1
|
Lennon JT, Abramoff RZ, Allison SD, Burckhardt RM, DeAngelis KM, Dunne JP, Frey SD, Friedlingstein P, Hawkes CV, Hungate BA, Khurana S, Kivlin SN, Levine NM, Manzoni S, Martiny AC, Martiny JBH, Nguyen NK, Rawat M, Talmy D, Todd-Brown K, Vogt M, Wieder WR, Zakem EJ. Priorities, opportunities, and challenges for integrating microorganisms into Earth system models for climate change prediction. mBio 2024; 15:e0045524. [PMID: 38526088 PMCID: PMC11078004 DOI: 10.1128/mbio.00455-24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/26/2024] Open
Abstract
Climate change jeopardizes human health, global biodiversity, and sustainability of the biosphere. To make reliable predictions about climate change, scientists use Earth system models (ESMs) that integrate physical, chemical, and biological processes occurring on land, the oceans, and the atmosphere. Although critical for catalyzing coupled biogeochemical processes, microorganisms have traditionally been left out of ESMs. Here, we generate a "top 10" list of priorities, opportunities, and challenges for the explicit integration of microorganisms into ESMs. We discuss the need for coarse-graining microbial information into functionally relevant categories, as well as the capacity for microorganisms to rapidly evolve in response to climate-change drivers. Microbiologists are uniquely positioned to collect novel and valuable information necessary for next-generation ESMs, but this requires data harmonization and transdisciplinary collaboration to effectively guide adaptation strategies and mitigation policy.
Collapse
Affiliation(s)
- J. T. Lennon
- Department of Biology, Indiana University, Bloomington, Indiana, USA
| | - R. Z. Abramoff
- Lawrence Berkeley National Laboratory, Berkeley, California, USA
- Ronin Institute, Montclair, New Jersey, USA
| | - S. D. Allison
- Department of Ecology and Evolutionary Biology, University of California Irvine, Irvine, California, USA
- Department of Earth System Science, University of California Irvine, Irvine, California, USA
| | | | - K. M. DeAngelis
- Department of Microbiology, University of Massachusetts, Amherst, Massachusetts, USA
| | - J. P. Dunne
- NOAA/OAR Geophysical Fluid Dynamics Laboratory, Princeton, New Jersey, USA
| | - S. D. Frey
- Department of Natural Resources and the Environment, University of New Hampshire, Durham, New Hampshire, USA
| | - P. Friedlingstein
- College of Engineering, Mathematics, and Physical Sciences, University of Exeter, Exeter, United Kingdom
| | - C. V. Hawkes
- Department of Plant and Microbial Biology, North Carolina State University, Raleigh, North Carolina, USA
| | - B. A. Hungate
- Department of Biological Sciences, Center for Ecosystem Science, Northern Arizona University, Flagstaff, Arizona, USA
| | - S. Khurana
- Department of Physical Geography, Bolin Centre for Climate Research, Stockholm University, Stockholm, Sweden
| | - S. N. Kivlin
- Department of Ecology and Evolutionary Biology, University of Tennessee, Knoxville, Tennessee, USA
| | - N. M. Levine
- Department of Biological Sciences, University of Southern California, Los Angeles, California, USA
| | - S. Manzoni
- Department of Physical Geography, Bolin Centre for Climate Research, Stockholm University, Stockholm, Sweden
| | - A. C. Martiny
- Department of Ecology and Evolutionary Biology, University of California Irvine, Irvine, California, USA
| | - J. B. H. Martiny
- Department of Ecology and Evolutionary Biology, University of California Irvine, Irvine, California, USA
| | - N. K. Nguyen
- American Society for Microbiology, Washington, DC, USA
| | - M. Rawat
- National Science Foundation, Washington, DC, USA
| | - D. Talmy
- Department of Microbiology, University of Tennessee, Knoxville, Tennessee, USA
| | - K. Todd-Brown
- Department of Environmental Engineering Sciences, University of Florida, Gainesville, Florida, USA
| | - M. Vogt
- Institute for Biogeochemistry and Pollutant Dynamics, ETH Zürich, Zürich, Switzerland
| | - W. R. Wieder
- National Center for Atmospheric Research, Boulder, Colorado, USA
- Institute of Arctic and Alpine Research, University of Colorado, Boulder, Colorado, USA
| | - E. J. Zakem
- Department of Global Ecology, Carnegie Institution for Science, Stanford, California, USA
| |
Collapse
|
2
|
Verma S, Chitikela S, Singh V, Khurana S, Pushpam D, Jain D, Kumar S, Gupta Y, Malik PS. A phase II study of metformin plus pemetrexed and carboplatin in patients with non-squamous non-small cell lung cancer (METALUNG). Med Oncol 2023; 40:192. [PMID: 37261532 DOI: 10.1007/s12032-023-02057-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 05/16/2023] [Indexed: 06/02/2023]
Abstract
Immune checkpoint inhibitors (ICIs) ± chemotherapy is the standard treatment for driver mutation-negative non-small cell lung cancer (NSCLC). However, accessibility to ICIs in LMICs is limited due to high cost, and platinum-based chemotherapy remains the mainstay of treatment. Metformin has anticancer properties, and studies suggest synergism between metformin and pemetrexed. Based on preclinical evidence, this combination may be more beneficial for STK11-mutated NSCLC, a subgroup, inherently resistant to ICIs. In this Simon two-stage, single-arm phase 2 trial, we investigated metformin with pemetrexed-carboplatin (PC) in patients with treatment-naive stage IV non-squamous NSCLC. The primary outcome was 6-month progression-free survival (PFS) rate. Secondary outcomes were safety, overall survival (OS), overall response rate (ORR), proportion of STK11 mutation, and effect of STK11 mutation on 6-month PFS rate. The study was terminated for futility after interim analysis. The median follow-up was 34.1 months. The 6-month PFS rate was 28% (95% CI 12.4-0.46). The median PFS and OS were 4.5 (95% CI 2.2-6.1) and 7.4 months (95% CI 5.3-15.3), respectively. The ORR was 72%. Gastrointestinal toxicities were the most common. No grade 4/5 toxicities were reported. Targeted sequencing was possible in nine cases. Two patients had STK11 mutation and a poor outcome (PFS < 12 weeks). We could not demonstrate the benefit of metformin with CP in terms of improvement in 6-month PFS rate; however, the combination was safe (CTRI/2019/02/017815).
Collapse
Affiliation(s)
- S Verma
- Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi, India
| | - S Chitikela
- Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi, India
| | - V Singh
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - S Khurana
- Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi, India
| | - D Pushpam
- Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi, India
| | - D Jain
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - S Kumar
- Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi, India
| | - Y Gupta
- Department of Endocrinology, All India Institute of Medical Sciences, New Delhi, India
| | - P S Malik
- Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi, India.
- Department of Medical Oncology, Dr.B.R.A.I.R.C.H., All India Institute of Medical Sciences, Room 245, New Delhi, India.
| |
Collapse
|
3
|
Tansir G, Khurana S, Malik P, Pramanik R, Kumar L, Bhatla N. 20P A single-center retrospective analysis of clinical patterns, management and survival outcomes of malignant ovarian germ cell tumors. ESMO Open 2023. [DOI: 10.1016/j.esmoop.2023.101041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
|
4
|
Nambirajan A, Jangra K, Khurana S, Malik P, Mohan A, Jain D. EP03.01-005 Clinicopathological Features of ROS1-rearranged Adenocarcinomas: A Single Institutional Experience Spanning Four Years From India. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
5
|
Rathor A, Malik P, Tanwar P, Khurana S, Kumar S, Mohan A, Nambirajan A, Jain D. EP11.01-011 Clinical Application of Liquid Biopsy for Assessing Early EGFR Mutation Detection in Non-Small Cell Lung Carcinoma. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
|
6
|
Verma S, Malik P, Kalra K, Singh V, Kumar S, Khurana S, Pushpam D, Jain D, Gupta Y. P2.02-03 A Phase II Study of Metformin with Pemetrexed/Carboplatin in Patients with Metastatic Non-Squamous Non-Small Cell Lung Cancer. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
|
7
|
Kumar R, Kumar R, Khurana N, Singh SK, Khurana S, Verma S, Sharma N, Vyas M, Dua K, Khursheed R, Awasthi A, Vishwas S. Improved neuroprotective activity of Fisetin through SNEDDS in ameliorating the behavioral alterations produced in rotenone-induced Parkinson's model. Environ Sci Pollut Res Int 2022; 29:50488-50499. [PMID: 35230633 DOI: 10.1007/s11356-022-19428-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 02/21/2022] [Indexed: 06/14/2023]
Abstract
Fisetin is a polyphenolic flavonoid reported to have antioxidant, anti-inflammatory, and anti-cancer activities. However, it loses its importance as an effective phytochemical due to its poor water solubility and lower bioavailability. In the present study, the self-nanoemulsifying drug delivery system (SNEDDS) of fisetin was developed in order to improve its pharmacological activity. The developed SNEDDS of fisetin was evaluated for improving the rotenone-induced behavioral changes in the rats, and its efficacy was compared with naïve fisetin. It was noticed that fisetin loaded in the SNEDDS formulation significantly (p < 0.001) ameliorated the rotenone-induced alteration in the body weight, grip strength, beam walk, postural instability, etc., in rats when compared to the effect of naïve fisetin. Naïve fisetin significantly (p < 0.05) ameliorated the effect of rotenone on the level of dopamine only at a higher dose. Whereas, SNEDDS of fisetin produced a significant (p < 0.05) effect at both dose levels when compared with the diseased group as well as also produced a significant (p < 0.05) effect when compared with the naïve fisetin group. The results of histopathological examination revealed about the neuroprotective effect of SNEDDS loaded with fisetin as observed through the protection of neuronal damage. From this study, it was concluded that SNEDDS improved the anti-Parkinsonian activity of fisetin by improving the behavioral alteration produced by rotenone due to enhancement in its solubility and bioavailability.
