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Kumar M, Venishetty S, Jindal A, Bihari C, Maiwall R, Vijayaraghavan R, Saggere Muralikrishna S, Arora V, Kumar G, Sarin SK. Tranexamic acid in upper gastrointestinal bleed in patients with cirrhosis: A randomized controlled trial. Hepatology 2024:01515467-990000000-00771. [PMID: 38441903 DOI: 10.1097/hep.0000000000000817] [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: 07/21/2023] [Accepted: 01/22/2024] [Indexed: 04/12/2024]
Abstract
BACKGROUND AND AIMS Patients with Child-Turcotte-Pugh class B and C cirrhosis with upper gastrointestinal bleeding (UGIB) have systemic as well as localized (in the mucosa of the esophagus and stomach) fibrinolysis. The aim of this study was to evaluate the efficacy and safety of tranexamic acid in the treatment of acute UGIB in patients with cirrhosis. APPROACH AND RESULTS A total of 600 patients with advanced liver cirrhosis (Child-Turcotte-Pugh class B or C) presenting with UGIB were randomly allocated to either the tranexamic acid (n=300) or the placebo group (n=300). The primary outcome measure was the proportion of patients developing 5-day treatment failure. Failure to control bleeding by day 5 was seen in 19/300 (6.3%) patients in the tranexamic acid group and 40/300 (13.3%) patients in the placebo group ( p =0.006). Esophageal endoscopic variceal ligation (EVL) site as a source of failure to control bleeding by day 5 among patients undergoing first-time esophageal EVL (excluding patients with a previous post-EVL ulcer as a source of bleed) was seen in 11/222 (4.9%) patients in the tranexamic acid group and 27/225 (1212.0%) patients in the placebo group ( p =0.005). However, 5-day and 6-week mortality was similar in the tranexamic acid and placebo groups. CONCLUSIONS Tranexamic acid significantly reduces the failure to control bleeding by day 5 and failure to prevent rebleeding after day 5 to 6 weeks in patients with advanced liver cirrhosis (Child-Turcotte-Pugh class B or C) presenting with UGIB, by preventing bleeding from the EVL site.
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Affiliation(s)
- Manoj Kumar
- Department of Hepatology and Liver Transplantation, Institute of Liver & Biliary Sciences, New Delhi, India
| | - Shantan Venishetty
- Department of Hepatology and Liver Transplantation, Institute of Liver & Biliary Sciences, New Delhi, India
| | - Ankur Jindal
- Department of Hepatology and Liver Transplantation, Institute of Liver & Biliary Sciences, New Delhi, India
| | - Chhagan Bihari
- Department of Pathology, Institute of Liver & Biliary Sciences, New Delhi, India
| | - Rakhi Maiwall
- Department of Hepatology and Liver Transplantation, Institute of Liver & Biliary Sciences, New Delhi, India
| | - Rajan Vijayaraghavan
- Department of Hepatology and Liver Transplantation, Institute of Liver & Biliary Sciences, New Delhi, India
| | | | - Vinod Arora
- Department of Hepatology and Liver Transplantation, Institute of Liver & Biliary Sciences, New Delhi, India
| | - Guresh Kumar
- Department of Biostatistics, Institute of Liver & Biliary Sciences, New Delhi, India
| | - Shiv K Sarin
- Department of Hepatology and Liver Transplantation, Institute of Liver & Biliary Sciences, New Delhi, India
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Jindal A, Sharma MK, Vijayaraghavan R, Sm S, Kumar G, Sarin SK. Severity of Acute Portal Hypertension Determines the Clinical Outcomes in Severe Alcoholic Hepatitis. Dig Dis Sci 2024; 69:298-307. [PMID: 37907805 DOI: 10.1007/s10620-023-08144-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Accepted: 10/02/2023] [Indexed: 11/02/2023]
Abstract
BACKGROUND Severe alcohol-associated hepatitis (SAH) presenting as acute-on-chronic liver failure (ACLF) has high mortality. Severe hepatic inflammation and ongoing hepatocellular cell death lead to rapid rise in portal pressure, a hyperdynamic circulation that might precipitate infections and organ failures. METHODS Consecutive SAH patients were classified based on baseline HVPG measurement as 6to < 12 mmHg, 12to < 20 mmHg, and ≥ 20 mmHg. We analyzed portal hypertension severity in relation to fibrosis stage, ACLF at presentation, response to prednisolone, severity scores(MELD and Maddrey's Discriminant Function, mDF), and 90-day mortality. RESULTS Of 819 SAH patients (94.6% ACLF, 85.4% histological cirrhosis, median MELD and mDF scores 25 and 66, respectively), 250(30.5%) had HVPG ≥ 20 mmHg. Patients with HVPG ≥ 20 mmHg more often had large esophageal varices (25.2%vs.13.2%; p-0.001), higher baseline MELD (27.1 ± 5.6vs.25.3 ± 5.2; p-0.001), and mDF(76.1 ± 16vs.68.4 ± 15.1; p-0.01) scores. No patient without ACLF had HVPG ≥ 20 mmHg. Moreover, during hospital course these patients had higher incidence of variceal bleed (17.2%vs.8.8%; p-0.001), acute kidney injury (36.4%vs.25.3%; p-0.001), and spontaneous bacterial peritonitis (6.4%vs.3.5%; p-0.05). Of 412(50.3%) eligible patients treated with prednisolone, 69.2% showed response at day 7(Lille's score < 0.45). 90-day mortality was 27.6%; and baseline MELD > 25.5[HR 1.78], HVPG ≥ 20 mmHg [HR 1.86], the presence of HE[HR 1.63], and prednisolone ineligibility due to sepsis[HR 1.27] were independent predictors. Mortality was unrelated to varices grade, variceal bleed, and histological cirrhosis. Repeat HVPG performed in 114(19.2%) patients after a median of 5.2 months showed significant decrease (3.6 mmHg; p-0.001) which correlated with improvement in MELD score(13points; p-0.05). CONCLUSION Development of ACLF and complications in SAH are likely a result of acute rise in HVPG. "High-risk" SAH are SAH patients with HVPG ≥ 20 mmHg in the presence of ascites. Understanding the drivers for acute rise in portal pressure in SAH ACLF might help introduction of newer therapies.
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Affiliation(s)
- Ankur Jindal
- Department of Hepatology, Institute of Liver and Biliary Sciences, D - 1, Vasant Kunj, New Delhi, 110070, India
| | - Manoj K Sharma
- Department of Hepatology, Institute of Liver and Biliary Sciences, D - 1, Vasant Kunj, New Delhi, 110070, India
| | - Rajan Vijayaraghavan
- Department of Hepatology, Institute of Liver and Biliary Sciences, D - 1, Vasant Kunj, New Delhi, 110070, India
| | - Shasthry Sm
- Department of Hepatology, Institute of Liver and Biliary Sciences, D - 1, Vasant Kunj, New Delhi, 110070, India
| | - Guresh Kumar
- Department of Biostatistics, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Shiv K Sarin
- Department of Hepatology, Institute of Liver and Biliary Sciences, D - 1, Vasant Kunj, New Delhi, 110070, India.
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Sundaram V, Ramanan RN, Selvaraj M, Ahemad N, Vijayaraghavan R, MacFarlane DR, Ooi CW. Probing the molecular interactions between cholinium-based ionic liquids and insulin aspart: A combined computational and experimental study. Int J Biol Macromol 2023; 253:126665. [PMID: 37689282 DOI: 10.1016/j.ijbiomac.2023.126665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 08/29/2023] [Accepted: 08/31/2023] [Indexed: 09/11/2023]
Abstract
Despite extensive studies revealing the potential of cholinium-based ionic liquids (ILs) in protein stabilization, the nature of interaction between ILs' constituents and protein residues is not well understood. In this work, we used a combined computational and experimental approach to investigate the structural stability of a peptide hormone, insulin aspart (IA), in ILs containing a choline cation [Ch]+ and either dihydrogen phosphate ([Dhp]-) or acetate ([Ace]-) as anions. Although IA remained stable in both 1 M [Ch][Dhp] and 1 M [Ch][Ace], [Dhp]- exhibited a much stronger stabilization effect than [Ace]-. Both the hydrophilic ILs intensely hydrated IA and increased the number of water molecules in IA's solvation shell. Undeterred by the increased number of water molecules, the native state of IA's hydrophobic core was maintained in the presence of ILs. Importantly, our results reveal the importance of IL concentration in the medium which was critical to maintain a steady population of ions in the microenvironment of IA and to counteract the denaturing effect of water molecules. Through molecular docking, we confirm that the anions exert the dominant effect on the structure of IA, while [Ch]+ have the secondary influence. The computational results were validated using spectroscopic analyses (ultra-violet, fluorescence, and circular dichroism) along with dynamic light scattering measurements. The extended stability of IA at 30 °C for 28 days in 1 M [Ch][Dhp] and [Ch][Ace] demonstrated in this study reveals the possibility of stabilizing IA using cholinium-based ILs.
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Affiliation(s)
- Vidya Sundaram
- Chemical Engineering Department, School of Engineering, Monash University Malaysia, Jalan Lagoon Selatan, 47500 Bandar Sunway, Selangor, Malaysia
| | - Ramakrishnan Nagasundara Ramanan
- Chemical Engineering Department, School of Engineering, Monash University Malaysia, Jalan Lagoon Selatan, 47500 Bandar Sunway, Selangor, Malaysia; Arkema Thiochemicals Sdn Bhd, Oasis Ara Damansara, 47301 Petaling Jaya, Selangor, Malaysia
| | - Manikandan Selvaraj
- Chemical Engineering Department, School of Engineering, Monash University Malaysia, Jalan Lagoon Selatan, 47500 Bandar Sunway, Selangor, Malaysia; Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA
| | - Nafees Ahemad
- School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, 47500 Bandar Sunway, Selangor, Malaysia
| | - R Vijayaraghavan
- School of Chemistry, Faculty of Science, Monash University, Clayton, Victoria 3800, Australia
| | - Douglas R MacFarlane
- School of Chemistry, Faculty of Science, Monash University, Clayton, Victoria 3800, Australia
| | - Chien Wei Ooi
- Chemical Engineering Department, School of Engineering, Monash University Malaysia, Jalan Lagoon Selatan, 47500 Bandar Sunway, Selangor, Malaysia; Advanced Engineering Platform, Monash University Malaysia, Jalan Lagoon Selatan, 47500 Bandar Sunway, Selangor, Malaysia.
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Maiwall R, Rao Pasupuleti SS, Hidam AK, Kumar A, Tevethia HV, Vijayaraghavan R, Majumdar A, Prasher A, Thomas S, Mathur RP, Kumar G, Sarin SK. A randomised-controlled trial (TARGET-C) of high vs. low target mean arterial pressure in patients with cirrhosis and septic shock. J Hepatol 2023; 79:349-361. [PMID: 37088310 DOI: 10.1016/j.jhep.2023.04.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [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: 09/23/2022] [Revised: 03/17/2023] [Accepted: 04/04/2023] [Indexed: 04/25/2023]
Abstract
BACKGROUND & AIMS A high mean arterial pressure (MAP) target has been associated with improved renal outcomes in patients with cirrhosis, though it has not been studied in critically ill patients with cirrhosis and septic shock (CICs). We compared the efficacy of a high (80-85 mmHg; H-MAP) vs. low (60-65; L-MAP) target MAP strategy in improving 28-day mortality in CICs. METHODS We performed open-label 1:1 randomisation of 150 CICs (H-MAP 75; L-MAP 75). The primary endpoint was 28-day mortality and secondary endpoints included reversal of shock, acute kidney injury (AKI) at day 5, the incidence of intradialytic hypotension (IDH), and adverse events. Endothelial markers were analysed in a subset of patients. RESULTS The baseline characteristics were comparable. On intention-to-treat analysis, 28-day mortality (65% vs. 56%; p = 0.54), reversal of shock (47% vs. 53%; p = 0.41) and AKI development (45% vs. 31%;p = 0.06) were not different between the H-MAP and L-MAP groups, respectively. A lower incidence of IDH (12% vs. 48%; p <0.001) and higher adverse events necessitating protocol discontinuation (24% vs. 11%; p = 0.031) were noted in the H-MAP group. On per-protocol analysis (L-MAP 67; H-MAP 57), a significantly higher reversal of AKI (53% vs. 31%; p = 0.02) and a lower incidence of IDH (4% vs. 53%; p <0.001) were observed in the H-MAP group. Endothelial repair markers such as ADAMTS (2.11 ± 1.13 vs. 1.15 ± 0.48; p = 0.002) and angiopoietin-2 (74.08 ± 53.00 vs. 41.80 ± 15.95; p = 0.016) were higher in the H-MAP group. CONCLUSIONS A higher MAP strategy does not confer a survival benefit in CICs, but improves tolerance to dialysis, lactate clearance and renal recovery. Higher adverse events indicate the need for better tools to evaluate target microcirculation pressures in CICs. IMPACT AND IMPLICATIONS Maintaining an appropriate organ perfusion pressure during sepsis is the ultimate goal of haemodynamic management. A higher mean arterial pressure (MAP) improves renal outcomes in patients with hepatorenal syndrome. Patients with cirrhosis and septic shock have severe circulatory disturbances, low MAP, and poor tissue perfusion. In these patients, targeting higher MAP vs. lower MAP does not confer any survival benefit but is associated with more adverse events. A higher target strategy was associated with better tolerance and lesser episodes of hypotension on dialysis. Patients who could achieve the higher target MAP, without the development of adverse events, had improved renal outcomes and better lactate clearance. Higher MAP was also associated with improvements in markers of endothelial function. A higher target MAP strategy, with close monitoring of adverse events, may be recommended for patients with cirrhosis and septic shock. CLINICAL TRIAL NUMBER NCT03145168.
