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Kansara S, Sawant P, Kaur T, Garg M, Pandey AK. LncRNA-mediated orchestrations of alternative splicing in the landscape of breast cancer. Biochim Biophys Acta Gene Regul Mech 2024; 1867:195017. [PMID: 38341138 DOI: 10.1016/j.bbagrm.2024.195017] [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] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 01/19/2024] [Accepted: 02/03/2024] [Indexed: 02/12/2024]
Abstract
Alternative splicing (AS) is a fundamental post-transcriptional process in eukaryotes, enabling a single gene to generate diverse mRNA transcripts, thereby enhancing protein variability. This process involves the excision of introns and the joining of exons in pre-mRNA(s) to form mature mRNA. The resulting mature mRNAs exhibit various combinations of exons, contributing to functional diversity. Dysregulation of AS can substantially modulate protein functions, impacting the onset and progression of numerous diseases, including cancer. Non-coding RNAs (ncRNAs) are distinct from protein-coding RNAs and consist of short and long types. Long non-coding RNAs (lncRNAs) play an important role in regulating several cellular processes, particularly alternative splicing, according to new research. This review provides insight into the latest discoveries concerning how lncRNAs influence alternative splicing within the realm of breast cancer. Additionally, it explores potential therapeutic strategies focused on targeting lncRNAs.
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Affiliation(s)
- Samarth Kansara
- Amity Institute of Biotechnology, Amity University Haryana, Panchgaon, Manesar, Haryana 122413, India
| | - Prajwali Sawant
- Amity Institute of Biotechnology, Amity University Haryana, Panchgaon, Manesar, Haryana 122413, India
| | - Taranjeet Kaur
- Department of Biotechnology, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, Gandhinagar, 382355, Gujarat, India
| | - Manoj Garg
- Amity Institute of Molecular Medicine and Stem Cell Research (AIMMSCR), Amity University, Uttar Pradesh, Sector-125, Noida 201313, India
| | - Amit Kumar Pandey
- Department of Biotechnology, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, Gandhinagar, 382355, Gujarat, India.
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Gorivale M, Sawant P, Kargutkar N, Hariharan P, Thaker P, Chiddarwar A, Nadkarni A. When a synonymous mutation breaks the silence in a thalassaemia patient. Br J Haematol 2024; 204:677-682. [PMID: 37742714 DOI: 10.1111/bjh.19115] [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: 05/16/2023] [Revised: 09/09/2023] [Accepted: 09/10/2023] [Indexed: 09/26/2023]
Abstract
Synonymous mutations were considered to lack functional roles in human diseases; however, distinguishing deleterious synonymous mutations from benign ones is still a challenge. In this article, we identified a deleterious synonymous mutation β-codon 16 (C>T). HBB: c.51C>T, in compound heterozygous form with known β-thalassaemia mutation patients who clinically presented as non-transfusion-dependent thalassaemia (NTDT). A total of 9 families with 11 compound heterozygous index cases were reported. In the heterozygous state, codon 16 (C>T) mutation results in borderline HbA2 (3.18 ± 0.36%) and slightly reduced RBC indices (RBCs: 4.73 ± 0.75 × 106 /μL, Hb: 12.26 ± 2.60 g/dL, MCV: 79.48 ± 8.40 fL, MCH: 25.95 ± 4.15 pg). The compound heterozygous patients showed elevated HbA2 (5.98 ± 1.17%) and HbF (12.75 ± 7.51%) and presented clinically as NTDT with a mean Hb of 6.95 ± 1.29 g/dL. Many of them were dependent on few transfusions and had mild splenomegaly. Of the 11 patients, 5 (45.4%) were treated with hydroxyurea. This study highlights the clinical significance of synonymous mutation, when inherited with other β-thalassaemia mutations leading to the phenotype of NTDT. Thus, the study would help to improve screening protocols for β-thalassaemia carriers, which will ultimately improve the prevention programme.
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Affiliation(s)
- M Gorivale
- ICMR-National Institute of Immunohaematology, Mumbai, India
| | - P Sawant
- ICMR-National Institute of Immunohaematology, Mumbai, India
| | - N Kargutkar
- ICMR-National Institute of Immunohaematology, Mumbai, India
| | - P Hariharan
- ICMR-National Institute of Immunohaematology, Mumbai, India
| | - P Thaker
- ICMR-National Institute of Immunohaematology, Mumbai, India
| | - A Chiddarwar
- ICMR-National Institute of Immunohaematology, Mumbai, India
| | - A Nadkarni
- ICMR-National Institute of Immunohaematology, Mumbai, India
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Sawant P, Mittal P, Tibdewal A, Mummudi N, Tandon S, Agarwal J. P05.05 Impact of Lung Stereotactic Body Radiotherapy on Pulmonary Function Test – Experience from Tertiary Cancer Centre in India. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Johannessen L, Dworakowski W, Sawant P, Ke N, Lefkovith A, D'Ippolito A, Eaton M, Henry S, Hodgson G. 14P Preclinical evaluation of intermittent dosing regimens on antitumor and PD activity of SY-5609, a potent and selective oral CDK7 inhibitor, in ovarian cancer xenografts. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Henry S, Johannessen L, Sawant P, Lefkovith A, Ke N, Dworakowski W, Hodgson G. 13P SY-5609, a highly potent and selective oral CDK7 inhibitor, exhibits robust antitumor activity in preclinical models of KRAS mutant cancers as a single agent and in combination with chemotherapy. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.291] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Sawant P, Gurram L, Mathew J, J M, Chopra S, A D, Ghadi Y, Ghosh J, Gupta S, Gulia S, TS S, Maheshwari A, Mahantshetty U. PO-1299 Outcomes of cervical cancer patients treated with hybrid CT-X Ray based intracavitary applications. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07750-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Gillard G, Proctor J, Hyzy S, Mikse O, Lamothe T, Mcdonough S, Clark N, Palchaudhuri R, Bhat A, Brooks M, Sarma G, Bhattarai P, Sawant P, Pearse B, Mcdonagh C, Boitano T, Cooke M. OP0307 A NOVEL TARGETED APPROACH TO ACHIEVE IMMUNE SYSTEM RESET: CD45-TARGETED ANTIBODY DRUG CONJUGATES AMELIORATE DISEASE IN PRECLINICAL AUTOIMMUNE DISEASE MODELS AND ENABLE AUTO-HSCT. