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Tandon N, Radosavljevic M, Vucevic D, Radenkovic M, Jancic J, Samardzic J. Anti-seizure Medications: Challenges and Opportunities. CNS Neurol Disord Drug Targets 2024; 23:CNSNDDT-EPUB-137077. [PMID: 38192128 DOI: 10.2174/0118715273275793231030060833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 09/16/2023] [Accepted: 10/03/2023] [Indexed: 01/10/2024]
Abstract
Epilepsy is a chronic neurological condition characterized by unprovoked, recurrent seizures. There are several types of epilepsy, and the cause of the condition can vary. Some cases of epilepsy have a genetic component, while others may be caused by brain injuries, infections, or other underlying conditions. Treatment for epilepsy typically involves anti-seizure medications (ASMs), although different approaches, such as surgery or a special diet, may be considered in specific cases. The treatment aims to effectively manage and potentially eliminate seizures while minimizing any accompanying side effects. Many different ASMs are available, and the choice of medication depends on several factors, including the type of seizures, the patient's age, general health, and potential drug interactions. For the treatment of epilepsy, there have been significant advancements in recent decades, which have led to the approval of many different ASMs. Newer ASMs offer a broader range of mechanisms of action, improved tolerability profiles, and reduced drug interactions compared to older drugs. This review aims to discuss the pharmacological characteristics, clinical applications, effectiveness, and safety of ASMs, with a particular emphasis on various age groups, especially children. Moreover, this review seeks to provide a comprehensive understanding of ASM therapy for epilepsy management, assisting physicians in selecting suitable ASMs for their patients.
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Affiliation(s)
- Neha Tandon
- Institute of Pharmacology, Clinical Pharmacology and Toxicology, Faculty of Medicine, University of Belgrade, Serbia
| | - Milica Radosavljevic
- Institute of Pharmacology, Clinical Pharmacology and Toxicology, Faculty of Medicine, University of Belgrade, Serbia
| | - Danijela Vucevic
- Institute of Pathophysiology, "Ljubodrag Buba Mihailović", Faculty of Medicine, University of Belgrade, Serbia
| | - Miroslav Radenkovic
- Institute of Pharmacology, Clinical Pharmacology and Toxicology, Faculty of Medicine, University of Belgrade, Serbia
| | - Jasna Jancic
- Clinic of Neurology and Psychiatry for Children and Youth, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Janko Samardzic
- Institute of Pharmacology, Clinical Pharmacology and Toxicology, Faculty of Medicine, University of Belgrade, Serbia
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Agarwal K, Kumar R, Ramachandaran R, Tandon N. Abdominopelvic paragangliomas: A cohort review of 15-year experience. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)01137-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Prakash K, Sam AF, K N, Tandon N. Effect of Preoperative Sarcopenia, Malnutrition and Functional status on Postoperative Morbidity Following Liver Transplantation. Prog Transplant 2022; 32:345-350. [PMID: 36253720 DOI: 10.1177/15269248221132255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
INTRODUCTION The effect of sarcopenia, malnutrition, and functional status on immediate post liver transplantation outcome is not well established. Most studies on sarcopenia are related to 1 and 3-year mortality. Studies evaluating the effect of malnutrition are at least a decade old. PROJECT AIMS We evaluated the effect of preoperative sarcopenia, malnutrition, and functional status on postoperative length of hospital and ICU stay, incidence of complications, and mortality. DESIGN In this prospective study conducted on living donor liver transplant recipients, sarcopenia and malnutrition were identified using the psoas muscle thickness to height and the Royal Free Hospital- Nutritional Prioritizing Tool respectively. The Eastern Cooperative Oncology Group performance status score was noted. Postoperatively, length-of-hospital stay, ICU stay, duration of mechanical ventilation and incidence of postoperative complications were noted. RESULTS Hospital and ICU length of stay, and duration of mechanical ventilation were greater in sarcopenic versus non-sarcopenic patients (35.9 (14.6) versus 26.7 (10.7) days, P = 0.02; 12.9 (4.8) versus 9.6 (3.8) days, P = 0.02 and 8 [5,23] versus 5 [4,7] days, P = 0.01 respectively). The incidence of acute kidney injury was higher in patients with sarcopenia (53.3% vs 19.4%, P = 0.02). Patients with malnutrition and repeated hospitalizations had higher ICU stays but hospital length of stay duration of mechanical ventilation or the incidence of postoperative complications were not affected. The Eastern Cooperative Oncology Group score did not affect postoperative outcome. CONCLUSION In living donor liver transplant recipients, sarcopenia increased hospital and ICU stays, and duration of mechanical ventilation postoperatively. Malnutrition increased ICU stays.
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Affiliation(s)
- Kelika Prakash
- Department of Anesthesiology and Critical Care, 80402Institute of Liver and Biliary Sciences, New Delhi, 110070, India
| | - Amal Francis Sam
- Department of Anesthesiology and Critical Care, 80402Institute of Liver and Biliary Sciences, New Delhi, 110070, India
| | - Nandakumar K
- Department of Anesthesiology and Critical Care, 80402Institute of Liver and Biliary Sciences, New Delhi, 110070, India
| | - Neha Tandon
- Department of Anesthesiology and Critical Care, 80402Institute of Liver and Biliary Sciences, New Delhi, 110070, India
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Arora M, Nazar GP, Sharma N, Jain N, Davidson F, Mohan S, Mohan D, Ali MK, Mohan V, Tandon N, Narayan KMV, Prabhakaran D, Bauld L, Srinath Reddy K. COVID-19 and tobacco cessation: lessons from India. Public Health 2022; 202:93-99. [PMID: 34933205 PMCID: PMC8633921 DOI: 10.1016/j.puhe.2021.11.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 10/20/2021] [Accepted: 11/11/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVES The Government of India prohibited the sale of tobacco products during the COVID-19 lockdown to prevent the spread of the SARS-CoV-2 virus. This study assessed the tobacco cessation behaviour and its predictors among adult tobacco users during the initial COVID-19 lockdown period in India. METHODS A cross-sectional study was conducted with 801 adult tobacco users (both smoking and smokeless tobacco) in two urban metropolitan cities of India over a 2-month period (July to August 2020). The study assessed complete tobacco cessation and quit attempts during the lockdown period. Logistic and negative binomial regression models were used to study the correlates of tobacco cessation and quit attempts, respectively. RESULTS In total, 90 (11.3%) tobacco users reported that they had quit using tobacco after the COVID-19 lockdown period. Overall, a median of two quit attempts (interquartile range 0-6) was made by tobacco users. Participants with good knowledge on the harmful effects of tobacco use and COVID-19 were significantly more likely to quit tobacco use (odds ratio [OR] 2.2; 95% confidence interval [CI] 1.2-4.0) and reported more quit attempts (incidence risk ratio 5.7; 95% CI 2.8-11.8) compared to those with poor knowledge. Participants who had access to tobacco products were less likely to quit tobacco use compared to those who had no access (OR 0.3; 95% CI 0.2-0.5]. CONCLUSIONS Access restrictions and correct knowledge on the harmful effects of tobacco use and COVID-19 can play an important role in creating a conducive environment for tobacco cessation among users.
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Affiliation(s)
- M Arora
- HRIDAY, New Delhi, India; Public Health Foundation of India, Haryana, New Delhi, India.
| | - G P Nazar
- HRIDAY, New Delhi, India; Public Health Foundation of India, Haryana, New Delhi, India
| | | | - N Jain
- Public Health Foundation of India, Haryana, New Delhi, India
| | - F Davidson
- Usher Institute and SPECTRUM Consortium, University of Edinburgh, Edinburgh, United Kingdom
| | - S Mohan
- Public Health Foundation of India, Haryana, New Delhi, India; Centre for Chronic Disease Control, New Delhi, India
| | - D Mohan
- Madras Diabetes Research Foundation, Chennai, India
| | - M K Ali
- Rollins School of Public Health, Emory University, Atlanta, USA
| | - V Mohan
- Madras Diabetes Research Foundation, Chennai, India
| | - N Tandon
- All India Institute of Medical Sciences, New Delhi, India
| | | | - D Prabhakaran
- Public Health Foundation of India, Haryana, New Delhi, India; Centre for Chronic Disease Control, New Delhi, India
| | - L Bauld
- Usher Institute and SPECTRUM Consortium, University of Edinburgh, Edinburgh, United Kingdom
| | - K Srinath Reddy
- Public Health Foundation of India, Haryana, New Delhi, India
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Malhotra R, Guleria P, Barwad A, Pramanik R, Tandon N. A unique case of light chain (AL) amyloidosis masquerading as hypophosphatemic osteomalacia. Osteoporos Int 2021; 32:387-392. [PMID: 32910218 DOI: 10.1007/s00198-020-05622-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 09/01/2020] [Indexed: 01/22/2023]
Abstract
Light chain (AL) amyloidosis is the result of a clonal plasma cell disorder which causes organ damage by deposition of misfolded light chains. Kidney is a common site of amyloid deposition. Proteinuria, usually in nephrotic range and unexplained renal insufficiency are the main manifestations of renal injury. We report a unique case of renal involvement by AL amyloidosis masquerading as metabolic bone disease. 38 year old male patient presented with progressively increasing diffuse bony pains, low backache and proximal weakness of both lower limbs since two years. On investigation, he was detected to have hypophosphatemic osteomalacia due to renal phosphate loss which was fibroblast growth factor 23 (FGF23)- independent. He also had nephrotic range low molecular weight proteinuria. Renal biopsy to ascertain the aetiology revealed deposition of amyloid fibrils in the glomerular mesangium on electron microscopy. Its characterization by immunofluorescence (IF) was consistent with immunoglobulin light chain (AL) amyloidosis. In the absence of a demonstrable plasma cell clone on bone marrow biopsy, we made a diagnosis of monoclonal gammopathy of renal significance (MGRS). He was treated with chemotherapy following which there was symptomatic improvement and reduction in phosphaturia. This case describes a unique presentation of renal injury due to AL amyloidosis masquerading as hypophosphatemic osteomalacia. The aim of this report is to highlight that hypophosphatemia in adults is usually acquired and treatment of underlying etiology results in cure, unlike in children where genetic counseling and phosphate replacement is the mainstay of treatment.
