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Wee T, Gupta N, Miller E, Pauranik A. Not Dandy Walker variant: a review of prominent retrocerebellar CSF space in children. Clin Radiol 2024; 79:330-337. [PMID: 38429135 DOI: 10.1016/j.crad.2024.01.025] [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] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 01/10/2024] [Accepted: 01/14/2024] [Indexed: 03/03/2024]
Abstract
The prominent retrocerebellar cerebrospinal fluid (CSF) space can be frequently encountered on paediatric neuroimaging studies. In cases involving abnormal vermian development where imaging does not align with the established criteria of Dandy-Walker malformation (DWM), the term "Dandy-Walker variant or continuum" has been historically employed to describe the aberrant posterior fossa development. Instead, the emphasis is on a more elaborate description of the findings in the posterior fossa. Moreover, combining the findings in the supratentorial brain can occasionally predict certain neurogenetic disorders that mimic Dandy-Walker phenotype. The present review demonstrates and differentiates the imaging features of various entities that result in an enlarged retrocerebellar CSF space, such as inferior vermian hypoplasia (IVH) and several neurogenetic conditions.
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Affiliation(s)
- T Wee
- Department of Radiology, University of British Columbia, Vancouver, BC, Canada
| | - N Gupta
- Department of Medical Imaging, Children's Hospital of Eastern Ontario (CHEO), Ottawa, ON, Canada
| | - E Miller
- Department of Diagnostic and Interventional Radiology, University of Toronto, Toronto, ON, Canada
| | - A Pauranik
- Department of Radiology, University of British Columbia, Vancouver, BC, Canada; Department of Radiology, BC Children's Hospital, Vancouver, BC, Canada.
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Aggarwal M, Gour A, Gupta N, Singh A, Sangwan V. Visual outcome and postoperative complications of cataract surgery in patients with ocular surface disorders. J Cataract Refract Surg 2024; 50:474-480. [PMID: 38237065 DOI: 10.1097/j.jcrs.0000000000001396] [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: 04/05/2023] [Accepted: 01/08/2024] [Indexed: 04/24/2024]
Abstract
PURPOSE To determine the visual outcome and postoperative complications of cataract surgery in patients with ocular surface disorders (OSDs). SETTING Tertiary eyecare center in North India. DESIGN Retrospective observational study. METHODS Patients with various OSDs with stabilized ocular surfaces who underwent cataract surgery during this period and had a minimum postoperative follow-up of 6 weeks were included. The primary outcome measures were postoperative corrected distance visual acuity (CDVA) at 6 weeks, best CDVA achieved, and postoperative complications. RESULTS The study included 20 men and 24 women. A total of 55 eyes were evaluated: Stevens-Johnson syndrome (SJS) 35 eyes, ocular cicatricial pemphigoid (OCP) 4 eyes, 8 eyes with dry eye disease (DED), 6 eyes with chemical injury and 2 eyes with vernal keratoconjunctivitis (VKC). The mean duration of OSD was 33.9 ± 52.17 months. The median preoperative CDVA was 2.0 (interquartile range [IQR], 1.45 to 2.0). The median CDVA ever achieved was 0.50 (IQR, 0.18 to 1.45) at 2 months and the median CDVA at 6 weeks was 0.6 (IQR, 0.3 to 1.5). Maximum improvement in CDVA was noted in patients with DED and SJS and the least in OCP. Phacoemulsification was performed in 47.27% eyes with intraoperative complications noted in 9% eyes. Postoperative surface complications occurred in 12 (21.82%) eyes. Other postoperative complications occurred in 9 (16%) eyes. CONCLUSIONS Cataract surgery outcome can be visually rewarding in patients with OSDs provided ocular surface integrity is adequately maintained preoperatively and postoperatively.
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Affiliation(s)
- Manvi Aggarwal
- From the Department of Cornea and Refractive Surgery Services, Dr. Shroff's Charity Eye Hospital, Daryaganj, New Delhi, India
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Gupta N, Gupta D, Vaska KG, Prinja S. Cost-Effectiveness Analysis of Systemic Therapy for Intensification of Treatment in Metastatic Hormone-Sensitive Prostate Cancer in India. Appl Health Econ Health Policy 2024; 22:415-426. [PMID: 38198103 DOI: 10.1007/s40258-023-00866-w] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/13/2023] [Indexed: 01/11/2024]
Abstract
BACKGROUND AND OBJECTIVE Androgen-deprivation therapy is the mainstay of treatment for patients with newly diagnosed metastatic hormone-sensitive prostate cancer (mHSPC). However, the intensification of treatment with either docetaxel or novel anti-androgens (abiraterone-acetate plus prednisone [AAP], enzalutamide, and apalutamide) is being recommended based on the improved clinical outcomes and quality of life among patients. This study aimed to determine the most cost-effective drug for treatment intensification for patients with mHSPC in India. METHODS A Markov model was developed with four health states: progression-free survival, progressive disease, best supportive care, and death. Lifetime costs and consequences were estimated for four treatment sequences: AAP-first, enzalutamide-first, apalutamide-first, and docetaxel-first. Incremental cost per quality-adjusted life-year (QALY) gained with a given treatment option was compared against the next best alternative and assessed for cost effectiveness using a willingness to pay threshold of 1 × per capita gross domestic product in India. RESULTS We estimated that the total lifetime cost per patient was ₹1,367,454 (US$17,487), ₹2,168,885 (US$27,735), ₹7,678,501 (US$98,190), and ₹1,358,746 (US$17,375) in the AAP-first, enzalutamide-first, apalutamide-first, and docetaxel-first treatment sequence, respectively. The mean quality-adjusted life-years lived per patient were 4.78, 5.03, 3.22, and 2.61, respectively. The AAP-first sequence incurs an incremental cost of ₹4014 (US$51) per quality-adjusted life-year gained as compared with the docetaxel-first sequence, with a 87% probability of being cost effective at the willingness-to-pay threshold of 1 × per-capita gross domestic product of India. The use of AAP-first also incurs an incremental net monetary benefit of ₹396,491 (US$5070) as compared with the docetaxel-first treatment sequence. Nearly a 48% reduction in the price of enzalutamide is required to make it a cost-effective treatment sequence as compared with AAP-first in India. CONCLUSIONS We concur with the inclusion of standard-dose AAP in India's publicly financed health insurance scheme for the intensification of treatment in mHSPC as it is the only cost-effective sequence among the various novel anti-androgens when compared with the docetaxel-first treatment sequence. Furthermore, a systematic reduction in the price of enzalutamide would further help to improve clinical outcomes among patients with mHSPC.
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Affiliation(s)
- Nidhi Gupta
- Department of Radiation Oncology, Government Medical College and Hospital, Chandigarh, India
| | - Dharna Gupta
- Department of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education and Research (PGIMER), Madhya Marg, Near Gol Market, Sector 14, Chandigarh, 160014, India
| | - Kiran Gopal Vaska
- National Health Authority, Ayushman Bharat PM-JAY, Government of India, New Delhi, India
| | - Shankar Prinja
- Department of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education and Research (PGIMER), Madhya Marg, Near Gol Market, Sector 14, Chandigarh, 160014, India.
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Gupta N, Konsam BD, Walia R, Bhadada SK, Chhabra R, Dhandapani S, Singh A, Ahuja CK, Sachdeva N, Saikia UN. An objective way to predict remission and relapse in Cushing disease using Bayes' theorem of probability. J Endocrinol Invest 2024:10.1007/s40618-024-02336-z. [PMID: 38619729 DOI: 10.1007/s40618-024-02336-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 02/12/2024] [Indexed: 04/16/2024]
Abstract
OBJECTIVE In this study on patients with Cushing disease, post-transsphenoidal surgery (TSS), we attempt to predict the probability of remaining in remission, at least for a year and relapse after that, using Bayes' theorem and the equation of conditional probability. The number of parameters, as well as the weightage of each, is incorporated in this equation. DESIGN AND METHODS The study design was a single-centre ambispective study. Ten clinical, biochemical, radiological and histopathological parameters capable of predicting Cushing disease remission were identified. The presence or absence of each parameter was entered as binary numbers. Bayes' theorem was applied, and each patient's probability of remission and relapse was calculated. RESULTS A total of 145 patients were included in the study. ROC plot showed a cut-off value of the probability of 0.68, with a sensitivity of 82% (range 73-89%) and a specificity of 94% (range 83-99%) to predict the probability of remission. Eighty-one patients who were in remission at 1 year were followed up for relapse and 23 patients developed relapse of the disease. The Bayes' equation was able to predict relapse in only 3 out of 23 patients. CONCLUSIONS Using various parameters, remission of Cushing disease can be predicted by applying Bayes' theorem of conditional probability with a sensitivity and a specificity of 82% and 94%, respectively. This study provided an objective way of predicting remission after TSS and relapse in patients with Cushing disease giving a weightage advantage to every parameter.
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Affiliation(s)
- N Gupta
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research (PGIMER), 1010, Nehru Extension Block, Chandigarh, 160012, India
| | - B D Konsam
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research (PGIMER), 1010, Nehru Extension Block, Chandigarh, 160012, India
| | - R Walia
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research (PGIMER), 1010, Nehru Extension Block, Chandigarh, 160012, India.
| | - S K Bhadada
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research (PGIMER), 1010, Nehru Extension Block, Chandigarh, 160012, India
| | - R Chhabra
- Department of Neurosurgery, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - S Dhandapani
- Department of Neurosurgery, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - A Singh
- Department of Neurosurgery, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - C K Ahuja
- Department of Radiodiagnosis, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - N Sachdeva
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research (PGIMER), 1010, Nehru Extension Block, Chandigarh, 160012, India
| | - U N Saikia
- Department of Histopathology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
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Sudharson NA, Lister P, Gupta N, Sharma M. Promoting informed choices: navigating global dental care challenges. Br Dent J 2024; 236:582. [PMID: 38671093 DOI: 10.1038/s41415-024-7362-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Accepted: 03/11/2024] [Indexed: 04/28/2024]
Affiliation(s)
- N A Sudharson
- Assistant Professor, Department of Prosthodontics, Christian Dental College, Ludhiana, India.
| | - P Lister
- Dentist, Emmanuel Hospital Association, Division of Dentistry, Unit of Christian Dental College, Ludhiana, India.
| | - N Gupta
- Senior Dental Consultant, Shri Rama Charitable Hospital, Prabhat Nagar, Dholewal, Ludhiana, India.
| | - M Sharma
- Sure Smiles Dental Clinics, Silgudi, West Bengal, India.
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Gupta N, Crowley P, Holtermann A, Straker L, Stamatakis E, Ding D. Are we ready for wearable-based global physical activity surveillance? Br J Sports Med 2024; 58:356-358. [PMID: 38336382 DOI: 10.1136/bjsports-2023-106780] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/28/2023] [Indexed: 02/12/2024]
Affiliation(s)
- Nidhi Gupta
- Musculoskeletal Disorders and Physical Work Load, The National Research Centre for the Working Work Environment, Copenhagen, Denmark
| | - Patrick Crowley
- Musculoskeletal Disorders and Physical Work Load, The National Research Centre for the Working Work Environment, Copenhagen, Denmark
| | - Andreas Holtermann
- Musculoskeletal Disorders and Physical Work Load, The National Research Centre for the Working Work Environment, Copenhagen, Denmark
| | - Leon Straker
- School of Allied Health, Curtin University, Perth, Western Australia, Australia
- enAble Institute, Curtin University, Perth, Western Australia, Australia
| | - Emmanuel Stamatakis
- Mackenzie Wearables Research Hub, Charles Perkins Centre, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Ding Ding
- Sydney School of Public Health, The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia
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Dixit J, Gupta N, Kataki A, Roy P, Mehra N, Kumar L, Singh A, Malhotra P, Gupta D, Goyal A, Rajsekar K, Krishnamurthy MN, Gupta S, Prinja S. Health-related quality of life and its determinants among cancer patients: evidence from 12,148 patients of Indian database. Health Qual Life Outcomes 2024; 22:26. [PMID: 38481231 PMCID: PMC10938809 DOI: 10.1186/s12955-024-02227-0] [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] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Accepted: 01/02/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND Cancer survivors experience a decrement in health-related quality of life (HRQoL) resulting from the disease as well as adverse effects of therapy. We evaluated the HRQoL of cancer patients, stratified by primary cancer site, stage, treatment response and associated adverse events, along with its determinants. METHODS Data were collected from 12,148 patients, sampled from seven purposively chosen leading cancer hospitals in India, to elicit HRQoL using the EuroQol questionnaire comprising of 5-dimensions and 5-levels (EQ-5D-5L). Multiple linear regression was used to determine the association between HRQoL and various socio-demographic as well as clinical characteristics. RESULTS Majority outpatients (78.4%) and inpatients (81.2%) had solid cancers. The disease was found to be more prevalent among outpatients (37.5%) and inpatients (40.5%) aged 45-60 years and females (49.3-58.3%). Most patients were found to be in stage III (40-40.6%) or stage IV (29.4-37.3%) at the time of recruitment. The mean EQ-5D-5 L utility score was significantly higher among outpatients [0.630 (95% CI: 0.623, 0.637)] as compared to inpatients [0.553 (95% CI: 0.539, 0.567)]. The HRQoL decreased with advancing cancer stage among both inpatients and outpatients, respectively [stage IV: (0.516 & 0.557); stage III (0.609 & 0.689); stage II (0.677 & 0.713); stage I (0.638 & 0.748), p value < 0.001]. The outpatients on hormone therapy (B = 0.076) showed significantly better HRQoL in comparison to patients on chemotherapy. However, palliative care (B=-0.137) and surgery (B=-0.110) were found to be associated with significantly with poorer HRQoL paralleled to chemotherapy. The utility scores among outpatients ranged from 0.305 (bone cancer) to 0.782 (Leukemia). Among hospitalized cases, the utility score was lowest for multiple myeloma (0.255) and highest for testicular cancer (0.771). CONCLUSION Older age, lower educational status, chemotherapy, palliative care and surgery, advanced cancer stage and progressive disease were associated with poor HRQoL. Our study findings will be useful in optimising patient care, formulating individualized treatment plan, improving compliance and follow-up.
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Affiliation(s)
- Jyoti Dixit
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Nidhi Gupta
- Department of Radiation Oncology, Government Medical College and Hospital, Chandigarh, India
| | - Amal Kataki
- Dr. B. Booroah Cancer Institute, Guwahati, Assam, India
| | - Partha Roy
- Dr. B. Booroah Cancer Institute, Guwahati, Assam, India
| | - Nikita Mehra
- Department of Medical Oncology, Adyar Cancer Institute, Chennai, Tamil Nadu, India
| | - Lalit Kumar
- Department of Medical Oncology, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Ashish Singh
- Department of Medical Oncology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Pankaj Malhotra
- Department of Clinical Haematology and Medical Oncology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Dharna Gupta
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Aarti Goyal
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Kavitha Rajsekar
- Department of Health Research, Ministry of Health and Family Welfare, New Delhi, India
| | | | - Sudeep Gupta
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, Maharashtra, India
| | - Shankar Prinja
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
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Dixit J, Malhotra P, Mehra N, Mathew A, Kumar L, Singh A, Gupta N, Krishnamurthy MN, Roy PS, Kataki AC, Gupta S, Prinja S. Cost-Effectiveness of Novel Agent Regimens for Transplant-Eligible Newly Diagnosed Multiple Myeloma Patients in India. Appl Health Econ Health Policy 2024:10.1007/s40258-024-00877-1. [PMID: 38448720 DOI: 10.1007/s40258-024-00877-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/20/2024] [Indexed: 03/08/2024]
Abstract
BACKGROUND Survival outcomes for multiple myeloma have improved dramatically since the introduction of novel therapeutic agents. While these drugs are highly effective in improving survival outcomes and quality of life in patients with multiple myeloma, they come at a significant cost. We assessed the cost-effectiveness of bortezomib-based triplet or quadruplet drug regimens in isolation and followed by autologous hematopoietic stem cell transplantation (AHSCT) for the treatment of newly diagnosed multiple myeloma (NDMM) in the Indian context. METHODS A Markov model was developed to assess the health and economic outcomes of novel drug regimens with and without AHSCT for the treatment of NDMM in India. We estimated the lifetime quality-adjusted life-years (QALYs) and costs in each scenario. The incremental cost-effectiveness ratios (ICERs) were computed and compared against the current willingness-to-pay threshold of a one-time per capita gross domestic product of ₹146,890 (US$1,927.70) for India. Parameter uncertainty was assessed through Monte Carlo probabilistic sensitivity analysis. RESULTS Among seven treatment sequences, the VCd (bortezomib, cyclophosphamide, dexamethasone) alone arm has the lowest cost and health benefits as compared to four treatment sequences, namely VTd (bortezomib, thalidomide, dexamethasone) alone, VRd (bortezomib, lenalidomide, dexamethasone) alone, VRd plus AHSCT and DVRd (Daratumumab, bortezomib, lenalidomide, dexamethasone) plus AHSCT. It was found that VTd plus AHSCT and VCd plus AHSCT arms were extendedly dominated (ED) by combination of two alternative treatments. Among the five non-dominated strategies, VRd has a lowest incremental cost of ₹ 2,20,093 (US$2,888) per QALY gained compared to VTd alone followed by VRd plus AHSCT [₹3,14,530 (US$4,128) per QALY gained] in comparison to VRd alone. None of the novel treatment sequences were found to be cost-effective at the current WTP threshold of ₹1,46,890 (US$1,927.7). CONCLUSION At the current WTP threshold of one-time per capita GDP (₹ 146,890) of India, VRd alone and VRd plus AHSCT has 38.1% and 6.9% probability to be cost-effective, respectively. Reduction in current reimbursement rates of novel drugs, namely VRd, lenalidomide, and pomalidomide plus dexamethasone under national insurance program and societal cost of transplant by 50%, would make VRd plus AHSCT and VTd plus AHSCT cost-effective at an incremental cost of ₹40,671 (US$34) and ₹97,639 (US$1,281) per QALY gained, respectively.
