1
|
Sangwan S, Bhattacharyya R, Banerjee D. Plastic compounds and liver diseases: Whether bisphenol A is the only culprit. Liver Int 2024; 44:1093-1105. [PMID: 38407523 DOI: 10.1111/liv.15879] [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: 10/13/2023] [Revised: 02/08/2024] [Accepted: 02/12/2024] [Indexed: 02/27/2024]
Abstract
Plastics, while providing modern conveniences, have become an inescapable source of global concern due to their role in environmental pollution. Particularly, the focus on bisphenol A (BPA) reveals its biohazardous nature and association with liver issues, specifically steatosis. However, research indicates that BPA is just one facet of the problem, as other bisphenol analogues, microplastics, nanoplastics and additional plastic derivatives also pose potential risks. Notably, BPA is implicated in every stage of non-alcoholic fatty liver disease (NAFLD) onset and progression, surpassing hepatitis B virus as a primary cause of chronic liver disease worldwide. As plastic contamination tops the environmental contaminants list, urgent action is needed to assess causative factors and mitigate their impact. This review delves into the molecular disruptions linking plastic pollutant exposure to liver diseases, emphasizing the broader connection between plastics and the rising prevalence of NAFLD.
Collapse
Affiliation(s)
- Sonal Sangwan
- Department of Experimental Medicine and Biotechnology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Rajasri Bhattacharyya
- Department of Experimental Medicine and Biotechnology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Dibyajyoti Banerjee
- Department of Experimental Medicine and Biotechnology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| |
Collapse
|
2
|
Harish MN, Choudhary AK, Kumar S, Dass A, Singh VK, Sharma VK, Varatharajan T, Dhillon MK, Sangwan S, Dua VK, Nitesh SD, Bhavya M, Sangwan S, Prasad S, Kumar A, Rajpoot SK, Gupta G, Verma P, Kumar A, George S. Double zero tillage and foliar phosphorus fertilization coupled with microbial inoculants enhance maize productivity and quality in a maize-wheat rotation. Sci Rep 2022; 12:3161. [PMID: 35210519 PMCID: PMC8873388 DOI: 10.1038/s41598-022-07148-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [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: 08/06/2021] [Accepted: 02/04/2022] [Indexed: 11/11/2022] Open
Abstract
Maize is an important industrial crop where yield and quality enhancement both assume greater importance. Clean production technologies like conservation agriculture and integrated nutrient management hold the key to enhance productivity and quality besides improving soil health and environment. Hence, maize productivity and quality were assessed under a maize–wheat cropping system (MWCS) using four crop-establishment and tillage management practices [FBCT–FBCT (Flat bed–conventional tillage both in maize and wheat); RBCT–RBZT (Raised bed–CT in maize and raised bed–zero tillage in wheat); FBZT–FBZT (FBZT both in maize and wheat); PRBZT–PRBZT (Permanent raised bed–ZT both in maize and wheat], and five P-fertilization practices [P100 (100% soil applied-P); P50 + 2FSP (50% soil applied-P + 2 foliar-sprays of P through 2% DAP both in maize and wheat); P50 + PSB + AM-fungi; P50 + PSB + AMF + 2FSP; and P0 (100% NK with no-P)] in split-plot design replicated-thrice. Double zero-tilled PRBZT–PRBZT system significantly enhanced the maize grain, starch, protein and oil yield by 13.1–19% over conventional FBCT–FBCT. P50 + PSB + AMF + 2FSP, integrating soil applied-P, microbial-inoculants and foliar-P, had significantly higher grain, starch, protein and oil yield by 12.5–17.2% over P100 besides saving 34.7% fertilizer-P both in maize and on cropping-system basis. P50 + PSB + AMF + 2FSP again had significantly higher starch, lysine and tryptophan content by 4.6–10.4% over P100 due to sustained and synchronized P-bioavailability. Higher amylose content (24.1%) was observed in grains under P50 + PSB + AMF + 2FSP, a beneficial trait due to its lower glycemic-index highly required for diabetic patients, where current COVID-19 pandemic further necessitated the use of such dietary ingredients. Double zero-tilled PRBZT–PRBZT reported greater MUFA (oleic acid, 37.1%), MUFA: PUFA ratio and P/S index with 6.9% higher P/S index in corn-oil (an oil quality parameter highly required for heart-health) over RBCT-RBCT. MUFA, MUFA: PUFA ratio and P/S index were also higher under P50 + PSB + AMF + 2FSP; avowing the obvious role of foliar-P and microbial-inoculants in influencing maize fatty acid composition. Overall, double zero-tilled PRBZT–PRBZT with crop residue retention at 6 t/ha per year along with P50 + PSB + AMF + 2FSP while saving 34.7% fertilizer-P in MWCS, may prove beneficial in enhancing maize productivity and quality so as to reinforce the food and nutritional security besides boosting food, corn-oil and starch industry in south-Asia and collateral arid agro-ecologies across the globe.