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.5744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Resetting the immune system through autologous hematopoietic stem cell transplant (autoHSCT) is a highly effective treatment in selected patients with autoimmune diseases. AutoHSCT can induce long-term remission with 80% progression free survival in multiple sclerosis patients (Muraro 2017, Burt 2019). Use of autoHSCT in scleroderma patients has achieved superior outcomes in two randomized studies compared to standard of care (Tyndall 2014, Sullivan 2018). These impressive results are achieved by a combination of the eradication of autoreactive immune effector cells and re-establishment of self-tolerance, i.e., immune system reset. However, only a small fraction of eligible patients undergo autoHSCT, largely due to toxicity associated with current conditioning protocols.Objectives:As part of our goal to enable more patients to benefit from immune system reset, we have generated novel anti-human CD45 ADCs that cross react with nonhuman primates (NHP) and an anti-mouse CD45 ADC to model the approach in mouse models of AID.Methods:The human-targeted CD45-ADC is an affinity-matured mAb that targets an epitope present on all human CD45 isoforms, is cross-reactive with NHP CD45, and is conjugated to a payload that efficiently kills both quiescent and cycling cells. This ADC is engineered to eliminate Fc-mediated effector function, enable site-specific conjugation of linker/payload, and enable rapid clearance. This ADC was evaluated in vitro and in vivo in hNSG and NHPs. The murine tool ADC specifically targets the CD45.2 isoform of mouse CD45, and is also engineered to eliminate effector function, allow for site-specific conjugation of linker payload, and be rapidly cleared. The payload for this murine tool ADC is potent and preferentially kills dividing cells. This ADC was tested for the ability to enable immune reset and ameliorate autoimmune disease in multiple disease models.Results:The anti-human CD45-ADC showed efficient killing of human HSCs and human and cyno PBMC, including CD3+cells from healthy donors and patients with MS. In hNSG, single doses of the CD45-ADC were well-tolerated and led to substantial depletion of human cells. In NHPs, single doses of CD45-ADC were well tolerated and depleted both peripheral lymphocytes and HSCs. Administration of a single dose of anti-human CD45-ADC to hNSGs with sclerodermatous xenoGVHD resulted in depletion of human T cells and resolution of symptoms. A single-dose of the anti-mouse CD45-ADC enabled full myeloablation and complete durable donor chimerism with congenic HSCT at 16 weeks. In a murine immunization model of MS, MOG-induced EAE, a single dose of the CD45-ADC followed by congenic HSCT prior to disease onset enabled full donor chimerism, significantly delayed disease onset and reduced disease severity. We are generating additional data in an adoptive transfer model of EAE to confirm and extend these results. In a murine model of arthritis, therapeutic treatment with a single dose of the CD45-ADC followed by congenic HSCT enabled complete donor chimerism and halted disease progression, comparable to with the effects of an anti-TNFα antibody. The ADC is being further evaluated in a model of type 1 diabetes and those data will be presented. These data demonstrate that CD45-ADC conditioning followed by congenic HSCT is sufficient for full myeloablation and immune reset.Conclusion:These results demonstrate that targeted immune depletion with a single dose of CD45-ADC can enable auto-HSCT and immune reset in multiple AID indications without toxic side effects. Targeted conditioning with CD45-ADC may represent a better tolerated approach for removing disease-causing cells as part of immune reset through auto-HSCT and enable more patients to benefit.Disclosure of Interests:Geoffrey Gillard Shareholder of: Magenta Therapeutics, Employee of: Magenta Therapeutics, Jennifer Proctor Shareholder of: Magenta Therapeutics, Employee of: Magenta Therapeutics, Sharon Hyzy Shareholder of: Magenta Therapeutics, Employee of: Magenta Therapeutics, Oliver Mikse Shareholder of: Magenta Therapeutics, Employee of: Magenta Therapeutics, Tahirih Lamothe Shareholder of: Magenta Therapeutics, Employee of: Magenta Therapeutics, Sean McDonough Shareholder of: Magenta Therapeutics, Employee of: Magenta Therapeutics, Nicholas Clark Shareholder of: Magenta Therapeutics, Employee of: Magenta Therapeutics, Rahul Palchaudhuri Shareholder of: Magenta Therapeutics, Employee of: Magenta Therapeutics, Anjali Bhat Shareholder of: Magenta Therapeutics, Employee of: Magenta Therapeutics, Melissa Brooks Shareholder of: Magenta Therapeutics, Employee of: Magenta Therapeutics, Ganapathy Sarma Shareholder of: Magenta Therapeutics, Employee of: Magenta Therapeutics, Prashant Bhattarai Shareholder of: Magenta Therapeutics, Employee of: Magenta Therapeutics, Pranoti Sawant Shareholder of: Magenta Therapeutics, Employee of: Magenta Therapeutics, Brad Pearse Shareholder of: Magenta Therapeutics, Employee of: Magenta Therapeutics, Charlotte McDonagh Shareholder of: Magenta Therapeutics, Employee of: Magenta Therapeutics, Tony Boitano Shareholder of: Magenta, Employee of: Magenta, Michael Cooke Shareholder of: Magenta, Employee of: Magenta
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Mehta P, Upadhye D, Hariharan P, Italia K, Sawant P, Nadkarni A, Subramanian G, Mukherjee MB. Identification of high oxygen affinity hemoglobin (Hb Andrew-Minneapolis) in an Indian family. Int J Lab Hematol 2017; 39:e51-e54. [PMID: 28042696 DOI: 10.1111/ijlh.12608] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- P Mehta
- National Institute of Immunohaematology, (ICMR), K.E.M Hospital Campus, Parel, Mumbai, India
| | - D Upadhye
- National Institute of Immunohaematology, (ICMR), K.E.M Hospital Campus, Parel, Mumbai, India
| | - P Hariharan
- National Institute of Immunohaematology, (ICMR), K.E.M Hospital Campus, Parel, Mumbai, India
| | - K Italia
- National Institute of Immunohaematology, (ICMR), K.E.M Hospital Campus, Parel, Mumbai, India
| | - P Sawant
- National Institute of Immunohaematology, (ICMR), K.E.M Hospital Campus, Parel, Mumbai, India
| | - A Nadkarni
- National Institute of Immunohaematology, (ICMR), K.E.M Hospital Campus, Parel, Mumbai, India
| | - G Subramanian
- Sri Manakula Vinayagar Medical College, Madagadipet, Puducherry, India
| | - M B Mukherjee
- National Institute of Immunohaematology, (ICMR), K.E.M Hospital Campus, Parel, Mumbai, India
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Sudha MR, Sawant P. Effect of capsule 'UB03' containing potential probiotic strains for the treatment of patients with irritable bowel syndrome. Benef Microbes 2011; 2:229-33. [DOI: 10.3920/bm2011.0014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The objective of this research was to study the efficacy and safety of capsule 'UB03' to treat patients with Irritable Bowel Syndrome (IBS). Thirty patients with Rome II IBS were assigned to receive capsule 'UB03' (10 billion lyophilised bacteria and yeast/capsule produced by Unique Biotech Limited, India) twice daily for 90 days. Assessment of IBS was carried out according with Rome II criteria and their severity for 90 days of treatment with an interval of 30 days. Complete haemogram, serum glutamic pyruvic transaminase, serum creatinine were performed as a part of safety evaluation at the time of inclusion and after 90 days of treatment. There was significant improvement in frequency of defecation (23%), consistency of stool, abdominal discomfort, bloating and flatulence. However, there was no significant change in abdominal pain and mucus in stool. This trial demonstrates that the consumption of capsule 'UB03' containing potential probiotic strains is found to be effective and safe for the treatment of patients with IBS.
