cases but this event was transient occurring immediately postprotamine administration, and normalizing at 2h postoperation. The standard postoperative haematological assessments routinely made 2h after operation failed to detect this phenomenon. Hypercoagulability following cardiac surgery in adult patients merits further evaluation in order that the clinical significance may be determined.
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Affiliation(s)
- F. Horkay
- Cardiothoracic Unit, Killingbeck Hospital, Leeds
| | - P. Martin
- Cardiothoracic Unit, Killingbeck Hospital, Leeds
| | - NK Gupta
- Cardiothoracic Unit, Killingbeck Hospital, Leeds
| | - Cmr Satur
- Cardiothoracic Unit, Killingbeck Hospital, Leeds
| | - DR Walker
- Cardiothoracic Unit, Killingbeck Hospital, Leeds
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Gupta NK, Verma C, Quraishi M, Mukherjee A. Schiff's bases derived from l-lysine and aromatic aldehydes as green corrosion inhibitors for mild steel: Experimental and theoretical studies. J Mol Liq 2016. [DOI: 10.1016/j.molliq.2015.12.027] [Citation(s) in RCA: 104] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Gupta NK, Quraishi MA, Verma C, Mukherjee AK. Green Schiff's bases as corrosion inhibitors for mild steel in 1 M HCl solution: experimental and theoretical approach. RSC Adv 2016. [DOI: 10.1039/c6ra22116e] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Three cysteine based Schiff bases were synthesized and their corrosion inhibition properties on mild steel in 1 M HCl solution were evaluated using weight loss and electrochemical studies and quantum chemical calculations.
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Affiliation(s)
- Neeraj Kumar Gupta
- Department of Chemistry
- Indian Institute of Technology
- Banaras Hindu University
- Varanasi 221005
- India
| | - M. A. Quraishi
- Department of Chemistry
- Indian Institute of Technology
- Banaras Hindu University
- Varanasi 221005
- India
| | - Chandrabhan Verma
- Department of Chemistry
- Indian Institute of Technology
- Banaras Hindu University
- Varanasi 221005
- India
| | - A. K. Mukherjee
- Department of Chemistry
- Indian Institute of Technology
- Banaras Hindu University
- Varanasi 221005
- India
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Mannis GN, Logan AC, Leavitt AD, Yanada M, Hwang J, Olin RL, Damon LE, Andreadis C, Ai WZ, Gaensler KM, Greene CC, Gupta NK, Kaplan LD, Mahindra A, Miyazaki Y, Naoe T, Ohtake S, Sayre PH, Smith CC, Venstrom JM, Wolf JL, Caballero L, Emi N, Martin TG. Delayed hematopoietic recovery after auto-SCT in patients receiving arsenic trioxide-based therapy for acute promyelocytic leukemia: a multi-center analysis. Bone Marrow Transplant 2014; 50:40-4. [PMID: 25243620 DOI: 10.1038/bmt.2014.201] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Revised: 07/28/2014] [Accepted: 08/07/2014] [Indexed: 11/09/2022]
Abstract
A potential link between arsenic (ATO)-based therapy and delayed hematopoietic recovery after autologous hematopoietic SCT (HSCT) for acute promyelocytic leukemia (APL) has previously been reported. We retrospectively reviewed the clinical histories of 58 patients undergoing autologous HSCT for APL at 21 institutions in the United States and Japan. Thirty-three (56%) of the patients received ATO-based therapy prior to stem cell collection. Delayed neutrophil engraftment occurred in 10 patients (17%): 9 of the 10 patients (90%) received prior ATO (representing 27% of all ATO-treated patients), compared with 1 of the 10 patients (10%) not previously treated with ATO (representing 4% of all ATO-naïve patients; P<0.001). Compared with ATO-naïve patients, ATO-treated patients experienced significantly longer times to ANC recovery (median 12 days vs 9 days, P<0.001). In multivariate analysis, the only significant independent predictor of delayed neutrophil engraftment was prior treatment with ATO (hazard ratio 4.87; P<0.001). Of the available stem cell aliquots from APL patients, the median viable post-thaw CD34+ cell recovery was significantly lower than that of cryopreserved autologous stem cell products from patients with non-APL AML. Our findings suggest that ATO exposure prior to CD34+ cell harvest has deleterious effects on hematopoietic recovery after autologous HSCT.