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Affiliation(s)
- Rakhi Maiwall
- Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Samba Siva Rao Pasupuleti
- Department of Statistics, Mizoram University (A Central University), Pachhunga University College Campus, Aizawl, India; Department of Applied Mathematics and Statistics, Mizoram University (A Central University), Pachhunga University College Campus, Aizawl, India
| | - Ashini Kumar Hidam
- Department of Clinical and Molecular Medicine, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Anupam Kumar
- Department of Clinical and Molecular Medicine, Institute of Liver and Biliary Sciences, New Delhi, India
| | | | - Rajan Vijayaraghavan
- Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Arpita Majumdar
- Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Adarsh Prasher
- Department of Clinical and Molecular Medicine, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Sherin Thomas
- Department of Biochemistry, Institute of Liver and Biliary Sciences, New Delhi, India
| | | | - Guresh Kumar
- Department of Statistics, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Shiv Kumar Sarin
- Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India.
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Vijayaraghavan R, Sarin SK, Bharadwaj A, Anand L, Maiwall R, Choudhury A, Benjamin J, Kanal U, Jamwal KD. Intragastric Balloon in Obese Compensated Nonalcoholic Steatohepatitis Cirrhosis Patients Is Safe and Achieves Significant Weight Reduction at 6-Months. Dig Dis Sci 2023; 68:1035-1041. [PMID: 35763235 DOI: 10.1007/s10620-022-07596-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 05/31/2022] [Indexed: 12/09/2022]
Abstract
BACKGROUND AND STUDY AIMS Weight reduction is the mainstay treatment for Nonalcoholic steatohepatitis (NASH). intragastric balloon (IGB) placement has proven benefit in terms of weight reduction. The aim of the present study is to assess the safety and efficacy of IGB placement in compensated NASH cirrhosis. PATIENTS AND METHODS Nonalcoholic steatohepatitis cirrhosis patients with CTP ≤ 7, BMI of > 30, and who were unable to achieve weight reduction with lifestyle modification in past 3 months were prospectively enrolled. Spatz3™ adjustable gastric balloon was placed endoscopically. Primary objective was to determine efficacy in weight loss at 6 months, with secondary objectives of reduction in hepatic venous pressure gradient (HVPG), liver fat (controlled attenuation parameter, CAP), liver stiffness measurement (LSM) and clinical events as well as the tolerability and adverse events due to IGB placement. RESULTS Altogether 56 cirrhosis patients, with a baseline BMI of 35.24 ± 3.92 and a CTP score of 6.27 ± 1.28 underwent IGB placement. The absolute weight reduction achieved was 15.88 kg (- 16.46%) and reduction in BMI was - 10.1% at 6 months. The percentage total body weight loss of ≥ 10% was achieved in 31 (55.35%) patients. The reduction in HVPG at 6-months was 11.12% (n = 16, 14.18 ± 2.12 to 12.60 ± 1.67 mmHg). The mean reduction in LSM was 28.6% and in CAP was 10.09%. Three (5.36%) patients required removal of IGB before 6-months due to persisting vomiting. No patient developed new-onset decompensation or any serious adverse event. CONCLUSION IGB placement is a safe, well tolerated and effective option for reduction in weight and portal pressure in compensated obese cirrhosis patients. TRIAL REGISTRY Clinicaltrails.gov identifier no: NCT03753438.
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Affiliation(s)
- Rajan Vijayaraghavan
- Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Shiv K Sarin
- Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India.
- Department of Hepatology, Institute of Liver and Biliary Sciences, D-1 Vasant Kunj, New Delhi, 110070, India.
| | - Ankit Bharadwaj
- Department of Epidemiology and Clinical Research, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Lovkesh Anand
- Department of Gastroenterology, Manipal Hospital, New Delhi, India
| | - Rakhi Maiwall
- Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Ashok Choudhury
- Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Jaya Benjamin
- Department of Clinical Nutrition, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Uma Kanal
- Department of Clinical Nutrition, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Kapil Dev Jamwal
- Department of Gastroenterology, Artemis Hospitals, Gurugram, Haryana, India
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Pande A, Sharma S, Khillan V, Rastogi A, Arora V, Shasthry SM, Vijayaraghavan R, Jagdish R, Kumar M, Kumar G, Mondot S, Dore J, Sarin SK. Fecal microbiota transplantation compared with prednisolone in severe alcoholic hepatitis patients: a randomized trial. Hepatol Int 2023; 17:249-261. [PMID: 36469298 DOI: 10.1007/s12072-022-10438-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [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: 06/07/2022] [Accepted: 10/09/2022] [Indexed: 12/11/2022]
Abstract
BACKGROUND Severe alcoholic hepatitis (SAH) has high 90-day mortality. Prednisolone therapy has shown modest survival benefits over placebo at 28 but not 90 days. Fecal microbial transplantation (FMT) has shown promise in these patients. We compared the efficacy and safety of the two therapies in SAH patients. METHODS Steroid eligible SAH patients were randomized in an open-label study to prednisolone (n = 60) 40 mg/day for 28 days (assessed at day-7 for continuation) or healthy donor FMT (n = 60) through naso-duodenal tube, daily for seven days. Primary outcome of study was day-90 survival. RESULTS Patients in prednisolone and FMT arms were comparable at baseline (discriminant function score 65 ± 16.2 and 68 ± 14, MELD score 17.1 and 16.5, respectively). Of 120 patients, 112 [prednisolone-57; FMT-55] completed trial. As per intention-to-treat analysis, 90-day survival was achieved by 56.6% (34/60) patients in prednisolone and 75% (45/60) in FMT group (p = 0.044, FMT HR = 0.528, 95%CI 0.279-0.998). Secondary outcome of 28-day survival [78.33% (47/60) and 88.33% (53/60) (p = 0.243, FMT HR = 0.535, 95%CI 0.213-1.34)] with comparable severity scores over time between both arms. Infections accounted for 11 (19.3%) and 2 (3.6%) deaths in prednisolone and FMT groups, respectively (p = 0.01). Path-tracing showed a slow establishment of microbiota and alpha diversity (Shannon index) improvement by day-28 (p = 0.029). FMT resulted in 23 new taxa by day-28, reduction from baseline in pathogenic taxa [Campylobacter (19-fold, p = 0.035), anaerobes (Parcubacteria, Weisella and Leuconostocaceae)], and increase of Alphaproteobacteria [~ sevenfold, p = 0.047] and Thaumarcheota (known ammonia oxidizer, p = 0.06). Lachnospiraceae (p = 0.008), Prevotella and Viellonella communities in gut favored survival (p < 0.05). CONCLUSION In severe alcoholic hepatitis, FMT is safe and improves 90-day survival and reduces infections by favorably modulating microbial communities. It can be a useful alternative to prednisolone therapy.
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Affiliation(s)
- Apurva Pande
- Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Shvetank Sharma
- Department of Molecular and Cellular Medicine, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Vikas Khillan
- Department of Microbiology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Archana Rastogi
- Department of Pathology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Vinod Arora
- Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India
| | | | - Rajan Vijayaraghavan
- Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Rakesh Jagdish
- Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Manoj Kumar
- Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Guresh Kumar
- Department of Clinical Research, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Stanislas Mondot
- Université Paris-Saclay, INRAE, Agro Paris Tech, Micalis Institute, 78350, Jouy-en-Josas, France
| | - Joél Dore
- Université Paris-Saclay, INRAE, Agro Paris Tech, Micalis Institute, 78350, Jouy-en-Josas, France
| | - Shiv K Sarin
- Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India.
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Arora V, Choudhary SP, Maiwall R, Vijayaraghavan R, Jindal A, Kumar G, Sarin SK. Low-dose continuous terlipressin infusion is effective and safer than intravenous bolus injections in reducing portal pressure and control of acute variceal bleeding. Hepatol Int 2023; 17:131-138. [PMID: 36542261 DOI: 10.1007/s12072-022-10416-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 08/24/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND AND AIMS Continuous infusion of terlipressin is better tolerated, and equally effective at lower doses than intravenous boluses in type 1 hepatorenal syndrome. This approach in cirrhosis patients with acute esophageal variceal bleed was investigated by comparing the efficacy and adverse events of continuous versus bolus administration of terlipressin. METHODS One hundred ten consecutive cirrhosis patients with acute esophageal variceal bleed (AEVB) were randomized to receive either terlipressin as bolus (BOL, n = 55), 2 mg every 4 h, or, continuous infusion (CONI, n = 55), 4 mg/24 h for 5 days. Hepatic venous pressure gradient (HVPG) was measured at baseline, 12 and 24 h and response to terlipressin was defined as > 10% decline from baseline. RESULTS Baseline demographics, model for end-stage liver disease (MELD) and HVPG were comparable between groups. The primary objective of HVPG response at 24 h was achieved in significantly more patients in CONI than BOL group {47/55(85.4%) vs. 32/55(58.2%), p = 0.002}. Early HVPG response at 12 h was also higher in CONI group (71.5 vs. 49.1%, p < 0.01). Median dose of terlipressin was significantly lower {4.25 ± 1.26 mg vs. 7.42 ± 1.42 mg/24 h, p < 0.001)} and adverse events were fewer {20/55(36.3%) vs. 31/55(56.4%), p = 0.03} in the CONI than BOL group. Significantly higher incidence of very early rebleed was noted in BOL group {8/55 (14.5%) vs. 1/55, (1.8%), p = 0.03}. Baseline HVPG (OR 1.90, 95% CI = 1.25-2.89, p = 0.002) and MELD (OR 1.18, 95% CI = 0.99-1.41, p = 0.05) were predictors of rebleed. CONCLUSION "HVPG-tailored" continuous terlipressin infusion is more effective than bolus administration in reducing HVPG at a lower dose with fewer adverse events in cirrhotic patients. CLINICAL TRIAL IDENTIFIER NCT02695862.
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Affiliation(s)
- Vinod Arora
- Department of Hepatology, Institute of Liver and Biliary Sciences, D-1 Vasant Kunj, New Delhi, India
| | - Shakti Prasad Choudhary
- Department of Hepatology, Institute of Liver and Biliary Sciences, D-1 Vasant Kunj, New Delhi, India
| | - Rakhi Maiwall
- Department of Hepatology, Institute of Liver and Biliary Sciences, D-1 Vasant Kunj, New Delhi, India
| | - Rajan Vijayaraghavan
- Department of Hepatology, Institute of Liver and Biliary Sciences, D-1 Vasant Kunj, New Delhi, India
| | - Ankur Jindal
- Department of Hepatology, Institute of Liver and Biliary Sciences, D-1 Vasant Kunj, New Delhi, India
| | - Guresh Kumar
- Department of Clinical Research and Biostatistics, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Shiv Kumar Sarin
- Department of Hepatology, Institute of Liver and Biliary Sciences, D-1 Vasant Kunj, New Delhi, India.
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Krishnaraj A, Bakbak E, Teoh H, Bhatt D, Quan A, Puar P, Lambotharan B, Kirubaharan A, Firoz I, Yanagawa B, Bari B, Kirubaharan R, Vijayaraghavan R, Demchuk A, Mancini G, Tanguay J, Tardif J, Voisine P, Leiter L, Verma S. TREATMENT IMPLICATIONS OF THE REDUCE-IT RESULTS TO PEOPLE OF SOUTH ASIAN (SA) DESCENT LIVING IN CANADA WITH KNOWN ATHEROSCLEROTIC CARDIOVASCULAR DISEASE(THE REDUCE-IT CANADA SA STUDY). Can J Cardiol 2022. [DOI: 10.1016/j.cjca.2022.08.205] [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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Liu L, Roessler K, Bilke S, Ding Y, Erlandson D, Fu Y, Hariharan B, Katz S, Lee J, Schulman C, Song F, Vijayaraghavan R, Wenz P, Xia E, Yan H, Zhu Y, Zhao C, Dockter J, Pawlowski T, Day J. 925P Analytical performance of a next-generation sequencing (NGS) assay kit for assessing homologous recombination deficiency (HRD) from solid tumor samples. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1050] [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: 11/27/2022] Open
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Yadav P, Trehanpati N, Maiwall R, Sehgal R, Singh R, Islam M, Jagdish RK, Vijayaraghavan R, Maheshwari D, Bhat S, Kale P, Kumar A, Baweja S, Kumar G, Ramakrishna G, Sarin SK. Soluble factors and suppressive monocytes can predict early development of sepsis in acute-on-chronic liver failure. Hepatol Commun 2022; 6:2105-2120. [PMID: 35502507 PMCID: PMC9315131 DOI: 10.1002/hep4.1949] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [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] [Received: 11/12/2021] [Revised: 02/22/2022] [Accepted: 03/06/2022] [Indexed: 01/08/2023] Open
Abstract
Patients with acute-on-chronic liver failure (ACLF) have a high probability of developing systemic inflammation and sepsis due to immune dysregulation. Fifty-nine patients with ACLF (12 without and 19 with systemic inflammation, and 28 with sepsis) were serially monitored for clinical and immunological changes at baseline, 6 hours, 24 hours, day 3, and day 7 following hospitalization. Ten healthy controls were also included. At all time points, soluble plasma factors and monocyte functions were studied. Patients with ACLF and systemic inflammation showed higher interleukin (IL)-6, vascular endothelial growth factor-a, monocyte chemoattractant protein 1, and macrophage inflammatory protein 1β than patients with no systemic inflammation. Patients with ACLF with sepsis had raised (p < 0.001) levels of IL-1Ra, IL-18, and triggering receptor expressed on myeloid cells 1 (TREM1) compared to patients with ACLF-systemic inflammation. Five of the 19 (26.3%) patients with systemic inflammation developed sepsis within 48-72 hours with a rapid rise in plasma levels of IL-1Ra (1203-35,000 pg/ml), IL-18 (48-114 pg/ml), and TREM1 (1273-4865 pg/ml). Monocytes of patients with ACLF with systemic inflammation and sepsis showed reduced human leukocyte antigen-DR but increased programmed death ligand 1 (PD-L1) and T-cell immunoglobulin and mucin domain-containing protein 3 (TIM3) (p < 0.04) expression with increased ETosis by monocytes at baseline and until day 7. Conclusion: High and rising levels of plasma IL-1Ra, IL-18, TREM1 soluble factors, and increased suppressive monocytes (PDL1+ve , TIM3+ve ) at baseline can stratify patients with ACLF at high risk of developing sepsis within 48-72 hours of hospitalization.