Collapse
Affiliation(s)
- Rajan Kumar
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, Punjab, 144411, India
| | - Rakesh Kumar
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, Punjab, 144411, India
| | - Navneet Khurana
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, Punjab, 144411, India.
| | - Sachin Kumar Singh
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, Punjab, 144411, India
| | - Shelly Khurana
- Department of Pharmacy, Government Polytechnic College, Amritsar, Punjab, India
| | - Surajpal Verma
- Department of Pharmaceutical Chemistry, Delhi Pharmaceutical Sciences and Research University, New Delhi, India
| | - Neha Sharma
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, Punjab, 144411, India
| | - Manish Vyas
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, Punjab, 144411, India
| | - Kamal Dua
- Discipline of Pharmacy, Graduate School of Health, University of Technology Sydney, Ultimo, Australia
| | - Rubiya Khursheed
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, Punjab, 144411, India
| | - Ankit Awasthi
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, Punjab, 144411, India
| | - Sukriti Vishwas
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, Punjab, 144411, India
| |
Collapse
|
8
|
Raju R, Khurana S, Mahadevan A, John DV. Central nervous system infections caused by pathogenic free-living amoebae: An Indian perspective. Trop Biomed 2022; 39:265-280. [PMID: 35838101 DOI: 10.47665/tb.39.2.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Pathogenic free-living amoebae (FLA), namely Acanthamoeba sp., Naegleria fowleri and Balamuthia mandrillaris are distributed worldwide. These neurotropic amoebae can cause fatal central nervous system (CNS) infections in humans. This review deals with the demographic characteristics, symptoms, diagnosis, and treatment outcomes of patients with CNS infections caused by FLA documented in India. There have been 42, 25, and 4 case reports of Acanthamoeba granulomatous amoebic encephalitis (GAE), N. fowleri primary amoebic meningoencephalitis (PAM), and B. mandrillaris meningoencephalitis (BAE), respectively. Overall, 17% of Acanthamoeba GAE patients and one of the four BAE patients had some form of immunosuppression, and more than half of the N. fowleri PAM cases had history of exposure to freshwater. Acanthamoeba GAE, PAM, and BAE were most commonly seen in males. Fever, headache, vomiting, seizures, and altered sensorium appear to be common symptoms in these patients. Some patients showed multiple lesions with edema, exudates or hydrocephalus in their brain CT/MRI. The cerebrospinal fluid (CSF) of these patients showed elevated protein and WBC levels. Direct microscopy of CSF was positive for amoebic trophozoites in 69% of Acanthamoeba GAE and 96% of PAM patients. One-fourth of the Acanthamoeba GAE and all the BAE patients were diagnosed only by histopathology following autopsy/biopsy samples. Twenty-one Acanthamoeba GAE survivors were treated with cotrimoxazole, rifampicin, and ketoconazole/amphotericin B, and all eleven PAM survivors were treated with amphotericin B alongside other drugs. A thorough search for these organisms in CNS samples is necessary to develop optimum treatment strategies.
Collapse
Affiliation(s)
- R Raju
- KIDWAI Memorial Institute of Oncology Research & Training Centre, Bangalore, India
| | - S Khurana
- Department of Medical Parasitology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - A Mahadevan
- Department of Neuropathology, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - D V John
- Department of Neuromicrobiology, National Institute of Mental Health and Neurosciences, Bangalore, India
| |
Collapse
|
9
|
Khurana S. Obituary: Dr. Ramesh Chander Mahajan. Trop Parasitol 2022. [DOI: 10.4103/tp.tp_10_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
|
10
|
Sharma VK, Khurana S, Kaur S, Ram J. Arcus lipoides juvenilis: a presenting sign of dyslipidaemia. QJM 2021; 114:333-334. [PMID: 32770245 DOI: 10.1093/qjmed/hcaa236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Indexed: 11/14/2022] Open
Affiliation(s)
- V K Sharma
- Department of Ophthalmology, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India
| | - S Khurana
- Department of Ophthalmology, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India
| | - S Kaur
- Department of Ophthalmology, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India
| | - J Ram
- Department of Ophthalmology, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India
| |
Collapse
|
11
|
Mittal A, Malik PS, Kumar S, Saikia J, Chitikela S, Khurana S, Bharti S, Jain D, Pathy S, Thulkar S, Kumar R, Madan K, Mohan A. Dose-dense Paclitaxel and Carboplatin as Neoadjuvant Chemotherapy for Stage IIB/IIIA Non-small Cell Lung Cancer - A Phase II trial. Clin Oncol (R Coll Radiol) 2021; 33:e553-e560. [PMID: 34340919 DOI: 10.1016/j.clon.2021.07.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 06/02/2021] [Accepted: 07/14/2021] [Indexed: 12/25/2022]
Abstract
AIMS The approach to potentially resectable non-small cell lung cancer (NSCLC) remains controversial. There is a benefit of neoadjuvant chemotherapy (NACT), but the ideal regimen is unknown. We evaluated the efficacy and safety of dose-dense NACT in potentially resectable NSCLC in this phase II trial. MATERIALS AND METHODS Paclitaxel at 80 mg/m2 on days 1, 8 and 15 with AUC-6 carboplatin on day 1, 3 weekly for four cycles was evaluated as NACT. Patients with Eastern Cooperative Oncology Group performance status 0-2, stage IIB and IIIA (with only non-bulky N2 nodes) were included. The primary end point was the objective response rate. Secondary end points included toxicity, progression-free survival, recurrence-free survival, complete resection rate and overall survival. The relative dose intensity (RDI) was calculated to define tolerability (CTRI/2016/05/006916). RESULTS In total, 37 patients were enrolled (median age 55 years). Most (78.8%) were smokers. Most patients had adenocarcinoma (57.6%) and stage IIIA disease (81.0%) according to the seventh American Joint Committee on Cancer staging system. Seventy-eight per cent of patients completed four cycles. The objective response rate was 75.6% with a complete response in 10.8%. The mean RDI of paclitaxel was 88.61%, with 68.0% of patients able to maintain an RDI ≥85.0%. In total, 187 toxicity events were recorded (120 grade 1, 64 grade 2 and three grade 3 events). Common toxicities were peripheral neuropathy (20.3%), myalgia (19.8%), nausea (15.7%) and neutropenia (10.2%). There were no treatment-related deaths. Seventeen patients underwent surgery (lobectomy 82.4%). After a median follow-up of 47 months (95% confidence interval 27-50.7 months), the median progression-free survival was 9.6 months (7.4-17.4) and overall survival was 29.2 months (16.0-37.2). CONCLUSION Dose-dense paclitaxel-carboplatin is feasible, safe and efficacious and should be evaluated further in potentially resectable NSCLC.
Collapse
Affiliation(s)
- A Mittal
- Department of Medical Oncology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - P S Malik
- Department of Medical Oncology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India.
| | - S Kumar
- Department of Surgical Oncology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - J Saikia
- Department of Surgical Oncology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - S Chitikela
- Department of Medical Oncology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - S Khurana
- Department of Medical Oncology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - S Bharti
- Department of Oncoanaesthesia and Palliative Medicine, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - D Jain
- Department of Pathology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - S Pathy
- Department of Radiation Oncology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - S Thulkar
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - R Kumar
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - K Madan
- Department of Pulmonary Medicine, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - A Mohan
- Department of Pulmonary Medicine, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| |
Collapse
|
12
|
Bampton TJ, Holmes-Walker DJ, Drogemuller CJ, Radford T, Anderson P, Etherton C, Russell CH, Khurana S, Torpy DJ, Couper JJ, Couper RLT, Macintyre P, Neo EL, Benitez-Aguirre P, Thomas G, Loudovaris T, Thomas HE, Palmer LJ, Wu D, Rogers NM, Williams L, Hawthorne WJ, O'Connell PJ, Kay TW, Pleass H, Chen JW, Coates PT. Australian experience with total pancreatectomy with islet autotransplantation to treat chronic pancreatitis. ANZ J Surg 2021; 91:2663-2668. [PMID: 33956377 DOI: 10.1111/ans.16853] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 03/12/2021] [Accepted: 03/17/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND This study aimed to describe the clinical outcomes of total pancreatectomy with islet autotransplantation (TP-IAT) in Australia. METHODS Individuals selected for TP-IAT surgery according to the Minnesota Criteria (Appendix) without evidence of diabetes were evaluated including time to transplantation from pancreatectomy, islet numbers infused and post-transplantation HbA1c, C-peptide, total daily insulin and analgesic requirement. RESULTS Sixteen individuals underwent TP-IAT from Australia and New Zealand between 2010 and 2020. Two recipients are deceased. The median islet equivalents/kg infused was 4244 (interquartile range (IQR) 2290-7300). The median C-peptide 1 month post-TP-IAT was 384 (IQR 210-579) pmol/L and at median 29.5 (IQR 14.5-46.5) months from transplant was 395 (IQR 139-862) pmol/L. Insulin independence was achieved in eight of 15 (53.3%) surviving recipients. A higher islet equivalents transplanted was most strongly associated with the likelihood of insulin independence (P < 0.05). Of the 15 surviving recipients, 14 demonstrated substantial reduction in analgesic requirement. CONCLUSION The TP-IAT programme in Australia has been a successful new therapy for the management of individuals with chronic pancreatitis including hereditary forms refractory to medical treatment to improve pain management with 50% insulin independence rates.