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Affiliation(s)
- R Malhotra
- Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India.
| | - P Guleria
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - A Barwad
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - R Pramanik
- Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi, India
| | - N Tandon
- Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India
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Shah MK, Kondal D, Patel SA, Singh K, Devarajan R, Shivashankar R, Ajay VS, Menon VU, Varthakavi PK, Viswanathan V, Dharmalingam M, Bantwal G, Sahay RK, Masood MQ, Khadgawat R, Desai A, Prabhakaran D, Narayan KMV, Tandon N, Ali MK. Effect of a multicomponent intervention on achievement and improvements in quality-of-care indices among people with Type 2 diabetes in South Asia: the CARRS trial. Diabet Med 2020; 37:1825-1831. [PMID: 31479537 PMCID: PMC7051882 DOI: 10.1111/dme.14124] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/28/2019] [Indexed: 11/30/2022]
Abstract
AIMS To evaluate whether and what combinations of diabetes quality metrics were achieved in a multicentre trial in South Asia evaluating a multicomponent quality improvement intervention that included non-physician care coordinators to promote adherence and clinical decision-support software to enhance physician practices, in comparision with usual care. METHODS Using data from the Centre for Cardiometabolic Risk Reduction in South Asia (CARRS) trial, we evaluated the proportions of trial participants achieving specific and combinations of five diabetes care targets (HbA1c <53 mmol/mol [7%], blood pressure <130/80 mmHg, LDL cholesterol <2.6 mmol/L, non-smoking status, and aspirin use). Additionally, we examined the proportions of participants achieving the following risk factor improvements from baseline: ≥11-mmol/mol (1%) reduction in HbA1c , ≥10-mmHg reduction in systolic blood pressure, and/or ≥0.26-mmol/l reduction in LDL cholesterol. RESULTS Baseline characteristics were similar in the intervention and usual care arms. Overall, 12.3%, 29.4%, 36.5%, 19.5% and 2.2% of participants in the intervention group and 16.2%, 38.3%, 31.6%, 11.3% and 0.8% of participants in the usual care group achieved any one, two, three, four or five targets, respectively. We noted sizeable improvements in HbA1c , blood pressure and cholesterol, and found that participants in the intervention group were twice as likely to achieve improvements in all three indices at 12 months that were sustained over 28 months of the study [relative risk 2.1 (95% CI 1.5,2.8) and 1.8 (95% CI 1.5,2.3), respectively]. CONCLUSIONS The intervention was associated with significantly higher achievement of and greater improvements in composite diabetes quality care goals. However, among these higher-risk participants, very small proportions achieved the complete group of targets, which suggests that achievement of multiple quality-of-care goals is challenging and that other methods may be needed in closing care gaps.
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Affiliation(s)
- M K Shah
- Department of Family and Preventive Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - D Kondal
- Centre of Excellence, Centre for Cardiometabolic Risk Reduction in South Asia, Public Health Foundation of India, Gurgaon, India
| | - S A Patel
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - K Singh
- Centre of Excellence, Centre for Cardiometabolic Risk Reduction in South Asia, Public Health Foundation of India, Gurgaon, India
| | - R Devarajan
- Centre of Excellence, Centre for Cardiometabolic Risk Reduction in South Asia, Public Health Foundation of India, Gurgaon, India
| | - R Shivashankar
- Centre for Chronic Disease Control India, Public Health Foundation of India, Gurgaon, India
| | - V S Ajay
- Centre of Excellence, Centre for Cardiometabolic Risk Reduction in South Asia, Public Health Foundation of India, Gurgaon, India
| | - V U Menon
- Department of Endocrinology and Diabetes, Amrita Institute of Medical Sciences, Kerala, India
| | - P K Varthakavi
- Department of Endocrinology, TNM College and BYL Nair Charity Hospital, Mumbai, India
| | - V Viswanathan
- MV Hospital for Diabetes & Diabetes Research Centre, Chennai, India
| | - M Dharmalingam
- Bangalore Endocrinology and Diabetes Research Centre, Karnataka, India
| | - G Bantwal
- Department of Endocrinology, St John's Medical College and Hospital, Karnataka, India
| | - R K Sahay
- Department of Endocrinology, Osmania General Hospital, Hyderabad, India
| | - M Q Masood
- Department of Medicine, Section of Endocrinology and Diabetes, Aga Khan University, Karachi, Pakistan
| | - R Khadgawat
- Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India
| | - A Desai
- Department of Medicine Endocrine Unit, Goa Medical College, Goa, India
| | - D Prabhakaran
- Department of Medicine Endocrine Unit, Goa Medical College, Goa, India
- Centre for Control of Chronic Conditions, Public Health Foundation of India, Gurgaon, India
| | - K M V Narayan
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - N Tandon
- Department of Medicine, Section of Endocrinology and Diabetes, Aga Khan University, Karachi, Pakistan
| | - M K Ali
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
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Yuan X, Wang L, Tandon N, Sun H, Tian J, Du H, Pascual JM, Guo L. Triheptanoin Mitigates Brain ATP Depletion and Mitochondrial Dysfunction in a Mouse Model of Alzheimer's Disease. J Alzheimers Dis 2020; 78:425-437. [PMID: 33016909 PMCID: PMC8502101 DOI: 10.3233/jad-200594] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Brain energy failure is an early pathological event associated with synaptic dysfunction in Alzheimer's disease (AD). Thus, mitigation or enhancement of brain energy metabolism may offer a therapeutic avenue. However, there is uncertainty as to what metabolic process(es) may be more appropriate to support or augment since metabolism is a multiform process such that each of the various metabolic precursors available is utilized via a specific metabolic pathway. In the brain, these pathways sustain not only a robust rate of energy production but also of carbon replenishment. OBJECTIVE Triheptanoin, an edible odd-chain fatty acid triglyceride, is uncommon in that it replenishes metabolites in the tricarboxylic acid cycle (TCA) cycle via anaplerosis in addition to fueling the cycle via oxidation, thus potentially leading to both carbon replenishment and enhanced mitochondrial ATP production. METHODS To test the hypothesis that triheptanoin is protective in AD, we supplied mice with severe brain amyloidosis (5×FAD mice) with dietary triheptanoin for four and a half months, followed by biological and biochemical experiments to examine mice metabolic as well as synaptic function. RESULTS Triheptanoin treatment had minimal impact on systemic metabolism and brain amyloidosis as well as tauopathy while attenuating brain ATP deficiency and mitochondrial dysfunction including respiration and redox balance in 5×FAD mice. Synaptic density, a disease hallmark, was also preserved in hippocampus and neocortex despite profound amyloid deposition. None of these effects took place in treated control mice. CONCLUSION These findings support the energy failure hypothesis of AD and justify investigating the mechanisms in greater depth with ultimate therapeutic intent.
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Affiliation(s)
- Xiaodong Yuan
- Department of Biological Sciences, The University of Texas at Dallas, Richardson, TX, USA.,Health Management Center, Jinan Central Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Lu Wang
- Department of Biological Sciences, The University of Texas at Dallas, Richardson, TX, USA
| | - Neha Tandon
- Department of Biological Sciences, The University of Texas at Dallas, Richardson, TX, USA
| | - Huili Sun
- Department of Biological Sciences, The University of Texas at Dallas, Richardson, TX, USA
| | - Jing Tian
- Department of Biological Sciences, The University of Texas at Dallas, Richardson, TX, USA
| | - Heng Du
- Department of Biological Sciences, The University of Texas at Dallas, Richardson, TX, USA.,Department of Pharmacology & Toxicology, The University of Kansas, Lawrence, KS, USA.,Higuchi Biosciences Center, The University of Kansas, Lawrence, KS, USA
| | - Juan M Pascual
- Department of Neurology and Neurotherapeutics, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Lan Guo
- Department of Biological Sciences, The University of Texas at Dallas, Richardson, TX, USA.,Department of Pharmacology & Toxicology, The University of Kansas, Lawrence, KS, USA.,Higuchi Biosciences Center, The University of Kansas, Lawrence, KS, USA
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Gupta Y, Goyal A, Kalaivani M, Singhal S, Bhatla N, Gupta N, Tandon N. High burden of cardiometabolic risk factors in spouses of Indian women with hyperglycaemia in pregnancy. Diabet Med 2020; 37:1058-1065. [PMID: 32112453 DOI: 10.1111/dme.14283] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/26/2020] [Indexed: 12/13/2022]
Abstract
AIM To evaluate the burden and association of cardiometabolic risk factors in the spouses of women with and without hyperglycaemia in pregnancy. METHODS Women with (n = 204) and without (n = 197) hyperglycaemia in pregnancy, along with their spouses, participated in this cross-sectional study. The hyperglycaemia in pregnancy group included women with gestational diabetes and diabetes in pregnancy. A detailed questionnaire was completed for all participants (men and women), documenting relevant personal and medical history, along with biochemical investigations (men). RESULTS A total of 401 couples were evaluated at the time point during the pregnancy of 24.7 ± 5.2 gestational weeks (mean ± sd). Dysglycaemia (prediabetes or diabetes), overweight/obesity (BMI ≥25 kg/m2 ) and metabolic syndrome were detected in 120 (58.9%), 123 (60.3%) and 98 spouses (48.3%) of women with hyperglycaemia in pregnancy, respectively. In the fully adjusted model, an increased risk of dysglycaemia [odds ratio 1.43 (95% CI 0.95-2.17); P = 0.088], overweight/obesity [odds ratio 1.49 (95% CI 0.98-2.27); P = 0.064] and metabolic syndrome [odds ratio 2.00 (95% CI 1.30-3.07); P = 0.001] was seen in the spouses of women with hyperglycaemia in pregnancy. The prevalence of these metabolic conditions was higher in spouses of women with diabetes in pregnancy compared to spouses of women with gestational diabetes mellitus. CONCLUSIONS A high burden of cardiometabolic risk factors was observed in the spouses of women with hyperglycaemia in pregnancy. The opportunity provided by pregnancy could be used by the healthcare system not only to improve the health of the woman and her offspring, but also her spouse.
