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Sinha A, Agarwal R, Kumar V, Garg N, Pundir DS, Singh H, Rani R, Panigrahy C. Multi-modal medical image fusion using improved dual-channel PCNN. Med Biol Eng Comput 2024:10.1007/s11517-024-03089-w. [PMID: 38656734 DOI: 10.1007/s11517-024-03089-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 03/31/2024] [Indexed: 04/26/2024]
Abstract
This paper proposes a medical image fusion method in the non-subsampled shearlet transform (NSST) domain to combine a gray-scale image with the respective pseudo-color image obtained through different imaging modalities. The proposed method applies a novel improved dual-channel pulse-coupled neural network (IDPCNN) model to fuse the high-pass sub-images, whereas the Prewitt operator is combined with maximum regional energy (MRE) to construct the fused low-pass sub-image. First, the gray-scale image and luminance of the pseudo-color image are decomposed using NSST to find the respective sub-images. Second, the low-pass sub-images are fused by the Prewitt operator and MRE-based rule. Third, the proposed IDPCNN is utilized to get the fused high-pass sub-images from the respective high-pass sub-images. Fourth, the luminance of the fused image is obtained by applying inverse NSST on the fused sub-images, which is combined with the chrominance components of the pseudo-color image to construct the fused image. A total of 28 diverse medical image pairs, 11 existing methods, and nine objective metrics are used in the experiment. Qualitative and quantitative fusion results show that the proposed method is competitive with and even outpaces some of the existing medical fusion approaches. It is also shown that the proposed method efficiently combines two gray-scale images.
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Affiliation(s)
- Adarsh Sinha
- Computer Science and Engineering, Thapar Institute of Engineering & Technology, Patiala, 147004, Punjab, India
| | - Rahul Agarwal
- Computer Science and Engineering, Thapar Institute of Engineering & Technology, Patiala, 147004, Punjab, India
| | - Vinay Kumar
- Computer Science and Engineering, Thapar Institute of Engineering & Technology, Patiala, 147004, Punjab, India
| | - Nitin Garg
- Computer Science and Engineering, Thapar Institute of Engineering & Technology, Patiala, 147004, Punjab, India
| | - Dhruv Singh Pundir
- Computer Science and Engineering, Thapar Institute of Engineering & Technology, Patiala, 147004, Punjab, India
| | - Harsimran Singh
- Computer Science and Engineering, Thapar Institute of Engineering & Technology, Patiala, 147004, Punjab, India
| | - Ritu Rani
- Computer Science and Engineering, Thapar Institute of Engineering & Technology, Patiala, 147004, Punjab, India
| | - Chinmaya Panigrahy
- Computer Science and Engineering, Thapar Institute of Engineering & Technology, Patiala, 147004, Punjab, India.
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2
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Kota PB, Agarwal R, Yerramsetty V, Kulkarni V, Ramnadh SG, Gupta PC. Efficacy and Safety of Primary Subclavian Aneurysmorrhaphy in Advanced Arterial Thoracic Outlet Syndrome: Long Term Single Institution Outcomes. Eur J Vasc Endovasc Surg 2024; 67:516-517. [PMID: 37918615 DOI: 10.1016/j.ejvs.2023.10.034] [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] [Received: 05/21/2023] [Revised: 10/25/2023] [Accepted: 10/29/2023] [Indexed: 11/04/2023]
Affiliation(s)
- Prajna B Kota
- Department of Vascular and Endovascular Surgery, Care Hospital, Banjara Hills, Hyderabad, India
| | - Rahul Agarwal
- Department of Vascular and Endovascular Surgery, Care Hospital, Banjara Hills, Hyderabad, India
| | | | - Venugopal Kulkarni
- Department of Vascular and Endovascular Surgery, Care Hospital, Banjara Hills, Hyderabad, India
| | - Satyendra G Ramnadh
- Department of Vascular and Endovascular Surgery, Care Hospital, Banjara Hills, Hyderabad, India
| | - Prem C Gupta
- Department of Vascular and Endovascular Surgery, Care Hospital, Banjara Hills, Hyderabad, India.
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3
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Madadelahi M, Agarwal R, Martinez-Chapa SO, Madou MJ. A roadmap to high-speed polymerase chain reaction (PCR): COVID-19 as a technology accelerator. Biosens Bioelectron 2024; 246:115830. [PMID: 38039729 DOI: 10.1016/j.bios.2023.115830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 11/07/2023] [Accepted: 11/08/2023] [Indexed: 12/03/2023]
Abstract
The limit of detection (LOD), speed, and cost of crucial COVID-19 diagnostic tools, including lateral flow assays (LFA), enzyme-linked immunosorbent assays (ELISA), and polymerase chain reactions (PCR), have all improved because of the financial and governmental support for the epidemic. The most notable improvement in overall efficiency among them has been seen with PCR. Its significance for human health increased during the COVID-19 pandemic, when it emerged as the commonly used approach for identifying the virus. However, because of problems with speed, complexity, and expense, PCR deployment in point-of-care settings continues to be difficult. Microfluidic platforms offer a promising solution by enabling the development of smaller, more affordable, and faster PCR systems. In this review, we delve into the engineering challenges associated with the advancement of high-speed microfluidic PCR equipment. We introduce criteria that facilitate the evaluation and comparison of factors such as speed, LOD, cycling efficiency, and multiplexing capacity, considering sample volume, fluidics, PCR reactor geometry and materials, as well as heating/cooling methods. We also provide a comprehensive list of commercially available PCR devices and conclude with projections and a discussion regarding the current obstacles that need to be addressed in order to progress further in this field.
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Affiliation(s)
- Masoud Madadelahi
- School of Engineering and Sciences, Tecnologico de Monterrey, Monterrey, 64849, NL, Mexico; Department of Mechanical Engineering, Isfahan University of Technology, Isfahan, 84156-83111, Iran.
| | - Rahul Agarwal
- School of Engineering and Sciences, Tecnologico de Monterrey, Monterrey, 64849, NL, Mexico
| | | | - Marc J Madou
- School of Engineering and Sciences, Tecnologico de Monterrey, Monterrey, 64849, NL, Mexico; Autonomous Medical Devices Incorporated (AMDI), Santa Ana, CA, 92704, USA.
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Agarwal R, Gamare JS, Nandi C, Phatak R, Sharma MK, Jayachandran K, Kaity S. A "Two-Step" Electrochemical Approach for Recovery of Plutonium and Uranium from Aqueous Acidic Waste Solutions. Inorg Chem 2024; 63:2090-2097. [PMID: 38235667 DOI: 10.1021/acs.inorgchem.3c03926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
Chemical quality control of nuclear fuel, particularly the determination of Pu and U contents by chemical methods, results in analytical acidic aqueous waste solutions from which Pu and U must be recovered efficiently for the remediation of radioactive wastes. Reported methods involve several complicated steps requiring addition of chemical oxidants/reductants for valence adjustments and generation of secondary wastes, thereby making the recovery process cumbersome. Herein, we report a novel two-step electrochemical approach for Pu and U recovery from acidic aqueous waste solutions containing different metallic impurities (Fe, Cr, Mn, Cd, Al, Ni, Co, Zn, and Mg) by bulk electrolysis using a Pt gauze electrode. Pu and U are recovered from these waste solutions in a two-step process: (i) bulk electrolysis of the mixed solution at a constant potential of 0.1 V vs Ag/AgCl/3 M KCl that results in the reduction of PuO22+ to Pu3+ followed by the precipitation of Pu3+ as K2(K0.5Pu0.5)(SO4)2, which is then filtered and separated and (ii) the filtrate solution is again subjected to bulk electrolysis at a constant potential of -0.35 V vs Ag/AgCl/3 M KCl resulting in the reduction of UO22+ to U4+. The U4+ is then precipitated as K2(K0.67U0.33)(SO4)2, which is filtered and separated, leading to a Pu- and U-free aqueous acidic waste solutions. Biamperometry shows that 97.8% and 99.1% recovery of Pu and U, respectively, is possible, and emission spectrometry confirms the purity of K2(K0.5Pu0.5)(SO4)2 and K2(K0.67U0.33)(SO4)2. Because of its operational simplicity, potential for remote handling, and excellent extraction efficiency, the present methodology can easily replace traditional methods for the recovery of Pu and U from acidic aqueous waste solutions.
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Affiliation(s)
- Rahul Agarwal
- Homi Bhabha National Institute, Mumbai 400 094, India
- Fuel Chemistry Division, Bhabha Atomic Research Centre (BARC), Trombay, Mumbai 400 085, India
| | - Jayashree S Gamare
- Fuel Chemistry Division, Bhabha Atomic Research Centre (BARC), Trombay, Mumbai 400 085, India
| | - Chiranjit Nandi
- Radiometallurgy Division, Bhabha Atomic Research Centre (BARC), Trombay, Mumbai 400085, India
| | - Rohan Phatak
- Fuel Chemistry Division, Bhabha Atomic Research Centre (BARC), Trombay, Mumbai 400 085, India
| | - Manoj K Sharma
- Homi Bhabha National Institute, Mumbai 400 094, India
- Fuel Chemistry Division, Bhabha Atomic Research Centre (BARC), Trombay, Mumbai 400 085, India
| | - Kavitha Jayachandran
- Fuel Chemistry Division, Bhabha Atomic Research Centre (BARC), Trombay, Mumbai 400 085, India
| | - Santu Kaity
- Radiometallurgy Division, Bhabha Atomic Research Centre (BARC), Trombay, Mumbai 400085, India
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Mohta M, Kumari S, Malhotra RK, Tyagi A, Agarwal R. Calculation of effective dose of phenylephrine bolus for treatment of post-spinal hypotension in pre-eclamptic patients undergoing caesarean section - a non-randomised controlled trial. Int J Obstet Anesth 2023; 56:103929. [PMID: 37826881 DOI: 10.1016/j.ijoa.2023.103929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 08/10/2023] [Accepted: 09/03/2023] [Indexed: 10/14/2023]
Abstract
BACKGROUND Patients with pre-eclampsia require smaller vasopressor doses compared with those with normotension for management of post-spinal hypotension during caesarean section. However, the literature has little evidence as to the phenylephrine dose required for patients with pre-eclampsia. METHODS Fifty patients, with either pre-eclampsia or normotension, and developing post-spinal hypotension during caesarean section under spinal anaesthesia, were studied. Women in both groups did not receive prophylactic vasopressors. The first patient in each group received phenylephrine 50 µg to treat the first episode of hypotension, defined as fall of systolic blood pressure ≥20% from baseline or an absolute value <100 mmHg. If hypotension was corrected within one minute it was considered a 'success'. The doses for the subsequent patients were determined by responses to all previous patients, according to a variation of Narayana's rule for the up-down sequential allocation method. RESULTS The 95% effective dose (ED95) and 50% effective dose (ED50) of phenylephrine was 41.7 µg (95% CI 33.8 to 49.6 µg) and 29.1 µg (95% CI 26.0 to 32.2 µg) respectively in the pre-eclampsia group, and 64.9 µg (95% CI 54.1 to 75.7 µg) and 47.3 µg (95% CI 39.7 to 54.9 µg) respectively in the normotensive group. The proportionate reduction in phenylephrine dose ranged from 33% (95% CI 18 to 44%) to 40% (95% CI 19 to 52%). CONCLUSION Patients with pre-eclampsia may need a 33% to 40% reduction in the first phenylephrine bolus dose, compared with patients with normotension, for the treatment of the first episode of post-spinal hypotension.