Collapse
Affiliation(s)
- M N Harish
- ICAR-Indian Agricultural Research Institute, New Delhi, 110 012, India
| | - Anil K Choudhary
- ICAR-Indian Agricultural Research Institute, New Delhi, 110 012, India. .,ICAR-Central Potato Research Institute, Shimla, Himachal Pradesh, 171 001, India.
| | - Sandeep Kumar
- ICAR-National Bureau of Plant Genetic Resources, New Delhi, 110012, India
| | - Anchal Dass
- ICAR-Indian Agricultural Research Institute, New Delhi, 110 012, India
| | - V K Singh
- ICAR-Indian Agricultural Research Institute, New Delhi, 110 012, India.,ICAR-Central Research Institute for Dryland Agriculture, Hyderabad, 500 059, India
| | - V K Sharma
- ICAR-Indian Agricultural Research Institute, New Delhi, 110 012, India
| | - T Varatharajan
- ICAR-Indian Agricultural Research Institute, New Delhi, 110 012, India
| | - M K Dhillon
- ICAR-Indian Agricultural Research Institute, New Delhi, 110 012, India
| | - Seema Sangwan
- CCS Haryana Agricultural University, Hisar, Haryana, 125 004, India
| | - V K Dua
- ICAR-Central Potato Research Institute, Shimla, Himachal Pradesh, 171 001, India
| | - S D Nitesh
- CSA University of Agriculture & Technology, Kanpur, Uttar Pradesh, 208 002, India
| | - M Bhavya
- University of Agricultural & Horticultural Sciences, Shivamogga, Karnataka, 577 204, India
| | - S Sangwan
- ICAR-Indian Agricultural Research Institute, New Delhi, 110 012, India
| | - Shiv Prasad
- ICAR-Indian Agricultural Research Institute, New Delhi, 110 012, India
| | - Adarsh Kumar
- ICAR-Indian Agricultural Research Institute, New Delhi, 110 012, India.,ICAR-National Bureau of Agriculturally Important Microorganisms, Kushmaur, Mau, Uttar Pradesh, 275 103, India
| | - S K Rajpoot
- ICAR-Indian Agricultural Research Institute, New Delhi, 110 012, India.,Institute of Agricultural Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, 221 005, India
| | - Gaurendra Gupta
- ICAR-Indian Agricultural Research Institute, New Delhi, 110 012, India.,ICAR-Indian Grassland and Fodder Research Institute, Jhansi, Uttar Pradesh, 284 003, India
| | - Prakash Verma
- ICAR-Indian Agricultural Research Institute, New Delhi, 110 012, India.,ICAR-National Dairy Research Institute, Karnal, Haryana, 132 001, India
| | - Anil Kumar
- Farm Science Centre, GAD Veterinary and Animal Sciences University, Tarn Taran, Punjab, 143 412, India
| | - S George
- Farm Science Centre, ICAR-Indian Institute of Horticultural Research, Gonikoppal, Karnataka, 571213, India
| |
Collapse
|
3
|
Ghosh S, Kapoor D, Vijayvergiya R, Sangwan S, Wangkheimayum S, Mehta S, Dhawan V. Correlation between soluble receptor for advanced glycation end products levels and coronary artery disease in postmenopausal nondiabetic women. World J Cardiol 2021; 13:130-143. [PMID: 34131476 PMCID: PMC8173337 DOI: 10.4330/wjc.v13.i5.130] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 03/04/2021] [Accepted: 04/28/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The established cardiovascular risk factors cannot explain the overall risk of coronary artery disease (CAD), especially in women. Therefore, there is a growing need for the assessment of novel biomarkers to identify women at risk. The receptor for advanced glycation end products (RAGE) and its interaction with the advanced glycation end product (AGE) ligand have been associated with atherogenesis. The soluble fraction of RAGE (sRAGE) antagonizes RAGE signaling and exerts an antiatherogenic effect.
AIM The study aim was to explore the association between plasma levels of sRAGE and CAD in nondiabetic postmenopausal women.