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Affiliation(s)
- Pushpa Yadav
- Laboratory of Molecular ImmunologyDepartment of Molecular and Cellular MedicineInstitute of Liver and Biliary Sciences New DelhiNew DelhiIndia
| | - Nirupama Trehanpati
- Laboratory of Molecular ImmunologyDepartment of Molecular and Cellular MedicineInstitute of Liver and Biliary Sciences New DelhiNew DelhiIndia
| | - Rakhi Maiwall
- 80402Department of HepatologyInstitute of Liver and Biliary SciencesNew DelhiIndia
| | - Rashi Sehgal
- Laboratory of Molecular ImmunologyDepartment of Molecular and Cellular MedicineInstitute of Liver and Biliary Sciences New DelhiNew DelhiIndia
| | - Ravinder Singh
- Laboratory of Molecular ImmunologyDepartment of Molecular and Cellular MedicineInstitute of Liver and Biliary Sciences New DelhiNew DelhiIndia
| | - Mojahidul Islam
- Laboratory of Molecular ImmunologyDepartment of Molecular and Cellular MedicineInstitute of Liver and Biliary Sciences New DelhiNew DelhiIndia
| | - Rakesh Kumar Jagdish
- 80402Department of HepatologyInstitute of Liver and Biliary SciencesNew DelhiIndia
| | - Rajan Vijayaraghavan
- 80402Department of HepatologyInstitute of Liver and Biliary SciencesNew DelhiIndia
| | - Deepanshu Maheshwari
- Laboratory of Molecular ImmunologyDepartment of Molecular and Cellular MedicineInstitute of Liver and Biliary Sciences New DelhiNew DelhiIndia
| | - Sadam Bhat
- Laboratory of Molecular ImmunologyDepartment of Molecular and Cellular MedicineInstitute of Liver and Biliary Sciences New DelhiNew DelhiIndia
| | - Pratibha Kale
- 80402Department of MicrobiologyInstitute of Liver and Biliary SciencesNew DelhiIndia
| | - Anupam Kumar
- Laboratory of Molecular ImmunologyDepartment of Molecular and Cellular MedicineInstitute of Liver and Biliary Sciences New DelhiNew DelhiIndia
| | - Sukriti Baweja
- Laboratory of Molecular ImmunologyDepartment of Molecular and Cellular MedicineInstitute of Liver and Biliary Sciences New DelhiNew DelhiIndia
| | - Guresh Kumar
- Laboratory of Molecular ImmunologyDepartment of Molecular and Cellular MedicineInstitute of Liver and Biliary Sciences New DelhiNew DelhiIndia
| | - Gayatri Ramakrishna
- Laboratory of Molecular ImmunologyDepartment of Molecular and Cellular MedicineInstitute of Liver and Biliary Sciences New DelhiNew DelhiIndia
| | - Shiv K Sarin
- 80402Department of HepatologyInstitute of Liver and Biliary SciencesNew DelhiIndia
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11
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Sundaram V, Ramanan RN, Selvaraj M, Vijayaraghavan R, MacFarlane DR, Ooi CW. Enhanced structural stability of insulin aspart in cholinium aminoate ionic liquids. Int J Biol Macromol 2022; 208:544-552. [PMID: 35331796 DOI: 10.1016/j.ijbiomac.2022.03.100] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Revised: 03/16/2022] [Accepted: 03/16/2022] [Indexed: 12/14/2022]
Abstract
Cholinium aminoates [Ch][AA] have gained tremendous interest as a promising ionic liquid medium for the synthesis and storage of proteins. However, high alkalinity of [Ch][AA] limits its usage with pH-sensitive proteins. Here, we probed the structure, stability, and interactions of a highly unstable therapeutic protein, insulin aspart (IA), in a range of buffered [Ch][AA] (b-[Ch][AA]) using a combination of biophysical tools and in silico pipeline including ultraviolet-visible, fluorescence, and circular dichroism spectroscopies, dynamic light scattering measurements and molecular docking. b-[Ch][AA] used in the study differed in concentrations and their anionic counterparts. We reveal information on ion and residue specific solvent-protein interactions, demonstrating that the structural stability of IA was enhanced by a buffered cholinium prolinate. In comparison to the glycinate and alaninate anions, the hydrophilic prolinate anions established more hydrogen bonds with the residues of IA and provided a less polar environment that favours the preservation of IA in its active monomeric form, opening new opportunities for utilizing [Ch][AA] as storage medium.
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Affiliation(s)
- Vidya Sundaram
- Chemical Engineering Discipline, School of Engineering, Monash University Malaysia, Jalan Lagoon Selatan, 47500 Bandar Sunway, Selangor, Malaysia; Biological Enginerring Discipline, Indian Institute of Technology Gandhinagar, Palaj, Gandhinagar-382055, Gujarat, India
| | - Ramakrishnan Nagasundara Ramanan
- Chemical Engineering Discipline, School of Engineering, Monash University Malaysia, Jalan Lagoon Selatan, 47500 Bandar Sunway, Selangor, Malaysia
| | - Manikandan Selvaraj
- Chemical Engineering Discipline, School of Engineering, Monash University Malaysia, Jalan Lagoon Selatan, 47500 Bandar Sunway, Selangor, Malaysia
| | - R Vijayaraghavan
- School of Chemistry, Faculty of Science, Monash University, Clayton, Victoria 3800, Australia
| | - Douglas R MacFarlane
- School of Chemistry, Faculty of Science, Monash University, Clayton, Victoria 3800, Australia
| | - Chien Wei Ooi
- Chemical Engineering Discipline, School of Engineering, Monash University Malaysia, Jalan Lagoon Selatan, 47500 Bandar Sunway, Selangor, Malaysia; Advanced Engineering Platform, Monash University Malaysia, Jalan Lagoon Selatan, 47500 Bandar Sunway, Selangor, Malaysia
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12
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Saranya CR, Vijayaraghavan R, Sathya Narayana Sharma K. Design of double sampling inspection plans for life tests under time censoring based on Pareto type IV distribution. Sci Rep 2022; 12:7953. [PMID: 35562578 PMCID: PMC9106667 DOI: 10.1038/s41598-022-11834-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 04/18/2022] [Indexed: 11/25/2022] Open
Abstract
Sampling inspection plans for life tests, called reliability sampling plans, are generally employed to determine the acceptance or non-acceptance of the lot(s) of finished products by performing tests on the sampled items, measuring the lifetime of the items and observing the number of failures of items. Lifetime of individual items is a prime quality characteristic that can be treated as a continuous random variable and can be modeled by an appropriate probability distribution. In this article, double sampling plans for life tests under time censoring with a provision to draw two random samples and to admit a maximum of one failure in the combined samples are formulated assuming that the lifetime random variable follows a Pareto type IV distribution. A methodical procedure for the selection of the plan parameters using reliable life criterion with the desired discrimination protecting the interests of the producer and the consumer in terms of the acceptable reliable life and unacceptable reliable life is evolved. The operating ratio is used as a measure of discrimination in designing the proposed reliability sampling plans.
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Affiliation(s)
- C R Saranya
- Department of Statistics, KSMDB College, Sasthamcotta, Kerala, India
| | - R Vijayaraghavan
- Department of Statistics, Bharathiar University, Coimbatore, 641 046, India
| | - K Sathya Narayana Sharma
- Department of Mathematics, School of Advanced Sciences, Vellore Institute of Technology, Vellore, Tamil Nadu, 632014, India.
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Maiwall R, Bajpai M, Singh A, Agarwal T, Kumar G, Bharadwaj A, Nautiyal N, Tevethia H, Jagdish RK, Vijayaraghavan R, Choudhury A, Mathur RP, Hidam A, Pati NT, Sharma MK, Kumar A, Sarin SK. Standard-Volume Plasma Exchange Improves Outcomes in Patients With Acute Liver Failure: A Randomized Controlled Trial. Clin Gastroenterol Hepatol 2022; 20:e831-e854. [PMID: 33524593 DOI: 10.1016/j.cgh.2021.01.036] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 12/29/2020] [Accepted: 01/24/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND High volume plasma-exchange (HVPE) improves survival in patients with acute liver failure (ALF), but apprehension regarding volume overload and worsening of cerebral edema remain. METHODS In an open-label randomized controlled trial, 40 consecutive patients of ALF were randomized 1:1 to either standard medical treatment (SMT) or SMT with standard-volume plasma-exchange (SVPE). SVPE was performed using centrifugal apheresis [target volume of 1.5 to 2.0 plasma volumes per session] until desired response was achieved. Cerebral edema was assessed by brain imaging. Results were analyzed in an intention-to-treat analysis. Primary outcome was 21-day transplant-free survival. The levels of cytokines, damage-associated molecular patterns (DAMPs) and endotoxins were analyzed at baseline and day 5. RESULTS ALF patients [aged 31.5 ± 12.2 years, 60% male, 78% viral, 83% hyperacute, 70% with SIRS were included. At day 5, SVPE [mean sessions 2.15 ± 1.42, median plasma volume replaced 5.049 L] compared to SMT alone, resulted in higher lactate clearance (p = .02), amelioration of SIRS (84% vs. 26%; P = .02), reduction in ammonia levels [(221.5 ± 96.9) vs.(439 ± 385.6) μg/dl, P = .02) and SOFA scores [9.9(±3.3) vs. 14.6(±4.8); P = .001]. There were no treatment related deaths. SVPE was associated with a higher 21-day transplant free-survival [75% vs. 45%; P = .04, HR 0.30, 95%CI 0.01-0.88]. A significant decrease in levels of pro-inflammatory cytokines and an increase in anti-inflammatory cytokines along with a decrease in endotoxin and DAMPs was seen with SVPE. CONCLUSION In ALF patients with cerebral edema, SVPE is safe and effective and improves survival possibly by a reduction in cytokine storm and ammonia. CLINICALTRIAL gov (identifier: NCT02718079).
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Affiliation(s)
- Rakhi Maiwall
- Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Meenu Bajpai
- Department of Transfusion Medicine, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Akanksha Singh
- Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Tanvi Agarwal
- Department of Clinical and Molecular Medicine, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Guresh Kumar
- Department of Biostatistics, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Ankit Bharadwaj
- Department of Biostatistics, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Nidhi Nautiyal
- Department of Clinical and Molecular Medicine, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Harsh Tevethia
- Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Rakesh Kumar Jagdish
- Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Rajan Vijayaraghavan
- Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Ashok Choudhury
- Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India
| | | | - Ashini Hidam
- Department of Clinical and Molecular Medicine, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Nirupama Trehan Pati
- Department of Clinical and Molecular Medicine, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Manoj Kumar Sharma
- Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Anupam Kumar
- Department of Clinical and Molecular Medicine, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Shiv Kumar Sarin
- Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India.
