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Roy S, Shanmugam G, Rakshit S, Pradeep R, George M, Sarkar K. Exploring the immunomodulatory potential of Brahmi (Bacopa monnieri) in the treatment of invasive ductal carcinoma. Med Oncol 2024; 41:115. [PMID: 38622289 DOI: 10.1007/s12032-024-02365-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Accepted: 03/19/2024] [Indexed: 04/17/2024]
Abstract
Bacopa monnieri (L) Wettst, commonly known as Brahmi, stands as a medicinal plant integral to India's traditional medical system, Ayurveda, where it is recognized as a "medhya rasayana"-a botanical entity believed to enhance intellect and mental clarity. Its significant role in numerous Ayurvedic formulations designed to address conditions such as anxiety, memory loss, impaired cognition, and diminished concentration underscores its prominence. Beyond its application in cognitive health, Brahmi has historically been employed in Ayurvedic practices for the treatment of inflammatory diseases, including arthritis. In contemporary biomedical research, Bacopa monnieri can attenuate the release of pro-inflammatory cytokines TNF-α and IL-6 in animal models. However, there remains a paucity of information regarding Bacopa's potential as an anticancer agent, warranting further investigation in this domain. Based on previous findings with Brahmi (Bacopa monnieri), the current study aims to find out the role of Brahmi plant preparation (BPP) in immunomodulatory actions on IDC. Employing a specific BPP concentration, we conducted a comprehensive study using MTT assay, ELISA, DNA methylation analysis, Western blotting, ChIP, and mRNA profiling to assess BPP's immunomodulatory properties. Our research finding showed the role of BPP in augmenting the action of T helper 1 (TH1) cells which secreted interferon-γ (IFN-γ) which in turn activated cytotoxic T-lymphocytes (CTL) to kill the cells of IDC (*p < 0.05). Moreover, we found out that treatment with BPP not only increased the activities of tumor-suppressor genes (p53 and BRCA1) but also decreased the activities of oncogenes (Notch1 and DNAPKcs) in IDC (*p < 0.05). BPP had an immense significance in controlling the epigenetic dysregulation in IDC through the downregulation of Histone demethylation & Histone deacetylation and upregulation of Histone methylation and Histone acetylation (*p < 0.05). Our Chromatin immunoprecipitation (ChIP)-qPCR data showed BPP treatment increased percentage enrichment of STAT1 & BRCA1 (*p < 0.05) and decreased percentage enrichment of STAT3, STAT5 & NF ΚB (*p < 0.05) on both TBX21 and BRCA1 gene loci in IDC. In addition, BPP treatment reduced the hypermethylation of the BRCA1-associated-DNA, which is believed to be a major factor in IDC (*p < 0.05). BPP not only escalates the secretion of type 1 specific cytokines but also escalates tumor suppression and harmonizes various epigenetic regulators and transcription factors associated with Signal Transducer and Activator of Transcription (STAT) to evoke tumor protective immunity in IDC.
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Affiliation(s)
- Sohini Roy
- Department of Biotechnology, SRM Institute of Science and Technology, Kattankulathur, Chennai, Tamil Nadu, 603203, India
| | - Geetha Shanmugam
- Department of Biotechnology, SRM Institute of Science and Technology, Kattankulathur, Chennai, Tamil Nadu, 603203, India
| | - Sudeshna Rakshit
- Department of Biotechnology, SRM Institute of Science and Technology, Kattankulathur, Chennai, Tamil Nadu, 603203, India
| | - R Pradeep
- Department of Biotechnology, SRM Institute of Science and Technology, Kattankulathur, Chennai, Tamil Nadu, 603203, India
| | - Melvin George
- Department of Clinical Pharmacology, SRM Medical College Hospital and Research Centre, SRM Institute of Science and Technology, Kattankulathur, Chennai, Tamil Nadu, 603203, India
| | - Koustav Sarkar
- Department of Biotechnology, SRM Institute of Science and Technology, Kattankulathur, Chennai, Tamil Nadu, 603203, India.
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Sriraman N, Sarkar A, Naskar S, Mahajan N, Mukherjee O, Pradeep R, George M, Sarkar K. Immunomodulatory effects of Diospyros peregrina fruit preparation (DFP) in non-small cell lung cancer (NSCLC) by utilizing dendritic cell-mediated antigen presentation and T helper (TH) cell differentiation. Med Oncol 2024; 41:107. [PMID: 38580762 DOI: 10.1007/s12032-024-02331-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Accepted: 02/12/2024] [Indexed: 04/07/2024]
Abstract
Diospyros peregrina is a dioecious plant which is native to India. It belongs to the family of Ebenaceae and is extensively used to treat various ailments, such as leucorrhoea and other uterine-related problems. Though few studies have been on D. peregrina for their anti-tumour response, little is known. Therefore, this intrigued us to understand its immunomodulator capabilities on various types of cancer extensively. Our primary focus is on NSCLC (Non-Small Cell Lung Cancer), which is ranked as the second largest form of cancer in the world, and the treatments demand non-invasive agents to target NSCLC effectively. In an objective to generate an efficient Lung Cancer Associated Antigen (LCA) specific anti-tumour immune response, LCA was presented using dendritic cells (DCs) in the presence of D. peregrina fruit preparation (DFP). Moreover, we also investigated DFP's role in the differentiation of T-helper (TH) cells. Therefore, this study aimed at better LCA presentation mediated by DFP by activating the LCA pulsed DCs and T helper cell differentiation for better immune response. DCs were pulsed with LCA for tumour antigen presentation in vitro, with and without DFP. Differentially pulsed DCs were irradiated to co-culture with autologous and allogeneic lymphocytes. Extracellular supernatants were collected for the estimation of cytokine levels by ELISA. LDH release assay was performed to test Cytotoxic T lymphocytes (CTLs) mediated lung tumour cell cytotoxicity. Thus, DFP may be a potential vaccine to generate anti-LCA immune responses to restrict NSCLC.
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Affiliation(s)
- Nawaneetan Sriraman
- Department of Biotechnology, SRM Institute of Science and Technology, Kattankulathur, Chennai, Tamil Nadu, 603203, India
| | - Ankita Sarkar
- Department of Biotechnology, SRM Institute of Science and Technology, Kattankulathur, Chennai, Tamil Nadu, 603203, India
| | - Sohom Naskar
- Department of Biotechnology, SRM Institute of Science and Technology, Kattankulathur, Chennai, Tamil Nadu, 603203, India
| | - Nitika Mahajan
- Department of Biotechnology, SRM Institute of Science and Technology, Kattankulathur, Chennai, Tamil Nadu, 603203, India
| | - Oishi Mukherjee
- Department of Biotechnology, SRM Institute of Science and Technology, Kattankulathur, Chennai, Tamil Nadu, 603203, India
| | - R Pradeep
- Department of Biotechnology, SRM Institute of Science and Technology, Kattankulathur, Chennai, Tamil Nadu, 603203, India
| | - Melvin George
- Department of Clinical Pharmacology, SRM Medical College Hospital and Research Centre, Kattankulathur, Tamil Nadu, 603203, India
| | - Koustav Sarkar
- Department of Biotechnology, SRM Institute of Science and Technology, Kattankulathur, Chennai, Tamil Nadu, 603203, India.
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Pradeep R, Siva V, Jothi MA, Murugan A, Shameem A, Sanjana S, Hemnath E, G Al-Sehemi A. Structural, surface morphological and dielectric studies of guanidinium salt incorporated poly (ethylene oxide)/poly (vinyl pyrrolidone) solid polymer electrolytes. Heliyon 2024; 10:e23524. [PMID: 38187254 PMCID: PMC10770557 DOI: 10.1016/j.heliyon.2023.e23524] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 12/05/2023] [Accepted: 12/05/2023] [Indexed: 01/09/2024] Open
Abstract
The research article investigates the effect of incorporating the guanidinium carbonate (GuC) salt into the poly vinylpyrrolidone (PVP) and polyethylene oxide (PEO) polymer matrix. Various weight percentages of GuC enriched PVP/PEO solid polymer electrolytes (SPEs) have been prepared by the simplest solution casting process. XRD analysis revealed that the incorporation of the GuC salt led to changes in the crystalline structure of the PVP/PEO. FTIR analysis confirms the presence of guanidinium carbonate in the blended polymeric system. FESEM imaging showed the uniform and smooth surface view of the electrolytes. DSC analysis suggests that the addition of the GuC led to a decrease in the melting temperature and an increase in the crystallisation temperature. The temperature-dependent dielectric analysis showed that the presence of the organic salt led to an increase in the dielectric constant of the polymer blend. Among all the prepared electrolytes, 25 wt.% GuC added polymer electrolyte achieved a higher conductivity of 3.00764 × 10-7 S/cm. Overall, the results of the study suggest that the incorporation of the GuC salt into the PVP/PEO can lead to significant changes in the structural, thermal, and dielectric properties of the blend. These findings have potential implications for the use of PVP/PEO blends in solid state battery applications.
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Affiliation(s)
- R. Pradeep
- Department of Physics and Nanotechnology, SRM Institute of Science and Technology, Kattankulathur, 603 203, Tamil Nadu, India
| | - V. Siva
- Department of Physics, Karpagam Academy of Higher Education, Coimbatore, 641 021, Tamil Nadu, India
- Centre for Energy and Environment, Karpagam Academy of Higher Education, Coimbatore, 641 021, Tamil Nadu, India
| | - M. Anandha Jothi
- Department of Physics, P. S. R. Engineering College, Sivakasi, 626140, Tamil Nadu, India
| | - A. Murugan
- Department of Science and Humanities, Karpagam College of Engineering, Coimbatore, 641 032, Tamil Nadu, India
| | - A. Shameem
- Centre for Energy and Environment, Karpagam Academy of Higher Education, Coimbatore, 641 021, Tamil Nadu, India
- Department of Science and Humanities, Karpagam Academy of Higher Education, Coimbatore, 641 021, Tamil Nadu, India
| | - S. Sanjana
- Department of Physics, Karpagam Academy of Higher Education, Coimbatore, 641 021, Tamil Nadu, India
- Centre for Energy and Environment, Karpagam Academy of Higher Education, Coimbatore, 641 021, Tamil Nadu, India
| | - E. Hemnath
- Centre of Drug Testing, Faculty of Pharmacy, Karpagam Academy of Higher Education, Coimbatore, 641 021, Tamil Nadu, India
| | - Abdullah G Al-Sehemi
- Research Center for Advanced Materials Science (RCAMS), King Khalid University, Abha, 61413, Saudi Arabia
- Department of Chemistry, College of Science, King Khalid University, Abha, 61413, Saudi Arabia
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Pradeep R, Amalnath SD, Kasturi N. Smartphone fundus photography by a physician in medical emergencies: An analytical cross-sectional study of 182 patients. Natl Med J India 2023; 36:291-294. [PMID: 38759976 DOI: 10.25259/nmji_208_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2024]
Abstract
Background Fundus examination is an integral part of the clinical evaluation of patients with medical emergencies. It is done at the bedside using a portable direct ophthalmoscope. Smartphone fundus photography (SFP) is a novel technique of retinal imaging. We evaluated the use of SFP by a physician in medical emergencies and compared it with direct ophthalmoscopy (DO) findings of the ophthalmologist. Methods We did a prospective study on patients admitted with medical emergencies with an indication for fundus examination. The SFP was done by the physician, and its findings were noted. These were compared with the DO findings of the ophthalmologist. Results Of the 182 patients studied, 111 (61%) had fundus findings by SFP and 95 (52.5%) by DO. Papilloedema (21.4%), haemorrhages (20%) and Roth spots (12.5%) were most common. DO missed early papilloedema and findings in the peripheral retina. Conclusions SFP is as effective as DO, in detecting retinal findings in patients with medical emergencies and can be performed at the bedside by the physician.