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Affiliation(s)
- M. Ratna Sudha
- Centre for Research & Development, Unique Biotech Limited, SP Biotech Park, Phase-II, Plot-2, Shameerpet, Hyderabad 500078, AP, India
| | - P. Sawant
- Department of Gasteroenterology, L.T.M. Medical College and Hospital, Sion, Mumbai, India
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Murugaraj P, Mainwaring DE, Chen LG, Sawant P, Al Kobaisi M, Yek WM. Interfacial aspects of adhesion in polymer nanocomposite thin-film devices. J Appl Polym Sci 2010. [DOI: 10.1002/app.31083] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Schlegel J, Sawant P, Paranjape S, Ozar B, Hibiki T, Ishii M. Void fraction and flow regime in adiabatic upward two-phase flow in large diameter vertical pipes. Nuclear Engineering and Design 2009. [DOI: 10.1016/j.nucengdes.2009.08.004] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Colah R, Nadkarni A, Gorakshakar A, Phanasgaonkar S, Sawant P, Surve R, Mohanty D, Ghosh K. Hb Showa Yakushiji [beta 110 (G12) Leu-->Pro] in 3 families from Western India: first report on homozygous Hb Showa Yakushiji. Blood Cells Mol Dis 2008; 41:166-8. [PMID: 18495504 DOI: 10.1016/j.bcmd.2008.04.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2008] [Revised: 04/11/2008] [Accepted: 04/15/2008] [Indexed: 10/22/2022]
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Ravindra BS, Desai N, Deviprasad S, Bhede V, Ravat S, Sawant P. Myotonic dystrophy in a patient of celiac disease: a new association? Trop Gastroenterol 2008; 29:114-115. [PMID: 18972777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Celiac disease (CD) has long been known to be associated with neurological and psychiatric manifestations; its in association with myotonic dystrophy however has not yet been reported. We report the case of a 27-year old female patient who presented to us with diarrhoea, weight loss, easy fatigability, irritability and alopecia of 8 months duration and was diagnosed to have celiac disease and put on gluten free diet. 8 weeks later she developed neurological symptoms and was found to have myotoni dystrophy in addition. At six month follow up patient had gained 5 kg, but the neurological symptoms remained the same. Treatment of neurological symptoms associated with gluten hypersensitivity depends on the type of neurological syndrome associated. Only exceptionally do these symptoms improve with gluten restriction and, in some patients, the neurological manifestations even progress despite resolution of both pathologic findings and intestinal symptoms.
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Affiliation(s)
- B S Ravindra
- Department of Gastroenterology, Lokmanya Tilak Medical College & Hospital, Mumbai, India
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Abstract
An accurate diagnosis of beta -thalassemia carriers, homozygous patients and identification of different structural hemoglobin variants is important for epidemiological studies as well as for management and prevention of the major hemoglobin disorders. There are many electrophoretic and chromatographic approaches for estimation of HbA2 and Hb F but cation exchange HPLC (CE-HPLC)using automated dedicated machines like the Variant Hb testing system have become the method of choice for these investigations. CE-HPLC also helps in the presumptive identification of many abnormal hemoglobin variants and has been useful for both neonatal screening of sickle cell disease as well as second trimester prenatal diagnosis of thalassemia by fetal blood analysis. Other applications of HPLC in hemoglobinopathies include separation of globin chains, measuring the ratio of gamma globin chains (Ggamma/Agamma) and the recently described denaturing HPLC for detecting mutations in both alpha and beta globin genes.
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Affiliation(s)
- R B Colah
- Institute of Immunohaematology (ICMR), 13th Floor, New Multistoreyed Building, KEM Hospital Campus, Parel, Mumbai, India.
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Manjunath SM, Desai ND, Alexander J, Patil S, Ughade S, Sawant P. Can anti-Helicobacter pylori and anti-CagA antibodies be used to select patients with dyspepsia for gastroscopy? Trop Gastroenterol 2006; 27:122-6. [PMID: 17310555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
BACKGROUND agA IgG antibody in sera may indicate presence of peptic ulcer disease among dyspeptic patients and therefore may be used as a serological marker to identify high risk patients for peptic ulcer who can be subjected to endoscopy. Present study was performed to identify association of CagA IgG antibody in patients with peptic ulcer. METHODS Consecutive patients with dyspepsia were subjected to endoscopy and sera was collected from each. Rapid urease test in antral tissue collected from each patient by endoscopic biopsy was performed. Antral tissue was also examined histologically. IgG Antibody against H. Pylori and CagA IgG antibody was tested in each patients sera. RESULTS Out of 82 patients with dyspepsia included in the study 28 had peptic ulcer. Of whom 26 were positive for anti IgG H. Pylori antibody. More than 80% patients with peptic ulcer patients had detectable anti Cag A antibody in contrast to 33% patients with non ulcer dyspepsia (P < 0.001). CONCLUSION Anti-Cag A antibody may be used as a screening test in patients with dyspepsia to select high risk patients for peptic ulcer for upper gastrointestinal endoscopy.