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Affiliation(s)
- Jyoti Dixit
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Pankaj Malhotra
- Department of Clinical Haematology and Medical Oncology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
| | - Nikita Mehra
- Department of Medical Oncology, Adyar Cancer Institute, Chennai, Tamil Nadu, India
| | - Anisha Mathew
- Department of Medical Oncology, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Lalit Kumar
- Department of Medical Oncology, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Ashish Singh
- Department of Medical Oncology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Nidhi Gupta
- Department of Radiation Oncology, Government Medical College and Hospital, Chandigarh, India
| | | | - Partha Sarathi Roy
- Department of Medical Oncology, Dr. B. Booroah Cancer Institute, Guwahati, Assam, India
| | - Amal Chandra Kataki
- Department of Gynaecologic Oncology, Dr. B. Booroah Cancer Institute, Guwahati, Assam, India
| | - Sudeep Gupta
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, Maharashtra, India
| | - Shankar Prinja
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
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Das R, Mehta DK, Gupta N. Understanding the Potential of mRNA as Biomarker to Revolutionize Diagnosis of Colorectal Cancer. Drug Res (Stuttg) 2024; 74:102-112. [PMID: 38350633 DOI: 10.1055/a-2244-6572] [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] [Subscribe] [Scholar Register] [Indexed: 02/15/2024]
Abstract
MicroRNA as potential biomarker for early diagnosis, differentiating various stages, interpreting the success of postoperative curative surgery and predicting early relapse of Colorectal cancer.In the realm of medical research, the quest to find effective biomarkers for various diseases has always been a top priority. Colorectal cancer (CRC), one of the leading causes of cancer-related deaths worldwide, is no exception. The emergence of microRNA (mRNA) as a potential biomarker for CRC has sparked immense interest among scientists and clinicians alike. mRNA, a molecule responsible for translating genetic information into functional proteins, presents a promising avenue for early detection and personalized treatment of this deadly disease. By analyzing the specific patterns and levels of mRNA expression in CRC cells, researchers have the ability to identify signatures that can aid in accurate diagnosis, predict patient prognosis, and even guide targeted therapies. This breakthrough in molecular biology not only enhances our understanding of CRC but also holds the potential to revolutionize the field of cancer diagnostics and treatment. In this article, we will delve deeper into the potential of mRNA as a biomarker for CRC, exploring its benefits and challenges in the field of cancer research.
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Affiliation(s)
- Rina Das
- M.M. College of Pharmacy, Maharishi Markandeshwar (Deemed to be) University, Mullana, Ambala, HR, India
| | - Dinesh Kumar Mehta
- M.M. College of Pharmacy, Maharishi Markandeshwar (Deemed to be) University, Mullana, Ambala, HR, India
| | - Nidhi Gupta
- M.M. College of Pharmacy, Maharishi Markandeshwar (Deemed to be) University, Mullana, Ambala, HR, India
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Gupta N, Graham L, Carpenter M, Gandhi GY. A Case of Metastatic Choriocarcinoma-Related Paraneoplastic Thyroid Storm. JCEM Case Rep 2024; 2:luae019. [PMID: 38476634 PMCID: PMC10928530 DOI: 10.1210/jcemcr/luae019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Indexed: 03/14/2024]
Abstract
Thyroid storm due to gestational trophoblastic disease (GTD) with metastatic choriocarcinoma is a rare but potentially life-threatening endocrine emergency. We report on a woman with molar pregnancy and metastatic choriocarcinoma who presented with thyroid storm (Burch-Wartofsky point scale of 45) a few weeks after the evacuation of GTD. She was initially managed with intravenous hydrocortisone, oral propylthiouracil (PTU), and esmolol infusion. After stabilization in the intensive care unit, 10 cycles of chemotherapy with etoposide, methotrexate, leucovorin, dactinomycin, and cyclophosphamide (EMA-CO) were initiated for stage 4 choriocarcinoma with brain and lung metastases. She underwent a hysterectomy soon after completing chemotherapy and received an additional 3 cycles of chemotherapy after the hysterectomy. As human chorionic gonadotropin (hCG) levels normalized, thyroid function reverted to normal as well. At the last follow-up, the patient was asymptomatic, euthyroid (without antithyroid medication), had a normal hCG titer of 1.7 mIU/mL (normal nonpregnant reference is < 5 mIU/mL), and the lung and brain lesions had resolved entirely. Management of thyroid storm in the presence of untreated metastatic choriocarcinoma requires a high index of suspicion and a multidisciplinary team approach to prevent complications and improve survival.
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Affiliation(s)
- Nidhi Gupta
- Division of Endocrinology, Department of Medicine, University of Florida College of Medicine-Jacksonville, Jacksonville, FL 32209, USA
| | - Lauren Graham
- Division of Endocrinology, Department of Medicine, University of Florida College of Medicine-Jacksonville, Jacksonville, FL 32209, USA
| | - Matthew Carpenter
- Department of Pathology and Laboratory Medicine, University of Florida College of Medicine-Jacksonville, Jacksonville, FL 32209, USA
| | - Gunjan Y Gandhi
- Division of Endocrinology, Department of Medicine, University of Florida College of Medicine-Jacksonville, Jacksonville, FL 32209, USA
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Wadhwa R, Gupta N, Dixit J, Malhotra P, Lakshmi PVM, Prinja S. Cost-Effectiveness Analysis of Denosumab in the Prevention of Skeletal-Related Events Among Patients With Breast Cancer With Bone Metastasis in India. JCO Glob Oncol 2024; 10:e2300396. [PMID: 38452304 PMCID: PMC10939583 DOI: 10.1200/go.23.00396] [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] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 12/25/2023] [Accepted: 01/12/2024] [Indexed: 03/09/2024] Open
Abstract
PURPOSE Denosumab is clinically superior to zoledronic acid (ZA) for preventing and delaying time to first and subsequent skeletal-related events (SREs) among patients with breast cancer (BC) with bone metastases. We evaluated the cost and health benefits of denosumab and ZA (once every 4 weeks and once every 12 weeks) among four different molecular subtypes of BC with bone metastases in India. MATERIALS AND METHODS A Markov model was developed in Microsoft Excel to estimate lifetime health consequences and resulting costs among cohort of 1,000 patients with BC with bone metastasis, for three intervention scenarios, namely denosumab (once every 4 weeks), ZA (once every 4 weeks), and ZA (once every 12 weeks). The health outcomes were measured in terms of SREs averted and quality-adjusted life-years (QALYs) gained. The cost of each intervention scenario was measured using both the health system and the patient's perspectives. Indirect costs because of lost productivity were not included. The future costs and outcomes were discounted at the standard rate of 3%. RESULTS Over a lifetime, the incremental number of SREs averted with use of denosumab once every 4 weeks (compared with ZA once every 4 weeks and once every 12 weeks) among patients with luminal A, luminal B, human epidermal growth factor receptor 2-enriched, and triple negative breast cancer were estimated as 0.39, 0.26, 0.25, and 0.19, respectively. The number of QALYs lived were slightly higher in the denosumab arm (1.45-2.80) compared with ZA once every 4 weeks and once every 12 weeks arms (1.44-2.78). However, denosumab once every 4 weeks was not found to be a cost-effective alternative for either of the four molecular subtypes of breast cancer. ZA once every 12 weeks was found to be a cost-effective option with an average cost-effectiveness ratio ranging between ₹68,254 and ₹73,636. CONCLUSION ZA once every 12 weeks is the cost-effective treatment option for BC with bone metastases in India. The present study findings hold significance for standard treatment guidelines under India's government-funded health insurance program.
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Affiliation(s)
- Raina Wadhwa
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Nidhi Gupta
- Department of Radiation Oncology, Government Medical College and Hospital, Chandigarh, India
| | - Jyoti Dixit
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Pankaj Malhotra
- Department of Clinical Haematology and Medical Oncology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - PVM Lakshmi
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Shankar Prinja
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
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Suorsa K, Leskinen T, Gupta N, Andersen LL, Pasanen J, Hettiarachchi P, Johansson PJ, Pentti J, Vahtera J, Stenholm S. Longitudinal Associations between 24-H Movement Behaviors and Cardiometabolic Biomarkers: A Natural Experiment over Retirement. Med Sci Sports Exerc 2024:00005768-990000000-00478. [PMID: 38415991 DOI: 10.1249/mss.0000000000003415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
INTRODUCTION Physical activity, sedentary behavior and sleep, that is, 24-h movement behaviors, often change in the transition from work to retirement, which may affect cardiometabolic health. This study investigates the longitudinal associations between changes in 24-h movement behaviors and cardiometabolic biomarkers during the retirement transition. METHODS Retiring public sector workers (n = 212, mean age 63.5 years, SD 1.1) from the Finnish Retirement and Aging study used a thigh-worn Axivity accelerometer and filled out a diary to obtain data on daily time spent in sedentary behavior (SED), light physical activity (LPA) and moderate-to-vigorous physical activity (MVPA) and sleep before and after retirement (one year in-between). Cardiometabolic biomarkers, including LDL-cholesterol, HDL-cholesterol, total:HDL-cholesterol ratio, triglycerides, C-reactive protein (CRP), fasting glucose and insulin, were measured. Associations between changes in 24-h movement behaviors and cardiometabolic biomarkers were analyzed using compositional robust regression and isotemporal substitution analysis. RESULTS Increasing LPA in relation to remaining behaviors was associated with an increase in HDL-cholesterol and decrease in total:HDL-cholesterol ratio (p < 0.05 for both). For instance, reallocation of 30 min from sleep/SED to LPA was associated with an increase in HDL-cholesterol by 0.02 mmol/l. Moreover, increasing MVPA in relation to remaining behaviors was associated with a decrease in triglycerides (p = 0.02). Reallocation of 30 min from SED/sleep to MVPA was associated with 0.07 - 0.08 mmol/l decrease in triglycerides. Findings related to LDL-cholesterol, CRP, fasting glucose and insulin were less conclusive. CONCLUSIONS During the transition from work to retirement, increasing physical activity at the expense of passive behaviors was associated with a better lipid profile. Our findings suggest that life transitions like retirement could be utilized more as an optimal time window for promoting physical activity and health.
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Affiliation(s)
| | | | - Nidhi Gupta
- Department of Musculoskeletal Disorders and Physical Work Load, National Research Centre for the Working Environment, Copenhagen, DENMARK
| | - Lars L Andersen
- Department of Musculoskeletal Disorders and Physical Work Load, National Research Centre for the Working Environment, Copenhagen, DENMARK
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13
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Gupta N, Waas B, Austin D, De Mazière AM, Kujala P, Stockwell AD, Li T, Yaspan BL, Klumperman J, Scales SJ. Apolipoprotein L1 (APOL1) renal risk variant-mediated podocyte cytotoxicity depends on African haplotype and surface expression. Sci Rep 2024; 14:3765. [PMID: 38355600 PMCID: PMC10866943 DOI: 10.1038/s41598-024-53298-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 01/30/2024] [Indexed: 02/16/2024] Open
Abstract
Homozygous Apolipoprotein L1 (APOL1) variants G1 and G2 cause APOL1-mediated kidney disease, purportedly acting as surface cation channels in podocytes. APOL1-G0 exhibits various single nucleotide polymorphisms, most commonly haplotype E150K, M228I and R255K ("KIK"; the Reference Sequence is "EMR"), whereas variants G1 and G2 are mostly found in a single "African" haplotype background ("EIK"). Several labs reported cytotoxicity with risk variants G1 and G2 in KIK or EIK background haplotypes, but used HEK-293 cells and did not verify equal surface expression. To see if haplotype matters in a more relevant cell type, we induced APOL1-G0, G1 and G2 EIK, KIK and EMR at comparable surface levels in immortalized podocytes. G1 and G2 risk variants (but not G0) caused dose-dependent podocyte death within 48h only in their native African EIK haplotype and correlated with K+ conductance (thallium FLIPR). We ruled out differences in localization and trafficking, except for possibly greater surface clustering of cytotoxic haplotypes. APOL1 surface expression was required, since Brefeldin A rescued cytotoxicity; and cytoplasmic isoforms vB3 and vC were not cytotoxic. Thus, APOL1-EIK risk variants kill podocytes in a dose and haplotype-dependent manner (as in HEK-293 cells), whereas unlike in HEK-293 cells the KIK risk variants did not.
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Affiliation(s)
- Nidhi Gupta
- Department of Discovery Immunology, Genentech, 1 DNA Way, South San Francisco, CA, 94080, USA
- Department of Molecular Biology, Genentech, 1 DNA Way, South San Francisco, CA, 94080, USA
| | - Bridget Waas
- Department of Discovery Immunology, Genentech, 1 DNA Way, South San Francisco, CA, 94080, USA
- Department of Cell and Developmental Biology, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Daniel Austin
- Department of Biochemical and Cellular Pharmacology, Genentech, 1 DNA Way, South San Francisco, CA, 94080, USA
| | - Ann M De Mazière
- Section of Cell Biology, Center for Molecular Medicine, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Pekka Kujala
- Section of Cell Biology, Center for Molecular Medicine, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Amy D Stockwell
- Department of Human Genetics, Genentech, 1 DNA Way, South San Francisco, CA, 94080, USA
| | - Tianbo Li
- Department of Biochemical and Cellular Pharmacology, Genentech, 1 DNA Way, South San Francisco, CA, 94080, USA
| | - Brian L Yaspan
- Department of Human Genetics, Genentech, 1 DNA Way, South San Francisco, CA, 94080, USA.
| | - Judith Klumperman
- Section of Cell Biology, Center for Molecular Medicine, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Suzie J Scales
- Department of Discovery Immunology, Genentech, 1 DNA Way, South San Francisco, CA, 94080, USA.
- Department of Molecular Biology, Genentech, 1 DNA Way, South San Francisco, CA, 94080, USA.
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14
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Kala T, Priyaranjan, Khanna SS, Kaur H, Gupta N, Shetty A, Tiwari HD. Utilization of Probiotics Among Dental Students: A KAP Study. J Pharm Bioallied Sci 2024; 16:S236-S238. [PMID: 38595383 PMCID: PMC11000926 DOI: 10.4103/jpbs.jpbs_476_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 09/06/2023] [Accepted: 09/11/2023] [Indexed: 04/11/2024] Open
Abstract
Aim The aim of the study is to know about the awareness of probiotics among undergraduate dental students. Materials and Methods We conducted cross-sectional research where we had distributed a questionnaire consisting of ten open-ended questions, among 150 dental students through emails. The questions were based on the utilization of probiotics in dentistry. The data obtained was statistically analyzed with the help of Chi-square test. Results In our study, we noted that most of the participants were aware of the term probiotics and had general ideas but were not fully aware of its pathogenesis. Around 83.2% of the participants were aware of probiotics and general concepts. We also noted that only 42.5% of the students agreed that probiotics can be used in the management of halitosis as well as periodontitis. Conclusion We concluded that most of the dental students had a lack of awareness as well as were not familiar with the usage of probiotics in dentistry.