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Affiliation(s)
- M Mohta
- Department of Anaesthesiology and Critical Care, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India.
| | - S Kumari
- Department of Anaesthesiology and Critical Care, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
| | - R K Malhotra
- Cancer Registry, Dr. BRAIRCH, All India Institute of Medical Sciences, Delhi, India
| | - A Tyagi
- Department of Anaesthesiology and Critical Care, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
| | - R Agarwal
- Department of Obstetrics and Gynaecology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
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Agarwal R, Martinez-Chapa SO, Madou MJ. Theoretical analysis of immunochromatographic assay and consideration of its operating parameters for efficient designing of high-sensitivity cardiac troponin I (hs-cTnI) detection. Sci Rep 2023; 13:18296. [PMID: 37880256 PMCID: PMC10600258 DOI: 10.1038/s41598-023-45050-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Accepted: 10/15/2023] [Indexed: 10/27/2023] Open
Abstract
Troponin is the American College of Cardiology and American Heart Association preferred biomarker for diagnosing acute myocardial infarction (MI). We provide a modeling framework for high sensitivity cardiac Troponin I (hs-cTnI) detection in chromatographic immunoassays (flow displacement mode) with an analytical limit of detection, i.e., LOD < 10 ng/L. We show that each of the various control parameters exert a significant influence over the design requirements to reach the desired LOD. Additionally, the design implications in a multiplexed fluidic network, as in the case of Simple Plex™ Ella instrument, are significantly affected by the choice of the number of channels or partitions in the network. We also provide an upgrade on the existing LOD equation to evaluate the necessary minimum volume to detect a particular concentration by considering the effects of stochastics and directly incorporating the target number of copies in each of the partitions in case of multiplexed networks. Even though a special case of cTnI has been considered in this study, the model and analysis are analyte agnostic and may be applied to a wide class of chromatographic immunoassays. We believe that this contribution will lead to more efficient designing of the immunochromatographic assays.
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Affiliation(s)
- Rahul Agarwal
- School of Engineering and Sciences, Tecnológico de Monterrey, Ave. Eugenio Garza Sada 2501, 64849, Monterrey, NL, Mexico.
| | - Sergio Omar Martinez-Chapa
- School of Engineering and Sciences, Tecnológico de Monterrey, Ave. Eugenio Garza Sada 2501, 64849, Monterrey, NL, Mexico
| | - Marc Jozef Madou
- School of Engineering and Sciences, Tecnológico de Monterrey, Ave. Eugenio Garza Sada 2501, 64849, Monterrey, NL, Mexico.
- Autonomous Medical Devices Incorporated (AMDI), 3511 W Sunflower Ave, Santa Ana, CA, 92704, USA.
- Mechanical and Aerospace Engineering, University of California, Irvine, USA.
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Gupta PC, Goel V, Tourani V, Kota PB, Agarwal R, Atreyapurapu V. Inferior vena cava leiomyosarcoma in a renal transplant recipient. J Vasc Surg Venous Lymphat Disord 2023; 11:1080-1081. [PMID: 37591595 DOI: 10.1016/j.jvsv.2023.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 04/28/2023] [Accepted: 05/08/2023] [Indexed: 08/19/2023]
Affiliation(s)
- Prem Chand Gupta
- Department of Vascular and Endovascular Surgery, Care Hospitals, Banjara Hills, Hyderabad, India.
| | - Vipin Goel
- Department of Surgical Oncology, Care Hospitals, Banjara Hills, Hyderabad, India
| | - Vijaya Tourani
- Department of Pathology, Care Hospitals, Banjara Hills, Hyderabad, India
| | - Prajna B Kota
- Department of Vascular and Endovascular Surgery, Care Hospitals, Banjara Hills, Hyderabad, India
| | - Rahul Agarwal
- Department of Vascular and Endovascular Surgery, Care Hospitals, Banjara Hills, Hyderabad, India
| | - Viswanath Atreyapurapu
- Department of Vascular and Endovascular Surgery, Care Hospitals, Banjara Hills, Hyderabad, India
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8
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Das S, Mishra SS, Rakshit K, Agarwal R. Case Report: Primary Ewing Sarcoma of the Penis. Indian J Surg Oncol 2023; 14:752-754. [PMID: 37900645 PMCID: PMC10611654 DOI: 10.1007/s13193-023-01793-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 06/28/2023] [Indexed: 10/31/2023] Open
Abstract
Background Ewing sarcoma is a malignancy that commonly affects the skeletal system and primary extraskeletal involvement is rare. Extraskeletal Ewing sarcoma (EES) arises in soft tissue anywhere in the body. These are very rarely seen aggressive tumours. There have been only 7 reported cases of EES of penis. Case Presentation We report a 22-year-young patient who presented to our hospital with a ulcero-proliferative growth in the shaft of penis. There were no other complaints indicating any metastasis. Incisional biopsy was suggestive of invasive malignancy. He was scheduled for a partial penectomy. Final HPE and IHC were suggestive of EES. Conclusion EES as a subtype of Ewing sarcoma is rare and it can occur in any soft tissue site. Hence, clinicians need to differentiate this entity from other soft tissue sarcomas. Early diagnosis and timely treatment of EES are pivotal for a favourable prognosis due to its aggressive nature. Supplementary Information The online version contains supplementary material available at 10.1007/s13193-023-01793-x.
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Affiliation(s)
- Soumen Das
- Department of Surgical Oncology, Netaji Subhas Chandra Bose Cancer Hospital, Nayabad Ave, New Garia, Pancha Sayar, Kolkata, West Bengal 700094 India
| | - Siddhartha Shankar Mishra
- Department of Surgical Oncology, Netaji Subhas Chandra Bose Cancer Hospital, Nayabad Ave, New Garia, Pancha Sayar, Kolkata, West Bengal 700094 India
| | - Kamalesh Rakshit
- Department of Surgical Oncology, Netaji Subhas Chandra Bose Cancer Hospital, Nayabad Ave, New Garia, Pancha Sayar, Kolkata, West Bengal 700094 India
| | - Rahul Agarwal
- Department of Surgical Oncology, Netaji Subhas Chandra Bose Cancer Hospital, Nayabad Ave, New Garia, Pancha Sayar, Kolkata, West Bengal 700094 India
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Pandey R, Nema R, Vishwakarma S, Singh AP, Mohan S, Patel P, Halder S, Halder A, Singh R, Agarwal R, Gupta V, Kumar A. Single Nucleotide Polymorphisms in Cytokine Genes are Associated with the Susceptibility to Oral Squamous Cell Carcinoma. Asian Pac J Cancer Prev 2023; 24:2353-2360. [PMID: 37505766 PMCID: PMC10676475 DOI: 10.31557/apjcp.2023.24.7.2353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Accepted: 07/07/2023] [Indexed: 07/29/2023] Open
Abstract
Oral squamous cell carcinoma (OSCC) is the most common type of cancer among men in the Indian subcontinent. Cytokines regulate inflammation and angiogenesis in a variety of cancers. Genetic variability in the cytokine genes can potentially influence the predisposition to oral carcinogenesis. The aim of the current study was to investigate the associations of SNPs in cytokine genes with the susceptibility of oral squamous cell carcinoma. In the present study, we have analyzed the allelic frequency of 32 single nucleotide polymorphisms (SNPs) using MassArray-based iPLEX assay in 16 cytokine genes in 166 OSCC patients and 151 healthy subjects from central India. Out of 32 SNPs analyzed, five SNPs were significantly associated with the risk of OSCC. AA and GG genotypes of IL-1β +3953 were associated with an increased and decreased risk of OSCC, respectively. In several genetic models, GG genotype and G allele in IL-12A 3'UTR G>A were found to be associated with an increased risk of OSCC. Similarly, the GG genotype of IL-12B +1188 T>G was associated with increased susceptibility to OSCC. We conclude that SNPs in the genes coding for IL-1β, IL-12A and IL-12B are associated with increased genetic susceptibility to OSCC in the central Indian population.
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Affiliation(s)
- Ritu Pandey
- Department of Biochemistry, All India Institute of Medical Sciences (AIIMS) Bhopal, Saket Nagar, Bhopal 462020, India.
| | - Rajeev Nema
- Department of Biochemistry, All India Institute of Medical Sciences (AIIMS) Bhopal, Saket Nagar, Bhopal 462020, India.
| | - Supriya Vishwakarma
- Department of Biochemistry, All India Institute of Medical Sciences (AIIMS) Bhopal, Saket Nagar, Bhopal 462020, India.
| | - Ajay Pal Singh
- All India Institute of Medical Sciences (AIIMS) Bhopal, Saket Nagar, Bhopal 462020, India.
- Present Address: Department of Internal Medicine, All India Institute of Medical Sciences (AIIMS) Rishikesh, Rishikesh 249203, India.
| | - Sruthy Mohan
- All India Institute of Medical Sciences (AIIMS) Bhopal, Saket Nagar, Bhopal 462020, India.
| | - Priti Patel
- All India Institute of Medical Sciences (AIIMS) Bhopal, Saket Nagar, Bhopal 462020, India.
| | - Subhojit Halder
- All India Institute of Medical Sciences (AIIMS) Bhopal, Saket Nagar, Bhopal 462020, India.
| | - Anupam Halder
- All India Institute of Medical Sciences (AIIMS) Bhopal, Saket Nagar, Bhopal 462020, India.
| | - Renu Singh
- Jawaharlal Nehru Cancer Hospital and Research Center, Idgah Hills, Bhopal, India.
| | - Rahul Agarwal
- Jawaharlal Nehru Cancer Hospital and Research Center, Idgah Hills, Bhopal, India.
| | - Vikas Gupta
- Department of ENT and Head and Neck Surgery, All India Institute of Medical Sciences (AIIMS) Bhopal, Saket Nagar, Bhopal 462020, India.
| | - Ashok Kumar
- Department of Biochemistry, All India Institute of Medical Sciences (AIIMS) Bhopal, Saket Nagar, Bhopal 462020, India.
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Pakira V, Agarwal R, Chatterjee S, Mukherjee A, Chakraborty S. Lipidest: a lipid profile screening test under extreme point of care settings using a portable spinning disc and an office scanner. Anal Methods 2023; 15:2427-2440. [PMID: 37191178 DOI: 10.1039/d3ay00412k] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
The demand for lipid profile (the cholesterol and triglyceride elements in the blood) testing outside resourced diagnostic centers is continuously increasing for personalized and community-based healthcare to ensure timely disease screening and management; however, it is inevitably challenged by several bottlenecks in the existing point of care technologies. These deficits include delicate sample pre-processing steps and device complexity, which give rise to unfavourable cost propositions to safeguard against compromised test accuracy. To circumvent these bottlenecks, herein, we introduce a new diagnostic technology, 'Lipidest', that integrates a portable spinning disc, a spin box, and an office scanner to reliably quantify the complete lipid panel from finger-prick blood. Our design facilitates the direct miniature adaptation of the established gold standard procedures as against any indirect sensing technologies that are otherwise common in point-of-care applications introduced commercially. The test procedure harmoniously connects all the elements of sample-to-answer integration in a single device, traversing the entire pipeline of the physical separation of plasma from the cellular components of the whole blood, the automated mixing with the test reagents on the same platform in situ, and office-scanner-adapted quantitative colorimetric analytics that eliminate any undesirable artefacts on account of variabilities in the background illumination and camera specifications. The exclusive value of eliminating sample preparation steps, including the rotationally actuated segregation of the specific blood constituents without any cross-interference between them, their automated homogeneous mixing with the respective test reagents, and the simultaneous, yet independent, quantitative readout without specialized instrumentation, render the test user-friendly and deployable in resource-constrained settings with a reasonably wide detection window. The extreme simplicity and modular nature of the device further make it amenable to mass manufacturing without incurring unfavourable costs. Extensive validation with laboratory-benchmark gold standards provide acceptable accuracy and indicates the value of the first-of-its-kind ultra-low-cost extreme-point-of-care test with a scientific foundation akin to highly accurate laboratory-centric technologies for cardiovascular health monitoring and beyond.
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Affiliation(s)
- Victor Pakira
- Advanced Technology Development Centre, Indian Institute of Technology Kharagpur, Kharagpur, 721302, India
| | - Rahul Agarwal
- Department of Mechanical Engineering, Indian Institute of Technology Kharagpur, Kharagpur, 721302, India.
| | - Subhamoy Chatterjee
- Department of Electronics and Electrical Communication Engineering, Indian Institute of Technology Kharagpur, Kharagpur, 721302, India
| | - Arghya Mukherjee
- Department of Mechanical Engineering, Indian Institute of Technology Kharagpur, Kharagpur, 721302, India.
| | - Suman Chakraborty
- Department of Mechanical Engineering, Indian Institute of Technology Kharagpur, Kharagpur, 721302, India.