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Affiliation(s)
- S M Manjunath
- Department of Gastroenterology, Lokmanya Tilak Municipal Medical College and General Hospital, Sion, Mumbai
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Das HS, Sawant P, Shirhatti RG, Vyas K, Vispute S, Dhadphale S, Patrawalla V, Desai N. Efficacy of low dose intradermal hepatitis B vaccine: results of a randomized trial among health care workers. Trop Gastroenterol 2002; 23:120-1. [PMID: 12693152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
BACKGROUND Hepatitis B virus (HBV) infection is an occupational health hazard among the healthcare workers. Vaccination against HBV has been established to be the most effective preventive strategy. The present study was designed to assess the efficacy of low dose intradermal HBV vaccine among the nursing staff in a tertiary care hospital setting. PATIENTS AND METHODS Staff nurses working in our hospital were included in the study as vaccine recipients. Each staff nurse was tested for HBsAg and anti-HBs (commercial ELISA). Those who tested negative for both the above markers were randomized to receive either three doses of intramuscular (i.m.) HBV vaccine (20 micrograms m each dose) at 0, 1 and 6 month interval or three doses of intradermal HBV vaccine (2 micrograms m each dose) at similar intervals. Each vaccine recipient was tested for the presence of anti HBs (commercial ELISA) at the end of 1 month and 1 year after the last dose of the vaccine. The anti-HBs titres were also estimated simultaneously in them. RESULTS Out of 153 staff nurses screened, 19 were either positive for HBsAg (n = 1) or anti HBs (n = 18). 96(72%) of the remaining 134 nurses agreed to receive HBV vaccine (i.m.--48, intradermal--48). At the end of 1 month after last dose of the vaccine, all vaccinees in both the group tested positive for anti-HBs. However the anti-HBs titres at 1 month were significantly higher among intramuscular vaccinees than the nurses receiving the vaccine through intra-dermal route (253 +/- 127.7 mIU/ml vs 151.3 +/- 92.8 mIU/ml, P < 0.001). Eighty four (85.5%) of these 96 vaccine recipient were available for evaluation of anti-HBs titre at the end of 1 year after the last dose of vaccine (1M group = 40, Intradermal group = 44). All the nurses continued to be positive for anti-HBs at the end of 1 year but the anti HBs-titre among i.m. vaccine recipient continued to remain at a significantly higher level than the similar titre among the intradermal vaccine recipients (256.4 +/- 124.7 mIU/ml vs 121.6 +/- 122.4 mIU/ml p < 0.001). CONCLUSION Intradermal route for HBV vaccine had similar immunogenic efficacy as the conventional intramuscular route, but the dose required in the former route is one tenth of the intramuscular route. Therefore intradermal route may reduce the cost of HBV vaccine markedly.
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Affiliation(s)
- H S Das
- Department of Gastroenterology, LTMMC and LTMGH, Sion, Mumbai
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Sawant P, Sahani S, Dongre N, Kulkarni S, Dewan B, Sudarshan S. Ranitidine alone and in combination with domperidone in reflux-type dyspepsia. Indian J Gastroenterol 2002; 21:84. [PMID: 11990339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Shetty SM, Kalokhe S, Rathi P, Desai N, Sethna KS, Rajyadhyaksha G, Sawant P. Duodenal leiomyoma--a rare cause of haematemesis. J Assoc Physicians India 2001; 49:1114-5. [PMID: 11868869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
Leiomyoma of the duodenum is a rare tumour. Small intestinal tumours contributing to upper gastrointestinal bleed is still rare. They usually present with malena and anaemia, rarely hematemesis. We report a case of leiomyoma of duodenum diagnosed on endoscopic ultrasound that presented with massive haematemesis.
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Affiliation(s)
- S M Shetty
- Department of Gastroenterology, LTMM College and LTMG Hospital, Sion, Mumbai
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Patraval V, Rathi P, Sawant P, Vyas K, Das H. Endoscopic sclerotherapy in children with extrahepatic portal venous obstruction. Trop Gastroenterol 2001; 22:137-40. [PMID: 11681106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
BACKGROUND Extrahepatic portal vein obstruction (EHPVO) is a common cause of variceal bleeding in children in India. There is paucity of data regarding the results of treatment with endoscopic sclerotherapy. METHODS Fifty-nine children (mean age 11 +/- 3.8 years; range 7 months to 12 years; 36 males and 23 females) were studied from February 1990 to September 1999. EHPVO was diagnosed on the basis of portal cavernoma on ultrasonography in 55 patients and on splenoportovenogram in 4 patients. Endoscopic sclerotherapy was caried out at weekly intervals for the first three weeks and at 3 weekly intervals thereafter till complete or near complete thrombosis was achieved. All patients were followed up with check endoscopy every 3-6 months after thrombosis of oesophageal varices. RESULTS Over a mean follow up of 25.4 months (range 3 to 87 months) total thrombosis was achieved in 53 (89.8%) of 59 children. The mean number of sclerotherapy sessions required were 7.5 +/- 2.2. The mean number of blood transfusions required per bleeding episode was 3.8 +/- 3.2. Of the 59 children 21 (35.6%) rebled, of which 17 (28.8%) bled during and 4(6.8) after thrombosis of varices. Seven (11.9%) children had more than one episode of bleeding. Once thrombosis of the varices was achieved 15 (26%) of 59 children developed fresh varices on follow up. Gastric varices were detected in 47 (60%) children. In 39 (66%) children it was present at the onset and in 8 (13.5%) children it developed after thrombosis of oesophageal varices. Bleeding from gastric varix occurred in 7(9%) children. Ascites developed in 6(10.6%) children. One child developed oesophageal stricture. There were 3 (5%) deaths. Two died due to upper gastrointestinal bleed while on sclerotherapy schedule and one died due to cerebral abscess. CONCLUSION EHPVO is an important and common cause of upper gastrointestinal bleeding in children in Western India. EST is safe and useful in controlling oesophageal variceal bleeding in children.