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Affiliation(s)
- R Pradeep
- Department of Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - S Deepak Amalnath
- Department of Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Nirupama Kasturi
- Department of Ophthalmology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
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Gupta D, Gupta H, Patel A, Dugani P, Pradeep R, Mehta A, Javali M, Acharya PT, Srinivasa R. Teaching Video NeuroImage: Slow Axial Myoclonus in Subacute Sclerosing Panencephalitis. Neurology 2022; 99:864-865. [PMID: 36240086 DOI: 10.1212/wnl.0000000000201283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 08/09/2022] [Indexed: 11/15/2022] Open
Affiliation(s)
- Dhananjay Gupta
- From the Department of Neurology (D.G., P.D., R.P., A.M., M.J., P.T.A., R.S.), Ramaiah Medical College, Bangalore; and Doaba Hospital and Neurocare Centre (D.G., H.G., A.P.), Jalandhar, India
| | - Haripriya Gupta
- From the Department of Neurology (D.G., P.D., R.P., A.M., M.J., P.T.A., R.S.), Ramaiah Medical College, Bangalore; and Doaba Hospital and Neurocare Centre (D.G., H.G., A.P.), Jalandhar, India
| | - Anuja Patel
- From the Department of Neurology (D.G., P.D., R.P., A.M., M.J., P.T.A., R.S.), Ramaiah Medical College, Bangalore; and Doaba Hospital and Neurocare Centre (D.G., H.G., A.P.), Jalandhar, India
| | - Pooja Dugani
- From the Department of Neurology (D.G., P.D., R.P., A.M., M.J., P.T.A., R.S.), Ramaiah Medical College, Bangalore; and Doaba Hospital and Neurocare Centre (D.G., H.G., A.P.), Jalandhar, India
| | - R Pradeep
- From the Department of Neurology (D.G., P.D., R.P., A.M., M.J., P.T.A., R.S.), Ramaiah Medical College, Bangalore; and Doaba Hospital and Neurocare Centre (D.G., H.G., A.P.), Jalandhar, India.
| | - Anish Mehta
- From the Department of Neurology (D.G., P.D., R.P., A.M., M.J., P.T.A., R.S.), Ramaiah Medical College, Bangalore; and Doaba Hospital and Neurocare Centre (D.G., H.G., A.P.), Jalandhar, India
| | - Mahendra Javali
- From the Department of Neurology (D.G., P.D., R.P., A.M., M.J., P.T.A., R.S.), Ramaiah Medical College, Bangalore; and Doaba Hospital and Neurocare Centre (D.G., H.G., A.P.), Jalandhar, India
| | - Purshottam T Acharya
- From the Department of Neurology (D.G., P.D., R.P., A.M., M.J., P.T.A., R.S.), Ramaiah Medical College, Bangalore; and Doaba Hospital and Neurocare Centre (D.G., H.G., A.P.), Jalandhar, India
| | - Rangasetty Srinivasa
- From the Department of Neurology (D.G., P.D., R.P., A.M., M.J., P.T.A., R.S.), Ramaiah Medical College, Bangalore; and Doaba Hospital and Neurocare Centre (D.G., H.G., A.P.), Jalandhar, India
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Parray AM, Chaudhari VA, Bhandare MS, Madhabananda K, Muduly DK, Sudhindran S, Mathews J, Pradeep R, Thammineedi SR, Amal K, Chaudhary D, Jitender R, Pandey D, Amar P, Penumadu P, Kalayarasan R, Elamurugan TP, Kantharia C, Pujari S, Ramesh H, Somashekhar SP, Fernandes A, Sexena R, Singh RK, Lattoo MR, Shah OJ, Jeswanth S, Roy M, Thambudorai R, Shrikhande SV. Impact of Covid-19 on gastrointestinal cancer surgery: A National Survey. Langenbecks Arch Surg 2022; 407:3735-3745. [PMID: 36098808 PMCID: PMC9469820 DOI: 10.1007/s00423-022-02675-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 09/02/2022] [Indexed: 11/24/2022]
Abstract
Purpose To understand the actual impact of the Covid-19 pandemic and frame the future strategies, we conducted a pan India survey to study the impact on the surgical management of gastrointestinal cancers. Methods A national multicentre survey in the form of a questionnaire from 16 tertiary care gastrointestinal oncology centres across India was conducted from January 2019 to June 2021 that was divided into a 15-month pre-Covid era and a similar period of active Covid pandemic era. Results There was significant disruption of services; 13 (81%) centres worked as dedicated Covid care centres and 43% reported suspension of essential care for more than 6 months. In active Covid phase, there was a 14.5% decrease in registrations and proportion of decrease was highest in the centres from South zone (22%). There was decrease in resections across all organ systems; maximum reduction was noted in hepatic resections (33%) followed by oesophageal and gastric resections (31 and 25% respectively). There was minimal decrease in colorectal resections (5%). A total of 584 (7.1%) patients had either active Covid-19 infection or developed infection in the post-operative period or had recovered from Covid-19 infection. Only 3 (18%) centres reported higher morbidity, while the rest of the centres reported similar or lower morbidity rates when compared to pre-Covid phase; however, 6 (37%) centres reported slightly higher mortality in the active Covid phase. Conclusion
Covid-19 pandemic resulted in significant reduction in new cancer registrations and elective gastrointestinal cancer surgeries. Perioperative morbidity remained similar despite 7.1% perioperative Covid 19 exposure. Supplementary Information The online version contains supplementary material available at 10.1007/s00423-022-02675-6.
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Affiliation(s)
- Amir M Parray
- Homi Bhabha National Institute, Tata Memorial Centre, Mumbai, India
| | | | | | - K Madhabananda
- All India Institute of Medical Sciences, Bhubaneshwar, India
| | - Dilip K Muduly
- All India Institute of Medical Sciences, Bhubaneshwar, India
| | - S Sudhindran
- Amrita Institute of Medical Sciences and Research Institute, Kochi, India
| | - Johns Mathews
- Amrita Institute of Medical Sciences and Research Institute, Kochi, India
| | - R Pradeep
- Asian Institute of Gastroenterology, Hyderabad, India
| | | | - K Amal
- Dr B Borooah Cancer Institute, Gauhati, India
| | | | - R Jitender
- Homi Bhabha Cancer Hospital (TMC), Sangrur, India
| | - Durgatosh Pandey
- Mahamana Pandit Madan Mohan Malaviya Cancer Centre & Homi Bhabha Cancer Hospital (TMC), Varanasi, India
| | - P Amar
- Mahamana Pandit Madan Mohan Malaviya Cancer Centre & Homi Bhabha Cancer Hospital (TMC), Varanasi, India
| | - Prasanth Penumadu
- Jawahar Lal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Raja Kalayarasan
- Jawahar Lal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - T P Elamurugan
- Jawahar Lal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | | | | | - H Ramesh
- Lakeshore Hospital and Research Centre, Kochi, India
| | | | | | - Rajan Sexena
- Sanjay Gandhi PGI of Medical Sciences, Lucknow, India
| | | | - Mohd R Lattoo
- Sher-I-Kashmir Institute of Medical Sciences, Srinagar, India
| | - Omar J Shah
- Sher-I-Kashmir Institute of Medical Sciences, Srinagar, India
| | | | | | | | - Shailesh V Shrikhande
- Homi Bhabha National Institute, Tata Memorial Centre, Mumbai, India. .,Department of Gastrointestinal and Hepato-Pancreato-Biliary, Surgical Oncology, Homi Bhabha National Institute, Tata Memorial Centre, Mumbai, Maharashtra, 400012, India.
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Gupta D, Mehta A, Shetty NA, Pradeep R, Mahendra JV, Acharya PT, Srinivasa R. Medically Refractory Idiopathic Intracranial Hypertension and HIV: A Rare Association. Neurol India 2022; 70:2229-2230. [PMID: 36352655 DOI: 10.4103/0028-3886.359268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Affiliation(s)
- Dhananjay Gupta
- Department of Neurology, Ramaiah Medical College, Bengaluru, Karnataka, India
| | - Anish Mehta
- Department of Neurology, Ramaiah Medical College, Bengaluru, Karnataka, India
| | - Nikith A Shetty
- Department of Neurology, Ramaiah Medical College, Bengaluru, Karnataka, India
| | - R Pradeep
- Department of Neurology, Ramaiah Medical College, Bengaluru, Karnataka, India
| | - J V Mahendra
- Department of Neurology, Ramaiah Medical College, Bengaluru, Karnataka, India
| | - P T Acharya
- Department of Neurology, Ramaiah Medical College, Bengaluru, Karnataka, India
| | - R Srinivasa
- Department of Neurology, Ramaiah Medical College, Bengaluru, Karnataka, India
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Dugani P, Mehta A, Furtado SV, Pradeep R, Javali M, Acharya P, Thyagaraj V, Srinivasa R. Spectrum of neurological manifestations among acute COVID-19 and long COVID-19 – A retrospective observational study. Ro J Neurol 2022. [DOI: 10.37897/rjn.2022.2.14] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective. Preliminary clinical data indicate that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is associated with neurological symptoms. To compare the clinical features, imaging and treatments in patients with and without COVID-19. To compare the mortality and in-hospital stay among patients with and without COVID-19 and negative patients. Materials and methods. In this retrospective, single-center study, we included all the patients who attended the department of neurology with neurologic symptoms with confirmed COVID-19 and long COVID-19 from June 2020 to January 2021. Data on clinical signs, diagnosis, laboratory findings were collected and analyzed from the records for positive patients and compared with neurologic patients without COVID-19 admitted in the same period. Statistical analysis: The mean values between study groups were compared using an independent sample t-test and Mann Whitney u test. Categorical outcomes were compared using the Chi square test. Data was analyzed using coGuide software. Results. Headache was the common neurologic manifestation present in COVID positive patients compared to COVID negative patients (39.13%). There was no statistically significant difference between the two groups in baseline parameters. Laboratory parameters like CRP, Serum Ferritin, LDH, D-dimer, ESR, and IL-6 showed a significant increase in COVID positive patients (P <0.05). In-hospital mortality was more in COVID positive patients than COVID negative patients (P <0.011). Conclusion. The study showed varied neurologic symptoms in COVID patients, with headache as the common symptom. Hospital stay, morbidity, mortality, and inflammatory parameters were more in COVID positive patients compared to COVID negative patients.
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Singh L, Javali M, Mehta A, Pradeep R, Srinivasa R, Acharya PT. Study of cerebrospinal fluid levels of lactate, lactate dehydrogenase and adenosine deaminase in the diagnosis and outcome of acute meningitis. Neurol Res 2021; 44:463-467. [PMID: 34850673 DOI: 10.1080/01616412.2021.2004366] [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: 10/19/2022]
Abstract
BACKGROUND Meningitis is a serious clinical health issue in most developing countries. Late diagnosis and treatment result in significant morbidity and mortality. This research aims to study the utility of CSF lactate, lactate dehydrogenase (LDH), and adenosine deaminase (ADA) as diagnostic markers in acute meningitis, and to differentiate among varied aetiologies of acute meningitis and their outcomes. METHOD A cross-sectional observational case-control study was conducted in 30 patients of suspected meningitis of varied aetiologies and 30 controls without any pre-existing neurological disorder and who underwent lumbar puncture during spinal anesthesia. A fresh CSF sample was collected in a heparinized vial following an aseptic lumbar puncture. The levels of lactate, LDH and ADA were estimated and recorded. RESULT CSF lactate was significantly elevated in bacterial meningitis (BM) and cryptococcal meningitis, with 100% sensitivity when compared to controls. Elevated LDH was found only in BM, hence elevated LDH levels may strongly signify bacterial etiology. Significantly elevated ADA levels were noted in tuberculous meningitis. Significantly elevated levels of lactate and ADA were suggestive of slower clinical recovery and a prolonged hospital stay (p < 0.001). CONCLUSION Estimation of CSF lactate, LDH, and ADA levels is a rapid, inexpensive and simple procedure and can play a major role in the early differentiation of bacterial, viral, tuberculous, and fungal meningitis. This would facilitate the initiation of appropriate treatment as early as possible, thereby decreasing mortality and complications.