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Affiliation(s)
- Y Gupta
- Departments of, Department of, Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India
| | - A Goyal
- Departments of, Department of, Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India
| | - M Kalaivani
- Department of, Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - S Singhal
- Department of, Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India
| | - N Bhatla
- Department of, Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India
| | - N Gupta
- Departments of, Department of, Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India
| | - N Tandon
- Departments of, Department of, Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India
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Tandon N, Goller K, Wang F, Soibam B, Gagea M, Jain AK, Schwartz RJ, Liu Y. Aberrant expression of embryonic mesendoderm factor MESP1 promotes tumorigenesis. EBioMedicine 2019; 50:55-66. [PMID: 31761621 PMCID: PMC6921370 DOI: 10.1016/j.ebiom.2019.11.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 11/07/2019] [Accepted: 11/07/2019] [Indexed: 12/18/2022] Open
Abstract
Background Mesoderm Posterior 1 (MESP1) belongs to the family of basic helix-loop-helix transcription factors. It is a master regulator of mesendoderm development, leading to formation of organs such as heart and lung. However, its role in adult pathophysiology remains unknown. Here, we report for the first time a previously-unknown association of MESP1 with non-small cell lung cancer (NSCLC). Methods MESP1 mRNA and protein levels were measured in NSCLC-derived cells by qPCR and immunoblotting respectively. Colony formation assay, colorimetric cell proliferation assay and soft agar colony formation assays were used to assess the effects of MESP1 knockdown and overexpression in vitro. RNA-sequencing and chromatin immunoprecipitation (ChIP)-qPCR were used to determine direct target genes of MESP1. Subcutaneous injection of MESP1-depleted NSCLC cells in immuno-compromised mice was done to study the effects of MESP1 mediated tumor formation in vivo. Findings We found that MESP1 expression correlates with poor prognosis in NSCLC patients, and is critical for proliferation and survival of NSCLC-derived cells, thus implicating MESP1 as a lung cancer oncogene. Ectopic MESP1 expression cooperates with loss of tumor suppressor ARF to transform murine fibroblasts. Xenografts from MESP1-depleted cells showed decreased tumor growth in vivo. Global transcriptome analysis revealed a MESP1 DNA-binding-dependent gene signature associated with various hallmarks of cancer, suggesting that transcription activity of MESP1 is most likely responsible for its oncogenic abilities. Interpretation Our study demonstrates MESP1 as a previously-unknown lineage-survival oncogene in NSCLC which may serve as a potential prognostic marker and therapeutic target for lung cancer in the future.
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Affiliation(s)
- Neha Tandon
- Department of Biology and Biochemistry, University of Houston, Houston, TX, United States
| | - Kristina Goller
- Department of Biology and Biochemistry, University of Houston, Houston, TX, United States
| | - Fan Wang
- Department of Biology and Biochemistry, University of Houston, Houston, TX, United States; Department of Oncology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, China
| | - Benjamin Soibam
- Computer Science and Engineering Technology, University of Houston-Downtown, Houston, TX, United States
| | - Mihai Gagea
- Department of Veterinary Medicine and Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Abhinav K Jain
- Center for Cancer Epigenetics, Department of Epigenetics and Molecular Carcinogenesis, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Robert J Schwartz
- Department of Biology and Biochemistry, University of Houston, Houston, TX, United States
| | - Yu Liu
- Department of Biology and Biochemistry, University of Houston, Houston, TX, United States.
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Mohan S, Jarhyan P, Ganesh S, Nikhil SV, Khatkar R, Rao BM, Reddy KS, Tandon N, Prabhakaran D. P1945High levels of unawareness and suboptimal management of hypertension in India: data from a large community based study. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0692] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 11/14/2022] Open
Abstract
Abstract
Background
Hypertension is the most common cause of the rising cardiovascular disease (CVD) epidemic in India. However, despite availability of proven therapies management remains sub-optimal.
Purpose
To determine the hypertension control rates and associated factors among adults with known hypertension in urban and rural India.
Methods
We conducted a representative population based cross-sectional survey among 12243 participants aged ≥30 years residing in rural and urban North and South India. Participants were selected using a multistage cluster random sampling technique. Trained personnel collected the data using an interviewer administered questionnaire, measured blood pressure, conducted anthropometry and collected bio-samples. Hypertension was defined as known hypertension (self-report of physician diagnosis) or systolic blood pressure (SBP) ≥140 mmHg or diastolic blood pressure (DBP) ≥90 mmHg. Control was defined as SBP <140 mmHg and DBP <90 mmHg among those with known hypertension. The associations were measured using logistic regression.
Results
The mean (±SD) age of participants was 47.7 (±12.5) years, women comprised 54%. The age-standardized prevalence of hypertension was 29.0% (95% CI: 28.2- 29.8) and known hypertension was 14.0% (13.4- 14.6). Among all hypertensives 38.6% (37.0–40.2) were on treatment and 26.2% (24.6–28.0) had their blood pressure controlled, while among known hypertensives 79.8% (77.8–81.7) were on treatment and 55.7% (53.3–58.1) had their blood pressure controlled. In multivariate analysis, participants from North Indian site [OR: 1.9 (1.6–2.3)], urban residents [1.3 (1.1–1.6)], younger participants [1.5 (1.2–1.8)], men [2.0 (1.5–2.6)], those with low socio-economic status [1.6 (1.1–2.3)], without comorbidities and those without a family history hypertension were more likely to be unaware about their hypertensive status and less likely to take treatment. Hypertension control was significantly higher in participants from South Indian site [1.5 (1.2–1.0)], the highly educated [1.6 (1.1–2.4)], those without heart diseases [1.8 (1.1–3.1)], those without central obesity [1.4 (1.1–1.9)], physically active individuals [1.5 (1.1–2.0)] and current non-alcohol users [1.9 (1.3–2.6)].
Conclusions
Many individuals with hypertension remain unaware and sub-optimally managed. This warrants the implementation of tailored public education to raise awareness, complemented by active screening for the early detection and effective management of hypertension, in order to stem the rising tide of preventable CVD in India.
Acknowledgement/Funding
Unrestricted educational grant from Eli Lilly under the Lilly NCD Partnership
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Affiliation(s)
- S Mohan
- Public Health Foundation of India, Gurgaon, India
| | - P Jarhyan
- Public Health Foundation of India, Gurgaon, India
| | - S Ganesh
- Public Health Foundation of India, Gurgaon, India
| | - S V Nikhil
- Public Health Foundation of India, Gurgaon, India
| | - R Khatkar
- Public Health Foundation of India, Gurgaon, India
| | - B M Rao
- KIMS ICON, Cardiology, Visakhapatnam, India
| | - K S Reddy
- Public Health Foundation of India, Gurgaon, India
| | - N Tandon
- All India Institute of Medical Sciences (AIIMS), New Delhi, India
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12
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Gujral UP, Prabhakaran D, Pradeepa R, Kandula NR, Kondal D, Deepa M, Zakai NA, Anjana RM, Rautela G, Mohan V, Narayan KMV, Tandon N, Kanaya AM. Isolated HbA1c identifies a different subgroup of individuals with type 2 diabetes compared to fasting or post-challenge glucose in Asian Indians: The CARRS and MASALA studies. Diabetes Res Clin Pract 2019; 153:93-102. [PMID: 31150721 PMCID: PMC6635041 DOI: 10.1016/j.diabres.2019.05.026] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 05/15/2019] [Accepted: 05/22/2019] [Indexed: 12/26/2022]
Abstract
AIMS Guidelines recommend hemoglobin A1c (HbA1c) as a diagnostic test for type 2 diabetes, but its accuracy may differ in certain ethnic groups. METHODS The prevalence of type 2 diabetes by HbA1c, fasting glucose, and 2 h glucose was compared in 3016 participants from Chennai and Delhi, India from the CARRS-2 Study to 757 Indians in the U.S. from the MASALA Study. Type 2 diabetes was defined as fasting glucose ≥ 7.0 mmol/L, 2-h glucose ≥ 11.1 mmol/L, or HbA1c ≥ 6.5%. Isolated HbA1c diabetes was defined as HbA1c ≥ 6.5% with fasting glucose < 7.0 mmol/L and 2 h glucose < 11.1 mmol/L. RESULTS The age, sex, and BMI adjusted prevalence of diabetes by isolated HbA1c was 2.9% (95% CI: 2.2-4.0), 3.1% (95% CI: 2.3-4.1), and 0.8% (95% CI: 0.4-1.8) in CARRS-Chennai, CARRS-Delhi, and MASALA, respectively. The proportion of diabetes diagnosed by isolated HbA1c was 19.4%, 26.8%, and 10.8% in CARRS-Chennai, CARRS-Delhi, and MASALA respectively. In CARRS-2, individuals with type 2 diabetes by isolated HbA1c milder cardio-metabolic risk than those diagnosed by fasting or 2-h measures. CONCLUSIONS In Asian Indians, the use of HbA1c for type 2 diabetes diagnosis could result in a higher prevalence. HbA1c may identify a subset of individuals with milder glucose intolerance.
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Affiliation(s)
- U P Gujral
- Emory Global Diabetes Research Center, Hubert Department of Global Health, Rollins School of Public Health, 1518 Clifton Road NE, Room 7040 N, Emory University, Atlanta, GA, USA.
| | - D Prabhakaran
- Public Health Foundation of India, Unit No. 316 Situated on 3rd Floor, Rectangle-1 Building, Plot No. D-4, District Centre Saket, New Delhi, India; London School of Hygiene and Tropical Medicine, Keppel Street, London, United Kingdom.
| | - R Pradeepa
- Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-communicable Diseases, Prevention & Control, ICMR Centre for Advanced Research on Diabetes, Chennai, India
| | - N R Kandula
- Division of General Internal Medicine, Northwestern University Feinberg School of Medicine, 750 N Lake Shore Drive, 6th Floor, Chicago, IL, USA.
| | - D Kondal
- Public Health Foundation of India, Unit No. 316 Situated on 3rd Floor, Rectangle-1 Building, Plot No. D-4, District Centre Saket, New Delhi, India.
| | - M Deepa
- Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-communicable Diseases, Prevention & Control, ICMR Centre for Advanced Research on Diabetes, Chennai, India
| | - N A Zakai
- Department of Medicine, Department of Pathology & Laboratory Medicine, Larner College of Medicine at the University of Vermont, 89 Beaumont Avenue, Courtyard at Given S269, Burlington, VT, USA.
| | - R M Anjana
- Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-communicable Diseases, Prevention & Control, ICMR Centre for Advanced Research on Diabetes, Chennai, India.
| | - G Rautela
- Public Health Foundation of India, Unit No. 316 Situated on 3rd Floor, Rectangle-1 Building, Plot No. D-4, District Centre Saket, New Delhi, India.
| | - V Mohan
- Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-communicable Diseases, Prevention & Control, ICMR Centre for Advanced Research on Diabetes, Chennai, India.
| | - K M V Narayan
- Emory Global Diabetes Research Center, Hubert Department of Global Health, Rollins School of Public Health, 1518 Clifton Road NE, Room 7040 N, Emory University, Atlanta, GA, USA; Department of Medicine, School of Medicine, 201 Dowman Drive Emory University, Atlanta, GA, USA.
| | - N Tandon
- Public Health Foundation of India, Unit No. 316 Situated on 3rd Floor, Rectangle-1 Building, Plot No. D-4, District Centre Saket, New Delhi, India; Department of Endocrinology and Metabolism, All Indian Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - A M Kanaya
- Division of General Internal Medicine, University of California, San Francisco, San Francisco, CA, USA.