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Affiliation(s)
- V Patraval
- Department of Gastroenterology, L.T. Municipal Medical College & L. T. Municipal General Hospital, Sion, Mumbai-400 022
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Abstract
Temporomandibular joint ankylosis presents a serious problem for airway management. This relatively rare problem becomes even more difficult to manage in children because of their smaller mouth opening with near total trismus, and the need for general anaesthesia before making any attempts to secure the airway. A technique for securing the airway that combines local blocks for nerves of larynx and topical anaesthesia of upper airways for placement of these blocks, and minimal general anaesthesia for these manoeuvres, is described. For general anaesthesia, a combination of halothane and ether by spontaneous ventilation, using bilateral nasopharyngeal airways, was used. Because of the severe trismus, a tongue depressor or tip of a laryngoscope was used with a fibreoptic light source in the buccal sulcus to visualize the tracheal tube in the pharynx. Nasal forceps, with a smaller tip and narrower blade than Magill forceps was used to guide the tracheal tube towards the air bubbles coming out of larynx. No attempt was made to visualize the larynx, but its position was guessed from the direction of these air bubbles. We review the anaesthetic technique in 15 such cases of severe trismus managed successfully between 1986 and 1999.
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Affiliation(s)
- L Vas
- Bai Jerbai Wadia Hospital for Children, Acharya Donde Marg, Parel, Bombay 400012, India
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21
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Rathi P, Sawant P, Gopanpallikar A. Comparison of two regimens on eradication of Helicobacter pylori. J Assoc Physicians India 2000; 48:852-3. [PMID: 11273492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
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22
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Das HS, Rathi P, Sawant P, Chodankar CM, Vyas K, Patrawala V, Dhadphale S. Colonic tuberculosis: colonoscopic appearance and clinico-pathologic analysis. J Assoc Physicians India 2000; 48:708-10. [PMID: 11273506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
BACKGROUND There has been a resurgence of interest in intestinal tuberculosis because of acquired immunodeficiency syndrome (AIDS) epidemic sweeping our country. Role of colonoscopy and colonoscopy directed histology for diagnosing the disease have been emphasised since last few years. AIMS AND OBJECTIVES To know the colonoscopic features in patients with intestinal tuberculosis and to study the clinicopathological findings in the same. METHODS We studied twenty-one patients with intestinal tuberculosis referred to us between 1993-1997. Colonoscopy was done in all patients and biopsy specimens were collected from the site of lesion during the procedure. RESULTS Ileocaecal disease was found in 9 patients, ileocaecal with contiguous ascending colon involvement in eight and segmental colonic tuberculosis in four cases. The colonoscopic findings included nodules in seven patients, nodules with ulcerations in three, ulcerations alone in seven, nodules with strictures in three and polypoidal mass in one patient. Eight cases revealed granuloma on histopathology. CONCLUSIONS Though bacteriological and histological assessment of tissue is essential to differentiate tuberculosis from other disorders, we stress the importance of colonoscopic appearances in diagnosing tuberculosis. We also recommend antituberculous chemotherapy in patients with high clinical suspicion of tuberculosis on the basis of colonoscopic appearance alone after ruling other causes on histopathological examination.
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Affiliation(s)
- H S Das
- Department of Gastroenterology and Pathology, LT Municipal Medical College and LT Municipal General Hospital, Sion, Mumbai 400 022
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23
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Vyas K, Sawant P, Rathi P, Das HS, Borse N. Foreign bodies in gut. J Assoc Physicians India 2000; 48:394-6. [PMID: 11273172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/16/2023]
Abstract
BACKGROUND Foreign body ingestion is common and a frightening experience to the patients and relatives. We report our experience with 102 patients, (78 children and 24 adults), with foreign body ingestion. METHODS After locating foreign bodies radiologically, 34 (43.6%) foreign bodies in children and 13 (54.2%) foreign bodies in adults were removed endoscopically. General anesthesia was used in 32 children and overtube was used for all sharp foreign bodies. RESULTS In our study, 78 (76%) patients were below 12 years of age. Coins (79.5%) were commonest foreign bodies in children while dentures (25%) were commonest in adults. Foreign bodies were most commonly sited in stomach (25.6%) in children and esophagus (58.3%) in adults. In 41 (52.6%) children and in three (12.5%) adults, i.e. total 44 out of 102 (43.1%) patients passed foreign bodies spontaneously. The largest foreign body that passed spontaneously was 4-cm long nail in a child. In 34 (43.6%) children and in 13 (54.2%) adults foreign bodies were removed endoscopically. Only 3.8% children and 33.3% adults required surgery. CONCLUSIONS There was no mortality in our series. Majority of foreign bodies do not require any intervention. Sharp foreign bodies are commonest indication for surgery. However, endoscopic removal is safe, effective and is the method of choice for most patients.