METHODS This case-control study included 110 nondiabetic postmenopausal women who were enrolled in two groups. Group I included 55 angiographically proven CAD subjects with > 50% stenosis in at least one of the major coronary arteries and Group II included 55 healthy control women who did not have CAD or had < 50% stenosis of the coronary arteries. Stenosis was confirmed by invasive angiography. Plasma sRAGE was determined by an enzyme-linked immunosorbent assay.
RESULTS We observed significantly lower plasma sRAGE concentrations in subjects with CAD vs healthy controls (P < 0.05). Univariate and multivariate logistic regression analysis also revealed a significant correlation between plasma sRAGE levels and CAD (P = 0.01). Multivariate odds ratios for CAD revealed that subjects with sRAGE concentrations below 225 pg/mL (lowest quartile) had a 6-fold increase in CAD prevalence independent of other risk factors.
CONCLUSION Our findings indicated that low sRAGE levels were independently associated with CAD in nondiabetic postmenopausal women. Risk assessment of CAD in postmenopausal women can be improved by including sRAGE along with other risk factors.
Collapse
Affiliation(s)
- Soumitra Ghosh
- Department ofCardiology, PGIMER, Chandigarh 160012, India
| | - Divya Kapoor
- Department of Experimental Medicine and Biotechnology, PGIMER, Chandigarh 160012, India
| | | | - Sonal Sangwan
- Department of Experimental Medicine and Biotechnology, PGIMER, Chandigarh 160012, India
| | | | - Sakshi Mehta
- Department of Experimental Medicine and Biotechnology, PGIMER, Chandigarh 160012, India
| | - Veena Dhawan
- Department of Experimental Medicine and Biotechnology, PGIMER, Chandigarh 160012, India
| |
Collapse
|
4
|
Abstract
Background: Hydatid disease (HD) is an ancient disease and even was known to Hippocrates. This disease involves all human parts and most common affected organs are liver and lungs. Incidence of unusual site is about 8-10%. The clinical picture depends upon the involved organs, its effects on adjacent structures, complications due to secondary infection, rupture, and anaphylaxis caused by hydatid cysts. Aim: The aim of this study was to find out incidence of unusual location of hydatid cyst in the human body. Materials and Methods: A retrospective study of HD was carried in a medical college between July 2007 and June 2012. A total 79 cases of HD were treated during this period. Information on clinical presentation and management were reviewed, and results presented as summary statistics. Results: Sixty one cases were of liver HD, and 11 were with hydatid lung disease. Fifty cases were with right lobe involvement, and rest 11 were with both lobe involvement. Out of 11 lung hydatid only one case was with bilateral lung involvement. Only eight cases of HD of uncommon locations and presentations were encountered during this period. First case presented with left hypochondriac mass as splenic HD, second with pelvic HD along with obstructive uropathy, third with non-functioning right kidney with bilateral psoas muscles HD, fourth with HD involving mesentery, fifth with pelvic pain due to right ovary HD, sixth with simultaneous involvement of the liver and right subdiaphragmatic region, seventh with HD of right inguinal region, and eighth with hydatid cyst of the left kidney. Even though, there was no mortality found in these patients, there was high morbidity. Conclusion: We conclude that Echinococcus granulosus can affect any organ in the body from head to toe, and a high suspicion of this disease is justified in endemic regions. Moreover, medical treatment should be given in the pre-operative period as well as in the post-operative period for 4-6 weeks.
Collapse
Affiliation(s)
- S Sachar
- Department of Radio-Diagnosis and Imaging, Muzaffarnagar Medical College, Begrajpur, Muzaffarnagar, Uttar Pradesh, India
| | - S Goyal
- Department of Surgery, Muzaffarnagar Medical College, Begrajpur, Muzaffarnagar, Uttar Pradesh, India
| | - S Goyal
- Department of Pathology, Dr. Ram Manohar Lohia Postgraduate Institute of Medical Sciences, New Delhi, India
| | - S Sangwan
- Department of Surgery, MM Institute of Medical Sciences and Research, Mulana, Haryana, India
| |
Collapse
|
5
|
Sangwan S, Chawla HS, Goyal A, Gauba K, Mohanty U. Progressive changes in arch width from primary to early mixed dentition period: a longitudinal study. J Indian Soc Pedod Prev Dent 2011; 29:14-9. [PMID: 21521912 DOI: 10.4103/0970-4388.79915] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE The present study was conducted to evaluate, on a longitudinal basis, the changes in intercanine and intermolar widths form the primary to the early mixed dentition periods. MATERIALS AND METHODS A total of 38 children aged 4-5 years, with normal occlusion without any proximal caries or any dental anomalies, were selected. The impressions were recorded and casts were prepared. Intercanine and intermolar widths were measured on these dental casts with the help of a digital vernier calliper. After 3 years follow-up, the impressions were recorded again and dental casts were prepared. Intercanine and intermolar widths were measured again at this stage and were compared with the baseline data using the paired t-test and the chi square test. RESULTS There is a significant increase in the intercanine (3.93 + 1.70 mm) and intermolar width (1.49 + 1.77 mm) during the transition period from primary to early mixed dentition in both the arches and both the sexes. The gender-wise comparison showed a greater increase in males than in females, but this was not statistically significant. CONCLUSION A thorough knowledge of growth changes during various stages of the mixed dentition period are important for a pediatric dentist to make an accurate diagnosis and treatment planning during preventive and interceptive orthodontics.
