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Choudhary P, Saini N, Yoon MH, Awasthi K, Pandey K. ZIF-8 @polycarbonate nanocomposite membranes for improved permeability and selectivity for hydrogen gas. Environ Sci Pollut Res Int 2023; 30:105387-105397. [PMID: 37713078 DOI: 10.1007/s11356-023-29650-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 08/29/2023] [Indexed: 09/16/2023]
Abstract
Through this work, we are reporting high-performance ZIF-8 @polycarbonate nanocomposite membranes with satisfactory structural stability for improving the gas separation performance. ZIF-8 nanoparticles were synthesised using the wet chemical route with cubic morphology and controlled size using CTAB as a surfactant. The membranes were prepared using the solution casting method by adding ZIF-8 filler at various concentrations. The synthesised filler material and MMMs were characterised through X-ray diffraction spectroscopy (XRD), transmission electron microscopy (TEM), scanning electron microscopy (SEM), Fourier transform infrared spectroscopy (FTIR), and RAMAN spectroscopy techniques. The gas separation measurements were taken using H2, CO2, and N2 gas in the purest form. The SEM results confirm the formation of spherulite-like morphology with the addition of ZIF-8 due to the crystallisation of the polymer, which increased the membrane's free volume and opened up additional pathways for the transportation of the gas molecules. The gas separation results confirmed that the 15 wt% ZIF-8/PC nanocomposite membrane showed the maximum H2 permeability of 180,970 barrer with an increment of 316.03%, while H2/CO2 and H2/N2 selectivity showed the increments of 89.43% and 103.64%, respectively. Therefore, this PC/ZIF-8 system seems to be a promising approach to developing new H2 selective membranes with high gas permeability and gas selectivity values.
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Affiliation(s)
- Prashant Choudhary
- Materials Research Centre, Malaviya National Institute of Technology Jaipur, Rajasthan, 302017, India
| | - Nishel Saini
- Department of Physics, Malaviya National Institute of Technology Jaipur, Rajasthan, 302017, India
| | - Myung Han Yoon
- Materials Science and Engineering, Gwangju Institute of Science and Technology (GIST), Gwangju, 500-712, Republic of Korea
| | - Kamlendra Awasthi
- Department of Physics, Malaviya National Institute of Technology Jaipur, Rajasthan, 302017, India
| | - Kamakshi Pandey
- Materials Research Centre, Malaviya National Institute of Technology Jaipur, Rajasthan, 302017, India.
- Department of Physics, Malaviya National Institute of Technology Jaipur, Rajasthan, 302017, India.
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Choudhary P, Agarwal A, Joshi M, Singh A, Kar SK. Spermatophagia Associated with Dhat Syndrome in a Patient with Schizophrenia: A Case Report. Indian J Psychol Med 2023; 45:437-438. [PMID: 37483587 PMCID: PMC10357912 DOI: 10.1177/02537176221140606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/25/2023] Open
Affiliation(s)
- Prashant Choudhary
- Dept. of Psychiatry, King George’s Medical University, Lucknow, Uttar Pradesh, India
| | - Aditya Agarwal
- Dept. of Psychiatry, King George’s Medical University, Lucknow, Uttar Pradesh, India
| | - Mohita Joshi
- Dept. of Psychiatry, King George’s Medical University, Lucknow, Uttar Pradesh, India
| | - Amit Singh
- Dept. of Psychiatry, King George’s Medical University, Lucknow, Uttar Pradesh, India
| | - Sujita Kumar Kar
- Dept. of Psychiatry, King George’s Medical University, Lucknow, Uttar Pradesh, India
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Kar SK, Choudhary P, Singh A, Singh V, Raje D. Beneficial cognitive outcomes following transcranial random noise stimulation (tRNS) in cognitively impaired patients: A case series. Asian J Psychiatr 2023; 84:103567. [PMID: 37004383 DOI: 10.1016/j.ajp.2023.103567] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 03/19/2023] [Accepted: 03/21/2023] [Indexed: 04/04/2023]
Affiliation(s)
- Sujita Kumar Kar
- Department of Psychiatry, King George's Medical University, Lucknow, Uttar Pradesh, India.
| | - Prashant Choudhary
- Department of Psychiatry, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Amit Singh
- Department of Psychiatry, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Vaibhav Singh
- Department of Psychiatry, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Devika Raje
- Department of Psychiatry, King George's Medical University, Lucknow, Uttar Pradesh, India
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Kearney K, Cordina R, Choudhary P, Tanous D, Celermajer D, Keogh A, Bart N, Jabbour A, Kotlyar E, Jansz P, Hayward C, Muthiah K, MacDonald P. Post-Transplantation Outcomes of Adult Congenital Heart Disease. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1239] [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: 04/05/2023] Open
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Gupta MB, Bagri S, Garg A, Singh DK, Choudhary P, Sahni S. Pulmonary function in cured pulmonary tuberculosis cases. Indian J Tuberc 2022; 69:535-538. [PMID: 36460385 DOI: 10.1016/j.ijtb.2021.08.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 08/16/2021] [Indexed: 06/17/2023]
Abstract
BACKGROUND In clinical practice it has been observed that several patients of cured pulmonary tuberculosis (PTB) suffer with lung dysfunction and these problems are less documented routinely. Prevalence of these abnormalities remains unknown. Aim of this study is to estimate the lung function abnormality and exercise capacity including diffusion capacity of lung for carbon monoxide (DLCO) in cured PTB cases. METHODS A hospital based observational descriptive study was carried out among 100 patients with PTB, who had been declared cured. These patients were evaluated by spirometry and DLCO to assess their lung function and were classified as normal or abnormal. Modified medical research council (mMRC) dyspnea scale for symptom assessment and 6-minute walk test (6MWT) to determine the exercise capacity was also done. Borg's scale was used for dyspnea assessment in 6MWT. RESULTS 83 (83%) patients having abnormal spirometry, 17 (17%) had obstructive pattern, 32 (32%) had restrictive pattern and 34 (34%) had mixed pattern. 22 (22%) patients had mild decrease in DLCO, 43 (43%) patients had moderate decrease in DLCO, while only 4 (4%) had severe decrease in DLCO. More than half of the patients having normal spirometry had reduced in DLCO. CONCLUSION The prevalence of abnormal lung functions is high even after complete anti-tubercular treatment. DLCO could be a better tool for evaluation of lung function in these patients. There is need to strengthen the National Programme to detect and treat TB patient earlier, also there is need to formulate guidelines for pulmonary rehabilitation of cured PTB patient.
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Affiliation(s)
- Mohan Bandhu Gupta
- Dept. Respiratory Medicine, School of Medical Sciences & Research, Gautam Buddh Nagar, India
| | - Sharad Bagri
- School of Medical Sciences & Research, Gautam Buddh Nagar, India
| | - Ankur Garg
- Dept. Respiratory Medicine, School of Medical Sciences & Research, Gautam Buddh Nagar, India
| | - Devendra Kumar Singh
- Dept. Respiratory Medicine, School of Medical Sciences & Research, Gautam Buddh Nagar, India.
| | - Prashant Choudhary
- Dept. Respiratory Medicine, School of Medical Sciences & Research, Gautam Buddh Nagar, India
| | - Subah Sahni
- Dept. Respiratory Medicine, School of Medical Sciences & Research, Gautam Buddh Nagar, India
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Camerlingo N, Vettoretti M, Del Favero S, Facchinetti A, Choudhary P, Sparacino G. Generation of post-meal insulin correction boluses in type 1 diabetes simulation models for in-silico clinical trials: More realistic scenarios obtained using a decision tree approach. Comput Methods Programs Biomed 2022; 221:106862. [PMID: 35597208 DOI: 10.1016/j.cmpb.2022.106862] [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: 02/04/2022] [Revised: 04/19/2022] [Accepted: 05/07/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND AND OBJECTIVE In type 1 diabetes (T1D) research, in-silico clinical trials (ISCTs) notably facilitate the design/testing of new therapies. Published simulation tools embed mathematical models of blood glucose (BG) and insulin dynamics, continuous glucose monitoring (CGM) sensors, and insulin treatments, but lack a realistic description of some aspects of patient lifestyle impacting on glucose control. Specifically, to effectively simulate insulin correction boluses, required to treat post-meal hyperglycemia (BG > 180 mg/dL), the timing of the bolus may be influenced by subjects' behavioral attitudes. In this work, we develop an easily interpretable model of the variability of correction bolus timing observed in real data, and embed it into a popular simulation tool for ISCTs. METHODS Using data collected in 196 adults with T1D monitored in free-living conditions, we trained a decision tree (DT) model to classify whether a correction bolus is injected in a future time window, based on predictors collected back in time, related to CGM data, previous insulin boluses and subject's characteristics. The performance was compared to that of a logistic regression classifier with LASSO regularization (LC), trained on the same dataset. After validation, the DT was embedded within a popular T1D simulation tool and an ISCT was performed to compare the simulated correction boluses against those observed in a subset of data not used for model training. RESULTS The DT provided better classification performance (accuracy: 0.792, sensitivity: 0.430, specificity: 0.878, precision: 0.455) than the LC and presented good interpretability. The most predictive features were related to CGM (and its temporal variations), time since the last insulin bolus, and time of the day. The correction boluses simulated by the DT, after implementation in the simulation tool, showed a good agreement with real-world data. CONCLUSIONS The DT developed in this work represents a simple set of rules to mimic the same timing of correction boluses observed on real data. The inclusion of the model in simulation tools allows investigators to perform ISCTs that more realistically represent the patient behavior in taking correction boluses and the post-prandial BG response. In the future, more complex models can be investigated.
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Affiliation(s)
- N Camerlingo
- Department of Information Engineering, University of Padova, Via G. Gradenigo 6B, Padova 35131, Italy
| | - M Vettoretti
- Department of Information Engineering, University of Padova, Via G. Gradenigo 6B, Padova 35131, Italy
| | - S Del Favero
- Department of Information Engineering, University of Padova, Via G. Gradenigo 6B, Padova 35131, Italy
| | - A Facchinetti
- Department of Information Engineering, University of Padova, Via G. Gradenigo 6B, Padova 35131, Italy
| | - P Choudhary
- Department of Diabetes, Leicester Diabetes Centre, University of Leicester, Gwendolen Rd, Leicester LE5 4PW, United Kingdom
| | - G Sparacino
- Department of Information Engineering, University of Padova, Via G. Gradenigo 6B, Padova 35131, Italy.
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Sathyanarayanan A, Crabtree T, Choudhary P, Elliott J, Evans ML, Lumb A, Wilmot EG. Delivering evidence-based interventions for type 1 diabetes in the virtual world - A review of UK practice during the SARS-CoV-2 pandemic. Diabetes Res Clin Pract 2022; 185:109777. [PMID: 35157943 PMCID: PMC8831709 DOI: 10.1016/j.diabres.2022.109777] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 02/02/2022] [Accepted: 02/07/2022] [Indexed: 12/05/2022]
Abstract
AIMS This review considers the impact of the SARS-CoV-2 pandemic on access to interventions for those living with type 1 diabetes and discusses the solutions which have been considered and actioned to ensure ongoing access care. METHODS We performed a focussed review of the published literature, and the guidelines for changes that have been effected during the pandemic. We also drew from expert recommendations and information about local practice changes for areas where formal data have not been published. RESULTS Evidence based interventions which support the achievement of improved glucose levels and/or reduction in hypoglycaemia include group structured education to support self-management, insulin pump therapy and continuous glucose monitoring. The SARS-CoV-2 pandemic had impacted the ability of diabetes services to deliver these intervention. Multiple adaptations have been put in place - transition to online delivery of education and care, and usage of diabetes technology. CONCLUSIONS Although various adaptations have been made during the pandemic that have positively influenced uptake of services, there are many areas of delivery that need immediate improvement in the UK. We recommend a proactive approach in recognising the digital divide and inequity in distribution of these changes and we recommend introducing measures to reduce them.