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Ng A, Asif A, Nathan A, Khetrapal P, Chan V, Rossiter M, Punwani S, Clarke C, Brew-Graves C, Emberton M, Agarwal R, Takwoingi Y, Deeks J, Giganti F, Allen C, Moore C, Kasivisvanathan V, Prime S. Comparison of biparametric and multiparametric magnetic resonance imaging for prostate cancer detection: an 8-month update on the PRIME Study (NCT04571840). Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00580-8] [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: 02/12/2023]
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Sehgal IS, Muthu V, Agarwal R. Aspergillus infection is an important complication of post-TB bronchiectasis. Int J Tuberc Lung Dis 2023; 27:89a-89. [PMID: 36853137 DOI: 10.5588/ijtld.22.0526] [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: 01/14/2023] Open
Affiliation(s)
- I S Sehgal
- Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - V Muthu
- Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - R Agarwal
- Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
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Agarwal R, Bjarnadottir M, Rhue L, Dugas M, Crowley K, Clark J, Gao G. Addressing Algorithmic Bias and the Perpetuation of Health Inequities: An AI Bias Aware Framework. Health Policy and Technology 2022. [DOI: 10.1016/j.hlpt.2022.100702] [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: 12/03/2022]
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14
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Agarwal R, Rodriguez Ortega S, Vasquez Mendez J. PSAT277 Glucocorticoid Therapy for Management of Hypoglycemia in the context of Non-Islet Cell Tumor-Induced Hypoglycemia. J Endocr Soc 2022. [PMCID: PMC9624981 DOI: 10.1210/jendso/bvac150.747] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background Non-islet cell tumor-induced hypoglycemia (NICTH) is a rare paraneoplastic syndrome which can cause recurrent hypoglycemia. There is no clear standard of care for management of hypoglycemia. Often, these patients have high morbidity and therefore surgical tumor resection is not always possible. Clinical case: This is the case of a 69 year-old male presenting with altered mental status in the context of hypoglycemia without clear etiology with an initial serum glucose level of 32 mg/dL (normal range 60-100 mg/dL) which quickly corrected after administration of intravenous glucose. He was found to have a large bowel obstruction with CT abdomen revealing an underlying neoplasm. Biopsy of suspected lesion on colonoscopy revealed colorectal adenocarcinoma. Repeated episodes of hypoglycemia complicated by seizures required inpatient management. Workup included serum insulin level which resulted in suppressed level (<1. 0 uU/mL, normal range 1.9-23. 0 uU/mL), low c-peptide level (0.1 ng/mL, normal range 1.1-4.4 ng/mL), low beta hydroxybutyrate level (0. 07 mmol/L, normal level <0.3 mmol/L), cortisol level of 43.7 mcg/dL, undetectable insulin like growth factor-1 (IGF-1) level (<10 ng/mL, normal range 59-230 ng/mL) and low insulin like growth factor-2 (IGF-2) level (66 ng/mL, normal range 333 - 967 ng/mL). IGF2: IGF1 ratio was 66 (ratio >10 is indicative for diagnosis of non-islet cell tumor hypoglycemia). Due to extremely poor oral intake and recurrent episodes of hypoglycemia despite continuous dextrose infusion, the patient was started on 20 mg prednisone daily. Eventually, 40 mg of intravenous methylprednisolone in addition to dextrose infusion was needed as maintenance therapy effectively preventing hypoglycemia. Given his poor functional status, the surgical and oncology team decided he was no longer a surgical or chemotherapy candidate. Eventually, palliative medicine was consulted and the patient was transitioned to comfort care with a plan for outpatient hospice. Conclusion NICTH should be suspected in any patient with hypoglycemia without clear etiology, especially if there are suggestions to NICTH such as known malignancy or newly diagnosed mass. Once NICTH is identified and a primary tumor is found, complete tumor resection represents ideal management, however, not always attainable. In such cases, dextrose infusion might be insufficient to prevent hypoglycemia and is not always the preferred option given the required long-term venous access. In these circumstances, early high dose glucocorticoids are safe and appear to successfully prevent hypoglycemic events. Presentation: Saturday, June 11, 2022 1:00 p.m. - 3:00 p.m.
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Horowitz M, Moctezuma S, Haridas K, Agarwal R. PSUN224 Resident Education for Improved Quality and Confidence in Inpatient Hyperglycemia Management. J Endocr Soc 2022. [DOI: 10.1210/jendso/bvac150.796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Abstract
Background
Hyperglycemia is widely prevalent in hospitalized patients and has been associated with adverse outcomes and increased mortality. Guidelines for inpatient management of hyperglycemia in non-critically ill adults are inconsistently implemented within our hospital system in a large academic center in New York. Thus, we strove to develop a formal curriculum for our internal medicine program to improve the level of confidence in trainees when managing inpatient hyperglycemia and to promote appropriate subspecialty consultation.
Methods
We designed a three-phase educational curriculum for internal medicine residents of all training levels. The first phase consisted of a pre-intervention questionnaire distributed online, examining the self-reported level of confidence and knowledge of hyperglycemia management in non-critically ill patients. The second phase consisted of a 50-minute lecture providing background on the prevalence and risk of inpatient hyperglycemia, standard guidelines for inpatient hyperglycemia management, appropriate insulin regimen initiation and adjustment and practice questions reviewed in real time. The third phase consisted of an online post-intervention questionnaire which, in addition to reassessing confidence and knowledge, examined change in individual confidence level in hyperglycemia management and the ability to recognize situations appropriate for endocrinology consultation. In the context of convenience sampling, all residents were eligible to participate in the second questionnaire independent of their participation in the first questionnaire or educational intervention.
Results
There were 57 total respondents for the pre-intervention questionnaire and 54 total respondents for the post-intervention questionnaire. 26 (48%) of the post-intervention questionnaire respondents completed the initial questionnaire and 22 (41%) attended the lecture. In examining confidence in managing inpatient hyperglycemia on a four-level scale (not comfortable, somewhat comfortable, comfortable, and very comfortable), there was an overall increase in percentage of "comfortable" responses (26% to 52%) with a subsequent decrease in "somewhat comfortable" responses (65% to 37%) when comparing post- to pre-intervention questionnaires. In addition, there was a higher percentage of "comfortable" responses in those who attended the lecture versus those who did not (59% vs. 47%). Furthermore, 21 of the 22 respondents who attended the lecture felt "more confident" in their ability to treat inpatient hyperglycemia. Lastly, those who attended the lecture were more likely to identify situations in which endocrinology should be consulted.
Conclusion
Currently, there is no formal longitudinal curriculum established for resident education in inpatient diabetes care and hyperglycemia management. The objective of this intervention was to identify and bridge the gap in practical knowledge and confidence level across all training levels. In a small sample size of residents, data revealed higher confidence in management and ability to recognize the necessity of endocrinology consults. Future research will focus on analyzing concrete data in a target unit to assess translation of the intervention to improved quality of inpatient glycemic control.
Presentation: Sunday, June 12, 2022 12:30 p.m. - 2:30 p.m.
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Agarwal R, Pitt B, Rossing P, Anker SD, Filippatos G, Ruilope LM, Kovesdy CP, Tuttle K, Vaduganathan M, Wanner C, Bansilal S, Gebel M, Joseph A, Lawatscheck R, Bakris G. In patients with type 2 diabetes chronic kidney disease is a modifiable cardiovascular risk factor. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background/Introduction
Chronic kidney disease (CKD) in patients with type 2 diabetes (T2D) is associated with an increased risk of cardiovascular (CV) events. The modifiability of CKD-associated CV risk in patients with T2D across a spectrum of CKD stages remains unknown.
Purpose
To test whether CKD, as defined jointly by estimated glomerular filtration rate (eGFR) and albuminuria (urine albumin-to-creatinine ratio [UACR]), is a modifiable CV risk factor in patients with T2D. Furthermore, to estimate the population-wide reduction in first CV events in the US if all eligible patients were treated with finerenone.
Methods
We estimated the incidence rates of CV events (composite of CV death, non-fatal stroke, non-fatal myocardial infarction, or hospitalisation for heart failure) over a median follow-up of 3.0 years in 13,026 patients with CKD and T2D, treated with finerenone or placebo, in a joint analysis by eGFR and UACR categories. Patients were from FIDELITY, a prespecified pooled analysis of two phase III trials, and had an eGFR ≥25 ml/min/1.73 m2 and UACR 30–5000 mg/g at screening.The potential impact of finerenone treatment on the US population was evaluated by simulating the number of first CV events that could be prevented per year with finerenone, using incidence rates from FIDELITY and prevalence rates of CKD in patients with T2D from the National Health and Nutrition Examination Survey (NHANES).
Results
Lower eGFR and higher UACR categories were associated with higher incidences of CV events in finerenone and placebo recipients (Figure). Finerenone reduced CV risk versus placebo (hazard ratio 0.86; 95% CI 0.78–0.95; p=0.0018) without evidence of moderation of risk reduction by combined eGFR and UACR categories (p interaction = 0.66; Figure 1). Using NHANES, a total of 6.4 million treatment-eligible individuals with CKD and T2D were identified; 75% had CKD with an eGFR ≥60 ml/min/1.73 m2 and 25% had CKD with an eGFR <60 ml/min/1.73 m2. Simulations using this NHANES population projected that 1 year of finerenone treatment could prevent 38,359 CV events in US patients with CKD and T2D, with 66% of events prevented in patients with eGFR ≥60 ml/min/1.73 m2.
Conclusions
Higher albuminuria and lower eGFR are associated with increased CV risk in patients with T2D. Across a range of eGFR and albuminuria categories, CV risk is modifiable. Therefore, CKD is a modifiable CV risk factor in part mediated by mineralocorticoid receptor overactivation. UACR screening to identify patients with T2D and albuminuria with an eGFR ≥60 ml/min/1.73 m2 is likely to provide a significant opportunity for population benefits.
Funding Acknowledgement
Type of funding sources: Private company. Main funding source(s): Bayer AG
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Affiliation(s)
- R Agarwal
- Richard L. Roudebush VA Medical Center and Indiana University , Indianapolis , United States of America
| | - B Pitt
- University of Michigan, Department of Medicine , Ann Arbor , United States of America
| | - P Rossing
- Steno Diabetes Center Copenhagen , Gentofte , Denmark
| | - S D Anker
- Berlin Institute of Health Center for Regenerative Therapies, Department of Cardiology (CVK) , Berlin , Germany
| | - G Filippatos
- National & Kapodistrian University of Athens, School of Medicine, Department of Cardiology, Attikon University Hospital , Athens , Greece
| | - L M Ruilope
- Institute of Research imas12, Cardiorenal Translational Laboratory and Hypertension Unit , Madrid , Spain
| | - C P Kovesdy
- University of Tennessee, Division of Nephrology, Department of Medicine , Memphis , United States of America
| | - K Tuttle
- Providence Medical Research Center, Providence Health Care , Seattle , United States of America
| | - M Vaduganathan
- Harvard Medical School, Cardiovascular Division, Brigham and Women's Hospital , Boston , United States of America
| | - C Wanner
- University Hospital of Wurzburg, Division of Nephrology , Wurzburg , Germany
| | - S Bansilal
- Bayer Corporation, US Medical Affairs , New Jersey , United States Minor Outlying Islands
| | - M Gebel
- Bayer AG, Research and Development, Integrated Analysis Statistics , Wuppertal , Germany
| | | | - R Lawatscheck
- Bayer AG, Medical Affairs & Pharmacovigilance, Pharmaceuticals , Berlin , Germany
| | - G Bakris
- University of Chicago Medicine, Department of Medicine , Chicago , United States of America
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Shavelle DM, Heywood TJ, Srivastava AV, Agarwal R, Prillinger JB, Roberts GJ, Yu JK, Price MJ. Ambulatory Pulmonary Artery Pressures After Transcatheter Edge-to-Edge Repair of the Mitral Valve in Patients With Heart Failure and Mitral Regurgitation. Am J Cardiol 2022; 184:90-95. [PMID: 36163050 DOI: 10.1016/j.amjcard.2022.08.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 08/06/2022] [Accepted: 08/29/2022] [Indexed: 11/29/2022]
Abstract
The objective of this study was to assess ambulatory hemodynamics after transcatheter edge-to-edge repair (TEER) of the mitral valve. Pulmonary artery pressure (PAP) measurements from implanted sensors were collected through a remote monitoring database and linked to Medicare fee-for-service claims data. Among patients with linked data, those undergoing TEER were included if the ambulatory PAP monitor was implanted ≥3 months before TEER and ≥3 months of PAP data after TEER were available. The primary end point was diastolic PAP (dPAP) at 3 months after TEER compared with baseline. A total of 50 patients undergoing TEER between July 2014 and March 2020 were included, with an average age of 75 ± 8 years and 70% were men. dPAP was significantly lower at 3 months after TEER than baseline, -1.8 ± 4.8 mm Hg, p = 0.010. The cumulative reduction in dPAP (area under the curve) was significantly lower at 3 months after TEER, 113 ± 267 mm Hg-days, p = 0.004. A reduction in dPAP at 3 months after TEER was independently associated with a significantly lower risk of heart failure hospitalization (p = 0.023). TEER of the mitral valve is associated with a clinically relevant and sustained reduction in dPAP.