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14
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Mathevan Pillai D, Vijayaraghavan R, Kumar R, Chaithanya Prasad K, Pandya K, Nagappan N. Spectrophotometric Analysis of Fluoride Concentration in Dentifrices for Children in India. J Pharm Bioall Sci 2022; 14:S943-S946. [PMID: 36110806 PMCID: PMC9469247 DOI: 10.4103/jpbs.jpbs_847_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 12/23/2021] [Indexed: 11/04/2022] Open
Abstract
Background: Aim: Settings and Design: Methods: Results: Conclusions:
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15
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Vijayaraghavan R, Maiwall R, Arora V, Choudhary A, Benjamin J, Aggarwal P, Jamwal KD, Kumar G, Joshi YK, Sarin SK. Reversal of Feed Intolerance by Prokinetics Improves Survival in Critically Ill Cirrhosis Patients. Dig Dis Sci 2022; 67:4223-4233. [PMID: 34392492 PMCID: PMC8364303 DOI: 10.1007/s10620-021-07185-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 07/19/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND AND AIMS Feed intolerance (FI) is common in cirrhosis patients in intensive care units (ICU). Prokinetics are the first line treatment for FI but their efficacy and safety in critically ill patient with cirrhosis is unknown. We evaluated the role of prokinetics in reversal of FI and clinical outcomes. METHODS Consecutive patients admitted in ICU developing new-onset FI, were randomized to receive either intravenous metoclopramide (Gr.A, n = 28), erythromycin (Gr.B, n = 27) or placebo (Gr.C, n = 28). FI was defined with the presence of 3 of 5 variables- absence of bowel sounds, gastric residual volume ≥ 500 ml, vomiting, diarrhoea and bowel distension. Primary end-point was complete resolution of FI (≥ 3 variables resolved) within 24-h and secondary end-points included resolution within 72-h and survival at 7-days. RESULTS Of the 1030 ICU patients, 201 (19.5%) developed FI and 83 patients were randomized. Baseline parameters between the groups were comparable. Complete resolution at 24-h was higher in Gr.A (7.14%) and B (22.2%) than C (0%, p = 0.017). Overall, 58 (69.9%) patients achieved resolution within 72 h, more with metoclopramide (n = 24, 85.7%) and erythromycin (n = 25, 92.6%) than with placebo (n = 9, 32.1%, p < 0.001). The 7-day survival was better in patients who achieved resolution within 72-h (65.5 vs. 36%, p = 0.011) than non-responders. High lactate (OR-3.32, CI-1.45-7.70, p = 0.005), shock at baseline (OR-6.34, CI-1.67-24.1, p = 0.007) and resolution of FI within 72 h (OR-0.11, CI, 0.03-0.51, p = 0.04) predicted 7-day mortality. CONCLUSIONS FI is common in critically-ill cirrhosis patients and non-resolution carries high mortality. Early recognition and treatment with prokinetics is recommended to improve short-term survival.
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Affiliation(s)
- Rajan Vijayaraghavan
- grid.418784.60000 0004 1804 4108Department of Hepatology, Institute of Liver and Biliary Sciences, D-1 Vasant Kunj, New Delhi, 110070 India
| | - Rakhi Maiwall
- grid.418784.60000 0004 1804 4108Department of Hepatology, Institute of Liver and Biliary Sciences, D-1 Vasant Kunj, New Delhi, 110070 India
| | - Vinod Arora
- grid.418784.60000 0004 1804 4108Department of Hepatology, Institute of Liver and Biliary Sciences, D-1 Vasant Kunj, New Delhi, 110070 India
| | - Ashok Choudhary
- grid.418784.60000 0004 1804 4108Department of Hepatology, Institute of Liver and Biliary Sciences, D-1 Vasant Kunj, New Delhi, 110070 India
| | - Jaya Benjamin
- grid.418784.60000 0004 1804 4108Department of Clinical Nutrition, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Prashant Aggarwal
- grid.418784.60000 0004 1804 4108Department of Anaesthesia and Critical Care, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Kapil Dev Jamwal
- grid.464746.30000 0004 1761 4703Department of Gastroenterology, Artemis Hospitals, Gurugram, Haryana India
| | - Guresh Kumar
- grid.418784.60000 0004 1804 4108Department of Clinical Research, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Y. K. Joshi
- grid.418784.60000 0004 1804 4108Department of Clinical Nutrition, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Shiv K. Sarin
- grid.418784.60000 0004 1804 4108Department of Hepatology, Institute of Liver and Biliary Sciences, D-1 Vasant Kunj, New Delhi, 110070 India
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16
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Senthil Eagappan AR, Rajaraman G, Bhavani S, Vijayaraghavan R, Harishma S, Jeyapreetha P. Comparative evaluation of fracture resistance of fiber-reinforced composite and alkasite restoration in class I cavity. Contemp Clin Dent 2022; 13:56-60. [PMID: 35466303 PMCID: PMC9030303 DOI: 10.4103/ccd.ccd_707_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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 09/26/2020] [Accepted: 10/21/2020] [Indexed: 11/04/2022] Open
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17
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Padmapriya D, Archana R, Sharma N, Vijayaraghavan R. Effects of Vitamin D3 Supplementation in Male Reproductive Function: A Double-Blinded Randomized Controlled Trial. CURR TOP NUTRACEUT R 2021. [DOI: 10.37290/ctnr2641-452x.20:334-339] [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: 11/24/2022]
Abstract
Vitamin D3 supplementation has been shown to be beneficial in improving male reproductive function in some but not all studies. Hence, the benefits of vitamin D3 supplementation on seminal parameters of male infertility remain inconclusive. The current study aims to evaluate the effect of vitamin D3 supplementation on male reproductive function. A double blinded randomized controlled trial was conducted among 120 infertile men. They were randomly assigned into vitamin D and placebo groups. Vitamin D3 (cholecalciferol) supplementation (2,000 IU) was given orally twice daily, and the placebo group received oral vitamin B complex supplementation twice daily. Basic spermogram parameters and hormonal assays including follicle stimulating hormone, luteinizing hormone, and thyroid hormone profile (free T3, free T4, and thyroid stimulating hormone) were performed before and after intervention. Two-way analysis of variance showed statistically significant difference (P < 0.001) with reference to progressive motility, total motility, sperm volume, and total sperm number. There was no statistical difference in the hormonal assay parameters of follicle stimulating hormone and luteinizing hormone; however, the thyroid profile (free T3) alone showed significance between the groups. The present study revealed the beneficial effect of vitamin D3 oral supplementation on spermogram parameters. However, intake of vitamin D3 did not change the levels of follicle stimulating hormone and luteinizing hormone among subfertile men.
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Affiliation(s)
- D. Padmapriya
- Department of Nursing, Saveetha College of Nursing, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu
| | - R. Archana
- Department of Physiology, Saveetha Medical College, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu
| | - Nidhi Sharma
- Department of Obstetrics and Gynaecology, Saveetha Medical College, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu and
| | - R. Vijayaraghavan
- Department of Research, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu
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18
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Mukund A, V Srinivasan S, Rana S, Vijayaraghavan R, Patidar Y, Arora V, Jindal A, Choudhury A, Shasthry SM, Sarin SK. Response evaluation of locoregional therapies in combined hepatocellular-cholangiocarcinoma and intrahepatic cholangiocarcinoma versus hepatocellular carcinoma: a propensity score matched study. Clin Radiol 2021; 77:121-129. [PMID: 34789395 DOI: 10.1016/j.crad.2021.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 10/14/2021] [Indexed: 11/16/2022]
Abstract
AIM To evaluate the response of locoregional therapy (LRT) on combined hepatocellular-cholangiocarcinoma (cHCC-CC) and intrahepatic cholangiocarcinoma (IHC) and compare their outcomes with propensity matched hepatocellular carcinoma (HCC) patients. MATERIALS AND METHODS From January 2011 to July 2020, 13 patients with cHCC-CC (11 men, two women, median age 56 years) and 15 IHC patients (10 men, five women, median age 60 years) were compared with 101 HCC patients (79 men, 22 women, median age 60 years) after LRT. All tumours were proven histologically. Among the 13 cHCC-CC patients, 11 received transarterial chemoembolisation (TACE), one received microwave ablation (MWA) and one received TACE with radiofrequency ablation (RFA). Of 15 IHC patients, eight received TACE, five received RFA, and one received MWA, and one received TACE with RFA. Propensity score matching (PSM) was done with conditional logistic regression adjusted for age, type of LRT, tumour specific features and Child-Pugh score. RESULTS After LRT, on univariate analysis an objective response was seen in 30% of cHCC-CC and 53% of IHC patients. PSM analysis demonstrated shorter progression-free survival (PFS; cHCC-CC versus HCC: 1.5 versus 7.5 months; IHC versus HCC: 6 versus 14 months, p<0.05), overall survival (OS; cHCC-CC versus HCC: 12 versus 28 months; IHC versus HCC: 18 versus 34 months, p<0.005), and poor objective response (cHCC-CC versus HCC: 25% versus 91%; IHC versus HCC: 58% versus 88%, p<0.05) in cHCC-CC and IHC patients versus HCC patients. Hypovascular tumour, macrovascular invasion, and infiltrative appearance were independent prognostic factors for OS in IHC patients. CONCLUSION cHCC-CC and IHC are aggressive tumours with a poor objective response, greater distant progression of the disease and shorter PFS and OS post LRT as compared to HCC.
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Affiliation(s)
- A Mukund
- Department of Interventional Radiology, Institute of Liver and Biliary Sciences, New Delhi, India.
| | - S V Srinivasan
- Department of Interventional Radiology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - S Rana
- Department of Interventional Radiology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - R Vijayaraghavan
- Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Y Patidar
- Department of Interventional Radiology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - V Arora
- Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - A Jindal
- Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - A Choudhury
- Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - S M Shasthry
- Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - S K Sarin
- Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India
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19
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Shah AH, Rana UA, Zhu H, Li J, Vijayaraghavan R, Macfarlane DR, Forsyth M, Siddiqi HM. Study of Proton Transport in Diethylmethylammonium Poly[4-styrenesulfonyl(trifluoromethylsulfonyl)imide]-Based Composite Membranes with Triflic Acid and Diethylmethylamine-Rich Compositions. J Phys Chem B 2021; 125:11005-11016. [PMID: 34570507 DOI: 10.1021/acs.jpcb.1c04399] [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: 11/30/2022]
Abstract
The study highlights the effect of acid- and base-rich conditions on the proton dynamics of diethylmethylammonium poly[4-styrenesulfonyl(trifluoromethylsulfonyl)imide, [DEMA][PSTFSI], a polymerized protic ionic liquid designed as a polymer electrolyte for nonhumidified polymer electrolyte membrane fuel cells. Different proportions of triflic acid (HTf) and diethylmethylamine (DEMA) were added to the pristine polymer. The thermal analysis of the mixtures revealed that the addition of the base increases the glassy/amorphous nature of the polymer; however, HTf plasticizes the polymer and lowers the Tg value, so that it falls outside of the differential scanning calorimetry-studied temperature range. 50 mol % doping of the HTf contents increases the conductivity upto 0.952 mS cm-1, and 50 mol % DEMA mixture has a conductivity of 0.169 mS cm-1 at 100 °C. Vogel-Tamman-Fulcher fitting of the ionic conductivities of the doped systems suggested that the ionic conductivities are completely decoupled from segmental motion of the polymer. A combination of Fourier transform infrared and static NMR studies demonstrated that HTf-added polymer composites show conduction via Grotthuss and vehicular mechanisms, while DEMA-added polymer composites show predominantly a Grotthuss mechanism by developing the aggregates of proton and added base.
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Affiliation(s)
- Azhar Hussain Shah
- Department of Chemistry, Quaid-i-Azam University, Islamabad 45320, Pakistan.,Department of Chemistry and the ARC Center of Excellence for Electromaterials Science, Monash University, Clayton 3800, Victoria, Australia
| | - Usman Ali Rana
- Sustainable Energy Technologies (SET) Center, College of Engineering, King Saud University, P.O. Box 800, Riyadh 11421, Saudi Arabia
| | - Haijin Zhu
- Institute for Frontier Materials, Deakin University, Geelong 3216, Victoria, Australia
| | - Jiaye Li
- Department of Chemistry and the ARC Center of Excellence for Electromaterials Science, Monash University, Clayton 3800, Victoria, Australia
| | - R Vijayaraghavan
- Department of Chemistry and the ARC Center of Excellence for Electromaterials Science, Monash University, Clayton 3800, Victoria, Australia
| | - Douglas R Macfarlane
- Department of Chemistry and the ARC Center of Excellence for Electromaterials Science, Monash University, Clayton 3800, Victoria, Australia
| | - Maria Forsyth
- Institute for Frontier Materials, Deakin University, Geelong 3216, Victoria, Australia
| | - Humaira M Siddiqi
- Department of Chemistry, Quaid-i-Azam University, Islamabad 45320, Pakistan
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Choudhury A, Vijayaraghavan R, Maiwall R, Kumar M, Duan Z, Yu C, Hamid SS, Jafri W, Butt AS, Devarbhavi H, Ning Q, Ma K, Tan SS, Shukla A, Dhiman R, Duseja A, Taneja S, Eapen CE, Goel A, Treeprasertsuk S, Al-Mahtab M, Ghazinyan H, Kim DJ, Sahu MK, Lee GH, Lesmana LA, Lesmana RC, Shah S, Abbas Z, Sollano JD, Rao PN, Kulkarni A, Shiha G, Shrestha A, Dokmeci AK, Yuen MF, Payawal DA, Kalista KF, Prasad VGM, Lau GK, Karim F, Jain P, Kumar G, Arora V, Pamecha V, Sinha P, Sarin SK. 'First week' is the crucial period for deciding living donor liver transplantation in patients with acute-on-chronic liver failure. Hepatol Int 2021; 15:1376-1388. [PMID: 34608586 DOI: 10.1007/s12072-021-10206-6] [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: 12/26/2020] [Accepted: 04/30/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND AIMS Acute-on-chronic liver failure (ACLF) is a rapidly progressive illness with high short-term mortality. Timely liver transplant (LT) may improve survival. We evaluated various indices for assessment of the severity of liver failure and their application for eligibility and timing of living donor LT (LDLT). METHODS Altogether 1021 patients were analyzed for the severity and organ failure at admission to determine transplant eligibility and 28 day survival with or without transplant. RESULTS The ACLF cohort [mean age 44 ± 12.2 years, males 81%) was of sick patients; 55% willing for LT at admission, though 63% of them were ineligible due to sepsis or organ failure. On day 4, recovery in sepsis and/or organ failure led to an improvement in transplant eligibility from 37% at baseline to 63.7%. Delay in LT up to 7 days led to a higher incidence of multiorgan failure (p < 0.01) contributing to 23% of the first week and 55% of all-cause 28-day mortality. In a matched cohort analysis, the actuarial survival with LT (n = 41) and conditional survival in the absence of transplant (n = 191) were comparable, when the condition, i.e., transplant was adjusted. The comparison curve showed differentiation in survival beyond 7 days (p < 0.01). CONCLUSIONS ACLF is a rapidly progressive disease and risk stratification within the first week of hospitalization is needed. 'Emergent LT' should be defined in the first week in the ACLF patients; the transplant window for improving survival in a live donor setting.