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Affiliation(s)
| | - T Crabtree
- University Hospitals of Derby and Burton NHS FT, DE22 3NE, UK; Division of Medical Sciences & Graduate Entry Medicine, School of Medicine, University of Nottingham, NG7 2RD, UK.
| | - P Choudhary
- Diabetes Research Centre, Leicester Diabetes Centre - Bloom, University of Leicester, LE1 7RH, UK.
| | - J Elliott
- Department of Oncology and Metabolism, University of Sheffield, S10 2TN, UK.
| | - M L Evans
- Wellcome Trust/ MRC Institute of Metabolic Science and Department of Medicine, University of Cambridge, CB2 1TN, UK.
| | - A Lumb
- Oxford Centre for Diabetes, Endocrinology and Metabolism, Churchill Hospital, Oxford OX3 7LE, UK; NIHR Oxford Biomedical Research Centre, Oxford OX4 2PG, UK.
| | - E G Wilmot
- University Hospitals of Derby and Burton NHS FT, DE22 3NE, UK; Division of Medical Sciences & Graduate Entry Medicine, School of Medicine, University of Nottingham, NG7 2RD, UK
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Makarious D, Choudhary P. Cardiac Resynchronisation Therapy in Adult Congenital Heart Disease: A Review of the Literature. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.445] [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: 11/24/2022]
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Conte S, Choudhary P, Iyer A, Jansz P, Macdonald P, Muthiah K. Midodrine to Treat Protein-Losing Enteropathy for Heart Transplant Candidacy. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.103] [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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10
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Singh D, Garg A, Bagri S, Choudhary P, Gupta M, Gaur S. The adverse effects of solid biomass fuel exposure on lung functions in non-smoking female population. J Family Med Prim Care 2022; 11:2499-2502. [PMID: 36119155 PMCID: PMC9480628 DOI: 10.4103/jfmpc.jfmpc_883_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 10/07/2021] [Accepted: 10/11/2021] [Indexed: 11/25/2022] Open
Abstract
Background: Though, smoking is the leading cause of chronic obstructive pulmonary disease worldwide, the household air pollution due to use of solid biomass fuel is considered as a major risk factor for the development of obstructive lung disease. The aim of the study was to assess the effect of solid biomass fuel exposure on lung functions in non-smoking female population. Methods: A hospital based, descriptive cross sectional study was carried out among 140 non-smoking female patients aged 40 or more and who had been exposed to solid biomass fuel. These patients underwent spirometry to assess their lung function and were classified as obstructive, restrictive or mixed. Modified medical research council (mMRC) dyspnoea scale for symptom assessment, 6-minute walk test (6 MWT) to determine the exercise capacity and Cumulative exposure index to assess the duration of exposure were also done. Results: All 140 (100%) patients having abnormal lung function, 4 (2.86%) had restrictive pattern, 5 (3.57%) had mixed pattern and 131 (93.57%) had obstructive pattern. Of 131 patients having obstructive pattern, 11 had mild obstruction, 49 had moderate obstruction, 39 had severe obstruction and 32 had very severe obstruction. Most commonly used biomass fuel was wood (43.57%). All the patients had shortness of breath, whereas cough was present in only 35.71% cases. 77 (55%) patients presented with a dyspnoea of mMRC grade 3 and above. Conclusion: Cumulative exposure index for solid biomass fuel is directly proportional to the severity of lung impairment as well as the symptom severity.
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Kha R, Melov S, Alahakoon T, Kirby A, Choudhary P. Predicting Cardiac and Pregnancy Outcomes in Women With Adult Congenital Heart Disease: How Much Does Physiology Matter? Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Camerlingo N, Vettoretti M, Sparacino G, Facchinetti A, Mader JK, Choudhary P, Del Favero S. A Mathematical Formula to Determine the Minimum Continuous Glucose Monitoring Duration to Assess Time-in-ranges: Sensitivity Analysis Over the Parameters. Annu Int Conf IEEE Eng Med Biol Soc 2021; 2021:1435-1438. [PMID: 34891555 DOI: 10.1109/embc46164.2021.9630689] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
In diabetes management, the fraction of time spent with glucose concentration within the physiological range of [70-180] mg/dL, namely time in range (TIR) is often computed by clinicians to assess glycemic control using a continuous glucose monitoring sensor. However, a sufficiently long monitoring period is required to reliably estimate this index. A mathematical equation derived by our group provides the minimum trial duration granting a desired uncertainty around the estimated TIR. The equation involves two parameters, pr and α, related to the population under analysis, which should be set based on the clinician's experience. In this work, we evaluated the sensitivity of the formula to the parameters.Considering two independent datasets, we predicted the uncertainty of TIR estimate for a population, using the parameters of the formula estimated for a different population. We also stressed the robustness of the formula by testing wider ranges of parameters, thus assessing the impact of large errors in the parameters' estimates.Plausible errors on the α estimate impact very slightly on the prediction (relative discrepancy < 5%), thus we suggest using a fixed value for α independently on the population being analyzed. Instead, pr should be adjusted to the TIR expected in the population, considering that errors around 20% result in a relative discrepancy of ~10%.In conclusion, the proposed formula is sufficiently robust to parameters setting and can be used by investigators to determine a suitable duration of the study.
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Choudhary P, Fourie KR, Ng S, Hamonic G, Bérubé N, Popowych Y, Wilson HL. Intrauterine immunizations trigger antigen-specific mucosal and systemic immunity in pigs and passive protection in suckling piglets. Vaccine 2021; 39:6322-6332. [PMID: 34535320 DOI: 10.1016/j.vaccine.2021.08.080] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 07/17/2021] [Accepted: 08/23/2021] [Indexed: 01/17/2023]
Abstract
We assessed whether vaccines administered to the uterus at breeding can lead to sufficient colostral antibodies to protect suckling piglets against Porcine Endemic Diarrhea Virus (PEDV). An antigen from Lawsonia intracellularis, a disease that impacts weanling intestinal health, was also included because we have extensive knowledge on the pig immune response to this antigen. Gilts were mock-bred at 2nd estrus with killed sperm including an intrauterine (i.u.) vaccine comprised of recombinant (r) PEDV Spike protein (rPEDVS1) and L. intracellularis flagellin (rFliC) formulated with poly I:C, host defense peptide, and polyphosphazene (TriAdj). Gilts returned to estrus within 3 weeks and they were inseminated with killed sperm (3rd estrus) or live sperm (4th estrus) with rPEDVS1-TriAdj vaccine. They also received an i.m. injection of rFliC-TriAdj at 3rd and 4th estrus to establish whether i.u. vaccination primes systemic immunity without inducing mucosal tolerance. Control gilts were administered semen alone at 2nd estrus which allowed us to compare litter weights and sizes to industry standards. Colostrum from gilts challenged with low dose PEDV plus alum was used as positive reference samples for neutralizing antibodies and passive protection. Thirteen weeks later, the i.u.-vaccinated gilts showed significant PEDVS1-specific serum, colostral, and uterine antibody titers and colostral PEDVS1-neutralizing antibodies but poor cell-mediated immunity. Piglets born to i.u. vaccinated gilts received partial passive protection from PEDV infection 3 days after birth but eventually succumbed to the disease. Immunization by the i.u./i.m. route triggered significant anti-FliC cell-mediated immunity and colostral FliC antibodies that remained high in weaned piglet serum. This trial and a repeat trial wherein gilts were immunized at 1st estrus without semen and at 2nd estrus with live semen showed that intrauterine immunization did not impact fertility, number of live births or piglet growth kinetics. Further optimization is needed to promote robust passive protection in suckling offspring.
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Affiliation(s)
- P Choudhary
- Vaccine and Infectious Disease Organization (VIDO), University of Saskatchewan, 120 Veterinary Road, Saskatoon, Saskatchewan S7N5E3, Canada
| | - K R Fourie
- Vaccine and Infectious Disease Organization (VIDO), University of Saskatchewan, 120 Veterinary Road, Saskatoon, Saskatchewan S7N5E3, Canada; Department of Veterinary Microbiology, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Saskatchewan S7N 5B4, Canada
| | - S Ng
- Vaccine and Infectious Disease Organization (VIDO), University of Saskatchewan, 120 Veterinary Road, Saskatoon, Saskatchewan S7N5E3, Canada
| | - G Hamonic
- Department of Large Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, S7N 5B4, Canada
| | - N Bérubé
- Vaccine and Infectious Disease Organization (VIDO), University of Saskatchewan, 120 Veterinary Road, Saskatoon, Saskatchewan S7N5E3, Canada
| | - Y Popowych
- Vaccine and Infectious Disease Organization (VIDO), University of Saskatchewan, 120 Veterinary Road, Saskatoon, Saskatchewan S7N5E3, Canada
| | - H L Wilson
- Vaccine and Infectious Disease Organization (VIDO), University of Saskatchewan, 120 Veterinary Road, Saskatoon, Saskatchewan S7N5E3, Canada; Department of Veterinary Microbiology, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Saskatchewan S7N 5B4, Canada.