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Affiliation(s)
- Tejaswi Kala
- Department of Public Health Dentistry, Tirumala Institute of Dental Sciences, Nizamabad, India
| | - Priyaranjan
- Dental Institute, RIMS, Ranchi, Jharkhand, India
| | - Shilpa Sunil Khanna
- Department of Oral and Maxillofacial Surgery, Sri Ramakrishna Dental College and Hospital, Coimbatore, Tamil Nadu, India
| | - Harveen Kaur
- Department of Oral Medicine and Radiology, Dr Harvansh Singh Judge Institute of Dental Sciences and Hospital, Panjab University, Chandigarh, India
| | - Nidhi Gupta
- Faculty, College of Dental Medicine, Qatar University, Qatar
| | - Anshuman Shetty
- Department of Conservative Dentistry and Endodontics, A.B. Shetty Memorial Institute of Dental Sciences, Nitte (Deemed to be University) Derlakatte, Mangaluru, Karnataka, India
| | - Heena Dixit Tiwari
- Rashtriya Kishore Swasthya Karyakram Consultant, District Medical and Health Office, Visakhapatnam, Andhra Pradesh, India
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15
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Gupta D, Gupta N, Singh N, Prinja S. Economic Evaluation of Targeted Therapies for Anaplastic Lymphoma Kinase- and ROS1 Fusion-Positive Non-Small Cell Lung Cancer in India. JCO Glob Oncol 2024; 10:e2300260. [PMID: 38359374 PMCID: PMC10881089 DOI: 10.1200/go.23.00260] [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] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 11/10/2023] [Accepted: 12/06/2023] [Indexed: 02/17/2024] Open
Abstract
PURPOSE Targeted therapies, such as crizotinib and ceritinib, have shown promising results in treating non-small cell lung cancer (NSCLC) with specific oncogenic drivers like anaplastic lymphoma kinase (ALK), c-ros (ROS1) oncogene, etc. This study aims to assess the cost-effectiveness of these therapies for patients with NSCLC in India. METHODS The Markov model consisted of three health states: progression-free survival, progressive disease, and death. Lifetime costs and consequences were estimated for three treatment arms: crizotinib, ceritinib, and chemotherapy for patients with ALK- and ROS1-positive NSCLC. Incremental cost per quality-adjusted life-year (QALY) gained with crizotinib and ceritinib was compared to chemotherapy and assessed using a willingness-to-pay threshold of one-time per capita gross domestic product in India. RESULTS The total lifetime cost per patient for ALK-positive NSCLC was ₹332,456 ($4,054 US dollars [USD]), ₹1,284,100 ($15,659 USD), and ₹2,337,779 ($28,509 USD) in the chemotherapy, crizotinib, and ceritinib arms, respectively. The mean QALYs lived per patient were 1.20, 2.21, and 3.34, respectively. For patients with ROS1-positive NSCLC, the total cost was ₹323,011 ($3,939 USD) and ₹1,763,541 ($21,507 USD) for chemotherapy and crizotinib, with mean QALYs lived per patient of 1.16 and 2.73, respectively. Nearly 92% and 81% reduction in the price of ceritinib and crizotinib is required to make it a cost-effective treatment option for ALK- and ROS1-positive NSCLC, respectively. CONCLUSION Our study findings suggest that the prices of ceritinib and crizotinib need to be reduced significantly to justify their value for inclusion in India's publicly financed health insurance scheme for treatment of patients with locally advanced/metastatic ALK- and ROS1-positive NSCLC, respectively.
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Affiliation(s)
- Dharna Gupta
- Department of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Nidhi Gupta
- Department of Radiation Oncology, Government Medical College and Hospital, Chandigarh, India
| | - Navneet Singh
- Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Shankar Prinja
- Department of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
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16
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Dhanawat M, Garima, Wilson K, Gupta S, Chalotra R, Gupta N. Convection-enhanced Diffusion: A Novel Tactics to Crack the BBB. Curr Drug Deliv 2024; 21:CDD-EPUB-137760. [PMID: 38275045 DOI: 10.2174/0115672018266501231207095127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 10/20/2023] [Accepted: 11/20/2023] [Indexed: 01/27/2024]
Abstract
Although the brain is very accessible to nutrition and oxygen, it can be difficult to deliver medications to malignant brain tumours. To get around some of these issues and enable the use of therapeutic pharmacological substances that wouldn't typically cross the blood-brain barrier (BBB), convection-enhanced delivery (CED) has been developed. It is a cutting-edge strategy that gets beyond the blood-brain barrier and enables targeted drug administration to treat different neurological conditions such as brain tumours, Parkinson's disease, and epilepsy. Utilizing pressure gradients to spread the medicine across the target area is the main idea behind this diffusion mechanism. Through one to several catheters positioned stereotactically directly within the tumour mass, around the tumour, or in the cavity created by the resection, drugs are given. This method can be used in a variety of drug classes, including traditional chemotherapeutics and cutting-edge investigational targeted medications by using positive-pressure techniques. The drug delivery volume must be optimized for an effective infusion while minimizing backflow, which causes side effects and lowers therapeutic efficacy. Therefore, this technique provides a promising approach for treating disorders of the central nervous system (CNS).
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Affiliation(s)
- Meenakshi Dhanawat
- Amity Institute of Pharmacy, Amity University Haryana, Amity Education Valley, Panchgaon, Manesar, Gurugram, Haryana -122413
| | - Garima
- M.M College of Pharmacy, Maharishi Markandeshwar (Deemed to be University), Mullana- Ambala, Haryana, India 133207
| | - Kashish Wilson
- M.M College of Pharmacy, Maharishi Markandeshwar (Deemed to be University), Mullana- Ambala, Haryana, India 133207
| | - Sumeet Gupta
- M.M College of Pharmacy, Maharishi Markandeshwar (Deemed to be University), Mullana- Ambala, Haryana, India 133207
| | - Rishabh Chalotra
- Department of Pharmacology, Central University of Punjab, Bathinda, India
| | - Nidhi Gupta
- M.M College of Pharmacy, Maharishi Markandeshwar (Deemed to be University), Mullana- Ambala, Haryana, India 133207
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17
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Das A, Ariyakumar G, Gupta N, Kamdar S, Barugahare A, Deveson-Lucas D, Gee S, Costeloe K, Davey MS, Fleming P, Gibbons DL. Identifying immune signatures of sepsis to increase diagnostic accuracy in very preterm babies. Nat Commun 2024; 15:388. [PMID: 38195661 PMCID: PMC10776581 DOI: 10.1038/s41467-023-44387-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Accepted: 12/12/2023] [Indexed: 01/11/2024] Open
Abstract
Bacterial infections are a major cause of mortality in preterm babies, yet our understanding of early-life disease-associated immune dysregulation remains limited. Here, we combine multi-parameter flow cytometry, single-cell RNA sequencing and plasma analysis to longitudinally profile blood from very preterm babies (<32 weeks gestation) across episodes of invasive bacterial infection (sepsis). We identify a dynamically changing blood immune signature of sepsis, including lymphopenia, reduced dendritic cell frequencies and myeloid cell HLA-DR expression, which characterizes sepsis even when the common clinical marker of inflammation, C-reactive protein, is not elevated. Furthermore, single-cell RNA sequencing identifies upregulation of amphiregulin in leukocyte populations during sepsis, which we validate as a plasma analyte that correlates with clinical signs of disease, even when C-reactive protein is normal. This study provides insights into immune pathways associated with early-life sepsis and identifies immune analytes as potential diagnostic adjuncts to standard tests to guide targeted antibiotic prescribing.
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Affiliation(s)
- A Das
- Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, King's College London, Guy's Hospital, London, UK.
- Division of Infection and Immunity, University College London, London, WC1E 6BT, UK.
| | - G Ariyakumar
- Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, King's College London, Guy's Hospital, London, UK
| | - N Gupta
- Department of Neonatology, Evelina London Neonatal Unit, Guy's and St Thomas' NHS Foundation Trust, London, UK
- Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - S Kamdar
- Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, King's College London, Guy's Hospital, London, UK
| | - A Barugahare
- Bioinformatics Platform and Department of Microbiology, Biomedicine Discovery Institute, Monash University, Clayton, VIC, 3800, Australia
| | - D Deveson-Lucas
- Bioinformatics Platform and Department of Microbiology, Biomedicine Discovery Institute, Monash University, Clayton, VIC, 3800, Australia
| | - S Gee
- Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, King's College London, Guy's Hospital, London, UK
| | - K Costeloe
- Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - M S Davey
- Infection and Immunity Program and Department of Biochemistry and Molecular Biology, Biomedicine Discovery Institute, Monash University, Clayton, VIC, 3800, Australia
- Division of Biomedical Sciences, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK
| | - P Fleming
- Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
- Department of Neonatology, Homerton Healthcare NHS Foundation Trust, London, UK
| | - D L Gibbons
- Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, King's College London, Guy's Hospital, London, UK.
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Patyal M, Kaur K, Bala N, Gupta N, Malik AK. Innovative lanthanide complexes: Shaping the future of cancer/ tumor chemotherapy. J Trace Elem Med Biol 2023; 80:127277. [PMID: 37572546 DOI: 10.1016/j.jtemb.2023.127277] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 07/26/2023] [Accepted: 07/29/2023] [Indexed: 08/14/2023]
Abstract
Developing new therapeutic and diagnostic metals and metal complexes is a stunning example of how inorganic chemistry is rapidly becoming an essential part of modern medicine. More study of bio-coordination chemistry is needed to improve the design of compounds with fewer harmful side effects. Metal-containing drugs are widely utilized in the treatment of cancer. Platinum complexes are effective against some cancers, but new coordination compounds are being created with improved pharmacological properties and a broader spectrum of anticancer action. The coordination complexes of the 15 lanthanides or rare earth elements in the periodic table are crucial for diagnosing and treating cancer. Understanding and treating cancer requires the detection of binding lanthanide (III) ions or complexes to DNA and breaking DNA by these complexes. Current advances in lanthanide-based coordination complexes as anticancer treatments over the past five years are discussed in this study.
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Affiliation(s)
- Meenakshi Patyal
- Department of Chemistry, Punjabi University, Patiala, Punjab, India
| | - Kirandeep Kaur
- Department of Chemistry, Punjabi University, Patiala, Punjab, India
| | - Neeraj Bala
- Department of Chemistry, Patel Memorial National College, Punjab, India
| | - Nidhi Gupta
- Department of Chemistry, Punjabi University, Patiala, Punjab, India.
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Crowley P, Kildedal R, Vindelev SO, Jacobsen SS, Larsen JR, Johansson PJ, Aadahl M, Straker L, Stamatakis E, Holtermann A, Mork PJ, Gupta N. A Novel System for the Device-Based Measurement of Physical Activity, Sedentary Behavior, and Sleep (Motus): Usability Evaluation. JMIR Form Res 2023; 7:e48209. [PMID: 37976096 PMCID: PMC10692873 DOI: 10.2196/48209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Revised: 09/29/2023] [Accepted: 09/29/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Device-based measurements of physical behavior, using the current methods, place a large burden on participants. The Motus system could reduce this burden by removing the necessity for in-person meetings, replacing diaries written on paper with digital diaries, and increasing the automation of feedback generation. OBJECTIVE This study aims to describe the development of the Motus system and evaluate its potential to reduce participant burden in a two-phase usability evaluation. METHODS Motus was developed around (1) a thigh-worn accelerometer with Bluetooth data transfer; (2) a smartphone app containing an attachment guide, a digital diary, and facilitating automated data transfer; (3) a cloud infrastructure for data storage; (4) an analysis software to generate feedback for participants; and (5) a web-based app for administrators. We recruited 19 adults with a mean age of 45 (SD 11; range 27-63) years, of which 11 were female, to assist in the two-phase evaluation of Motus. A total of 7 participants evaluated the usability of mockups for a smartphone app in phase 1. Participants interacted with the app while thinking aloud, and any issues raised were classified as critical, serious, or minor by observers. This information was used to create an improved and functional smartphone app for evaluation in phase 2. A total of 12 participants completed a 7-day free-living measurement with Motus in phase 2. On day 1, participants attempted 20 system-related tasks under observation, including registration on the study web page, reading the information letter, downloading and navigating the smartphone app, attaching an accelerometer on the thigh, and completing a diary entry for both work and sleep hours. Task completion success and any issues encountered were noted by the observer. On completion of the 7-day measurement, participants provided a rating from 0 to 100 on the System Usability Scale and participated in a semistructured interview aimed at understanding their experience in more detail. RESULTS The task completion rate for the 20 tasks was 100% for 13 tasks, >80% for 4 tasks, and <50% for 3 tasks. The average rating of system usability was 86 on a 0-100 scale. Thematic analysis indicated that participants perceived the system as easy to use and remember, and subjectively pleasing overall. Participants with shift work reported difficulty with entering sleep hours, and 66% (8/12) of the participants experienced slow data transfer between the app and the cloud infrastructure. Finally, a few participants desired a greater degree of detail in the generated feedback. CONCLUSIONS Our two-phase usability evaluation indicated that the overall usability of the Motus system is high in free-living. Issues around the system's slow data transfer, participants with atypical work shifts, and the degree of automation and detail of generated feedback should be addressed in future iterations of the Motus system. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/35697.
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Affiliation(s)
- Patrick Crowley
- The National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Rasmus Kildedal
- The National Research Centre for the Working Environment, Copenhagen, Denmark
| | | | | | - Jon Roslyng Larsen
- The National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Peter J Johansson
- Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden
- Occupational and Environmental Medicine, Uppsala University Hospital, Uppsala, Sweden
| | - Mette Aadahl
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Leon Straker
- School of Allied Health, Curtin University, Perth, Australia
| | - Emmanuel Stamatakis
- Charles Perkins Centre, Mackenzie Wearables Research Hub, University of Sydney, Sydney, Australia
- School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Andreas Holtermann
- The National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Paul Jarle Mork
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Nidhi Gupta
- The National Research Centre for the Working Environment, Copenhagen, Denmark
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Gupta N, Venkatesh HA, Pejaver R, Garg C, Nagesh K. Determining the Spinal Canal Depth in Neonates Using Bedside Ultrasonography. Indian Pediatr 2023; 60:927-930. [PMID: 37950466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2023]
Abstract
OBJECTIVE To provide a gestation age- and weight-specific mathematical formula for predicting the optimal depth of spinal needle insertion. METHODS The study included 127 neonates between 28 and 40 weeks of gestation and weighing 700 to 4000 grams, and a total of 202 ultrasound examinations were performed. Anterior and posterior borders were delineated using ultrasound and measured as spinal canal depth in lateral decubitus position at L3- L4 vertebral interspace. The mid-spinal canal depth (MSCD) was calculated. RESULTS Spinal canal dimensions showed an increasing trend with an increase in weight and post-menstrual age of the babies. The best correlation was found between weight and MSCD with an r2 of 0.85, which is given by the formula MSCD (cm) = 0.2 X weight in kg + 0.45. CONCLUSION Knowledge of the spinal canal depth using the formula may facilitate accurate needle placement, thereby decreasing traumatic lumbar puncture.
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Affiliation(s)
- Nidhi Gupta
- Department of Neonatology, Manipal Hospital, HAL, Old Airport Road, Bengaluru, Karnataka
| | - H A Venkatesh
- Department of Neonatology, Manipal Hospital, HAL, Old Airport Road, Bengaluru, Karnataka. Correspondence to: Dr. HA Venkatesh, Department of Neonatology, Manipal Hospital, HAL, Old Airport Road, Bengaluru, Karnataka.
| | - Rajath Pejaver
- Department of Neonatology, Manipal Hospital, HAL, Old Airport Road, Bengaluru, Karnataka
| | - Cherry Garg
- Department of Neonatology, Manipal Hospital, HAL, Old Airport Road, Bengaluru, Karnataka
| | - Karthik Nagesh
- Department of Neonatology, Manipal Hospital, HAL, Old Airport Road, Bengaluru, Karnataka
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21
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Patyal M, Verma D, Kaur K, Gupta N, Malik AK. Development of a novel green catalyzed nanostructured Cu(II) macrocyclic complex-based disposable electrochemical sensor for sensitive detection of bisphenol A in environmental samples. Environ Pollut 2023; 336:122420. [PMID: 37611790 DOI: 10.1016/j.envpol.2023.122420] [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] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 07/24/2023] [Accepted: 08/18/2023] [Indexed: 08/25/2023]
Abstract
BPA is an endocrine disruptor and the leading environmental pollutant due to its use as raw material in industries. Therefore, the present work reports the sensitive, efficient, and disposable electrochemical paper-based SPE for determining the BPA sensor using an amide-based macrocyclic complex (nanostructured complex of copper acetate with macrocyclic ligand, i.e., CuL (CH3COO)2) synthesized using Citrus limon (lemon) extract via sonication for the first time. The structural, morphological, and electrochemical analyses have been characterized by mass spectroscopy, FTIR, UV-Vis, XRD, FESEM-EDX, elemental mapping and electrochemical techniques. The sensor platform for detecting BPA was fabricated by simple drop-casting on the disposable paper-based SPE using macrocyclic complex, i.e., CuL (CH3COO)2/SPE. After optimizing the conditions, CuL (CH3COO)2/SPE electrode was employed for determining BPA via CV with a wide linear range of 31 × 10-9 μM-0.205 μM, low LOD of 0.027 nM, and high sensitivity of 49.71 μA (log nM)-1 cm-2 having correlation coefficient (R2) of 0.976 which is quite better in compared to other reported SPE sensor for detection of BPA. Further, our sensor also showed good selectivity and reproducibility, in addition to detecting BPA in environmental samples (tube well water, river water and drain water) with acceptable recoveries and RSDs values. In this work, the combination of macrocyclic complex and paper-based SPE has turned out to be a cost-effective electrochemical sensor.