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13
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Wang F, Liang R, Tandon N, Matthews ER, Shrestha S, Yang J, Soibam B, Yang J, Liu Y. H19X-encoded miR-424(322)/-503 cluster: emerging roles in cell differentiation, proliferation, plasticity and metabolism. Cell Mol Life Sci 2019; 76:903-920. [PMID: 30474694 PMCID: PMC6394552 DOI: 10.1007/s00018-018-2971-0] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2018] [Revised: 11/05/2018] [Accepted: 11/13/2018] [Indexed: 02/07/2023]
Abstract
miR-424(322)/-503 are mammal-specific members of the extended miR-15/107 microRNA family. They form a co-expression network with the imprinted lncRNA H19 in tetrapods. miR-424(322)/-503 regulate fundamental cellular processes including cell cycle, epithelial-to-mesenchymal transition, hypoxia and other stress response. They control tissue differentiation (cardiomyocyte, skeletal muscle, monocyte) and remodeling (mammary gland involution), and paradoxically participate in tumor initiation and progression. Expression of miR-424(322)/-503 is governed by unique mechanisms involving sex hormones. Here, we summarize current literature and provide a primer for future endeavors.
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Affiliation(s)
- Fan Wang
- Department of Oncology, The First Affiliated Hospital of Xian Jiaotong University, Xi'an, 710061, Shaanxi, China
- Department of Biology and Biochemistry, University of Houston, Houston, TX, 77204, USA
| | - Rui Liang
- Department of Biology and Biochemistry, University of Houston, Houston, TX, 77204, USA
| | - Neha Tandon
- Department of Biology and Biochemistry, University of Houston, Houston, TX, 77204, USA
| | - Elizabeth R Matthews
- Department of Biology and Biochemistry, University of Houston, Houston, TX, 77204, USA
| | - Shreesti Shrestha
- Department of Biology and Biochemistry, University of Houston, Houston, TX, 77204, USA
| | - Jiao Yang
- Department of Oncology, The First Affiliated Hospital of Xian Jiaotong University, Xi'an, 710061, Shaanxi, China
- Department of Biology and Biochemistry, University of Houston, Houston, TX, 77204, USA
| | - Benjamin Soibam
- Computer Science and Engineering Technology, University of Houston-Downtown, Houston, TX, 77002, USA
| | - Jin Yang
- Department of Oncology, The First Affiliated Hospital of Xian Jiaotong University, Xi'an, 710061, Shaanxi, China.
| | - Yu Liu
- Department of Biology and Biochemistry, University of Houston, Houston, TX, 77204, USA.
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Gupta Y, Kapoor D, Josyula LK, Praveen D, Naheed A, Desai AK, Pathmeswaran A, de Silva HA, Lombard CB, Shamsul Alam D, Prabhakaran D, Teede HJ, Billot L, Bhatla N, Joshi R, Zoungas S, Jan S, Patel A, Tandon N. A lifestyle intervention programme for the prevention of Type 2 diabetes mellitus among South Asian women with gestational diabetes mellitus [LIVING study]: protocol for a randomized trial. Diabet Med 2019; 36:243-251. [PMID: 30368898 DOI: 10.1111/dme.13850] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/25/2018] [Indexed: 01/05/2023]
Abstract
AIM This study aims to determine whether a resource- and culturally appropriate lifestyle intervention programme in South Asian countries, provided to women with gestational diabetes (GDM) after childbirth, will reduce the incidence of worsening of glycaemic status in a manner that is affordable, acceptable and scalable. METHODS Women with GDM (diagnosed by oral glucose tolerance test using the International Association of the Diabetes and Pregnancy Study Groups criteria) will be recruited from 16 hospitals in India, Sri Lanka and Bangladesh. Participants will undergo a repeat oral glucose tolerance test at 6 ± 3 months postpartum and those without Type 2 diabetes, a total sample size of 1414, will be randomly allocated to the intervention or usual care. The intervention will consist of four group sessions, 84 SMS or voice messages and review phone calls over the first year. Participants requiring intensification of the intervention will receive two additional individual sessions over the latter half of the first year. Median follow-up will be 2 years. The primary outcome is the proportion of women with a change in glycaemic category, using the American Diabetes Association criteria: (i) normal glucose tolerance to impaired fasting glucose, or impaired glucose tolerance, or Type 2 diabetes; or (ii) impaired fasting glucose or impaired glucose tolerance to Type 2 diabetes. Process evaluation will explore barriers and facilitators of implementation of the intervention in each local context, while trial-based and modelled economic evaluations will assess cost-effectiveness. DISCUSSION The study will generate important new evidence about a potential strategy to address the long-term sequelae of GDM, a major and growing problem among women in South Asia. (Clinical Trials Registry of India No: CTRI/2017/06/008744; Sri Lanka Clinical Trials Registry No: SLCTR/2017/001; and ClinicalTrials.gov Identifier No: NCT03305939).
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Affiliation(s)
- Y Gupta
- Department of Endocrinology & Metabolism, All India Institute of Medical Sciences, New Delhi, India
| | - D Kapoor
- Department of Endocrinology & Metabolism, All India Institute of Medical Sciences, New Delhi, India
| | - L K Josyula
- The George Institute for Global Health, Hyderabad, India
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
| | - D Praveen
- The George Institute for Global Health, Hyderabad, India
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
| | - A Naheed
- Initiative for Noncommunicable Diseases, Health Systems and Population Studies Division, icddr,b, Dhaka, Bangladesh
| | - A K Desai
- Department of Medicine, Goa Medical College and Hospital, Bambolim, Goa, India
| | - A Pathmeswaran
- Department ofPublic Health, University of Kelaniya, Ragama, Sri Lanka
| | - H A de Silva
- Department of Pharmacology, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka
| | - C B Lombard
- Department of Nutrition and Dietetics, Monash University, Melbourne, Australia
| | - D Shamsul Alam
- Faculty of Health, School of Kinesiology and Health Science, York University, Toronto, Canada
| | | | - H J Teede
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - L Billot
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
| | - N Bhatla
- Department of Obstetrics & Gynaecology, All India Institute of Medical Sciences, New Delhi, India
| | - R Joshi
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
| | - S Zoungas
- Division of Metabolism, Ageing and Genomics, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - S Jan
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
| | - A Patel
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
| | - N Tandon
- Department of Endocrinology & Metabolism, All India Institute of Medical Sciences, New Delhi, India
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Mohan S, Srinivasapura Venkateshmurthy N, Jarhyan P, Khatkar R, Malipeddi B, Reddy K, Tandon N, Dorairaj P. PO528 Screening For Undiagnosed Hypertension: Results From a Large Community Based Screening Program In India. Glob Heart 2018. [DOI: 10.1016/j.gheart.2018.09.404] [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] Open
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16
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Jarhyan P, Srinivasapura Venkateshmurthy N, Khatkar R, Malipeddi B, Reddy K, Tandon N, Prabhakaran D, Mohan S. PO518 Health Worker Led, m-health Enabled Screening, Follow-Up and Linkage to the Health System of People With Hypertension In India. Glob Heart 2018. [DOI: 10.1016/j.gheart.2018.09.396] [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] Open
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17
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Singh K, Johnson L, Devarajan R, Shivashankar R, Sharma P, Kondal D, Ajay VS, Narayan KMV, Prabhakaran D, Ali MK, Tandon N. Acceptability of a decision-support electronic health record system and its impact on diabetes care goals in South Asia: a mixed-methods evaluation of the CARRS trial. Diabet Med 2018; 35:1644-1654. [PMID: 30142228 DOI: 10.1111/dme.13804] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/20/2018] [Indexed: 02/03/2023]
Abstract
AIMS To describe physicians' acceptance of decision-support electronic health record system and its impact on diabetes care goals among people with Type 2 diabetes. METHODS We analysed data from participants in the Centre for Cardiometabolic Risk Reduction in South Asia (CARRS) trial, who received the study intervention (care coordinators and use of a decision-support electronic health record system; n=575) using generalized estimating equations to estimate the association between acceptance/rejection of decision-support system prompts and outcomes (mean changes in HbA1c , blood pressure and LDL cholesterol) considering repeated measures across all time points available. We conducted in-depth interviews with physicians to understand the benefits, challenges and value of the decision-support electronic health record system and analysed physicians' interviews using Rogers' diffusion of innovation theory. RESULTS At end-of-trial, participants with diabetes for whom glycaemic, systolic blood pressure, diastolic blood pressure and LDL cholesterol decision-support electronic health record prompts were accepted vs rejected, experienced no reduction in HbA1c [mean difference: -0.05 mmol/mol (95% CI -0.22, 0.13); P=0.599], but statistically significant improvements were observed for systolic blood pressure [mean difference: -11.6 mmHg (95% CI -13.9, -9.3); P ≤ 0.001], diastolic blood pressure [mean difference: -5.2 mmHg (95% CI -6.5, -3.8); P ≤ 0.001] and LDL cholesterol [mean difference: -0.7 mmol/l (95% CI -0.6, -0.8); P ≤0.001], respectively. The relative advantages and compatibility of the decision-support electronic health record system with existing clinic set-ups influenced physicians' acceptance of it. Software complexities and data entry challenges could be overcome by task-sharing. CONCLUSION Wider adherence to decision-support electronic health record prompts could potentially improve diabetes goal achievement, particularly when accompanied by assistance from a non-physician health worker.