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Bornstein SR, Guan K, Brunßen C, Mueller G, Kamvissi-Lorenz V, Lechler R, Trembath R, Mayr M, Poston L, Sancho R, Ahmed S, Alfar E, Aljani B, Alves TC, Amiel S, Andoniadou CL, Bandral M, Belavgeni A, Berger I, Birkenfeld A, Bonifacio E, Chavakis T, Chawla P, Choudhary P, Cujba AM, Delgadillo Silva LF, Demcollari T, Drotar DM, Duin S, El-Agroudy NN, El-Armouche A, Eugster A, Gado M, Gavalas A, Gelinsky M, Guirgus M, Hansen S, Hanton E, Hasse M, Henneicke H, Heller C, Hempel H, Hogstrand C, Hopkins D, Jarc L, Jones PM, Kamel M, Kämmerer S, King AJF, Kurzbach A, Lambert C, Latunde-Dada Y, Lieberam I, Liers J, Li JW, Linkermann A, Locke S, Ludwig B, Manea T, Maremonti F, Marinicova Z, McGowan BM, Mickunas M, Mingrone G, Mohanraj K, Morawietz H, Ninov N, Peakman M, Persaud SJ, Pietzsch J, Cachorro E, Pullen TJ, Pyrina I, Rubino F, Santambrogio A, Schepp F, Schlinkert P, Scriba LD, Siow R, Solimena M, Spagnoli FM, Speier S, Stavridou A, Steenblock C, Strano A, Taylor P, Tiepner A, Tonnus W, Tree T, Watt F, Werdermann M, Wilson M, Yusuf N, Ziegler CG. The transCampus Metabolic Training Programme Explores the Link of SARS-CoV-2 Virus to Metabolic Disease. Horm Metab Res 2021; 53:204-206. [PMID: 33652492 DOI: 10.1055/a-1377-6583] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Currently, we are experiencing a true pandemic of a communicable disease by the virus SARS-CoV-2 holding the whole world firmly in its grasp. Amazingly and unfortunately, this virus uses a metabolic and endocrine pathway via ACE2 to enter our cells causing damage and disease. Our international research training programme funded by the German Research Foundation has a clear mission to train the best students wherever they may come from to learn to tackle the enormous challenges of diabetes and its complications for our society. A modern training programme in diabetes and metabolism does not only involve a thorough understanding of classical physiology, biology and clinical diabetology but has to bring together an interdisciplinary team. With the arrival of the coronavirus pandemic, this prestigious and unique metabolic training programme is facing new challenges but also new opportunities. The consortium of the training programme has recognized early on the need for a guidance and for practical recommendations to cope with the COVID-19 pandemic for the community of patients with metabolic disease, obesity and diabetes. This involves the optimal management from surgical obesity programmes to medications and insulin replacement. We also established a global registry analyzing the dimension and role of metabolic disease including new onset diabetes potentially triggered by the virus. We have involved experts of infectious disease and virology to our faculty with this metabolic training programme to offer the full breadth and scope of expertise needed to meet these scientific challenges. We have all learned that this pandemic does not respect or heed any national borders and that we have to work together as a global community. We believe that this transCampus metabolic training programme provides a prime example how an international team of established experts in the field of metabolism can work together with students from all over the world to address a new pandemic.
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Affiliation(s)
- S R Bornstein
- Department of Medicine III, Medical Faculty Carl Gustav Carus, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Germany
- Division of Diabetes & Nutritional Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
- University Hospital Zurich, Department of Endocrinology and Diabetology, Zurich, Switzerland
- Paul Langerhans Institute Dresden (PLID) of the Helmholtz Center Munich at the University Hospital Carl Gustav Carus and Medical Faculty, Dresden, Germany
| | - K Guan
- Institute of Pharmacology and Toxicology, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - C Brunßen
- Division of Vascular Endothelium and Microcirculation, Department of Medicine III, Medical Faculty Carl Gustav Carus, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Germany
| | - G Mueller
- Department of Medicine III, Medical Faculty Carl Gustav Carus, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Germany
| | - V Kamvissi-Lorenz
- Division of Diabetes & Nutritional Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | | | - R Trembath
- Department of Medical & Molecular Genetics, King's College London, London, UK
| | - M Mayr
- School of Cardiovascular Medicine and Science, Faculty of Life Science & Medicine, KCL, London, UK
| | - L Poston
- Department of Women and Children's Health, School of Life Course Sciences, King's College London, London, UK
| | - R Sancho
- Department of Medicine III, Medical Faculty Carl Gustav Carus, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Germany
- Centre for Stem Cells and Regenerative Medicine, King's College London, London, UK
| | - S Ahmed
- Center for Regenerative Therapies Dresden, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - E Alfar
- Institute of Pharmacology and Toxicology, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - B Aljani
- Center for Regenerative Therapies Dresden, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - T C Alves
- Institute for Clinical Chemistry and Laboratory Medicine, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - S Amiel
- Department of Diabetes Research, School of Life Course Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - C L Andoniadou
- Department of Medicine III, Medical Faculty Carl Gustav Carus, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Germany
- Craniofacial Development and Stem Cell Biology, KCL, London, UK
| | - M Bandral
- Paul Langerhans Institute Dresden (PLID) of the Helmholtz Center Munich at the University Hospital Carl Gustav Carus and Medical Faculty, Dresden, Germany
| | - A Belavgeni
- Department of Medicine III, Medical Faculty Carl Gustav Carus, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Germany
| | - I Berger
- Department of Medicine III, Medical Faculty Carl Gustav Carus, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Germany
| | - A Birkenfeld
- Department of Medicine III, Medical Faculty Carl Gustav Carus, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Germany
- Division of Diabetes & Nutritional Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany
| | - E Bonifacio
- Center for Regenerative Therapies Dresden, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
- Paul Langerhans Institute Dresden (PLID) of the Helmholtz Center Munich at the University Hospital Carl Gustav Carus and Medical Faculty, Dresden, Germany
| | - T Chavakis
- Institute for Clinical Chemistry and Laboratory Medicine, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - P Chawla
- Paul Langerhans Institute Dresden (PLID) of the Helmholtz Center Munich at the University Hospital Carl Gustav Carus and Medical Faculty, Dresden, Germany
| | - P Choudhary
- Division of Diabetes & Nutritional Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - A M Cujba
- Department of Medicine III, Medical Faculty Carl Gustav Carus, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Germany
| | - L F Delgadillo Silva
- Paul Langerhans Institute Dresden (PLID) of the Helmholtz Center Munich at the University Hospital Carl Gustav Carus and Medical Faculty, Dresden, Germany
| | - T Demcollari
- Centre for Stem Cells and Regenerative Medicine, King's College London, London, UK
| | - D M Drotar
- Paul Langerhans Institute Dresden (PLID) of the Helmholtz Center Munich at the University Hospital Carl Gustav Carus and Medical Faculty, Dresden, Germany
| | - S Duin
- Department of Medicine III, Medical Faculty Carl Gustav Carus, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Germany
- Centre for Translational Bone, Joint and Soft Tissue Research, Medical Faculty and University Hospital, Technische Universität Dresden, Dresden, Germany
| | - N N El-Agroudy
- Department of Medicine III, Medical Faculty Carl Gustav Carus, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Germany
| | - A El-Armouche
- Institute of Pharmacology and Toxicology, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - A Eugster
- Center for Regenerative Therapies Dresden, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - M Gado
- Department of Medicine III, Medical Faculty Carl Gustav Carus, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Germany
| | - A Gavalas
- Paul Langerhans Institute Dresden (PLID) of the Helmholtz Center Munich at the University Hospital Carl Gustav Carus and Medical Faculty, Dresden, Germany
| | - M Gelinsky
- Centre for Translational Bone, Joint and Soft Tissue Research, Medical Faculty and University Hospital, Technische Universität Dresden, Dresden, Germany
| | - M Guirgus
- Paul Langerhans Institute Dresden (PLID) of the Helmholtz Center Munich at the University Hospital Carl Gustav Carus and Medical Faculty, Dresden, Germany
| | - S Hansen
- Institute of Pharmacology and Toxicology, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - E Hanton
- Peter Gorer Department of Immunobiology, Guy's Hospital, London, UK
| | - M Hasse
- Institute of Pharmacology and Toxicology, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - H Henneicke
- Department of Medicine III, Medical Faculty Carl Gustav Carus, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Germany
| | - C Heller
- Department of Medicine III, Medical Faculty Carl Gustav Carus, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Germany
| | - H Hempel
- Division of Vascular Endothelium and Microcirculation, Department of Medicine III, Medical Faculty Carl Gustav Carus, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Germany
| | - C Hogstrand
- Department of Nutritional Sciences, Faculty of Life Sciences & Medicine, KCL, London, UK
| | - D Hopkins
- Department of Diabetic Medicine, King's College Hospital NHS Foundation Trust and KCL, London, UK
| | - L Jarc
- Paul Langerhans Institute Dresden (PLID) of the Helmholtz Center Munich at the University Hospital Carl Gustav Carus and Medical Faculty, Dresden, Germany
| | - P M Jones
- Department of Diabetes Research, School of Life Course Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - M Kamel
- Paul Langerhans Institute Dresden (PLID) of the Helmholtz Center Munich at the University Hospital Carl Gustav Carus and Medical Faculty, Dresden, Germany
| | - S Kämmerer
- Institute of Pharmacology and Toxicology, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - A J F King
- Department of Diabetes Research, School of Life Course Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - A Kurzbach
- Department of Medicine III, Medical Faculty Carl Gustav Carus, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Germany
| | - C Lambert
- Centre for Stem Cells and Regenerative Medicine, King's College London, London, UK
| | | | - I Lieberam
- Centre for Stem Cells and Regenerative Medicine, King's College London, London, UK
| | - J Liers
- Department of Radiopharmaceutical and Chemical Biology, Institute of Radiopharmaceutical Cancer Research, Helmholtz-Zentrum Dresden-Rossendorf, Dresden, Germany
| | - J W Li
- Center for Regenerative Therapies Dresden, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - A Linkermann
- Department of Medicine III, Medical Faculty Carl Gustav Carus, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Germany
| | - S Locke
- Department of Medicine III, Medical Faculty Carl Gustav Carus, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Germany
| | - B Ludwig
- Department of Medicine III, Medical Faculty Carl Gustav Carus, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Germany
- University Hospital Zurich, Department of Endocrinology and Diabetology, Zurich, Switzerland
- Paul Langerhans Institute Dresden (PLID) of the Helmholtz Center Munich at the University Hospital Carl Gustav Carus and Medical Faculty, Dresden, Germany
- Center for Regenerative Therapies Dresden, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - T Manea
- Centre for Stem Cells and Regenerative Medicine, King's College London, London, UK
| | - F Maremonti
- Department of Medicine III, Medical Faculty Carl Gustav Carus, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Germany
| | - Z Marinicova
- Paul Langerhans Institute Dresden (PLID) of the Helmholtz Center Munich at the University Hospital Carl Gustav Carus and Medical Faculty, Dresden, Germany
| | - B M McGowan
- Department of Diabetes and Endocrinology, London, UK
| | - M Mickunas
- Peter Gorer Department of Immunobiology, Guy's Hospital, London, UK
| | - G Mingrone
- Department of Diabetes Research, School of Life Course Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Università Cattolica del Sacro Cuore, Rome, Italy
| | - K Mohanraj
- Institute for Clinical Chemistry and Laboratory Medicine, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - H Morawietz
- Division of Vascular Endothelium and Microcirculation, Department of Medicine III, Medical Faculty Carl Gustav Carus, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Germany
| | - N Ninov
- Paul Langerhans Institute Dresden (PLID) of the Helmholtz Center Munich at the University Hospital Carl Gustav Carus and Medical Faculty, Dresden, Germany
| | - M Peakman
- Peter Gorer Department of Immunobiology, Guy's Hospital, London, UK
| | - S J Persaud
- Department of Diabetes Research, School of Life Course Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - J Pietzsch
- Department of Radiopharmaceutical and Chemical Biology, Institute of Radiopharmaceutical Cancer Research, Helmholtz-Zentrum Dresden-Rossendorf, Dresden, Germany
| | - E Cachorro
- Institute of Pharmacology and Toxicology, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - T J Pullen
- School of Life Course Sciences, Faculty of Life Sciences & Medicine, KCL, London, UK
| | - I Pyrina
- Institute for Clinical Chemistry and Laboratory Medicine, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - F Rubino
- Department of Diabetes Research, School of Life Course Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - A Santambrogio
- Department of Medicine III, Medical Faculty Carl Gustav Carus, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Germany
| | - F Schepp