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Affiliation(s)
- Meenakshi Patyal
- Department of Chemistry, Punjabi University, Patiala, Punjab, India
| | - Damini Verma
- Special Centre for Nanoscience, Jawaharlal Nehru University, New Delhi, India
| | - Kirandeep Kaur
- Department of Chemistry, Punjabi University, Patiala, Punjab, India
| | - Nidhi Gupta
- Department of Chemistry, Punjabi University, Patiala, Punjab, India.
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22
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Gupta N, Kumar A, Vaddavalli PK, Mahapatra NR, Varshney A, Ghosh P. Efficient reduction of the scrolling of Descemet membrane endothelial keratoplasty grafts by engineering the medium. Acta Biomater 2023; 171:239-248. [PMID: 37739249 DOI: 10.1016/j.actbio.2023.09.024] [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: 05/26/2023] [Revised: 09/08/2023] [Accepted: 09/15/2023] [Indexed: 09/24/2023]
Abstract
The Descemet Membrane Endothelial Keratoplasty (DMEK) procedure for corneal transplantation is challenging due to the need to unscroll the donor graft within the recipient's eye. This process of unscrolling is complex, time-consuming, leads to a loss of endothelial cells and, most importantly, can negatively impact the graft's adhesion and integration with the host tissue after surgery. This problem is particularly evident when the graft is young. However, the physics behind this scrolling is not well understood, and therefore no sustainable solution is attained. Here, we propose that the concentration gradient of the medium used during transplant leads to a displacement gradient across the graft thickness, resulting in an out-of-plane folding or scrolling of the graft tissue. Using chitosan bilayer-based experimental models, it is experimentally demonstrated that this diffusion-coupled-deformation phenomenon can successfully explain why younger donor grafts tend to scroll tighter than older ones. Most importantly, we illustrate here through experiments that the medium can be engineered to reduce the scroll tightness and thus reduce the surgical inconveniences and improve post-transplant recovery. STATEMENT OF SIGNIFICANCE: This paper addresses a major issue that surgeons face while doing Descemet Membrane Endothelial Keratoplasty (DMEK) in unscrolling grafts during the graft insertion procedure. The currently used tapping method to unscroll the graft inside the patient's eye significantly reduces endothelial cell count, thus affecting its lifetime. Surprisingly, the physics behind graft scrolling is not well understood, so no sustainable solutions are proposed by the medical community. In this work, we present the underlying mechanism of DMEK graft scroll and illustrate experimentally the reason for scroll tightness through a chitosan bilayer based experiment model. Most importantly, we have successfully demonstrated that the preserving medium of the grafts can be engineered to reduce scroll tightness.
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Affiliation(s)
- Nidhi Gupta
- Department of Cornea Dr Shroff's Charity Eye Hospital, Delhi, India
| | - Amit Kumar
- Department of Biotechnology & Department of Applied Mechanics, IIT Madras, India
| | | | | | - Akhil Varshney
- Eicher-Shroff Center for Stem Cell Research, Dr Shroff's Charity Eye Hospital, Daryaganj, Delhi, India.
| | - Pijush Ghosh
- Department of Applied Mechanics and Biomedical Engineering; Center for Soft and Biological Matter, IIT Madras, India.
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23
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Gupta N, Dutta A, Baruah MM, Bhansali A, Ahuja CK, Dhandapani S, Bhadada SK, Saikia UN, Walia R. An Integrated Clinical Score to Predict Remission in Cushing's Disease. Indian J Endocrinol Metab 2023; 27:501-505. [PMID: 38371189 PMCID: PMC10871004 DOI: 10.4103/ijem.ijem_314_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 10/05/2023] [Accepted: 10/25/2023] [Indexed: 02/20/2024] Open
Abstract
Objective To derive a clinical score from parameters that favor remission of Cushing's disease (CD) after pituitary surgery. Methods This is an analysis of 11 clinical, hormonal, and post-operative parameters that each favored remission in a cohort of 145 patients with CD treated by trans-sphenoidal surgery (TSS). Each parameter was designated as a categorical variable (presence/absence), and several favorable parameters present for each patient were calculated. From this, a median parameter score (clinical score) of the entire cohort was derived, which was then compared to the event of remission/persistence of CD. Results The median number of favorable parameters present in the entire cohort was 3 (0-7). The significant count of patients in remission increased with the increasing number of parameters. The receiver-operator characteristic curve showed that the presence of ≥3 parameters was associated with remission in CD with a sensitivity of 84.2% and a specificity of 80%. Patients with a clinical score ≥3 had significantly higher remission rates (88.9%) than those who had persistent disease (27.3%; P = 0.001). Conclusion A clinical score of ≥3 predicts remission in CD treated by TSS; however, it requires validation in other large cohorts. Rather than assessing individual parameters to predict remission in CD, an integrated clinical score is a better tool for follow-up and patient counseling.
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Affiliation(s)
- Nidhi Gupta
- Department of Endocrinology, PGIMER, Chandigarh, India
| | - Aditya Dutta
- Department of Endocrinology, PGIMER, Chandigarh, India
| | | | - Anil Bhansali
- Department of Endocrinology, PGIMER, Chandigarh, India
| | | | | | | | | | - Rama Walia
- Department of Endocrinology, PGIMER, Chandigarh, India
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24
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Kapoor S, Gupta N, Sharma A. A Polyherbal Ashwagandha Formulation Exhibits Adjunctive Antitumor Efficacy Against U266 Myeloma Cells by Multi-Strategic Cytotoxic Effects: An Experimental Approach. Asian Pac J Cancer Prev 2023; 24:3705-3714. [PMID: 38019228 PMCID: PMC10772745 DOI: 10.31557/apjcp.2023.24.11.3705] [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: 04/17/2023] [Accepted: 11/04/2023] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND The present study explored the molecular mechanism of herbal (Unani) drug Habb-e-asgandh as anti-tumorigenic adjuvant therapy experimentally in U266 cells and its role in treatment of Multiple myeloma. The formulation of Habb-e-asgandh is investigated alone or as a combinatorial therapy with standard drug lenalidomide to check for its efficacy against U266 myeloma cells for prevention of drug relapse and resistance. METHODS We performed the following assays on singly or in combination of Habb-e-asgandh-Lenalidomide treated U266 cells. The cytotoxicity evaluation done by MTT assay, we studied cell cycle kinetics by Propidium Iodide staining, mitochondrial apoptosis analysis by Annexin V/PI dual staining and JC1 staining assays. Further, anti-oxidative potential was assessed by ORAC assay and cytokine levels estimation of anti-inflammatory (TNF-alpha and IL6) and anti-angiogenic (VEGF and Ang-2) markers were done by ELISA. RESULTS The myeloma U266 cells when treated with Habb-e-asgandh alone or in combination with standard drug lenalidomide showed cytotoxicity in dose dependent manner with promising effects at 0.4 mg/ml (IC30) and 1.5 mg/ml (IC50) inhibitory concentrations. The formulation treated cells showed modulation in cell cycle kinetics patterned by sub Go/G1 population accumulation. Furthermore, it induced mitochondrial apoptosis mainly at half maximal inhibitory concentration and in combinatorial combinations. Significantly elevated oxidative capacities (p<0.05) and reduced levels of angiogenic and pro-inflammatory markers were observed. Multiple mechanism based inhibition by Habb-e-asgandh in co-treatment with lenalidomide against myeloma cells is indicated. Conclusion: Habb-e-asgandh formulation possess anti-tumorigenic efficacy against multiple myeloma. The adjunctive Habb-e-asgandh formulation with standard chemotherapeutic drug may prove to be a potent anti-myeloma agent in interventional therapy for Multiple myeloma if further studied in future avenues.
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25
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Parekh M, Ruzza A, Rovati M, Tzamalis A, Romano D, Gupta N, Vaddavalli P, Bhogal M, Jhanji V, Sawant O, Semeraro F, Ponzin D, Jacob S, Dragnea DC, Rodriguez-Calvo-de-Mora M, Dhubhghaill SN, Fogla R, Sharma N, Jurkunas UV, Ferrari S, Romano V. DMEK surgical training: An instructional guide on various wet-lab methods. Surv Ophthalmol 2023; 68:1129-1152. [PMID: 37392969 DOI: 10.1016/j.survophthal.2023.06.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 06/21/2023] [Accepted: 06/26/2023] [Indexed: 07/03/2023]
Abstract
Descemet membrane endothelial keratoplasty (DMEK) is a partial-thickness corneal transplantation procedure that involves selective transplantation of the Descemet membrane and endothelium. DMEK offers significant advantages over other keratoplasty techniques, such as faster visual rehabilitation, better final visual acuity due to minimal optical interface effects, lower risk of allograft rejection, and less long-term dependence on topical steroids. Despite all its advantages, DMEK has been found to be more challenging than other corneal transplantation techniques, and its steep learning curve appears to be an obstacle to its widespread use and adoption by corneal surgeons worldwide. DMEK surgical training laboratories (wet labs) provide a window of opportunity for surgeons to learn, prepare, manipulate, and deliver these grafts in a risk-free environment. Wet labs are a significant learning tool, especially for those institutions that have limited tissue availability in their local centers. We provide a step-by-step guide for preparing DMEK grafts using different techniques on human and nonhuman models with instructional videos. This article should eventually help the trainees and the educators understand the requirements for performing DMEK and conducting a DMEK wet lab and develop their skills and interests from a wide variety of available techniques.
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Affiliation(s)
- Mohit Parekh
- Schepens Eye Research Institute of Mass Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA.
| | - Alessandro Ruzza
- International Center for Ocular Physiopathology, Fondazione Banca degli Occhi del Veneto Onlus, Venice, Italy
| | - Marco Rovati
- Eye Unit, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - Argyrios Tzamalis
- 2nd Department of Ophthalmology, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece
| | - Davide Romano
- Eye Unit, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - Nidhi Gupta
- Department of Cornea, Refractive Surgery and Ocular Surface Disorders, Dr. Shroff's Charity Eye Hospital, New Delhi, India
| | - Pravin Vaddavalli
- Cornea Institute, LV Prasad Eye Institute, Hyderabad, Telangana, India
| | | | - Vishal Jhanji
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Onkar Sawant
- Department of Research and Development, Center for Vision and Eye Banking Research, Eversight, Cleveland, OH, USA
| | - Francesco Semeraro
- Eye Unit, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - Diego Ponzin
- International Center for Ocular Physiopathology, Fondazione Banca degli Occhi del Veneto Onlus, Venice, Italy
| | - Soosan Jacob
- Department of Cataract and Glaucoma Services, Dr. Agarwal's Refractive and Cornea Foundation, Chennai, India
| | | | | | | | - Rajesh Fogla
- Department of Ophthalmology, Apollo Hospitals, Hyderabad, Telangana, India
| | - Namrata Sharma
- Department of Ophthalmology, All India Institute of Medical Sciences, New Delhi, India
| | - Ula V Jurkunas
- Schepens Eye Research Institute of Mass Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Stefano Ferrari
- International Center for Ocular Physiopathology, Fondazione Banca degli Occhi del Veneto Onlus, Venice, Italy
| | - Vito Romano
- Eye Unit, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy; Eye Unit, ASST Spedali Civili di Brescia, Brescia, Italy.
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26
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Harrison Z, Montgomery EC, Bush JR, Gupta N, Bumgardner JD, Fujiwara T, Baker DL, Jennings JA. Cis-2-Decenoic Acid and Bupivacaine Delivered from Electrospun Chitosan Membranes Increase Cytokine Production in Dermal and Inflammatory Cell Lines. Pharmaceutics 2023; 15:2476. [PMID: 37896236 PMCID: PMC10610339 DOI: 10.3390/pharmaceutics15102476] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 10/01/2023] [Accepted: 10/11/2023] [Indexed: 10/29/2023] Open
Abstract
Wound dressings serve to protect tissue from contamination, alleviate pain, and facilitate wound healing. The biopolymer chitosan is an exemplary choice in wound dressing material as it is biocompatible and has intrinsic antibacterial properties. Infection can be further prevented by loading dressings with cis-2-decenoic acid (C2DA), a non-antibiotic antimicrobial agent, as well as bupivacaine (BUP), a local anesthetic that also has antibacterial capabilities. This study utilized a series of assays to elucidate the responses of dermal cells to decanoic anhydride-modified electrospun chitosan membranes (DA-ESCMs) loaded with C2DA and/or BUP. Cytocompatibility studies determined the toxic loading ranges for C2DA, BUP, and combinations, revealing that higher concentrations (0.3 mg of C2DA and 1.0 mg of BUP) significantly decreased the viability of fibroblasts and keratinocytes. These high concentrations also inhibited collagen production by fibroblasts, with lower loading concentrations promoting collagen deposition. These findings provide insight into preliminary cellular responses to DA-ESCMs and can guide future research on their clinical application as wound dressings.
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Affiliation(s)
- Zoe Harrison
- Department of Biomedical Engineering, University of Memphis, Memphis, TN 38152, USA; (Z.H.); (E.C.M.); (J.R.B.); (N.G.); (J.D.B.)
| | - Emily C. Montgomery
- Department of Biomedical Engineering, University of Memphis, Memphis, TN 38152, USA; (Z.H.); (E.C.M.); (J.R.B.); (N.G.); (J.D.B.)
| | - Joshua R. Bush
- Department of Biomedical Engineering, University of Memphis, Memphis, TN 38152, USA; (Z.H.); (E.C.M.); (J.R.B.); (N.G.); (J.D.B.)
| | - Nidhi Gupta
- Department of Biomedical Engineering, University of Memphis, Memphis, TN 38152, USA; (Z.H.); (E.C.M.); (J.R.B.); (N.G.); (J.D.B.)
| | - Joel D. Bumgardner
- Department of Biomedical Engineering, University of Memphis, Memphis, TN 38152, USA; (Z.H.); (E.C.M.); (J.R.B.); (N.G.); (J.D.B.)
| | - Tomoko Fujiwara
- Department of Chemistry, University of Memphis, Memphis, TN 38152, USA; (T.F.); (D.L.B.)
| | - Daniel L. Baker
- Department of Chemistry, University of Memphis, Memphis, TN 38152, USA; (T.F.); (D.L.B.)
| | - Jessica Amber Jennings
- Department of Biomedical Engineering, University of Memphis, Memphis, TN 38152, USA; (Z.H.); (E.C.M.); (J.R.B.); (N.G.); (J.D.B.)
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Suorsa K, Gupta N, Leskinen T, Andersen LL, Pasanen J, Hettiarachchi P, Johansson PJ, Pentti J, Vahtera J, Stenholm S. Modifications of 24-h movement behaviors to prevent obesity in retirement: a natural experiment using compositional data analysis. Int J Obes (Lond) 2023; 47:922-930. [PMID: 37221289 PMCID: PMC10511314 DOI: 10.1038/s41366-023-01326-0] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 05/02/2023] [Accepted: 05/04/2023] [Indexed: 05/25/2023]
Abstract
BACKGROUND Retirement often leads to a more passive lifestyle and may therefore lead to weight gain. This study aims to investigate longitudinal associations between changes in 24-h movement behaviors and BMI and waist circumference in relation to the transition from work to retirement. METHODS The study population included 213 retiring public sector workers (mean age 63.5 years, standard deviation 1.1) from the Finnish Retirement and Aging study. Before and after retirement participants wore an Axivity accelerometer on their thigh and filled in a daily log for at least four days to measure daily time spent sleeping, in sedentary behavior (SED), light physical activity (LPA) and moderate-to-vigorous physical activity (MVPA). Also, their body mass index (BMI) and waist circumference were measured repeatedly. Compositional linear regression analysis and isotemporal substitution analysis were used to study associations between one-year changes in 24-h movement behaviors and concurrent changes in BMI and waist circumference. RESULTS An increase in MVPA in relation to sleep, SED and LPA was associated with a decreasing BMI (β = -0.60, p = 0.04) and waist circumference (β = -2.14, p = 0.05) over one year from before retirement to after retirement. In contrast, increasing sleep in relation to SED, LPA and MVPA was associated with an increasing BMI (β = 1.34, p = 0.02). Reallocating 60 min from MVPA to SED or sleep was estimated to increase BMI by on average 0.8-0.9 kg/m2 and waist circumference by 3.0 cm during one year. CONCLUSIONS During the transition from work to retirement, increasing MVPA was associated with a slight decrease in BMI and waist circumference, whereas increasing sleep was associated with an increasing BMI. Common life transitions, like retirement, should be considered when giving recommendations and guidance for physical activity and sleep.
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Affiliation(s)
- Kristin Suorsa
- Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland.