Collapse
Affiliation(s)
- S Sangwan
- Department of Pedodontics, Government Dental College, Rohtak, India.
| | | | | | | | | |
Collapse
|
6
|
Sharma I, Dhaliwal LK, Saha SC, Sangwan S, Dhawan V. Role of 8-iso-prostaglandin F2alpha and 25-hydroxycholesterol in the pathophysiology of endometriosis. Fertil Steril 2009; 94:63-70. [PMID: 19324352 DOI: 10.1016/j.fertnstert.2009.01.141] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [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: 09/17/2008] [Revised: 01/09/2009] [Accepted: 01/26/2009] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To investigate the involvement of 8-iso-PGF(2alpha) and 25-hydroxycholesterol (25-OH-Chol) in the pathophysiology of endometriosis. DESIGN Observational case-control study using enzyme immunoassay and high-performance liquid chromatography (HPLC). SETTING Postgraduate Institute of Medical Education and Research. PATIENT(S) Forty-five women undergoing laparoscopy (n = 25), laparotomy (n = 19), or tubal ligation (n =1). INTERVENTION(S) Venipuncture and laparoscopic peritoneal fluid (PF) collection. MAIN OUTCOME MEASURE(S) The levels of 8-iso-PGF(2alpha) were determined both in urine and PF of all the patients using enzyme immunoassay. The levels of 25-OH-Chol were determined by using reversed phase HPLC both in the plasma and PF samples. Oxidative damage to DNA was assessed by agarose gel electrophoresis. RESULT(S) Significantly increased levels of 8-iso-PGF(2alpha) were observed both in urine and PF of women with endometriosis compared with control women. Similarly, higher levels of 25-OH-Chol were observed both in plasma and PF of patients compared with controls and the difference was statistically significant. A clear-cut tailing pattern was observed in DNA of patients with endometriosis, indicating significant DNA damage. CONCLUSION(S) Our observations implicate oxidative stress in the pathophysiology of endometriosis. For the first time, we demonstrate that 8-iso-PGF(2alpha) and oxysterols (the known promoters of steroidogenesis) might be the culprits in this disease.
Collapse
Affiliation(s)
- Indu Sharma
- Department of Experimental Medicine and Biotechnology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | | | | | | | | |
Collapse
|
7
|
Jagmohan P, Sangwan S, Sethi S, Solanki RS, Chauhan BKS. Radiological quiz - neuroradiology. Indian J Radiol Imaging 2006. [DOI: 10.4103/0971-3026.29071] [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: 11/04/2022] Open
Affiliation(s)
- P Jagmohan
- Department of Radio-Diagnosis, Lady Hardinge Medical college and Ass. Hospitals, New Delhi - 110 001, India
| | - S Sangwan
- Department of Radio-Diagnosis, Lady Hardinge Medical college and Ass. Hospitals, New Delhi - 110 001, India
| | - S Sethi
- Department of Radio-Diagnosis, Lady Hardinge Medical college and Ass. Hospitals, New Delhi - 110 001, India
| | - RS Solanki
- Department of Radio-Diagnosis, Lady Hardinge Medical college and Ass. Hospitals, New Delhi - 110 001, India
| | - BKS Chauhan
- Department of Radio-Diagnosis, Lady Hardinge Medical college and Ass. Hospitals, New Delhi - 110 001, India
| |
Collapse
|
8
|
Jagmohan P, Sangwan S, Solanki RS, Toppo S. Radiological quiz - obstetrics. Indian J Radiol Imaging 2006. [DOI: 10.4103/0971-3026.32387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
9
|
Rawat NS, Negi A, Sangwan S, Sharma U, Thukral BB, Saxena NC. Aggressive adenocarcinoma of gallbladder with distant metastases and venous thrombosis at initial presentation. Indian J Radiol Imaging 2006. [DOI: 10.4103/0971-3026.32255] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
10
|
Sangwan S, Shah A, Smaldone G. Minimizing facial and ocular deposition of nebulized budesonide: Importance of facemask design. J Allergy Clin Immunol 2005. [DOI: 10.1016/j.jaci.2004.12.022] [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]
|
11
|
Jagmohan P, Sangwan S, Sethi SK, Solanki RS. Radiological quiz - obstetrics. Indian J Radiol Imaging 2005. [DOI: 10.4103/0971-3026.29162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
12
|
Jagmohan P, Sangwan S, Sethi SK, Solanki RS. Sinonasal adenoid cystic carcinoma. Indian J Radiol Imaging 2005. [DOI: 10.4103/0971-3026.29166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