- Department of Medicine III, Medical Faculty Carl Gustav Carus, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Germany
| | - P Schlinkert
- Institute of Pharmacology and Toxicology, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - L D Scriba
- Department of Medicine III, Medical Faculty Carl Gustav Carus, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Germany
| | - R Siow
- Vascular Biology & Inflammation Section, School of Cardiovascular Medicine & Sciences, British Heart Foundation of Research Excellence, King's College London, London, UK
| | - M Solimena
- Paul Langerhans Institute Dresden (PLID) of the Helmholtz Center Munich at the University Hospital Carl Gustav Carus and Medical Faculty, Dresden, Germany
- Molecular Diabetology, University Hospital and Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - F M Spagnoli
- Centre for Stem Cells and Regenerative Medicine, King's College London, London, UK
| | - S Speier
- Paul Langerhans Institute Dresden (PLID) of the Helmholtz Center Munich at the University Hospital Carl Gustav Carus and Medical Faculty, Dresden, Germany
| | - A Stavridou
- Center for Regenerative Therapies Dresden, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - C Steenblock
- Department of Medicine III, Medical Faculty Carl Gustav Carus, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Germany
| | - A Strano
- Institute of Pharmacology and Toxicology, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - P Taylor
- Department of Women and Children's Health, School of Life Course Sciences, King's College London, London, UK
| | - A Tiepner
- Institute of Pharmacology and Toxicology, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - W Tonnus
- Department of Medicine III, Medical Faculty Carl Gustav Carus, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Germany
| | - T Tree
- Peter Gorer Department of Immunobiology, Guy's Hospital, London, UK
| | - F Watt
- Centre for Stem Cells and Regenerative Medicine, King's College London, London, UK
| | - M Werdermann
- Department of Medicine III, Medical Faculty Carl Gustav Carus, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Germany
| | - M Wilson
- School of Life Course Sciences, Faculty of Life Sciences & Medicine, KCL, London, UK
| | - N Yusuf
- Peter Gorer Department of Immunobiology, Guy's Hospital, London, UK
| | - C G Ziegler
- Department of Medicine III, Medical Faculty Carl Gustav Carus, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Germany
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15
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Waghmare RB, Choudhary P, Moses J, Anandharamakrishnan C, Stapley AG. Trends in Approaches to Assist Freeze-Drying of Food: A Cohort Study on Innovations. Food Reviews International 2021. [DOI: 10.1080/87559129.2021.1875232] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- Roji B. Waghmare
- Computational Modelling and Nanoscale Processing Unit, Indian Institute of Food Processing Technology (IIFPT), Ministry of Food Processing Industries, Govt. Of India, Thanjavur, India
| | - P. Choudhary
- Computational Modelling and Nanoscale Processing Unit, Indian Institute of Food Processing Technology (IIFPT), Ministry of Food Processing Industries, Govt. Of India, Thanjavur, India
| | - J.A. Moses
- Computational Modelling and Nanoscale Processing Unit, Indian Institute of Food Processing Technology (IIFPT), Ministry of Food Processing Industries, Govt. Of India, Thanjavur, India
| | - Chinnaswamy Anandharamakrishnan
- Computational Modelling and Nanoscale Processing Unit, Indian Institute of Food Processing Technology (IIFPT), Ministry of Food Processing Industries, Govt. Of India, Thanjavur, India
| | - Andrew G.F. Stapley
- Department of Chemical Engineering, Loughborough University, Leicestershire, UK
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Wilmot EG, Lumb A, Hammond P, Murphy HR, Scott E, Gibb FW, Platts J, Choudhary P. Time in range: A best practice guide for UK diabetes healthcare professionals in the context of the COVID-19 global pandemic. Diabet Med 2021; 38:e14433. [PMID: 33073388 PMCID: PMC7645943 DOI: 10.1111/dme.14433] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 09/21/2020] [Accepted: 10/15/2020] [Indexed: 12/15/2022]
Abstract
The emergence of continuous glucose monitoring has driven improvements in glycaemic control and quality of life for people with diabetes. Recent changes in access to continuous glucose monitoring systems within UK health services have increased the number of people able to benefit from these technologies. The COVID-19 pandemic has created an opportunity for diabetes healthcare professionals to use continuous glucose monitoring technology to remotely deliver diabetes services to support people with diabetes. This opportunity can be maximized with improved application and interpretation of continuous glucose monitoring-generated data. Amongst the diverse measures of glycaemic control, time in range is considered to be of high value in routine clinical care because it is actionable and is visibly responsive to changes in diabetes management. Importantly, it is also been linked to the risk of developing complications associated with diabetes and can be understood by people with diabetes and healthcare professionals alike. The 2019 International Consensus on Time in Range has established a series of target glucose ranges and recommendations for time spent within these ranges that is consistent with optimal glycaemic control. The recommendations cover people with type 1 or type 2 diabetes, with separate targets indicated for elderly people or those at higher risk from hypoglycaemia, as well as for women with type 1 diabetes during pregnancy. The aim of this best practice guide was to clarify the intent and purpose of these international consensus recommendations and to provide practical insights into their implementation in UK diabetes care.
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Affiliation(s)
- E. G. Wilmot
- Diabetes DepartmentRoyal Derby HospitalUniversity Hospitals of Derby and Burton NHS Foundation TrustDerbyUK
- Faculty of Medicine and Health SciencesUniversity of NottinghamNottinghamUK
| | - A. Lumb
- Oxford Centre for Diabetes, Endocrinology and MetabolismUniversity of OxfordOxfordUK
- NIHR Oxford Biomedical Research CentreOxfordUK
| | - P. Hammond
- Diabetes Resource CentreHarrogate District Hospital, Harrogate and District NHS Foundation TrustHarrogateUK
| | - H. R. Murphy
- Norwich Medical SchoolUniversity of East AngliaNorwichUK
- Women's Health Academic CentreDivision of Women's and Children's HealthKing's College LondonLondonUK
| | - E. Scott
- Leeds Institute for Cardiovascular and Metabolic MedicineUniversity of LeedsLeedsUK
| | - F. W. Gibb
- Edinburgh Centre for Endocrinology & DiabetesRoyal Infirmary of EdinburghLittle France CrescentEdinburghUK
- Centre for Cardiovascular ScienceUniversity of EdinburghEdinburghUK
| | - J. Platts
- Diabetes CentreUniversity Hospital LlandoughCardiff and Vale University Health BoardPenarthUK
| | - P. Choudhary
- Department of DiabetesSchool of Life Course SciencesKing's College LondonLondonUK
- Leicester Diabetes CentreUniversity of LeicesterLeicesterUK
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Chakranon P, Lai YK, Tang YW, Choudhary P, Khunti K, Lee SWH. Distal technology interventions in people with diabetes: an umbrella review of multiple health outcomes. Diabet Med 2020; 37:1966-1976. [PMID: 31631398 DOI: 10.1111/dme.14156] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [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] [Accepted: 10/18/2019] [Indexed: 12/15/2022]
Abstract
AIM To summarize and evaluate the existing evidence on the effectiveness of distal technology with regard to multiple health outcomes in people with diabetes. METHODS We searched PubMed, EMBASE and the Cochrane Database of Systematic Reviews from database inception to 31 August 2018 for systematic reviews and/or meta-analyses of studies that examined the impact of distal technology and reported any clinical or patient-related outcomes among people with type 1 or type 2 diabetes. RESULTS The umbrella review identified 95 reviews, including 162 meta-analyses with 46 unique outcomes. Evidence from meta-analyses of randomized controlled studies supports the use of distal technology, especially telehealth and mHealth (healthcare delivered by mobile technology), in people with diabetes for improving HbA1c values by 2-4 mmol/mol (0.2-0.4%). For other health outcomes, such as changes in fasting plasma glucose levels, risk of diabetic ketoacidosis or frequency of severe hypoglycaemia, the evidence was weaker. No evidence was reported for most patient-reported outcomes including quality of life, self-efficacy and medication-taking. The evidence base was poor, with most studies rated as low to very low quality. CONCLUSION Distal technologies were associated with a modest improvement in glycaemic control, but it was unclear if they improved major clinical outcomes or were cost-effective in people with diabetes. More robust research to improve wider outcomes in people with diabetes is needed before such technologies can be recommended as part of routine care for any patient group.
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Affiliation(s)
- P Chakranon
- Faculty of Pharmacy, Silapakorn University, Pathom, Thailand
| | - Y K Lai
- Department of Pharmacy, Hospital Universiti Kebangsaan Malaysia, Cheras, Malaysia
| | - Y W Tang
- School of Pharmacy, Monash University Malaysia, Bandar Sunway, Malaysia
| | - P Choudhary
- Department of Diabetes, School of Life Course Sciences, King's College London, London, UK
| | - K Khunti
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | - S W H Lee
- School of Pharmacy, Monash University Malaysia, Bandar Sunway, Malaysia
- Asian Centre for Evidence Synthesis in Population, Implementation and Clinical Outcomes (PICO), Health and Well-being Cluster, Global Asia in the 21st Century (GA21) Platform, Monash University Malaysia, Selangor, Malaysia
- School of Pharmacy, Taylor's University Lakeside Campus, Jalan Taylors, Selangor, Malaysia
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18
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Abstract
Growing numbers of people with type 1 diabetes are using do-it-yourself closed-loop systems. While these technologies are not approved by regulatory bodies and are not commercially available, users of the technology report improvements in HbA1c and time in range, and reduced burden of diabetes. Healthcare professionals have expressed their concern that legal or regulatory body actions could ensue if they support people who choose to use do-it-yourself closed-loop systems. Diabetes UK's position statements make recommendations that aim to provide guidance for both people with diabetes and healthcare professionals, based on the current professional and legal situation. They respect an individual's right to make their own informed decisions about their diabetes management, and recommend that they should have access to the technology they need for optimal diabetes management. People who wish to use do-it-yourself closed-loop systems should continue to receive support and care from their diabetes team. Healthcare professionals should engage in conversations around do-it-yourself closed-loop systems, if the issue is raised, to allow a balanced discussion of risks and benefits. However, healthcare professionals cannot recommend the use of do-it-yourself closed-loop systems because of a lack of regulatory body approval and robust, published research to support safety or effectiveness. People using this technology should be aware that they do so at their own risk. This position statement recognizes that the development of diabetes technology is a rapidly changing environment, and guidance around do-it-yourself systems is required from professional and regulatory bodies.
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Affiliation(s)
| | - E G Wilmot
- University Hospital of Derby and Burton NHS Foundation Trust, Derby, UK
| | - P Choudhary
- Department of Diabetes, School of Life Course Sciences, King's College London, London, UK
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19
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Nevrekar V, Choudhary P, Tiwari A, Suryaprakash V, Upadhyay A. 908P Impact of serum galactomannan assay on diagnosis and outcome of invasive fungal infections in high risk febrile neutropenia: A prospective cohort study. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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20
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Dalal PK, Roy D, Choudhary P, Kar SK, Tripathi A. Emerging mental health issues during the COVID-19 pandemic: An Indian perspective. Indian J Psychiatry 2020; 62:S354-S364. [PMID: 33227050 PMCID: PMC7659779 DOI: 10.4103/psychiatry.indianjpsychiatry_372_20] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 06/06/2020] [Accepted: 08/31/2020] [Indexed: 12/24/2022] Open
Abstract
The current global health crisis, the COVID-19 pandemic, has posed an unprecedented challenge to our health systems, economy, socio-political organizations, and the infrastructure of most countries and the world. This pandemic has affected physical health as well as mental health adversely. Several recent evidence suggests that health systems across the world have to improve their preparedness in context to infectious pandemics. The research on mental health aspects of COVID-19 and other related pandemics is lacking due to obvious reasons. This narrative review article, along with our personal views, is on various current and future mental health issues in the context of the COVID-19 pandemic focusing on various challenges and suggested solutions. The aim is also to update mental health strategies in the context of such rapidly spreading contagious illness, which can act as a resource for such a situation, currently and in future. We recommend that there is a need to facilitate mental health research to understand the psychiatric aspects of the COVID-19 pandemic, include psychiatrists in the task force, and make available psychotropic and other medications with special attention to the deprived sector of the society.