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Affiliation(s)
- K Singh
- Centre for Chronic Conditions and Injuries, Public Health Foundation of India, Gurgaon, Haryana, India
- Centre for Chronic Disease Control, New Delhi, India
- Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India
- Centre for Control of Chronic Conditions, New Delhi, India
| | - L Johnson
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - R Devarajan
- Centre for Control of Chronic Conditions, New Delhi, India
- Centre of Excellence - Centre for Cardio-metabolic Risk Reduction in South Asia
| | - R Shivashankar
- Centre for Chronic Conditions and Injuries, Public Health Foundation of India, Gurgaon, Haryana, India
- Centre for Chronic Disease Control, New Delhi, India
- Centre for Control of Chronic Conditions, New Delhi, India
| | - P Sharma
- St. Georges Medical University of London, London, UK
- Plovdiv Medical University, Plovdiv, Bulgaria
| | - D Kondal
- Centre for Chronic Conditions and Injuries, Public Health Foundation of India, Gurgaon, Haryana, India
- Centre for Chronic Disease Control, New Delhi, India
- Centre for Control of Chronic Conditions, New Delhi, India
| | - V S Ajay
- Centre for Chronic Conditions and Injuries, Public Health Foundation of India, Gurgaon, Haryana, India
- Centre for Chronic Disease Control, New Delhi, India
- Centre for Control of Chronic Conditions, New Delhi, India
| | - K M V Narayan
- Centre for Control of Chronic Conditions, New Delhi, India
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - D Prabhakaran
- Centre for Chronic Conditions and Injuries, Public Health Foundation of India, Gurgaon, Haryana, India
- Centre for Chronic Disease Control, New Delhi, India
- Centre for Control of Chronic Conditions, New Delhi, India
| | - M K Ali
- Centre for Control of Chronic Conditions, New Delhi, India
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - N Tandon
- Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India
- Centre for Control of Chronic Conditions, New Delhi, India
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Srinivasapura Venkateshmurthy N, Jarhyan P, Gupta R, Malipeddi B, Reddy K, Tandon N, Prabhakaran D, Mohan S. PO509 High Burden of Cardio-Metabolic Risk Factors Among People With Diabetes In India: Results From a Large Community Based Study UDAY. Glob Heart 2018. [DOI: 10.1016/j.gheart.2018.09.392] [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] Open
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19
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Devarajan R, Singh K, Kondal D, Shivashankar R, Narayan K, Prabhakaran D, Tandon N, Ali M. MS02.9 Association of Body Mass Index and Other Cardiovascular Risk Factors With Diabetic Retinopathy Among People With Poorly-Controlled Type 2 Diabetes Mellitus In South Asia: The CARRS Trial. Glob Heart 2018. [DOI: 10.1016/j.gheart.2018.09.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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20
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Garg A, Shivashankar R, Vora K, Ali M, Mohan V, Mohan D, Kadir M, Tandon N, Venkat Narayan K, Prabhakaran D. PO206 Family History of Cardiometabolic Diseases (CMDS) as a Determinant of CMD Risk Behaviours: A Secondary Analysis of CARRS Study. Glob Heart 2018. [DOI: 10.1016/j.gheart.2018.09.176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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21
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Yoo S, Singh K, Shivashankar R, Huffman M, Kadir M, Ali M, Mohan V, Narayan K, Tandon N, Prabhakaran D. PO531 Primary and Secondary Prevention of Cardiovascular Diseases In Three South Asian Metropolitan Cities: Analysis of Self-Reported Medication Use In Community-Based CARRS Study. Glob Heart 2018. [DOI: 10.1016/j.gheart.2018.09.407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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22
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Gillespie T, Dhillon P, Ward K, Aggarwal A, Bumb D, Kondal D, Kaushik N, Mohan D, Mohan V, Swaminathan R, Rama R, Manoharan N, Malhotra R, Rath G, Tandon N, Goodman M, Prabhakaran D. Feasibility and Results of Cancer Registry and Noncommunicable Disease Cohort Data Linkages in India. J Glob Oncol 2018. [DOI: 10.1200/jgo.18.53600] [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: 11/20/2022] Open
Abstract
Background: Cancer registries worldwide are vital to determine cancer burden, plan cancer control measures, and facilitate research. Population-based cancer registries are a priority for LMICs by the UICC; the National Cancer Registry Program (NCRP) of India oversees 28 such registries. A primary function of registries is to combine data for the same individual from multiple sources. For other disease cohorts where cancer is an outcome of interest, registries can potentially connect information by linking datasets together. Barriers to successful registration and linkages include systems in which cancer is not a notifiable disease, no universal unique individual identifier exists, and lack of trained personnel. This study utilizes technology and infrastructure to develop better linkages, surveillance, and outcomes. Aim: To assess the feasibility of linking large cohorts designed for cardio-metabolic disease research with cancer registries in New Delhi and Chennai; determine additional steps required for linkage accuracy and completeness; and develop detailed protocols for future applications. Methods: A pilot protocol for linkage between a large diabetes cohort and cancer registries in Delhi and Chennai was developed using MatchPro, a probabilistic record linkage program developed for cancer registries. Probabilistic software links datasets together in the presence of uncertainty (eg misspelled or abbreviated names) to identify record pairs with high probability of representing the same individual. For this study, algorithms were developed to address unique aspects of names and demographics in India. The software and algorithms focused on: detecting duplicates in cancer registries; and linking registries with external files from diabetes cohorts. In Delhi, 3 1-year datasets covering 3 years (2010, 2011, 2012) were linked with the diabetes cohort; in Chennai, the linkage included 3 5-year datasets covering 15 years (2000-04, '05-'09, '10-'14). The unique ID (Aadhaar) is not collected or linked systematically between different systems at this point in time. Results: Linkage attempts yielded potential matches ranked according to probabilistic scores; highest scores were reviewed to determine true matches. In Chennai, this process yielded: (2010-2014) 21% self-reported (SR) cases matching perfectly, 36% requiring follow-up, 13 nonreported (NR) cases found; 2005-2009: 33% SR cases matched perfectly, 1 NR case found; 2000-2004: 1 NR case. Also, 2 training workshops on data linkages and software were held. Conclusion: Linkages between cancer registries and other data sources are feasible in LMICs using probabilistic record linkage software augmented by manual matching. Future efforts to use existing epidemiologic resources (cohorts) and cancer research infrastructure (registries and clinical centers) can enhance research including understanding shared risk factors and pathophysiologic mechanisms e.g., between cancer and other NCD.
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Affiliation(s)
| | | | - K. Ward
- Emory University, Surgery, Atlanta, GA
| | | | - D. Bumb
- Emory University, Surgery, Atlanta, GA
| | - D. Kondal
- Emory University, Surgery, Atlanta, GA
| | | | - D. Mohan
- Emory University, Surgery, Atlanta, GA
| | - V. Mohan
- Emory University, Surgery, Atlanta, GA
| | | | - R. Rama
- Emory University, Surgery, Atlanta, GA
| | | | | | - G. Rath
- Emory University, Surgery, Atlanta, GA
| | - N. Tandon
- Emory University, Surgery, Atlanta, GA
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Tandon N, Soibam B, Schwartz R, Liu Y. Abstract 5437: MESP1 cooperates with loss of ARF in malignant transformation. Cancer Res 2018. [DOI: 10.1158/1538-7445.am2018-5437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Cancer is a highly complex disease involving multiple genetic and epigenetic abnormalities. Inactivation or expression of key regulators can be critical for the maintenance and survival of tumor. My research aims at characterizing one such novel gene, Mesoderm Posterior Basic Helix-Loop-Helix transcription factor-1 (MESP1), in lung cancer initiation and progression. MESP1 is transiently expressed during embryonic development and is the first sign of nascent mesoderm. It is a master regulator of cardiovascular development. Our lab has discovered through genome-wide identification of MESP1 targets that it is required in mesendoderm lineage development. However, whether MESP1 plays any role in adult physiology, diseases and cancer, has never been investigated. The Cancer Genome Atlas (TCGA) data show that MESP1 expression is upregulated in cancers of all mesendoderm-derived tissues. Bioinformatic gene expression analysis of clinical lung adenocarcinoma patient samples (396) showed that MESP1 was highly overexpressed in lung cancer. Similarly, RT-qPCR analysis of patient RNA samples from various stages of lung cancer showed that MESP1 expression was induced in early stages of lung cancer. It was found that MESP1 stable overexpression in ARF-null MEFs leads to oncogenic transformation of cells. This was evidenced by changes in various hallmarks of cancer such as increased cell proliferation, colony formation and anchorage-independent growth (about 6-fold increase in no. of colonies per field). In order to determine if the MESP1-induced oncogenic transformation was p53 dependent, we overexpressed MESP1 in p53-null MEFs. Interestingly, we saw no significant change in cell proliferation, colony formation and anchorage-independent growth in MESP1-overexpressing p53 null MEFs, suggesting that these effects are p53-independent. Upon performing global transcriptomic analyses in MESP1-overexpressing ARF-null MEFs, we found that cell adhesion and cell migration were among the top pathways that were significantly altered. Future studies will focus on in vivo studies to check for effect of MESP1-overexpression and/or knockdown on tumor formation and investigate the mechanism of MESP1-induced oncogenic transformation linked with increased cellular adhesion and migration. Lung cancer is the leading cause of cancer-related deaths in both men and women. More than 50% of cases are diagnosed only at an advanced stage, for which the survival rate of the patient is only 4%. Hence, knowledge of new driver oncogenes of lung cancer is imperative. These results suggest that MESP1 plays an important role in cancer initiation and progression. Ultimately, this research would pave the way for therapeutic intervention of key processes regulated by MESP1 involved in lung cancer.
Citation Format: Neha Tandon, Benjamin Soibam, Robert Schwartz, Yu Liu. MESP1 cooperates with loss of ARF in malignant transformation [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 5437.