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Affiliation(s)
- David M Shavelle
- Memorial Care Heart and Vascular Institute, Long Beach Medical Center, Long Beach, California.
| | - Thomas J Heywood
- Division of Cardiovascular Diseases, Scripps Clinic, La Jolla, California
| | - Ajay V Srivastava
- Division of Cardiovascular Diseases, Scripps Clinic, La Jolla, California
| | - Rahul Agarwal
- Global Data Science and Analytics, Abbott, Santa Clara, California
| | | | | | - Joseph K Yu
- Global Data Science and Analytics, Abbott, Santa Clara, California
| | - Matthew J Price
- Division of Cardiovascular Diseases, Scripps Clinic, La Jolla, California
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Agarwal R, Dittmar T, Contassot E, Navarini A. 436 Modelling darier disease using human epidermal organoids. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.445] [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: 11/28/2022]
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Agarwal R, Winer S, Stanczyk F, Ho J. P-696 Serum androgen levels and risk of endometrial hyperplasia and malignancy in patients with polycystic ovarian syndrome: a cross-sectional analysis. Hum Reprod 2022. [DOI: 10.1093/humrep/deac107.645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Study question
In patients with polycystic ovarian syndrome (PCOS), are serum androgen levels (total and free testosterone) associated with the risk of endometrial hyperplasia or cancer?
Summary answer
Patients with PCOS diagnosed with endometrial hyperplasia or cancer had statistically significantly lower serum levels of androgens compared to PCOS patients with a normal endometrium.
What is known already
PCOS affects as many as 12% of women of reproductive age. Women with PCOS are almost three times as likely to develop endometrial cancer as women without PCOS, and endometrial hyperplasia precedes cancer in 36% of cases. Known risk factors of endometrial hyperplasia include anovulation, obesity, and resultant unopposed estrogen stimulation of the endometrium. A hallmark of PCOS is hyperandrogenism, however the effect of androgens on the endometrium is unclear.
Study design, size, duration
This was a cross-sectional, retrospective study of patients aged 18-40, being evaluated for oligomenorrhea and/or PCOS in the Reproductive Endocrinology Clinic at Los Angeles County Hospital, California, USA. All patients underwent an endometrial biopsy and serum measurement of free and total testosterone, estradiol, and hemoglobin A1c. Patients diagnosed with PCOS and with an endometrial biopsy diagnosis were included in the study. Patients on any hormonal therapy were excluded.
Participants/materials, setting, methods
In all patients included in the study, serum androgen levels (free and total testosterone) were measured by mass spectrometry. All endometrial biopsies were analyzed by an experienced histopathology, and all diagnoses of endometrial hyperplasia or cancer were confirmed by histologic studies.
Main results and the role of chance
Using the Rotterdam criteria, a total of 232 patients were diagnosed with PCOS during the study period. Of these patients, 161 patients (70%) had a normal endometrium, 19 (8%) were diagnosed with endometrial hyperplasia (EH) without atypia, 38 (16%) were diagnosed with EH with atypia, and 14 (6%) were diagnosed with endometrial cancer. Patients with a normal endometrium had a mean total testosterone of 60.9 ng/dL and mean free testosterone of 9.3 ng/dL. Relatively, patients with EH without atypia, EH with atypia, and endometrial cancer had lower mean total testosterone levels of 50.1 ng/dL, 45.5 ng/dL, and 30.1 ng/dL, respectively (p-values 0.04, 0.02, 0.001, respectively), as well as lower mean free testosterone levels of 8.2 pg/mL, 6.7 pg/mL, and 5.5 pg/mL, respectively (p-values 0.04, 0.03, and 0.01, respectively). There was no significant difference in age, parity, BMI, estradiol levels, or hemoglobin A1c between the four groups.
Limitations, reasons for caution
Limitations of our study include its retrospective nature. Furthermore, hormone levels were only measured in the serum, and not in the endometrial tissue directly, which would give the most insight into their actions on the endometrium.
Wider implications of the findings
Our findings suggest that androgens have a protective effect on the endometrium against endometrial hyperplasia and cancer. Further studies are needed to evaluate the therapeutic potential role of androgens in the prevention or treatment of these conditions.
Trial registration number
not applicable
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Affiliation(s)
- R Agarwal
- Keck School of Medicine of the University of Southern California, Reproductive Endocrinology and Infertility , Los Angeles, U.S.A
| | - S Winer
- Keck School of Medicine of the University of Southern California, Reproductive Endocrinology and Infertility , Los Angeles, U.S.A
| | - F Stanczyk
- Keck School of Medicine of the University of Southern California, Reproductive Endocrinology and Infertility , Los Angeles, U.S.A
| | - J Ho
- Keck School of Medicine of the University of Southern California, Reproductive Endocrinology and Infertility , Los Angeles, U.S.A
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Frost S, Pilley M, Porter C, Agarwal R. Patient perspectives on nipple-areola complex micropigmentation during the COVID-19 pandemic. J Plast Reconstr Aesthet Surg 2022; 75:2831-2870. [PMID: 35780000 PMCID: PMC9225963 DOI: 10.1016/j.bjps.2022.06.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 05/06/2022] [Accepted: 06/07/2022] [Indexed: 11/26/2022]
Abstract
Background Micropigmentation is a well-recognised option for nipple-areola complex reconstruction, as part of the breast reconstruction pathway for patients following mastectomy. As a part of delayed breast reconstruction, this treatment was put on hold during the COVID-19 pandemic. Aims To assess the views of patients regarding micropigmentation in response to the COVID-19 pandemic, and whether their attitudes to seeking out this part of the reconstructive journey had been altered. Methods A questionnaire undertaken with 53 patients between August & September 2020 attending the Micropigmentation clinic. Findings 81.1% of patients reported COVID-19 had not impacted their decision, with a similar proportion happy to proceed with the treatment at the time of questioning. Conclusions The results highlight the importance of nipple-areola complex to our patients’ reconstructive journey.
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Affiliation(s)
- S Frost
- Department of Plastic Surgery, University Hospitals of Leicester NHS Trust, Infirmary Square, Leicester, LE1 5WW, UK.
| | - M Pilley
- Department of Plastic Surgery, University Hospitals of Leicester NHS Trust, Infirmary Square, Leicester, LE1 5WW, UK
| | - C Porter
- Department of Plastic Surgery, University Hospitals of Leicester NHS Trust, Infirmary Square, Leicester, LE1 5WW, UK
| | - R Agarwal
- Department of Plastic Surgery, University Hospitals of Leicester NHS Trust, Infirmary Square, Leicester, LE1 5WW, UK.
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Nathan A, Sato Y, Tate K, wani P, Terry C, Fazeli F, Bouge A, Goodwin E, Wright J, Bertaina A, Klein O, Agarwal R, Roncarolo M, Bacchetta R. Gene Editing/Gene Therapies: BENCH TO BEDSIDE: ENGINEERED AUTOLOGOUS CD4LVFOXP3 TREG-LIKE CELL PRODUCT FOR PHASE 1 STUDY IN PATIENTS WITH IPEX SYNDROME. Cytotherapy 2022. [DOI: 10.1016/s1465-3249(22)00382-6] [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: 11/03/2022]
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22
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Coniglio A, Khan M, Minhas A, Rao V, Patel C, Milano C, Bryner B, Schroder J, Russell S, Agarwal R. Trends in Substance Use in Patients Requiring Advanced Heart Failure Therapies. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Jain M, Seth S, Agarwal R, Verma SP. The pigmented cells in bone marrow: Metastatic malignant melanoma. INDIAN J PATHOL MICR 2022; 65:485-486. [PMID: 35435404 DOI: 10.4103/ijpm.ijpm_1444_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023] Open
Affiliation(s)
- M Jain
- Department of Pathology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - S Seth
- Department of Ophthalmology, Rama Medical College and Research Centre, Kanpur, Uttar Pradesh, India
| | - R Agarwal
- Department of Clinical Haematology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - S P Verma
- Department of Clinical Haematology, King George's Medical University, Lucknow, Uttar Pradesh, India
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Agarwal R, Priyonugroho G, Hertine S, Wicaksono SH, Almazini P, Zamroni D, Muliawan HS. The association between neutrophil to lymphocyte ratio and echocardiographic parameters in hospitalised adults with COVID-19 - a retrospective analysis. Eur Heart J 2022. [PMCID: PMC9383406 DOI: 10.1093/eurheartj/ehab849.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
The neutrophil to lymphocyte ratio (NLR) is an inflammatory biomarker with prognostic value in several cardiovascular conditions. Hyperinflammation contributes to severe coronavirus disease 2019 (COVID-19), which is characterized by a multi-organ dysfunction. Cardiovascular complications of COVID-19 include arrhythmias, myocardial damage, acute heart failure, and acute coronary syndrome. Transthoracic echocardiography (TTE) can be used to assess cardiovascular structure and function non-invasively.
Purpose
To investigate the association between NLR at admission and TTE abnormalities in hospitalised adults with COVID-19.
Methods
This single-centre retrospective study was conducted at a COVID-19 referral hospital in Indonesia. All consecutive hospitalised adults with confirmed COVID-19 who underwent TTE assessments between 3 April 2020 to 6 April 2021 were included. Comprehensive data including NLR at admission, demographics, co-morbidities, peak severity of COVID-19, and TTE parameters were extracted from electronic medical records. A receiver operating characteristic (ROC) curve analysis was conducted to determine the optimal NLR cut-off for prediction of severe-critical COVID-19. Patients with high and low NLR were compared using the chi-square test and odds ratios (OR), with a confidence level of 95%.
Results
A total of 487 patients were included in this study. From ROC curve analysis, the area under curve was 0.80 (95% CI: 0.76 – 0.84). The optimal NLR cut-off was determined as 4.42, which predicted severe-critical COVID-19 with a sensitivity of 74.5% and a specificity of 74.6%. Based on this, the low NLR and high NLR groups had 223 and 264 patients, respectively. Male sex, diabetes, and chronic kidney disease occurred more frequently in the high NLR group (P < 0.05). On TTE assessment, the high NLR group had higher odds of left ventricular (LV) systolic dysfunction (OR: 2.49; 95% CI: 1.14 – 5.45), LV wall motion abnormalities (OR: 2.62; 95% CI: 1.41 – 4.87), valve abnormalities (OR: 2.04; 95% CI: 1.35 – 3.07), and right ventricular (RV) dysfunction (OR: 10.55; 95% CI: 2.46 – 45.25).