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Affiliation(s)
- P. K. Dalal
- Department of Psychiatry, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Deblina Roy
- Department of Psychiatry, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Prashant Choudhary
- Department of Psychiatry, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Sujita Kumar Kar
- Department of Psychiatry, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Adarsh Tripathi
- Department of Psychiatry, King George's Medical University, Lucknow, Uttar Pradesh, India
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21
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de Galan BE, McCrimmon RJ, Ibberson M, Heller SR, Choudhary P, Pouwer F, Speight J, Carlton J, Pieber TR, Rosilio M, Tack CJ, Müllenborn M. Reducing the burden of hypoglycaemia in people with diabetes through increased understanding: design of the Hypoglycaemia REdefining SOLutions for better liVEs (Hypo-RESOLVE) project. Diabet Med 2020; 37:1066-1073. [PMID: 31970814 PMCID: PMC7317819 DOI: 10.1111/dme.14240] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/16/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Hypoglycaemia is the most frequent complication of treatment with insulin or insulin secretagogues in people with diabetes. Severe hypoglycaemia, i.e. an event requiring external help because of cognitive dysfunction, is associated with a higher risk of adverse cardiovascular outcomes and all-cause mortality, but underlying mechanism(s) are poorly understood. There is also a gap in the understanding of the clinical, psychological and health economic impact of 'non-severe' hypoglycaemia and the glucose level below which hypoglycaemia causes harm. AIM To increase understanding of hypoglycaemia by addressing the above issues over a 4-year period. METHODS Hypo-RESOLVE is structured across eight work packages, each with a distinct focus. We will construct a large, sustainable database including hypoglycaemia data from >100 clinical trials to examine predictors of hypoglycaemia and establish glucose threshold(s) below which hypoglycaemia constitutes a risk for adverse biomedical and psychological outcomes, and increases healthcare costs. We will also investigate the mechanism(s) underlying the antecedents and consequences of hypoglycaemia, the significance of glucose sensor-detected hypoglycaemia, the impact of hypoglycaemia in families, and the costs of hypoglycaemia for healthcare systems. RESULTS The outcomes of Hypo-RESOLVE will inform evidence-based definitions regarding the classification of hypoglycaemia in diabetes for use in daily clinical practice, future clinical trials and as a benchmark for comparing glucose-lowering interventions and strategies across trials. Stakeholders will be engaged to achieve broadly adopted agreement. CONCLUSION Hypo-RESOLVE will advance our understanding and refine the classification of hypoglycaemia, with the ultimate aim being to alleviate the burden and consequences of hypoglycaemia in people with diabetes.
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Affiliation(s)
- B. E. de Galan
- Radboud University Medical CentreNijmegenThe Netherlands
- Maastricht University Medical Centre+MaastrichtThe Netherlands
| | | | - M. Ibberson
- Swiss Institute of BioinformaticsLausanneSwitzerland
| | | | | | - F. Pouwer
- University of Southern DenmarkOdenseDenmark
- Deakin UniversityGeelongAustralia
| | - J. Speight
- University of Southern DenmarkOdenseDenmark
- Deakin UniversityGeelongAustralia
- Australian Centre for Behavioural Research in DiabetesMelbourneAustralia
| | | | | | - M. Rosilio
- Lilly FranceNeuilly‐sur‐Seine CedexFrance
| | - C. J. Tack
- Radboud University Medical CentreNijmegenThe Netherlands
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22
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Kar SK, Choudhary P, Agarwal V, Dalal PK. Fusion of extended and accelerated protocol of rTMS in management of OCD: A case study. Asian J Psychiatr 2020; 48:101917. [PMID: 31901583 DOI: 10.1016/j.ajp.2019.101917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 12/25/2019] [Accepted: 12/25/2019] [Indexed: 10/25/2022]
Affiliation(s)
- Sujita Kumar Kar
- Department of Psychiatry, King George's Medical University, Lucknow, U.P., India.
| | - Prashant Choudhary
- Department of Psychiatry, King George's Medical University, Lucknow, U.P., India.
| | - Vivek Agarwal
- Department of Psychiatry, King George's Medical University, Lucknow, U.P., India.
| | - Pronob Kumar Dalal
- Department of Psychiatry, King George's Medical University, Lucknow, U.P., India.
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Femia G, Zhu D, Choudhary P, B. Ross S, Muthurangu V, Richmond D, Celermajer D, Semsarian C, Puranik R. 136 Long Term Clinical Outcomes in CMR Quantified Left Ventricular Noncompaction. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Garrett CJ, Choudhary P, Amiel SA, Fonagy P, Ismail K. Recurrent diabetic ketoacidosis and a brief history of brittle diabetes research: contemporary and past evidence in diabetic ketoacidosis research including mortality, mental health and prevention. Diabet Med 2019; 36:1329-1335. [PMID: 31418474 DOI: 10.1111/dme.14109] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [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] [Accepted: 08/13/2019] [Indexed: 12/11/2022]
Abstract
Pharmacological, technological and educational approaches have advanced the treatment of Type 1 diabetes in the last four decades and yet diabetic ketoacidosis (DKA) continues to be a leading cause of admission in Type 1 diabetes. This article begins by reviewing the contemporary epidemiological evidence in DKA. It highlights a rise in DKA episodes in the last two decades, with DKA continuing to be the leading cause of death in young people with Type 1 diabetes, and that DKA episodes are a marker for subsequent all-cause mortality. It also summarizes the limited evidence base for DKA prevention and associations with psychopathology. To emphasize the importance of this group with high-risk Type 1 diabetes and the degree to which they have been overlooked in the past two decades, the article summarizes the research literature of recurrent DKA during 1976-1991 when it was extensively investigated as part of the phenomenon of 'brittle diabetes'. This period saw numerous basic science studies investigating the pathophysiology of recurrent DKA. Subsequently, research centres published their experiences of brittle diabetes research participants manipulating their treatment under research conditions. Unfortunately, the driver for this behaviour and whether it was indicative of other people with ketoacidosis was not pursued. In summary, we suggest there has been a stasis in the approach to recurrent DKA prevention, which is likely linked to historical cases of mass sabotage of brittle diabetes research. Further investigation is required to clarify possible psychological characteristics that increase the risk of DKA and thereby targets for DKA prevention.
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Affiliation(s)
- C J Garrett
- Diabetes and Metabolism Department, Bart's Health NHS Trust, London, UK
- Diabetes and Mental Health Research Group, King's College London, London, UK
| | - P Choudhary
- Diabetes Research Group, King's College London, London, UK
| | - S A Amiel
- Diabetes Research Group, King's College London, London, UK
| | - P Fonagy
- Division of Psychology and Language Sciences at University College London, London, UK
| | - K Ismail
- Diabetes and Mental Health Research Group, King's College London, London, UK
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Choudhary P, de Portu S, Arrieta A, Castañeda J, Campbell FM. Use of sensor-integrated pump therapy to reduce hypoglycaemia in people with Type 1 diabetes: a real-world study in the UK. Diabet Med 2019; 36:1100-1108. [PMID: 31134668 DOI: 10.1111/dme.14043] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/25/2019] [Indexed: 01/04/2023]
Abstract
AIMS To assess the efficacy of insulin pumps with automated insulin suspension systems in a real-world setting. METHODS We analysed anonymized data uploaded to CareLink™ by people (n=920) with Type 1 diabetes using the MiniMed Paradigm Veo system and the MiniMed 640G system (Medtronic International Trading Sàrl, Tolochanez, Switzerland) with SmartGuard technology, with or without automated insulin suspension enabled, between February 2016 and June 2018. Users with ≥15 days of sensor data and ≥70% sensor-wear time were classified as sensor-augmented pump alone, sensor-integrated pump with low glucose suspend enabled or sensor-integrated pump with predictive low glucose management enabled. RESULTS The median (25th -75th percentile) system use was 161 (58-348) days. The median time spent with sensor glucose values ≤3 mmol/l was 0.8 (0.3-1.7)% in the sensor-augmented pump group, 0.3 (0.1-0.7)% in the sensor-integrated pump with low glucose suspend group, and 0.3 (0.1-0.5)% in the sensor-integrated pump with predictive low glucose management group. In individuals switching from sensor-augmented pump to sensor-integrated pump with low glucose suspend (n=31), there were significant reductions in the monthly rate of hypoglycaemic events <3 mmol/l (rate ratio 0.63, 95% CI 0.45-0.89; P=0.009) and in the percentage of time with glucose values ≤3 mmol/l [sensor-augmented pump: 0.63% (95% CI 0.34-1.29), sensor-integrated pump with low glucose suspend: 0.33% (95% CI 0.16-0.64); P=0.001]. The monthly rate of hypoglycaemic events decreased further in individuals (n=139) switching from sensor-integrated pump with low glucose suspend to sensor-integrated pump with predictive low glucose management [rate ratio 0.82 (95% CI 0.69-0.98); P<0.0274]. Similar results were seen for events <3.9 mmol/l. There was no difference in median time spent in target glucose range. CONCLUSION Real-world UK data show that increasing automation of insulin suspension reduces hypoglycaemia exposure in people with Type 1 diabetes.
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Affiliation(s)
- P Choudhary
- King's College London, School of Life Course Sciences, London, UK
| | - S de Portu
- Medtronic International Trading Sàrl, Tolochenaz, Switzerland
| | - A Arrieta
- Medtronic, Bakken Research Centre, Maastricht, The Netherlands
| | - J Castañeda
- Medtronic, Bakken Research Centre, Maastricht, The Netherlands
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Choudhary P, de Portu S, Delbaere A, Lyon J, Pickup JC. A modelling study of the budget impact of improved glycaemic control in adults with Type 1 diabetes in the UK. Diabet Med 2019; 36:988-994. [PMID: 30710449 DOI: 10.1111/dme.13924] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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] [Accepted: 01/31/2019] [Indexed: 01/08/2023]
Abstract
AIMS To develop a novel interactive budget impact model that assesses affordability of diabetes treatments in specific populations, and to test the model in a hypothetical scenario by estimating cost savings resulting from reduction in HbA1c from ≥69 mmol/mol (8.5%) to a target of 53 mmol/mol (7.0%) in adults with Type 1 diabetes in the UK. METHODS A dynamic, interactive model was created using the projected incidence and progression over a 5-year horizon of diabetes-related complications (micro- and macrovascular disease, severe hypoglycaemia and diabetic ketoacidosis) for different HbA1c levels, with flexible input of population size, complications and therapy costs, HbA1c distribution and other variables. The model took a National Health Service and societal perspective. RESULTS The model was developed, and in the proposed hypothetical situation, reductions in complications and expected costs evaluated. Achievement of target HbA1c in individuals with HbA1c ≥69 mmol/mol (8.5%) would reduce expected chronic complications from 6.8 to 1.2 events per 100 person-years, and diabetic ketoacidosis from 14.5 to 1.0 events per 100 person-years. Potential cumulative direct cost savings achievable in the modelled population were estimated at £687 m over 5 years (£5,585/person), with total (direct and indirect) savings of £1,034 m (£8,400/person). CONCLUSIONS Implementation of strategies aimed at achieving target glucose levels in people with Type 1 diabetes in the UK has the potential to drive a significant reduction in complication costs. This estimate may provide insights into the potential for investment in achieving savings through improved diabetes care in the UK.