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland.
| | - Nidhi Gupta
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Tuija Leskinen
- Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Lars L Andersen
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Jesse Pasanen
- Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Pasan Hettiarachchi
- Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, Uppsala University Hospital, Uppsala, Sweden
| | - Peter J Johansson
- Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, Uppsala University Hospital, Uppsala, Sweden
| | - Jaana Pentti
- Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
- Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Jussi Vahtera
- Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Sari Stenholm
- Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
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Whitcroft KL, Altundag A, Balungwe P, Boscolo-Rizzo P, Douglas R, Enecilla MLB, Fjaeldstad AW, Fornazieri MA, Frasnelli J, Gane S, Gudziol H, Gupta N, Haehner A, Hernandez AK, Holbrook EH, Hopkins C, Hsieh JW, Huart C, Husain S, Kamel R, Kim JK, Kobayashi M, Konstantinidis I, Landis BN, Lechner M, Macchi A, Mazal PP, Miri I, Miwa T, Mori E, Mullol J, Mueller CA, Ottaviano G, Patel ZM, Philpott C, Pinto JM, Ramakrishnan VR, Roth Y, Schlosser RJ, Stjärne P, Van Gerven L, Vodicka J, Welge-Luessen A, Wormald PJ, Hummel T. Position paper on olfactory dysfunction: 2023. Rhinology 2023; 61:1-108. [PMID: 37454287 DOI: 10.4193/rhin22.483] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/18/2023]
Abstract
BACKGROUND Since publication of the original Position Paper on Olfactory Dysfunction in 2017 (PPOD-17), the personal and societal burden of olfactory disorders has come sharply into focus through the lens of the COVID-19 pandemic. Clinicians, scientists and the public are now more aware of the importance of olfaction, and the impact of its dysfunction on quality of life, nutrition, social relationships and mental health. Accordingly, new basic, translational and clinical research has resulted in significant progress since the PPOD-17. In this updated document, we present and discuss currently available evidence for the diagnosis and management of olfactory dysfunction. Major updates to the current version include, amongst others: new recommendations on olfactory related terminology; new imaging recommendations; new sections on qualitative OD and COVID-19 OD; updated management section. Recommendations were agreed by all co-authors using a modified Delphi process. CONCLUSIONS We have provided an overview of current evidence and expert-agreed recommendations for the definition, investigation, and management of OD. As for our original Position Paper, we hope that this updated document will encourage clinicians and researchers to adopt a common language, and in so doing, increase the methodological quality, consistency, and generalisability of work in this field.
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Affiliation(s)
- K L Whitcroft
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
- and UCL Ear Institute, Faculty of Brain Sciences, University College London, London, UK
- and The Centre for Olfactory Research and Applications, Institute of Philosophy, School of Advanced Studies, University of London, London, UK
| | - A Altundag
- Department of Otorhinolaryngology, Istanbul Surgery Hospital, Istanbul, Turkey
| | - P Balungwe
- Faculté de Médecine, Université Catholique de Bukavu, Bukavu, Democratic Republic of the Congo
- and Hôpital Provincial Général de Référence de Bukavu, Bukavu, Democratic Republic of the Congo
| | - P Boscolo-Rizzo
- Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, Trieste, Italy
| | - R Douglas
- Department of Otorhinolaryngology, University of Auckland, New Zealand
| | - M L B Enecilla
- Department of Otorhinolaryngology-Head and Neck Surgery, St. Luke's Medical Center, Global City, Philippines
- and Department of Otolaryngology - Head and Neck Surgery, Asian Hospital and Medical Center, Muntinlupa, Philippines
- and Department of Otorhinolaryngology, Medical Center Taguig, Taguig, Philippines
| | - A W Fjaeldstad
- The Centre for Olfactory Research and Applications, Institute of Philosophy, School of Advanced Studies, University of London, London, UK
- and Department of Otorhinolaryngology, University Clinic for Flavour, Balance and Sleep, Regional Hospital Gødstrup, Herning, Denmark
- and Department of Clinical Medicine, Flavour Institute, Aarhus University, Aarhus, Denmark
- and Center for Eudaimonia and Human Flourishing, Linacre College, University of Oxford, Oxford, UK
| | - M A Fornazieri
- Department of Clinical Surgery, Universidade Estadual de Londrina and Pontifícia Universidade Católica do Paraná, Londrina, Brazil
| | - J Frasnelli
- Research Chair in Chemosensory Neuroanatomy, Department of Anatomy, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
- and Centre for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montréal, Montréal, QC, Canada
| | - S Gane
- The Centre for Olfactory Research and Applications, Institute of Philosophy, School of Advanced Studies, University of London, London, UK
- and Royal National Throat Nose and Ear Hospital, UCLH, London
| | - H Gudziol
- Department of Otorhinolaryngology, University of Jena, Jena, Germany
| | - N Gupta
- Department of Otorhinolaryngology, University College of Medical Sciences and GTB Hospital, Delhi, India
| | - A Haehner
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
| | - A K Hernandez
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
- and Department of Otolaryngology - Head and Neck Surgery, Asian Hospital and Medical Center, Muntinlupa, Philippines
- and Department of Otolaryngology - Head and Neck Surgery, Philippine General Hospital, University of the Philippines - Manila, Manila, Philippines
| | - E H Holbrook
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA
| | - C Hopkins
- Guys and St Thomas NHS Trust, London, United Kingdom
| | - J W Hsieh
- Rhinology-Olfactology Unit, Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital of Geneva Medical School, Geneva, Switzerland
| | - C Huart
- Department of Otorhinolaryngology, Cliniques universitaires Saint-Luc, Brussels, Belgium
- and Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium
| | - S Husain
- Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia
| | - R Kamel
- Department of Otorhinolaryngology, Cairo University, Cairo, Egypt
| | - J K Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Konkuk University, College of Medicine, Seoul, Republic of Korea
| | - M Kobayashi
- Department of Otorhinolaryngology-Head and Neck Surgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan
| | - I Konstantinidis
- Smell and Taste Clinic, Second Academic Otorhinolaryngology Department, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - B N Landis
- Rhinology-Olfactology Unit, Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital of Geneva Medical School, Geneva, Switzerland
| | - M Lechner
- Division of Surgery and Interventional Science, University College London, London, UK
- and UCL Cancer Institute, University College London, London, UK
- and ENT Department, Homerton Healthcare NHS Foundation Trust, London, UK
| | - A Macchi
- ENT Clinic, University of Insubria, ASST Sette Laghi, Varese, Italy
| | - P P Mazal
- Servicio de Otorrinolaringología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - I Miri
- Service Médecine Physique Réadaptation fonctionnelle, Institut Mohamed Kassab d'Orthopédie, Mannouba, Tunisia
| | - T Miwa
- Department of Otorhinolaryngology, Kanazawa Medical University, Uchinada, Kahoku, Ishikawa, Japan
| | - E Mori
- Department of Otorhinolaryngology, Jikei University, School of Medicine, Tokyo, Japan
| | - J Mullol
- Rhinology Unit and Smell Clinic, ENT Department, Hospital Clínic, Universitat de Barcelona
- IDIBAPS
- CIBERES. Barcelona, Catalonia, Spain
| | - C A Mueller
- Department of Otorhinolaryngology, Medical University of Vienna, Vienna, Austria
| | - G Ottaviano
- Department of Neurosciences DNS, Otolaryngology Section, University, Padua, Italy
| | - Z M Patel
- Department of Otolaryngology, Stanford University School of Medicine, Stanford, California, USA
| | - C Philpott
- Norwich Medical School, University of East Anglia, Norwich, UK
- and The Smell and Taste Clinic, James Paget University Hospital, Gorleston, UK
| | - J M Pinto
- Section of Otolaryngology-Head and Neck Surgery, The University of Chicago Medicine and Biological Sciences, Chicago, IL, USA
| | - V R Ramakrishnan
- Department of Otolaryngology-Head and Neck Surgery, Indiana University of School Medicine, Indianapolis, IN, USA
| | - Y Roth
- The Institute for Nose and Sinus Therapy and Clinical Investigations, Department of Otolaryngology - Head and Neck Surgery, Edith Wolfson Medical Center, Tel Aviv University Sackler Faculty of Medicine, Holon, Israel
| | - R J Schlosser
- Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA
| | - P Stjärne
- Section of Rhinology, Department of Otorhinolaryngology, Karolinska University Hospital and Karolinska Institute, Stockholm, Sweden
| | - L Van Gerven
- Department of Otorhinolaryngology, UZ Leuven, Belgium
- and Department of Neurosciences, Experimental Otorhinolaryngology, KU Leuven, Belgium
- and Department of Microbiology, Immunology and Transplantation, Allergy and Clinical Immunology Research Unit, KU Leuven, Belgium
| | - J Vodicka
- Department of Otorhinolaryngology and Head and Neck Surgery, Hospital Pardubice, Faculty of Health Studies, University of Pardubice, Pardubice, Czech Republic
| | - A Welge-Luessen
- University Hospital Basel - Otorhinolaryngology, Basel, Switzerland
| | - P J Wormald
- Department of Surgery-Otorhinolaryngology Head and Neck Surgery, University of Adelaide, Adelaide, SA, Australia
| | - T Hummel
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
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Jain S, Cetnar A, Woollard J, Gupta N, Blakaj D, Chakravarti A, Ayan AS. Pulse parameter optimizer: an efficient tool for achieving prescribed dose and dose rate with electron FLASH platforms. Phys Med Biol 2023; 68:19NT01. [PMID: 37735967 DOI: 10.1088/1361-6560/acf63e] [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: 04/24/2023] [Accepted: 09/01/2023] [Indexed: 09/23/2023]
Abstract
Purpose. Commercial electron FLASH platforms deliver ultra-high dose rate doses at discrete combinations of pulse parameters including pulse width (PW), pulse repetition frequency (PRF) and number of pulses (N), which dictate unique combinations of dose and dose rates. Additionally, collimation, source to surface distance, and airgaps also vary the dose per pulse (DPP). Currently, obtaining pulse parameters for the desired dose and dose rate is a cumbersome manual process involving creating, updating, and looking up values in large spreadsheets for every treatment configuration. This work presents a pulse parameter optimizer application to match intended dose and dose rate precisely and efficiently.Methods. Dose and dose rate calculation methods have been described for a commercial electron FLASH platform. A constrained optimization for the dose and dose rate cost function was modelled as a mixed integer problem in MATLAB (The MathWorks Inc., Version9.13.0 R2022b, Natick, Massachusetts). The beam and machine data required for the application were acquired using GafChromic film and alternating current current transformers (ACCTs). Variables for optimization included DPP for every collimator, PW and PRF measured using ACCT and airgap factors.Results. Using PW, PRF,Nand airgap factors as parameters, a software was created to optimize dose and dose rate, reaching the closest match if exact dose and dose rates are not achievable. Optimization took 20 s or less to converge to results. This software was validated for accuracy of dose calculation and precision in matching prescribed dose and dose rate.Conclusion. A pulse parameter optimization application was built for a commercial electron FLASH platform to increase efficiency in dose, dose rate, and pulse parameter prescription process. Automating this process reduces safety concerns associated with manual look up and calculation of these parameters, especially when many subjects at different doses and dose rates are to be safely managed.
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Affiliation(s)
- S Jain
- The Department of Radiation Oncology, The Ohio State University Wexner Medical Center, United States of America
| | - A Cetnar
- The Department of Radiation Oncology, The Ohio State University Wexner Medical Center, United States of America
| | - J Woollard
- The Department of Radiation Oncology, The Ohio State University Wexner Medical Center, United States of America
| | - N Gupta
- The Department of Radiation Oncology, The Ohio State University Wexner Medical Center, United States of America
| | - D Blakaj
- The Department of Radiation Oncology, The Ohio State University Wexner Medical Center, United States of America
| | - A Chakravarti
- The Department of Radiation Oncology, The Ohio State University Wexner Medical Center, United States of America
| | - A S Ayan
- The Department of Radiation Oncology, The Ohio State University Wexner Medical Center, United States of America
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Abstract
Zika virus (ZIKV) is an arthropod-borne flavivirus that presents with acute febrile illness associated with rash, arthralgia and conjunctivitis. After years of sporadic reports in Africa, the three major outbreaks of this disease occurred in Yap Islands (2007), French Polynesia (2013-14) and South Americas (2015-16). Although, serological surveys suggested the presence of ZIKV in India in 1950s, cross-reactivity could not be ruled out. The first four proven cases of ZIKV from India were reported in 2017. This was followed by major outbreaks in the states of Rajasthan and Madhya Pradesh in 2018. Fortunately, the outbreaks in India were not associated with neurological complications. These outbreaks in India highlighted the spread of this disease beyond geographical barriers owing to the growing globalization, increased travel and ubiquitous presence of its vector, the Aedes mosquito. In this review, we discuss the epidemiology, clinical features and management of ZIKV in India.
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Affiliation(s)
- N Gupta
- From the Department of Medicine, All India Institute of Medical Sciences, 3rd Floor, Teaching Block, New Delhi 110029
| | - P Kodan
- From the Department of Medicine, All India Institute of Medical Sciences, 3rd Floor, Teaching Block, New Delhi 110029
| | - K Baruah
- National Vector Borne Disease Control Programme, Ministry of Health and Family Welfare, Government of India, 22 Shyam Nath Marg, New Delhi 110054, India
| | - M Soneja
- From the Department of Medicine, All India Institute of Medical Sciences, 3rd Floor, Teaching Block, New Delhi 110029
| | - A Biswas
- From the Department of Medicine, All India Institute of Medical Sciences, 3rd Floor, Teaching Block, New Delhi 110029
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Sil A, Das A, Patra AC, Kumar R, Pandhi D, De D, Seetharam K, Bhari N, Gupta N, Rao R, Mittal A, Rathore S, Poojary S, Barua S, Jagadeesan S, Mohanty S, Padhi T, Sankar V, Betkerur J, Das NK. Impact of COVID-19 Pandemic on Dermatology Teaching Program in India: A Survey on the Faculty and Residents' Perspective. Indian Dermatol Online J 2023; 14:643-652. [PMID: 37727561 PMCID: PMC10506814 DOI: 10.4103/idoj.idoj_85_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 06/02/2023] [Accepted: 06/03/2023] [Indexed: 09/21/2023] Open
Abstract
Background Impact of COVID-19 pandemic has been immense. An innocent casualty of this disaster is medical education and training. Dermatology, which primarily deals with out-patient services, medical and surgical interventions, and in-patient services, was one of the worst hit. The National Medical Commission of India has implemented competency-based medical education (CBME) in Dermatology, Venereology, and Leprosy since 2019. The new curriculum relies on acquiring practical and procedural skills, training skills in research methodology, professionalism, attitude, and communication. Objectives The study was undertaken to understand the implications of the COVID-19 pandemic on postgraduate dermatology CBME training in India. Materials and Methods A questionnaire-based survey was carried out on postgraduate dermatology teachers and residents in India after obtaining ethics committee approval. An online semi-structured English questionnaire was administered by Google Forms. The calculated sample size was 366 dermatology faculty and 341 postgraduate students. Validity (Content validity ratio (CVR) ≥0.56) and reliability (Cronbach's alpha coefficient 0.7249) of the questionnaire were determined. Results Among the 764 responses received, 51.4% reported that their institutes were converted to exclusive COVID hospitals. Domains of dermatology education affected were procedural training (n = 655), bedside clinical teaching (n = 613), outpatient department-based clinical teaching (n = 487), bedside laboratory procedures (n = 463), research activities (n = 453), histopathology (n = 412), and theory classes (n = 302). To keep up with the teaching-learning process, online platforms were mostly utilized: Zoom Meeting (n = 379), Google Meet (n = 287), and WhatsApp Interaction (n = 224). Teaching during ward rounds was significantly more affected in exclusively COVID institutes than non-exclusive COVID institutes (P < 0.001). Psychomotor skill development suffered a major jolt with 26.7% of respondents reporting a standstill (P < 0.001). Communication skills among students suffered due to social distancing, mask, and poor attendance of patients. According to 23.84% of respondents, formative assessment was discontinued. Conclusion Online seminars, journal clubs, and assessments have been incorporated during the pandemic. Online modalities should be used as a supplementary method as psychomotor skills, communication skills, research work, and bedside clinics may not be replaced by the e-learning.