Collapse
Affiliation(s)
- Tristan J Bampton
- Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia.,The Central and Northern Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - D Jane Holmes-Walker
- Department of Endocrinology, Westmead Hospital, Sydney, New South Wales, Australia.,Westmead Institute for Medical Research, Sydney, New South Wales, Australia
| | - Chris J Drogemuller
- The Central and Northern Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Toni Radford
- The Central and Northern Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Patricia Anderson
- Westmead Institute for Medical Research, Sydney, New South Wales, Australia
| | - C Etherton
- The Central and Northern Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - C H Russell
- The Central and Northern Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - S Khurana
- Department of Gastroenterology, Women's and Children's Hospital, Adelaide, South Australia, Australia
| | - David J Torpy
- The Central and Northern Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - J J Couper
- Department of Gastroenterology, Women's and Children's Hospital, Adelaide, South Australia, Australia
| | - R L T Couper
- Department of Gastroenterology, Women's and Children's Hospital, Adelaide, South Australia, Australia
| | - Pamela Macintyre
- The Central and Northern Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - E L Neo
- Flinders Medical Centre, Adelaide, South Australia, Australia
| | - Paul Benitez-Aguirre
- Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
| | - G Thomas
- Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.,Westmead Children's Hospital, Sydney, New South Wales, Australia
| | - T Loudovaris
- Islet biology, St Vincent's Institute, Melbourne, Victoria, Australia
| | - H E Thomas
- Islet biology, St Vincent's Institute, Melbourne, Victoria, Australia
| | - Lyle J Palmer
- School of Public Health, The University of Adelaide, Adelaide, South Australia, Australia
| | - Denghao Wu
- Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
| | - Natasha M Rogers
- Westmead Institute for Medical Research, Sydney, New South Wales, Australia.,Department of Renal Medicine, Westmead Hospital, Sydney, New South Wales, Australia
| | - L Williams
- Westmead Institute for Medical Research, Sydney, New South Wales, Australia
| | - W J Hawthorne
- Westmead Institute for Medical Research, Sydney, New South Wales, Australia.,Department of Renal Medicine, Westmead Hospital, Sydney, New South Wales, Australia.,Department of Surgery, Westmead Hospital, Sydney, New South Wales, Australia
| | - P J O'Connell
- Westmead Institute for Medical Research, Sydney, New South Wales, Australia.,Department of Renal Medicine, Westmead Hospital, Sydney, New South Wales, Australia
| | - Tom W Kay
- Islet biology, St Vincent's Institute, Melbourne, Victoria, Australia
| | - Henry Pleass
- Westmead Institute for Medical Research, Sydney, New South Wales, Australia.,Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.,Department of Renal Medicine, Westmead Hospital, Sydney, New South Wales, Australia.,Department of Surgery, Westmead Hospital, Sydney, New South Wales, Australia
| | - John W Chen
- The Central and Northern Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, South Australia, Australia.,Department of Gastroenterology, Women's and Children's Hospital, Adelaide, South Australia, Australia
| | - P Toby Coates
- Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia.,The Central and Northern Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | | |
Collapse
|
13
|
Kumar R, Kumar R, Khurana N, Singh SK, Khurana S, Verma S, Sharma N, Kapoor B, Vyas M, Khursheed R, Awasthi A, Kaur J, Corrie L. Enhanced oral bioavailability and neuroprotective effect of fisetin through its SNEDDS against rotenone-induced Parkinson's disease rat model. Food Chem Toxicol 2020; 144:111590. [DOI: 10.1016/j.fct.2020.111590] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 06/24/2020] [Accepted: 07/07/2020] [Indexed: 12/22/2022]
|
14
|
Kumar R, Kumar R, Khursheed R, Awasthi A, Ramanunny AK, Kaur J, Khurana N, Singh SK, Khurana S, Pandey NK, Kapoor B, Sharma N. Validated Reverse Phase-High-Performance Liquid Chromatography Method for Estimation of Fisetin in Self-Nanoemulsifying Drug Delivery System. Assay Drug Dev Technol 2020; 18:274-281. [DOI: 10.1089/adt.2020.983] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Rajan Kumar
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, Punjab, India
| | - Rakesh Kumar
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, Punjab, India
| | - Rubiya Khursheed
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, Punjab, India
| | - Ankit Awasthi
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, Punjab, India
| | | | - Jaskiran Kaur
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, Punjab, India
| | - Navneet Khurana
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, Punjab, India
| | - Sachin Kumar Singh
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, Punjab, India
| | - Shelly Khurana
- Deparment of Pharmacy, Government Polytechnic College, Amritsar, Punjab, India
| | - Narendra Kumar Pandey
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, Punjab, India
| | - Bhupinder Kapoor
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, Punjab, India
| | - Neha Sharma
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, Punjab, India
| |
Collapse
|
15
|
Khurana S, Roy S, Gupta M. Who manages health workforce in the States of India: Profile, knowledge and perceptions of the team. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Problem
Human resources in the public health sector is of prime importance in a limited resource setting country, who at times work in a high-pressure, limited resource environment and where skilled staff continue to remain in short supply. The role of Human Resource for Health (HRH) team responsible for managing this health workforce is crucial. They play an important role in improving the human resource practices and creating an enabling organizational culture for optimal resource utilization. The paper explores the profile of the HRH teams of the states of India, their knowledge levels, and perceptions of their role.
Methods
The participants were HR Managers from 29 states of India who look after HRH in National Health Mission and State Health Departments. Cross-sectional survey tool was used for data collection. Quantitative data analysis included univariate and bivariate analysis. One Way ANOVA test of significance and post-hoc tests using Tukey's method was used to ascertain the groups with significant difference.
Results
Most of the HRH team members are postgraduates or have management background. Their experience varies from <1year to > 25 years. Mostly of them perceive their role to be limited to implementing bare essential HRM practices, mostly administrative. The educational qualification of the members did not have any significant bearing on their technical knowledge related to HRM practices; but their experience in public health sector showed a significant association.
Lessons
This study lends evidence to the principle that professionals who have been in the system for long, know about HRH and the associated policies better, and hence may be better equipped to handle HRH and establish good HR Management (HRM) systems. Better role clarity among the HRH teams, expansion of their current scope of work to include advanced practices of HRM and continuous capacity building mechanisms are needed to help strengthen the development and management of HRH.
Key messages
This study, a first of its kind in the country, lend evidence related to the principle for deciding the profile of team who should be entrusted with managing and development of HRH. The Study gives evidence to focus on the role clarity of HRH to zero down their knowledge and skills gaps and enhance their competencies through better capacity building.