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Affiliation(s)
- K Vyas
- Department of Gastroenterology, LT Municipal Medical College and LT Municipal General Hospital, Sion, Mumbai
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24
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Borse NC, Rathi PM, Sawant P. Hepatitis G virus: an innocent contaminant. J Assoc Physicians India 1999; 47:721-3. [PMID: 10778595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Affiliation(s)
- N C Borse
- Dept. of Gastroenterology, LTM Med College, Sion, Mumbai
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25
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Bhatnagar M, Nanivadekar SA, Patrawala V, Sawant P, Rathi PM, Bhat P, Dhadphale S. Relation of gastric juice vitamin C levels with H. pylori infection. Indian J Gastroenterol 1999; 18:129-30. [PMID: 10407575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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26
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Sawant P, Rathi PM, Upadhyaya A. Hepatitis B subtypes and hepatitis C genotypes in cirrhosis in western India: results of a pilot study. J Assoc Physicians India 1999; 47:580-3. [PMID: 10999152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
BACKGROUND Hepatitis B virus (HBV) and Hepatitis C virus (HCV) are the major causes of viral chronic liver diseases in India. HBV subtypes and HCV genotypes have not been reported from Western India. The aims of the study were (i) To study the prevalence of viral markers to HBV and HCV in adult cirrhotics, (ii) To determine HBV subtypes and HCV genotypes using serological and molecular biological methods. METHODS A total of 99 adult cirrhotic patients, proven by liver biopsy, laparoscopy, or a combined score of clinical features, biochemical tests, ultrasonography of abdomen, and radioisotope 99m Technetium scan in presence of oesophageal varices were studied. Sera collected from these patients were stored at -8 degrees C and subjected to various tests. HBsAg was determined by ELISA, anti-HBc by ELISA and anti HCV Ab was determined by the third generation ELISA. HBsAg subtypes were determined by enzyme immunoassay. HCV RNA was determined by PCR in those who tested positive for anti HCV antibody. Genotyping of HCV was done with a second generation PCR. RESULTS HBsAg was detected in 16, out of which subtyping was possible in 14, adw was found in 6 and ayw in 8. Anti HCV Ab was found in 5. Genotyping was possible in three samples which revealed one to be of genotypes 3, one of genetic group 4, and one of genetic group 5. CONCLUSIONS Subtypes and genotypes of HBV and HCV have not been reported from Western India. Their determination can have implications in understanding the spectrum of disease, characteristics and response to treatment.
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Affiliation(s)
- P Sawant
- Dept. of Gastroenterology, L.T. Mun. Med. College, Sion, Mumbai
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27
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Das H, Taribagil S, Rathi P, Kumar M, Sawant P. Multiple sewing needles retrieved from the gut. Indian J Gastroenterol 1999; 18:91. [PMID: 10319549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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28
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Gopanpallikar AM, Rathi PM, Sawant P, Gupta R, Dhadphale SD, Patrawala VN. Cardiac anomalies associated with extrahepatic portal venous obstruction. Indian Pediatr 1998; 35:1143-4. [PMID: 10216558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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29
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Gupta R, Sawant P, Parameshwar RV, Lele VR, Kulhalli PM, Mahajani SS. Gastric mucosal blood flow and hepatic perfusion index in patients with portal hypertensive gastropathy. J Gastroenterol Hepatol 1998; 13:921-6. [PMID: 9794191 DOI: 10.1111/j.1440-1746.1998.tb00762.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Endoscopic laser Doppler velocimetry is a simple non-invasive method to measure gastric mucosal blood flow. The present study is an attempt to determine a correlation, if any, between gastric mucosal blood flow and the hepatic perfusion index in patients with portal hypertensive gastropathy and their relationship to the severity of liver disease. Thirty patients with portal hypertensive gastropathy due to cirrhosis of the liver (eight class A, 13 class B, nine class C, according to Child-Pugh Classification) and six normal subjects were recruited into the study. In all subjects, the gastric mucosal blood flow and venous vasomotor reflex response was measured at two sites: the lesser and greater curvature, using endoscopic laser Doppler velocimetry. The hepatic perfusion index was measured using dynamic liver scintigraphy. The hepatic perfusion index (ratio of arterial/portal venous perfusion) in normal subjects and patients with portal hypertensive gastropathy belonging to Child-Pugh class A, B and C were 0.36 +/- 0.02, 0.53 +/- 0.08, 0.62 +/- 0.14 and 1.04 +/- 0.28, respectively. The gastric mucosal blood flow was similar in Child's A, B and C cases, while the venous vasomotor reflex response was reduced according to the Child-Pugh score (Child's A 37.4 +/- 5.4%, normal control 62.3 +/- 10.9%, Child's B 38.3 +/- 18.2%, Child's C 22.5 +/- 15.2%) and was statistically significant. The gastric mucosal blood flow and hepatic perfusion index are inversely correlated. The hepatic perfusion index altered with grading of cirrhotic change. This study confirms that the severity of portal hypertensive gastropathy is correlated with Child-Pugh score.
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Affiliation(s)
- R Gupta
- Department of Gastroenterology, Lokmanya Tilak Municipal Medical College and Hospital, Sion, Mumbai, India
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30
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Gopanpallikar AM, Sawant P, Rathi P, Chodankar CM, Bhatnagar M, Nanivadekar SA. Spectrum of colonic polyps. Indian Pediatr 1998; 35:897-900. [PMID: 10216600] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Affiliation(s)
- A M Gopanpallikar
- Department of Gastroenterology, L.T.M. Medical College, Mumbai, India
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31
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Gupta R, Rathi P, Sawant P, Nadkarni SP, Dhadphale S, Soman CS. Carcinoid tumour of the caecum. J Assoc Physicians India 1998; 46:233-4. [PMID: 11273122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/16/2023]
Affiliation(s)
- R Gupta
- Department of Gastroenterology, LTMMC, Mumbai-400 022
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32
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Dhadphale S, Sawant P, Rathi P, Shirhatti RG, Gupta R, Gopanpallikar A, Patrawala V. Bleeding duodenal varix in splenic vein thrombosis and chronic pancreatitis. Indian J Gastroenterol 1998; 17:29-30. [PMID: 9465513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Isolated duodenal varix is rare. We report a patient with bleeding duodenal varix with splenic vein thrombosis due to chronic pancreatitis.
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Affiliation(s)
- S Dhadphale
- Department of Gastroenterology, L T M Medical College and General Hospital, Mumbai
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33
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Gopanpallikar A, Rathi P, Sawant P, Gupta R, Dhadphale S, Deshmukh HL. Hepatic artery pseudoaneurysm associated with amebic liver abscess presenting as upper GI hemorrhage. Am J Gastroenterol 1997; 92:1391-3. [PMID: 9260822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
We report the case of a 40-yr-old man who presented with recurrent hemorrhage of the upper GI tract who was found to have hepatic artery pseudoaneurysm and amebic liver abscess. Our patient is unique in having hepatic artery pseudoaneurysm and amebic liver abscess diagnosed simultaneously, the association of which has not been previously described.