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Affiliation(s)
- Lovelina Singh
- Department of Neurology, MS Ramaiah Medical College & Hospital, Bengaluru, India
| | - Mahendra Javali
- Department of Neurology, MS Ramaiah Medical College & Hospital, Bengaluru, India
| | - Anish Mehta
- Department of Neurology, MS Ramaiah Medical College & Hospital, Bengaluru, India
| | - R Pradeep
- Department of Neurology, MS Ramaiah Medical College & Hospital, Bengaluru, India
| | - R Srinivasa
- Department of Neurology, MS Ramaiah Medical College & Hospital, Bengaluru, India
| | - P T Acharya
- Department of Neurology, MS Ramaiah Medical College & Hospital, Bengaluru, India
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Ampar N, Mehta A, Mahale RR, Javali M, Pradeep R, Acharya P, Srinivasa R. Electrophysiological Evaluation of Audiovestibular Pathway Dysfunction in Parkinson's Disease and Its Correlates: A Case Control Study. Ann Indian Acad Neurol 2021; 24:531-535. [PMID: 34728946 PMCID: PMC8513948 DOI: 10.4103/aian.aian_1011_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 11/29/2020] [Accepted: 12/04/2020] [Indexed: 11/16/2022] Open
Abstract
Background: Parkinson's disease (PD) is associated with brainstem dysfunction causing non-motor symptoms. Vestibular evoked myogenic potential (VEMP) and brainstem auditory evoked potential (BAEP) are electrophysiological tests to assess the vestibular and auditory pathways in the brainstem. Objectives: To study the abnormalities of cervical VEMP (cVEMP) and BAEP in PD and to correlate the findings with the symptoms related to brainstem involvement. Patients and Methods: cVEMP and BAEP were recorded in 25 PD patients and compared 25 age matched controls. The PD patients were assessed with the following clinical scales: REM Sleep Disorder Screening Questionnaire (RBD-SQ), Epworth Sleepiness Scale (ESS), mini-BESTest, Geriatric Depression Scale (GDS-15) and MMSE (Mini-mental state examination). The P13 and N23 peak latencies and the P13/N23 amplitude of cVEMP, the latencies of waves I, III and V, and the inter-peak latencies (IPL) of waves I-III, III-V and I-V of BAEP were measured. Results: The PD patients showed prolonged latencies and reduced amplitude in cVEMP responses. They had abnormal BAEP in the form of prolonged absolute latencies of wave V, followed by wave III and I–V IPL with no significant difference in waves I and I–III IPL. The cVEMP abnormality was correlated directly with RBD-SQ and inversely with mini-BESTest scores. There were no correlations between cVEMP/BAEP abnormality and disease severity, GDS-15, ESS and MMSE. Conclusion: PD is associated with cVEMP and BAEP abnormalities that suggest auditory and vestibular pathway dysfunction in the brainstem and cVEMP correlates with the symptoms of brainstem degeneration like RBD and postural instability.
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Affiliation(s)
- Nikith Ampar
- Department of Neurology, Ramaiah Medical College, Bangalore, India
| | - Anish Mehta
- Department of Neurology, Ramaiah Medical College, Bangalore, India
| | - Rohan R Mahale
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Mahendra Javali
- Department of Neurology, Ramaiah Medical College, Bangalore, India
| | - R Pradeep
- Department of Neurology, Ramaiah Medical College, Bangalore, India
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11
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Ramya R, Swarnalakshmi R, Preethi A, Pradeep R. A case of progressive systemic sclerosis/lupus overlap syndrome: Presenting with parotid swelling. J Oral Maxillofac Pathol 2021; 25:372. [PMID: 34703142 PMCID: PMC8491334 DOI: 10.4103/0973-029x.325259] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2019] [Revised: 05/11/2020] [Accepted: 08/05/2020] [Indexed: 11/13/2022] Open
Abstract
An overlap syndrome is a medical condition which shares features of at least two more widely recognized disorders. Autoimmune connective tissue diseases include systemic lupus erythematosus (SLE), scleroderma, polymyositis, dermatomyositis, rheumatoid arthritis and Sjögren's syndrome where overlap syndrome most commonly seen in combination with SLE and systemic sclerosis (SSc). Sjogren's is an autoimmune exocrinopathy, in which systemic diseases such as arthritis, interstitial lung disease and renal disease may develop in addition to the pathognomonic features such as dry eyes and mouth. The other associated disease with Sjogren's includes sialadenitis. Sialadenitis of the parotid gland is one of the major disorders of salivary gland. This article presents a rare case report of a patient diagnosed with sialadenitis of the parotid gland and associated with progressive SSc/lupus overlap syndrome and secondary Sjogren's.
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Affiliation(s)
- R Ramya
- Department of Oral Pathology, SRM Dental College, Chennai, Tamil Nadu, India
| | - R Swarnalakshmi
- Department of Oral Pathology, SRM Dental College, Chennai, Tamil Nadu, India
| | - Arunachalam Preethi
- Department of Oral Pathology, SRM Dental College, Chennai, Tamil Nadu, India
| | - R Pradeep
- Department of Prosthodontics, Tagore Dental College, Chennai, Tamil Nadu, India
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12
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Manohar KM, Sasikala M, Anuradha S, Ramji C, Sashidhar RB, Rao GV, Pradeep R, Reddy DN. MUC1, CK20, and CDX2 immunohistochemical markers can sub-classify periampullary carcinomas into pancreaticobiliary, intestinal, and mixed subtypes. INDIAN J PATHOL MICR 2021; 64:693-701. [PMID: 34673588 DOI: 10.4103/ijpm.ijpm_726_20] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Introduction Pancreaticobiliary subtype of Periampullary carcinoma (PAC) has a poor prognosis in comparison to the intestinal subtype. We assessed the potential of cytokeratins and mucin markers to classify the sub-types of periampullary tumors and compared them with the survival data to identify markers that may predict prognosis. Methodology PAC tumor tissues were obtained from 94 patients undergoing Whipples Pancreaticoduodenectomy. Paraffin-embedded tissues were immunostained with cytokeratins CK7, CK20), mucins (MUC1, MUC2, MUC5Ac), and CDX2 antibodies. The survival status of patients was obtained as follow-up up to 5-years of surgery. The Receiver Operating Character Curve (ROC) analysis was used for detecting sensitivity and specificity. The survival data were analyzed using the Kaplan-Meier survival curve. Results Tumors were initially categorized on the basis of histological classification as pancreaticobiliary (n = 46), intestinal (n = 35) and indeterminate (n = 13). Further, using immunohistochemical markers (MUC1, CK20, and CDX2), we gave systematic classification of IHC-PB (n = 51), IHC-Int (n = 30) and IHC-Mixed (n = 13). The interobserver analysis showed good agreement between histologic and IHC type with a kappa value of 0.554. Combined expression of CK20, MUC1 and CDX2 accurately classify the mixed type of tumor. Overall survival rate and duration were 74.4% and 44.95 ± 2.29 months. Survival analysis for subtypes reveal, pancreaticobiliary tumors have low survival (27.9 ± 1.63 months) than mixed type (35.5 ± 0.45 months) and intestinal-type (52.92 ± 2.18 months). Among these, intestinal-type have better survival. Only TNM Stage III (tumor staging as per American Joint Committee on Cancer classification) and perineural invasion have been associated with predicting poor survival in PAC patients. Conclusion Our results suggest that the combined expression of MUC1, CK20 and CDX2 could serve as markers to diagnose histological inconclusive specimens as mixed subtype tumors.
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Affiliation(s)
- K Murali Manohar
- Research Labs, Asian Healthcare Foundation, AIG Hospitals, Somajiguda, Telangana, India
| | - M Sasikala
- Research Labs, Asian Healthcare Foundation, AIG Hospitals, Somajiguda, Telangana, India
| | - S Anuradha
- Research Labs, Asian Healthcare Foundation, AIG Hospitals, Somajiguda, Telangana, India
| | - C Ramji
- Research Labs, Asian Healthcare Foundation, AIG Hospitals, Somajiguda, Telangana, India
| | - R B Sashidhar
- Department of Biochemistry, University College of Science, Osmania University, Hyderabad, Telangana, India
| | - G V Rao
- Research Labs, Asian Healthcare Foundation, AIG Hospitals; GI Surgery Divison, Asian Institute of Gastroenterology, Somajiguda, Telangana, India
| | - R Pradeep
- GI Surgery Divison, Asian Institute of Gastroenterology, Somajiguda, Telangana, India
| | - D Nageshwar Reddy
- Research Labs, Asian Healthcare Foundation, AIG Hospitals; GI Surgery Divison, Asian Institute of Gastroenterology, Somajiguda, Telangana, India
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13
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Gogineni S, Mehta A, Shah AG, Kumar S, Nagappa HH, Pradeep R, Javali M, Acharya P, Srinivasa R. A Case of Possible IgG4-Related Disease with Bilateral Optic Neuropathy and Bilateral Hippocampal Bleed. Neurol India 2021; 69:484-486. [PMID: 33904482 DOI: 10.4103/0028-3886.314517] [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: 11/04/2022]
Abstract
IgG4-related disease (IgG4-RD) is a multisystem inflammatory disorder. The diagnosis requires consideration of clinical, radiographic, serological, and pathological evidence. Neurological involvement by IgG4-RD is relatively uncommon and is being increasingly recognized and reported with hypertrophic pachymeningitis and hypophysitis as the most frequent manifestations. IgG4-related involvement of brain parenchyma is rare, but isolated case reports exist. Here, we report a case of a young boy who presented to us with bilateral optic neuropathy and bilateral hippocampal bleed-related neurological involvement in a possible IgG4-RD, a rare entity.
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Affiliation(s)
- Sujana Gogineni
- Department of Neurology, Ramaiah Institute of Neurosciences, Ramaiah Medical College and Hospitals, Bangalore, Karnataka, India
| | - Anish Mehta
- Department of Neurology, Ramaiah Institute of Neurosciences, Ramaiah Medical College and Hospitals, Bangalore, Karnataka, India
| | - Arjun Gaurang Shah
- Department of Medicine, Ramaiah Institute of Neurosciences, Ramaiah Medical College and Hospitals, Bangalore, Karnataka, India
| | - Selva Kumar
- Department of Medicine, Ramaiah Institute of Neurosciences, Ramaiah Medical College and Hospitals, Bangalore, Karnataka, India
| | - H H Nagappa
- Department of Medicine, Ramaiah Institute of Neurosciences, Ramaiah Medical College and Hospitals, Bangalore, Karnataka, India
| | - R Pradeep
- Department of Neurology, Ramaiah Institute of Neurosciences, Ramaiah Medical College and Hospitals, Bangalore, Karnataka, India
| | - Mahendra Javali
- Department of Neurology, Ramaiah Institute of Neurosciences, Ramaiah Medical College and Hospitals, Bangalore, Karnataka, India
| | - Puroshottam Acharya
- Department of Neurology, Ramaiah Institute of Neurosciences, Ramaiah Medical College and Hospitals, Bangalore, Karnataka, India
| | - Rangasetty Srinivasa
- Department of Neurology, Ramaiah Institute of Neurosciences, Ramaiah Medical College and Hospitals, Bangalore, Karnataka, India
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14
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Gogineni S, Gupta D, Pradeep R, Mehta A, Javali M, Acharya PT, Srinivasa R. Deep Cerebral Venous Thrombosis-A Clinicoradiological Study. J Neurosci Rural Pract 2021; 12:560-565. [PMID: 34295112 PMCID: PMC8289541 DOI: 10.1055/s-0041-1730109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Stroke is a common neurological emergency. Almost 80% of strokes are due to arterial occlusion. Venous thrombosis comprises less than 1–2% of all strokes. Involvement of the deep cerebral venous system is still rare and accounts for about 10.9% of all cerebral venous thromboses (CVT). CVT diagnosis is often delayed or missed, because of its variable clinical manifestations. We retrospectively (2015–18) and prospectively (2018–20) reviewed all the cases of CVT in a tertiary care center in south India. Out of a total of 52 CVT cases, 12 were due to the involvement of deep cerebral venous system. Their clinical presentation, imaging characteristics, and outcomes were assessed. The most frequent presentation was headache followed by seizures. Hyperhomocysteinemia was the most common risk factor noted. Imaging characteristics were variable, and a high index of suspicion was required for early diagnosis. All patients had favorable outcome in our study, and except one, all were treated conservatively.
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Affiliation(s)
- Sujana Gogineni
- Department of Neurology, Ramaiah Medical College, Bengaluru, India
| | - Dhananjay Gupta
- Department of Neurology, Ramaiah Medical College, Bengaluru, India
| | - R Pradeep
- Department of Neurology, Ramaiah Medical College, Bengaluru, India
| | - Anish Mehta
- Department of Neurology, Ramaiah Medical College, Bengaluru, India
| | - Mahendra Javali
- Department of Neurology, Ramaiah Medical College, Bengaluru, India
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15
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Talukdar R, Tsuji Y, Jagtap N, Pradeep R, Rao GV, Reddy DN. Non-compliance to practice guidelines still exist in the early management of acute pancreatitis: Time for reappraisal? Pancreatology 2021; 21:S1424-3903(21)00471-3. [PMID: 34049823 DOI: 10.1016/j.pan.2021.05.301] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 04/26/2021] [Accepted: 05/13/2021] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Earlier national surveys on the management of acute pancreatitis (AP) had reported non-compliance to practice guidelines. In the past decade, several guidelines were revised based on new evidence. In this multicenter international survey, we aimed to evaluate the practice patterns of early management of AP and compliance to the revised treatment guidelines across different disciplines and practice environments. METHODS A structured questionnaire was sent via email to a target population of 654 that constituted of medical and surgical gastroenterologists, physicians and general surgeons, paediatricians from academic and non-academic centres across 30 countries. Other than demographic variables, the questionnaire contained items pertaining to early management of AP, such as, assessment at admissions and within first 72 h s, details regarding analgesics, IV hydration, oral/enteral feeding and antibiotic use. RESULTS The response rate was 46.2% and after exclusions, a total of 297 participant's responses were analysed. Majority of the participants were from Asia, followed by Europe and the Americas. 181 (60.9%) claimed to follow practice guidelines, out of which 59 (32.6%) followed more than one. On further probing, only 41.9% were actually compliant to feeding and 59.7% to antibiotic guidelines. Even though participants opted for aggressive hydration, early feeding and avoidance of prophylactic antibiotics, there were non-compliance and discrepancies in titration of fluid therapy, indications of feeding and antibiotic use. DISCUSSION Discrepancies and non-compliance still appear to exist in the early management of AP due to lack of strong evidence. We discuss ways that could improve compliance to the existing guidelines until stronger evidence comes to the fore.