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Affiliation(s)
- Ashok Choudhury
- Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, 110070, India.,Department of Transplant, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Rajan Vijayaraghavan
- Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, 110070, India.,Department of Transplant, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Rakhi Maiwall
- Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, 110070, India.,Department of Transplant, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Manoj Kumar
- Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, 110070, India.,Department of Transplant, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Zhongping Duan
- Translational Hepatology Institute Capital Medical University, Beijing You'an Hospital, Beijing, China
| | - Chen Yu
- Translational Hepatology Institute Capital Medical University, Beijing You'an Hospital, Beijing, China
| | - Saeed Sadiq Hamid
- Department of Medicine, Aga Khan University Hospital, Karachi, Pakistan
| | - Wasim Jafri
- Department of Medicine, Aga Khan University Hospital, Karachi, Pakistan
| | - Amna Subhan Butt
- Department of Medicine, Aga Khan University Hospital, Karachi, Pakistan
| | - Harshad Devarbhavi
- Department of Gastroenterology and Hepatology, St John Medical College, Bangalore, India
| | - Qin Ning
- Department of Infectious Disease, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ke Ma
- Department of Infectious Disease, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Soek-Siam Tan
- Department of Medicine, Hospital Selayang, Batu Caves, Selangor, Malaysia
| | - Akash Shukla
- Department of Hepatology, KEM Hospital and Seth GSMC, Mumbai, India
| | - Radhakrishna Dhiman
- Department of Hepatology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Ajay Duseja
- Department of Hepatology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Sunil Taneja
- Department of Hepatology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - C E Eapen
- Department of Gastrointestinal Sciences, Christian Medical College, Vellore, India
| | - Ashish Goel
- Department of Gastrointestinal Sciences, Christian Medical College, Vellore, India
| | | | - Mamun Al-Mahtab
- Department of Hepatology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Hasmik Ghazinyan
- Department of Hepatology, Nork Clinical Hospital of Infectious Diseases, Yerevan, Armenia
| | - Dong Joon Kim
- Centre for Liver and Digestive Diseases, Gangwon-Do, Hallym University Chuncheon Sacred Heart Hospital, Chuncheon, Republic of Korea
| | - Manoj K Sahu
- Department of Gastroenterology and Biliary Sciences, IMS and SUM Hospital, Bhubaneswar, Odisha, India
| | - Guan Huei Lee
- Department of Gastroenterology and Hepatology, National University Health System, Singapore, Singapore
| | | | | | - Samir Shah
- Department of Hepatology, Global Hospital, Mumbai, India
| | - Zaigham Abbas
- Department of Hepatogastroenterology, Ziauddin University, Karachi, Pakistan
| | - Jose D Sollano
- Department of Hepatology, Cardinal Santos Medical Centre, Manila, Philippines
| | - P N Rao
- Asian Institute of Gastroenterology, Hyderabad, India
| | | | - Gamal Shiha
- Department of Internal Medicine, Egyptian Liver Research Institute and Hospital, Cairo, Egypt
| | | | - AKadir Dokmeci
- Department of Gastroenterology, Ankara University School of Medicine, Ankara, Turkey
| | - Man Fung Yuen
- Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China
| | | | - Kemal Fariz Kalista
- Division of Hepatobiliary Cipto Mangunkusuamo Hospital, University of Indonesia, Jakarta, Indonesia
| | | | - George K Lau
- Department of Gastroenterology, Humanity and Health Medical Centre, Hong Kong, China
| | - Fazal Karim
- Department of Hepatology, Sir Salimullah Medical College, Dhaka, Bangladesh
| | - Priyanka Jain
- Department of Biostatistics, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Guresh Kumar
- Department of Biostatistics, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Vinod Arora
- Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, 110070, India.,Department of Transplant, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Viniyendra Pamecha
- Department of Hepatobiliary Surgery, Institute of Liver and Biliary Sciences, New Delhi, India.,Department of Liver Transplantation, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Piyush Sinha
- Department of Hepatobiliary Surgery, Institute of Liver and Biliary Sciences, New Delhi, India.,Department of Liver Transplantation, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Shiv K Sarin
- Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, 110070, India. .,Department of Transplant, Institute of Liver and Biliary Sciences, New Delhi, India.
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Avinash Tejasvi ML, Maragathavalli G, Putcha UK, Ramakrishna M, Vijayaraghavan R, Anulekha Avinash CK. Impact of ERCC1 gene polymorphisms on response to cisplatin based therapy in oral squamous cell carcinoma (OSCC) patients. INDIAN J PATHOL MICR 2021; 63:538-543. [PMID: 33154302 DOI: 10.4103/ijpm.ijpm_964_19] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background and Objectives Cisplatin is one of the major drugs that used in the treatment of oral cancer.Excision repair cross-complementation group 1 (ERCC1) is a key DNA repair gene in the nucleotide excision repair pathway which is activated in the repair of intra- and interstrand DNA crosslink caused by platinum-based treatment. The aim of this study was to investigate the association between polymorphisms in ERCC1 (C118T & C8092A) genes and the response to cisplatin-based chemotherapy. Methods ERCC1polymorphisms (C118T & C8092A) were studied using PCR-RFLP method from 150 OSCC patients as cases as well as 150 normal tissues from the same patients were collected as controls for this study. Results: Frequencies of ERCC1 C118C, C118T and T118T genotypes were 60%, 28% and 12% in OSCC patients and 78%, 19% and 3% in the controls, respectively. The C118T & T118T genotype had a 1.69 and 4.97 -folds increased risk for OSCC. Frequencies of ERCC1 C8092C, C8092A and A8092A were 78%, 18% and 4% in the OSCC patients and 89%, 10%, amd 1% in the controls, respectively. The C8092A genotype showed a 1.97-fold increased risk for OSCC. Interpretation & Conclusions In conclusion, this study highlights the DNA repair gene polymorphisms that might play a role in mediating susceptibility to oral squamous cell carcinoma and cisplatin therapy. Our data suggest that the ERCC1 C118T, T118T and ERCC1 C8092A genotypes are genetic risk factors for Oral squamous cell carcinoma and ERCC1 118 C/T and C8092A polymorphisms have significant influence on clinical outcome.
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Affiliation(s)
- M L Avinash Tejasvi
- Department of Oral Medicine and Radiology, Kamineni Institute of Dental Sciences, Narketpally, Telangana, Ph.D Scholar (Oral Medicine and Radiology), Saveetha University, Chennai, Tamil Nadu, India
| | - G Maragathavalli
- Department of Oral Medicine and Radiology, Saveetha Dental College and Hospitals, Chennai, Tamil Nadu, India
| | - Uday Kumar Putcha
- Department of Pathology and Microbiology, National Institute of Nutrition, Hyderabad, Telangana, India
| | - M Ramakrishna
- Department of Radiation Oncology, MNJ Institute of Oncology and Regional Cancer Centre, Hyderabad, Telangana, India
| | - R Vijayaraghavan
- Department of Research and Development, Saveetha University, Chennai, Tamil Nadu, India
| | - C K Anulekha Avinash
- Department of Prosthodontics, Kamineni Institute of Dental Sciences, Narketpally, Telangana, India
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Matuszek K, Vijayaraghavan R, Kar M, Mahadevan S, MacFarlane DR. Guanidinium Organic Salts as Phase-Change Materials for Renewable Energy Storage. ChemSusChem 2021; 14:2757-2762. [PMID: 33982440 DOI: 10.1002/cssc.202100724] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 05/10/2021] [Indexed: 06/12/2023]
Abstract
A dearth of inexpensive means of energy storage is constraining the expansion of intermittent renewable energy sources such as sun and wind. Thermal energy storage technology utilizing phase-change materials (PCMs) is a promising solution, enabling storage of large quantities of thermal energy at a relatively low cost. Guanidinium mesylate, which melts at 208 °C with latent heat of fusion of ΔHf =190 J g-1 is a promising PCM candidate for these applications.[1] Here, studies on guanidinium organic salts were conducted, including heat capacity, thermal conductivity, advanced thermal stability, long-term cycling, and economic analysis. The data place guanidinium mesylate among the best PCMs operating in the 100-220 °C temperature region in terms of thermal energy storage, with total volumetric energy storage measured as 622 MJ m-3 (173 kWh m-3 ). Additionally, it was shown to be stable during cycling, with over 400 cycles performed. Simple economic analysis indicated a cost of 6 USD per MJ of stored thermal energy. This study proves that guanidinium mesylate and potentially other similar salts can be feasible as PCMs for inexpensive energy storage for renewable energy storage applications.
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Affiliation(s)
- Karolina Matuszek
- School of Chemistry, Monash University, 3800, Clayton, VIC, Australia
| | - R Vijayaraghavan
- School of Chemistry, Monash University, 3800, Clayton, VIC, Australia
| | - Mega Kar
- School of Chemistry, Monash University, 3800, Clayton, VIC, Australia
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23
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Somanath D, Vijayakumar J, Suriyakumari KVP, Vijayaraghavan R. Effect of Fucoidan on the Regulation of Antioxidant Enzymes in Hepatorenal Tissues of Streptozotocin-Induced Diabetic Rats. Indian J Pharm Sci 2021. [DOI: 10.36468/pharmaceutical-sciences.871] [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: 11/22/2022] Open
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24
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Sundaram V, Ramanan RN, Selvaraj M, Vijayaraghavan R, MacFarlane DR, Ooi CW. Structural stability of insulin aspart in aqueous cholinium aminoate ionic liquids based on molecular dynamics simulation studies. J Mol Liq 2021. [DOI: 10.1016/j.molliq.2020.114501] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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25
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Jain P, Shasthry SM, Choudhury AK, Maiwall R, Kumar G, Bharadwaj A, Arora V, Vijayaraghavan R, Jindal A, Sharma MK, Bhatia V, Sarin SK. Alcohol associated liver cirrhotics have higher mortality after index hospitalization: Long-term data of 5,138 patients. Clin Mol Hepatol 2020; 27:175-185. [PMID: 33317256 PMCID: PMC7820216 DOI: 10.3350/cmh.2020.0068] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 09/29/2020] [Indexed: 12/12/2022] Open
Abstract
Background/Aims Liver cirrhosis is an important cause of morbidity and mortality globally. Every episode of decompensation and hospitalization reduces survival. We studied the clinical profile and long-term outcomes comparing alcohol-related cirrhosis (ALC) and non-ALC. Methods Cirrhosis patients at index hospitalisation (from January 2010 to June 2017), with ≥1 year follow-up were included. Results Five thousand and one hundred thirty-eight cirrhosis patients (age, 49.8±14.6 years; male, 79.5%; alcohol, 39.5%; Child-A:B:C, 11.7%:41.6%:46.8%) from their index hospitalization were analysed. The median time from diagnosis of cirrhosis to index hospitalization was 2 years (0.2–10). One thousand and seven hundred seven patients (33.2%) died within a year; 1,248 (24.3%) during index hospitalization. 59.5% (2,316/3,890) of the survivors, required at least one readmission, with additional mortality of 19.8% (459/2,316). ALC compared to non-ALC were more often (P<0.001) male (97.7% vs. 67.7%), younger (40–50 group, 36.2% vs. 20.2%; P<0.001) with higher liver related complications at baseline, (P<0.001 for each), sepsis: 20.3% vs. 14.9%; ascites: 82.2% vs. 65.9%; spontaneous bacterial peritonitis: 21.8% vs. 15.7%; hepatic encephalopathy: 41.0% vs. 25.0%; acute variceal bleeding: 32.0% vs. 23.7%; and acute kidney injury 30.5% vs. 19.6%. ALC patients had higher Child-Pugh (10.6±2.0 vs. 9.0±2.3), model for end-stage liver-disease scores (21.49±8.47 vs. 16.85±7.79), and higher mortality (42.3% vs. 27.3%, P<0.001) compared to non-ALC. Conclusions One-third of cirrhosis patients die in index hospitalization. 60% of the survivors require at least one rehospitalization within a year. ALC patients present with higher morbidity and mortality and at a younger age.