Collapse
Affiliation(s)
- S Khurana
- Human Resource for Health Division, National Health Systems Resource Centre, New Delhi, India
| | - S Roy
- Human Resource for Health Division, National Health Systems Resource Centre, New Delhi, India
| | - M Gupta
- Human Resource for Health Division, National Health Systems Resource Centre, New Delhi, India
| |
Collapse
|
16
|
Purkayastha S, Cheng J, Chang M, Wang R, Soulen M, Stavropoulos S, Khurana S, Silva A, McGirr A, Bai H. 3:18 PM Abstract No. 266 Differentiation of low- and high-grade renal cell carcinoma using magnetic resonance–based radiomics. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
|
17
|
Rauschert L, Purkayastha S, Zhao Y, Xi I, Wang R, Khurana S, McGirr A, Soulen M, Zhang Z, Silva A, Stavropoulos S, Ahn S, Bai H. 3:18 PM Abstract No. 292 Differentiation of malignant and benign renal tumors using magnetic resonance–based radiomics. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
|
18
|
Khurana S, Dadwal R, Sharma N, Mewara A, Singh S, Bagga R, Yadav R, Sethi S. Loop mediated isothermal amplification assay for detection of Trichomonas vaginalis in vaginal swabs among symptomatic women from North India. Lett Appl Microbiol 2020; 70:196-202. [PMID: 31808556 DOI: 10.1111/lam.13260] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2019] [Revised: 12/04/2019] [Accepted: 12/04/2019] [Indexed: 11/30/2022]
Abstract
Trichomonas vaginalis is one of the most common curable sexually transmitted pathogens infecting both men and women worldwide. Unlike traditional methods such as microscopy and culture, nucleic acid amplification tests rapidly detect this agent, assisting in treatment. Conventional polymerase chain reaction (PCR), the loop-mediated isothermal amplification (LAMP), and the Xpert TV assay were evaluated using 28 microscopy positive T. vaginalis samples and 125 microscopy negative samples from symptomatic females of reproductive age. The sensitivity of all tests was 100% and the specificity was 100%, 100%, and 99·2% for PCR, Xpert TV, and LAMP, respectively. The inter-rater reliability was excellent for PCR: Xpert TV (kappa-coefficient = 1) and good for LAMP assay: Xpert TV/PCR (kappa-coefficient = 0·98) and conventional PCR: LAMP (kappa-coefficient = 0·98). The study highlights the importance of PCR for screening T. vaginalis in women, particularly in laboratories where the Xpert-TV assay is not available or not affordable. The LAMP assay showed a lower positive predictive value which merits further evaluation. SIGNIFICANCE AND IMPACT OF THE STUDY: Trichomonas vaginalis is a common sexually transmitted pathogen associated with considerable morbidity and risk of complications. Due to the limitations of traditional diagnostic modalities, three molecular assays were compared: conventional polymerase chain reaction (PCR), Xpert TV assay, and loop mediated isothermal amplification (LAMP) assay for detecting T. vaginalis in symptomatic females. All tests had a sensitivity of 100% and the inter-rater reliability was excellent for PCR: Xpert TV, and good for LAMP assay: Xpert TV/PCR. The translational impact of this study lies in the possible use of conventional PCR and LAMP in laboratories where the Xpert TV assay is not available or not affordable.
Collapse
Affiliation(s)
- S Khurana
- Department of Medical Parasitology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - R Dadwal
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - N Sharma
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - A Mewara
- Department of Medical Parasitology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - S Singh
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - R Bagga
- Department of Gynecology and Obstetrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - R Yadav
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - S Sethi
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| |
Collapse
|
19
|
Khurana S, Gupta PC, Balamurugan R, Sharma VK, Ram J. Crystalline cataract in diabetes. QJM 2020; 113:57. [PMID: 31086962 DOI: 10.1093/qjmed/hcz111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- S Khurana
- Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - P C Gupta
- Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - R Balamurugan
- Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - V K Sharma
- Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - J Ram
- Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| |
Collapse
|
20
|
Kumar R, Khursheed R, Kumar R, Awasthi A, Sharma N, Khurana S, Kapoor B, Khurana N, Singh SK, Gowthamarajan K, Wadhwani A. Self-nanoemulsifying drug delivery system of fisetin: Formulation, optimization, characterization and cytotoxicity assessment. J Drug Deliv Sci Technol 2019. [DOI: 10.1016/j.jddst.2019.101252] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
|
21
|
Khurana S, Waidha K, Guleria R, Sharda S, Bose S. Regulation of circulating micro-RNAs and their targets in obstructive sleep apnea. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.534] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
22
|
Varshney A, Vanidassane I, Ramavth D, Malik P, Khurana S, Garg V, Vadlamani S, Kalra K, Gunasekar S, Kumar S, Sethi S, Yadav M, Pathy S, Jain D. Chemotherapy in advanced thymic malignancies. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz436.007] [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
|
23
|
Malik P, Yadav A, Jain D, Pathy S, Mohan A, Khurana S, Kumar S. P1.01-02 Pemetrexed-Carboplatin Versus Paclitaxel (Weekly)-Carboplatin as First Line Chemotherapy in Advanced Non-Squamous NSCLC. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
24
|
Singendonk M, Kritas S, Omari T, Feinle-Bisset C, Page AJ, Frisby CL, Kentish SJ, Ferris L, McCall L, Kow L, Chisholm J, Khurana S. Upper Gastrointestinal Function in Morbidly Obese Adolescents Before and 6 Months After Gastric Banding. Obes Surg 2019; 28:1277-1288. [PMID: 29103072 DOI: 10.1007/s11695-017-3000-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 12/14/2022]
Abstract
BACKGROUND The effects of laparoscopic adjustable gastric band (LAGB) placement on upper gastrointestinal tract function in obese adolescents are unknown. Therefore, our aim was to determine the short-term effects of LAGB on esophageal motility, gastroesophageal reflux, gastric emptying, appetite-regulatory hormones, and perceptions of post-prandial hunger and fullness. METHODS This study was part of a prospective cohort study (March 2009-December 2015) in one tertiary referral hospital. The study included obese adolescents (14-18 years) with a body mass index (BMI) > 40 (or ≥ 35 with comorbidities). Gastric emptying was assessed by 13C-octanoic acid breath test, pharyngeal, and esophageal motor function by high-resolution manometry with impedance (HRIM), and appetite and other perceptions using 100-mm visual analogue scales. Dysphagia symptoms were scored using a Dakkak questionnaire. Data were compared pre- and post-LAGB placement and at a 6-month follow-up. RESULTS Based upon analysis of 15 adolescents, at the 6-month follow-up, LAGB placement: (i) led to a significant reduction in weight and BMI; (ii) increased fullness and decreased hunger post-meal; (iii) increased symptoms of dysphagia after solid food; and, despite these effects, (iv) caused little or no changes to appetite hormones, while (v) effects on gastric emptying, esophageal motility, esophageal bolus transport, and esophageal emptying were not significant. CONCLUSION In adolescents, LAGB improved BMI and altered the sensitivity to nutrients without significant effects on upper gastrointestinal tract physiology at the 6-month follow-up.
Collapse
Affiliation(s)
- M Singendonk
- Department of Pediatric Gastroenterology and Nutrition, Emma Children's Hospital/AMC, Amsterdam, The Netherlands
| | - S Kritas
- Gastroenterology Unit, Women's & Children's Hospital, Adelaide, Australia
| | - T Omari
- Human Physiology, Medical Science and Technology, School of Medicine, Flinders University, Adelaide, South Australia, Australia.
| | - C Feinle-Bisset
- Centre for Nutrition and Gastrointestinal Diseases, Adelaide Medical School, University of Adelaide, Adelaide, Australia.,NHMRC Centre of Research Excellence in Translating Nutritional Science to Good Health, University of Adelaide, Adelaide, Australia
| | - A J Page
- South Australian Health and Medical Research Institute (SAHMRI), Adelaide, Australia
| | - C L Frisby
- Centre for Nutrition and Gastrointestinal Diseases, Adelaide Medical School, University of Adelaide, Adelaide, Australia.,South Australian Health and Medical Research Institute (SAHMRI), Adelaide, Australia
| | - S J Kentish
- Centre for Nutrition and Gastrointestinal Diseases, Adelaide Medical School, University of Adelaide, Adelaide, Australia.,South Australian Health and Medical Research Institute (SAHMRI), Adelaide, Australia
| | - L Ferris
- Gastroenterology Unit, Women's & Children's Hospital, Adelaide, Australia.,Human Physiology, Medical Science and Technology, School of Medicine, Flinders University, Adelaide, South Australia, Australia
| | - L McCall
- Gastroenterology Unit, Women's & Children's Hospital, Adelaide, Australia
| | - L Kow
- Department of Surgery, Flinders Medical Centre, Adelaide, Australia
| | - J Chisholm
- Department of Surgery, Flinders Medical Centre, Adelaide, Australia
| | - S Khurana
- Paediatric Surgery & Urology, Women's & Children's Hospital, Adelaide, Australia.,Department of Surgery, Flinders Medical Centre, Adelaide, Australia
| |
Collapse
|
25
|
Kancharla H, Malik P, Khurana S, Jain D, Kumar S, Pathy S. EP1.01-91 Outcomes with Systemic Chemotherapy with Weekly Regimen in Advanced NSCLC Patients with PS 2 and Above and Without Driver Mutation. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.2064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
26
|
Gundu N, Malik P, Khurana S, Pathy S, Yadav M, Jain D, Kancharla H. Non-small cell lung carcinoma (NSCLC) patients with baseline brain imaging: A prospective observational study. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz066.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
27
|
Kancharla H, Malik P, Khurana S, Gundu N, Yadav A, Jain D, Pathy S, Kumar S. P3.01-51 Outcomes with Systemic Chemotherapy in Advanced NSCLC Patients with Performance Status 2 and Above and without Driver Mutation. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
28
|
Khurana S, Shivakumar M, Sujith Kumar Reddy GV, Jayashree P, Ramesh Bhat Y, Lewis LES. Long-term neurodevelopment outcome of caffeine versus aminophylline therapy for apnea of prematurity. J Neonatal Perinatal Med 2018; 10:355-362. [PMID: 29286928 DOI: 10.3233/npm-16147] [Citation(s) in RCA: 4] [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] [Indexed: 01/27/2023]
Abstract
OBJECTIVE Methylxanthines are the most commonly prescribed drug in neonatal setups. However, Clinicians show indecision in choosing the right agent for Apnea of Prematurity in most of the developing countries. Present study aimed to compare rate of mortality and survival with normal neurodevelopment outcome at 18 to 24 months of corrected age, between Caffeine- and Aminophylline-treated infants for apnea of prematurity. METHODS 240 infants were randomly allocated to caffeine and aminophylline for apnea of prematurity during February 2012 to January 2015. Long-term neurodevelopmental assessment was done only from children who had attained corrected age of 18 to 24 months during April 2014 to February 2016. Cognitive, language and motor deficits were assessed by Bayley Scale of infant and toddler development (BSID - III). Postnatal characteristics such as hearing and visual impairments during NICU stay were noted and same were followed up. RESULTS Infants allocated to caffeine group showed 83% less risk of getting cognitive impairment (RR 0.16; CI 95% range 0.02 to 1.36), 50% less risk of developing motor deficits (RR 0.50; CI 95% range 0.12 to 1.95) and 24% less risk of developing language problems (RR 0.76; CI 95% range 0.36 to 1.58). However in all the neurodevelopment domains the difference between groups was not statistically significant. Risk of mortality in caffeine group was 9% less over aminophylline group which was statistically non-significant (RR - 0.92; CI 95% range - 0.45 to 1.84; p = 0.81). Physical growth parameters were found to be similar in both the groups. Risk of developing visual abnormality and hearing impairments was also statistically non-significant between the groups. CONCLUSION Caffeine and aminophylline showed similar effects in reducing the rate of mortality and improving the survival without neurodevelopment delays; though the clinical significance of caffeine over aminophylline cannot be undermined.