Conclusions
COVID-19 patients with a high NLR at admission had higher odds of abnormal TTE findings, including LV systolic dysfunction, LV wall motion abnormalities, valve abnormalities, and RV dysfunction. This indicates a possible link between inflammation and cardiovascular dysfunction in COVID-19, which must be confirmed in larger prospective studies. Abstract Figure. ROC Curve Analysis Abstract Figure. Odds Ratios for TTE Abnormalities
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Affiliation(s)
- R Agarwal
- Fakultas Kedokteran Universitas Indonesia (FKUI), Central Jakarta, Indonesia
| | - G Priyonugroho
- Rumah Sakit Universitas Indonesia, Department of Pulmonology and Respiratory Medicine, Depok, Indonesia
| | - S Hertine
- Rumah Sakit Universitas Indonesia, Depok, Indonesia
| | - S H Wicaksono
- Rumah Sakit Universitas Indonesia, Department of Cardiology and Vascular Medicine, Depok, Indonesia
| | - P Almazini
- Rumah Sakit Universitas Indonesia, Department of Cardiology and Vascular Medicine, Depok, Indonesia
| | - D Zamroni
- Rumah Sakit Universitas Indonesia, Department of Cardiology and Vascular Medicine, Depok, Indonesia
| | - H S Muliawan
- Rumah Sakit Universitas Indonesia, Department of Cardiology and Vascular Medicine, Depok, Indonesia
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Agarwal R, Priyonugroho G, Hertine S, Wicaksono SH, Almazini P, Zamroni D, Muliawan HS. The association between transthoracic echocardiographic parameters and severity of COVID-19 in hospitalised adults - a retrospective analysis. Eur Heart J 2022. [PMCID: PMC9383382 DOI: 10.1093/eurheartj/ehab849.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Funding Acknowledgements Type of funding sources: None. Background The coronavirus disease 2019 (COVID-19) is an ongoing global pandemic with more than 220 million cases and 4.5 million deaths reported worldwide. Its clinical spectrum varies widely, and non-invasive prognostic markers are valuable as they can guide efficient resource allocation. Cardiovascular complications of COVID-19 include myocardial injury, acute heart failure, and arrhythmias. Both de novo cardiovascular complications and pre-existing cardiovascular co-morbidities are associated with a poor prognosis. Transthoracic echocardiography (TTE) can be used to assess cardiovascular structure and function non-invasively. Purpose To investigate the association between TTE parameters and severity of disease in hospitalised adults with confirmed COVID-19 Methods This single-centre retrospective analysis was conducted at a COVID-19 referral hospital in Indonesia. All consecutive adults hospitalised with confirmed COVID-19 who underwent TTE assessment between 3 April 2020 to 6 April 2021 were included. Comprehensive data including demographics, peak COVID-19 severity, pre-existing co-morbidities, and TTE findings were extracted from electronic medical records. Patients with mild-moderate and severe-critical disease were compared using the chi-square test and odds ratios (OR), with a confidence level of 95%. Results A total of 488 patients were included in this study; 202 with mild-moderate disease and 286 with severe-critical disease. Frequency of old age (>60 years), obesity, diabetes, chronic kidney disease, and congestive heart failure were higher in the severe-critical group (P < 0.05). On TTE assessment, Patients with severe-critical disease had higher odds of left ventricular hypertrophy (LVH) (OR: 2.20; CI: 1.49 – 3.24), LV wall motion abnormality (OR: 3.33; CI: 1.68 – 6.60), diastolic dysfunction (OR: 1.46; CI: 1.02 – 2.11), valve abnormality (OR: 1.93; CI: 1.27 – 2.92), and right ventricular (RV) dysfunction (OR: 5.53; CI: 1.63 – 18.73). After matching for age, obesity, and diabetes, patients with severe-critical COVID-19 continued to have higher odds of LVH (OR: 1.91; CI: 1.21 – 3.02), LV wall motion abnormality (OR: 2.76; CI: 1.28 – 5.96), diastolic dysfunction (OR: 1.55; CI: 1.00 – 2.38), and RV dysfunction (OR: 3.86; CI: 1.06 – 14.08). Conclusions The presence of LVH, LV wall motion abnormality, diastolic dysfunction, and RV dysfunction on TTE assessment were associated with severe-critical disease in hospitalised adults with COVID-19. These findings must be validated in a larger prospective study.
Abstract Figure. Odds Ratios for the Entire Cohort
Abstract Figure. Odds Ratios for the Matched Cohort ![]()
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Affiliation(s)
- R Agarwal
- Fakultas Kedokteran Universitas Indonesia (FKUI), Central Jakarta, Indonesia
| | - G Priyonugroho
- Rumah Sakit Universitas Indonesia, Department of Pulmonology and Respiratory Medicine, Depok, Indonesia
| | - S Hertine
- Rumah Sakit Universitas Indonesia, Depok, Indonesia
| | - S H Wicaksono
- Rumah Sakit Universitas Indonesia, Department of Cardiology and Vascular Medicine, Depok, Indonesia
| | - P Almazini
- Rumah Sakit Universitas Indonesia, Department of Cardiology and Vascular Medicine, Depok, Indonesia
| | - D Zamroni
- Rumah Sakit Universitas Indonesia, Department of Cardiology and Vascular Medicine, Depok, Indonesia
| | - H S Muliawan
- Rumah Sakit Universitas Indonesia, Department of Cardiology and Vascular Medicine, Depok, Indonesia
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Rossing P, Agarwal R, Anker S, Filippatos G, Pitt B, Ruilope L, Joseph A, Gebel M, Kolkhof P, Nowack C, Bakris G. POS-350 FINERENONE IN MILD TO SEVERE CHRONIC KIDNEY DISEASE AND TYPE 2 DIABETES: THE FIDELITY PRESPECIFIED POOLED ANALYSIS. Kidney Int Rep 2022. [DOI: 10.1016/j.ekir.2022.01.371] [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: 10/19/2022] Open
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Agarwal R, Dumpala RMR, Sharma MK, Noronha DM, Gamare JS, Jayachandran K, Nandi C, Kaity S. Electrochemical recovery of plutonium from aqueous carbonate waste solutions. Chem Commun (Camb) 2022; 58:1111-1114. [PMID: 34979537 DOI: 10.1039/d1cc06603j] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Recovery of plutonium from aqueous carbonate waste solutions generated during the reprocessing of spent nuclear fuel is a key concern for sustainable nuclear energy programmes and the remediation of radioactive waste. Reported methods proceed through secondary waste generation caused by acidification of carbonate waste and make the recovery process cumbersome. Herein, we report a simple method for the recovery of Pu as solid PuO2 powder from carbonate waste solution in a two-step process. (i) Pu was selectively electrochemically precipitated as plutonium-hydroxide in the presence of interfering U, Th, Ru, Zr, Nb, Cs and the degradation products of tri-butyl phosphate by bulk electrolysis at -0.9 V using a Pt gauze electrode and (ii) the precipitate was annealed at 973 K for conversion to pure PuO2 powder. The present approach is simple, avoids the generation of secondary waste and reduces the exposure of working personnel to radiation.
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Affiliation(s)
- Rahul Agarwal
- Homi Bhabha National Institute, Mumbai 400094, India. .,Fuel Chemistry Division, Bhabha Atomic Research Centre, Mumbai 400085, India
| | | | - Manoj K Sharma
- Homi Bhabha National Institute, Mumbai 400094, India. .,Fuel Chemistry Division, Bhabha Atomic Research Centre, Mumbai 400085, India
| | - Donald M Noronha
- Fuel Chemistry Division, Bhabha Atomic Research Centre, Mumbai 400085, India
| | - Jayashree S Gamare
- Fuel Chemistry Division, Bhabha Atomic Research Centre, Mumbai 400085, India
| | - Kavitha Jayachandran
- Homi Bhabha National Institute, Mumbai 400094, India. .,Fuel Chemistry Division, Bhabha Atomic Research Centre, Mumbai 400085, India
| | - Chiranjit Nandi
- Radiometallurgy Division, Bhabha Atomic Research Centre, Mumbai 400085, India
| | - Santu Kaity
- Radiometallurgy Division, Bhabha Atomic Research Centre, Mumbai 400085, India
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Agarwal R, Dumpala RMR, Sharma MK. Nitric Acid Concentration Strongly Influences Low Level Uranium Determination on PEDOT-PSS Coated Glassy Carbon Electrode. Analyst 2022; 147:4724-4729. [DOI: 10.1039/d2an01390h] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Understanding the parametric optimization and addition of modification in existing technique are key to successful research in analytical sciences. The present study reports an electroanalytical technique by modifying the electrode...
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Gupta P, Agarwal R, Atreyapurapu V, Sharma P, Yerramsetty V, Saripalli C, Reddy KS, Atturu G. COVID-19 and clotting: A wave of acute limb ischemia. Indian J Vasc Endovasc Surg 2022. [DOI: 10.4103/ijves.ijves_47_22] [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: 11/11/2022] Open
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Wu C, Nagel SJ, Agarwal R, Pötter-Nerger M, Hamel W, Sharan AD, Connolly AT, Cheeran B, Larson PS. Reduced Risk of Reoperations With Modern Deep Brain Stimulator Systems: Big Data Analysis From a United States Claims Database. Front Neurol 2021; 12:785280. [PMID: 34925219 PMCID: PMC8675885 DOI: 10.3389/fneur.2021.785280] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 10/29/2021] [Indexed: 11/24/2022] Open
Abstract
Objective: There have been significant improvements in the design and manufacturing of deep brain stimulation (DBS) systems, but no study has considered the impact of modern systems on complications. We sought to compare the relative occurrence of reoperations after de novo implantation of modern and traditional DBS systems in patients with Parkinson's disease (PD) or essential tremor (ET) in the United States. Design: Retrospective, contemporaneous cohort study. Setting: Multicenter data from the United States Centers for Medicare and Medicaid Services administrative claims database between 2016 and 2018. Participants: This population-based sample consisted of 5,998 patients implanted with a DBS system, of which 3,869 patients had a de novo implant and primary diagnosis of PD or ET. Follow-up of 3 months was available for 3,810 patients, 12 months for 3,561 patients, and 24 months for 1,812 patients. Intervention: Implantation of a modern directional (MD) or traditional omnidirectional (TO) DBS system. Primary and Secondary Outcome Measures: We hypothesized that MD systems would impact complication rates. Reoperation rate was the primary outcome. Associated diagnoses, patient characteristics, and implanting center details served as covariates. Kaplan–Meier analysis was performed to compare rates of event-free survival and regression models were used to determine covariate influences. Results: Patients implanted with modern systems were 36% less likely to require reoperation, largely due to differences in acute reoperations and intracranial lead reoperations. Risk reduction persisted while accounting for practice differences and implanting center experience. Risk reduction was more pronounced in patients with PD. Conclusions: In the first multicenter analysis of device-related complications including modern DBS systems, we found that modern systems are associated with lower reoperation rates. This risk profile should be carefully considered during device selection for patients undergoing DBS for PD or ET. Prospective studies are needed to further investigate underlying causes.
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Affiliation(s)
- Chengyuan Wu
- Department of Neurological Surgery, Vickie and Jack Farber Institute for Neuroscience, Thomas Jefferson University, Philadelphia, PA, United States
| | - Sean J Nagel
- Department of Neurological Surgery, Center for Neuro-Restoration, Cleveland Clinic, Cleveland, OH, United States
| | | | - Monika Pötter-Nerger
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Wolfgang Hamel
- Department of Neurological Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ashwini D Sharan
- Department of Neurological Surgery, Vickie and Jack Farber Institute for Neuroscience, Thomas Jefferson University, Philadelphia, PA, United States
| | | | | | - Paul S Larson
- Department of Neurological Surgery, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
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Mohta M, Bambode N, Chilkoti GT, Agarwal R, Malhotra RK, Batra P. Neonatal outcomes following phenylephrine or norepinephrine for treatment of spinal anaesthesia-induced hypotension at emergency caesarean section in women with fetal compromise - a randomised controlled study. Int J Obstet Anesth 2021; 49:103247. [PMID: 35012812 DOI: 10.1016/j.ijoa.2021.103247] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 10/24/2021] [Accepted: 12/12/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Norepinephrine is as effective as phenylephrine for management of spinal anaesthesia-induced hypotension. Most of the studies comparing these vasopressors have been conducted in healthy pregnant women undergoing elective caesarean section. In the current study, we tested the null hypothesis that there is no difference in neonatal outcome when phenylephrine or norepinephrine is used to treat spinal anaesthesia-induced hypotension in women undergoing emergency caesarean section for fetal compromise. METHODS Patients undergoing caesarean section for fetal compromise who developed spinal anaesthesia-induced hypotension were randomised to receive phenylephrine 100 μg or norepinephrine 8 μg for treatment of each hypotensive episode, defined as systolic blood pressure <100 mmHg. Umbilical cord arterial and venous blood samples were obtained for blood gas analysis. The primary outcome measure was umbilical artery pH. RESULTS One hundred patients (50 in each group) were studied. There was no significant difference in umbilical artery pH between the two groups (mean difference 0.001; 95% CI -0.032 to 0.034). The number of hypotensive episodes, vasopressor boluses required, the incidence of bradycardia, heart rate and blood pressure trends following vasopressor administration, and the incidence of nausea/vomiting were not significantly different between groups. CONCLUSION Phenylephrine 100 μg and norepinephrine 8 μg were not significantly different in terms of neonatal outcome when administered as intravenous boluses for treatment of spinal anaesthesia-induced hypotension in parturients undergoing emergency caesarean sections for fetal compromise.