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Affiliation(s)
- Rupjyoti Talukdar
- Dept. of Medical Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, India; Wellcome-DBT Indian Alliance Labs., Institute of Basic and Translational Research, Asian Healthcare Foundation, Hyderabad, India.
| | - Yoshihisa Tsuji
- Dept. of General Medicine, Sapporo Medical University, Japan
| | - Nitin Jagtap
- Dept. of Medical Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, India
| | - R Pradeep
- Dept. of Surgical Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, India
| | - G V Rao
- Dept. of Surgical Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, India
| | - D Nageshwar Reddy
- Dept. of Medical Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, India
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16
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Miryala A, Javali M, Mehta A, Pradeep R, Acharya P, Srinivasa R. Study of Short Latency Somatosensory and Brain Stem Auditory Evoked Potentials Patients with Acute Ischemic Stroke Involving Middle Cerebral Artery Territory. J Neurosci Rural Pract 2021; 12:478-482. [PMID: 34295101 PMCID: PMC8289523 DOI: 10.1055/s-0041-1727558] [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: 11/18/2022] Open
Abstract
Background
The precise timings of evoked potentials in evaluating the functional outcome of stroke have remained indistinct. Few studies in the Indian context have studied the outcome of early prognosis of stroke utilizing evoked potentials.
Objective
The aim of this study was to determine somatosensory evoked potentials (SSEPs) and brain stem auditory evoked potentials (BAEPs), their timing and abnormalities in acute ischemic stroke involving the middle cerebral artery (MCA) territory and to correlate SSEP and BAEP with the functional outcome (National Institutes of Health Stroke Scale (NIHSS), modified Rankin scale (mRS) and Barthel’s index) at 3 months.
Methods
MCA territory involved acute ischemic stroke patients (
n
= 30) presenting consecutively to the hospital within 3 days of symptoms onset were included. Details about clinical symptoms, neurological examination, treatment, NIHSS score, mRS scores were collected at the time of admission. All patients underwent imaging of the brain and were subjected to SSEP and BAEP on two occasions, first at 1 to 3 days and second at 4 to 7 days from the onset of stroke. At 3 months of follow-up, NIHSS, mRS, and Barthel’s index were recorded.
Results
P37 and N20 amplitude had a strong negative correlation (at 1–3 and 4–7 days) with NIHSS at admission, NIHSS at 3 months, mRS at admission, and mRS at 3 months and a significant positive correlation with Barthel’s index (
p
< 0.0001). BAEP wave V had a negative correlation (at 1–3 and 4–7 days) with NIHSS at admission, NIHSS at 3 months, mRS at admission, and mRS at 3 months and a positive correlation with Barthel’s index (
p
< 0.0001).
Conclusion
SSEP abnormalities recorded on days 4 to 7 from onset of stroke are more significant than those recorded within 1 to 3 days of onset of stroke; hence, the timing of 4 to 7 days after stroke onset can be considered as better for predicting functional outcome.
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Affiliation(s)
- Abhishek Miryala
- Department of Neurology, MS Ramaiah Medical College & Hospital, Bengaluru, Karnataka, India
| | - Mahendra Javali
- Department of Neurology, MS Ramaiah Medical College & Hospital, Bengaluru, Karnataka, India
| | - Anish Mehta
- Department of Neurology, MS Ramaiah Medical College & Hospital, Bengaluru, Karnataka, India
| | - R Pradeep
- Department of Neurology, MS Ramaiah Medical College & Hospital, Bengaluru, Karnataka, India
| | - Purushottam Acharya
- Department of Neurology, MS Ramaiah Medical College & Hospital, Bengaluru, Karnataka, India
| | - Rangasetty Srinivasa
- Department of Neurology, MS Ramaiah Medical College & Hospital, Bengaluru, Karnataka, India
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17
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Talukdar R, Reddy DN, Tandan M, Gupta R, Lakhtakia S, Ramchandani M, Kalapala R, Basha J, Nabi Z, Reddy M, Darishetty S, Koppoju V, Pradeep R, Rao GV. Impact of ductal interventions on diabetes in patients with chronic pancreatitis. J Gastroenterol Hepatol 2021; 36:1226-1234. [PMID: 33000865 DOI: 10.1111/jgh.15279] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 08/29/2020] [Accepted: 09/19/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND AIM Even though ductal interventions in chronic pancreatitis (CP) are known to improve pain, its impact on diabetes is unclear. In this cohort study, we evaluated the impact of ductal interventions on diabetes in these patients. METHODS Consecutive patients with CP visiting the pancreas clinic between August 1, 2011, and July 21, 2012, were enrolled and followed until December 2018. Detailed clinical, laboratory, imaging, and treatment data were recorded at enrolment and follow-up. Patients were followed up every 6 months through hospital visit and/or telephonic interview. Risk factors for diabetes were evaluated using logistic regression. The impact of ductal interventions on diabetes was evaluated using Kaplan-Meier survival analyses and Cox proportional hazards. RESULTS A total of 644 patients were enrolled of which 137 were excluded. Of these, 326 (64.3%) patients had idiopathic CP, and 283 (55.8%) patients underwent ductal intervention. The cumulative incidence of diabetes was 57.9%. Median duration between symptom onset and ductal intervention was similar irrespective of diabetes (2.6 [0.6-6.0] vs 3.0 [1.0-5.5] years; P = 0.69). Alcohol intake and pancreatic ductal calculi were independent risk factors for diabetes (odds ratio [95% confidence interval] of 2.05 (1.18-3.55), P = 0.01, and 2.05 (1.28-3.28), P = 0.003, respectively). Kaplan-Meier analyses revealed that diabetes free interval was significantly longer in patients undergoing ductal interventions, predominantly in those with idiopathic CP with obstructive ductal calculi (hazard ratio [95% confidence interval] 0.39 [0.28-0.55]; P < 0.0001). There were no differences in glycemic status in patients with non-idiopathic CP and those with pre-existing diabetes. CONCLUSION Early ductal intervention could delay development of diabetes in patients with idiopathic CP with obstructive ductal calculi.
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Affiliation(s)
- Rupjyoti Talukdar
- Department of Medical Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, India.,Wellcome DBT Laboratories, Institute of Basic Sciences and Translational Research, Hyderabad, India.,Pancreas Research Group, Asian Institute of Gastroenterology, Hyderabad, India
| | - D Nageshwar Reddy
- Department of Medical Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, India
| | - Manu Tandan
- Department of Medical Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, India
| | - Rajesh Gupta
- Department of Medical Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, India
| | - Sundeep Lakhtakia
- Department of Medical Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, India
| | - Mohan Ramchandani
- Department of Medical Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, India
| | - Rakesh Kalapala
- Department of Medical Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, India
| | - Jahangeer Basha
- Department of Medical Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, India
| | - Zaheer Nabi
- Department of Medical Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, India
| | - Manohar Reddy
- Department of Medical Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, India
| | - Santosh Darishetty
- Department of Medical Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, India
| | - Vinod Koppoju
- Department of Medical Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, India
| | - R Pradeep
- Department of Surgical Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, India
| | - G Venkat Rao
- Department of Surgical Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, India
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18
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Nemichandra SC, Pradeep R, Harsha S, Radhika K, Iqbal R. Erectile Dysfunction in Migraine in Indian Patients. Ann Indian Acad Neurol 2021; 23:792-795. [PMID: 33688129 PMCID: PMC7900724 DOI: 10.4103/aian.aian_554_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 12/16/2019] [Accepted: 12/25/2019] [Indexed: 01/03/2023] Open
Abstract
Background: Migraine is one of the common causes of primary headache worldwide. Migraine headaches significantly affect family and social activities. Migraine also impacts the sexual function of the sufferers. There are no published studies in India so far where they have studied the erectile function in male migrainers. This study is done to look for erectile dysfunction in male migrainers. Materials and Methods: This case-control study was done to look for presence of erectile dysfunction in male migrainers and the factors affecting it. Thirty age matched males with migraine and without migraine were studied. The International Headache Society's International Classification of Headache Disorders, 3rd Edition, was used to diagnose migraine with or without aura. Migraine disability assessment scale was used to assess migraine-related disability, Numerical Rating Scale was used assess to the severity of headaches, Migraine-Specific Quality of Life Questionnaire to assess the quality of life, and International Index of Erectile Function score was used to assess the erectile function. Results: The mean age of the cases was 38.83 ± 5.7 years and that of the controls was 38.63 ± 5.3 years. The erectile dysfunction was seen in 80% of migrainers and none in the control group had erectile dysfunction. Those with erectile dysfunction had more severe headache which were severely disabling. Conclusion: Erectile dysfunction is common in migraine. There is a significant negative correlation of erectile dysfunction with severe disabling migraine.
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Affiliation(s)
- S C Nemichandra
- Department of Neurology, JSS Medical College, Mysuru, Karnataka, India
| | - R Pradeep
- Department of Neurology, M.S. Ramaiah Medical College, Bengaluru, Karnataka, India
| | - S Harsha
- Department of Neurology, JSS Medical College, Mysuru, Karnataka, India
| | - K Radhika
- Department of Community Medicine, M.S. Ramaiah Medical College, Bengaluru, Karnataka, India
| | - Roshan Iqbal
- Department of Neurology, JSS Medical College, Mysuru, Karnataka, India
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19
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Shankar AK, Javali M, Mehta A, Pradeep R, Mahale R, Acharya P, Srinivasa R. Role of High Frequency Oscillations of Somatosensory Evoked Potentials in Deciphering Pathophysiology of Migraine. J Neurosci Rural Pract 2021; 12:12-15. [PMID: 33531754 PMCID: PMC7846343 DOI: 10.1055/s-0040-1716793] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background
Habituation deficit is considered as a neurophysiological abnormality among migraineurs in the interictal period. For clear comprehension and clarity about the mechanism underlying habituation in migraine, a sophisticated method, i.e., high frequency oscillations (HFOs) evoked potentials, have been utilized. However, studies pertaining to this in the Indian context are rare.
Objective
The aim of the study is to determine the utility of HFO of somatosensory evoked potential (SSEP) in deciphering the pathophysiology of migraine.
Materials and Methods
Sixty subjects including 30 migraineurs in the interictal period and 30 healthy controls were considered for the study. Median nerve SSEP was recorded in patients and controls by standard protocols. HFO was extracted offline using the Digital zero-phase shift band-pass filtering at 450 and 750 Hz. The early and late HFOs were determined with respect to the N20 peak and were compared between the groups.
Results
Of total 30 migraineurs, 18 had hemicranial headache and 12 had holocranial headache. N20 latency, P25 latency, N20 onset to peak amplitude, and N20 onset to P25 amplitude were comparable in migraineurs and controls. The intraburst frequency of early HFOs in migraineurs was significantly higher (
p
= 0.04), whereas the peak-to-peak amplitude was significantly lower (
p
= 0.001).
Conclusion
Early HFOs on SSEP represent the thalamocortical excitatory drive in migraineurs. Overall, the study reports that reduced amplitude of early HFOs in the interictal period suggest reduced thalamocortical drive in migraineurs.