Collapse
Affiliation(s)
- S Khurana
- Department of Physiotherapy, School of Allied Health Sciences, Madhav Nagar, Manipal University, Manipal, Karnataka, India
| | - M Shivakumar
- Department of Pediatrics, Neonatology Unit, Kasturba Medical College, Madhav Nagar, Manipal University, Manipal, Karnataka, India
| | - G V Sujith Kumar Reddy
- Department of Pediatrics, Neonatology Unit, Kasturba Medical College, Madhav Nagar, Manipal University, Manipal, Karnataka, India
| | - P Jayashree
- Department of Physiotherapy, School of Allied Health Sciences, Madhav Nagar, Manipal University, Manipal, Karnataka, India
| | - Y Ramesh Bhat
- Department of Physiotherapy, School of Allied Health Sciences, Madhav Nagar, Manipal University, Manipal, Karnataka, India
| | - L E S Lewis
- Department of Pediatrics, Neonatology Unit, Kasturba Medical College, Madhav Nagar, Manipal University, Manipal, Karnataka, India
| |
Collapse
|
29
|
Madsen PL, Joerg L, Khurana S, Wong W, De Pasquale C, Selvanayagam J. P1791The decreasing limb of frank and starlings law of the heart is associated with an increase in left ventricular end-diastolic volume. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p1791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- P L Madsen
- Herlev Hospital - Copenhagen University Hospital, Dept. of Cardiology, Copenhagen, Denmark
| | - L Joerg
- Cantonal Hospital St. Gallen, Dept of Cardiology, St. Gallen, Switzerland
| | - S Khurana
- Flinders Medical Centre and Flinders University, Dept of Cardiology, Adelaide, Australia
| | - W Wong
- Flinders Medical Centre and Flinders University, Dept of Cardiology, Adelaide, Australia
| | - C De Pasquale
- Flinders Medical Centre and Flinders University, Dept of Cardiology, Adelaide, Australia
| | - J Selvanayagam
- Flinders Medical Centre and Flinders University, Dept of Cardiology, Adelaide, Australia
| |
Collapse
|
30
|
Khurana S, Singh R. Workflow scheduling and reliability improvement by hybrid intelligence optimization approach with task ranking. ICST Transactions on Scalable Information Systems 2018. [DOI: 10.4108/eai.13-7-2018.161408] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
|
31
|
Omari T, Connor F, McCall L, Ferris L, Ellison S, Hanson B, Abu-Assi R, Khurana S, Moore D. A study of dysphagia symptoms and esophageal body function in children undergoing anti-reflux surgery. United European Gastroenterol J 2018; 6:819-829. [PMID: 30023059 PMCID: PMC6047286 DOI: 10.1177/2050640618764936] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [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: 11/27/2017] [Accepted: 02/22/2018] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The role of high-resolution esophageal impedance manometry (HRIM) for establishing risk for dysphagia after anti-reflux surgery is unclear. We conducted a prospective study of children with primary gastroesophageal reflux (GER) disease, for whom symptoms of dysphagia were determined pre-operatively and then post-operatively and we examined for features that may predict post-operative dysphagia. METHODS Thirteen children (aged 6.8-15.5 years) undergoing work-up prior to 360o Nissen fundoplication were included in the study. A dysphagia score assessed symptoms at pre-operative study and post-operatively (mean 1.4 years). A HRIM procedure recorded 5-ml liquid, 5-ml viscous and 2-cm solid boluses. We assessed esophageal motility, esophago-gastric junction (EGJ) morphology, EGJ contractility and pressure-flow variables indicative of bolus distension pressures and bolus clearance pressures. A composite pressure-flow index score was also derived. RESULTS Pre-operative pressure-flow index was positively correlated with post-operative dysphagia score (viscous bolus r = 0.771, p < 0.005). Of three variables that comprise the pressure-flow index, the ramp pressure measured during bolus clearance was the main driver of the effect seen (viscous bolus r = 0.819, p < 0.005). CONCLUSIONS In order to mitigate symptoms in relation to anti-reflux surgery, dysphagia symptoms and esophageal function need to be pre-operatively assessed. In patients with normal motility, an elevated pressure-flow index may predict post-operative dysphagia.
Collapse
Affiliation(s)
- T Omari
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
- Centre for Neuroscience, Flinders University, Adelaide, Australia
| | - F Connor
- Department of Gastroenterology, Royal Children's Hospital, Brisbane, Australia
| | - L McCall
- Gastroenterology Unit, Women's & Children's Hospital, Adelaide, Australia
| | - L Ferris
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
- Centre for Neuroscience, Flinders University, Adelaide, Australia
| | - S Ellison
- Gastroenterology Unit, Women's & Children's Hospital, Adelaide, Australia
| | - B Hanson
- UCL Mechanical Engineering, University College London, London, UK
| | - R Abu-Assi
- Gastroenterology Unit, Women's & Children's Hospital, Adelaide, Australia
| | - S Khurana
- Paediatric Surgery & Urology, Women's & Children's Hospital, Adelaide, Australia
| | - D Moore
- Gastroenterology Unit, Women's & Children's Hospital, Adelaide, Australia
| |
Collapse
|
32
|
Boukhvalova MS, Mbaye A, Kovtun S, Yim KC, Konstantinova T, Getachew T, Khurana S, Falsey AR, Blanco JCG. Improving ability of RSV microneutralization assay to detect G-specific and cross-reactive neutralizing antibodies through immortalized cell line selection. Vaccine 2018; 36:4657-4662. [PMID: 29960801 DOI: 10.1016/j.vaccine.2018.06.045] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 06/08/2018] [Accepted: 06/16/2018] [Indexed: 11/29/2022]
Abstract
Respiratory syncytial virus (RSV) is a significant cause of bronchiolitis and pneumonia. Protection against RSV is associated with neutralizing antibodies against the fusion (F) and attachment (G) glycoproteins. Several RSV vaccine candidates are in development, but their immunogenicity is hard to compare due to the little-understood differences between multiple RSV neutralizing antibody assays used. Existing assays utilize primarily Vero or HEp-2 cells, but their ability to detect G-neutralizing antibodies or antibodies against specific RSV strains is unclear. In this work, we developed an RSV microneutralization assay (MNA) using unmodified RSV and immortalized cell line derived from human airway epithelial cells (A549). Performance of A549-, HEp-2- and Vero-based MNA was compared under the same assay conditions (fixed amount of virus and cells) with regards to detection of neutralizing antibodies against RSV A or B viruses, G-reactive neutralizing antibodies, and effect of complement. Our results indicate that A549 cells yield the highest MNA titers, particularly in the RSV A/A2 MNA, are least susceptible to complement-enhancing effect of neutralizing titer readout and are superior to Vero or HEp-2 MNA at recognizing G-reactive neutralizing antibodies when no complement is used. Vero cells, however, can be more consistent at recognizing neutralizing antibodies against multiple RSV strains. The choice of substrate cells thus affects the outcome of MNA, as some immortalized cells better support detection of broader range of neutralizing antibodies, while others facilitate detection of G-targeting neutralizing antibodies, a long-thought prerogative of primary airway epithelial cells.