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Affiliation(s)
- Amrita Sil
- Department of Pharmacology, Rampurhat Government Medical College and Hospital, Rampurhat, India
| | - Anupam Das
- Department of Dermatology, KPC Medical College and Hospital, Kolkata, West Bengal, India
| | - Aparesh C. Patra
- Department of Dermatology, NRS Medical College, Kolkata, West Bengal, India
| | - Rajesh Kumar
- Department of Dermatology, Grant Medical College, Mumbai, Maharashtra, India
| | - Deepika Pandhi
- Department of Dermatology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
| | - Dipankar De
- Department of Dermatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Kolalapudi Seetharam
- Department of Dermatology, GSL Medical College, Rajahmundry, Andhra Pradesh, India
| | - Neetu Bhari
- Department of Dermatology, AIIMS, New Delhi, Delhi, India
| | - Nidhi Gupta
- Department of Dermatology, RD Gardi Medical College, Ujjain, Madhya Pradesh, India
| | - Raghavendra Rao
- Department of Dermatology, Kasturba Medical College Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Asit Mittal
- Department of Dermatology, Rabindranath Tagore Institute of Medical Science, Udaipur, Rajasthan, India
| | - Santosh Rathore
- Department of Dermatology, Smt. NHL Municipal Medical College, Ahmedabad, Gujarat, India
| | - Shital Poojary
- Department of Dermatology, K. J. Somaiya Medical College, Mumbai, Maharashtra, India
| | - Shyamanta Barua
- Department of Dermatology, Assam Medical College and Hospital, Dibrugarh, Assam, India
| | - Soumya Jagadeesan
- Department of Dermatology, Amrita Institute of Medical Sciences, Kochi, Kerala, India
| | - Swosty Mohanty
- Department of Dermatology, Era’s Lucknow Medical College and Hospital, Lucknow, Uttar Pradesh, India
| | - Tanmay Padhi
- Department of Dermatology, VSS Institute of Medical Science and Research, Burla, Odisha, India
| | - Vikas Sankar
- Department of Dermatology, Patna Medical College and Hospital, Patna, Bihar, India
| | - Jaydev Betkerur
- Department of Dermatology, JSS Medical College and Hospital, Mysore, Karnataka, India
| | - Nilay K. Das
- Department of Dermatology, College of Medicine and Sagore Dutta Hospital, Kolkata, West Bengal, India
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Gupta N, Sharma S, Nigam A. Response: COVID-19 vaccine hesitancy among pregnant women attending tertiary care centre: A cross-sectional study. Int J Gynaecol Obstet 2023; 162:1126. [PMID: 37450288 DOI: 10.1002/ijgo.15002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/18/2023]
Affiliation(s)
- Nidhi Gupta
- Department of Obstetrics & Gynaecology, Hamdard Institute of Medical Science & Research and Hakeem Abdul Hameed Centenary Hospital, Jamia Hamdard, New Delhi, India
| | - Sumedha Sharma
- Department of Obstetrics & Gynaecology, Hamdard Institute of Medical Science & Research and Hakeem Abdul Hameed Centenary Hospital, Jamia Hamdard, New Delhi, India
| | - Aruna Nigam
- Department of Obstetrics & Gynaecology, Hamdard Institute of Medical Science & Research and Hakeem Abdul Hameed Centenary Hospital, Jamia Hamdard, New Delhi, India
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Chauhan AS, Sharma D, Mehndiratta A, Gupta N, Garg B, Kumar AP, Prinja S. Validating the rigour of adaptive methods of economic evaluation. BMJ Glob Health 2023; 8:e012277. [PMID: 37751935 PMCID: PMC10533726 DOI: 10.1136/bmjgh-2023-012277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Accepted: 08/29/2023] [Indexed: 09/28/2023] Open
Abstract
BACKGROUND There has been a lot of debate on how to 'generalise' or 'translate' findings of economic evaluation (EE) or health technology assessment (HTA) to other country contexts. Researchers have used various adaptive HTA (aHTA) methods like model-adaptation, price-benchmarking, scorecard-approach, etc., for transferring evidence from one country to other. This study was undertaken to assess the degree of accuracy in results generated from aHTA approaches specifically for EE. METHODS By applying selected aHTA approaches, we adapted findings of globally published EE to Indian context. The first-step required identifying two interventions for which Indian EE (referred to as the 'Indian reference study') has been conducted. The next-step involved identification of globally published EE. The third-step required undertaking quality and transferability check. In the fourth step, outcomes of EE meeting transferability standards, were adapted using selected aHTA approaches. Lastly, adapted results were compared with findings of the Indian reference study. RESULTS The adapted cost estimates varied considerably, while adapted quality-adjusted life-years did not differ much, when matched with the Indian reference study. For intervention I (trastuzumab), adapted absolute costs were 11 and 6 times higher than the costs reported in the Indian reference study for control and intervention arms, respectively. Likewise, adapted incremental cost and incremental cost-effectiveness ratio (ICER) were around 3.5-8 times higher than the values reported in the Indian reference study. For intervention II (intensity-modulated radiation therapy), adapted absolute cost was 35% and 12% lower for the comparator and intervention arms, respectively, than the values reported in the Indian reference study. The mean incremental cost and ICER were 2.5 times and 1.5 times higher, respectively, than the Indian reference study values. CONCLUSION We conclude that findings from aHTA methods should be interpreted with caution. There is a need to develop more robust aHTA approaches for cost adjustment. aHTA may be used for 'topic prioritisation' within the overall HTA process, whereby interventions which are highly cost-ineffective, can be directly ruled out, thus saving time and resources for conducting full HTA for interventions that are not well studied or where evidence is inconclusive.
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Affiliation(s)
- Akashdeep Singh Chauhan
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Deepshikha Sharma
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | | | - Nidhi Gupta
- Department of Radiation Oncology, Government Medical College and Hospital, Chandigarh, India
| | - Basant Garg
- National Health Authority, Ayushman Bharat PM-JAY, Government of India, New Delhi, India
| | - Amneet P Kumar
- Department of Women and Child Development, Government of Haryana, Panchkula, Haryana, India
| | - Shankar Prinja
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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Gupta N, Singh R, Gupta V, Jain DP, Das M. Identification of plastic rice in adulterated raw and cooked rice. Toxicol Mech Methods 2023; 33:584-589. [PMID: 37032459 DOI: 10.1080/15376516.2023.2197490] [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: 01/29/2023] [Revised: 03/24/2023] [Accepted: 03/25/2023] [Indexed: 04/11/2023]
Abstract
In the present study, attempts have been made to identify the presence of plastic rice in adulterated raw and cooked rice by comparing the compositional and morphological properties of fake rice and real rice using Fourier transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM) and thermogravimetric analysis (TGA) techniques. Various rice samples from the national capital region of India were studied for their compositional and morphological properties. The surface morphology of real rice and plastic rice was analyzed using scanning electron microscopy. Results suggest that plastic rice used as an adulterant in raw or cooked rice is made up of polystyrene, which is a well-known toxic chemical entity. The studies suggest that these techniques can be used as a scientific tool to detect and identify the presence of plastic rice in adulterated raw and cooked rice.
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Affiliation(s)
- Nidhi Gupta
- Shriram Institute for Industrial Research Delhi, Delhi, India
| | - Ruchi Singh
- Shriram Institute for Industrial Research Delhi, Delhi, India
| | - Vishal Gupta
- Shriram Institute for Industrial Research Delhi, Delhi, India
| | - Dharam Pal Jain
- Shriram Institute for Industrial Research Delhi, Delhi, India
| | - Mukul Das
- Shriram Institute for Industrial Research Delhi, Delhi, India
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Biswas B, Rana A, Gupta N, Gupta I, Puria R, Thakur A. A Novel Robust Method Mimicking Human Substratum To Dissect the Heterogeneity of Candida auris Biofilm Formation. Microbiol Spectr 2023; 11:e0089223. [PMID: 37439683 PMCID: PMC10434199 DOI: 10.1128/spectrum.00892-23] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 06/21/2023] [Indexed: 07/14/2023] Open
Abstract
Candida auris is a pathogen of urgent threat level as marked by the CDC. The formation of biofilms is an essential property of this fungus to establish infection and escape drug treatment. However, our understanding of pathogenesis through biofilm is hampered by heterogeneity in C. auris biofilms observed in different studies. It is imperative to replicate in vivo conditions for studying C. auris biofilm formation in vitro. Different methods are standardized, but the surface used to form biofilms lacks consistency as well as the architecture of a typical biofilm. Here, we report an in vitro technique to grow C. auris biofilms on gelatin-coated coverslips. Interestingly, C. auris cells grown on gelatin-coated coverslips either on modified synthetic sweat media or RPMI 1640 resulted in similar multilayer biofilm formation with extracellular polymeric substances (EPS). This method is also consistent with the biofilm formation of other Candida species, such as Candida glabrata and Candida albicans. Biofilms of C. glabrata developed through this method show pseudohyphae and EPS. This method can be used to understand the molecular basis of biofilm formation, associated pathogenesis, and drug tolerance. The technique is cost-effective and would thus serve in rightful screening and repurposing drug libraries for designing new therapeutics against the less-studied high-alarm pathogen C. auris. IMPORTANCE Heterogeneity is seen when multidrug-resistant C. auris biofilm is cultured using different reported methods. Biofilm formed on the gelatin surface mimics the condition of a host environment that has multilayers and EPS. This method has feasibility for drug screening and analyzing biofilms through three-dimensional (3D) reconstruction. This in vitro biofilm formation technique is also exploited to study the formation of biofilm of other Candida species. The biofilms of C. glabrata and C. albicans can also be correctly mimicked using gelatin in the biofilm-forming environment. Thus, the novel in vitro method for biofilm formation reported here can be widely used to understand the mechanism of biofilm formation, related virulence properties, and drug tolerance of C. auris and other Candida species. This simple and low-cost technique is highly suitable for screening novel inhibitors and repurposed libraries and to design new therapeutics against Candida species.
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Affiliation(s)
- Biswambhar Biswas
- Laboratory of Protein Translation and Fungal Pathogenesis, Regional Centre for Biotechnology, Faridabad, Haryana, India
| | - Aishwarya Rana
- Laboratory of Protein Translation and Fungal Pathogenesis, Regional Centre for Biotechnology, Faridabad, Haryana, India
| | - Nidhi Gupta
- Laboratory of Protein Translation and Fungal Pathogenesis, Regional Centre for Biotechnology, Faridabad, Haryana, India
| | - Ishaan Gupta
- Department of Biochemical Engineering and Biotechnology, Indian Institute of Technology Delhi, Delhi, India
| | - Rekha Puria
- School of Biotechnology, Gautam Buddha University, Greater Noida, Uttar Pradesh, India
| | - Anil Thakur
- Laboratory of Protein Translation and Fungal Pathogenesis, Regional Centre for Biotechnology, Faridabad, Haryana, India
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Gupta B, Ahluwalia P, Gupta N, Gupta A. Role of Nebulized Heparin in Clinical Outcome of COVID-19 Patients with Respiratory Symptoms: A Systematic Review. Indian J Crit Care Med 2023; 27:572-579. [PMID: 37636853 PMCID: PMC10452767 DOI: 10.5005/jp-journals-10071-24511] [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: 05/01/2023] [Accepted: 07/14/2023] [Indexed: 08/29/2023] Open
Abstract
Coronavirus disease-2019 (COVID-19) is an extremely contagious illness caused by the SARS-CoV-2 virus and has been declared a pandemic by the World Health Organization (WHO). There are currently no particular treatments, however, nebulized heparin has been offered as a viable therapy. The purpose of this systematic review is to assess the efficacy of nebulized heparin in COVID-19 patients with respiratory symptoms. Methods Relevant studies were identified through a systematic search of the PubMed, Medline, Embase, Cochrane Library and Web of Science, and Scopus databases. The search terms included "nebulized heparin," "COVID-19," and "SARS-CoV-2." Studies that evaluated the use of nebulized heparin in COVID-19 patients with respiratory symptoms were included. The rest of the studies along with those that were not published in English were excluded. The systematic review was registered under PROSPERO-CRD42023413927. Observations Five studies have been included in this systematic review. Case reports, case series, observational studies, and randomized controlled trial (RCT) comprised the studies. The patient sample sizes ranged from 2 to 98. The studies assessed the efficacy of nebulized heparin in COVID-19 patients with variable disease severity. The evaluated outcomes included mortality, hospital stay duration, oxygen requirements, and laboratory parameters. Conclusion Based on the clinical studies included in this systematic review, nebulized heparin may be useful in the management of COVID-19. Oxygen saturation was greater, inflammatory indicators were lower, and hospital stays were shorter in these patients. However, the studies had limitations, including inconsistent sample sizes, varying dosages of nebulized heparin, and no control groups. Nebulized heparin in patients with COVID-19 needs to be studied further to determine its safety and effectiveness. How to cite this article Gupta B, Ahluwalia P, Gupta N, Gupta A. Role of Nebulized Heparin in Clinical Outcome of COVID-19 Patients with Respiratory Symptoms: A Systematic Review. Indian J Crit Care Med 2023;27(8):572-579.
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Affiliation(s)
- Bhavna Gupta
- Department of Anaesthesia, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Pallavi Ahluwalia
- Department of Anaesthesia, Teerthanker Mahaveer Medical College, Moradabad, Uttar Pradesh, India
| | - Nidhi Gupta
- Department of Anesthesia and Critical Care, Doon Medical College, Dehradun, Uttarakhand, India
| | - Anish Gupta
- Department of CTVS, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
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Gupta N, Kumar H, Gupta S, S M B, Saini K. A Concise Review on Natural Products and Their Derivatives for Breast Cancer Treatment. Chem Biodivers 2023; 20:e202300688. [PMID: 37431959 DOI: 10.1002/cbdv.202300688] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 05/12/2023] [Revised: 07/10/2023] [Accepted: 07/11/2023] [Indexed: 07/12/2023]
Abstract
Cancer is a leading cause of death worldwide. Among other cancers, breast cancer has been found to produce maximum number of cases in 2020. Different factors including geographical, genetic, hormonal, oral contraceptives and modern lifestyle could be responsible for the development of breast cancer and different pathways can be targeted for breast cancer treatment. The various conventional approaches used for the treatment of breast cancer including radiotherapy, chemotherapy, hormone and immunotherapy. But due to the side effects associated with these conventional treatments such as non-selectivity, multidrug resistance and bioavailability, there is a need for the development of better therapeutic agents for breast cancer treatment. Several natural products have been explored for breast cancer treatment. However, many of these natural products suffered from the limitations of poor water solubility and possess toxic side effects. To overcome these limitations, several structural analogs of natural products have been synthesized and possess potent anti-breast cancer effects with less side effects over their precursor molecules. In the present manuscript, we describe the pathogenesis of breast cancer, some potent natural products used in the treatment of breast cancer and their selected structural analogs possessing potent anti-breast cancer effects. Database such as Science direct, Pubmed and Google scholar were searched using keywords 'risk factors', 'screening methods','receptors', and 'natural products and derivatives', Registered clinical trials on selected natural products were also analyzed. Present study concludes that eight selected natural products and their derivatives possess wide potential to exhibit anti-breast cancer effects and could be explored further to develop better chemotherapeutic agents against breast cancer.
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Affiliation(s)
- Nidhi Gupta
- M. M. College of Pharmacy, Maharishi Markandeshwar (Deemed to be University), Mullana, Ambala, Haryana, India, 133207
| | - Hitesh Kumar
- M. M. College of Pharmacy, Maharishi Markandeshwar (Deemed to be University), Mullana, Ambala, Haryana, India, 133207
| | - Sumeet Gupta
- M. M. College of Pharmacy, Maharishi Markandeshwar (Deemed to be University), Mullana, Ambala, Haryana, India, 133207
| | - Basavarajaiah S M
- PG Department of Chemistry, Vijaya College, RV Road, Bengaluru, 560004
| | - Kamal Saini
- M. M. College of Pharmacy, Maharishi Markandeshwar (Deemed to be University), Mullana, Ambala, Haryana, India, 133207
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Naik B, Gupta N, Godara P, Srivastava V, Kumar P, Giri R, Prajapati VK, Pandey KC, Prusty D. Structure-based virtual screening approach reveals natural multi-target compounds for the development of antimalarial drugs to combat drug resistance. J Biomol Struct Dyn 2023:1-25. [PMID: 37528665 DOI: 10.1080/07391102.2023.2240415] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/03/2023]
Abstract
Compared to the previous year, there has been an increase of nearly 2 million malaria cases in 2021. The emergence of drug-resistant strains of Plasmodium falciparum, the most deadly malaria parasite, has led to a decline in the effectiveness of existing antimalarial drugs. To address this problem, the present study aimed to identify natural compounds with the potential to inhibit multiple validated antimalarial drug targets. The natural compounds from the Natural Product Activity and Species Source (NPASS) database were screened against ten validated drug targets of Plasmodium falciparum using a structure-based molecular docking method. Twenty compounds, with targets ranging from three to five, were determined as the top hits. The molecular dynamics simulations of the top six complexes (NPC246162 in complex with PfAdSS, PfGDH, and PfNMT; NPC271270 in complex with PfCK, PfGDH, and PfdUTPase) confirmed their stable binding affinity in the dynamic environment. The Tanimoto coefficient and distance matrix score analysis show the structural divergence of all the hit compounds from known antimalarials, indicating minimum chances of cross-resistance. Thus, we propose further investigating these compounds in biochemical and parasite inhibition studies to reveal the real therapeutic potential. If found successful, these compounds may be a new avenue for future drug discovery efforts to combat existing antimalarial drug resistance.Communicated by Ramaswamy H. Sarma.