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Affiliation(s)
- G N Mannis
- Division of Hematologic Malignancies and Blood and Marrow Transplantation, Department of Medicine, University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA
| | - A C Logan
- Division of Hematologic Malignancies and Blood and Marrow Transplantation, Department of Medicine, University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA
| | - A D Leavitt
- Departments of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - M Yanada
- Department of Hematology, Fujita Health University School of Medicine, Toyoake, Japan
| | - J Hwang
- Department of Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | - R L Olin
- Division of Hematologic Malignancies and Blood and Marrow Transplantation, Department of Medicine, University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA
| | - L E Damon
- Division of Hematologic Malignancies and Blood and Marrow Transplantation, Department of Medicine, University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA
| | - C Andreadis
- Division of Hematologic Malignancies and Blood and Marrow Transplantation, Department of Medicine, University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA
| | - W Z Ai
- Division of Hematologic Malignancies and Blood and Marrow Transplantation, Department of Medicine, University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA
| | - K M Gaensler
- Division of Hematologic Malignancies and Blood and Marrow Transplantation, Department of Medicine, University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA
| | - C C Greene
- Division of Hematologic Malignancies and Blood and Marrow Transplantation, Department of Medicine, University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA
| | - N K Gupta
- Division of Hematologic Malignancies and Blood and Marrow Transplantation, Department of Medicine, University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA
| | - L D Kaplan
- Division of Hematologic Malignancies and Blood and Marrow Transplantation, Department of Medicine, University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA
| | - A Mahindra
- Division of Hematologic Malignancies and Blood and Marrow Transplantation, Department of Medicine, University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA
| | - Y Miyazaki
- Department of Hematology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - T Naoe
- Department of Hematology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - S Ohtake
- Department of Clinical Laboratory Science, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - P H Sayre
- Division of Hematologic Malignancies and Blood and Marrow Transplantation, Department of Medicine, University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA
| | - C C Smith
- Division of Hematologic Malignancies and Blood and Marrow Transplantation, Department of Medicine, University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA
| | - J M Venstrom
- Division of Hematologic Malignancies and Blood and Marrow Transplantation, Department of Medicine, University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA
| | - J L Wolf
- Division of Hematologic Malignancies and Blood and Marrow Transplantation, Department of Medicine, University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA
| | - L Caballero
- Departments of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - N Emi
- Department of Hematology, Fujita Health University School of Medicine, Toyoake, Japan
| | - T G Martin
- Division of Hematologic Malignancies and Blood and Marrow Transplantation, Department of Medicine, University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA
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Singh NK, Singha MK, Cadoni E, Gupta NK. Dynamic Characteristics of Aluminium Alloys at Wide Range of Strain Rates. Proceedings of the Indian National Science Academy 2013. [DOI: 10.16943/ptinsa/2013/v79i4/47998] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Kumar YP, Gupta NK. Response of Metallic Plates Subjected to Underwater Explosion. Proceedings of the Indian National Science Academy 2013. [DOI: 10.16943/ptinsa/2013/v79i4/48012] [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]
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Uppal S, Gupta NK, Tandan A, Dwivedi R, Gupta S, Kumar S. Comparative evaluation of vertical dimension at rest before extraction, after extraction and after rehabilitation with complete denture - A Cephalometric study. J Oral Biol Craniofac Res 2013; 3:73-7. [PMID: 25737888 DOI: 10.1016/j.jobcr.2013.04.001] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2013] [Accepted: 04/06/2013] [Indexed: 10/26/2022] Open
Abstract
INTRODUCTION The determination of physiologic rest position of the mandible to the maxillae is of paramount importance in almost all fields of dentistry. The stability of vertical dimension at rest has been controversial if the rest position of mandible remains constant throughout life or not. Despite of several studies on the rest position of the mandible and facial vertical dimension, certain fundamental disagreements remain unresolved. The present study aims to compare the vertical dimension at rest, before and after extraction and after rehabilitation with complete denture. MATERIAL & METHODS This study was conducted in a total of ten randomly selected patients, who had some natural teeth present with one or more opposing posterior teeth with vertical occlusal stops but were advised for extraction because of poor prognosis. Digital lateral cephalograms were done and measurements recorded at three stages: prior to extraction of remaining natural teeth, post extraction and after complete denture rehabilitation. RESULTS Vertical dimension at rest was found to be greatest in post rehabilitation followed by pre-extraction than post extraction state. The differences in changes were found to be statistically significant. CONCLUSION Vertical dimension at rest shows a decrease following extraction of natural teeth, the occlusal stops, and an increase on rehabilitation. It can be stated that vertical dimension at rest is not stable position and varies following extraction of natural teeth and rehabilitation.