Collapse
Affiliation(s)
- M S Boukhvalova
- Sigmovir Biosystems, Inc, 9610 Medical Center Drive, Suite 100, Rockville, MD 20850, USA.
| | - A Mbaye
- Sigmovir Biosystems, Inc, 9610 Medical Center Drive, Suite 100, Rockville, MD 20850, USA
| | - S Kovtun
- Sigmovir Biosystems, Inc, 9610 Medical Center Drive, Suite 100, Rockville, MD 20850, USA
| | - K C Yim
- Sigmovir Biosystems, Inc, 9610 Medical Center Drive, Suite 100, Rockville, MD 20850, USA
| | - T Konstantinova
- Sigmovir Biosystems, Inc, 9610 Medical Center Drive, Suite 100, Rockville, MD 20850, USA
| | - T Getachew
- Sigmovir Biosystems, Inc, 9610 Medical Center Drive, Suite 100, Rockville, MD 20850, USA
| | - S Khurana
- Division of Viral Products, Center for Biologics Evaluation and Research (CBER), Food and Drug Administration (FDA), 10903 New Hampshire Avenue, Silver Spring, MD 20993, USA
| | - A R Falsey
- University of Rochester Medical Center, Rochester General Hospital, 1425 Portland Avenue, Infectious Diseases Unit, Rochester, NY 14621, USA
| | - J C G Blanco
- Sigmovir Biosystems, Inc, 9610 Medical Center Drive, Suite 100, Rockville, MD 20850, USA
| |
Collapse
|
33
|
Abstract
The primary objective of this narrative review was to evaluate the current literature and to provide further insight into the role of concurrent training on various components of physical health or performance. Literature was obtained by electronic searches of databases using specific keywords. Combined effect of training sessions proved to be as beneficial as drug interactions. Results from cross-sectional, longitudinal, and intervention studies are reviewed and discussed with main focus on physical parameters, such as body composition, physiological parameters, molecular adaptation, athlete’s perspective, order of execution, interference phenomena and recovery. In conclusion, concurrent resistance and endurance training is an effective method for enhancing overall fitness as well as improving quality of life.
Collapse
Affiliation(s)
- P. Jha
- Human Performance Lab, Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia, New Delhi 110070, India
| | - S. Khurana
- Department of Rehabilitation, Indian Spinal Injuries Centre, Sector-C, Vasant Kunj, New Delhi 110070, India
| | - K. Ali
- Human Performance Lab, Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia, New Delhi 110070, India
| | - I. Ahmad
- Exercise Physiology Lab, Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia, New Delhi 110070, India
| | - S. Verma
- Exercise Physiology Lab, Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia, New Delhi 110070, India
| |
Collapse
|
34
|
Abstract
Management of cervical cancer has undergone refinement in the past two decades; concurrent chemo-radiation (CCRT) (with cisplatin alone or in combination) is currently the standard treatment approach for patients with locally advanced disease (FIGO stage IIB-IVA). About 30%-40% of such patients fail to achieve complete response; alternative approaches are needed to improve outcome for them. Treatment with bevacizumab (an inhibitor of vascular endothelial growth factor) along with chemotherapy is associated with improved survival in patients with recurrent or metastatic cervical cancer. Weekly paclitaxel and carboplatin for 4-6 weeks as dose dense chemotherapy prior to CCRT is currently under study in a phase III, multicentric trial. Role of adjuvant chemotherapy after CCRT in patients with positive lymph nodes, larger tumor volume and those with stage III-IVA disease needs further exploration. Novel agents targeting molecular pathways are currently being studied. Recent development of immune check point inhibitors is exciting, results of ongoing studies are awaited with interest.
Collapse
Affiliation(s)
- Lalit Kumar
- Department of Medical Oncology, Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India.
| | - P Harish
- Department of Medical Oncology, Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - Prabhat S Malik
- Department of Medical Oncology, Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - S Khurana
- Department of Medical Oncology, Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| |
Collapse
|
35
|
Mangla A, Kim GJ, Agarwal N, Khurana S, Catchatourian R, Jiang JJ. Localized insulin amyloidosis with use of concentrated insulin: a potential complication. Diabet Med 2016; 33:e32-e35. [PMID: 27087031 DOI: 10.1111/dme.13137] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/11/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND Insulin-derived amyloidosis is a rare form of amyloidosis composed of insulin fibrils. The pH and concentration of insulin are known to influence the conformational state of the insulin hormone, with an increasing concentration favouring a more complex conformation. Concentrated insulin delivers a large amount of insulin to a localized area, raising the possibility of inducing conformational changes, forming insulin fibrils and leading to localized insulin amyloidosis. CASE REPORT A middle-aged woman with long history of Type 2 diabetes mellitus, treated with concentrated human insulin (U-500 insulin) presented with nodular lesions at the site of her daily insulin injections. A punch biopsy of the nodules showed skin with dermal amyloidosis staining favourably with Congo Red stain. The amyloid tumours were resected and areas positive for Congo Red stain were sent for liquid chromatography tandem mass spectrometry, which showed a peptide profile consistent with amyloid insulin. CONCLUSION Concentrated insulin was first introduced in 1952, however, it is only over the last two decades that it has been used increasingly, in congruence with the increasing incidence of obesity and diabetes mellitus seen in the USA. Only a few cases of insulin amyloidosis at the site of injection have been described in literature. With the increase in the use of insulin, this complication seems to be occurring more frequently. This is the first case report of a person with diabetes mellitus who developed localized insulin amyloidosis with the use of concentrated insulin, and points towards a potential complication of developing insulin amyloidosis with the use of concentrated insulin.
Collapse
Affiliation(s)
- A Mangla
- Department of Internal Medicine, John H. Stroger Jr. Hospital of Cook County, Chicago, USA
| | - G J Kim
- Department of Pathology, John H. Stroger Jr. Hospital of Cook County, Chicago, USA
| | - N Agarwal
- Division of Hematology/Oncology, John H. Stroger Jr. Hospital of Cook County, Chicago, USA
| | - S Khurana
- Department of Internal Medicine, John H. Stroger Jr. Hospital of Cook County, Chicago, USA
| | - R Catchatourian
- Department of Internal Medicine, John H. Stroger Jr. Hospital of Cook County, Chicago, USA
- Division of Hematology/Oncology, John H. Stroger Jr. Hospital of Cook County, Chicago, USA
| | - J J Jiang
- Department of Pathology, John H. Stroger Jr. Hospital of Cook County, Chicago, USA
| |
Collapse
|
36
|
Hua L, Linke RJ, Boucaut HAP, Khurana S. Micturating cystourethrogram as a tool for investigating UTI in children - An institutional audit. J Pediatr Urol 2016; 12:292.e1-292.e5. [PMID: 27230383 DOI: 10.1016/j.jpurol.2016.03.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 06/23/2015] [Accepted: 03/04/2016] [Indexed: 11/19/2022]
Abstract
BACKGROUND Micturating cystourethrograms (MCUG) are the gold standard for evaluating vesicoureteric reflux (VUR). There is a growing consensus for increasing the threshold for performing MCUGs following urinary tract infections (UTI) in children. There are several varying guidelines. It is important to detect high-grade reflux in the setting of an UTI because of potential long-term complications. OBJECTIVE This audit aimed to retrospectively: (1) identify the conformance rate of local guidelines at the Women's and Children's Hospital (WCH); (2) assess predictors for an abnormal MCUG; and (3) compare local guidelines against the Royal Children's Hospital, Melbourne (RCH), National Institute for Healthcare and Excellence (NICE), and American Academy of Pediatrics (AAP) guidelines for selectively detecting high-grade reflux. METHOD The number of MCUGs performed from 2008 to 2012 at the WCH radiology department was collected. Patients undergoing MCUG during the 2012 calendar year were identified. Only children having an initial MCUG as part of an UTI investigation with prerequisite imaging as per guidelines were included. Each child's age, sex, referral source, reason, renal ultrasound (RUS) prior to the MCUG, MCUG result and VUR grade were recorded. The WCH guidelines were applied to determine conformance, to evaluate predictors for an abnormal MCUG, and compared against other retrospectively applied guidelines (RCH, NICE, AAP). RESULTS/DISCUSSION There was complete data for 168 children who underwent MCUG as part of an UTI investigation (median age 0.79 years, range 0.12-8.74, male:female 67:101). There were 67/168 abnormal MCUGs (62 children with VUR, five bladder diverticulum), and 97 refluxing renal units (43 high-grade VUR units). No posterior urethral valves (PUV) were identified as part of the UTI investigation. A total of 143/168 patients had prior RUS (normal:abnormal 67:76). The WCH guidelines had 82% conformance. There was no statistically significant association between an abnormal MCUG and age, sex, referral source, reason, or prior RUS result. The WCH guidelines may have missed five children with high-grade VUR (four children had surgery), compared with RCH, APP and NICE, with 8, 15, and 17 children, respectively, having high-grade VUR (two, five, and five children had surgery, respectively) show in the Summary Table. The retrospective study had limitations and possible selection bias (children with UTI without a MCUG). There were no standard treatment approaches for VUR; hence establishing a MCUG guideline is difficult. An alternative is the top-down approach. CONCLUSION Current institutional guidelines for considering MCUG following UTI in children vary considerably. The MCUG guidelines at any institution must take into account the local management guidelines for high-grade VUR.