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Affiliation(s)
- A Gopanpallikar
- Department of Gastroenterology, Lokmanya Tilak Municipal Medical College and General Hospital, Sion, Mumbai, India
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34
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Yadav S, Gupta R, Oak SN, Rathi P, Kulkarni BK, Sawant P. Primary gastric lymphoma in a boy. Indian J Gastroenterol 1997; 16:112-3. [PMID: 9248189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Primary gastric lymphoma is an extremely uncommon entity in children, and diffuse large-cell-type lymphoma in this age group is still rarer. An 11-year-old boy with primary gastric lymphoma who responded to CHOP regime is reported.
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Affiliation(s)
- S Yadav
- Department of Pediatric Surgery, I.T. M General Hospital, Mumbai
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35
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Rathi P, Gupta R, Gopanpallikar A, Sawant P. Endoscopic retrieval of impacted spigot from gastrostomy tube. Indian J Gastroenterol 1997; 16:120-1. [PMID: 9248201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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36
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Affiliation(s)
- R Gupta
- Dept. of Gastroenterology, L.T.M. Medical College and L.T.M. General Hospital, Bombay, India
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37
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Satarkar RP, Sawant P, Nanivadekar S, Shroff C. Helicobacter pylori and intestinal metaplasia of gastric mucosa. Indian J Gastroenterol 1997; 16:16-7. [PMID: 9167374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND The role of Helicobacter pylori in stomach carcinogenesis is currently under study. H pylori-related chronic gastritis leading to dysplasia or intestinal metaplasia (IM) especially of the colonic type is postulated as one of the mechanisms. METHODS We studied 120 patients with or without H pylori infection to determine the frequency of occurrence of IM in the stomach. RESULTS IM was found in 16.6% of patients; most cases had the small intestinal type, which is not known to have a malignant potential. There was no relation between H pylori infection and development of IM. CONCLUSION H pylori infection leading to IM does not appear to be a factor in the genesis of carcinoma stomach in our population.
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Affiliation(s)
- R P Satarkar
- Department of Gastroenterology, LTMG Hospital, Mumbai
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38
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Abstract
We established the prevalence of gallbladder varices (GBVs) as seen on duplex sonogram of children with portal hypertension. Fifty-five consecutive children with portal hypertension underwent duplex sonographic examination by an experienced sonologist who was blinded to clinical presentation. Forty children had extrahepatic portovenous obstruction (EHPVO), 12 had cirrhosis, and three had noncirrhotic portal hypertension. GBVs were seen on sonography in 10 of 40 children with EHPVO (25%), two of 12 children with cirrhosis (16.6%), and no children with noncirrhotic portal hypertension. Sonographic findings of GBVs were confirmed on duplex sonographic imaging. Among patients with EHPVO, GBVs did not correlate with size of esophageal varices, number of sessions of sclerotherapy, presence or absence of gastric varices, portal gastropathy, or splenorenal shunt placement. In cirrhotic patients, GBVs did not correlate with Child Pugh grade. Children with EHPVO have a higher incidence of developing GBVs. The clinical significance of GBVs is their propensity to bleed during biliary surgery; thus, the operating surgeon should be made aware of them.
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Affiliation(s)
- P M Rathi
- Department of Gastroenterology, L.T. Municipal Medical College, Bombay, India
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39
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Oak S, Bhatnagar M, Kulkarni B, Nanivadekar S, Karmarkar S, Sawant P. Prepyloric diaphragm detected following foreign body ingestion. Indian J Gastroenterol 1996; 15:109-10. [PMID: 8840645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Prepyloric diaphragms are unusual and are usually detected in adulthood. We report a five-year-old boy who presented with history of ingestion of a coin and was found to have a prepyloric diaphragms on laparotomy.
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Affiliation(s)
- S Oak
- Department of Pediatric Surgery, LTMG Hospital, Bombay
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40
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Bhatnagar MS, Nanivadekar SA, Sawant P, Rathi PM, Upadhyay AP. Asymptomatic spinal tuberculosis presenting as esophageal stricture. Indian J Gastroenterol 1996; 15:72-3. [PMID: 8935940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Esophageal tuberculosis is rare and is usually due to secondary extension from contiguous structures. We report a patient who presented with dysphagia and was found to have esophageal stricture. Endoscopic biopsy was not suggestive of malignancy or tuberculosis. CT scan of the thorax revealed involvement of the fourth thoracic vertebra with paratracheal lymphadenopathy. The patient responded to anti-tubercular therapy.
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Affiliation(s)
- M S Bhatnagar
- Department of Gastroenterology, LTMG Hospital & LTM Medical College, Bombay
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41
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Bhatnagar MS, Nanivadekar SA, Sawant P, Rathi PM. Achalasia cardia dilatation using polyethylene balloon (Rigiflex) dilators. Indian J Gastroenterol 1996; 15:49-51. [PMID: 8935934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Results of 20 dilatation sessions in 15 patients with achalasia cardia were assessed to determine the safety and efficacy of polyethylene balloon achalasia dilators (Rigiflex). METHODS All patients underwent an initial dilatation by inflating a 30 mm balloon to 9 psi for one minute. Need for subsequent dilatations was assessed on symptom assessment; 35 mm balloon was used for repeat procedure. RESULTS Overall success rate was 93.3%. The 30 mm balloon achieved a satisfactory result in 73.3% and the 35 mm balloon in 75% of the remainder. Only one patient needed surgery. No short-term complications were observed. The only late complication encountered over an average follow-up period of 16.2 months was gastroesophageal reflux in two patients. CONCLUSIONS Dilatation using Rigiflex dilators is a safe, effective and simple procedure for treating patients with achalasia.
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Affiliation(s)
- M S Bhatnagar
- Department of Gastroenterology, LTMG Hospital & LTM Medical College, Bombay
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42
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Nanivadekar SA, Dave UR, Sawant P, Satarkar RP. Esophageal dilation in pediatric patients using balloon along the side of the endoscope. Indian J Gastroenterol 1996; 15:14-5. [PMID: 8840620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Balloon dilation is an effective modality of treatment for esophageal strictures. As standard through-the-scope balloons do not pass through the biopsy channel of pediatric endoscopes, we have developed a technique by which these balloons can be used in pediatric patients by passing them alongside the endoscope. We report our experience of dilation in four patients using this technique.