13
|
Jagmohan P, Sangwan S, Sethi SK, Solanki RS. Sinonasal adenoid cystic carcinoma. Indian J Radiol Imaging 2005. [DOI: 10.4103/0971-3026.29179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
14
|
Aggarwal K, Jain VK, Sangwan S. Comparative study of ketoconazole versus selenium sulphide shampoo in pityriasis versicolor. Indian J Dermatol Venereol Leprol 2003; 69:86-7. [PMID: 17642841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Forty patients suffering from pityriasis versicolor were treated with either 2% ketoconazole shampoo (20 patients) or 2.5% selenium sulphide shampoo (20 patients), once a week for three weeks. On global assessment after one month of start of therapy, 19 (95%) out of 20 patients treated with ketoconazole shampoo were cured while one case had mild residual disease. In selenium sulphide shampoo group, 17 (85%) out of 20 patients were cured, one had mild residual disease and two had considerable residual disease. No significant difference was observed in the response rates in the two groups. Relapse occurred in one patient of ketoconazole group and two patients of selenium sulphide group during the follow-up period of three months.
Collapse
Affiliation(s)
- K Aggarwal
- Dept. of Skin, VD & Leprosy, Pt. BDS Postgraduate Institute of Medical Sciences, Rohtak-124 001
| | | | | |
Collapse
|
15
|
Sangwan S, Agosti JM, Bauer LA, Otulana BA, Morishige RJ, Cipolla DC, Blanchard JD, Smaldone GC. Aerosolized protein delivery in asthma: gamma camera analysis of regional deposition and perfusion. J Aerosol Med 2002; 14:185-95. [PMID: 11681650 DOI: 10.1089/08942680152484117] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Bioavailability of an aerosolized anti-inflammatory protein, soluble interleukin-4 receptor (IL-4R), was measured in patients with asthma using two different aerosol delivery systems, a prototype aerosol delivery system (AERx tethered model, Aradigm, Hayward, CA) and PARI LC STAR nebulizer (Pari, Richmond, VA). Regional distribution of the drug in the respiratory tract obtained by planar imaging using gamma camera scintigraphy was utilized to explain the differences in bioavailability. The drug, an experimental protein being developed for asthma, was mixed with radiolabel 99mTechnetium diethylene triaminepentaacetic acid (99mTc-DTPA). Aerosols were characterized in vitro using cascade impaction (mass median aerodynamic diameter [MMAD] and geometric standard deviation [GSD]); the AERx MMAD 2.0 microm (GSD 1.35), the PARI 3.5 microm (GSD 2.5). Four patients with asthma requiring maintenance aerosolized steroids were studied. First, regional volume was determined utilizing equilibrium 133Xe scanning. Then, after a brief period of instruction, patients inhaled four breaths of protein using AERx (0.45 mg in total) followed 1 week later by inhalation via PARI (3.0 mg nebulized until dry). Each deposition image was followed by a measurement of regional perfusion using injected 99mTc albumin macroaggregates. Deposition of 99mTc-DTPA in the subjects was determined by mass balance. Regional analysis was performed using computerized regions of interest. The regional distribution of deposited drug was normalized for regional volume and perfusion. Following each single inhalation, serial blood samples were drawn over a 7-day period to determine area under the curve (AUC) of protein concentration in the blood. Median AUC(AERx)/AUC(PARI) was 7.66/1, based on the amount of drug placed in each device, indicating that AERx was 7.66 times more efficient than PARI. When normalized for total lung deposition (AUC per mg deposited) the ratio decreased to 2.44, indicating that efficiencies of the drug delivery system and deposition were major factors. When normalized for sC/P and (pU/L)xe ratios (central to peripheral and upper to lower ratios are parameters of regional distribution of deposited particles and regional per- fusion ['p']), AUC(AER)x/AUC(PARI) further decreased to 1.35, demonstrating that peripheral sites of deposition with the AERx affected the final blood concentration of the drug. We conclude that inhaled bioavailability of aerosolized protein, as expressed by AUC, is a quantifiable function of lung dose and regional deposition as defined by planar scintigraphy.