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Affiliation(s)
- M Mohta
- Department of Anaesthesiology and Critical Care, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India.
| | - N Bambode
- Department of Anaesthesiology and Critical Care, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
| | - G T Chilkoti
- Department of Anaesthesiology and Critical Care, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
| | - R Agarwal
- Department of Obstetrics and Gynaecology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
| | - R K Malhotra
- Delhi Cancer Registry, Dr. BRA IRCH, All India Institute of Medical Sciences, Delhi, India
| | - P Batra
- Department of Paediatrics, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
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Gopalakrishnan S, Chaurasia S, Sankar MJ, Paul VK, Deorari AK, Joshi M, Agarwal R. Stepwise interventions for improving hand hygiene compliance in a level 3 academic neonatal intensive care unit in north India. J Perinatol 2021; 41:2834-2839. [PMID: 34321595 DOI: 10.1038/s41372-021-01141-3] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Revised: 06/20/2021] [Accepted: 06/30/2021] [Indexed: 11/09/2022]
Abstract
OBJECTIVE We evaluated effect of sequentially introducing four WHO-recommended interventions to promote hand-hygiene compliance in tertiary-care NICU. STUDY DESIGN Four dedicated research nurses directly observed doctors and nurses to record success in hand-hygiene opportunities at randomly selected NICU beds and randomly sampled time-slots in four phases (of 4-weeks each): I-Baseline, II-Self-directed learning; III-Participatory learning; IV-Closed-Circuit Television (CCTV); and V-CCTV-plus (with feedback). FINDINGS Hand-hygiene compliance changed from 61.8% (baseline) to 77% (end) with overall relative change: 24.6% (95% CI 18, 32; p value= 0.003); compared with preceding phase, relative changes of 21% (15, 28; <0.001), 4% (0, 8; 0.008), -10% (-13, -6; <0.001), and 10% (5, 15; <0.001) during phases II, III, IV, and V, respectively were observed. Rise in hand-hygiene compliance was higher for after-WHO-moments (12.7%; upto 2.5-folds for moment 5, <0.001) compared to before-WHO-moments (5.2%). Educational interventions, feedback and monitoring WHO moments can improve hand-hygiene compliance significantly among health-care providers in NICU.
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Affiliation(s)
| | - Suman Chaurasia
- Department of Neonatology, All India Institute of Medical Sciences, Rishikesh, Dehradun, 249203, Uttarakhand, India.
| | - M J Sankar
- Newborn Health Knowledge Centre (NHKC) and WHO Collaborating Centre for Training and Research in Newborn Care, Department of Pediatrics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India.
| | - V K Paul
- Department of Pediatrics, AIIMS, New Delhi, India
| | - A K Deorari
- WHO Collaborating Centre for Training & Research in Newborn Care, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India
| | - M Joshi
- WHO Collaborating Centre for Training & Research in Newborn Care, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India
| | - R Agarwal
- Newborn Health Knowledge Centre (NHKC) and WHO Collaborating Centre for Training and Research in Newborn Care, Department of Pediatrics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India
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Gopalakrishnan S, Chaurasia S, Sankar MJ, Paul VK, Deorari AK, Joshi M, Agarwal R. Correction: Stepwise interventions for improving hand hygiene compliance in a level 3 academic neonatal intensive care unit in north India. J Perinatol 2021; 41:2847. [PMID: 34645955 DOI: 10.1038/s41372-021-01224-1] [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: 11/09/2022]
Affiliation(s)
| | - Suman Chaurasia
- Department of Neonatology, All India Institute of Medical Sciences, Rishikesh, Dehradun, 249203, Uttarakhand, India.
| | - M J Sankar
- Newborn Health Knowledge Centre (NHKC) and WHO Collaborating Centre for Training and Research in Newborn Care, Department of Pediatrics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India.
| | - V K Paul
- Department of Pediatrics, AIIMS, New Delhi, India
| | - A K Deorari
- WHO Collaborating Centre for Training & Research in Newborn Care, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India
| | - M Joshi
- WHO Collaborating Centre for Training & Research in Newborn Care, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India
| | - R Agarwal
- Newborn Health Knowledge Centre (NHKC) and WHO Collaborating Centre for Training and Research in Newborn Care, Department of Pediatrics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India
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Blomain E, Jiang A, Donaldson S, Agarwal R, Bertaina A, Shyr D, Shin D, Hoppe R, Hiniker S. Impact of Testicular Boost on Oncologic Outcomes and Late Effects in Pediatric Patients With Leukemia Receiving Fractionated Total Body Irradiation (TBI): A Single-Institution Experience. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.667] [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: 10/20/2022]
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Karki S, Steven S, Kaur G, Das D, Agarwal R. Use of Elastic Stain Technique to Detect Histologically Occult Vascular Invasion in Resected Colorectal Carcinomas at Danbury Hospital. Am J Clin Pathol 2021. [DOI: 10.1093/ajcp/aqab191.146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction/Objective
Colorectal carcinoma (CRC) represents a leading cause of cancer related death in the western world and is by far the most common malignancy of the gastrointestinal tract. Vascular invasion (VI), in particular extramural VI by tumor is recognized as a feature of colorectal cancer progression, and the latter is an independent prognostic indicator of disease recurrence and survival in colorectal carcinoma. The purpose of this study is to detect VI in resected colorectal tumor samples and compare sensitivity of elastic staining to routine H&E staining at Danbury Hospital.
Methods/Case Report
A total of 50 colorectal cancer specimens from segmental colon resection or endoscopic polypectomy performed at Danbury Hospital over a 3-year period were included. Histologic sections of each tumor were assessed for the presence of VI by routine H&E staining. Superficial recuts of each tumor were subjected to elastic Von Giesen staining and reassessed for the presence of vascular invasion. Sensitivity of routine H&E staining for the detection of VI was calculated with elastic stain serving as the “gold standard”.
Results (if a Case Study enter NA)
In this study, VI by carcinoma was identified by H&E stain and/or elastic stain in 17 (34%) out of 50 cases. H&E stain and elastic stain detected VI in 12 (24%) and 16 (32%) out of 50 cases, respectively. There was a single case for which H&E stain showed vascular invasion that was not confirmed by elastic stain, representing a false negative for the H&E technique. Elastic staining detected VI in 5 cases for which the corresponding H&E stain was falsely negative for VI. Overall, vascular invasion status (absent or present) was concordant in 44 (88 %) of the 50 cases. With elastic stain deemed the “gold standard” for VI detection, the sensitivity, specificity, negative predictive value, and positive predictive value of H&E stain were found to be 68.7%, 97.0%, 86.8%, and 91.6%, respectively.
Conclusion
Although H & E staining of colorectal carcinoma tissue sections have a very good specificity and positive predictive value for the detection of VI, this technique suffers from a suboptimal sensitivity. For these reasons, we agree with previously published literature reports that the use of elastic stain as a supplement to H & E staining should be strongly considered for the proper evaluation and prognostication of colorectal carcinoma specimens.
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Affiliation(s)
- S Karki
- Anatomic and Clinical Pathology, Danbury Hospital, Danbury, Connecticut, UNITED STATES
| | - S Steven
- Anatomic and Clinical Pathology, Danbury Hospital, Danbury, Connecticut, UNITED STATES
| | - G Kaur
- Anatomic and Clinical Pathology, Danbury Hospital, Danbury, Connecticut, UNITED STATES
| | - D Das
- Anatomic and Clinical Pathology, Danbury Hospital, Danbury, Connecticut, UNITED STATES
| | - R Agarwal
- Clinical Research, Danbury Hospital, Danbury, Connecticut, UNITED STATES
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Abd. Aziz N, Agarwal R, Latiff AA, Ismail N. RESVERATROL AS A POTENTIAL AGENT FOR NEUROPROTECTION AGAINST INTRACEREBRAL HEMORRHAGE: INSIGHT ON THE ROLE OF ADENOSINE A1 RECEPTORS. материалы конференции 2021. [DOI: 10.19163/medchemrussia2021-2021-88] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
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Agarwal D, Agarwal M, Chandra M, Mishra A, Agarwal R. Knowledge assessment and outcomes of otolaryngology practice amidst the COVID-19 pandemic in a busy ENT department. Ann R Coll Surg Engl 2021; 103:589-598. [PMID: 34464553 DOI: 10.1308/rcsann.2021.0004] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Otolaryngology health personnel are at high risk of acquiring COVID-19 disease and, hence, are likely to have high stress levels. This study was designed to evaluate the feedback of otolaryngology healthcare workers in ENT departments who are managing patients in the coronavirus pandemic. METHODS A questionnaire focused on all aspects of healthcare delivery was completed by otolaryngology healthcare workers. RESULTS The findings, based on statistical analyses, included high stress levels and inadequate disease-related information in these workers. CONCLUSIONS Healthcare authorities need to take care of issues related to mental health in healthcare professionals in addition to spreading awareness about safe practices. Further studies are needed to continuously monitor feedback from personnel as the coronavirus pandemic unravels in the future.
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Affiliation(s)
- D Agarwal
- King George's Medical University, Lucknow, India
| | - M Agarwal
- Intern, Era's Lucknow Medical College, Lucknow, India
| | - M Chandra
- King George's Medical University, Lucknow, India
| | - A Mishra
- King George's Medical University, Lucknow, India
| | - R Agarwal
- Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
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Agarwal R, Contassot E, Navarini A. LB724 Human epidermal organoids: Establishing a reproducible stratified human epidermal organoid culture system. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.07.017] [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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Fishman MA, Antony AB, Hunter CW, Pope JE, Staats PS, Agarwal R, Connolly AT, Dalal N, Deer TR. The Cost of Lost Productivity in an Opioid Utilizing Pain Sample. J Pain Res 2021; 14:2347-2357. [PMID: 34377015 PMCID: PMC8349546 DOI: 10.2147/jpr.s309691] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 07/19/2021] [Indexed: 11/23/2022] Open
Abstract
Background and Aims Chronic pain affects more adults in the United States than any other condition. Opioid medications are widely used in the treatment of chronic pain, but there remains considerable risk and cost associated with their use. This study aims to characterize the effects of opioid prescribing for chronic pain and similar pain conditions on lost productivity in the United States. Methods This was a retrospective, longitudinal, observational study of chronic pain patients in 2011–2014. We identified patients with a diagnosis of musculoskeletal pain receiving index prescription for opioids in administrative claims and studied disability absence in a linked health and productivity management database. Patients were grouped as de novo and continued use opioid users before index, and by opioid dose in the year after index. Days of disability were compared before and after index with bootstrapping. Effect of opioid dose group on disability was evaluated with negative binomial regression. Lost productivity cost was compared before and after index. Results The cohort contained 16,273 de novo and 6604 continued use patients. On average, de novo patients used 24.8 days of disability after index, an increase of 18.3 more days compared to before (p < 0.001). Continued use patients used 30.7 days after index, 9 more days than before (p < 0.001). There was a dose–response relationship between dose group and days of disability in de novo patients (p < 0.001). The weighted-average cost per person of lost productivity was $4344 higher in the year after index compared to the year before. Conclusion Opioid prescriptions for pain patients were associated with significant disability use and lost productivity costs. With the evolution of opioid-prescribing practices, CDC recommendations, and the HHS Pain Management Best Practices, there is opportunity to use alternative pain therapies without the risks of opioid-induced side effects to improve work productivity.