Collapse
Affiliation(s)
- L Hua
- Department of Surgery, Central Adelaide Local Health Network, Adelaide, Australia.
| | - R J Linke
- Department of Medical Imaging, Women's and Children's Hospital, Adelaide, Australia
| | - H A P Boucaut
- Department of Paediatric Surgery and Urology, Women's and Children's Hospital, Adelaide, Australia
| | - S Khurana
- Department of Paediatric Surgery and Urology, Women's and Children's Hospital, Adelaide, Australia
| |
Collapse
|
37
|
Megha K, Khurana S, Sehgal R. Genotyping of acanthamoeba spp causing granulomatous amoebic encephalitis. Int J Infect Dis 2016. [DOI: 10.1016/j.ijid.2016.02.788] [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: 11/29/2022] Open
|
38
|
Khurana S, Biswal M, Kaur H, Malhotra P, Arora P, Megha K, Taneja N, Sehgal R. Free living amoebae in water sources of critical units in a tertiary care hospital in India. Indian J Med Microbiol 2016; 33:343-8. [PMID: 26068332 DOI: 10.4103/0255-0857.158543] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Isolation of free-living amoebae (FLA) is reported sparsely from water taps, ventilators, air conditioners, haemodialysis units and dental irrigation systems of hospitals worldwide. Their prevalence in hospital environment especially in wards having immunocompromised patients may pose a risk to this group of susceptible population as they may cause disease themselves or may carry pathogens inside them. No study from India has performed such surveillance. OBJECTIVE To evaluate extent of FLA contamination in water sources of bone marrow transplant (BMT) intensive care unit (ICU), transplant ICU, haemodialysis unit and high dependency unit in a tertiary care hospital in India. MATERIALS AND METHODS A total of hundred samples including fifty each of tap water samples and swabs from mouth of taps used for drinking, bathing and hand washing purposes in these units were collected according to standard procedure. Samples were inoculated onto non-nutrient agar plates at room temperature followed by morphological confirmation. Molecular identification including polymerase chain reaction (PCR) and sequencing was performed in culture positive samples. RESULTS Four tap water samples and ten swab samples showed growth of trophozoites and cyst formation. Morphologically, four amoebae resembled Acanthamoeba spp. which was further confirmed by PCR and sequencing showed them to be of T3 and T4 genotypes. CONCLUSION The presence of these FLA in hospital water sources emphasises the urgent need of implementing effective preventive measures. Further studies are required to estimate the true prevalence of FLA in Indian hospitals by taking larger number of samples.
Collapse
Affiliation(s)
- S Khurana
- Department of Medical Parasitology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | | | | | | | | | | | | | | |
Collapse
|
39
|
Kim K, Kim D, Juh H, Khurana S, Rhyu K. Robot‐assisted total knee arthroplasty in haemophilic arthropathy. Haemophilia 2016; 22:446-52. [DOI: 10.1111/hae.12875] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/16/2015] [Indexed: 11/28/2022]
Affiliation(s)
- K.‐I. Kim
- Department of Orthopaedic Surgery Center for Joint Diseases and Rheumatism Kyung Hee University Hospital at Gangdong Seoul Korea
| | - D.‐K. Kim
- Department of Orthopaedic Surgery Center for Joint Diseases and Rheumatism Kyung Hee University Hospital at Gangdong Seoul Korea
| | - H.‐S. Juh
- Department of Orthopaedic Surgery Center for Joint Diseases and Rheumatism Kyung Hee University Hospital at Gangdong Seoul Korea
| | - S. Khurana
- Department of Orthopaedic Surgery Center for Joint Diseases and Rheumatism Kyung Hee University Hospital at Gangdong Seoul Korea
| | - K.‐H. Rhyu
- Department of Orthopaedic Surgery Center for Joint Diseases and Rheumatism Kyung Hee University Hospital at Gangdong Seoul Korea
| |
Collapse
|
40
|
Mehdi S, Jeyarajah C, Storrar J, Craig C, Orekoya O, Obot I, Shah D, Halkyard E, Webster I, Sheikh H, Bayman N, Blackhall F, Khurana S, Sundar R, Taggart S. 158 Management of small cell lung cancer in Manchester's Northwest Sector. Lung Cancer 2016. [DOI: 10.1016/s0169-5002(16)30175-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
41
|
Abstract
PURPOSE The diagnosis of toxoplasmosis is challenging since conventional methods like culture and immunofluorescence are not universally available. Serology, which is used regularly might be negative during early phase of infection and in immunosuppressed patients or may remain positive for a long time. Several molecular tests have been used for the diagnosis of toxoplasmosis, but none of them have an internal control which would inform us regarding the presence of polymerase chain reaction (PCR) inhibitors thus, undermining the confidence of a laboratory physician. MATERIALS AND METHODS We designed a multiplex PCR containing primers targeting human beta globin gene which would act as internal control and two primers against the B1 gene and 5s gene which aid in sensitive detection of T. gondii. RESULTS Multiplex PCR had a sensitivity of 83.3% and specificity of 100%. CONCLUSION Multiplex PCR may provide a sensitive and specific tool for diagnosis of human toxoplasmosis.
Collapse
Affiliation(s)
| | | | - S Khurana
- Department of Medical Parasitology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| |
Collapse
|
42
|
Abstract
We report two cases of fatal chronic meningoencephalitis caused by Balamuthia mandrillaris in immunocompetent men. Diagnosis of amoebic meningoencephalitis was made ante-mortem in one case and postmortem in another by histopathological examination and confirmed by demonstration of B. mandrillaris deoxyribonucleic acid (DNA) by polymerase chain reaction (PCR).
Collapse
Affiliation(s)
| | | | | | | | - B D Radotra
- Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| |
Collapse
|
43
|
Nguyen P, Khurana S, Peltsch H, Grandbois J, Eibl J, Crispo J, Ansell D, Tai TC. Prenatal glucocorticoid exposure programs adrenal PNMT expression and adult hypertension. J Endocrinol 2015; 227:117-27. [PMID: 26475702 DOI: 10.1530/joe-15-0244] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Prenatal exposure to glucocorticoids (GCs) programs for hypertension later in life. The aim of the current study was to examine the impact of prenatal GC exposure on the postnatal regulation of the gene encoding for phenylethanolamine N-methyltransferase (PNMT), the enzyme involved in the biosynthesis of the catecholamine, epinephrine. PNMT has been linked to hypertension and is elevated in animal models of hypertension. Male offspring of Wistar-Kyoto dams treated with dexamethasone (DEX) developed elevated systolic, diastolic and mean arterial blood pressure compared to saline-treated controls. Plasma epinephrine levels were also elevated in adult rats exposed to DEX in utero. RT-PCR analysis revealed adrenal PNMT mRNA was higher in DEX exposed adult rats. This was associated with increased mRNA levels of transcriptional regulators of the PNMT gene: Egr-1, AP-2, and GR. Western blot analyses showed increased expression of PNMT protein, along with increased Egr-1 and GR in adult rats exposed to DEX in utero. Furthermore, gel mobility shift assays showed increased binding of Egr-1 and GR to DNA. These results suggest that increased PNMT gene expression via altered transcriptional activity is a possible mechanism by which prenatal exposure to elevated levels of GCs may program for hypertension later in life.