Collapse
Affiliation(s)
- S Sangwan
- Department of Medicine, State University of New York at Stony Brook, 11794-8172, USA
| | | | | | | | | | | | | | | |
Collapse
|
16
|
Ardehali A, Laks H, Levine M, Shpiner R, Ross D, Watson LD, Shvartz O, Sangwan S, Waters PF. A prospective trial of inhaled nitric oxide in clinical lung transplantation. Transplantation 2001; 72:112-5. [PMID: 11468544 DOI: 10.1097/00007890-200107150-00022] [Citation(s) in RCA: 80] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Reperfusion injury (RI) is a major cause of mortality and morbidity among lung transplant recipients. We sought to determine if prophylactic administration of inhaled nitric oxide (NO) to lung transplant recipients at reperfusion would prevent RI. We also hypothesized that if prophylactic NO proves ineffective in preventing RI then it may improve pulmonary hemodynamics and gas exchange in the subset of patients who develop RI. METHODS After informed consent, 28 consecutive, adult lung transplant recipients received NO at 20 ppm at reperfusion. NO was withdrawn for 15 min at 6 and 12 hr after reperfusion, and gas exchange and hemodynamics were measured. RESULTS Five of the 28 lung transplant recipients (18%) developed RI. Withdrawal of NO for 15 min in this subset of patients resulted in a significant rise in mean pulmonary artery pressure and a reduction in oxygenation index. All five patients with RI were kept on inhaled NO until full functional recovery of the allograft and were then weaned from mechanical ventilation. None required extracorporeal membrane oxygenation support; the early mortality in this group was 20% (1/5). The remaining 23 patients without RI had uneventful early postoperative course and were weaned from NO and mechanical ventilation within 36 hr of transplantation. CONCLUSIONS Prophylactic-inhaled NO does not prevent RI in human lung transplantation. However, inhaled NO, started at reperfusion, improves gas exchange and reduces pulmonary artery pressure in those patients who develop RI.
Collapse
Affiliation(s)
- A Ardehali
- Division of Cardiothoracic Surgery, Department of Surgery, UCLA Medical Center, 10833 Le Conte Avenue, Los Angeles, CA 90095, USA.
| | | | | | | | | | | | | | | | | |
Collapse
|
17
|
Sangwan S, Au C, Mahajan A. Pro: Pediatric anesthesiologists should be the primary echocardiographers for pediatric patients undergoing cardiac surgical procedures. J Cardiothorac Vasc Anesth 2001; 15:388-90. [PMID: 11426376 DOI: 10.1053/jcan.2001.23333] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [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: 11/11/2022]
Affiliation(s)
- S Sangwan
- Department of Anesthesiology, University of California Los Angeles, School of Medicine, Los Angeles, CA, USA
| | | | | |
Collapse
|
18
|
Shapiro NL, Huang RY, Sangwan S, Willner A, Laks H. Tracheal stenosis and congenital heart disease in patients with Down syndrome: diagnostic approach and surgical options. Int J Pediatr Otorhinolaryngol 2000; 54:137-42. [PMID: 10967384 DOI: 10.1016/s0165-5876(00)00361-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Upper airway obstruction is a prevalent feature in patients with Down syndrome. However, these patients may be completely asymptomatic in the early months of life. The recognition of a problem within the airway quite often occurs when these children present for cardiac surgery, diagnostic radiography with sedation, or during the induction and intubation for anesthesia. Tracheal stenosis is rare in the general population, but is seen somewhat more frequently in patients with Down syndrome. The incidence of tracheal stenosis in children with congenital heart disease, which is seen in 40% of patients with Down syndrome, has been reported to be 1.2%. Patients with Down syndrome also tend to have other upper airway obstructive pathology such as nasopharyngeal, oropharyngeal, and subglottic compromise. These entities, combined with the high incidence of cardiac disease, put these children at risk for acute and chronic cardiopulmonary compromise. We present two patients with Down syndrome and congenital heart disease who were found to have significant tracheal stenosis at the time of their cardiac surgery. The perioperative management of their airway defects including diagnostic evaluation and treatment modalities are discussed.