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Affiliation(s)
- P Choudhary
- King's College London School of Life Course Sciences, London, UK
| | - S de Portu
- Medtronic International Trading, Tolochenaz, Switzerland
| | - A Delbaere
- Medtronic International Trading, Tolochenaz, Switzerland
| | - J Lyon
- Medtronic UK, Watford, UK
| | - J C Pickup
- King's College London School of Life Course Sciences, London, UK
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Choudhary P, Campbell F, Joule N, Kar P. A Type 1 diabetes technology pathway: consensus statement for the use of technology in Type 1 diabetes. Diabet Med 2019; 36:531-538. [PMID: 30773681 DOI: 10.1111/dme.13933] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/14/2019] [Indexed: 01/11/2023]
Abstract
In both adults and children with diabetes, technologies such as continuous subcutaneous insulin infusion using insulin pumps and continuous glucose monitoring can help improve diabetes control, reduce hypoglycaemia and improve quality of life. Access to these technologies in the UK is very variable. Some technologies are recommended by the National Institute for Health and Care Excellence, while others have not been appraised, and new technologies are emerging all the time. Additionally, different guidelines for adults and children further complicate access to diabetes technology in the transition from paediatric to adult care. Against this background, Diabetes UK and NHS England have brought together a multidisciplinary group of experts, including clinicians and people with diabetes, to develop this consensus guideline, combining the different technologies into a common pathway to aid clinical and policy decision-making. We created a pathway that supports the incremental addition of technology as monotherapy and then dual therapy in the same way that we incrementally add in therapeutic agents to support people with Type 2 diabetes to achieve their personalized glycaemic targets. The pathway emphasizes the importance of structured education, specialist support and appropriate access to psychological therapies, as essential pillars for optimized use of diabetes-related technology, and recommends the re-evaluation of its use when the individual is unable either to use the technology appropriately or to achieve the intended outcomes. This pathway is endorsed by UK-wide clinical and patient associations and we recommend that providers and commissioners use it to ensure the right individual with diabetes has access to the right technology in a timely way to help achieve better outcomes.
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Affiliation(s)
| | - F Campbell
- St James's University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | | | - P Kar
- Diabetes, NHS England, London, UK
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Bahl A, Choudhary P, Bhatia K, Singhla S, Shrivastava G, Bal J, Anand A, Chaturvedi H. Palliative chemotherapy (CT) with or without cetuximab (CTX) in recurrent or metastatic squamous cell carcinoma of the head and neck (R/M SCCHN): An Indian retrospective analysis. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy438.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Trivedi S, Choudhary P, Lo Q, Sritharan H, Batumalai V, Delaney G, Thomas L. P3498Persistent reductions in Global Longitudinal Strain late after completion of radiotherapy in chemotherapy naive patients with left sided breast cancer. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p3498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- S Trivedi
- Westmead Hospital, Department of Cardiology, Sydney, Australia
| | - P Choudhary
- Westmead Hospital, Department of Cardiology, Sydney, Australia
| | - Q Lo
- Liverpool Hospital, Department of Cardiology, Sydney, Australia
| | - H Sritharan
- Liverpool Hospital, Department of Cardiology, Sydney, Australia
| | - V Batumalai
- Liverpool Hospital, Cancer Therapy Centre, Sydney, Australia
| | - G Delaney
- Liverpool Hospital, Cancer Therapy Centre, Sydney, Australia
| | - L Thomas
- Westmead Hospital, Department of Cardiology, Sydney, Australia
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Shah S, Bhaskar V, Venkatraghavan K, Choudhary P, M. G, Trivedi K. Silver Diamine Fluoride: A Review and Current Applications. Journal of Advanced Oral Research 2018. [DOI: 10.1177/2229411220140106] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Shalin Shah
- College of Dental Science and Research Centre, Ahmedabad, Gujarat, India
| | - Vijay Bhaskar
- Department of Pedodontics and Preventive Dentistry, Ahmedabad Dental College and Hospital, Vivekanand Society, Bhadaj-Ranchhodpura, Gandhinagar, Gujarat
| | | | - Prashant Choudhary
- College of Dental Science and Research Centre, Ahmedabad, Gujarat, India
| | - Ganesh M.
- Department of Pedodontics and Preventive Dentistry, Ahmedabad Dental College and Hospital, Vivekanand Society, Bhadaj-Ranchhodpura, Gandhinagar, Gujarat
| | - Krishna Trivedi
- College of Dental Science and Research Centre, Ahmedabad, Gujarat, India
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Dere K, Choudhary P, Bhaskar V, Ganesh M, Venkataraghavan K, Shah S. Prevalence and Characteristics of Chewing Habits of Areca Nut, Gutka & Tobacco among School Children of Rural Areas in and Around Gandhinagar District, Gujarat. Journal of Advanced Oral Research 2018. [DOI: 10.1177/2229411220140205] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Krishna Dere
- Departments of Pedodontics and Preventive Dentistry, College of Dental Science and Research Centre, Manipur, Sanand, Ahmedabad
| | - Prashant Choudhary
- Departments of Pedodontics and Preventive Dentistry, College of Dental Science and Research Centre, Manipur, Sanand, Ahmedabad
| | - Vijay Bhaskar
- Ahmedabad Dental College and Hospital, Vivekanand Society, Santej, Rancharda, Kalol, Dist. Gandhinagar, Gujarat, India
| | - Mahadevan Ganesh
- Ahmedabad Dental College and Hospital, Vivekanand Society, Santej, Rancharda, Kalol, Dist. Gandhinagar, Gujarat, India
| | - Karthik Venkataraghavan
- Departments of Pedodontics and Preventive Dentistry, College of Dental Science and Research Centre, Manipur, Sanand, Ahmedabad
| | - Shalin Shah
- Departments of Pedodontics and Preventive Dentistry, College of Dental Science and Research Centre, Manipur, Sanand, Ahmedabad
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Abstract
The inability to achieve optimal diabetes glucose control in people with diabetes is multifactorial, but one contributor may be inadequate control of postprandial glucose. In patients treated with multiple daily injections of insulin, both the dose and timing of meal-related rapid-acting insulin are key factors in this. There are conflicting opinions and evidence on the optimal time to administer mealtime insulin. We performed a comprehensive literature search to review the published data, focusing on the use of rapid-acting insulin analogues in patients with Type 1 diabetes. Pharmacokinetic and pharmacodynamic studies of rapid-acting insulin analogues, together with postprandial glucose excursion data, suggest that administering these 15-20 min before food would provide optimal postprandial glucose control. Data from clinical studies involving people with Type 1 diabetes receiving structured meals and rapid-acting insulin analogues support this, showing a reduction in post-meal glucose levels of ~30% and less hypoglycaemia when meal insulin was taken 15-20 min before a meal compared with immediately before the meal. Importantly, there was also a greater risk of postprandial hypoglycaemia when patients took rapid-acting analogues after eating compared with before eating.
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Affiliation(s)
- D. Slattery
- Kings College LondonWeston Education CentreLondonUK
| | - S. A. Amiel
- Kings College LondonWeston Education CentreLondonUK
| | - P. Choudhary
- Kings College LondonWeston Education CentreLondonUK
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Abstract
Rhabdomyosarcoma (RMS), a malignant neoplasm of skeletal muscle origin, is the most common soft tissue sarcoma caused by infectious disease etiology, especially in nondeveloped countries. Despite being a relatively rare cancer, it accounts for approximately 40% of all recorded soft tissue sarcomas. Alveolar RMSs are seen to occur in children, while around 80% cases occur in the first three decades of life. We present here, a case of a 12-year-old child having alveolar RMS, presenting clinically and radiologically with pleural effusion.
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Affiliation(s)
- Tiwari K Vijayesh
- Department of Pulmonary Medicine, Rohilkhand Medical College and Hospital, Bareilly, Uttar Pradesh, India
| | - Abhishek Kumar
- Department of Pulmonary Medicine, Rohilkhand Medical College and Hospital, Bareilly, Uttar Pradesh, India
| | - Nitesh Mohan
- Department of Pathology, Rohilkhand Medical College and Hospital, Bareilly, Uttar Pradesh, India
| | - Pooja Bansal
- Department of Forensic Medicine, Rohilkhand Medical College and Hospital, Bareilly, Uttar Pradesh, India
| | - Prashant Choudhary
- Department of Pulmonary Medicine, Rohilkhand Medical College and Hospital, Bareilly, Uttar Pradesh, India
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Nekkanti S, Kaur K, Madiyal M, Choudhary P. Effect of chewing gums containing probiotics and xylitol on oral health in children: A randomized controlled trial. J Int Oral Health 2018. [DOI: 10.4103/jioh.jioh_170_18] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Choudhary S, Sivakumar I, Buzayan M, Choudhary P. Dimensional accuracy of double poured casts obtained from extended pour alginate impressions: An in vitro study. J Int Oral Health 2018. [DOI: 10.4103/jioh.jioh_199_18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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36
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Trivedi S, Choudhary P, Lo Q, Sritharan H, Batumalai V, Delaney G, Thomas L. Persistent Reductions in Global Longitudinal Strain Late After Radiotherapy in Chemotherapy Naive Left-Sided Breast Cancer Patients. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.490] [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: 11/26/2022]
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Sivasubramaniyam S, Amiel SA, Choudhary P. Proportion of daily capillary blood glucose readings required in the target range for target glycaemic control: shift of focus from target range to proportion in range. Diabet Med 2017; 34:1456-1460. [PMID: 28763121 DOI: 10.1111/dme.13438] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [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] [Accepted: 07/27/2017] [Indexed: 11/28/2022]
Abstract
AIM Most guidelines provide people with Type 1 diabetes with pre- and post-meal capillary blood glucose (CBG) targets to achieve optimal glycaemic control. We evaluated the proportion of daily CBG readings between 4 and 10 mmol/l in people achieving different HbA1c levels. METHOD We analysed CBG data from routine pump/meter downloads from 201 adults treated with continuous subcutaneous insulin infusion (CSII) at a single hospital clinic. Exclusion criteria were CSII < 6 months, < 3 CBG/day, pregnancy, haemoglobinopathy and continuous sensor use. People were categorized into three groups based on HbA1c : < 58 mmol/mol, < 7.5% (n = 58); 58-74 mmol/mol, 7.5-8.9% (n = 107); and ≥ 75 mmol/mol, ≥ 9.0% (n = 36). RESULTS Participants had a mean age of 43 ± 13 years and mean HBA1c of 64 mmol/mol (8.0 ± 1.1%). 47% of people started CSII for raised HbA1c , 25% due to hypoglycaemia and the rest during pregnancy. Downloads contained a mean of 22 ± 6.8 days of data per participant. CBG frequency was similar between the three groups (5.6 ± 2.0, 5.6 ± 1.9 and 5.4 ± 1.2 CBG/day; P = 0.468). The proportion of CBG readings between 4 and 10 mmol/l (72-180 mg/dl) was 57.3 ± 25.4%, 50.6 ± 11.1% and 39.9 ± 16.5% (P < 0.0001); < 4 mmol was 13.8%, 8.8% and 4.4% (P < 0.0001) and > 10 mmol/l was 28.9 ± 16.5%, 40.6 ± 12.1% and 55.6 ± 17.9% (P < 0.0001) in the three groups respectively. CONCLUSIONS Participants achieving HBA1c < 58 mmol/mol (< 7.5%) had ~ 60% of CBG readings in range (4-10 mmol/l), with up to 30% of readings > 10 mmol/l. This target of achieving 60% or more readings within target, and being permissive with up to 30% readings > 10 mmol/l may be a novel target for people with diabetes, and may reduce anxiety associated with readings out of range.