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Affiliation(s)
- Biswajit Naik
- Department of Biochemistry, School of Life Sciences, Central University of Rajasthan, Ajmer, India
| | - Nidhi Gupta
- Department of Biochemistry, School of Life Sciences, Central University of Rajasthan, Ajmer, India
| | - Priya Godara
- Department of Biochemistry, School of Life Sciences, Central University of Rajasthan, Ajmer, India
| | - Varshita Srivastava
- Department of Biochemistry, School of Life Sciences, Central University of Rajasthan, Ajmer, India
| | - Prateek Kumar
- School of Basic Sciences, Indian Institute of Technology Mandi, Kamand, India
| | - Rajanish Giri
- School of Basic Sciences, Indian Institute of Technology Mandi, Kamand, India
| | - Vijay Kumar Prajapati
- Department of Biochemistry, School of Life Sciences, Central University of Rajasthan, Ajmer, India
| | - Kailash C Pandey
- Icmr-National Institute of Malaria Research, And Academy of Scientific and Innovative Research (AcSIR-ICMR), India
| | - Dhaneswar Prusty
- Department of Biochemistry, School of Life Sciences, Central University of Rajasthan, Ajmer, India
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Panwar V, Gupta N, Bhoriwal SK. Left main bronchus completely occluded by tumour fragment following right pneumonectomy. Anaesth Rep 2023; 11:e12261. [PMID: 38028659 PMCID: PMC10680573 DOI: 10.1002/anr3.12261] [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] [Accepted: 11/02/2023] [Indexed: 12/01/2023] Open
Affiliation(s)
- V. Panwar
- Department of Onco‐Anaesthesia and Palliative MedicineDr. B.R.A. Institute‐Rotary Cancer Hospital, All India Institute of Medical SciencesNew DelhiIndia
| | - N. Gupta
- Department of Onco‐Anaesthesia and Palliative MedicineDr. B.R.A. Institute‐Rotary Cancer Hospital, All India Institute of Medical SciencesNew DelhiIndia
| | - S. K. Bhoriwal
- Department of Surgical OncologyDr. B.R.A. Institute‐Rotary Cancer Hospital, All India Institute of Medical SciencesNew DelhiIndia
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van Riel L, van Hulst RA, van Hest L, van Moorselaar RJA, Boerrigter BG, Franken SM, Wolthuis RMF, Dubbink HJ, Marciniak SJ, Gupta N, van de Beek I, Houweling AC. Recommendations on scuba diving in Birt-Hogg-Dubé syndrome. Expert Rev Respir Med 2023; 17:1003-1008. [PMID: 37991821 PMCID: PMC10763569 DOI: 10.1080/17476348.2023.2284375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 11/10/2023] [Indexed: 11/23/2023]
Abstract
INTRODUCTION Although very uncommon, severe injury and death can occur during scuba diving. One of the main causes of scuba diving fatalities is pulmonary barotrauma due to significant changes in ambient pressure. Pathology of the lung parenchyma, such as cystic lesions, might increase the risk of pulmonary barotrauma. AREAS COVERED Birt-Hogg-Dubé syndrome (BHD), caused by pathogenic variants in the FLCN gene, is characterized by skin fibrofolliculomas, an increased risk of renal cell carcinoma, multiple lung cysts and spontaneous pneumothorax. Given the pulmonary involvement, in some countries patients with BHD are generally recommended to avoid scuba diving, although evidence-based guidelines are lacking. We aim to provide recommendations on scuba diving for patients with BHD, based on a survey of literature on pulmonary cysts and pulmonary barotrauma in scuba diving. EXPERT OPINION In our opinion, although the absolute risks are likely to be low, caution is warranted. Given the relative paucity of literature and the potential fatal outcome, patients with BHD with a strong desire for scuba diving should be informed of the potential risks in a personal assessment. If available a diving physician should be consulted, and a low radiation dose chest computed tomography (CT)-scan to assess pulmonary lesions could be considered.
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Affiliation(s)
- L. van Riel
- Department of Human Genetics, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
- Department of Human Genetics, Amsterdam UMC, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam, Netherlands
| | - RA. van Hulst
- Department of Hyperbaric Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - L. van Hest
- Department of Human Genetics, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - RJA. van Moorselaar
- Department of Urology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - BG. Boerrigter
- Department of Pulmonary Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - SM. Franken
- Department of Dermatology, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - RMF. Wolthuis
- Department of Human Genetics, Amsterdam UMC, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam, Netherlands
| | - HJ. Dubbink
- Department of Pathology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - SJ. Marciniak
- Cambridge Institute for Medical Research, Cambridge Biomedical Campus, University of Cambridge, Cambridge, UK
- Royal Papworth Hospital, Trumpington, Cambridge, UK
| | - N. Gupta
- Division of Pulmonary, Critical Care and Sleep Medicine, University of Cincinnati, Cincinnati, Ohio, USA
| | - I. van de Beek
- Family Cancer Clinic, Netherlands Cancer Institute, Amsterdam, Netherlands
| | - AC. Houweling
- Department of Human Genetics, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
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Sudhakar S, Gupta N, Ghambir N, Singh R, Singh D. Comparative Evaluation of Intracanal Smear Layer Removal by Different Root Canal Irrigants: A Scanning Electron Microscope Study. Int J Clin Pediatr Dent 2023; 16:633-638. [PMID: 37731794 PMCID: PMC10507302 DOI: 10.5005/jp-journals-10005-2648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/22/2023] Open
Abstract
Aim The purpose of the study is to compare and evaluate the efficacy of different root canal irrigants-100, 75, 50, and 25% neem extract, 100, 75, 50, and 25% apple cider vinegar (ACV), a combination of 5.25% sodium hypochlorite (NaOCl) and 17% ethylenediaminetetraacetic acid (EDTA), and saline on smear layer removal using a scanning electron microscope (SEM). Materials and methods A total of 80 freshly extracted single-rooted teeth were collected and divided into 10 groups-group I: normal saline (negative control), group II: NaOCl with EDTA (positive control), group III: 100% neem extract, group IV: 75% neem extract, group V: 50% neem extract, group VI: 25% neem extract, group VII: 100% ACV, group VIII: 75% ACV, group IX: 50% ACV, and group X: 25% ACV. The samples were irrigated with a specific group of irrigants, then split in a longitudinal axis and processed for analysis in an SEM. Microphotographs were obtained and scored according to Torabinejad et al. Results Microphotographs were assessed and showed that 100% neem extract was similar to NaOCl with EDTA, followed by 75% neem extract and 100% ACV. Conclusion This study showed that 100% neem extract removed the smear layer, similar to the NaOCl with EDTA. How to cite this article Sudhakar S, Gupta N, Ghambir N, et al. Comparative Evaluation of Intracanal Smear Layer Removal by Different Root Canal Irrigants: A Scanning Electron Microscope Study. Int J Clin Pediatr Dent 2023;16(4):633-638.
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Affiliation(s)
- S Sudhakar
- Department of Pediatric and Preventive Dentistry, Santosh Dental College, Santosh (Deemed to be University), Ghaziabad, Uttar Pradesh, India
| | - Nidhi Gupta
- Department of Pediatric and Preventive Dentistry, Santosh Dental College, Santosh (Deemed to be University), Ghaziabad, Uttar Pradesh, India
| | - Natasha Ghambir
- Department of Pediatric and Preventive Dentistry, Santosh Dental College, Santosh (Deemed to be University), Ghaziabad, Uttar Pradesh, India
| | - Rashi Singh
- Department of Pediatric and Preventive Dentistry, Santosh Dental College, Santosh (Deemed to be University), Ghaziabad, Uttar Pradesh, India
| | - Divya Singh
- Department of Pediatric and Preventive Dentistry, Santosh Dental College, Santosh (Deemed to be University), Ghaziabad, Uttar Pradesh, India
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Gupta N, Sharma S, Nigam A, Panasar S, Kumar S. COVID-19 vaccine hesitancy among pregnant women attending tertiary care centre: A cross-sectional study. Int J Gynaecol Obstet 2023; 162:70-77. [PMID: 37078596 DOI: 10.1002/ijgo.14794] [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: 07/16/2022] [Revised: 01/05/2023] [Accepted: 03/30/2023] [Indexed: 04/21/2023]
Abstract
OBJECTIVE To evaluate the knowledge and attitude towards coronavirus disease 2019 (COVID-19) vaccination during pregnancy and to discover factors that lead to non-acceptance of vaccine. METHODS A cross-sectional study was performed in the Department of Obstetrics and Gynecology, Hamdard Institute of Medical Science & Research, New Delhi over a period of 3 months through a web-based questionnaire via Google form. The questionnaire was assessed using Cronbach α for internal consistency, which was 0.795. RESULTS News (74%) was the major source of knowledge among pregnant women. Around 60% women were not willing to receive the vaccine, mainly because of their fear of a harmful effect on pregnancy. The anticipated vaccine acceptance rate was 41% but actual vaccine acceptance rate in pregnancy was 7.3%. CONCLUSION Efforts should be made to reduce the gap of knowledge regarding vaccine among pregnant women.
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Affiliation(s)
- Nidhi Gupta
- Department of Obstetrics & Gynaecology, Hamdard Institute of Medical Science & Research and Hakeem Abdul Hameed Centenary Hospital, New Delhi, India
| | - Sumedha Sharma
- Department of Obstetrics & Gynaecology, Hamdard Institute of Medical Science & Research and Hakeem Abdul Hameed Centenary Hospital, New Delhi, India
| | - Aruna Nigam
- Department of Obstetrics & Gynaecology, Hamdard Institute of Medical Science & Research and Hakeem Abdul Hameed Centenary Hospital, New Delhi, India
| | - Sanjeet Panasar
- Department of Community Medicine, ABVIMS & RML Hospital, New Delhi, India
| | - Siddharth Kumar
- Hamdard Institute of Medical Science & Research, Hakeem Abdul Hameed Centenary Hospital, New Delhi, India
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George E, MacPherson C, Pruthi S, Bilaniuk L, Fletcher J, Houtrow A, Gupta N, Glenn OA. Long-Term Imaging Follow-up from the Management of Myelomeningocele Study. AJNR Am J Neuroradiol 2023:ajnr.A7926. [PMID: 37385677 PMCID: PMC10337608 DOI: 10.3174/ajnr.a7926] [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: 04/18/2023] [Accepted: 05/23/2023] [Indexed: 07/01/2023]
Abstract
BACKGROUND AND PURPOSE Short-term results demonstrate that prenatal repair of a myelomeningocele is associated with a reduction in hydrocephalus and an increased likelihood of the reversal of Chiari II malformations compared with postnatal repair. The purpose of this study was to identify the long-term imaging findings at school age among subjects who underwent pre- versus postnatal repair of a myelomeningocele. MATERIALS AND METHODS A subset of subjects enrolled in the Management of Myelomeningocele Study who underwent either prenatal (n = 66) or postnatal (n = 63) repair of a lumbosacral myelomeningocele and had follow-up brain MR imaging at school age were included. The prevalence of posterior fossa features of Chiari II malformation and supratentorial abnormalities and the change in these findings from fetal to school-age MR imaging were compared between the 2 groups. RESULTS Prenatal repair of a myelomeningocele was associated with higher rates of normal location of fourth ventricle and lower rates of hindbrain herniation, cerebellar herniation, tectal beaking, brainstem distortion, and kinking at school age compared with postnatal repair (all P < .01). Supratentorial abnormalities, including corpus callosal abnormalities, gyral abnormalities, heterotopia, and hemorrhage, were not significantly different between the 2 groups (all P > .05). The rates of resolution of brainstem kinking, tectal beaking, cerebellar and hindbrain herniation, and normalization of fourth ventricle size from fetal to school age MR imaging were higher among the prenatal compared with postnatal surgery group (all, P < .02). CONCLUSIONS Prenatal repair of a myelomeningocele is associated with persistent improvement in posterior fossa imaging findings of Chiari II malformation at school age compared with postnatal repair.
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Affiliation(s)
- E George
- From the Departments of Radiology and Biomedical Imaging (E.G., O.A.G.)
| | - C MacPherson
- Biostatistics Center (C.M.), Milken Institute School of Public Health, The George Washington University, Washington, DC
| | - S Pruthi
- Department of Radiology (S.P.), Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, Tennessee
| | - L Bilaniuk
- Department of Radiology (L.B.), Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - J Fletcher
- Department of Psychology (J.F.), University of Houston, Houston, Texas
| | - A Houtrow
- Department of Physical Medicine and Rehabilitation (A.H.), University of Pittsburgh, Pittsburgh, Pennsylvania
| | - N Gupta
- Neurological Surgery (N.G.)
- Pediatrics (N.G.), University of California, San Francisco, San Francisco, California
| | - O A Glenn
- From the Departments of Radiology and Biomedical Imaging (E.G., O.A.G.)
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Prinja S, Dixit J, Gupta N, Dhankhar A, Kataki AC, Roy PS, Mehra N, Kumar L, Singh A, Malhotra P, Goyal A, Rajsekar K, Krishnamurthy MN, Gupta S. Financial toxicity of cancer treatment in India: towards closing the cancer care gap. Front Public Health 2023; 11:1065737. [PMID: 37404274 PMCID: PMC10316647 DOI: 10.3389/fpubh.2023.1065737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 04/18/2023] [Indexed: 07/06/2023] Open
Abstract
Background The rising economic burden of cancer on patients is an important determinant of access to treatment initiation and adherence in India. Several publicly financed health insurance (PFHI) schemes have been launched in India, with treatment for cancer as an explicit inclusion in the health benefit packages (HBPs). Although, financial toxicity is widely acknowledged to be a potential consequence of costly cancer treatment, little is known about its prevalence and determinants among the Indian population. There is a need to determine the optimal strategy for clinicians and cancer care centers to address the issue of high costs of care in order to minimize the financial toxicity, promote access to high value care and reduce health disparities. Methods A total of 12,148 cancer patients were recruited at seven purposively selected cancer centres in India, to assess the out-of-pocket expenditure (OOPE) and financial toxicity among cancer patients. Mean OOPE incurred for outpatient treatment and hospitalization, was estimated by cancer site, stage, type of treatment and socio-demographic characteristics. Economic impact of cancer care on household financial risk protection was assessed using standard indicators of catastrophic health expenditures (CHE) and impoverishment, along with the determinants using logistic regression. Results Mean direct OOPE per outpatient consultation and per episode of hospitalization was estimated as ₹8,053 (US$ 101) and ₹39,085 (US$ 492) respectively. Per patient annual direct OOPE incurred on cancer treatment was estimated as ₹331,177 (US$ 4,171). Diagnostics (36.4%) and medicines (45%) are major contributors of OOPE for outpatient treatment and hospitalization, respectively. The overall prevalence of CHE and impoverishment was higher among patients seeking outpatient treatment (80.4% and 67%, respectively) than hospitalization (29.8% and 17.2%, respectively). The odds of incurring CHE was 7.4 times higher among poorer patients [Adjusted Odds Ratio (AOR): 7.414] than richest. Enrolment in PM-JAY (CHE AOR = 0.426, and impoverishment AOR = 0.395) or a state sponsored scheme (CHE AOR = 0.304 and impoverishment AOR = 0.371) resulted in a significant reduction in CHE and impoverishment for an episode of hospitalization. The prevalence of CHE and impoverishment was significantly higher with hospitalization in private hospitals and longer duration of hospital stay (p < 0.001). The extent of CHE and impoverishment due to direct costs incurred on outpatient treatment increased from 83% to 99.7% and, 63.9% to 97.1% after considering both direct and indirect costs borne by the patient and caregivers, respectively. In case of hospitalization, the extent of CHE increased from 23.6% (direct cost) to 59.4% (direct+ indirect costs) and impoverishment increased from 14.1% (direct cost) to 27% due to both direct and indirect cost of cancer treatment. Conclusion There is high economic burden on patients and their families due to cancer treatment. The increase in population and cancer services coverage of PFHI schemes, creating prepayment mechanisms like E-RUPI for outpatient diagnostic and staging services, and strengthening public hospitals can potentially reduce the financial burden among cancer patients in India. The disaggregated OOPE estimates could be useful input for future health technology analyses to determine cost-effective treatment strategies.