Collapse
MESH Headings
- Cardiac Surgical Procedures
- Down Syndrome/complications
- Down Syndrome/diagnosis
- Ductus Arteriosus, Patent/diagnosis
- Ductus Arteriosus, Patent/etiology
- Ductus Arteriosus, Patent/surgery
- Endoscopy/methods
- Female
- Follow-Up Studies
- Heart Defects, Congenital/diagnosis
- Heart Defects, Congenital/etiology
- Heart Defects, Congenital/surgery
- Heart Septal Defects, Ventricular/diagnosis
- Heart Septal Defects, Ventricular/etiology
- Heart Septal Defects, Ventricular/surgery
- Humans
- Infant
- Infant, Newborn
- Intubation, Intratracheal
- Tracheal Stenosis/diagnosis
- Tracheal Stenosis/etiology
- Tracheal Stenosis/surgery
- Treatment Outcome
Collapse
Affiliation(s)
- N L Shapiro
- Division of Head and Neck Surgery, UCLA School of Medicine, 62-158 CHS, 10833 LeConte Avenue, Los Angeles, CA 90095, USA.
| | | | | | | | | |
Collapse
|
19
|
Sangwan S. Making of a popular debate: the "Indian forester" and the emerging agenda of state forestry in India, 1875-1904. Indian Econ Soc Hist Rev 1999; 36:187-237. [PMID: 21786478 DOI: 10.1177/001946469903600203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
|
20
|
Affiliation(s)
- M Sopher
- University of California Los Angeles School of Medicine, USA
| | | | | | | | | | | |
Collapse
|
21
|
Sangwan S. Book Reviews : RICHARD H. GROVE, Green Imperialism: Colonial Expansion, Tropical Island Edens and the Origins of Environmentalism, 1600-1860. New Delhi: Oxford University Press, 1995, xiv + 540 pp. Rs 375. Science, Technology and Society 1996. [DOI: 10.1177/097172189600100116] [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] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- S. Sangwan
- National Institute of Science, Technology and Development Studies New Delhi
| |
Collapse
|
22
|
Sangwan S, Heinle A. Use of transesophageal echocardiography for placement and testing of an automatic implantable cardiac defibrillator. J Cardiothorac Vasc Anesth 1993; 7:126-7. [PMID: 8431565 DOI: 10.1016/1053-0770(93)90149-f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
|
23
|
Stein DG, Drinkwater DC, Laks H, Permut LC, Sangwan S, Chait HI, Child JS, Bhuta S. Cardiac preservation in patients undergoing transplantation. A clinical trial comparing University of Wisconsin solution and Stanford solution. J Thorac Cardiovasc Surg 1991; 102:657-65. [PMID: 1943183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Recent laboratory investigations have shown significantly improved donor heart preservation and function when the University of Wisconsin solution (UW) is used for arrest and storage. These findings prompted us to compare UW to Stanford solution in a clinical trial. After giving informed consent, patients were blindly randomized to receive a heart arrested and stored in UW or a heart arrested in Stanford solution and stored in normal saline. Orthotopic transplants were performed in a routine manner. Fourteen patients with a mean age of 54 years were randomized to UW, and 15 patients with a mean age of 51 years were randomized to Stanford solution. Mean donor ages (UW 27 years, Stanford 24 years) and ischemic times (UW 150 minutes, Stanford 135 minutes) were similar. Several differences were observed intraoperatively. At end ischemia, mean adenosine triphosphate (UW 5.87 mmol/gm wet weight, Stanford 4.75 mmol/gm) and creatine phosphate (UW 9.26 mmol/gm, Stanford 4.75 mmol/gm) levels were higher in the UW hearts (p less than 0.05). Defibrillation requirements (UW 14% [2/14], Stanford 53% [8/15]) were significantly less in the UW group (p = 0.05). The number of patients requiring temporary intraoperative pacing also showed a significant difference with 7% (1/14) of UW patients versus 47% (7/15) of Stanford patients requiring pacing (p less than 0.05). Intraoperative requirement for inotropic support showed a trend in favor of the UW group. End-ischemic and postreperfusion histologic characteristics were similar between the two groups. No differences in hemodynamics or ejection fractions were noted postoperatively, but trends toward improved rhythm and decreased inotropic support were present in the UW group. Overall 6-month survival rates were similar (UW 86% [12/14], Stanford 93% [14/15]). No preservation-related deaths occurred. We conclude: (1) UW is a safe and effective preservation solution for human cardiac transplantation; (2) considering the improved end-ischemic adenosine triphosphate and creatine phosphate levels, decreased defibrillations, decreased intraoperative pacing, and trend toward decreased requirement for inotropic support in the UW group, UW appears to be superior to Stanford solution for donor heart preservation.