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Affiliation(s)
- Priyanka Jain
- Department of Clinical Research, Institute of Liver and Biliary Sciences, New Delhi, India
| | | | | | - Rakhi Maiwall
- Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Guresh Kumar
- Department of Clinical Research, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Ankit Bharadwaj
- Department of Clinical Research, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Vinod Arora
- Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Rajan Vijayaraghavan
- Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Ankur Jindal
- Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Manoj Kumar Sharma
- Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Vikram Bhatia
- Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Shiv Kumar Sarin
- Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India
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26
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Mukund A, Ramalingam R, Anandpara KM, Patidar Y, Vijayaraghavan R, Sarin SK. Efficacy and safety of percutaneous microwave ablation for hepatocellular carcinomas <4 cm in difficult location. Br J Radiol 2020; 93:20191025. [PMID: 32970472 PMCID: PMC7716003 DOI: 10.1259/bjr.20191025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 09/09/2020] [Accepted: 09/14/2020] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE Tumor location is a critical factor for determining technical success and local recurrence following percutaneous ablation of hepatocellular carcinomas (HCC). The purpose of this retrospective study was to evaluate the safety and outcome measures of percutaneous microwave ablation (pMWA) for HCCs <4 cm in difficult locations. METHODS Retrospective review included 81 patients who underwent pMWA for HCCs <4 cm. Fourty-three patients (30 males and 13 females; mean age, 61 years) with 53 HCCs located near the diaphragm, heart, gallbladder, kidney, gastrointestinal tract, large vessel and exophytic location were included under difficult location group. Thirty-eight patients (29 males and nine females; mean age, 60 years) with 48 HCCs in other locations were included under control group. Baseline demographics were recorded. Technical efficacy, local tumor progression (LTP), and complication rates were evaluated. RESULTS Mean follow-up period was 3.4 months (range 1-7). There was no major complication in both the groups; two patients had a mild perihepatic hemorrhage in the difficult location group which was managed conservatively. There was no difference between the groups in the overall technical efficacy rate (84.9% vs 91.7%, p = 0.294), LTP rate (4.4% vs 2.2%. p = 0.57) or complication rate (4.6% vs 0%, p = 0.177). CONCLUSION Our data suggest that there is no significant difference in technical efficacy, LTP or complication rates for MWA in both difficult and normal locations. ADVANCES IN KNOWLEDGE With proper patient selection, pre-procedural planning and appropriate technique, pMWA is feasible, safe, and effective for small HCCs in difficult location with an acceptable range of complications.
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Affiliation(s)
- Amar Mukund
- Department of Interventional Radiology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Ravindran Ramalingam
- Department of Interventional Radiology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Karan Manoj Anandpara
- Department of Interventional Radiology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Yashwant Patidar
- Department of Interventional Radiology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Rajan Vijayaraghavan
- Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Shiv Kumar Sarin
- Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India
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27
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Vijayaraghavan R, Kar M, Sivanesh NE, Samuel VJ, Surianarayanan M, Olsen S, MacFarlane DR. Influence of ion structure on thermal runaway behaviour of aprotic and protic ionic liquids. Chem Commun (Camb) 2020; 56:11819-11822. [PMID: 33021275 DOI: 10.1039/d0cc04937a] [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] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Accelerated rate calorimetric studies have been employed to study the exothermic and thermal runaway behaviour of some aprotic and protic ionic liquids based on several families of ions including the bis(flurorsulfonyl)imide anion ([FSI]-); it was found that the protic salts are safer than aprotic salts of the [FSI]- anion.
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Affiliation(s)
- R Vijayaraghavan
- School of Chemistry, Monash University, Clayton, Victoria 3800, Australia.
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28
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Arora V, Vijayaraghavan R, Maiwall R, Sahney A, Thomas SS, Ali R, Jain P, Kumar G, Sarin SK. Paracentesis-Induced Circulatory Dysfunction With Modest-Volume Paracentesis Is Partly Ameliorated by Albumin Infusion in Acute-on-Chronic Liver Failure. Hepatology 2020; 72:1043-1055. [PMID: 31849085 DOI: 10.1002/hep.31071] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 12/06/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND AIMS Paracentesis-induced circulatory dysfunction (PICD) is a serious complication of large-volume (>5 L) paracentesis in cirrhosis and is reduced with albumin infusion. There is a lack of data on PICD in acute-on-chronic liver failure (ACLF). Because ACLF patients have greater hemodynamic derangements than patients with decompensated cirrhosis, we investigated whether PICD could develop with modest-volume paracentesis (MVP) and the role of albumin infusion. APPROACH AND RESULTS A total of 80 ACLF patients undergoing <5 L paracentesis were randomized to receive albumin (8 g/dL of ascitic fluid; n = 40) or no albumin (n = 40) and serially followed to detect PICD. Baseline characteristics were comparable between groups, including volume of ascitic tap (4.16 ± 0.23 versus 4.14 ± 0.27 L; P = 0.72) and plasma renin activity (PRA; 20.5 ± 7.03 versus 23.2 ± 8.24 ng/mL/hour; P = 0.12). PICD was more frequent in the no-albumin group than the albumin group (70% versus 30%; P = 0.001), with higher incidence of hepatic encephalopathy (50% versus 27.5%; P = 0.04), hyponatremia (67.5% versus 22.5%; P < 0.001), acute kidney injury (62.5% versus 30%; P = 0.001), and in-house mortality (62.5% versus 27.5%; P = 0.003). PRA of 25.15 ng/mL at day 3 had sensitivity and specificity of 71% and 68%, respectively, for development of PICD at day 6. Albumin infusion decreased the incidence of PICD at day 6 (odds ratio, 0.068; 95% confidence interval, 0.011-0.43; P = 0.005). CONCLUSIONS PICD is common and develops even with MVP in ACLF patients. Albumin infusion decreases the incidence of PICD and mortality in patients with ACLF. Clinical trial identifier: NCT02467348.
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Affiliation(s)
- Vinod Arora
- Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Rajan Vijayaraghavan
- Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Rakhi Maiwall
- Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Amrish Sahney
- Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Sherin Sarah Thomas
- Department of Biochemistry, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Rehmat Ali
- Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Priyanka Jain
- Department of Clinical Research, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Guresh Kumar
- Department of Clinical Research, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Shiv Kumar Sarin
- Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India
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Abstract
Polycystic Ovary Syndrome is a multifactorial reproductive problem and a leading cause of female infertility worldwide. Evidences have shown that Oxidative Stress and decreased antioxidant status are often linked with PCOS. Insulin Resistance in PCOS patients ranges from 50% to 70% and may encourage OS by production of reactive oxygen species.Objective: Our study determines serum MDA levels along with plasma glucose, serum insulin, and insulin resistance in obese and nonobese PCOS subjects.Materials and methods: A case control study was conducted on diagnosed 100 PCOS patients and 100 controls. Fasting plasma glucose was measured by enzymatic method. Insulin was estimated by chemiluminescent microparticle immunoassay using Abott Architect i 2000 SR analyser. Insulin resistance was calculated by HOMA-IR. Malonaldehyde is determined as Thiobarbituric acid reactive substances.Results: CRP and serum MDA levels were increased in women with PCOS irrespective of obesity compared to their respective controls with a p value of < .001. However, though fasting glucose, serum insulin, and IR were increased in both obese and nonobese women with PCOS compared to their BMI adjusted controls with p value of < .001, the values were within reference range in nonobese women.Conclusion: Our study suggests that women with PCOS have oxidative stress and elevated CRP irrespective of obesity. However, hyperinsulinemia and Insulin resistance are seen only in obese women with PCOS, indicating that these women are at high risk for developing low grade inflammation and cardiovascular diseases.
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Affiliation(s)
- Doddappa M Bannigida
- Department of Biochemistry, Koppal Institute of Medical Sciences, Koppal, India
- Department of Research, Saveetha University, Thandalam, India
| | - B Shivananda Nayak
- Faculty of Medical Sciences, Department of preclinical Sciences, The University of the West Indies, Trinidad
- Department of Biochemistry, Subbaiah Institute of Medical sciences, Shimoga, India
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30
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Banerjee S, Arora A, Vijayaraghavan R, Patti AF. Extraction and crosslinking of bromelain aggregates for improved stability and reusability from pineapple processing waste. Int J Biol Macromol 2020; 158:318-326. [PMID: 32353500 DOI: 10.1016/j.ijbiomac.2020.04.220] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [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: 02/12/2020] [Revised: 04/23/2020] [Accepted: 04/24/2020] [Indexed: 01/01/2023]
Abstract
The present study is first of its kind that focuses upon the extraction of bromelain from pineapple core waste and stabilising it as insoluble cross-linked aggregates. The influence of process variables such as the choice of precipitant, type of cross-linker, concentration of cross-linker and the reaction time for cross-linking step was investigated upon the activity recovery of bromelain cross-linked aggregates. The optimization of this biocatalyst preparation specifically recovered 87% of the enzymatic activity available in pineapple core waste by ammonium sulphate (60%, w/v) precipitation followed by cross-linking for 4 h with 80 mM glutaraldehyde. Cross-linked bromelain aggregates were thermally more stable and exhibited higher pH stability in comparison to free bromelain. The cross-linked bromelain aggregates exhibited higher operational stability in different organic solvents at 4 °C. The highest operational stability (% stability given in parenthesis) was observed in acetone (100%) followed by hexane (53.6%), ethyl acetate (39.6%), ethanol (32.5%) and chloroform (14.9%). The kinetic studies revealed higher Km value (5.45 mM) after the formation of cross-linked bromelain aggregates as compared to free bromelain (5.04 mM) with almost similar Vmax values. Cross-linked bromelain aggregates also showed significant reusability characteristics with an activity retention of >85% after 5-time cycles. Such recyclability of bromelain cross-linked aggregates could lead to potential industrial applications in both food and non-food sector. In addition, the present extraction method avoids costs related to purification and expensive immobilization carriers.
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Affiliation(s)
- Shivali Banerjee
- IITB - Monash Research Academy, Indian Institute of Technology Bombay, Powai, Mumbai 400076, India; Bio-Processing Laboratory, Centre for Technology Alternatives for Rural Areas, Indian Institute of Technology Bombay, Powai, Mumbai 400076, India; School of Chemistry, Green Chemical Futures, Monash University, Wellington Road, Clayton, Victoria 3800, Australia
| | - Amit Arora
- IITB - Monash Research Academy, Indian Institute of Technology Bombay, Powai, Mumbai 400076, India; Bio-Processing Laboratory, Centre for Technology Alternatives for Rural Areas, Indian Institute of Technology Bombay, Powai, Mumbai 400076, India.
| | - R Vijayaraghavan
- School of Chemistry, Green Chemical Futures, Monash University, Wellington Road, Clayton, Victoria 3800, Australia
| | - Antonio F Patti
- School of Chemistry, Green Chemical Futures, Monash University, Wellington Road, Clayton, Victoria 3800, Australia.
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Matuszek K, Vijayaraghavan R, Forsyth CM, Mahadevan S, Kar M, MacFarlane DR. Pyrazolium Phase-Change Materials for Solar-Thermal Energy Storage. ChemSusChem 2020; 13:159-164. [PMID: 31657142 DOI: 10.1002/cssc.201902601] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Revised: 10/24/2019] [Indexed: 06/10/2023]
Abstract
Thermal energy storage technology utilizing phase-change materials (PCMs) can be a promising solution for the intermittency of renewable energy sources. This work describes a novel family of PCMs based on the pyrazolium cation, that operate in the 100-200 °C temperature range, offering safe, inexpensive capacity and low supercooling. Thermal stability and extensive cycling tests of the most promising PCM candidate, pyrazolium mesylate (Tm =168±1 °C, ΔHf =160 J g-1 ±5 %, ΔHtotal v =495 MJ m-3 ±5 %) show potential for its use in thermal storage applications. Additionally, this work discusses the molecular origins of the high thermal energy storage capacity of these ionic materials based on their crystal structures, revealing the importance of hydrogen bonds in PCM performance.