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Affiliation(s)
- S Sivasubramaniyam
- King's College London, London, UK
- London North West Healthcare Trust, London, UK
| | - S A Amiel
- King's College London, London, UK
- King's College Hospital, London, UK
| | - P Choudhary
- King's College London, London, UK
- King's College Hospital, London, UK
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Choudhary P, Roy P, Kumar Kar S. Improvement of weight and attitude towards eating behaviour with high frequency rTMS augmentation in anorexia nervosa. Asian J Psychiatr 2017; 28:160. [PMID: 28784375 DOI: 10.1016/j.ajp.2017.05.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2017] [Accepted: 05/07/2017] [Indexed: 10/19/2022]
Affiliation(s)
- Prashant Choudhary
- Department of Psychiatry, King George's Medical University, Lucknow, UP, India.
| | - Pritha Roy
- Department of Psychiatry, King George's Medical University, Lucknow, UP, India.
| | - Sujita Kumar Kar
- Department of Psychiatry, King George's Medical University, Lucknow, UP, India.
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Hope SV, Knight BA, Shields BM, Hill A, Choudhary P, Strain WD, Hattersley AT, McDonald TJ, Jones AG. 105RANDOM NON-FASTING C-PEPTIDE CAN BE USED AS A RISK ASSESSMENT TOOL FOR HYPOGLYCAEMIA IN ELDERLY NSULIN-TREATED PATIENTS WITH TYPE 2 DIABETES. Age Ageing 2017. [DOI: 10.1093/ageing/afx061.105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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40
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Bonadonna RC, Yale JF, Brulle-Wohlhueter C, Boëlle-Le Corfec E, Choudhary P, Bailey TS. Hypoglykämie als Funktion des HbA1c bei Typ-2-Diabetes mellitus (T2DM): Insulin glargin 300 E/ml in einer Metaanalyse auf Patientenebene der Studien EDITION 1, 2 und 3. DIABETOL STOFFWECHS 2017. [DOI: 10.1055/s-0037-1601738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- RC Bonadonna
- Division of Endocrinology, University of Parma School of Medicine, Parma, Italy
| | - JF Yale
- Division of Endocrinology and Metabolism, McGill University, Montreal, Canada
| | | | | | - P Choudhary
- Diabetes Research Group, King's College, London, United Kingdom
| | - TS Bailey
- AMCR Institute Inc., Escondido, United States
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41
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Dutta A, Sethi N, Choudhary P, Panday BC, Sood J. Abstract PR458. Anesth Analg 2016. [DOI: 10.1213/01.ane.0000492845.20898.ed] [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: 11/05/2022]
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42
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Zecchin R, Baihn J, Dickson C, Haeusler K, Hungerford J, Lindsay G, Pettitt M, Rull M, Te Siachico E, Te Whaiti S, Thelander J, Vail T, McNulty K, Choudhary P, Tanous D, Denniss R. Referral of Patients With Congenital Heart Disease to Cardiac Rehabilitation. Heart Lung Circ 2016. [DOI: 10.1016/j.hlc.2016.06.733] [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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McCombe A, Touma F, Jackson D, Canniffe C, Choudhary P, Pressley L, Tanous D, Robinson PJ, Celermajer D. Sudden cardiac death in adults with congenitally corrected transposition of the great arteries. Open Heart 2016; 3:e000407. [PMID: 27493760 PMCID: PMC4947757 DOI: 10.1136/openhrt-2016-000407] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Revised: 04/30/2016] [Accepted: 05/24/2016] [Indexed: 01/03/2023] Open
Abstract
Background Congenitally corrected transposition of the great arteries (ccTGA) is a rare congenital heart disease. There have been only few reports of sudden cardiac death (SCD) in patients with ccTGA and reasonable ventricular function. Methods A retrospective review of the medical records of all patients attending our adult congenital heart centre, with known ccTGA. Results From a database of over 3500 adult patients with congenital heart disease, we identified 39 (∼1%) with ccTGA and ‘two-ventricle’ circulations. 65% were male. The mean age at diagnosis was 12.4±11.4 years and the mean age at last time of review was 34.3±11.3 years. 24 patients (56%) had a history of surgical intervention. 8 (19%) had had pacemaker implantation and 2 had had a defibrillator implanted for non-sustained ventricular tachycardia (NSVT). In 544 years of patient follow-up, there had been five cases of SCD in our population; 1 death per 109 patient-years. Two of these patients had had previously documented supraventricular or NSVT. However, they were all classified as New York Heart Association (NYHA) class I or II, and systemic (right) ventricular function had been recorded as normal, mildly or mildly–moderately impaired, at most recent follow-up. Conclusions Our experience suggests the need for improved risk stratification and/or surveillance for malignant arrhythmia in adults with ccTGA, even in those with reasonable functional class on ventricular function.
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Affiliation(s)
- A McCombe
- Department of Cardiology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia; Discipline of Medicine, Central Clinical School, University of Sydney, Sydney, New South Wales, Australia
| | - F Touma
- Department of Cardiology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia; Discipline of Medicine, Central Clinical School, University of Sydney, Sydney, New South Wales, Australia
| | - D Jackson
- Department of Cardiology , Royal Prince Alfred Hospital , Sydney, New South Wales , Australia
| | - C Canniffe
- Department of Cardiology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia; Department of Cardiology, Mater Misericordiae Hospital, Dublin, Ireland
| | - P Choudhary
- Department of Cardiology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia; Discipline of Medicine, Central Clinical School, University of Sydney, Sydney, New South Wales, Australia; Department of Cardiology, Westmead Hospital, Sydney, New South Wales, Australia
| | - L Pressley
- Department of Cardiology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia; Discipline of Medicine, Central Clinical School, University of Sydney, Sydney, New South Wales, Australia
| | - D Tanous
- Department of Cardiology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia; Discipline of Medicine, Central Clinical School, University of Sydney, Sydney, New South Wales, Australia; Department of Cardiology, Westmead Hospital, Sydney, New South Wales, Australia
| | - Peter J Robinson
- Department of Cardiology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia; Discipline of Medicine, Central Clinical School, University of Sydney, Sydney, New South Wales, Australia
| | - D Celermajer
- Department of Cardiology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia; Discipline of Medicine, Central Clinical School, University of Sydney, Sydney, New South Wales, Australia
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Shah S, Venkataraghavan K, Choudhary P, Mohammad S, Trivedi K, Shah SG. Evaluation of antimicrobial effect of azadirachtin plant extract (Soluneem (™)) on commonly found root canal pathogenic microorganisms (viz. Enterococcus faecalis) in primary teeth: A microbiological study. J Indian Soc Pedod Prev Dent 2016; 34:210-6. [PMID: 27461802 DOI: 10.4103/0970-4388.186741] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
AIM The aim of this study is to evaluate the antimicrobial activity of Soluneem ™ when used as an irrigating solution along with other commonly used irrigating solution sodium hypochlorite (NaOCl) against Enterococcus faecalis. MATERIALS AND METHODS Microorganism used in this study was E. faecalis (Microbial Type Culture Collection 439). Test substance used was Soluneem ™, which was obtained from Vittal Mallya Scientific Research Foundation (VMSRF), Bengaluru. This study was conducted in a microbiology laboratory (Biocare Research India Pvt., Ltd. Laboratory, Ahmedabad, Gujarat) to evaluate the antimicrobial effect of Soluneem ™ (Azadirachtin) on E. faecalis. Antimicrobial activity testing was performed using the macrobroth dilution method according to the Clinical Laboratory Standards Institute guidelines. All determinations were performed thrice. RESULTS Minimum bactericidal concentration (MBC) was seen as 2.6% for Soluneem ™ while the same was seen at 0.1% for NaOCl. Independent sample t-test was carried out to compare the MBC of Soluneem ™ and NaOCl, which showed that there was no statistically significant difference between them, i.e., 2.6% Soluneem ™ was as effective as 0.1% NaOCl. CONCLUSION Soluneem ™ showed antimicrobial activity against E. faecalis at various concentrations. It was also found that the efficacy of Soluneem ™ at 2.6% concentration and above was relatively similar to that of gold standard irrigating solution (NaOCl) on inhibition of E. faecalis.
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Affiliation(s)
- Shanal Shah
- Department of Pedodontics and Preventive Dentistry, College of Dental Sciences and Research Centre, Ahmedabad, Gujarat, India
| | - Karthik Venkataraghavan
- Department of Pedodontics and Preventive Dentistry, College of Dental Sciences and Research Centre, Ahmedabad, Gujarat, India
| | - Prashant Choudhary
- Department of Dentistry, Faculty of Dentistry, SEGi University, Kota Damansara PJU 5, 47810 Petaling Jaya, Selangor, Malaysia
| | - Shameer Mohammad
- Department of Pedodontics and Preventive Dentistry, College of Dental Sciences and Research Centre, Ahmedabad, Gujarat, India
| | - Krishna Trivedi
- Department of Pedodontics and Preventive Dentistry, College of Dental Sciences and Research Centre, Ahmedabad, Gujarat, India
| | - Shalin G Shah
- Department of Pedodontics and Preventive Dentistry, College of Dental Sciences and Research Centre, Ahmedabad, Gujarat, India
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Venkataraghavan K, Majithia U, Choudhary P, Trivedi K, Shah S, Virda M. Comparative evaluation of application of different fluoride varnishes on artificial early enamel lesion: An in vitro study. Indian J Dent Res 2016; 27:521-527. [DOI: 10.4103/0970-9290.195642] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Trivedi K, Bhaskar V, Ganesh M, Venkataraghavan K, Choudhary P, Shah S, Krishnan R. Erosive potential of commonly used beverages, medicated syrup, and their effects on dental enamel with and without restoration: An in vitro study. J Pharm Bioallied Sci 2015; 7:S474-80. [PMID: 26538901 PMCID: PMC4606643 DOI: 10.4103/0975-7406.163508] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Aim: This study evaluates erosive potential of commonly used beverages, medicated syrup, and their effects on dental enamel with and without restoration in vitro. Materials and Methods: Test medias used in this study included carbonated beverage, noncarbonated beverage, high-energy sports drink medicated cough syrup, distilled water as the control. A total of 110 previously extracted human premolar teeth were selected for the study. Teeth were randomly divided into two groups. Test specimens were randomly distributed to five beverages groups and comprised 12 specimens per group. Surface roughness (profilometer) readings were performed at baseline and again, following immersion for 14 days (24 h/day). Microleakage was evaluated. The results obtained were analyzed for statistical significance using SPSS-PC package using the multiple factor ANOVA at a significance level of P < 0.05. Paired t-test, Friedman test ranks, and Wilcoxon signed ranks test. Results: For surface roughness high-energy sports drink and noncarbonated beverage showed the highly significant difference with P values of 0.000 and 0.000, respectively compared to other test media. For microleakage high-energy sports drink had significant difference in comparison to noncarbonated beverage (P = 0.002), medicated syrup (P = 0.000), and distilled water (P = 0.000). Conclusion: High-energy sports drink showed highest surface roughness value and microleakage score among all test media and thus greater erosive potential to enamel while medicated syrup showed least surface roughness value and microleakage among all test media.