Collapse
Affiliation(s)
- D G Stein
- Division of Cardiothoracic Surgery, University of California, Los Angeles Medical Center
| | | | | | | | | | | | | | | |
Collapse
|
24
|
Wong RS, Baum VC, Sangwan S. Truncus arteriosus: recognition and therapy of intraoperative cardiac ischemia. Anesthesiology 1991; 74:378-80. [PMID: 1990917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- R S Wong
- Department of Anesthesiology, University of California-Los Angeles School of Medicine 90024-1778
| | | | | |
Collapse
|
25
|
Abstract
A case report is presented of a patient receiving chronic phenytoin therapy who demonstrated resistance to pancuronium by increased hourly requirements. Stable neuromuscular blockade was achieved by atracurium infusion at normal rates. Possible explanations for the differences in response to the two non-depolarizing muscle relaxants are discussed.
Collapse
Affiliation(s)
- D R Hickey
- Department of Anesthesia, McGill University, Royal Victoria Hospital, Montreal, Quebec, Canada
| | | | | |
Collapse
|
26
|
Laycock JR, Baxter MK, Bevan JC, Sangwan S, Donati F, Bevan DR. The potency of pancuronium at the adductor pollicis and diaphragm in infants and children. Anesthesiology 1988; 68:908-11. [PMID: 3377235 DOI: 10.1097/00000542-198806000-00012] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
To measure the potency of pancuronium at the diaphragm and adductor pollicis in infants and children, train-of-four stimulation was applied to the ulnar and phrenic nerves under N2O-halothane anesthesia. The force of contraction of the adductor pollicis was measured and compared with the diaphragmatic electromyogram (EMG). Cumulative dose response curves were determined for pancuronium in 18 patients divided equally into three age groups: 0-1 yr, 1-3 yr, and 3-10 yr. The potency of pancuronium at both muscles decreased with increasing age (P less than 0.05), while the adductor pollicis:diaphragm potency ratio remained constant. The mean doses (+/- SEM) required to depress adductor pollicis first twitch responses by 90% (ED90) were 42 +/- 3.3 micrograms/kg in the 0-1-yr group, 47 +/- 4.2 micrograms/kg in the 1-3-yr group, and 62 +/- 4.1 micrograms/kg in the 3-10-yr group. Corresponding figures for the diaphragm were 70 +/- 4.3 micrograms/kg, 81 +/- 5.1 micrograms/kg, and 101 +/- 4.4 micrograms/kg, respectively. The ED90 ratios (diaphragm ED90/adductor pollicis ED90) in the three age groups were 1.69 +/- .07, 1.75 +/- .14, and 1.64 +/- .09, respectively. These results are consistent with similar rates of maturation of the diaphragm and the adductor pollicis muscles in infancy and childhood. Thus, train-of-four monitoring of the adductor pollicis is likely to overestimate the degree of neuromuscular blockade of the diaphragm in pediatric patients.
Collapse
Affiliation(s)
- J R Laycock
- Department of Anaesthesia, Montreal Children's Hospital, Quebec, Canada
| | | | | | | | | | | |
Collapse
|
27
|
Abstract
Seventy-three patients undergoing elective perianal surgery were randomly divided into a control group, a group who received a caudal injection of 20 ml bupivacaine 0.5% plain and a group who received diamorphine 2.5 mg in 10 ml normal saline by caudal injection; a comparison was then made of postoperative analgesia requirements. The bupivacaine group had better analgesia than the control group for the first 8 hours, after which there was no difference. The diamorphine group had better analgesia than the control group for the first 24 hours postoperatively. Side effects were less in the diamorphine group than the control, or the bupivacaine group. In particular, 41% of the bupivacaine group complained of some degree of urinary retention and one patient required temporary catheterisation. It is concluded that caudal diamorphine gives good postoperative analgesia for perianal operations, particularly when motor blockade is not wanted by the surgeon.
Collapse
|
28
|
Sherry KM, Sangwan S. Coronary artery air embolism in the presence of nitrous oxide. Anaesthesia 1986; 41:433-4. [PMID: 3706696 DOI: 10.1111/j.1365-2044.1986.tb13241.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
|
29
|
|