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Affiliation(s)
| | | | - Corey W Hunter
- Ainsworth Institute of Pain Management, New York, NY, USA
| | | | | | | | | | | | - Timothy R Deer
- The Spine and Nerve Center of the Virginias, Charleston, WV, USA
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Hawkes EA, Lee ST, Chong G, Gilbertson M, Grigg A, Churilov L, Fancourt T, Keane C, Ritchie D, Koldej R, Agarwal R, Manos K, Smith C, Houdyk K, Hawking J, Barraclough A. IMMUNE PRIMING WITH NIVOLUMAB FOLLOWED BY NIVOLUMAB & RITUXIMAB IN 1
ST
LINE TREATMENT OF FOLLICULAR LYMPHOMA: THE PHASE 2 1
ST
FLOR STUDY. Hematol Oncol 2021. [DOI: 10.1002/hon.81_2879] [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: 11/08/2022]
Affiliation(s)
- E. A. Hawkes
- Olivia Newton‐John Cancer Research and Wellness Centre Medical Oncology and Haematology Melbourne Australia
| | - S. T. Lee
- Austin Health, Molecular Imaging and Therapy Melbourne Australia
| | - G. Chong
- Ballarat Regional Intergrated Cancer Centre Haematology and Oncology Ballarat Australia
| | | | - A. Grigg
- Austin Health Haematology Melbourne Australia
| | - L. Churilov
- Melbourne Brain Centre Florey Institute of Neuroscience and Mental Health Melbourne Australia
| | - T. Fancourt
- Austin Health Anatomical Pathology Melbourne Australia
| | - C. Keane
- Princess Alexandra Hospital Haematology Brisbane Australia
| | - D. Ritchie
- Peter MacCallum Cancer Centre and Royal Melbourne Hospital Haematology Melbourne Australia
| | - R. Koldej
- The Royal Melbourne Hospital ACRF Translational Research Laboratory Melbourne Australia
| | - R. Agarwal
- Austin Health Molecular Diagnostics Melbourne Australia
| | - K. Manos
- Austin Health Haematology Melbourne Australia
| | - C. Smith
- Austin Health Cancer Clinical Trials Centre Melbourne Australia
| | - K. Houdyk
- Austin Health Cancer Clinical Trials Centre Melbourne Australia
| | - J. Hawking
- Austin Health Cancer Clinical Trials Centre Melbourne Australia
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Shukla S, Kushwaha R, Singh M, Saroj R, Puranik V, Agarwal R, Kaur D. Quantification of bioactive compounds in guava at different ripening stages. Food Res 2021. [DOI: 10.26656/fr.2017.5(3).554] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Guava (Psidium guajava L.) is one of the most important tropical fruits belonging to
the genus Psidium and the Myrtaceae family and claim to have phenolic compounds
that have been reported to possess strong antioxidant activity. This study was aimed to
evaluate the bioactive constituents in guava cultivars at different ripening stages by
HPLC. The five guava cultivars were selected at different ripening stages and the
bioactive components were analysed by high-pressure liquid chromatography. The
quantification of bioactive compounds revealed that the highest amount of bioactive
compounds was found in cultivar Safeda at the unripe stage, while a minimum amount
was found in ripe Apple Colour guava cultivar. The six bioactive compounds were
quantified in the range of gallic acid (9.46-63.08 mg/100 g), quercetin (0.11-2.51
mg/100 g), myrcetin (0.09-0.034 mg/100 g), ascorbic acid (7.45-75.07 mg/100 g),
apegenin (0.01-0.032 mg/100 g) and lycopene (0.34-0.92 mg/100 g). The exploratory
evaluation of guava samples was performed through Principal Component Analysis
(PCA), the bioactive compounds, lycopene, myricetin, and quercetin are dominant
variables on this PC1 (61.52%) (Scores better than 0.7), thereby causing greater
variability among these samples. The second principal component (PC2) represents
16.54% of the total variance and the ascorbic acid, gallic acid and apeginin (score
better than 0.7), are the dominant variables on this PC.
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Bertaina A, Grimm P, Kristovich K, Barbarito G, Lippner E, Fathallah-Shaykh S, Al-Uzri A, van der Elst K, Agarwal R, Selpicka P, Shah A, Weinberg K, Parkman R, Roncarolo M, Gallo A, Conception W, Lewis D. Sequential hematopoietic stem cell and kidney transplantation in schimke immuno-osseous dysplasia: towards a model for establishing functional immune tolerance for solid organ transplantation. Cytotherapy 2021. [DOI: 10.1016/s1465324921004989] [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: 11/17/2022]
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Blumer V, Rivera-Maza M, Friede K, Truby L, Mentz R, Patel M, Schroder J, Zajarias A, Amin A, Russell S, Katz J, Agarwal R. Percutaneous Coronary Interventions in Patients Supported with Left Ventricular Assist Devices. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.334] [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: 10/21/2022] Open
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Truby L, Kwee L, Agarwal R, Grass E, Devore A, Patel C, Rogers J, Chen D, Schroder J, Milano C, Shah S, Holley C. Proteomic Profiling of Heart Transplant Recipients Identifies CLE4C Expression as a Novel Biomarker of Primary Graft Dysfunction. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.1859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Abstract
Preparation of a stable U(v) complex in an aqueous medium is a challenging task owing to its disproportionation nature (conversion into more stable U(vi) and U(iv) species) and sensitivity to atmospheric oxygen. The stable uranyl (UO22+)/dipicolinic acid (DPA) complex ([U(VI)O2(DPA)(OH)(H2O)]-) was formed at pH 10.5-12.0, which was confirmed by potentiometric and spectrophotometric titrations, and NMR, ESI-MS and EXAFS spectroscopy. The complex [U(VI)O2(DPA)(OH)(H2O)]- can be electrochemically reduced on the Pt electrode at -0.9 eV (vs. Ag/AgCl) to [U(V)O2(DPA)(OH)(H2O)]2- in aqueous medium under an anaerobic environment. According to cyclic voltammetric analysis, a pair of oxidation and reduction waves at E'0 = -0.592 V corresponds to the [U(VI)O2(DPA)(OH)(H2O)]-/[U(V)O2(DPA)(OH)(H2O)]2- redox couple and the formation of [U(V)O2(DPA)(OH)(H2O)]2- was confirmed by the electron stoichiometry (n = 0.97 ± 0.05) of the reduction reaction of [U(VI)O2(DPA)(OH)(H2O)]-. The pentavalent uranyl complex [U(V)O2(DPA)(OH)(H2O)]2- was further characterized via UV-vis-NIR absorption spectrophotometry and X-ray absorption (XANES and EXAFS) spectroscopy. The [U(V)O2(DPA)(OH)(H2O)]2- complex is stable at pH 10.5-12.0 in anaerobic water for a few days. DFT calculation shows the strong complexing ability of DPA stabilizing the unstable oxidation state U(v) in aqueous medium.
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Affiliation(s)
- Rahul Agarwal
- Homi Bhabha National Institute, Mumbai 400 094, India. and Fuel Chemistry Division, Bhabha Atomic Research Centre (BARC), Trombay, Mumbai 400 085, India
| | - Rama Mohana Rao Dumpala
- Radio Chemistry Division, Bhabha Atomic Research Centre (BARC), Trombay, Mumbai 400 085, India
| | - Manoj K Sharma
- Homi Bhabha National Institute, Mumbai 400 094, India. and Fuel Chemistry Division, Bhabha Atomic Research Centre (BARC), Trombay, Mumbai 400 085, India
| | - Ashok Kumar Yadav
- Atomic & Molecular Physics Division, Bhabha Atomic Research Centre (BARC), Trombay, Mumbai 400 085, India
| | - Tamal Kanti Ghosh
- The Environmental research group, R&D, Tata Steel, Jamshedpur, Jharkhand 831001, India
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Agarwal R, Atreyapurapu V, Sharma P, Yerramsetty V, Burli P, Atturu G, Gupta P. Hybrid and percutaneous salvage of a thrombosed native arteriovenous fistula: 1-year outcomes. Indian J Vasc Endovasc Surg 2021. [DOI: 10.4103/ijves.ijves_154_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Acharya A, Agarwal R, Baker M, Baudry J, Bhowmik D, Boehm S, Byler KG, Chen S, Coates L, Cooper C, Demerdash O, Daidone I, Eblen J, Ellingson S, Forli S, Glaser J, Gumbart JC, Gunnels J, Hernandez O, Irle S, Kneller D, Kovalevsky A, Larkin J, Lawrence T, LeGrand S, Liu SH, Mitchell J, Park G, Parks J, Pavlova A, Petridis L, Poole D, Pouchard L, Ramanathan A, Rogers D, Santos-Martins D, Scheinberg A, Sedova A, Shen Y, Smith J, Smith M, Soto C, Tsaris A, Thavappiragasam M, Tillack A, Vermaas J, Vuong V, Yin J, Yoo S, Zahran M, Zanetti-Polzi L. Supercomputer-Based Ensemble Docking Drug Discovery Pipeline with Application to Covid-19. J Chem Inf Model 2020; 60:5832-5852. [PMID: 33326239 PMCID: PMC7754786 DOI: 10.1021/acs.jcim.0c01010] [Citation(s) in RCA: 109] [Impact Index Per Article: 27.3] [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] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Indexed: 01/18/2023]
Abstract
We present a supercomputer-driven pipeline for in silico drug discovery using enhanced sampling molecular dynamics (MD) and ensemble docking. Ensemble docking makes use of MD results by docking compound databases into representative protein binding-site conformations, thus taking into account the dynamic properties of the binding sites. We also describe preliminary results obtained for 24 systems involving eight proteins of the proteome of SARS-CoV-2. The MD involves temperature replica exchange enhanced sampling, making use of massively parallel supercomputing to quickly sample the configurational space of protein drug targets. Using the Summit supercomputer at the Oak Ridge National Laboratory, more than 1 ms of enhanced sampling MD can be generated per day. We have ensemble docked repurposing databases to 10 configurations of each of the 24 SARS-CoV-2 systems using AutoDock Vina. Comparison to experiment demonstrates remarkably high hit rates for the top scoring tranches of compounds identified by our ensemble approach. We also demonstrate that, using Autodock-GPU on Summit, it is possible to perform exhaustive docking of one billion compounds in under 24 h. Finally, we discuss preliminary results and planned improvements to the pipeline, including the use of quantum mechanical (QM), machine learning, and artificial intelligence (AI) methods to cluster MD trajectories and rescore docking poses.