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Affiliation(s)
- S A Nanivadekar
- Department of Gastroenterology, L T M G Hospital, Sion, Bombay
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43
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Abstract
Esophageal tuberculosis is rare, and its association with intramural pseudodiverticulosis is not widely appreciated. We report a patient with dysphagia who proved to have esophageal narrowing, mediastinal lymphadenopathy, and intramural pseudodiverticulosis. Results of endoscopy and biopsy were nonspecific, but biopsy of the supraclavicular node showed histology consistent with tuberculosis. The patient experienced a dramatic response to antitubercular therapy, with resolution of the esophageal narrowing, mediastinal lymphadenopathy, and esophageal intramural pseudodiverticulosis.
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Affiliation(s)
- A P Upadhyay
- Department of Gastroenterology, Lokmanya Tilak Municipal Medical College, Bombay, India
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44
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Bhatnagar MS, Kanakia R, Rajgopalan K, Nanivadekar SA, Sawant P. Percutaneous endoscopic gastrostomy using inexpensive indigenous substitutes. J Assoc Physicians India 1995; 43:809-10. [PMID: 8773052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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45
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Affiliation(s)
- R S Bhatia
- Department of Gastroenterology, Lokmanya Tilak Municipal Medical College and Hospital, Sion, Bombay
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46
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Sawant P, Bhatia R, Kulhalli P, Mahajani SS, Nanivadekar SA. Effect of a short course of indomethacin on gastric mucosal blood flow using endoscopic laser-Doppler velocimetry. Indian J Gastroenterol 1995; 14:137-8. [PMID: 8868356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To assess the effect of a short course of indomethacin on gastric mucosal blood flow (GMBF). METHODS Patients with musculo-skeletal pain of recent origin and were prescribed a short course of therapy with indomethacin (25 mg tid for 7 days) were studied Baseline measurements of GMBF were carried out using endoscopic laser-Doppler velocimetry prior to starting indomethacin. At sites on the antrum, incisura, lesser and greater curvatures, and fundus. GMBF measurements were repeated after indomethacin therapy, as above and also on sites of erosions, it any. RESULTS Baseline GMBF at sites on the antrum, incisura, greater and lesser curvatures, and fundus were (mean) 8.6, 7.9, 8.8, 8.5 and 8.7 volts, respectively. Post-therapy values did not differ from the corresponding baseline values (8.7, 8.5, 8.6, 8.6 and 8.3 volts, respectively). However, ten of the 16 patients developed gastric mucosal erosions and the mean GMBF on these sites of erosion was significantly reduced (6.6 +/- 1.3 volts, p < 0.05). CONCLUSIONS A short course of indomethacin therapy produces a patchy decrease in blood flow in the gastric mucosa and erosions were seen in these areas.
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Affiliation(s)
- P Sawant
- Department of Gastroenterology, Lokmanya Tilak Municipal Medical College and Hospital, Bombay
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47
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Sawant P, Bhatia R, Kulhalli PM, Mahajani SS, Nanivadekar SA. Comparison of gastric mucosal blood flow in normal subjects and in patients with portal hypertension using endoscopic laser-Doppler velocimetry. Indian J Gastroenterol 1995; 14:87-90. [PMID: 7657372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To compare gastric mucosal blood flow (GMBF) in normal subjects with that in patients with portal hypertension with or without portal hypertensive gastropathy (PHG). METHODS GMBF was measured by endoscopic laser-Doppler velocimetry in 20 gastroscopically normal subjects and 30 patients with portal hypertension with or without PHG. The effects of breath-holding (vasomotor reflex), submucosal epinephrine and sublingual isosorbide dinitrate were also studied. RESULTS In normal subjects, GMBF on the greater curvature was (mean +/- SD) 9.5 +/- 1.3 V and on the lesser curvature, 9.1 +/- 1.9 V. Breath-holding caused a reduction in GMBF by 57.1 +/- 13.7%, submucosal epinephrine reduced it by 41.5 +/- 21.5% and sublingual isosorbide caused a rise of 25.8 +/- 15.2%. The GMBF on the greater and lesser curvature respectively in patients with mild PHG (7.7 +/- 1.2 V and 7.7 +/- 0.8 V) and those with severe PHG (6.5 +/- 3.5 V and 6.3 +/- 2.2 V), was significantly less than that in normal subjects (p < 0.05 and p < 0.001 respectively). Vasomotor reflex was blunted in patients with mild and severe PHG (23.3% +/- 20.3 and 23.1% +/- 17.7 respectively, p < 0.001). Responses to submucosal epinephrine and sublingual isosorbide were similar to those recorded in normal subjects. CONCLUSIONS Patients with portal hypertension have significantly reduced GMBF and significantly attenuated vasomotor reflex in the gastric vascular bed as compared to normal subjects.
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Affiliation(s)
- P Sawant
- Department of Gastroenterology, Lokmanya Tilak Municipal Medical College & Hospital, Sion, Bombay
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48
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Devarbhavi H, Sawant P, Nanivadekar SA, Bhatia RS. Congenital abnormalities in a case with extrahepatic portal venous obstruction. Indian J Gastroenterol 1995; 14:33. [PMID: 7860122] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- H Devarbhavi
- Department of Gastroenterology, Lokmanya Tilak Municipal Medical College and Hospital, Bombay
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Nanivadekar SA, Satarkar RP, Dave UR, Sawant P, Chopda N. Use of indigenous and economical substitutes for variceal band ligation accessories. Indian J Gastroenterol 1995; 14:38. [PMID: 7860128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Bhatia R, Sawant P, Nanivadekar SU, Patel HD, Devarbhavi H. Large villous adenoma of the duodenum. Indian J Gastroenterol 1994; 13:145. [PMID: 7829148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
A 27-year-old man, who had symptoms of gastric outlet obstruction, was found on endoscopy to have a large duodenal polyp which on histology was diagnosed as villous adenoma. The tumor was resected surgically and the patient remained asymptomatic until two years later.
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Affiliation(s)
- R Bhatia
- Department of Gastroenterology, Lokmanya Tilak Municipal Medical College and Hospital, Sion, Bombay
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