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Affiliation(s)
- Abhinandan K Shankar
- Department of neurology, MS Ramaiah Medical College & Hospital, Bengaluru, Karnataka, India
| | - Mahendra Javali
- Department of neurology, MS Ramaiah Medical College & Hospital, Bengaluru, Karnataka, India
| | - Anish Mehta
- Department of neurology, MS Ramaiah Medical College & Hospital, Bengaluru, Karnataka, India
| | - R Pradeep
- Department of neurology, MS Ramaiah Medical College & Hospital, Bengaluru, Karnataka, India
| | - Rohan Mahale
- Department of neurology, MS Ramaiah Medical College & Hospital, Bengaluru, Karnataka, India
| | - Purushottam Acharya
- Department of neurology, MS Ramaiah Medical College & Hospital, Bengaluru, Karnataka, India
| | - Rangasetty Srinivasa
- Department of neurology, MS Ramaiah Medical College & Hospital, Bengaluru, Karnataka, India
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20
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Pradeep R, Gupta D, Mehta A, Srinivasa R, Javali M, Acharya PT. Wake-Up Sleepyhead: Unilateral Diencephalic Stroke Presenting with Excessive Sleepiness. J Neurosci Rural Pract 2019; 10:145-147. [PMID: 30765992 PMCID: PMC6337964 DOI: 10.4103/jnrp.jnrp_258_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Altered sleep architecture and stroke share a reciprocal relationship. More than half of the stroke patients display sleep abnormalities including hypersomnia, insomnia, parasomnia, periodic limb movements, or sleep-disordered breathing. Conversely, one of the major causes of severe organic hypersomnia is acute brainstem strokes, involving thalamic infarctions, which may be reversible over 6-12 months. Here, we report a patient with increased lethargy and drowsiness who was diagnosed to have a right thalamic and hypothalamic ischemic stroke.
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Affiliation(s)
- R Pradeep
- Department of Neurology, MS Ramaiah Medical College, Bengaluru, Karnataka, India
| | - Dhananjay Gupta
- Department of Neurology, MS Ramaiah Medical College, Bengaluru, Karnataka, India
| | - Anish Mehta
- Department of Neurology, MS Ramaiah Medical College, Bengaluru, Karnataka, India
| | - R Srinivasa
- Department of Neurology, MS Ramaiah Medical College, Bengaluru, Karnataka, India
| | - Mahendra Javali
- Department of Neurology, MS Ramaiah Medical College, Bengaluru, Karnataka, India
| | - P T Acharya
- Department of Neurology, MS Ramaiah Medical College, Bengaluru, Karnataka, India
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Abstract
Background: Migraine is a common cause of primary headache, with women being affected thrice as common as men. Very few studies are available on sexual dysfunction in female migraineurs. There are no published studies done on the same in India till now. This study was done to look for the prevalence and predictors of sexual dysfunction disorder in females suffering from migraine. Materials and Methods: This is a cross-sectional study done to look for the prevalence and predictors of female sexual dysfunction in migraine. Sixty female patients with migraine were studied. The International Headache Society's International Classification of Headache Disorders, 3rd Edition, was followed to diagnose migraine with or without aura. Migraine disability assessment scale was used to assess migraine-related disability, and Female Sexual Function Index (FSFI) score was used to assess female sexual function. Results: Sexual dysfunction was found in 78.3% migraineurs. The mean FSFI score was 23.1 ± 4.76. The FSFI scores in all the domains were lower in the individuals studied. Acute headaches resulted in loss of sexual desire among all the migraineurs. Conclusion: Sexual dysfunction is common in migraine with all domains of sexual function being affected. There is a significant negative correlation of sexual function with duration of acute episodes of headache and increasing frequency of migraine attacks per month.
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Affiliation(s)
- R Pradeep
- Department of Neurology, MS Ramaiah Medical College, Bengaluru, Karnataka, India
| | - Harsha Sundarmurthy
- Department of Neurology, JSS Medical College and Hospital, Mysuru, Karnataka, India
| | - Vivek Karan
- Department of Neurology, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India
| | - Praveen Kulkarni
- Department of Preventive and Social Medicine, JSS Medical College and Hospital, Mysuru, Karnataka, India
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22
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Rao GV, Pradeep R, Sasikala M, Pavan Kumar P, Krishna VV, Mahesh Shetty G, Talukdar R, Tandan M, Jagadeesh R, Nageshwar Reddy D. Distal pancreatectomy with autologous islet transplantation in chronic pancreatitis patients: First case series from India. Indian J Gastroenterol 2018; 37:452-456. [PMID: 30276765 DOI: 10.1007/s12664-018-0881-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 08/03/2018] [Indexed: 02/04/2023]
Abstract
Pancreatectomy and autologous islet transplantation (AIT) are performed in highly specialized centers to alleviate abdominal pain and preserve endocrine function in patients with chronic pancreatitis. We aimed at initiating AIT studies in India for the first time in patients undergoing distal pancreatectomy (DP) to prevent development of diabetes. Four out of 14 chronic pancreatitis patients screened underwent DP with AIT. Pancreatectomy specimen preserved in Wisconsin solution was subjected to islet isolation employing standard protocol using collagenase V. Isolated islets were infused into the liver through portal vein after quality assessment and the four patients were followed for 1 year. During the study period, blood glucose, fasting insulin, and C-peptide were analyzed and glucose tolerance was assessed. Three patients could be infused with islets (4363 Islet equivalents, IEQ/kg, 3860 IEQ/kg, 3600 IEQ/kg) into liver without any infusion-related complications. Two of these patients maintained glucose tolerance and glycemic control (HbA1c: 6.0%) and one became diabetic at the end of 1 year (HbA1c: 7.5%). Circulating fasting insulin increased (2.7-24.4 μU/mL and 4.0-21.2 μU/mL) and C-peptide levels increased (2.2 to 3.6, 3.4-5.6 ng/mL) in these two patients. Circulating insulin was 2.7 μU/mL and C-peptide was 2.4 ng/mL in the patient who became diabetic at the end of 1 year, while insulin was 2.3 μU/mL and C-peptide was 1.2 ng/mL in the patient who could not be infused with islets after DP. Safety and feasibility of autologous islet transplantation is established in India for the first time.
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Affiliation(s)
- G V Rao
- Asian Institute of Gastroenterology, Somajiguda, Hyderabad, 500 082, India.,Asian Healthcare Foundation, Somajiguda, Hyderabad, 500 082, India
| | - R Pradeep
- Asian Institute of Gastroenterology, Somajiguda, Hyderabad, 500 082, India
| | - M Sasikala
- Asian Healthcare Foundation, Somajiguda, Hyderabad, 500 082, India.
| | - P Pavan Kumar
- Asian Healthcare Foundation, Somajiguda, Hyderabad, 500 082, India
| | - V V Krishna
- Asian Healthcare Foundation, Somajiguda, Hyderabad, 500 082, India
| | - G Mahesh Shetty
- Asian Institute of Gastroenterology, Somajiguda, Hyderabad, 500 082, India
| | - R Talukdar
- Asian Institute of Gastroenterology, Somajiguda, Hyderabad, 500 082, India.,Asian Healthcare Foundation, Somajiguda, Hyderabad, 500 082, India
| | - M Tandan
- Asian Institute of Gastroenterology, Somajiguda, Hyderabad, 500 082, India
| | - R Jagadeesh
- Asian Institute of Gastroenterology, Somajiguda, Hyderabad, 500 082, India
| | - D Nageshwar Reddy
- Asian Institute of Gastroenterology, Somajiguda, Hyderabad, 500 082, India.,Asian Healthcare Foundation, Somajiguda, Hyderabad, 500 082, India
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23
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Goutam UK, Sharma RK, Singh J, Dutta K, Sule US, Pradeep R, Gadkari SC. HAXPES beamline PES-BL14 at the Indus-2 synchrotron radiation source. J Synchrotron Radiat 2018; 25:1541-1547. [PMID: 30179195 DOI: 10.1107/s1600577518008408] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Accepted: 06/06/2018] [Indexed: 06/08/2023]
Abstract
The Hard X-ray Photo-Electron Spectroscopy (HAXPES) beamline (PES-BL14), installed at the 1.5 T bending-magnet port at the Indian synchrotron (Indus-2), is now available to users. The beamline can be used for X-ray photo-emission electron spectroscopy measurements on solid samples. The PES beamline has an excitation energy range from 3 keV to 15 keV for increased bulk sensitivity. An in-house-developed double-crystal monochromator [Si (111)] and a platinum-coated X-ray mirror are used for the beam monochromatization and manipulation, respectively. This beamline is equipped with a high-energy (up to 15 keV) high-resolution (meV) hemispherical analyzer with a microchannel plate and CCD detector system with SpecsLab Prodigy and CasaXPS software. Additional user facilities include a thin-film laboratory for sample preparation and a workstation for on-site data processing. In this article, the design details of the beamline, other facilities and some recent scientific results are described.
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Affiliation(s)
- U K Goutam
- Technical Physics Division, Bhabha Atomic Research Centre, Trombay, Mumbai, India
| | - R K Sharma
- Technical Physics Division, Bhabha Atomic Research Centre, Trombay, Mumbai, India
| | - J Singh
- Technical Physics Division, Bhabha Atomic Research Centre, Trombay, Mumbai, India
| | - K Dutta
- Technical Physics Division, Bhabha Atomic Research Centre, Trombay, Mumbai, India
| | - U S Sule
- Technical Physics Division, Bhabha Atomic Research Centre, Trombay, Mumbai, India
| | - R Pradeep
- Technical Physics Division, Bhabha Atomic Research Centre, Trombay, Mumbai, India
| | - S C Gadkari
- Technical Physics Division, Bhabha Atomic Research Centre, Trombay, Mumbai, India
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24
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Agarwal RK, Sedai A, Ankita K, Parmar L, Dhanya R, Dhimal S, Shriniwas R, Sumithra P, Iyer HV, Gowda A, Gujjal P, Pradeep R, Pushpa H, Jain S, Kondaveeti S, Dasaratha Ramaiah J, Raviteja, Sharma H, Jali S, Viragi S, Bobati S, Tallur NR, Ramprakash S, Faulkner L. Multi-institutional, retrospective review of blood transfusion practices and outcomes in a large cohort of thalassemia patients in South India. Pediatric Hematology Oncology Journal 2017. [DOI: 10.1016/j.phoj.2017.12.001] [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: 10/18/2022] Open
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25
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Sasikala M, Ravikanth VV, Murali Manohar K, Deshpande N, Singh S, Pavan Kumar P, Talukdar R, Ghosh S, Aslam M, Rao GV, Pradeep R, Reddy DN. Bach2 repression mediates Th17 cell induced inflammation and associates with clinical features of advanced disease in chronic pancreatitis. United European Gastroenterol J 2017; 6:272-282. [PMID: 29511557 DOI: 10.1177/2050640617716596] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Accepted: 05/25/2017] [Indexed: 12/29/2022] Open
Abstract
Objectives Altered immune homeostasis and involvement of T cells has been reported in chronic pancreatitis (CP). We evaluated the role of Bach2 (BTB and CNC homology basic leucine zipper transcription factor 2), a key regulator of immune homeostasis in the chronicity of CP. Methods Expression of Bach2 and T-cell transcription factors, enumeration of BACH2+/CD4+ T-lymphocytes were performed by qRT-PCR and flow cytometry respectively. Bach2silenced human CD4+ T-lymphocytes were exposed to CP tissue extract to assess T-cell lineage commitment. Aryl hydrocarbon receptor (Ahr) and Deubiquitinase enzyme A (DUBA/OTUD5gene) were evaluated as markers of persistent Th17 cell differentiation. Bach2 gene (exons) was sequenced to identify risk variants and functionally validated. Results Decrease in Bach2 (p < 0.0001) and increase (p < 0.001) in TBX21, RORC, Ahr, PRDM1, IL23R mRNA were noted in pancreatic tissues, while BACH2+/CD4+ T-lymphocytes were decreased (p < 0.01) in circulation and tissues. Exposure of Bach2 silenced CD4+ T-lymphocytes to CP tissue extract showed increased Ahr, decreased OTUD5, and enhanced Th17 cell differentiation. Sequencing of Bach2 gene revealed association of novel variant (rs9111 in 5'-UTR) with advanced disease and luciferase assay confirmed its role in Bach2 repression. Conclusion Bach2 repression mediates Th17 cell induced inflammation and rs9111-TT in individuals with primary genetic susceptibility to CP is associated with clinical features of advanced disease.