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Affiliation(s)
- Shankar Prinja
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Jyoti Dixit
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Nidhi Gupta
- Department of Radiation Oncology, Government Medical College and Hospital, Chandigarh, India
| | - Anushikha Dhankhar
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | | | | | - Nikita Mehra
- Department of Medical Oncology, Adyar Cancer Institute, Chennai, India
| | - Lalit Kumar
- Department of Medical Oncology, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Ashish Singh
- Department of Medical Oncology, Christian Medical College, Vellore, India
| | - Pankaj Malhotra
- Department of Clinical Hematology and Medical Oncology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Aarti Goyal
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Kavitha Rajsekar
- Department of Health Research, Ministry of Health and Family Welfare, New Delhi, India
| | | | - Sudeep Gupta
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, India
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Rathore A, Gupta N, Kahn C, Kadariya D. Euglycemic diabetic ketoacidosis caused by empagliflozin complicated by failure to thrive in a geriatric patient. Arch Clin Cases 2023; 10:89-92. [PMID: 37313125 PMCID: PMC10258732 DOI: 10.22551/2023.39.1002.10248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023] Open
Abstract
Euglycemic diabetic ketoacidosis (euDKA) is a rare but deadly complication of sodium-glucose cotransport-2 (SGLT-2) inhibitors. Primarily indicated for the treatment of Type 2 Diabetes Mellitus, the incidence of euDKA is expected to rise as SGLT-2 inhibitors become a mainstay therapy for diabetics with heart failure. Diagnosis of euDKA can be difficult given the presence of normoglycemia and is especially challenging among geriatric patients that are complicated by additional comorbidities. We present a case of an elderly male with multiple comorbidities who presented for dehydration and altered mentation from a nursing home facility. Laboratory investigations showed signs of acute renal failure, uremia, electrolyte abnormalities, and severe metabolic acidosis due to high levels of plasma beta-hydroxybutyrate. He was admitted to the medical intensive care unit (ICU) for further management. A presumptive diagnosis of euDKA was strongly suspected due to his laboratory data and medication reconciliation which revealed the recent initiation of empagliflozin. The patient was promptly started on a standardized treatment protocol for DKA with continuous infusion of regular insulin with strict glucose monitoring, along with intravenous fluids, and a small dose of sodium bicarbonate infusion as per current standard guidelines. With the rapid improvement in symptoms and metabolic derangements, the diagnosis was confirmed. Geriatric patients from nursing home facilities are a high-risk cohort who if not properly cared for by nursing staff can develop dehydration, malnutrition and worsening frailty including sarcopenia that exposes them to increased risk of medication side effects, such as euDKA. Clinicians should consider euDKA in their differential diagnosis in elderly patients with overt or relative insulinopenia who are receiving SGLT-2 inhibitors when presenting with acute changes in health and mentation.
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Affiliation(s)
- Azeem Rathore
- Department of Medicine, University of Florida College of Medicine, Jacksonville FL, USA
| | - Nidhi Gupta
- Department of Medicine, Division of Endocrinology, University of Florida College of Medicine, Jacksonville FL, USA
| | - Cameron Kahn
- Department of Medicine, University of Florida College of Medicine, Jacksonville FL, USA
| | - Dinesh Kadariya
- Department of Medicine, Division of Cardiology, University of Florida College of Medicine, Jacksonville FL, USA
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Alaqil AI, Gupta N, Alothman SA, Al-Hazzaa HM, Stamatakis E, Del Pozo Cruz B. Arabic translation and cultural adaptation of sedentary behavior, dietary habits, and preclinical mobility limitation questionnaires: A cognitive interview study. PLoS One 2023; 18:e0286375. [PMID: 37307255 DOI: 10.1371/journal.pone.0286375] [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: 12/12/2022] [Accepted: 05/15/2023] [Indexed: 06/14/2023] Open
Abstract
BACKGROUND Developing global evidence on the influence of health-related behaviors (e.g., sedentary behavior, diet) and mobility limitations on health requires global consortia from diverse sets of countries. Thus, the purpose was to translate and culturally adapt (i) the Sedentary Behavior Questionnaire (SBQ); (ii) the Dietary Habits Questionnaire adapted from the Survey of Health, Aging and Retirement in Europe (SHARE) study; (iii) the Preclinical Mobility Limitation questionnaire for use in the Saudi Arabian context. METHOD 50 adult Saudi participants (mean age 41.7±9.6, 48% female) participated in this study. We followed a systematic cross-cultural adaptation process that involved forward translation, synthesis, back-translation, expert panel, and pre-testing (cognitive interviewing). Four rounds of cognitive interviews were held with 40 participants for the SBQ, SHARE questionnaire, and the Preclinical Mobility Limitation questionnaire, an additional round was needed for the Preclinical Mobility Limitation questionnaire. Descriptive data (means ± standard deviations and frequencies with percentages) were reported for characteristics. RESULT With some minor changes to the questionnaires, the SBQ, Dietary Habits, and Preclinical Mobility Limitation questionnaires were translated and cross-culturally adapted into Arabic. 100% of the participants confirmed that the resulting Arabic versions of the SBQ, Dietary Habits questionnaire, and Preclinical Mobility Limitation questionnaires were appropriate and fully understandable for Arabic speakers in communicating the intended meanings of the items in each. For example, item SBQ1, 'Watching television (including videos on VCR/DVD)' was changed to 'Sitting and watching television or videos (including smartphones, tablets)'. CONCLUSION The SBQ, Dietary Habits questionnaire, and Preclinical Mobility Limitation questionnaire were successfully cross-culturally adapted into Arabic and are now ready for use in Saudi Arabian.
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Affiliation(s)
- Abdulrahman I Alaqil
- Department of Physical Education, College of Education, King Faisal University, Al-Ahsa, Saudi Arabia
- Center for Active and Healthy Ageing (CAHA), Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
- Department of Musculoskeletal Disorders and Physical Workload, National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Nidhi Gupta
- Department of Musculoskeletal Disorders and Physical Workload, National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Shaima A Alothman
- Lifestyle and Health Research Center, Health Sciences Research Center, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Hazzaa M Al-Hazzaa
- Lifestyle and Health Research Center, Health Sciences Research Center, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Emmanuel Stamatakis
- Charles Perkins Centre, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
| | - Borja Del Pozo Cruz
- Center for Active and Healthy Ageing (CAHA), Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
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Christensen MR, Nabe-Nielsen K, Holtermann A, Gupta N. Does it matter for health if steps are taken during work or leisure? A prospective accelerometer study using register-based long-term sickness absence. Int J Behav Nutr Phys Act 2023; 20:69. [PMID: 37296445 DOI: 10.1186/s12966-023-01468-4] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 05/18/2023] [Indexed: 06/12/2023] Open
Abstract
BACKGROUND Walking is known to be good for health. However, it is unknown whether it matters if steps are taken during work or leisure. Therefore, we aimed to examine the prospective association between accelerometer-measured steps taken during work or leisure and register-based long-term sickness absence (LTSA). METHODS We included 937 blue- and white-collar workers from the PODESA cohort who wore a thigh-based accelerometer over four days to measure number of steps during work and leisure. Steps were divided into domain based on diary data. First event of LTSA was retrieved from a national register with four years' follow-up. We used Cox proportional hazard models to analyze the association between domain-specific and total daily steps and LTSA, adjusted for age, sex, job type, smoking, and steps in the other domain (e.g., work/leisure). RESULTS We found more steps at work to be associated with a higher LTSA risk [Hazard Ratio (HR):1.04; 95% CI: 1.00-1.08 per 1000 steps]. No significant association was found between steps during leisure and LTSA (HR: 0.97; 95% CI: 0.91-1.02), nor between total daily steps and LTSA (HR: 1.01; CI 95% 0.99-1.04). CONCLUSIONS More steps at work were associated with higher risk of LTSA, while steps during leisure was not clearly associated with LTSA risk. These findings partly support 'the physical activity paradox' stating that the association between physical activity and health depends on the domain.
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Affiliation(s)
- Marie Raunkjær Christensen
- The National Research Centre for the Working Environment, Lersø Parkallé 105, Copenhagen Ø, 2100, Denmark.
| | - Kirsten Nabe-Nielsen
- The National Research Centre for the Working Environment, Lersø Parkallé 105, Copenhagen Ø, 2100, Denmark
- Department of Public Health, Section of Social Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Andreas Holtermann
- The National Research Centre for the Working Environment, Lersø Parkallé 105, Copenhagen Ø, 2100, Denmark
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Nidhi Gupta
- The National Research Centre for the Working Environment, Lersø Parkallé 105, Copenhagen Ø, 2100, Denmark
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Nehra P, Chauhan AS, Malhotra P, Kumar L, Singh A, Gupta N, Mehra N, Mathew A, Kataki AC, Gupta S, Prinja S. Cost-effectiveness analysis of different combination therapies for the treatment of chronic lymphocytic leukaemia in India. Lancet Reg Health Southeast Asia 2023; 13:100201. [PMID: 37383548 PMCID: PMC10305972 DOI: 10.1016/j.lansea.2023.100201] [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] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 11/24/2022] [Accepted: 04/10/2023] [Indexed: 06/30/2023]
Abstract
Background Over the years, there has been introduction of newer drugs, like bendamustine and ibrutinib, for the management of chronic lymphocytic leukaemia (CLL). Though these drugs lead to better survival, they are also associated with higher cost. The existing evidence on cost effectiveness of these drugs is from high-income countries, which has limited generalisability for low-income and middle-income counties. Therefore, the present study was undertaken to assess the cost-effectiveness of three therapeutic regimens, chlorambucil plus prednisolone (CP), bendamustine plus rituximab (BR) and ibrutinib for CLL treatment in India. Methods A Markov model was developed for estimating lifetime costs and consequences in a hypothetical cohort of 1000 CLL patients following treatment with different therapeutic regimens. The analysis was performed based on a limited societal perspective, 3% discount rate and lifetime horizon. The clinical effectiveness of each regime in the form of progression-free survival and occurrence of adverse events were assessed from various randomised controlled trials. A structured comprehensive review of literature was undertaken for the identification of relevant trials. The data on utility values and out of pocket expenditure was obtained from primary data collected from 242 CLL patients across six large cancer hospitals in India. Findings As compared to the most affordable regimen comprising of CP as first-line followed by BR as second-line therapy, none of the other therapeutic regimens were cost-effective at one time per capita gross-domestic product of India. However, if the current price of either combination of BR and ibrutinib or even ibrutinib alone could be reduced by more than 80%, regimen comprising of BR as first-line therapy followed by second-line ibrutinib would become cost-effective. Interpretation At the current market prices, regimen comprising of CP as first-line followed by BR as second-line therapy is the most cost-effective strategy for CLL treatment in India. Funding Department of Health Research, Government of India.
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Affiliation(s)
- Prerika Nehra
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Akashdeep Singh Chauhan
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Pankaj Malhotra
- Department of Clinical Haematology and Medical Oncology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Lalit Kumar
- Department of Medical Oncology, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Ashish Singh
- Department of Medical Oncology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Nidhi Gupta
- Department of Radiation Oncology, Government Medical College and Hospital, Chandigarh, India
| | - Nikita Mehra
- Department of Medical Oncology, Adyar Cancer Institute, Chennai, Tamil Nadu, India
| | - Anisha Mathew
- Department of Medical Oncology, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Amal Chandra Kataki
- Department of Gynaecologic Oncology, Dr. B. Booroah Cancer Institute, Guwahati, Assam, India
| | - Sudeep Gupta
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, Maharashtra, India
| | - Shankar Prinja
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
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Gupta N, Kumar A, Verma VK. Strategies adopted by gastric pathogen Helicobacter pylori for a mature biofilm formation: Antimicrobial peptides as a visionary treatment. Microbiol Res 2023; 273:127417. [PMID: 37267815 DOI: 10.1016/j.micres.2023.127417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 05/15/2023] [Accepted: 05/21/2023] [Indexed: 06/04/2023]
Abstract
Enormous efforts in recent past two decades to eradicate the pathogen that has been prevalent in half of the world's population have been problematic. The biofilm formed by Helicobacter pylori provides resistance towards innate immune cells, various combinatorial antibiotics, and human antimicrobial peptides, despite the fact that these all are potent enough to eradicate it in vitro. Biofilm provides the opportunity to secrete various virulence factors that strengthen the interaction between host and pathogen helping in evading the innate immune system and ultimately leading to persistence. To our knowledge, this review is the first of its kind to explain briefly the journey of H. pylori starting with the chemotaxis, the mechanism for selecting the site for colonization, the stress faced by the pathogen, and various adaptations to evade these stress conditions by forming biofilm and the morphological changes acquired by the pathogen in mature biofilm. Furthermore, we have explained the human GI tract antimicrobial peptides and the reason behind the failure of these AMPs, and how encapsulation of Pexiganan-A(MSI-78A) in a chitosan microsphere increases the efficiency of eradication.
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Affiliation(s)
- Nidhi Gupta
- Department of Microbiology, University of Delhi South Campus, Benito Juarez Marg, New Delhi 110021, India.
| | - Atul Kumar
- Department of Microbiology, University of Delhi South Campus, Benito Juarez Marg, New Delhi 110021, India
| | - Vijay Kumar Verma
- Department of Microbiology, University of Delhi South Campus, Benito Juarez Marg, New Delhi 110021, India.
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Ansari S, Gupta N, Verma R, Singh ON, Gupta J, Kumar A, Yadav MK, Binayke A, Tiwari M, Periwal N, Sood V, Mani S, Awasthi A, Shalimar, Nayak B, Ranjith‐Kumar CT, Surjit M. Antiviral activity of the human endogenous retrovirus‐R envelope protein against SARS‐CoV‐2. EMBO Rep 2023; 24:e55900. [PMCID: PMC10328075 DOI: 10.15252/embr.202255900] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 03/31/2023] [Accepted: 04/26/2023] [Indexed: 09/29/2023] Open
Abstract
Coronavirus‐induced disease‐19 (COVID‐19), caused by SARS‐CoV‐2, is still a major global health challenge. Human endogenous retroviruses (HERVs) represent retroviral elements that were integrated into the ancestral human genome. HERVs are important in embryonic development as well as in the manifestation of diseases, including cancer, inflammation, and viral infections. Here, we analyze the expression of several HERVs in SARS‐CoV‐2‐infected cells and observe increased activity of HERV‐E, HERV‐V, HERV‐FRD, HERV‐MER34, HERV‐W, and HERV‐K‐HML2. In contrast, the HERV‐R envelope is downregulated in cell‐based models and PBMCs of COVID‐19 patients. Overexpression of HERV‐R inhibits SARS‐CoV‐2 replication, suggesting its antiviral activity. Further analyses demonstrate the role of the extracellular signal‐regulated kinase (ERK) in regulating HERV‐R antiviral activity. Lastly, our data indicate that the crosstalk between ERK and p38 MAPK controls the synthesis of the HERV‐R envelope protein, which in turn modulates SARS‐CoV‐2 replication. These findings suggest the role of the HERV‐R envelope as a prosurvival host factor against SARS‐CoV‐2 and illustrate a possible advantage of integration and evolutionary maintenance of retroviral elements in the human genome.
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Affiliation(s)
- Shabnam Ansari
- Virology LaboratoryTranslational Health Science and Technology Institute, NCR Biotech Science ClusterFaridabadIndia
| | - Nidhi Gupta
- Virology LaboratoryTranslational Health Science and Technology Institute, NCR Biotech Science ClusterFaridabadIndia
- Present address:
Department of BiochemistryAll India Institute of Medical SciencesNew DelhiIndia
| | - Rohit Verma
- Virology LaboratoryTranslational Health Science and Technology Institute, NCR Biotech Science ClusterFaridabadIndia
| | - Oinam N Singh
- Virology LaboratoryTranslational Health Science and Technology Institute, NCR Biotech Science ClusterFaridabadIndia
| | - Jyoti Gupta
- Virology LaboratoryTranslational Health Science and Technology Institute, NCR Biotech Science ClusterFaridabadIndia
| | - Amit Kumar
- Virology LaboratoryTranslational Health Science and Technology Institute, NCR Biotech Science ClusterFaridabadIndia
| | - Mukesh Kumar Yadav
- Virology LaboratoryTranslational Health Science and Technology Institute, NCR Biotech Science ClusterFaridabadIndia
| | - Akshay Binayke
- Immunobiology LaboratoryTranslational Health Science and Technology Institute, NCR Biotech Science ClusterFaridabadIndia
| | - Mahima Tiwari
- Translational Health Science and Technology Institute, NCR Biotech Science ClusterFaridabadIndia
| | - Neha Periwal
- Department of Biochemistry, School of Chemical and Life SciencesJamia Hamdard UniversityNew DelhiIndia
| | - Vikas Sood
- Department of Biochemistry, School of Chemical and Life SciencesJamia Hamdard UniversityNew DelhiIndia
| | - Shailendra Mani
- Translational Health Science and Technology Institute, NCR Biotech Science ClusterFaridabadIndia
| | - Amit Awasthi
- Immunobiology LaboratoryTranslational Health Science and Technology Institute, NCR Biotech Science ClusterFaridabadIndia
| | - Shalimar
- Department of GastroenterologyAll India Institute of Medical SciencesNew DelhiIndia
| | - Baibaswata Nayak
- Department of GastroenterologyAll India Institute of Medical SciencesNew DelhiIndia
| | - CT Ranjith‐Kumar
- University School of Biotechnology, Guru Gobind Singh Indraprastha UniversityNew DelhiIndia
| | - Milan Surjit
- Virology LaboratoryTranslational Health Science and Technology Institute, NCR Biotech Science ClusterFaridabadIndia
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