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Affiliation(s)
- Karolina Matuszek
- School of Chemistry, Monash University, Clayton, VIC 3800, Australia
| | - R Vijayaraghavan
- School of Chemistry, Monash University, Clayton, VIC 3800, Australia
| | - Craig M Forsyth
- School of Chemistry, Monash University, Clayton, VIC 3800, Australia
| | - Surianarayanan Mahadevan
- Chemical Engineering Department, Central Leather Research Institute, Adyar, Chennai, 6000-20, Tamilnadu, India
| | - Mega Kar
- School of Chemistry, Monash University, Clayton, VIC 3800, Australia
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Francis Y, Vijayakumar J, Raghunath G, Vijayalakshmi S, Sivanesan S, Vijayaraghavan R, Sukumar E. Protective effect of Carica papaya leaf extract against mercuric chloride-induced nephrotoxicity in wistar rats. Pharmacogn Mag 2020. [DOI: 10.4103/pm.pm_11_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Deras I, Du T, Zhao C, Haseley N, Yazdanparast A, Jiang T, Mentzer A, Purdy A, Crain B, Echegaray C, Lee D, Lee J, Silhavy J, O’Brien K, Vijayaraghavan R, Garcia R, Haigis R, Pawlowski T, Dockter J. Clinical and analytical accuracy of a 523 gene panel next-generation sequencing (NGS) assay on formalin-fixed paraffin-embedded (FFPE) solid tumour samples. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz257.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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34
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Natarajan U, Venkatesan T, Vijayaraghavan R, Samuel S, Rathinavelu A. Abstract 5187: Effect of histone deacetylase inhibitor on PD-L1 expression in lung cancer cells. Cancer Res 2019. [DOI: 10.1158/1538-7445.am2019-5187] [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: 11/16/2022]
Abstract
Abstract
Programmed Cell Death Ligand-1 (PD-L1) is frequently expressed on tumor cells and tumor-infiltrating immune cells. The expression of PD-L1 is indicative of immunosuppression and cause for poor prognosis in several cancers. The effects of PD-L1 are mediated through its binding to the Programmed Cell Death-1 (PD-1) receptor, which is a co-inhibitory surface molecule that is expressed on lymphoid and non-lymphoid derived cells. After PD-L1 binding the PD-1 receptor mediates the signals intracellularly to suppress peripheral T-cell responses. Therefore, determining the mechanisms of up-regulation or down-regulation of the PD-L1 is very crucial for the purpose of devising strategies to reactivate the T-cells that can lead to enhanced tumor attack. However, the cellular mechanisms that determine the levels of PD-L1 are not fully understood at this time. Hence, we analyzed different cancer cell lines for the expression levels of PD-L1 and confirmed the highest-level of expression in HCC827 lung cancer cells. In addition, H460, H1975 (Lung Cancer), SJSA1 (Osteosarcoma) and U-87 MG (Glioblastoma) cells were found to express PD-L1 in high levels. Relatively, lower level expression of PD-L1 was detected in H226 (Squamous Cell Carcinoma) PANC-1 (Pancreatic Cancer), CFPAC-1 (Pancreatic, Ductal Adenocarcinoma) and LNCaP (Prostate Cancer) cells compared to HCC827. Since, alterations in gene expressions are often regulated by epigenetic modifications, we conducted experiments to determine whether the expression of PD-L1 can also be altered by the HDAC inhibitor SAHA (Suberoylanilide hydroxamic acid). In our experiments, SAHA (7.5 μM) was able to reduce the expression of PD-L1 in a time and dose dependent manner and produced more than 50% decrease in the protein levels within 24 hrs. while the level of PD-L1 was significantly reduced, concomitant decreases in EGFR, phospho-EGFR levels were also observed in HCC827 cells following SAHA treatment. Furthermore, SAHA was able to increase the levels of acetyl-H2B, acetyl-H3 and acetyl-H4, which confirmed the impact of HDAC inhibition on the acetylation status of histones. Since de-acetylation mediated unwinding of the DNA is typically responsible for the increased expression of genes such as p21/CDKN1A, it is suspected that the decrease in the PD-L1 levels may be due to reduced transcription of the CD274 gene that is coding for PD-L1. However, it is not clear whether the decrease in PD-L1 expression observed is because of p21 mediated negative control on the transcription process or due to some other mechanism. Additional studies are required to fully understand the actual mechanisms that may be involved in the regulation of PD-L1 expression by HDACs and their inhibitors. (This research was supported by the Royal Dames of Cancer Research Inc., Fort Lauderdale, Florida).
Citation Format: Umamaheswari Natarajan, Thiagarajan Venkatesan, R Vijayaraghavan, Shila Samuel, Appu Rathinavelu. Effect of histone deacetylase inhibitor on PD-L1 expression in lung cancer cells [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 5187.
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Affiliation(s)
| | | | | | - Shila Samuel
- 1VRR Inst. of Biomedical Science, Kattuppakkam, Chennai, India
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Selvan CT, Malkovskiy AV, Vijayaraghavan R, Babu GR, Senthilkumar S. New insights into odontological exploration of drowning using rat model - A pilot study. J Forensic Odontostomatol 2019; 37:51-62. [PMID: 31187743 PMCID: PMC6875243] [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] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Dental forensics for the resolution of unnatural death remains an underdeveloped field. Accordingly, an experimental study was conducted with six to seven months old Wistar rats that were drowned in order to identify key postmortem features and pattern of dental decomposition. The visual, structural and elemental changes were assessed periodically. Based on mode of death, they were designated as SB (euthanized and soil buried), FWD (fresh water drowned) and SWD (sea water drowned). Postmortem features as well as the structural and elemental patterns of decomposition of teeth were analyzed with Field Emission Scanning Electron Microscopy (FE-SEM) and Energy Dispersive Spectroscopy (EDAX) periodically for two months. The periodic observation of elemental changes in the teeth of SB, FWD and SWD rats allowed us to derive an equation using linear regression analysis to relate the degree of dental decomposition with the time since death. The difference in pattern of surface deterioration was also observed. The present findings could provide a better knowledge in resolving unnatural deaths and supporting evidence for legal prosecution.
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Affiliation(s)
- C T Selvan
- Institute of Forensic Science, Gujarat Forensic Sciences University, Gujarat. India
| | - A V Malkovskiy
- Biomaterials & Advanced Drug Delivery Laboratory (BioADD), Stanford University School of Medicine, Stanford University, Palo Alto, CA ,USA
| | - R Vijayaraghavan
- Department of Research and Development, Saveetha Institute of Medical and Technical Sciences, Chennai. TN India
| | - G R Babu
- Institute of Forensic Science, Gujarat Forensic Sciences University, Gujarat. India
| | - S Senthilkumar
- Department of Research and Development, Saveetha Institute of Medical and Technical Sciences, Chennai. TN India
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Sahney A, Sharma BC, Jindal A, Anand L, Arora V, Vijayaraghavan R, Dhamija RM, Kumar G, Bhardwaj A, Sarin SK. A double-blind randomized controlled trial to assess efficacy of bromocriptine in cirrhotic patients with hepatic parkinsonism. Liver Int 2019; 39:684-693. [PMID: 30554466 DOI: 10.1111/liv.14024] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Revised: 11/28/2018] [Accepted: 12/01/2018] [Indexed: 12/14/2022]
Abstract
BACKGROUND Parkinsonism like features can be seen in cirrhotics, possibly related to alterations in brain dopamine metabolism, transport and receptor integrity at basal ganglia. Hepatic parkinsonism is often not suspected and only ammonia-reducing therapies are given to such patients. We investigated the efficacy and safety of bromocriptine, a dopaminergic agent, in patients with hepatic parkinsonism. PATIENTS AND METHODS Cirrhotics were screened for the presence of extrapyramidal symptoms and were diagnosed as hepatic parkinsonism if any two of tremor, bradykinesia and/or rigidity were present, supported by MRI brain showing T1 hyperintensities in basal ganglia and substantia nigra. Patients were randomized to receive placebo (Gr A, n = 22) or bromocriptine (Gr B, n = 24) for 12 weeks. Complete, partial and non-response were defined as 30%, 10%-30% and <10% reduction,respectively, in Unified Parkinson's Disease Rating Scale motor score. RESULTS Of 1016 cirrhotics, 50 (4.9%) had hepatic parkinsonism. Patients in two treatment groups were comparable for MELD score, arterial NH3 and frequency of portosystemic shunts. Bromocriptine therapy for 12 weeks resulted in improvement in rigidity, tremors, bradykinesia and gait compared to placebo with complete and partial response in seven vs none (29.1%, 0%, P < 0.01) and 12 vs one (50%, 4.5%, P < 0.01) patients. Prolonged and more severe motor symptoms were associated with non-response to bromocriptine therapy. There were no major side effects in either treatment group. CONCLUSIONS Hepatic parkinsonism is seen in ~5% cirrhotics. Bromocriptine is a safe and effective therapy for these patients and is more effective in mild to moderate hepatic parkinsonism.
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Affiliation(s)
- Amrish Sahney
- Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India
| | | | - Ankur Jindal
- Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Lovkesh Anand
- Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Vinod Arora
- Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Rajan Vijayaraghavan
- Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India
| | | | - Guresh Kumar
- Department of Clinical Research, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Ankit Bhardwaj
- Department of Clinical Research, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Shiv Kumar Sarin
- Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India
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Natarajan U, Venkatesan T, Samuel SS, Vijayaraghavan R, Rathinavelu A. Effects of SAHA and RG7388 on p21
WAF1/CIP1
and p27
KIP1
mediated Pathways in Cancer Cells. FASEB J 2019. [DOI: 10.1096/fasebj.2019.33.1_supplement.647.28] [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: 11/11/2022]
Affiliation(s)
- Umamaheswari Natarajan
- VRR Institute for Biomedical ScienceChennaiIndia
- Rumbaugh Goodwin Institute for Cancer ResearchNova Southeastern UniversityFt. LauderdaleFL
| | - Thiagarajan Venkatesan
- Rumbaugh Goodwin Institute for Cancer ResearchNova Southeastern UniversityFt. LauderdaleFL
| | | | | | - Appu Rathinavelu
- Rumbaugh Goodwin Institute for Cancer ResearchNova Southeastern UniversityFt. LauderdaleFL
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MacFarlane DR, Chong AL, Forsyth M, Kar M, Vijayaraghavan R, Somers A, Pringle JM. New dimensions in salt-solvent mixtures: a 4th evolution of ionic liquids. Faraday Discuss 2019; 206:9-28. [PMID: 29034392 DOI: 10.1039/c7fd00189d] [Citation(s) in RCA: 64] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
In the field of ionic liquids (ILs) it has long been of fundamental interest to examine the transition from salt-in-solvent behaviour to pure liquid-salt behaviour, in terms of structures and properties. At the same time, a variety of applications have beneficially employed IL-solvent mixtures as media that offer an optimal set of properties. Their properties in many cases can be other than as expected on the basis of simple mixing concepts. Instead, they can reflect the distinct structural and interaction changes that occur as the mixture passes through the various stages from pure coulombic medium, to "plasticised" coulombic medium, into a meso-region where distinct molecular and ionic domains can co-exist. Such domains can persist to quite a high dilution into the salt-in-solvent regime and their presence manifests itself in a number of important synergistic interaction effects in diverse areas such as membrane transport and corrosion protection. Similarly, the use of ionic liquids in synthetic processes where there is a significant volume fraction of molecular species present can produce a variety of distinct and unexpected effects. The range of these salt-solvent mixtures is considerably broader than just those based on ionic liquids, since there is only minor value in the pure salt being a liquid at the outset. In other words, the extensive families of organic and metal salts become candidates for study and use. Our perspective then is of an evolution of ionic liquids into a broader field of fundamental phenomena and applications. This can draw on an even larger family of tuneable salts that exhibit an exciting combination of properties when mixed with molecular liquids.
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Affiliation(s)
- Douglas R MacFarlane
- School of Chemistry, The Australian Centre of Excellence for Electromaterials Science, Monash University, Clayton, Vic 3800, Australia.
| | - Alison L Chong
- School of Chemistry, The Australian Centre of Excellence for Electromaterials Science, Monash University, Clayton, Vic 3800, Australia.
| | - Maria Forsyth
- Institute for Frontier Materials, The Australian Centre of Excellence for Electromaterials Science Deakin University, Melbourne, Australia.
| | - Mega Kar
- School of Chemistry, The Australian Centre of Excellence for Electromaterials Science, Monash University, Clayton, Vic 3800, Australia.
| | - R Vijayaraghavan
- School of Chemistry, The Australian Centre of Excellence for Electromaterials Science, Monash University, Clayton, Vic 3800, Australia.
| | - Anthony Somers
- Institute for Frontier Materials, The Australian Centre of Excellence for Electromaterials Science Deakin University, Melbourne, Australia.
| | - Jennifer M Pringle
- Institute for Frontier Materials, The Australian Centre of Excellence for Electromaterials Science Deakin University, Melbourne, Australia.
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Zhu H, Vijayaraghavan R, MacFarlane DR, Forsyth M. Self-assembled structure and dynamics of imidazolium-based protic salts in water solution. Phys Chem Chem Phys 2019; 21:2691-2696. [PMID: 30657496 DOI: 10.1039/c8cp07254j] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Protic ionic liquids containing cations with long alkyl chains can form self-assembled micelles, vesicles, microemulsions, and lyotropic liquid crystal structures in water, acid water or tetrahydrofuran, etc. As a result of this unique property, they are regarded as a novel category of amphiphiles, and are gaining importance in the field of colloid and interface chemistry. The critical micelle concentration (CMC) of protic salts, e.g., alkyl-ammonium nitrates in water, was found to increase with decreasing chain length. It is generally believed that a long alkyl chain length is essential for the formation of self-assembled structures. So far, no self-assembled structure has been reported for protic ionic liquids with an alkyl chain length of n < 4. This paper reports on the structure and dynamics of two imidazolium based protic organic salts with no alkyl chain or a methyl group (n = 1) attached to the cation in water solution, determined through a detailed analysis of NMR spectra and pulsed-field gradient NMR data. We demonstrate that these imidazolium cations with no or a short alkyl chain (n = 1) can form a self-assembled clustering structure in water solution, which has a strong influence on the diffusion behavior of imidazolium molecular ions. It is speculated that this self-assembled structure is likely to be present in other similar solutions of ionic liquids with short alkyl chains.
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Affiliation(s)
- Haijin Zhu
- Institute for Frontier Materials, Deakin University, 75 Pigdons Rd, Geelong, Victoria 3216, Australia.