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Affiliation(s)
| | | | | | - Yu Liu
- University of Houston, Houston, TX
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24
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Padmanabhan D, Kella DANESH, Tandon N, Deshmukh A, Mulpuru SIVA, Kapa SURAJ, Mehta RAMILA, Dalzell CONNIE, Olson NORA, Felmlee JOEL, Jondal MARYL, Asirvatham SAMUEL, Watson ROBERT, Cha YONGM, Friedman PAUL. 207Clinical utility of performing magnetic resonance imaging in patients with cardiac implantable electronic devices in situ. Europace 2018. [DOI: 10.1093/europace/euy015.056] [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: 11/14/2022] Open
Affiliation(s)
| | - DANESH Kella
- Mayo Clinic, Rochester, United States of America
| | - N Tandon
- Mayo Clinic, Rochester, United States of America
| | - A Deshmukh
- Mayo Clinic, Rochester, United States of America
| | - SIVA Mulpuru
- Mayo Clinic, Rochester, United States of America
| | - SURAJ Kapa
- Mayo Clinic, Rochester, United States of America
| | - RAMILA Mehta
- Mayo Clinic, Rochester, United States of America
| | | | - NORA Olson
- Mayo Clinic, Rochester, United States of America
| | - JOEL Felmlee
- Mayo Clinic, Rochester, United States of America
| | | | | | | | - YONG-M Cha
- Mayo Clinic, Rochester, United States of America
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Chakraborty S, Chopra M, Mani K, Giri AK, Banerjee P, Sahni NS, Siddhu A, Tandon N, Bharadwaj D. Prevalence of vitamin B12
deficiency in healthy Indian school-going adolescents from rural and urban localities and its relationship with various anthropometric indices: a cross-sectional study. J Hum Nutr Diet 2018; 31:513-522. [DOI: 10.1111/jhn.12541] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- S. Chakraborty
- Genomics and Molecular Medicine Unit; CSIR-Institute of Genomics and Integrative Biology; New Delhi India
- Academy of Scientific and Innovative Research; CSIR-Institute of Genomics and Integrative Biology; New Delhi India
| | - M. Chopra
- Department of Food and Nutrition; Lady Irwin College; University of Delhi; New Delhi India
| | - K. Mani
- Department of Biostatistics; All India Institute of Medical Sciences; New Delhi India
| | - A. K. Giri
- Genomics and Molecular Medicine Unit; CSIR-Institute of Genomics and Integrative Biology; New Delhi India
- Academy of Scientific and Innovative Research; CSIR-Institute of Genomics and Integrative Biology; New Delhi India
| | - P. Banerjee
- Genomics and Molecular Medicine Unit; CSIR-Institute of Genomics and Integrative Biology; New Delhi India
| | - N. S. Sahni
- School of Computational and Integrative Sciences; Jawaharlal Nehru University; New Delhi India
| | - A. Siddhu
- Department of Home Science; Lady Irwin College; University of Delhi; New Delhi India
| | - N. Tandon
- Department of Endocrinology and Metabolism; All India Institute of Medical Sciences; New Delhi India
| | - D. Bharadwaj
- Genomics and Molecular Medicine Unit; CSIR-Institute of Genomics and Integrative Biology; New Delhi India
- Academy of Scientific and Innovative Research; CSIR-Institute of Genomics and Integrative Biology; New Delhi India
- Systems Genomics Laboratory; School of Biotechnology; Jawaharlal Nehru University; New Delhi India
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Singh A, Govil D, Baveja UK, Gupta A, Tandon N, Srinivasan S, Gupta S, Patel SJ, Saigal S, Soin AS. Epidemiological Analysis of Extended-Spectrum Beta-Lactamase-Producing Bacterial Infections in Adult Live Donor Liver Transplant Patients. Indian J Crit Care Med 2018; 22:290-296. [PMID: 29743768 PMCID: PMC5930533 DOI: 10.4103/ijccm.ijccm_206_17] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Introduction: Bacterial infections are a leading cause of morbidity and mortality in patients receiving solid-organ transplants. Extended-spectrum beta-lactamases (ESBL) pathogens are the most important pathogenic bacteria infecting these patients. Aim: This study aims to evaluate for the incidence and characteristics of ESBL-positive organism, to look for the clinical outcomes in ESBL-positive infected cases, and to evaluate and draft the antibiotic policy in posttransplant patients during the first 28 days posttransplant. Materials and Methods: This is a retrospective data analysis of liver transplant recipients infected with ESBL culture-positive infections. All the culture sites such as blood, urine, and endotracheal tube aspirates were screened for the first ESBL infection they had and noted. This data were collected till day 28 posttransplant. The antibiotic susceptibility pattern and the most common organism were also noted. Results: A total of 484 patients was screened and 116 patients had ESBL-positive cultures. Out of these, 54 patients had infections and 62 patients were ESBL colonizers. The primary infection site was abdominal fluid (40.7%), with Klebsiella accounting for most of the ESBL infections. Colistin was the most sensitive antibiotic followed by tigecycline. The overall mortality was 11.4% and 31 out of 54 ESBL-infected patients died. Conclusions: Infections with ESBL-producing organism in liver transplant recipients has a high mortality and very limited therapeutic options.
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Affiliation(s)
- Ajeet Singh
- Institute of Critical Care and Anesthesiology, Medanta The Medicity, Gurgaon, Haryana, India
| | - Deepak Govil
- Institute of Critical Care and Anesthesiology, Medanta The Medicity, Gurgaon, Haryana, India
| | - Usha Krishan Baveja
- Department of Pathology and Laboratory Medicine, Medanta The Medicity, Gurgaon, Haryana, India
| | - Anand Gupta
- Transplant Critical Care, Saroj Super Speciality Hospital, New Delhi, India
| | - Neha Tandon
- Department of Biology and Biochemistry, University of Houston, Houston, Texas, USA
| | - Shrikanth Srinivasan
- Institute of Critical Care and Anesthesiology, Medanta The Medicity, Gurgaon, Haryana, India
| | - Sachin Gupta
- Institute of Critical Care and Anesthesiology, Medanta The Medicity, Gurgaon, Haryana, India
| | - Sweta J Patel
- Institute of Critical Care and Anesthesiology, Medanta The Medicity, Gurgaon, Haryana, India
| | - Sanjiv Saigal
- Institute of Digestive and Hepatobiliary Sciences, Medanta The Medicity, Gurgaon, Haryana, India
| | - Arvinder Singh Soin
- Institute of Liver Transplantation and Regenerative Medicine, Medanta The Medicity, Gurgaon, Haryana, India
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Abstract
Lentiviruses are used very widely to generate stable expression mammalian cell lines. They are used for both gene down-regulation (by using shRNA) or for gene up-regulation (by using ORF of gene of interest). The technique of generating stable cell lines using 3rd generation lentivirus is very robust and it typically takes about 1-2 weeks to get stable expression for most mammalian cell lines. The advantage of using the 3rd generation lentivirus are that are very safe and they are replication incompetent.
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Affiliation(s)
- Neha Tandon
- Department of Biology and Biochemistry, University of Houston, Houston, USA
| | - Kaushik N Thakkar
- Department of Radiation Oncology, Stanford University, Stanford, CA, USA
| | - Edward L LaGory
- Department of Radiation Oncology, Stanford University, Stanford, CA, USA
| | - Yu Liu
- Department of Biology and Biochemistry, University of Houston, Houston, USA
| | - Amato J Giaccia
- Department of Radiation Oncology, Stanford University, Stanford, CA, USA
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Cheng M, Yang J, Shady M, Ulz P, Heitzer E, Socci N, Seshan V, Offin M, Stephens D, Makhnin A, Tandon N, Datta S, Selcuklu D, Huberman K, Vanness K, Gedvilaite E, Viale A, Arcila M, Ladanyi M, Chaft J, Rudin C, Berger M, Solit D, Li B, Tsui D. OA 10.05 Non-Invasive Molecular Profiling in NSCLC by Targeted and Whole Exome Analysis of Plasma cfDNA. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.385] [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: 11/16/2022]
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Tyagi S, Kabra M, Tandon N, Saxena R, Pati H, Choudhry V. Clinico-Haematological Profile of Thalassemia Intermedia Patients. INT J HUM GENET 2017. [DOI: 10.1080/09723757.2003.11885860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Seema Tyagi
- Department of Hematology, All India Institute of Medical Sciences, New Delhi 110 029, India
| | - M. Kabra
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi 110 029, India
| | - N. Tandon
- Department of Endocrinology, All India Institute of Medical Sciences, New Delhi 110 029, India
| | - R. Saxena
- Department of Hematology, All India Institute of Medical Sciences, New Delhi 110 029, India
| | - H.P. Pati
- Department of Hematology, All India Institute of Medical Sciences, New Delhi 110 029, India
| | - V.P. Choudhry
- Department of Hematology, All India Institute of Medical Sciences, New Delhi 110 029, India
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Mohan S, Ghosh S, Jarhyan P, Nikhil S, Gummidi B, Bhaskara Rao M, Srinath Reddy K, Tandon N, Prabhakaran D. P4549A large community-wide innovative screening programme for undiagnosed hypertension in India: findings from UDAY. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p4549] [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: 11/12/2022] Open
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Jyotsna VP, Pal S, Kandasamy D, Gamanagatti S, Garg PK, Raizada N, Sahni P, Bal CS, Tandon N, Ammini AC. Evolving management of insulinoma: Experience at a tertiary care centre. Indian J Med Res 2017; 144:771. [PMID: 28361831 PMCID: PMC5393089 DOI: 10.4103/ijmr.ijmr_1477_14] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND & OBJECTIVES Since our previous study in 2006, several new modalities for localization of cause of endogenous hyperinsulinemic hypoglycaemia such as multiphasic computed tomography (CT), multiphasic magnetic resonance imaging (MRI), endoscopic ultrasound (EUS), intraoperative ultrasound, and intra-arterial calcium infusion with arterial stimulation venous sampling (ASVS) have become available. Therefore, to evaluate the relative usefulness of various imaging modalities to guide future management in terms of diagnosis and patient care, we analyzed presentation and management of patients of endogenous hyperinsulinemic hypoglycaemia. METHODS In this retrospective study, medical records of patients admitted with endogenous hyperinsulinemic hypoglycaemia were retrieved. Data pertaining to clinical features, diagnosis, imaging, surgery and patient outcome were extracted. The localization of insulinoma by preoperative imaging techniques was compared with the findings at surgery to assess the accuracy of localization. RESULTS Fasting hypoglycaemia was present in all, and post-prandial hypoglycaemia (plasma glucose ≤50 mg/dl within four hours of meal) in 25.8 per cent. Mean duration of symptoms before reaching a diagnosis of hyperinsulinemic hypoglycaemia was 3.9 years. Mean duration of provocative fast was 21.8 h (range 6-48 h). Among the currently used imaging modalities, the sensitivity of localizing tumour was 79.3 per cent for multiphasic CT, 85 per cent for multiphasic MRI and 95 per cent for EUS. EUS detected tumour missed by both CT and MRI. All, except one of the operated patients, were cured by surgery. INTERPRETATION & CONCLUSIONS Our results suggest that patients with insulinoma have a varied presentation. Multiphasic contrast-enhanced MRI/CT scan, EUS and ASVS may be complimentary in pre-operative localization.