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Affiliation(s)
- M Sasikala
- Asian Healthcare Foundation, Asian Institute of Gastroenterology, Somajiguda, India
| | - V V Ravikanth
- Asian Healthcare Foundation, Asian Institute of Gastroenterology, Somajiguda, India
| | - K Murali Manohar
- Asian Healthcare Foundation, Asian Institute of Gastroenterology, Somajiguda, India
| | - Neha Deshpande
- Asian Healthcare Foundation, Asian Institute of Gastroenterology, Somajiguda, India
| | - Sandhya Singh
- Asian Healthcare Foundation, Asian Institute of Gastroenterology, Somajiguda, India
| | - P Pavan Kumar
- Asian Healthcare Foundation, Asian Institute of Gastroenterology, Somajiguda, India
| | - R Talukdar
- Asian Healthcare Foundation, Asian Institute of Gastroenterology, Somajiguda, India
| | - Sudip Ghosh
- National Institute of Nutrition, Tarnaka, Hyderabad, India Equally contributed to the study and shared first authorship
| | - Mohsin Aslam
- Asian Healthcare Foundation, Asian Institute of Gastroenterology, Somajiguda, India
| | - G V Rao
- Asian Healthcare Foundation, Asian Institute of Gastroenterology, Somajiguda, India
| | - R Pradeep
- Asian Healthcare Foundation, Asian Institute of Gastroenterology, Somajiguda, India
| | - D Nageshwar Reddy
- Asian Healthcare Foundation, Asian Institute of Gastroenterology, Somajiguda, India
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26
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Murali Manohar K, Sasikala M, Kvsrr Y, Sunil V, Talukdar R, Murthy H, Ramji C, Rao GV, Pradeep R, Reddy DN. Plasma microRNA192 in combination with serum CA19-9 as non-invasive prognostic biomarker in periampullary carcinoma. Tumour Biol 2017; 39:1010428317695018. [PMID: 28351309 DOI: 10.1177/1010428317695018] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
In this study, circulating microRNAs (miRNAs) are being investigated as non-invasive biomarkers for early diagnosis and prognosis of human cancers. Since the prognosis for pancreatobiliary subtype of periampullary carcinoma is poor, we assessed the prognostic relevance of miRNAs in combination with CA19-9 as noninvasive biomarker in periampullary carcinoma. Circulating miRNAs in plasma and serum CA19-9 were evaluated in periampullary carcinoma patients (n = 109) undergoing Whipple's pancreaticoduodenectomy and in healthy volunteers (n = 92). Tumour tissues were subjected to staging and subtyping prior to determining differentially expressed miRNAs in them by quantitative real-time polymerase chain reaction (qRT-PCR). Statistical analysis involved correlation, receiver operating characteristic, logistic regression, survival analyses and Cox-proportional regression. Of the three differentially expressed circulating miRNA, miRNA192 was significantly increased both in circulation and in tumour tissue and correlated with tumour stage and aggressiveness (r = 0.96, P < 0.0001). Area under the curve of circulating miRNA192 + CA19-9 combination was 0.877 (95% confidence interval, 0.72 to 0.96) for stage III and 0.92 (95% confidence interval, 0.77 to 0.88) for tumour aggressiveness. The combination was associated with poor survival (median: 22 months, P = 0.0008) in stage III patients. Cox-proportional regression analysis revealed prognostic importance of combination of circulating miR192 and CA19-9 (HR = 1.005, P = 0.0001) in periampullary carcinoma. In conclusion, combination of circulating miRNA192 with serum CA19-9 is a better prognostic biomarker than CA19-9 alone.
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Affiliation(s)
- K Murali Manohar
- 1 Institute of Basic Sciences and Translational Research, Asian Healthcare Foundation, Asian Institute of Gastroenterology, Hyderabad, India
| | - Mitnala Sasikala
- 1 Institute of Basic Sciences and Translational Research, Asian Healthcare Foundation, Asian Institute of Gastroenterology, Hyderabad, India
| | - Yesaswini Kvsrr
- 1 Institute of Basic Sciences and Translational Research, Asian Healthcare Foundation, Asian Institute of Gastroenterology, Hyderabad, India
| | - V Sunil
- 2 Asian Institute of Gastroenterology, Hyderabad, India
| | - Rupjyoti Talukdar
- 1 Institute of Basic Sciences and Translational Research, Asian Healthcare Foundation, Asian Institute of Gastroenterology, Hyderabad, India
- 2 Asian Institute of Gastroenterology, Hyderabad, India
| | - Hvv Murthy
- 1 Institute of Basic Sciences and Translational Research, Asian Healthcare Foundation, Asian Institute of Gastroenterology, Hyderabad, India
| | - C Ramji
- 1 Institute of Basic Sciences and Translational Research, Asian Healthcare Foundation, Asian Institute of Gastroenterology, Hyderabad, India
| | - G V Rao
- 1 Institute of Basic Sciences and Translational Research, Asian Healthcare Foundation, Asian Institute of Gastroenterology, Hyderabad, India
- 2 Asian Institute of Gastroenterology, Hyderabad, India
| | - R Pradeep
- 2 Asian Institute of Gastroenterology, Hyderabad, India
| | - D Nageshwar Reddy
- 1 Institute of Basic Sciences and Translational Research, Asian Healthcare Foundation, Asian Institute of Gastroenterology, Hyderabad, India
- 2 Asian Institute of Gastroenterology, Hyderabad, India
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27
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Pradeep R, Naresh K, Hussain TA, Vikram L, Sivasankar B. Crystal and molecular structure of novel binuclear ten coordinated praseodymium(III) with octadentateethylenediaminetetraacetate – Synthesis, characterization and antioxidant, antiviral and anticancer activities. Journal of Saudi Chemical Society 2017. [DOI: 10.1016/j.jscs.2016.11.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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28
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Dineshshankar J, Venkateshwaran R, Vidhya J, Anuradha R, Mary GP, Pradeep R, Senthileagappan AR. Denture bar-coding: An innovative technique in forensic dentistry. J Pharm Bioallied Sci 2015; 7:S350-3. [PMID: 26538876 PMCID: PMC4606618 DOI: 10.4103/0975-7406.163450] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Denture markers play an important role in forensic odontology and also in identifying a person. A number of methods are there for identifying dentures from a less expensive technique to a more expensive technique. Out of different denture markers, the bar-coding system is a way of collecting data from the mobile. Even a huge amount of data can be stored in that. It can be easily incorporated during acrylization of the denture and thus could be helpful in identification. This article reviews the strengths of bar-coding and how easily it can be used in the routine procedure.
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Affiliation(s)
- Janardhanam Dineshshankar
- Department of Oral and Maxillofacial Pathology, Vivekanandha Dental College for Women, Tiruchengode, Tamil Nadu, India
| | | | - J Vidhya
- Department of Prosthodontics, Sree Balaji Dental College, Chennai, Tamil Nadu, India
| | - R Anuradha
- Department of Prosthodontics, Madha Dental College and Hospital, Chennai, Tamil Nadu, India
| | - Gold Pealin Mary
- Department of Conservative and Endodontics, Sree Balaji Dental College, Chennai, Tamil Nadu, India
| | - R Pradeep
- Department of Prosthodontics, Tagore Dental College, Chennai, Tamil Nadu, India
| | - A R Senthileagappan
- Department of Pedodontics, Chettinad Dental College and Research Institute, Kancheepuram, Tamil Nadu, India
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29
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Shapovalyants SG, Michalev AI, Timofeev ME, Polushkin VG, Volkov VV, Oettinger AP, Lorenz R, Koch A, Köckerling F, Burcharth J, Andresen K, Pommergaard HC, Bisgaard T, Rosenberg J, Friis-Andersen H, Li JW, Le F, Zheng MH, Roscio F, Combi F, Frattini P, Clerici F, Scandroglio I, Zhao X, Nie Y, Liu J, Wang M, Kuo L, Tsai CC, Mok KT, Liu SI, Chen IS, Chou NH, Wang BW, Chen YC, Chang BM, Liang TJ, Kang CH, Tsai CY, Dudai M, Zeng YJ, Liu TL, Shi CM, Sun L, Shu R, Kawaguchi M, Takahashi Y, Tochimoto M, Horiguchi Y, Kato H, Tawaraya K, Hosokawa O, Huang C, Sorge A, Masoni L, Maglio R, Di Marzo F, Mosconi C, Gallinella Muzi M, Kato J, Iuamoto L, Meyer A, Almehdi R, Alazri Y, Sahoo B, Ahmed R, Nasser M, Inaba T, Fukuhsima R, Yaguchi Y, Horikawa M, Ogawa E, Kumata Y, Pokorny H, Fischer I, Resinger C, Lorenz V, Podar S, Längue F, Etherson K, Atkinson K, Khan S, Pradeep R, Viswanath Y, Munipalle PC, Chung J, Schuricht A, Magalhães C, Marcos M, Flores A, Sekmen U, Paksoy M, Ceriani F, Cutaia S, Canziani M, Caravati F. Inguinal Hernia: Recurrences, Tailored Surgery & Pubic Inguinal Pain Syndrome (Sportsman Hernia). Hernia 2015; 19 Suppl 1:S167-75. [PMID: 26518795 DOI: 10.1007/bf03355345] [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: 11/28/2022]
Affiliation(s)
- S G Shapovalyants
- Department of Hospital Surgery 2, Russian National Research Medical University, Moscow, Russia
| | - A I Michalev
- Department of Hospital Surgery 2, Russian National Research Medical University, Moscow, Russia
| | - M E Timofeev
- Department of Hospital Surgery 2, Russian National Research Medical University, Moscow, Russia
| | - V G Polushkin
- Department of Hospital Surgery 2, Russian National Research Medical University, Moscow, Russia
| | - V V Volkov
- Department of Hospital Surgery 2, Russian National Research Medical University, Moscow, Russia
| | - A P Oettinger
- Institution of Applied Medical Sciences, Russian National Research Medical University, Moscow, Russia
| | - R Lorenz
- Hernia Center 3 Chirurgen, Berlin, Germany
| | - A Koch
- Surgical Practise, Cottbus, Germany
| | - F Köckerling
- Klinik für Allgemein, Viszeral und Gefäβchirurgie, Vivantes Klinikum Spandau, Berlin, Germany
| | - J Burcharth
- Center for Perioperative Optimization, Department of Surgery, Herlev Hospital, Herlev, Denmark
| | - K Andresen
- Center for Perioperative Optimization, Department of Surgery, Herlev Hospital, Herlev, Denmark.,Department of Surgery, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark
| | - H-C Pommergaard
- Center for Perioperative Optimization, Department of Surgery, Herlev Hospital, Herlev, Denmark
| | - T Bisgaard
- Department of Surgery, Hvidovre Hospital, Hvidovre, Denmark.,The Danish Hernia Database, Copenhagen, Denmark
| | - J Rosenberg
- Center for Perioperative Optimization, Department of Surgery, Herlev Hospital, Herlev, Denmark.,The Danish Hernia Database, Copenhagen, Denmark.,Department of Surgery, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark
| | | | - J W Li
- Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | | | | | - F Roscio
- Department of Surgery - Division of General Surgery, Galmarini Hospital, Tradate, Italy
| | - F Combi
- Department of Surgery - Division of General Surgery, Galmarini Hospital, Tradate, Italy
| | - P Frattini
- Department of Surgery - Division of General Surgery, Galmarini Hospital, Tradate, Italy
| | - F Clerici
- Department of Surgery - Division of General Surgery, Galmarini Hospital, Tradate, Italy
| | - I Scandroglio
- Department of Surgery - Division of General Surgery, Galmarini Hospital, Tradate, Italy
| | - X Zhao
- Beijing Chao-Yang Hospital, Beijing, China
| | | | | | | | - L Kuo
- Department of General Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | | | | | | | | | | | | | | | | | | | | | | | - M Dudai
- Hernia Excellence, Ramat Aviv Medical Center, Tel Aviv, Israel
| | - Y J Zeng
- Department of Gastroenterology and Hernia, The first affiliated hospital of Kunming Medical University, Kunming, China
| | - T L Liu
- Department of Gastroenterology and Hernia, The first affiliated hospital of Kunming Medical University, Kunming, China
| | - C M Shi
- Department of Gastroenterology and Hernia, The first affiliated hospital of Kunming Medical University, Kunming, China
| | - L Sun
- Department of Gastroenterology and Hernia, The first affiliated hospital of Kunming Medical University, Kunming, China
| | - R Shu
- Department of Gastroenterology and Hernia, The first affiliated hospital of Kunming Medical University, Kunming, China
| | - M Kawaguchi
- Yokohama Sakae Kyosai Hospital, Yokohama, Japan
| | - Y Takahashi
- Yokohama Sakae Kyosai Hospital, Yokohama, Japan
| | - M Tochimoto
- Yokohama Sakae Kyosai Hospital, Yokohama, Japan
| | - Y Horiguchi
- Yokohama Sakae Kyosai Hospital, Yokohama, Japan
| | - H Kato
- Yokohama Sakae Kyosai Hospital, Yokohama, Japan
| | - K Tawaraya
- Yokohama Sakae Kyosai Hospital, Yokohama, Japan
| | - O Hosokawa
- Yokohama Sakae Kyosai Hospital, Yokohama, Japan
| | - C Huang
- Cathay medical center, Taipei, Taiwan.,Taipei medical university, Taipei, Taiwan
| | - A Sorge
- Ospedale S. Giovanni Bosco, Napoli, Italy
| | | | - R Maglio
- Ospedale Israelitico, Roma, Italy
| | - F Di Marzo
- Ospedale S. Giovanni Bosco, Napoli, Italy
| | - C Mosconi
- Policlinico Universitario Tor Vergata, Roma, Italy
| | | | - J Kato
- University of Sao Paulo Medical School, Sao Paulo, Brazil
| | - L Iuamoto
- University of Sao Paulo Medical School, Sao Paulo, Brazil
| | - A Meyer
- Abdominal Wall Repair Center, Samaritano Hospital, Sao Paulo, Brazil
| | | | | | | | | | | | - T Inaba
- Department of Surgery, Teikyo University Hospital, Tokyo, Japan
| | - R Fukuhsima
- Department of Surgery, Teikyo University Hospital, Tokyo, Japan
| | - Y Yaguchi
- Department of Surgery, Teikyo University Hospital, Tokyo, Japan
| | - M Horikawa
- Department of Surgery, Teikyo University Hospital, Tokyo, Japan
| | - E Ogawa
- Department of Surgery, Teikyo University Hospital, Tokyo, Japan
| | - Y Kumata
- Department of Surgery, Teikyo University Hospital, Tokyo, Japan
| | - H Pokorny
- LK Wiener Neustadt, Wiener Neustadt, Austria
| | | | | | | | | | | | - K Etherson
- Department of Surgery, James Cook University Hospital, Middlesbrough, UK
| | - K Atkinson
- Department of Surgery, James Cook University Hospital, Middlesbrough, UK
| | - S Khan
- Department of Surgery, James Cook University Hospital, Middlesbrough, UK
| | - R Pradeep
- Department of Surgery, James Cook University Hospital, Middlesbrough, UK
| | - Y Viswanath
- Department of Surgery, James Cook University Hospital, Middlesbrough, UK
| | | | - J Chung
- University of Pennsylvania Health System, Philadelphia, USA
| | - A Schuricht
- University of Pennsylvania Health System, Philadelphia, USA
| | | | - M Marcos
- Centro Hospitalar Porto, Porto, Portugal.,Institute Cuf, Porto, Portugal
| | - A Flores
- Centro Hospitalar Porto, Porto, Portugal.,Institute Cuf, Porto, Portugal
| | - U Sekmen
- Acibadem Hospital, Istanbul, Turkey
| | - M Paksoy
- Dept. of Gen. Surg., Istanbul Uni. Cerrahpasa Med. School, Istanbul, Turkey
| | - F Ceriani
- Multimedica Santa Maria, Castellanza, Va, Italy
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30
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Abstract
BACKGROUND Sexual functioning and variables that influence sexual functioning have not been studied in Indian women with epilepsy. MATERIALS AND METHODS In a pilot study, female (age, 18-45 years) outpatients with epilepsy who were in a stable sexual relationship for at least 1-year were screened using the mini international neuropsychiatric interview. Those without anxiety or depressive disorders (n = 60) were studied using the female sexual function index (FSFI; higher scores indicate better functioning). Findings were compared with age- and sex- matched sample of healthy control women drawn from the same sociodemographic population. RESULTS Women with epilepsy had significantly poorer sexual functioning on all FSFI subscales (desire, arousal, lubrication, orgasm, satisfaction, pain), as well as on the total scale scores, and >70% of these women were rated as dysfunctional on individual FSFI subscales and on the total scale. In multivariate analysis, use of clobazam and phenobarbitone, and longer time after the last seizure were each associated with significantly higher FSFI scores; and longer duration of epilepsy was associated with significantly lower FSFI scores. CONCLUSION There is a substantial impairment of sexual functioning in women with epilepsy. This study demonstrates the need for increased awareness of the problem, better case identification, and improved seizure control.