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Affiliation(s)
- A. Acharya
- School of Physics, Georgia Institute of Technology, Atlanta, GA 30332, USA
| | - R. Agarwal
- UT/ORNL Center for Molecular Biophysics, Oak Ridge National Laboratory, TN, 37830, USA
- The University of Tennessee, Knoxville. Department of Biochemistry & Cellular and Molecular Biology, 309 Ken and Blaire Mossman Bldg. 1311 Cumberland Avenue Knoxville, TN, 37996, USA
- Graduate School of Genome Science and Technology, University of Tennessee, Knoxville, TN, 37996, USA
| | - M. Baker
- Computer Science and Mathematics Division, Oak Ridge National Lab, Oak Ridge, TN 37830, USA
| | - J. Baudry
- The University of Alabama in Huntsville, Department of Biological Sciences. 301 Sparkman Drive, Huntsville, AL 35899, USA
| | - D. Bhowmik
- Computational Sciences and Engineering Division, Oak Ridge National Laboratory, Oak Ridge, TN 37831, USA
| | - S. Boehm
- Computer Science and Mathematics Division, Oak Ridge National Lab, Oak Ridge, TN 37830, USA
| | - K. G. Byler
- The University of Alabama in Huntsville, Department of Biological Sciences. 301 Sparkman Drive, Huntsville, AL 35899, USA
| | - S.Y. Chen
- Computational Science Initiative, Brookhaven National Laboratory, Upton, NY 11973, USA
| | - L. Coates
- Neutron Scattering Division, Oak Ridge National Laboratory, Oak Ridge, TN 37831, USA
| | - C.J. Cooper
- UT/ORNL Center for Molecular Biophysics, Oak Ridge National Laboratory, TN, 37830, USA
- Graduate School of Genome Science and Technology, University of Tennessee, Knoxville, TN, 37996, USA
| | - O. Demerdash
- Biosciences Division, Oak Ridge National Lab, Oak Ridge, TN 37830, USA
| | - I. Daidone
- Department of Physical and Chemical Sciences, University of L’Aquila, I-67010 L’Aquila, Italy
| | - J.D. Eblen
- UT/ORNL Center for Molecular Biophysics, Oak Ridge National Laboratory, TN, 37830, USA
- The University of Tennessee, Knoxville. Department of Biochemistry & Cellular and Molecular Biology, 309 Ken and Blaire Mossman Bldg. 1311 Cumberland Avenue Knoxville, TN, 37996, USA
| | - S. Ellingson
- University of Kentucky, Division of Biomedical Informatics, College of Medicine, UK Medical Center MN 150, Lexington KY, 40536, USA
| | - S. Forli
- Scripps Research, La Jolla, CA, 92037, USA
| | - J. Glaser
- National Center for Computational Sciences, Oak Ridge National Laboratory, Oak Ridge, TN 37830, USA
| | - J. C. Gumbart
- School of Physics, Georgia Institute of Technology, Atlanta, GA 30332, USA
| | - J. Gunnels
- HPC Engineering, Amazon Web Services, Seattle, WA 98121, USA
| | - O. Hernandez
- Computer Science and Mathematics Division, Oak Ridge National Lab, Oak Ridge, TN 37830, USA
| | - S. Irle
- Computational Sciences and Engineering Division, Oak Ridge National Laboratory, Oak Ridge, TN 37831, USA
- Chemical Sciences Division, Oak Ridge National Laboratory, Oak Ridge, TN 37831, USA
- Bredesen Center for Interdisciplinary Research and Graduate Education, University of Tennessee, Knoxville, TN 37996, USA
| | - D.W. Kneller
- Neutron Scattering Division, Oak Ridge National Laboratory, Oak Ridge, TN 37831, USA
| | - A. Kovalevsky
- Neutron Scattering Division, Oak Ridge National Laboratory, Oak Ridge, TN 37831, USA
| | - J. Larkin
- NVIDIA Corporation, Santa Clara, CA 95051, USA
| | - T.J. Lawrence
- Biosciences Division, Oak Ridge National Lab, Oak Ridge, TN 37830, USA
| | - S. LeGrand
- NVIDIA Corporation, Santa Clara, CA 95051, USA
| | - S.-H. Liu
- UT/ORNL Center for Molecular Biophysics, Oak Ridge National Laboratory, TN, 37830, USA
- The University of Tennessee, Knoxville. Department of Biochemistry & Cellular and Molecular Biology, 309 Ken and Blaire Mossman Bldg. 1311 Cumberland Avenue Knoxville, TN, 37996, USA
| | - J.C. Mitchell
- Biosciences Division, Oak Ridge National Lab, Oak Ridge, TN 37830, USA
| | - G. Park
- Computational Science Initiative, Brookhaven National Laboratory, Upton, NY 11973, USA
| | - J.M. Parks
- UT/ORNL Center for Molecular Biophysics, Oak Ridge National Laboratory, TN, 37830, USA
- The University of Tennessee, Knoxville. Department of Biochemistry & Cellular and Molecular Biology, 309 Ken and Blaire Mossman Bldg. 1311 Cumberland Avenue Knoxville, TN, 37996, USA
- Graduate School of Genome Science and Technology, University of Tennessee, Knoxville, TN, 37996, USA
| | - A. Pavlova
- School of Physics, Georgia Institute of Technology, Atlanta, GA 30332, USA
| | - L. Petridis
- UT/ORNL Center for Molecular Biophysics, Oak Ridge National Laboratory, TN, 37830, USA
- The University of Tennessee, Knoxville. Department of Biochemistry & Cellular and Molecular Biology, 309 Ken and Blaire Mossman Bldg. 1311 Cumberland Avenue Knoxville, TN, 37996, USA
| | - D. Poole
- NVIDIA Corporation, Santa Clara, CA 95051, USA
| | - L. Pouchard
- Computational Science Initiative, Brookhaven National Laboratory, Upton, NY 11973, USA
| | - A. Ramanathan
- Data Science and Learning Division, Argonne National Lab, Lemont, IL 60439, USA
| | - D. Rogers
- National Center for Computational Sciences, Oak Ridge National Laboratory, Oak Ridge, TN 37830, USA
| | | | | | - A. Sedova
- Biosciences Division, Oak Ridge National Lab, Oak Ridge, TN 37830, USA
| | - Y. Shen
- UT/ORNL Center for Molecular Biophysics, Oak Ridge National Laboratory, TN, 37830, USA
- The University of Tennessee, Knoxville. Department of Biochemistry & Cellular and Molecular Biology, 309 Ken and Blaire Mossman Bldg. 1311 Cumberland Avenue Knoxville, TN, 37996, USA
- Graduate School of Genome Science and Technology, University of Tennessee, Knoxville, TN, 37996, USA
| | - J.C. Smith
- UT/ORNL Center for Molecular Biophysics, Oak Ridge National Laboratory, TN, 37830, USA
- The University of Tennessee, Knoxville. Department of Biochemistry & Cellular and Molecular Biology, 309 Ken and Blaire Mossman Bldg. 1311 Cumberland Avenue Knoxville, TN, 37996, USA
| | - M.D. Smith
- UT/ORNL Center for Molecular Biophysics, Oak Ridge National Laboratory, TN, 37830, USA
- The University of Tennessee, Knoxville. Department of Biochemistry & Cellular and Molecular Biology, 309 Ken and Blaire Mossman Bldg. 1311 Cumberland Avenue Knoxville, TN, 37996, USA
| | - C. Soto
- Computational Science Initiative, Brookhaven National Laboratory, Upton, NY 11973, USA
| | - A. Tsaris
- National Center for Computational Sciences, Oak Ridge National Laboratory, Oak Ridge, TN 37830, USA
| | | | | | - J.V. Vermaas
- National Center for Computational Sciences, Oak Ridge National Laboratory, Oak Ridge, TN 37830, USA
| | - V.Q. Vuong
- Computational Sciences and Engineering Division, Oak Ridge National Laboratory, Oak Ridge, TN 37831, USA
- Chemical Sciences Division, Oak Ridge National Laboratory, Oak Ridge, TN 37831, USA
- Bredesen Center for Interdisciplinary Research and Graduate Education, University of Tennessee, Knoxville, TN 37996, USA
| | - J. Yin
- National Center for Computational Sciences, Oak Ridge National Laboratory, Oak Ridge, TN 37830, USA
| | - S. Yoo
- Computational Science Initiative, Brookhaven National Laboratory, Upton, NY 11973, USA
| | - M. Zahran
- Department of Biological Sciences, New York City College of Technology, The City University of New York (CUNY), Brooklyn, NY 11201, USA
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Bajpai J, Majumdar A, Satwik R, Rohatgi N, Jain V, Gupta D, Agarwal R, Mittal S, Verma SK, Parikh PM, Aggarwal S. Practical consensus recommendations on fertility preservation in patients with breast cancer. South Asian J Cancer 2020; 7:110-114. [PMID: 29721475 PMCID: PMC5909286 DOI: 10.4103/sajc.sajc_113_18] [Citation(s) in RCA: 7] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Young women diagnosed with cancer today have a greater chance of long-term survival than ever before. Successful survivorship for this group of patients includes maintaining a high quality of life after a cancer diagnosis and treatment; however, lifesaving treatments such as chemotherapy, radiation, and surgery can impact survivors by impairing reproductive and endocrine health. Expert oncologists along with reproductive medicine specialists discuss fertility preservation options in this chapter since fertility preservation is becoming a priority for young women with breast cancer. This expert group used data from published literature, practical experience and opinion of a large group of academic oncologists to arrive at these practical consensus recommendations for the benefit of community oncologists.
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Affiliation(s)
- Jyoti Bajpai
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - A Majumdar
- Center of IVF and Human Reproduction, Sir Gangaram Hospital, New Delhi, India
| | - R Satwik
- Center of IVF and Human Reproduction, Sir Gangaram Hospital, New Delhi, India
| | - N Rohatgi
- Department of Medical Oncology, Max Saket Hospital, New Delhi, India
| | - V Jain
- Department of Gynaecology and Obstretics, Ludhiana Medicity Hospital, Ludhiana, Punjab, India
| | - D Gupta
- Department of Medical Oncology, Dharamshila Cancer Hospital, New Delhi, India
| | - R Agarwal
- Department of Surgical Oncology, Medanta Hospital, Gurugram, Haryana, India
| | - S Mittal
- Department of Medical Oncology, Action Balajee Cancer Center, New Delhi, India
| | - S K Verma
- Department of Medical Oncology, Jolly Grant Himalayan Institute, Dehradoon, Uttarakhand, India
| | - P M Parikh
- Department of Oncology, Shalby Cancer and Research Institutes, Mumbai, Maharashtra, India
| | - S Aggarwal
- Department of Medical Oncology, Sir Gangaram Hospital, New Delhi, India
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Reddy A, Ck A, Milton A, Agarwal R. Evaluation of rBapB, rOmpC and rOmpA proteins of Salmonella Typhimurium as vaccine candidates for control of zoonotic salmonellosis in poultry. Int J Infect Dis 2020. [DOI: 10.1016/j.ijid.2020.09.1255] [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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50
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Roydhouse JK, Menapace LA, Xia H, Song P, Berman T, Agarwal R, Suzman DL, Wright K, Beaver JA, Kluetz PG. Concomitant botanical medicine use among patients participating in commercial prostate cancer trials. Complement Ther Med 2020; 54:102549. [PMID: 33183667 DOI: 10.1016/j.ctim.2020.102549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 08/24/2020] [Accepted: 08/25/2020] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVES Patients with cancer frequently use botanical medications. The concomitant use of such medications by patients on commercial trials has not been well-described, despite the importance of these trials for evaluating the safety and efficacy of new agents. We sought to describe the use of botanical medications taken by patients with prostate cancer enrolled on global commercial trials. DESIGN Retrospective study. SETTING Regulatory repository of commercial clinical trial data. INTERVENTIONS Anti-cancer therapy. MAIN OUTCOME MEASURES Botanical and medication use data were pooled across six international commercial randomized trials for metastatic prostate cancer with detailed information on medication and indications. Botanical products were considered to have potential for drug interaction if they led to a change in drug exposure in human trials. Potential for interaction was ascertained by PubMed review. Descriptive statistics were used for analysis. RESULTS Of 7318 enrolled patients, 700 (10 %) reported botanical use at any time and 653 (9%) reported use of botanical products while on trial. Nearly half of botanical product types were not classified by plant (43 %). The highest proportion of botanical use was among patients in Asian countries (32 %), followed by patients in North America (13 %). Eighty-six different types of botanical products were used; of these, nineteen had a patient-reported anti-cancer indication. CONCLUSIONS Botanical medicine use among patients with prostate cancer in commercial trials is moderate, although it varies by region. Practitioners should be aware of the use of botanical interventions in a clinical trial context.
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Affiliation(s)
- J K Roydhouse
- ORISE Fellow, Office of Hematology and Oncology Products, Center for Drug Evaluation and Research, Food and Drug Administration (US FDA), Silver Spring, MD, USA; Menzies Institute for Medical Research, University of Tasmania, Hobart TAS, Australia.
| | - L A Menapace
- Office of Hematology and Oncology Products, Center for Drug Evaluation and Research, US FDA, Silver Spring, MD, USA; National Heart, Lung and Blood Institute (NHLBI), National Institutes of Health (NIH), Bethesda, MD, USA
| | - H Xia
- Division of Clinical Pharmacology, Center for Drug Evaluation and Research, US FDA, Silver Spring, MD, USA
| | - P Song
- Division of Clinical Pharmacology, Center for Drug Evaluation and Research, US FDA, Silver Spring, MD, USA
| | - T Berman
- Office of Oncologic Diseases, Center for Drug Evaluation and Research, US FDA, Silver Spring, MD, USA
| | - R Agarwal
- New Drug Products Branch II, Center for Drug Evaluation and Research, US FDA, Silver Spring, MD, USA
| | - D L Suzman
- Office of Oncologic Diseases, Center for Drug Evaluation and Research, US FDA, Silver Spring, MD, USA
| | - K Wright
- Office of Prescription Drug Promotion, Center for Drug Evaluation and Research, US FDA, Silver Spring, MD, USA
| | - J A Beaver
- Office of Oncologic Diseases, Center for Drug Evaluation and Research, US FDA, Silver Spring, MD, USA
| | - P G Kluetz
- Oncology Center of Excellence, US FDA, Silver Spring, MD, USA
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