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Affiliation(s)
- Saurabh Uppal
- Junior Resident, Department of Prosthodontics, Babu Banarsi Das College of Dental Sciences, Lucknow, India
| | - N K Gupta
- Professor, Department of Prosthodontics, Babu Banarsi Das College of Dental Sciences, Lucknow, India
| | - Amrit Tandan
- Head & Professor, Department of Prosthodontics, Babu Banarsi Das College of Dental Sciences, Lucknow, India
| | - Ravi Dwivedi
- Professor, Department of Prosthodontics, Babu Banarsi Das College of Dental Sciences, Lucknow, India
| | - Swati Gupta
- Professor, Department of Prosthodontics, Babu Banarsi Das College of Dental Sciences, Lucknow, India
| | - Sulabh Kumar
- Senior Lecturer, Department of Prosthodontics, Babu Banarsi Das College of Dental Sciences, Lucknow, India
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Powles E, Marsden R, Gupta NK, Green T. P138 I don't know, let's try some canestan: an audit of non-specific balanitis treatment and outcomes. Br J Vener Dis 2012. [DOI: 10.1136/sextrans-2012-050601c.138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Gupta NK, Agrawal RK, Srivastav AB, Ved ML. Echocardiographic evaluation of heart in chronic obstructive pulmonary disease patient and its co-relation with the severity of disease. Lung India 2011; 28:105-9. [PMID: 21712919 PMCID: PMC3109831 DOI: 10.4103/0970-2113.80321] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Background: Chronic obstructive pulmonary disease (COPD) has considerable effects on cardiac functions, including those of the right ventricle, left ventricle, and pulmonary blood vessels. Most of the increased mortality associated with COPD is due to cardiac involvement. Echocardiography provides a rapid, noninvasive, portable, and accurate method to evaluate the cardiac changes. Aims: To assess the cardiac changes secondary to COPD by echocardiography and to find out the correlation between echocardiographic findings and severity of COPD, if there is any. Materials and Methods: A total 40 of patients of COPD were selected and staged by pulmonary function test (PFT) and evaluated byechocardiography. Results: On echocardiographic evaluation of COPD, 50% cases had normal echocardiographic parameters. Measurable tricuspid regurgitation (TR) was observed in 27/40 cases (67.5%). Pulmonary hypertension (PH), which is defined as systolic pulmonary arterial pressure (sPAP)> 30 mmHg was observed in 17/27 (63%) cases in which prevalence of mild, moderate, and severe PH were 10/17 (58.82%), 4/17 (23.53%), and 3/17 (17.65%), respectively. The frequencies of PH in mild, moderate, severe, and very severe COPD were 16.67%, 54.55%, 60.00%, and 83.33%, respectively. Right atrial pressure was 10 mmHg in 82.5% cases and 15 mmHg in 17.5% cases. Cor pulmonale was observed in 7/17 (41.17%) cases; 7.50% cases had left ventricle (LV) systolic dysfunction and 47.5% cases had evidence of LV diastolic dysfunction defined as A ≥ E (peak mitral flow velocity of the early rapid filling wave (E), peak velocity of the late filling wave caused by atrial contraction (A) on mitral valve tracing) Left ventricle hypertrophy was found in 22.5% cases. Conclusion: Prevalence of PH has a linear relationship with severity of COPD and severe PH is almost associated with cor pulmonale. Echocardiography helps in early detection of cardiac complications in COPD cases giving time for early interventions.