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Affiliation(s)
- Vivek Karan
- Department of Neurology, JSS Medical College and Hospital, JSS University, Mysore, Karnataka, India
| | - S Harsha
- Department of Neurology, JSS Medical College and Hospital, JSS University, Mysore, Karnataka, India
| | - B S Keshava
- Department of Neurology, JSS Medical College and Hospital, JSS University, Mysore, Karnataka, India
| | - R Pradeep
- Department of Neurology, JSS Medical College and Hospital, JSS University, Mysore, Karnataka, India
| | - T S Sathyanarayana Rao
- Department of Psychiatry, JSS Medical College and Hospital, JSS University, Mysore, Karnataka, India
| | - Chittaranjan Andrade
- Department of Psychopharmacology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
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Mishra H, Pradeep R, Rao GV, Anuradha S, Nageshwar Reddy D. Isolated tuberculosis of the spleen: A case report and review of literature. Indian J Surg 2014; 75:235-6. [PMID: 24426436 DOI: 10.1007/s12262-012-0511-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2008] [Accepted: 04/25/2012] [Indexed: 11/28/2022] Open
Abstract
Isolated involvement of spleen in tuberculosis is a rare entity, particularly among immunocompetent hosts. Herein, we present a 28-year-old man with left abdominal discomfort for 2 years who was found to have a cystic lesion in spleen on evaluation. Eventually, he was diagnosed to have isolated splenic tuberculosis with an involvement of a single lymph node at the splenic hilum. In this rare form of tuberculosis, it seems that splenectomy in addition to standard antitubercular therapy is curative.
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Affiliation(s)
- H Mishra
- Department of Surgical Gastroenterology, Asian Institute of Gastroenterology, 6-3-661, Somajiguda, Hyderabad, 500082 India
| | - R Pradeep
- Department of Surgical Gastroenterology, Asian Institute of Gastroenterology, 6-3-661, Somajiguda, Hyderabad, 500082 India
| | - G V Rao
- Department of Surgical Gastroenterology, Asian Institute of Gastroenterology, 6-3-661, Somajiguda, Hyderabad, 500082 India
| | - S Anuradha
- Department of Pathology, Asian Institute of Gastroenterology, 6-3-661, Somajiguda, Hyderabad, 500082 India
| | - D Nageshwar Reddy
- Department of Medical Gastroenterology, Asian Institute of Gastroenterology, 6-3-661, Somajiguda, Hyderabad, 500082 India
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Kanth VVR, Bhalsing S, Sasikala M, Rao GV, Pradeep R, Avanthi US, Reddy DN. Microsatellite instability and promoter hypermethylation in colorectal cancer in India. Tumour Biol 2014; 35:4347-55. [PMID: 24408015 DOI: 10.1007/s13277-013-1570-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2013] [Accepted: 12/17/2013] [Indexed: 12/01/2022] Open
Abstract
Microsatellite instability (MSI) is an important factor in tumor development and is a hypermutable phenotype caused by the loss of DNA mismatch repair activity. It is important to identify tumors with microsatellite instability as the patients have a better prognosis and differ with response to chemotherapy. Limited data are available on the incidence of MSI in Indian colorectal cancers (CRCs). The objectives of this study were to identify the extent of MSI in Indian CRC patients below 50 years and to determine promoter methylation status of hMLH1 and hMSH2 in relation to MSI. A total of 450 patients were diagnosed with CRC, out of which 91 individuals were recruited as per Bethesda guidelines and were tested for instability by the NCI-recommended Bethesda panel (BAT25, BAT26, D2S123, D5S346, and D17S2720) using labeled primers. The fragments were separated and analyzed on a Beckman GeXP sequencer. Promoter methylation status was determined by restriction enzyme digestion and PCR. MSI (high and low) was seen in 48.4% (44/91) of CRC patients, out of which microsatellite instability-high (MSI-H) was detected in 13.2% (12/91) and microsatellite instability-low (MSI-L) in 35.2% (32/91) and the rest were microsatellite stable (MSS), 51.6% (47/91). Majority of the MSI-H tumors were adenocarcinomas (10/12), in the rectum (8/12), and moderately or poorly differentiated (12/12). Promoter hypermethylation was seen in 75% of the MSI-H, 56.24% of MSI-L, and only 23.4% of MSS individuals. MSI (high and low) was associated with 48.4% of CRC patients, and a significantly higher proportion of promoter hypermethylation of hMLH1 and hMSH2 genes was associated with instable tumors.
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Mohan V, Pradeep R. Carotid intima-media thickness in type 2 diabetes mellitus. J Assoc Physicians India 2012; 60:9-10. [PMID: 23547406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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Sasikala M, Talukdar R, Pavan kumar P, Radhika G, Rao GV, Pradeep R, Subramanyam C, Nageshwar Reddy D. β-Cell dysfunction in chronic pancreatitis. Dig Dis Sci 2012; 57:1764-72. [PMID: 22383081 DOI: 10.1007/s10620-012-2086-7] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2011] [Accepted: 02/06/2012] [Indexed: 12/12/2022]
Abstract
Chronic pancreatitis (CP) is a progressive inflammatory disease characterized by irreversible destruction of pancreatic secretory parenchyma, fibrosis, exocrine atrophy, and endocrine insufficiency leading to diabetes. Secondary diabetes occurring in CP subsequent to destruction of pancreatic β-cells is distinct, since it involves β-cell dysfunction amidst an inflammatory milieu. Even though considerable knowledge is available on the pathophysiology and clinical management of CP, relatively much less is known about the molecular events leading to β-cell dysfunction. Investigators have demonstrated that altered morphology, reduced β-cell mass, and β-cell numbers result in endocrine insufficiency. However, recent reports and our observations suggest that β-cell dysfunction develops in the early stages of CP while clinical diabetes manifests later, when there is profound fibrosis. In the early stages, altered internal milieu and physiology arising due to inflammation and release of cytokines might lead to deranged signaling pathways and islet dysfunction. Subsequently, development of fibrosis causes islet destruction. This suggests that endocrine deficiency in CP is multifactorial. Although the role of transcription factors (Pdx-1, MafA, NeuroD) on β-cell functions is understood, alterations in internal milieu of pancreatic tissue that affects β-cell functions in CP has not been elucidated. In this review, we summarize the factors that have an effect on islet functions. Understanding molecular events of β-cell dysfunction in CP can lead to the development of targeted preventive and therapeutic modalities.
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Affiliation(s)
- M Sasikala
- Asian Healthcare Foundation, Hyderabad, India.
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Pavan Kumar P, Radhika G, Rao GV, Pradeep R, Subramanyam C, Talukdar R, Reddy DN, Sasikala M. Interferon γ and glycemic status in diabetes associated with chronic pancreatitis. Pancreatology 2011; 12:65-70. [PMID: 22487478 DOI: 10.1016/j.pan.2011.12.005] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND/AIMS Although the role of cytokines in the etiopathology of chronic pancreatitis (CP) is well recognized, information on pancreatic tissue cytokines in CP with/without associated diabetes is unavailable. The aim of the present study was to identify the differences in pancreatic cytokines and observe their correlations with the glycemic status in CP. METHODS Pancreata were obtained from CP patients (n = 44), with/without associated diabetes and non-diabetic control subjects (n= 20). Patients with CP were classified into two groups after ascertaining their diabetic status. Pancreatic cytokines (IL 1β, IL 6, IL 8, IL 10, IL 12P70, TNF α, IFN γ) were analyzed by flow cytometer. The influence of individual and cocktail of cytokines on glucose stimulated insulin release (GSIR) was examined by challenging the islets from control subjects. RESULTS The pancreatic IFN γ levels in diabetic and non diabetic CP patients were significantly higher in comparison to controls. The glucose stimulated insulin release (GSIR) in response to high glucose concentration in control islets, islets from non-diabetic and diabetic CP patients was 8.2, 5.67 and 3.15 μU × 10(-3)/min/islet equivalent respectively. IFN γ resulted in 82.35% decrease in GSIR from the control islet cells at a concentration of >20 pg/ml which was reversed by epigallocatechin-3-gallate (EGCG). CONCLUSION These results suggest that IFN γ among other cytokines, play a major role in β-cell dysfunction associated with CP.
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Affiliation(s)
- P Pavan Kumar
- Asian Healthcare Foundation, 6-3-661, Somajiguda, Hyderabad 500082, India
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Mansard MJ, Rao U, Pradeep R, Sekaran A, Rao GV, Reddy DN. Vascular anatomy of strictured small bowel. Trop Gastroenterol 2011; 32:103-106. [PMID: 21922872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
AIM To investigate the role of ischemia in the pathogenesis of small bowel strictures. METHODS Vascular anatomy of 39 small bowel strictures was studied using modified Spalteholtz method. Ten normal small bowel segments were studied as controls. RESULTS 71.8% of small bowel strictures showed block in the mesenteric vessels (p=0.008). Subset analysis of tuberculous strictures showed block in the mesenteric vessels in 70.8% of strictures (p=0.0098). CONCLUSIONS Ischemia plays a significant role in the pathogenesis of small bowel strictures. Mesenteric vasculopathy has a significant association with tuberculous strictures of the intestine.