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Affiliation(s)
- Viveka P Jyotsna
- Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India
| | - Sujoy Pal
- Department of Gastrointestinal Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - D Kandasamy
- Department of Radiology, All India Institute of Medical Sciences, New Delhi, India
| | - S Gamanagatti
- Department of Radiology, All India Institute of Medical Sciences, New Delhi, India
| | - P K Garg
- Department of Gastroenterology, All India Institute of Medical Sciences, New Delhi, India
| | - N Raizada
- Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India
| | - Peush Sahni
- Department of Gastrointestinal Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - C S Bal
- Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - N Tandon
- Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India
| | - A C Ammini
- Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India
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Kowalski AJ, Poongothai S, Chwastiak L, Hutcheson M, Tandon N, Khadgawat R, Sridhar GR, Aravind SR, Sosale B, Anjana RM, Rao D, Sagar R, Mehta N, Narayan KMV, Unutzer J, Katon W, Mohan V, Ali MK. The INtegrating DEPrEssioN and Diabetes treatmENT (INDEPENDENT) study: Design and methods to address mental healthcare gaps in India. Contemp Clin Trials 2017. [PMID: 28642211 DOI: 10.1016/j.cct.2017.06.013] [Citation(s) in RCA: 21] [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] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Depression and diabetes are highly prevalent worldwide and often co-exist, worsening outcomes for each condition. Barriers to diagnosis and treatment are exacerbated in low and middle-income countries with limited health infrastructure and access to mental health treatment. The INtegrating DEPrEssioN and Diabetes treatmENT (INDEPENDENT) study tests the sustained effectiveness and cost-effectiveness of a multi-component care model for individuals with poorly-controlled diabetes and depression in diabetes clinics in India. MATERIALS AND METHODS Adults with diabetes, depressive symptoms (Patient Health Questionnaire-9 score≥10), and ≥1 poorly-controlled cardiometabolic indicator (either HbA1c≥8.0%, SBP≥140mmHg, and/or LDL≥130mg/dl) were enrolled and randomized to the intervention or usual care. The intervention combined collaborative care, decision-support, and population health management. The primary outcome is the between-arm difference in the proportion of participants achieving combined depression response (≥50% reduction in Symptom Checklist score from baseline) AND one or more of: ≥0.5% reduction in HbA1c, ≥5mmHg reduction in SBP, or ≥10mg/dl reduction in LDL-c at 24months (12-month intervention; 12-month observational follow-up). Other outcomes include control of individual parameters, patient-centered measures (i.e. treatment satisfaction), and cost-effectiveness. RESULTS The study trained seven care coordinators. Participant recruitment is complete - 940 adults were screened, with 483 eligible, and 404 randomized (196 to intervention; 208 to usual care). Randomization was balanced across clinic sites. CONCLUSIONS The INDEPENDENT model aims to increase access to mental health care and improve depression and cardiometabolic disease outcomes among complex patients with diabetes by leveraging the care provided in diabetes clinics in India (clinicaltrials.gov number: NCT02022111).
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Affiliation(s)
- A J Kowalski
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA 30322, United States
| | - S Poongothai
- Madras Diabetes Research Foundation, Dr. Mohan's Diabetes Specialities Centre, 4, Conran Smith Road, Gopalapuram, Chennai 600 086, Tamil Nadu, India
| | - L Chwastiak
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States
| | - M Hutcheson
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA 30322, United States
| | - N Tandon
- All India Institute of Medical Sciences, Department of Endocrinology & Metabolism, Biotechnology Block, 3rd Floor, Rm #312, Ansari Nagar, New Delhi 110 029, India
| | - R Khadgawat
- All India Institute of Medical Sciences, Department of Endocrinology & Metabolism, Biotechnology Block, 3rd Floor, Rm #312, Ansari Nagar, New Delhi 110 029, India
| | - G R Sridhar
- Endocrine and Diabetes Centre, Visakhapatnam, Andhra Pradesh, India
| | - S R Aravind
- Diacon Hospital, Diabetes Care and Research Center, Rajajinagar, Bangalore 560 010, Karantaka, India
| | - B Sosale
- Diacon Hospital, Diabetes Care and Research Center, Rajajinagar, Bangalore 560 010, Karantaka, India
| | - R M Anjana
- Madras Diabetes Research Foundation, Dr. Mohan's Diabetes Specialities Centre, 4, Conran Smith Road, Gopalapuram, Chennai 600 086, Tamil Nadu, India
| | - D Rao
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States; Department of Global Health, University of Washington, Seattle, WA, United States
| | - R Sagar
- All India Institute of Medical Sciences, Department of Psychiatry, Ansari Nagar, New Delhi 110 029, India
| | - N Mehta
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA 30322, United States
| | - K M V Narayan
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA 30322, United States
| | - J Unutzer
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States
| | - W Katon
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States
| | - V Mohan
- Madras Diabetes Research Foundation, Dr. Mohan's Diabetes Specialities Centre, 4, Conran Smith Road, Gopalapuram, Chennai 600 086, Tamil Nadu, India
| | - M K Ali
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA 30322, United States.
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Tandon N, Muchtar E, Sidana S, Dispenzieri A, Lacy MQ, Dingli D, Buadi FK, Hayman SR, Chakraborty R, Hogan WJ, Gonsalves W, Warsame R, Kourelis TV, Leung N, Kapoor P, Kumar SK, Gertz MA. Revisiting conditioning dose in newly diagnosed light chain amyloidosis undergoing frontline autologous stem cell transplant: impact on response and survival. Bone Marrow Transplant 2017; 52:1126-1132. [DOI: 10.1038/bmt.2017.68] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Revised: 02/17/2017] [Accepted: 03/01/2017] [Indexed: 11/09/2022]
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Gupta Y, Kapoor D, Desai A, Praveen D, Joshi R, Rozati R, Bhatla N, Prabhakaran D, Reddy P, Patel A, Tandon N. Conversion of gestational diabetes mellitus to future Type 2 diabetes mellitus and the predictive value of HbA 1c in an Indian cohort. Diabet Med 2017; 34:37-43. [PMID: 26926329 DOI: 10.1111/dme.13102] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/25/2016] [Indexed: 01/18/2023]
Abstract
AIM To investigate the distribution of and risk factors for dysglycaemia (Type 2 diabetes and prediabetes) in women with previous gestational diabetes mellitus in India. METHODS All women (n = 989) from two obstetric units in New Delhi and Hyderabad with a history of gestational diabetes were invited to participate, of whom 366 (37%) agreed. Sociodemographic, medical and anthropometric data were collected and 75-g oral glucose tolerance test were carried out. RESULTS Within 5 years (median 14 months) of the pregnancy in which they were diagnosed with gestational diabetes, 263 (72%) women were dysglycaemic, including 119 (32%) and 144 (40%) with Type 2 diabetes and prediabetes, respectively. A higher BMI [odds ratio 1.16 per 1-kg/m2 greater BMI (95% CI 1.10, 1.28)], presence of acanthosis nigricans [odds ratio 3.10, 95% CI (1.64, 5.87)], postpartum screening interval [odds ratio 1.02 per 1 month greater screening interval 95% CI (1.01, 1.04)] and age [odds ratio 1.10 per 1-year older age 95% CI (1.04, 1.16)] had a higher likelihood of having dysglycaemia. The American Diabetes Association-recommended threshold HbA1c value of ≥ 48 mmol/mol (6.5%) had a sensitivity and specificity of 81.4 and 90.7%, respectively, for determining the presence of Type 2 diabetes postpartum. CONCLUSION The high post-pregnancy conversion rates of gestational diabetes to diabetes reported in the present study reinforce the need for mandatory postpartum screening and identification of strategies for preventing progression to Type 2 diabetes. Use of the American Diabetes Association-recommended HbA1c threshold for diabetes may lead to significant under-diagnosis.