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Affiliation(s)
- N K Gupta
- Department of Tuberculosis and Chest Diseases, R N T Medical College, Udaipur, Rajasthan, India
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Abstract
BACKGROUND Misconceptions surround the use of hepatotoxic drugs in chronic liver disease. While many prescription and over-the-counter (OTC) agents can be used safely, this often runs counter to labelled warnings/contraindications, especially for the statins and other commonly used agents. AIM To evaluate published data on the use of hepatotoxic drugs in chronic liver disease including pharmacokinetic changes in cirrhosis and drug interactions, where available, to formulate recommendations on their use. METHODS Using a combination of PubMed searches, review texts, the Physicians' Desk Reference and expert opinion, drugs considered at higher risk of hepatotoxicity in chronic liver disease were evaluated. RESULTS Most drugs and OTC products including herbals have not been formally studied in chronic liver disease, but available data suggest that several of the most commonly used agents, especially the statins, can be used safely. While there is an increased risk of drug-induced liver injury for drugs used in the treatment of tuberculosis and HIV patients with hepatitis B or C, recommendations for their safe use are emerging. CONCLUSIONS Although many clinicians remain hesitant to use hepatotoxic drugs in chronic liver disease, the database supporting this view is limited to just a few agents. Most medications can be used safely in patients with chronic liver disease with appropriate monitoring.
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Affiliation(s)
- N K Gupta
- Division of Gastroenterology, Georgetown University Medical Center, Washington, DC 20007, USA
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Achyut BR, Moorchung N, Srivastava AN, Gupta NK, Mittal B. Risk of lymphoid follicle development in patients with chronic antral gastritis: role of endoscopic features, histopathological parameters, CagA status and interleukin-1 gene polymorphisms. Inflamm Res 2008; 57:51-6. [PMID: 18288454 DOI: 10.1007/s00011-007-7033-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
OBJECTIVE Helicobacter pylori infection causes gastritis, lymphoid follicle formation and development of MALT lymphoma. We evaluated endoscopic, histological, serological and genetic risk factors associated with lymphoid follicle development in gastritis. MATERIALS AND METHODS After upper GI endoscopy, 3 antral biopsies were taken from 120 patients for histological examination. H. pylori was diagnosed using rapid urease test (RUT), modified Giemsa stain and IgG anti-CagA ELISA. Genotyping of IL-1B (-511C/T) and IL-1RN (86 bp VNTR) genes were performed by PCR-RFLP/PCR. RESULTS In 120 patients, 45 (37.5%) showed presence of lymphoid follicles in antral gastric mucosa. H. pylori was positive by modified Giemsa stain (26%) RUT (50%) and anti-CagA IgG in 67.5%, The presence of nodularity (p = 0.030), neutrophilic infiltration (p = 0.010), lymphocytic infiltration (p = 0.002), glandular atrophy (p = 0.0001), glandular shortening (p = 0.001), fibrosis (p = 0.0001), plasma cells (p = 0.007), eosinophils (p = 0.012), anti-CagA antibodies (p = 0.003) and H. pylori density (p = 0.020) were associated with risk (odds ratio = 11.5, 3.8, 11.0, 8.4, 3.8, 4.6, 5.8, 16.0, 10.8 and 2.8 respectively) of lymphoid follicle. However, IL-1 gene polymorphisms did not influence lymphoid follicle development CONCLUSION The presence of modularity, lymphocytic infiltration, glandular atrophy, glandular shortening, fibrosis, plasma cells, eosinophils and anti-CagA IgG antibodies are risk factors for lymphoid follicle development in patients with gastritis.
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Affiliation(s)
- B R Achyut
- Department of Genetics, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
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Meena SK, Bhasin S, Gupta NK, Saini N. Sex selective abortions leading to skewed child sex ratio in an urban locality of East Delhi. Contraception 2007. [DOI: 10.1016/j.contraception.2007.05.035] [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: 11/28/2022]
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