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Affiliation(s)
- Magnus Jayaraj Mansard
- Department of Surgical Gastroenterology, Asian Institute of Gastroenterology, 6-3-661, Somajiguda, Hyderabad- 500082.
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Dubale N, Anupama NK, Tandon M, Pradeep R, Reddy D, Rao G. Anomalous biliary duct mistaken as hilar stricture. A case report. J Interv Gastroenterol 2011; 1:34-36. [PMID: 21686112 DOI: 10.4161/jig.1.1.14600] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2010] [Revised: 07/11/2010] [Accepted: 07/16/2010] [Indexed: 11/19/2022]
Abstract
Anomalous biliary anatomy is frequently encountered by surgeons during cholecystectomy. Importance of its recognition lies in avoiding serious biliary injuries. One such anomaly is cholecystohepatic duct. We describe rare clinical situation wherein agenesis of CHD along with cholecystohepatic duct was mistaken for hilar stricture.
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38
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B J, Pradeep R, Kumar A, Gopal B. Correlation between the Sucrose Synthase Protein Subfamilies, Variations in Structure and Expression in Stress-derived Expressed Sequence Tag Datasets. ACTA ACUST UNITED AC 2008. [DOI: 10.4172/jpb.1000050] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Dama RR, Mansard MJ, Shetty MG, Rao GV, Pradeep R, Reddy DN. Education of imaging. Gastrointestinal: diagnostic dilemma of tattoed small bowel. J Gastroenterol Hepatol 2008; 23:819. [PMID: 18410614 DOI: 10.1111/j.1440-1746.2008.05448.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Affiliation(s)
- R R Dama
- Asian Institute of Gastroenterology, Surgical Gastroenterology, Hyderabad, Andhra Pradesh, India
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40
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Rakesh K, Banerjee R, Gupta R, Ramji C, Pradeep R, Rao GV, Reddy DN. Eosinophilic pancreatitis with pseudocyst. Indian J Gastroenterol 2007; 26:136-7. [PMID: 17704583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Eosinophilic pancreatitis is a rare entity in patients having underlying systemic manifestations such as peripheral eosinophilia, elevated serum IgE levels and/ or eosinophilic infiltrates in other organs, including the gastrointestinal tract. We report a 38-year-old woman with peripheral eosinophilia in association with acute pancreatitis, pancreatic ascites and pseudocyst.
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Affiliation(s)
- K Rakesh
- Asian Institute of Gastroenterology, Somajiguda, Hyderabad, India
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41
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Rao GV, Pradeep R, Mansard MJ, Ramji C, Banerjee R, Nageshwar Reddy D. Endocytoscopy assists in the intraoperative diagnosis of carcinoma in a patient with chronic pancreatitis. Endoscopy 2007; 39 Suppl 1:E317-8. [PMID: 18273771 DOI: 10.1055/s-2007-966798] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- G V Rao
- Department of Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, Andhra Pradesh, India.
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42
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Gupta R, Lakhtakia S, Tandan M, Banerjee R, Ramchandani M, Anuradha S, Ramji C, Rao GV, Pradeep R, Reddy DN. Capsule endoscopy in obscure gastrointestinal bleeding--an Indian experience. Indian J Gastroenterol 2006; 25:188-90. [PMID: 16974033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Obscure gastrointestinal bleeding (OGIB) is a common indication for capsule endoscopy (CE). Reports on diagnostic yield of CE in this situation show a wide variation. We evaluated the diagnostic yield and clinical impact of CE in patients with OGIB. METHODS We reviewed the medical records of patients with OGIB who underwent CE at our institution between June 2002 and October 2005. RESULTS 154 patients (mean age 47 [SD 17] years; 117 men), including 74 with overt OGIB and 80 with occult OGIB, underwent CE. CE yielded positive findings in 57 of 74 patients (77%) with overt OGIB and 22 of 80 (27%) of those with occult OGIB (p < 0.0001); the overall positive diagnostic yield was 52%. NSAID-induced lesions (15%), angiodysplasias (14%) and aphthous ulcers (12%) were the most frequent findings. CE helped in planning further management in 79% of patients with overt OGIB and 26% of those with occult OGIB. CONCLUSION CE is a useful diagnostic technique in patients with OGIB, especially those with overt OGIB.
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Affiliation(s)
- Rajesh Gupta
- Department of Medical Gastroenterology, Asian Institute of Gastroenterology, 6-3-661 Somajiguda, Hyderabad 500-082, India.
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Abstract
OBJECTIVE To report the first case of Nelson's syndrome due to an ectopic intracranial corticotropin-secreting tumor arising entirely within the cavernous sinus. METHODS We present a case report of Nelson's syndrome with clinical, laboratory, and radiologic features throughout a 25-year period. RESULTS A 54-year-old woman had been treated for Cushing's disease with bilateral adrenalectomy in 1971. Subsequently, Nelson's syndrome developed, and she had severe generalized hyperpigmentation and substantially increased plasma corticotropin levels. In 1976, she underwent a transsphenoidal hypophysectomy. Postoperatively, despite the development of panhypopituitarism and diabetes insipidus, she remained hyperpigmented and had persistently increased plasma corticotropin levels. Throughout the years, efforts to identify the site of the corticotropin-secreting tumor were unsuccessful until 1988, when magnetic resonance imaging revealed a mass in the right cavernous sinus; subsequently, petrosal sinus cannulation corroborated the intracavernous source of excess corticotropin. Cobalt-60 gamma knife radiotherapy in 1992 was followed by a clinical and hormonal response 4 1/2 years later. CONCLUSION This report describes only the second reported case of an intracranial corticotropin-secreting tumor arising entirely within the cavernous sinus and the first such case associated with Nelson's syndrome. Although rare, the possibility of an ectopic intracranial or extracranial pituitary adenoma should be considered in patients with pituitary hypersecretion without clear-cut intrasellar abnormalities or those with no response to surgical resection of the pituitary gland.
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Affiliation(s)
- J R Tucci
- Division of Endocrinology and Metabolism, Roger Williams Medical Center, Boston University School of Medicine, and Brown University School of Medicine, Providence, Rhode Island, USA
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Haribhakti SP, Awasthi S, Pradeep R, Kapoor VK, Kaushik SP. Carcinoma gallbladder: atypical presentations and unusual associations. Trop Gastroenterol 1997; 18:32-4. [PMID: 9197173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Patients with carcinoma of the gall bladder (CaGB) may have atypical presentations and unusual associations. Out of 324 patients with CaGB seen at a tertiary referral center in northern India, 26 (8%) had atypical clinical presentations and 34 (10%) had unusual associations. The atypical presentations were empyema (5), acute cholecystitis (3), post-cholecystectomy benign biliary stricture (3), carcinoma of the head of pancreas (3), gastric outlet obstructions (2) and liver abscess (1). Unusual associations were common bile duct stones (18), left supraclavicular lymph node metastasis (11), Mirizzi's syndrome (3), inguinal lymph node metastasis (1) and umbilical metastasis (1). Majority of these patients had advanced disease and curative resection was not possible; a worthwhile palliation was however possible in the majority.
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Affiliation(s)
- S P Haribhakti
- Department of Surgical Gastroenterology, Sanjay Gandhi Post-Graduate Institute of Medical Sciences Lucknow, India
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Kapoor VK, Pradeep R, Haribhakti SP, Singh V, Sikora SS, Saxena R, Kaushik SP. Intrahepatic segment III cholangiojejunostomy in advanced carcinoma of the gallbladder. Br J Surg 1996; 83:1709-11. [PMID: 9038546 DOI: 10.1002/bjs.1800831215] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The majority of patients with advanced carcinoma of the gallbladder have irresectable disease and require palliation for jaundice, pruritus and cholangitis. Intrahepatic segment III cholangiojejunostomy has been described for palliation of high biliary obstruction in these patients. Forty-one patients with stage IV gallbladder cancer underwent intrahepatic segment III cholangiojejunostomy. Subsequent jaundice, pruritus and cholangitis were documented; liver function tests and isotope hepatobiliary scans were performed. All patients had jaundice, 29 had pruritus and 12 had cholangitis. Postoperative complications included anastomotic leak in six patients and wound infection in six. Five patients died within 30 days of operation. Thirty-two patients were available for follow-up. The procedure failed to relieve jaundice, pruritus or cholangitis in four patients; 18 were free of jaundice, pruritus and cholangitis until death or last follow-up, and ten had recurrent jaundice or cholangitis. Isotope scanning was found to be useful to predict success of the procedure. Intrahepatic segment III cholangiojejunostomy provided excellent palliation from jaundice, pruritus and cholangitis with acceptable mortality and morbidity rates in patients with advanced carcinoma of the gallbladder.
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Affiliation(s)
- V K Kapoor
- Department of Surgical Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
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47
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Abstract
Prognosis of carcinoma of the gallbladder can be improved by diagnosing the disease in the early stages. Records of 14 patients with early (UICC AJCC TNM stages I and II) carcinoma of the gallbladder were analyzed. Clinical presentation in all these patients was like benign biliary disease. Ultrasonography could diagnose carcinoma of the gallbladder in only five patients; in the remaining nine patients, even the ultrasonographic diagnosis was benign biliary disease. All patients were operated; carcinoma of the gallbladder was diagnosed at operation in two more patients, but it was first detected only after histological examination in seven patients. All patients except four had associated gallstones. Preoperative diagnosis of early carcinoma of the gallbladder is difficult. The only way to diagnose early carcinoma of the gallbladder is by early surgical treatment of patients with clinical features of benign biliary disease.
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Affiliation(s)
- V K Kapoor
- Department of Surgical Gastroenterology, Sanjay Gandhi Post-Graduate Institute of Medical Sciences, Lucknow, India
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Abstract
BACKGROUND The role of resectional surgery in patients with advanced stages of gallbladder carcinoma has not been fully defined. It is generally believed that the survival depends on the stage of the disease, rather than on the treatment option. METHODS Seventeen selected risk factors were analyzed using univariate and multivariate analyses to predict survival in 87 patients with gallbladder carcinoma who had undergone some form of surgical treatment. Similarly, a subset of 55 patients with American Joint Committee on Cancer Stage IV disease also was analyzed separately. RESULTS Palpable mass, tumor (T) status, local infiltration, lymph node involvement, distant metastasis, TNM stage, and the type of surgical treatment (laparotomy alone, bypass, or resection) were significant risk factors by univariate analysis. In addition to palpable mass and the type of surgical treatment, age was also a significant predictor of survival by multivariate analysis. Multivariate analysis of patients with Stage IV disease revealed the same three factors to be significant. In this subset of patients, the median survival after resectional surgery was 16.3 months; after biliary and/or gastric bypass, 4.8 months; and after laparotomy alone, 1.6 months. CONCLUSIONS The type of surgical treatment significantly influenced survival. Resectional surgery was associated with better survival compared with biliary and/or gastric bypass or laparotomy alone for patients with all stages of the disease, including those with advanced carcinoma of the gallbladder.
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Affiliation(s)
- R Pradeep
- Department of Surgical Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
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Pradeep R, Kaushik SP. Intra-abdominal abscess--a challenge for abdominal surgeons. Indian J Gastroenterol 1995; 14:1-2. [PMID: 7860108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Sikora SS, Kapoor R, Pradeep R, Kapoor VK, Saxena R, Kaushik SP. Palliative surgical treatment of malignant obstructive jaundice. Eur J Surg Oncol 1994; 20:580-4. [PMID: 7523198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
One-hundred-and-forty-five cases of malignant obstructive jaundice were seen from January 1989-December 1992. Carcinoma gallbladder (74/145) and carcinoma pancreas (67/145) were the two common causes. Fifty patients underwent a palliative surgical biliary bypass procedure. Jaundice was present in all the patients. Pruritus (40/50), cholangitis (17/50) and gastric outlet obstruction (11/50) were the other predominant symptoms which required palliation. Surgical palliation was achieved with a morbidity and mortality of 38% and 8%, respectively. Jaundice, pruritus and cholangitis were relieved in 92%, 88% and 88%, respectively. All patients with gastric outlet obstruction had complete relief. The mean hospital stay was 18.5 days. The mean survival was 6.5 months and 8.6 months for carcinoma gallbladder and carcinoma pancreas, respectively.
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Affiliation(s)
- S S Sikora
- Department of Surgical Gastroenterology, Sanjay Gandhi Post-Graduate Institute of Medical Sciences, Lucknow, U.P., India
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