Collapse
Affiliation(s)
- P Nguyen
- Medical Sciences DivisionNorthern Ontario School of Medicine, Sudbury, Ontario, CanadaDepartments of BiologyChemistry and BiochemistryBiomolecular Sciences ProgramLaurentian University, Sudbury, Ontario, Canada Medical Sciences DivisionNorthern Ontario School of Medicine, Sudbury, Ontario, CanadaDepartments of BiologyChemistry and BiochemistryBiomolecular Sciences ProgramLaurentian University, Sudbury, Ontario, Canada
| | - S Khurana
- Medical Sciences DivisionNorthern Ontario School of Medicine, Sudbury, Ontario, CanadaDepartments of BiologyChemistry and BiochemistryBiomolecular Sciences ProgramLaurentian University, Sudbury, Ontario, Canada
| | - H Peltsch
- Medical Sciences DivisionNorthern Ontario School of Medicine, Sudbury, Ontario, CanadaDepartments of BiologyChemistry and BiochemistryBiomolecular Sciences ProgramLaurentian University, Sudbury, Ontario, Canada Medical Sciences DivisionNorthern Ontario School of Medicine, Sudbury, Ontario, CanadaDepartments of BiologyChemistry and BiochemistryBiomolecular Sciences ProgramLaurentian University, Sudbury, Ontario, Canada
| | - J Grandbois
- Medical Sciences DivisionNorthern Ontario School of Medicine, Sudbury, Ontario, CanadaDepartments of BiologyChemistry and BiochemistryBiomolecular Sciences ProgramLaurentian University, Sudbury, Ontario, Canada Medical Sciences DivisionNorthern Ontario School of Medicine, Sudbury, Ontario, CanadaDepartments of BiologyChemistry and BiochemistryBiomolecular Sciences ProgramLaurentian University, Sudbury, Ontario, Canada
| | - J Eibl
- Medical Sciences DivisionNorthern Ontario School of Medicine, Sudbury, Ontario, CanadaDepartments of BiologyChemistry and BiochemistryBiomolecular Sciences ProgramLaurentian University, Sudbury, Ontario, Canada Medical Sciences DivisionNorthern Ontario School of Medicine, Sudbury, Ontario, CanadaDepartments of BiologyChemistry and BiochemistryBiomolecular Sciences ProgramLaurentian University, Sudbury, Ontario, Canada
| | - J Crispo
- Medical Sciences DivisionNorthern Ontario School of Medicine, Sudbury, Ontario, CanadaDepartments of BiologyChemistry and BiochemistryBiomolecular Sciences ProgramLaurentian University, Sudbury, Ontario, Canada Medical Sciences DivisionNorthern Ontario School of Medicine, Sudbury, Ontario, CanadaDepartments of BiologyChemistry and BiochemistryBiomolecular Sciences ProgramLaurentian University, Sudbury, Ontario, Canada
| | - D Ansell
- Medical Sciences DivisionNorthern Ontario School of Medicine, Sudbury, Ontario, CanadaDepartments of BiologyChemistry and BiochemistryBiomolecular Sciences ProgramLaurentian University, Sudbury, Ontario, Canada Medical Sciences DivisionNorthern Ontario School of Medicine, Sudbury, Ontario, CanadaDepartments of BiologyChemistry and BiochemistryBiomolecular Sciences ProgramLaurentian University, Sudbury, Ontario, Canada
| | - T C Tai
- Medical Sciences DivisionNorthern Ontario School of Medicine, Sudbury, Ontario, CanadaDepartments of BiologyChemistry and BiochemistryBiomolecular Sciences ProgramLaurentian University, Sudbury, Ontario, Canada Medical Sciences DivisionNorthern Ontario School of Medicine, Sudbury, Ontario, CanadaDepartments of BiologyChemistry and BiochemistryBiomolecular Sciences ProgramLaurentian University, Sudbury, Ontario, Canada Medical Sciences DivisionNorthern Ontario School of Medicine, Sudbury, Ontario, CanadaDepartments of BiologyChemistry and BiochemistryBiomolecular Sciences ProgramLaurentian University, Sudbury, Ontario, Canada Medical Sciences DivisionNorthern Ontario School of Medicine, Sudbury, Ontario, CanadaDepartments of BiologyChemistry and BiochemistryBiomolecular Sciences ProgramLaurentian University, Sudbury, Ontario, Canada
| |
Collapse
|
44
|
Sharma M, Beke N, Khurana S, Bhatti HS, Sehgal R, Malla N. An ocular cysticercosis case: Caused by Asian genotype of Taenia solium. Indian J Med Microbiol 2015; 33:583-5. [DOI: 10.4103/0255-0857.167319] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
45
|
Khurana S, Ravi A, Sutula J, Milone R, Williamson R, Plumb J, Vestbo J, Singh D. Clinical characteristics and airway inflammation profile of COPD persistent sputum producers. Respir Med 2015; 108:1761-70. [PMID: 25459449 DOI: 10.1016/j.rmed.2014.09.020] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2014] [Revised: 09/27/2014] [Accepted: 09/30/2014] [Indexed: 01/08/2023]
Abstract
BACKGROUND COPD patients with chronic bronchitis include a subgroup with persistent sputum production on most or every day. We hypothesized that COPD patients with persistent sputum production have a different profile of airway inflammation, and more severe clinical characteristics. OBJECTIVE To compare the airway inflammation profile and clinical characteristics of COPD persistent and non-persistent sputum producers. METHODS COPD persistent sputum producers (n = 26) and non-persistent sputum producers (n = 26) underwent sputum induction and pulmonary function tests. Exacerbation history was recorded; the St. George's Respiratory Questionnaire, Modified Medical Research Council Dyspnoea scale and COPD Assessment Tool were completed. 33 COPD patients provided sputum for bacteriology. RESULTS Persistent sputum producers had lower post-bronchodilator FEV1% predicted (p = 0.01), diffusion capacity (p = 0.04), 6 min walk test distance (p = 0.05), and higher closing volume (p = 0.01), BODE index (p = 0.01), rate of bacterial colonization (p = 0.004) and exacerbations (p = 0.03) compared to non-persistent sputum producers. The mean SGRQ and CAT scores were higher in persistent sputum producers (p = 0.01 and 0.03 respectively). Sputum neutrophil and eosinophil total cell counts were higher in persistent sputum producers (p = 0.02 and 0.05 respectively). Sputum levels of eotaxin (p = 0.02), MCP-1 (p = 0.02), TNF-α (p = 0.03) and IL-6 (p = 0.05) were higher in persistent sputum producers. CONCLUSION COPD persistent sputum producers have more severe clinical characteristics and increased concentrations of some inflammatory mediators in the airways.
Collapse
|
46
|
Khurana S, Rao B, Lewis L, Kumaran D, Kamath A. Effect of structured neonatal physiotherapy intervention on neurobehavior of moderate to late preterm infants—a randomized controlled trial. Physiotherapy 2015. [DOI: 10.1016/j.physio.2015.03.3610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
47
|
Ravi A, Khurana S, Banyard A, Plumb J, Booth G, Catley M, Healy L, Smith E, Vestbo J, Singh D. S47 Enhanced Il-6/ccl3 Signalling In The Plasma Of Patients With Copd. Thorax 2014. [DOI: 10.1136/thoraxjnl-2014-206260.53] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
48
|
Wissmann F, Burda O, Khurana S, Klages T, Langner F. Dosimetry of secondary cosmic radiation up to an altitude of 30 km. Radiat Prot Dosimetry 2014; 161:299-302. [PMID: 24345463 DOI: 10.1093/rpd/nct329] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Dosimetric measurements in the field of secondary cosmic radiation were extensively made during the last years. Since the majority of these measurements were performed on-board passenger aircraft at altitudes between 10 and 12 km, measurements at higher altitudes are desirable for the verification of the legal dose assessment procedures for aircrew. A simple solution is to use a high-altitude balloon that reaches altitudes as high as 30 km. In this work, it is shown that the dose rate profile up to 30 km can be measured with acceptable uncertainties using a Si-detector.
Collapse
Affiliation(s)
- F Wissmann
- Physikalisch-Technische Bundesanstalt (PTB), Bundesallee 100, D-38116 Braunschweig, Germany
| | - O Burda
- Physikalisch-Technische Bundesanstalt (PTB), Bundesallee 100, D-38116 Braunschweig, Germany
| | - S Khurana
- Physikalisch-Technische Bundesanstalt (PTB), Bundesallee 100, D-38116 Braunschweig, Germany
| | - T Klages
- Physikalisch-Technische Bundesanstalt (PTB), Bundesallee 100, D-38116 Braunschweig, Germany
| | - F Langner
- Physikalisch-Technische Bundesanstalt (PTB), Bundesallee 100, D-38116 Braunschweig, Germany
| |
Collapse
|
49
|
Khurana S, Jain NK, Bedi PMS. Nanostructured lipid carriers based nanogel for meloxicam delivery: mechanistic,in-vivoand stability evaluation. Drug Dev Ind Pharm 2014; 41:1368-75. [DOI: 10.3109/03639045.2014.950586] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
|
50
|
Paliwal N, Jain P, Dubey N, Sharma S, Khurana S, Kumar Paliwal S. A liquid chromatography tandem mass spectrometry based regulatory compliant method for the determination of tenofovir in human serum. Drug Res (Stuttg) 2013; 64:306-12. [PMID: 24310362 DOI: 10.1055/s-0033-1361090] [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: 10/25/2022]
Abstract
A simple, rapid, and specific assay based on solid phase extraction and liquid chromatography-electrospray ionization tandem mass spectrometry (LC-ESI MS-MS) for the quantitative analysis of Tenofovir in human serum using Tenofovir D6 as internal standard (IS) have been developed. The precursor to product ion transitions of m/z 288.2/176.2 and m/z 293.9/182.3 used to measure the analyte and internal standard (Tenofovir and Tenofovir D6). The method was validated over a concentration range of 5.06-603.72 ng mL(-1). The method was validated over the parameters like selectivity, matrix effect, sensitivity, linearity, precision, accuracy, various stabilities (bench top stability, standard stock solution stability in refrigerator and at room temperature, stock dilution stability, auto sampler stability, freeze thaw stability, long term stability - 65°C±10°C & long term stability - 22°C±5°C, reagent stability, dry extract stability, wet extract stability in refrigerator and at bench top, blood stability), effect of potentially interfering drugs, dilution integrity, recovery and reinjection reproducibility. The mean % recovery of Tenofovir was 98.22% with a precision of 2.42%, The mean % recovery of Tenofovir D6 was 100.96% with a precision of 2.88%. The RSD % of intra-day and inter-day assay was≤15%.
Collapse
Affiliation(s)
| | - P Jain
- Jubilant Clinsys Ltd, Noida, India
| | - N Dubey
- Jubilant Clinsys Ltd, Noida, India
| | - S Sharma
- Jubilant Clinsys Ltd, Noida, India
| | | | | |
Collapse
|