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Affiliation(s)
- Y Gupta
- Department of Endocrinology, All India Institute of Medical Sciences, New Delhi, India
| | - D Kapoor
- Centre for Chronic Disease Control, Gurgaon, India
| | - A Desai
- Endocrine Unit-Department of Medicine, Goa Medical College, Goa, India
| | - D Praveen
- Division of Epidemiology, George Institute for Global Health, Hyderabad, India
| | - R Joshi
- George Institute for Global Health, University of Sydney, Sydney, Australia
| | - R Rozati
- Centre for Fertility Management-MHRT, Hyderabad, India
| | - N Bhatla
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India
| | | | - P Reddy
- School of Medicine and Public Health, University of Newcastle and St Vincents Health Network, Sydney, Australia
| | - A Patel
- George Institute for Global Health, University of Sydney, Sydney, Australia
| | - N Tandon
- Department of Endocrinology, All India Institute of Medical Sciences, New Delhi, India
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Prabhash K, Noronha V, Patil VM, Joshi A, Tandon N, Sharma V, Ramaswamy A, More SB, Gaud S. Epidermal growth factor receptor positive lung cancer: The nontrial scenario. Indian J Cancer 2017; 54:132-135. [DOI: 10.4103/0019-509x.219583] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Devarajan R, Singh K, Kondal D, Shivashankar R, Narayan K, Prabhakaran D, Tandon N, Ali M. PT316 Associations Between Blood Pressure- and Lipid-Lowering Medications Use and Cardiac Risk Factor Control: Findings From the Carrs Trial. Glob Heart 2016. [DOI: 10.1016/j.gheart.2016.03.633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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37
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Vamadevan A, Jindal D, Venugopal V, Roy A, Tandon N, Prabhakaran D. PS208 Improved Blood Pressure Associated With Mpower Heart Intervention: A Multi-Faceted Intervention for Hypertension in India. Glob Heart 2016. [DOI: 10.1016/j.gheart.2016.03.169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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38
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Vamadevan A, Jindal D, Jha D, Venugopal V, Gupta P, Roy A, Prieto D, Perel P, Tandon N, Patel V, Prabhakaran D. PT204 Mwellcare Trial: A Multi-Center, Cluster Randomized, Controlled Clinical Trial of Mwellcare, an Mhealth System for an Integrated Management of Patients With Hypertension and Diabetes in India. Glob Heart 2016. [DOI: 10.1016/j.gheart.2016.03.556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Gupta P, Sinha S, Joshi M, Vats S, Sharma M, Srivastava R, Bhalla S, Mohan V, Tandon N, Unnikrishnan A, Reddy K, Prabhakaran D. PS218 Education Programs for Primary Care Physicians: An Experience From Various Capacity Building Initiatives on Chronic Conditions in India. Glob Heart 2016. [DOI: 10.1016/j.gheart.2016.03.175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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40
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Devarajan R, Singh K, Kondal D, Shivashankar R, Narayan K, Prabhakaran D, Tandon N, Ali M. PT315 Effects of a Multicomponent Intervention Strategy on Processes of Care and Cardiac Risk Factor Control in Poorly Controlled Type 2 Diabetes Patients: The Carrs Trial. Glob Heart 2016. [DOI: 10.1016/j.gheart.2016.03.632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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42
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Singh K, Chandra Sekaran A, Bhaumik S, Chattopadhyay K, Gamage A, Silva P, Roy A, Tandon N, Prabhakaran D. PM034 Evidence on Cost-Effectiveness of Interventions to Control Cardiovascular Diseases and Diabetes Mellitus in South Asia: A Systematic Review. Glob Heart 2016. [DOI: 10.1016/j.gheart.2016.03.265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Abstract
BACKGROUND Stress and vulnerability likely interact to play a major role in psychosis. While much has been written about the neural diathesis-stress model in psychosis and its clinical risk states, little is known about HPA axis biomarkers in non-help-seeking individuals at familial high risk (FHR). We sought to prospectively measure pituitary volume (PV) in adolescents and young adults at FHR for schizophrenia and to follow their emerging sub-clinical psychotic symptoms and clinical trajectories. METHOD Forty healthy controls and 38 relatives of patients with schizophrenia or schizoaffective disorder were identified in Pittsburgh, USA. PV was derived from baseline 1.5 T magnetic resonance imaging. Chapman's schizotypy scales were acquired at baseline, and structured clinical interviews for DSM-IV-TR Axis I diagnoses were attempted annually for up to 3 years. RESULTS Seven individuals converted to psychosis. PV did not differ between FHR and control groups overall. Within the FHR group, PV was positively correlated with Chapman's positive schizotypy (Magical Ideation and Perceptual Aberration) scores, and there was a significant group × PV interaction with schizotypy. PV was significantly higher in FHR subjects carrying any baseline Axis I diagnosis (p = 0.004), and higher still in individuals who went on to convert to psychosis (p = 0.0007). CONCLUSIONS Increased PV is a correlate of early positive schizotypy, and may predict trait vulnerability to subsequent psychosis in FHR relatives. These preliminary findings support a model of stress-vulnerability and HPA axis activation in the early phases of psychosis.
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Affiliation(s)
- J L Shah
- Massachusetts Mental Health Center and Beth Israel Deaconess Medical Center,Boston,MA,USA
| | - N Tandon
- Massachusetts Mental Health Center and Beth Israel Deaconess Medical Center,Boston,MA,USA
| | - E R Howard
- Massachusetts Mental Health Center and Beth Israel Deaconess Medical Center,Boston,MA,USA
| | - D Mermon
- Western Psychiatric Institute and Clinic,University of Pittsburgh School of Medicine,Pittsburgh,PA,USA
| | - J M Miewald
- Western Psychiatric Institute and Clinic,University of Pittsburgh School of Medicine,Pittsburgh,PA,USA
| | - D M Montrose
- Western Psychiatric Institute and Clinic,University of Pittsburgh School of Medicine,Pittsburgh,PA,USA
| | - M S Keshavan
- Massachusetts Mental Health Center and Beth Israel Deaconess Medical Center,Boston,MA,USA
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Kumar N, Kaur G, Kanga U, Mehra NK, Neolia SC, Tandon N, Zucman SC. CTLA4+49G allele associates with early onset of type 1 diabetes in North Indians. Int J Immunogenet 2015; 42:445-52. [DOI: 10.1111/iji.12233] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Revised: 06/22/2015] [Accepted: 07/19/2015] [Indexed: 12/15/2022]
Affiliation(s)
- N. Kumar
- Department of Transplant Immunology and Immunogenetics; All India Institute of Medical Sciences; New Delhi India
| | - G. Kaur
- Department of Transplant Immunology and Immunogenetics; All India Institute of Medical Sciences; New Delhi India
| | - U. Kanga
- Department of Transplant Immunology and Immunogenetics; All India Institute of Medical Sciences; New Delhi India
| | - N. K. Mehra
- Department of Transplant Immunology and Immunogenetics; All India Institute of Medical Sciences; New Delhi India
| | - S. C. Neolia
- Department of Transplant Immunology and Immunogenetics; All India Institute of Medical Sciences; New Delhi India
| | - N. Tandon
- Department of Endocrinology and Metabolism; All India Institute of Medical Sciences; New Delhi India
| | - S. C. Zucman
- Institut National de la Santé et de la Recherche Médicale (INSERM) UMR 1149; Hôpital Robert Debre; Université Paris Diderot; Paris France
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Noronha V, Prabhash K, Joshi A, Patil V, Chougule A, Kaushal R, Jambhekar N, Tandon N, Philip D. 3051 Relevance of performance status as a prognosticator in EGFR mutant NSCLC. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)31693-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Weetman AP, Tandon N, Metcalfe RA. T cell reactivity in endocrine ophthalmopathy. Dev Ophthalmol 2015; 25:20-8. [PMID: 8359350 DOI: 10.1159/000422420] [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] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Affiliation(s)
- A P Weetman
- Department of Medicine, University of Sheffield Clinical Sciences Centre, Northern General Hospital, UK
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Tandon N, Banavali S, Menon H, Gujral S, Kadam PA, Bakshi A. Is there a role for metronomic induction (and maintenance) therapy in elderly patients with acute myeloid leukemia? A literature review. Indian J Cancer 2015; 50:154-8. [PMID: 23979209 DOI: 10.4103/0019-509x.117033] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Acute myeloid leukemia (AML) in older adults differs biologically and clinically from that in younger patients and is characterized by adverse chromosomal abnormalities, stronger intrinsic resistance, and lower tolerance to chemotherapy. In patients over age 60 with AML, cure rates are under 10% despite intensive chemotherapy, and most of them die within a year of diagnosis. Over the last decade, metronomic chemotherapy has emerged as a potential strategy to control advanced/refractory cancer. Here, we report a case of a 68-year-old gentleman having AML with high-risk cytogenetic features, who achieved complete remission on our oral metronomic PrET (PrET: Prednisolone, etoposide, thioguanine) protocol on an outpatient basis. He was later treated with standard high-dose (HD) cytosine arabinoside (Ara-C) consolidation followed by maintenance with etoposide, thioguanine, and sodium valproate. Presently, the patient is nearly 35 months since diagnosis and 21 months off treatment. This case report and review highlights that the combination of oral low-intensity metronomic therapy, followed by standard HD consolidation therapy and metronomic maintenance therapy may be well tolerated by elderly patients especially with less proliferative, high (cytogenetic)-risk AML who are otherwise deemed to be unfit for intensive intravenous induction chemotherapy regimens. References for this review were identified through searches of Pubmed for recent publications on the subject as well as searches of the files of the authors themselves. The final list was generated on the basis of originality and relevance to this review.
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Affiliation(s)
- N Tandon
- Department of Medical Oncology, Tata Memorial Hospital, Parel, Mumbai, Maharashtra, India
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Ingwersen SH, Petri KC, Tandon N, Yoon KH, Chen L, Vora J, Yang W. Liraglutide pharmacokinetics and dose-exposure response in Asian subjects with Type 2 diabetes from China, India and South Korea. Diabetes Res Clin Pract 2015; 108:113-9. [PMID: 25684604 DOI: 10.1016/j.diabres.2015.01.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [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: 06/10/2014] [Revised: 09/02/2014] [Accepted: 01/04/2015] [Indexed: 02/07/2023]
Abstract
AIMS To investigate the population pharmacokinetics and exposure-response relationship of liraglutide, a human glucagon-like peptide-1 (GLP-1) analogue, in Asian subjects with Type 2 diabetes mellitus. METHODS Data were derived from a published 16-week, randomized, double-blind, double-dummy, active-controlled, parallel-group trial of liraglutide in China, India and South Korea. The analysis utilized 2061 pharmacokinetic (PK) samples from 605 subjects exposed to liraglutide 0.6, 1.2 or 1.8 mg once daily. Demographic factors (body weight, age, gender, country) of importance for liraglutide clearance were evaluated. An exploratory exposure-response analysis was conducted to investigate effects on glycated haemoglobin (HbA1c) and body weight. RESULTS Estimated liraglutide exposure (area under the curve; AUC) appeared to increase proportionally with increasing liraglutide dose (0.6-1.8 mg). The covariate analysis confirmed previous findings in a global clinical trial. Body weight was a predictor of liraglutide exposure; compared to a reference subject of 67 kg, exposure was 32% lower for maximum (115 kg) and 54% higher for minimum (37 kg) observed body weights. Gender, age and country had no relevant effect on exposure. Exposure-response analysis supported the use of 1.2mg as maintenance dose with the option of individual dose escalation to 1.8 mg to optimize treatment outcomes. CONCLUSIONS Exposure appeared to increase proportionally with increasing liraglutide dose in Asian subjects with Type 2 diabetes mellitus. The only PK relevant predictor of exposure was body weight. The exposure-response relationships for HbA1c and body weight in Asian subjects were similar to observations in global populations.
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Affiliation(s)
| | | | - N Tandon
- All India Institute of Medical Sciences, New Delhi, India
| | - K-H Yoon
- Catholic Medical Center, The Catholic University of Korea, South Korea
| | - L Chen
- Department of Endocrinology, Wuhan Union Hospital, Wuhan, Hubei, China
| | - J Vora
- Royal Liverpool University Hospitals, Liverpool, UK
| | - W Yang
- Department of Endocrinology, China-Japan Friendship Hospital, Beijing, China
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