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40
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Vijayaraghavan R, Thay WY. Protein loosing enteropathy after Fontan procedure. Med J Malaysia 2018; 73:175-176. [PMID: 29962503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Fontan and Baudet described the procedure in 1971 and was very useful to improve the quality of life in many complex cyanotic heart diseases. It has gone through various modifications since then to improve the outcome. The mortality was reported as 2.1% and survival rate of at 5 years, 10 years, 15 years and 20 years were 91%, 80%, 73%and 69% respectively. Though it was a useful palliative procedure to improve the quality of life, it has complications which may affect the morbidity and mortality like Protein loosing enteropathy ,reduced exercise capacity thromboembolism. The patients with protein losing enteropathy present with Pleural effusion, ascites, and edema and they need periodic replacement of Albumin and frequent reviews and close follow up in the management to reduce the mortality and to improve the quality of life .These complications we come across and they need our support in the management at district level hospitals.
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Affiliation(s)
| | - W Y Thay
- Hospital Tawau, Department of Paediatrics, Sabah, Malaysia
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41
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Liu L, Toung JM, Jassowicz AF, Vijayaraghavan R, Kang H, Zhang R, Kruglyak KM, Huang HJ, Hinoue T, Shen H, Salathia NS, Hong DS, Naing A, Subbiah V, Piha-Paul SA, Bibikova M, Granger G, Barnes B, Shen R, Gutekunst K, Fu S, Tsimberidou AM, Lu C, Eng C, Moulder SL, Kopetz ES, Amaria RN, Meric-Bernstam F, Laird PW, Fan JB, Janku F. Targeted methylation sequencing of plasma cell-free DNA for cancer detection and classification. Ann Oncol 2018; 29:1445-1453. [PMID: 29635542 PMCID: PMC6005020 DOI: 10.1093/annonc/mdy119] [Citation(s) in RCA: 82] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Background Targeted methylation sequencing of plasma cell-free DNA (cfDNA) has a potential to expand liquid biopsies to patients with tumors without detectable oncogenic alterations, which can be potentially useful in early diagnosis. Patients and methods We developed a comprehensive methylation sequencing assay targeting 9223 CpG sites consistently hypermethylated according to The Cancer Genome Atlas. Next, we carried out a clinical validation of our method using plasma cfDNA samples from 78 patients with advanced colorectal cancer, non-small-cell lung cancer (NSCLC), breast cancer or melanoma and compared results with patients' outcomes. Results Median methylation scores in plasma cfDNA samples from patients on therapy were lower than from patients off therapy (4.74 versus 85.29; P = 0.001). Of 68 plasma samples from patients off therapy, methylation scores detected the presence of cancer in 57 (83.8%), and methylation-based signatures accurately classified the underlying cancer type in 45 (78.9%) of these. Methylation scores were most accurate in detecting colorectal cancer (96.3%), followed by breast cancer (91.7%), melanoma (81.8%) and NSCLC (61.1%), and most accurate in classifying the underlying cancer type in colorectal cancer (88.5%), followed by NSCLC (81.8%), breast cancer (72.7%) and melanoma (55.6%). Low methylation scores versus high were associated with longer survival (10.4 versus 4.4 months, P < 0.001) and longer time-to-treatment failure (2.8 versus 1.6 months, P = 0.016). Conclusions Comprehensive targeted methylation sequencing of 9223 CpG sites in plasma cfDNA from patients with common advanced cancers detects the presence of cancer and underlying cancer type with high accuracy. Methylation scores in plasma cfDNA correspond with treatment outcomes.
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Affiliation(s)
- L Liu
- Illumina, Inc., San Diego, The University of Texas MD Anderson Cancer Center, Houston, USA.
| | - J M Toung
- Illumina, Inc., San Diego, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - A F Jassowicz
- Department of Investigational Cancer Therapeutics (Phase I Clinical Trials Program), The University of Texas MD Anderson Cancer Center, Houston, USA
| | - R Vijayaraghavan
- Illumina, Inc., San Diego, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - H Kang
- Illumina, Inc., San Diego, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - R Zhang
- Illumina, Inc., San Diego, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - K M Kruglyak
- Illumina, Inc., San Diego, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - H J Huang
- Department of Investigational Cancer Therapeutics (Phase I Clinical Trials Program), The University of Texas MD Anderson Cancer Center, Houston, USA
| | - T Hinoue
- Van Andel Research Institute, Grand Rapids, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - H Shen
- Van Andel Research Institute, Grand Rapids, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - N S Salathia
- Illumina, Inc., San Diego, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - D S Hong
- Department of Investigational Cancer Therapeutics (Phase I Clinical Trials Program), The University of Texas MD Anderson Cancer Center, Houston, USA
| | - A Naing
- Department of Investigational Cancer Therapeutics (Phase I Clinical Trials Program), The University of Texas MD Anderson Cancer Center, Houston, USA
| | - V Subbiah
- Department of Investigational Cancer Therapeutics (Phase I Clinical Trials Program), The University of Texas MD Anderson Cancer Center, Houston, USA
| | - S A Piha-Paul
- Department of Investigational Cancer Therapeutics (Phase I Clinical Trials Program), The University of Texas MD Anderson Cancer Center, Houston, USA
| | - M Bibikova
- Illumina, Inc., San Diego, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - G Granger
- Illumina, Inc., San Diego, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - B Barnes
- Illumina, Inc., San Diego, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - R Shen
- Illumina, Inc., San Diego, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - K Gutekunst
- Illumina, Inc., San Diego, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - S Fu
- Department of Investigational Cancer Therapeutics (Phase I Clinical Trials Program), The University of Texas MD Anderson Cancer Center, Houston, USA
| | - A M Tsimberidou
- Department of Investigational Cancer Therapeutics (Phase I Clinical Trials Program), The University of Texas MD Anderson Cancer Center, Houston, USA
| | - C Lu
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - C Eng
- Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - S L Moulder
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - E S Kopetz
- Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - R N Amaria
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - F Meric-Bernstam
- Department of Investigational Cancer Therapeutics (Phase I Clinical Trials Program), The University of Texas MD Anderson Cancer Center, Houston, USA
| | - P W Laird
- Van Andel Research Institute, Grand Rapids, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - J-B Fan
- Illumina, Inc., San Diego, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - F Janku
- Department of Investigational Cancer Therapeutics (Phase I Clinical Trials Program), The University of Texas MD Anderson Cancer Center, Houston, USA.
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Song CP, Ramanan RN, Vijayaraghavan R, MacFarlane DR, Chan ES, Show PL, Yong ST, Ooi CW. Effect of salt-based adjuvant on partition behaviour of protein in aqueous two-phase systems composed of polypropylene glycol and cholinium glycinate. Sep Purif Technol 2018. [DOI: 10.1016/j.seppur.2017.09.017] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Shasthry SM, Rastogi A, Bihari C, Vijayaraghavan R, Arora V, Sharma MK, Sarin SK. Histological activity score on baseline liver biopsy can predict non-response to steroids in patients with severe alcoholic hepatitis. Virchows Arch 2018. [DOI: 10.1007/s00428-018-2330-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Abstract
Highly efficient low-viscosity protic ionic liquids with enhanced CO2 absorption capacities exhibiting more than 20% w/w uptake.
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Affiliation(s)
- Tamas Oncsik
- School of Chemistry
- Monash University
- Clayton Campus
- Vic 3800
- Australia
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Rao J, Vijayaraghavan R, Zhou Y, Howlett PC, MacFarlane DR, Forsyth M, Zhu H. The influence of anion chemistry on the ionic conductivity and molecular dynamics in protic organic ionic plastic crystals. Phys Chem Chem Phys 2018; 20:4579-4586. [DOI: 10.1039/c7cp07330e] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [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
Protic organic ionic plastic crystals based on different anions exhibit more than two orders of magnitude difference in conductivity.
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Affiliation(s)
- Jun Rao
- ARC Centre of Excellence for Electromaterials Science (ACES)
- Institute for Frontier Materials (IFM)
- Deakin University
- Melbourne Campus at Burwood
- Burwood VIC 3125
| | - R. Vijayaraghavan
- ARC Centre of Excellence for Electromaterials Science (ACES)
- School of Chemistry
- Monash University
- Clayton
- Australia
| | - Yundong Zhou
- ARC Centre of Excellence for Electromaterials Science (ACES)
- Institute for Frontier Materials (IFM)
- Deakin University
- Melbourne Campus at Burwood
- Burwood VIC 3125
| | - Patrick C. Howlett
- ARC Centre of Excellence for Electromaterials Science (ACES)
- Institute for Frontier Materials (IFM)
- Deakin University
- Melbourne Campus at Burwood
- Burwood VIC 3125
| | - Douglas R. MacFarlane
- ARC Centre of Excellence for Electromaterials Science (ACES)
- School of Chemistry
- Monash University
- Clayton
- Australia
| | - Maria Forsyth
- ARC Centre of Excellence for Electromaterials Science (ACES)
- Institute for Frontier Materials (IFM)
- Deakin University
- Melbourne Campus at Burwood
- Burwood VIC 3125
| | - Haijin Zhu
- ARC Centre of Excellence for Electromaterials Science (ACES)
- Institute for Frontier Materials (IFM)
- Deakin University
- Melbourne Campus at Burwood
- Burwood VIC 3125
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Nithyadharseni P, Abhilash K, Petnikota S, Anilkumar M, Jose R, Ozoemena K, Vijayaraghavan R, Kulkarni P, Balakrishna G, Chowdari B, Adams S, Reddy M. Synthesis and Lithium Storage Properties of Zn, Co and Mg doped SnO2 Nano Materials. Electrochim Acta 2017. [DOI: 10.1016/j.electacta.2017.06.170] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Jassowicz A, Liu L, Huang H, Hong D, Naing A, Subbiah V, Piha-Paul S, Toung J, Vijayaraghavan R, Zhang R, Kang H, Fu S, Tsimberiodou A, Lu C, Eng C, Moulder S, Kopetz S, Amaria R, Meric-Bernstam F, Janku F. Targeted methylation sequencing of plasma cell-free DNA identifies patients with advanced breast, colorectal, non-small cell lung cancer, melanoma with poor outcomes. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx363.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Díaz M, Ortiz A, Pringle J, Wang X, Vijayaraghavan R, MacFarlane D, Forsyth M, Ortiz I. Protic plastic crystal/PVDF composite membranes for Proton Exchange Membrane Fuel Cells under non-humidified conditions. Electrochim Acta 2017. [DOI: 10.1016/j.electacta.2017.07.076] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [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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Jayakumar S, Raghunath G, Ilango S, Vijayakumar J, Vijayaraghavan R. Effect of Fluoxetine on the Hippocampus of Wistar Albino Rats in Cold Restraint Stress Model. J Clin Diagn Res 2017; 11:AF01-AF06. [PMID: 28764145 DOI: 10.7860/jcdr/2017/26958.9953] [Citation(s) in RCA: 5] [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] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Accepted: 03/06/2017] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Stress has been known to be a potential modulator of learning and memory. Long term stress can lead to depression. Fluoxetine is a selective serotonin reuptake inhibitor group of drug used in the treatment of depression. AIM The present study was conducted to evaluate the potential of Fluoxetine on cold restraint induced stress in the hippocampus of Wistar rats. MATERIALS AND METHODS A total of 18 male wistar albino rats were divided randomly into three groups (n=6). Group 1 was the control group which were kept in normal laboratory conditions. Group 2 was the negative control group which were given cold restraint stress for period of four weeks. Group 3 was the experimental group, where the animals were pretreated with fluoxetine 10 mg/kg for a period of one week followed by cold restraint stress for 30 minutes and cotreated with fluoxetine 10 mg/kg for a period of four weeks. The whole study was done for a period of five weeks followed by behavioural studies and subsequently sacrificed with removal of brain for various histological, Immunohistochemical (IHC), neurochemical and antioxidant analysis. The values were expressed as Mean±SEM. One-way analysis of variance followed by Tukey's multiple comparisons test was used for the comparison of means. A probability of 0.05 and less was taken as statistically significant using Prism Graphpad software version 6.01. RESULTS The results show there was significant improvement in the Morris water maze test after treatment with fluoxetine in Group 2. Similar results were also noted in the levels of neurotransmitters and antioxidant levels in brain and also in the number of cells counted in IHC and histological studies by H&E when Group 3 was compared with Group 2. The treatment reversed the damage in Group 2 which was comparable with the control group. CONCLUSION The results revealed that administration of fluoxetine 10 mg/kg given orally has a potential antistressor effect by improving the neurogenic and neuroprotective effect on the cold restraint stress induced hippocampal damage.
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Affiliation(s)
- Saikarthik Jayakumar
- Research Scholar, Department of Anatomy, Saveetha University, Chennai, Tamil Nadu, India
| | - Gunapriya Raghunath
- Professor and Head, Department of Anatomy, Saveetha Medical College, Chennai, Tamil Nadu, India
| | - Saraswathi Ilango
- Research Scholar, Department of Physiology, Bharath University, Chennai, Tamil Nadu, India
| | - J Vijayakumar
- Professor, Department of Anatomy, Saveetha Medical College, Chennai, Tamil Nadu, India
| | - R Vijayaraghavan
- Director of Research, Department of Anatomy, Saveetha University, Chennai, Tamil Nadu, India
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