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Affiliation(s)
- Krishna Trivedi
- Department of Pedodontics and Preventive Dentistry, College of Dental Science and Research Centre, Manipur, Sanand, Ahmedabad, India
| | - Vijay Bhaskar
- Department of Pedodontics and Preventive Dentistry, Ahmedabad Dental College and Hospital, Vivekanand Society, Santej, Rancharda, Kalol, Dist. Gandhinagar, Gujarat, India
| | - Mahadevan Ganesh
- Department of Pedodontics and Preventive Dentistry, Ahmedabad Dental College and Hospital, Vivekanand Society, Santej, Rancharda, Kalol, Dist. Gandhinagar, Gujarat, India
| | - Karthik Venkataraghavan
- Department of Pedodontics and Preventive Dentistry, College of Dental Science and Research Centre, Manipur, Sanand, Ahmedabad, India
| | - Prashant Choudhary
- Department of Pedodontics and Preventive Dentistry, Faculty of Dentistry, SEGI University, Kota Damansara, Malaysia
| | - Shalin Shah
- Department of Pedodontics and Preventive Dentistry, College of Dental Science and Research Centre, Manipur, Sanand, Ahmedabad, India
| | - Ramesh Krishnan
- Department of Pedodontics and Preventive Dentistry, The Vinayaka Mission's Sankarachariyar Dental College, Salem, Tamil Nadu, India
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Beato-Víbora P, Yeoh E, Rogers H, Hopkins D, Amiel SA, Choudhary P. Sustained benefit of continuous subcutaneous insulin infusion on glycaemic control and hypoglycaemia in adults with Type 1 diabetes. Diabet Med 2015. [PMID: 26213236 DOI: 10.1111/dme.12869] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [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: 12/20/2022]
Abstract
AIM To evaluate the sustainability of the benefits of continuous subcutaneous insulin infusion therapy in routine practice in a cohort of adults with diabetes. METHODS The clinical records of all adults starting continuous subcutaneous insulin infusion over 12 years at our centre were included in this study. Baseline and mean annual HbA(1c) levels were recorded. The frequency of mild-to-moderate and severe hypoglycaemia and hypoglycaemia awareness were analysed in a subgroup. RESULTS Adequate data were available from 327 patients, of whom 71% were female. The patients' mean ± sd age was 41 ± 14 years, the mean ± sd (range) follow-up for continuous subcutaneous insulin infusion was 4.3 ± 2.7 (1-12) years. The mean ± sd HbA(1c) concentration fell by 8 ± 5 mmol/mol (0.7 ± 0.5%) at year 1 [to 63 ± 12 mmol/mol from 70 ± 18 mmol/mol (7.9 ± 1.1% from 8.6 ± 1.6%); P < 0.0005], sustained to year 5. In patients with initial poor control, HbA(1c) dropped by 12 ± 11 mmol/mol (1.1 ± 1.0%; P < 0.0005) at year 1, sustained to year 6. The percentage of patients with ≥ 5 mild to moderate hypoglycaemic episodes per week fell from 29 to 12% (n = 163; P = 0.006). In the subgroup (n = 87; follow-up 2.5 ± mean ± sd 1.1 years), the frequency of severe hypoglycaemia fell from 0.6 ± 1.7 episodes per patient per year to 0.3 ± 0.9 (P = 0.047). Of 24 patients with impaired awareness of hypoglycaemia (Gold score ≥ 4), the mean ± sd Gold score improved from 4.9 ± 0.9 to 3.8 ± 1.7 (P = 0.011). Nine people regained awareness. No deterioration in HbA(1c) was seen in the hypoglycaemia-prone groups. CONCLUSIONS The benefits of continuous subcutaneous insulin infusion with regard to improving glycaemic control and reducing hypoglycaemia frequency, along with improvement in hypoglycaemia awareness without deterioration in glycaemic control, can be sustained over several years in clinical practice.
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Affiliation(s)
- P Beato-Víbora
- Department of Diabetes, King's College Hospital, London, UK
| | - E Yeoh
- Department of Diabetes, King's College Hospital, London, UK
| | - H Rogers
- Department of Diabetes, King's College Hospital, London, UK
| | - D Hopkins
- Department of Diabetes, King's College Hospital, London, UK
| | - S A Amiel
- Diabetes Research Group, King's College London, London, UK
| | - P Choudhary
- Diabetes Research Group, King's College London, London, UK
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Shah S, Bhaskar V, Venkataraghavan K, Choudhary P, Ganesh M, Trivedi K. Efficacy of silver diamine fluoride as an antibacterial as well as antiplaque agent compared to fluoride varnish and acidulated phosphate fluoride gel: an in vivo study. Indian J Dent Res 2015; 24:575-81. [PMID: 24355958 DOI: 10.4103/0970-9290.123374] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Silver diamine fluoride (SDF) is already proven as an antibacterial agent in vitro. Present study was formulated to compare the efficacy of SDF as an antibacterial as well as antiplaque agent in vivo with fluoride varnish and acidulated phosphate fluoride (APF) gel. STUDY DESIGN Total 123 children (male = 82, female = 41) were included in the study for a period of 18 months. Children were divided into three different groups-Group 1: SDF; Group 2: fluoride varnish; and Group 3: APF gel. All subjects were evaluated via plaque score at 6 th, 12 th, and 18 th months as well as Streptococcus mutans counts in saliva at 72 h, 6 th, 12 th, and 18 th months of follow-up. RESULTS Significant reduction was found in plaque score as well as S. mutans counts irrespective of group division. On intergroup comparison, no statistically significant difference was found in plaque score, but significant reduction in S. mutans counts was found in Group 1 as compared with Groups 2 and 3, while no significant difference was found between Groups 2 and 3. CONCLUSION In vivo application of SDF on enamel significantly decreases S. mutans counts as compared to fluoride varnish and APF gel.
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Affiliation(s)
- Shalin Shah
- Department of Pedodontics and Preventive Dentistry, College of Dental Science and Research Centre, Bopal-Ghuma Road, Manipur, Ahmedabad, Gujarat, India
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Venkataraghavan K, Shah V, Choudhary P, Trivedi K, Shah S. Anatomical abnormalities in multiple permanent teeth. J Clin Diagn Res 2015; 9:ZJ05-6. [PMID: 26023664 DOI: 10.7860/jcdr/2015/11663.5842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Accepted: 02/14/2015] [Indexed: 11/24/2022]
Affiliation(s)
- Karthik Venkataraghavan
- Professor and HOD, Department of Pedodontics and Preventive Dentistry, College of Dental Sciences & Research Centre , Ahmedabad, Gujarat, India
| | - Vidhi Shah
- Post Graduate Student, Department of Pedodontics and Preventive Dentistry, College of Dental Sciences & Research Centre , Ahmedabad, Gujarat, India
| | - Prashant Choudhary
- Senior Lecturer, Faculty of Dentistry SEGi university, No. 9, Jalan Teknologi, Taman Sains Selangor , Kota Damansara PJU 5, 47810 Petaling Jaya,Selangor, Malaysia
| | - Krishna Trivedi
- Senior Lecturer, Department of Pedodontics and Preventive Dentistry, College of Dental Sciences & Research Centre , Ahmedabad, Gujarat, India
| | - Shalin Shah
- Senior Lecturer, Department of Pedodontics and Preventive Dentistry, College of Dental Sciences & Research Centre , Ahmedabad, Gujarat, India
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Thabit H, Elleri D, Leelarathna L, Allen JM, Lubina-Solomon A, Stadler M, Walkinshaw E, Iqbal A, Choudhary P, Wilinska ME, Barnard KD, Heller SR, Amiel SA, Evans ML, Dunger DB, Hovorka R. Unsupervised home use of an overnight closed-loop system over 3-4 weeks: a pooled analysis of randomized controlled studies in adults and adolescents with type 1 diabetes. Diabetes Obes Metab 2015; 17:452-8. [PMID: 25492378 PMCID: PMC4510702 DOI: 10.1111/dom.12427] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Revised: 12/01/2014] [Accepted: 12/04/2014] [Indexed: 12/25/2022]
Abstract
AIMS To compare overnight closed-loop and sensor-augmented pump therapy in patients with type 1 diabetes by combining data collected during free-living unsupervised randomized crossover home studies. METHODS A total of 40 participants with type 1 diabetes, of whom 24 were adults [mean ± standard deviation (s.d.) age 43 ± 12 years and glycated haemoglobin (HbA1c) 8.0 ± 0.9%] and 16 were adolescents (mean ± s.d. age 15.6 ± 3.6 years and HbA1c 8.1 ± 0.8%), underwent two periods of sensor-augmented pump therapy in the home setting, in combination with or without an overnight closed-loop insulin delivery system that uses a model predictive control algorithm to direct insulin delivery. The order of the two interventions was random; each period lasted 4 weeks in adults and 3 weeks in adolescents. The primary outcome was time during which sensor glucose readings were in the target range of 3.9-8.0 mmol/l. RESULTS The proportion of time when sensor glucose was in the target range (3.9-8.0 mmol/l) overnight (between 24:00 and 08:00 hours) was 18.5% greater during closed-loop insulin delivery than during sensor-augmented therapy (p < 0.001). Closed-loop therapy significantly reduced mean overnight glucose levels by 0.9 mmol/l (p < 0.001), with no difference in glycaemic variability, as measured by the standard deviation of sensor glucose. Time spent above the target range was reduced (p = 0.001), as was time spent in hypoglycaemia (<3.9 mmol/l; p = 0.014) during closed-loop therapy. Lower mean overnight glucose levels during closed-loop therapy were brought about by increased overnight insulin delivery (p < 0.001) without changes to the total daily delivery (p = 0.84). CONCLUSION Overnight closed-loop insulin therapy at home in adults and adolescents with type 1 diabetes is feasible, showing improvements in glucose control and reducing the risk of nocturnal hypoglycaemia.
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Affiliation(s)
- H Thabit
- Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge, Cambridge, UK
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