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Targeting inflammation in diabetes: Newer therapeutic options

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World Journal of Diabetes 2014年第5期5卷 697-710页

作者： neeraj kumar Agrawal Saket Kant Department of Endocrinology and Metabolism Institute of Medical Sciences Banaras Hindu University Varanasi 221005 India

Inflammation has been recognised to both decrease beta cell insulin secretion and increase insulin resis-tance. Circulating cytokines can affect beta cell function directly leading to secretory dysfunction and increased apoptosis. These cytokines can also indirectly affect beta cell function by increasing adipocyte *** resulting glucotoxicity and lipotoxicity further enhance the inflammatory process resulting in a vicious cycle. Weight reduction and drugs such as metformin have been shown to decrease the levels of C-Reactive Protein by 31% and 13%, respectively. Pioglitazone, insulin and statins have anti-inflammatory effects. In-terleukin 1 and tumor necrosis factor-α antagonists are in trials and NSAIDs such as salsalate have shown an improvement in insulin sensitivity. Inhibition of 12-lipo-oxygenase, histone de-acetylases, and activation of sirtuin-1 are upcoming molecular targets to reduce in-flammation. These therapies have also been shown to decrease the conversion of pre-diabetes state to diabe-tes. Drugs like glicazide, troglitazone, N-acetylcysteine and selective COX-2 inhibitors have shown benefit in diabetic neuropathy by decreasing inflammatory mark-ers. Retinopathy drugs are used to target vascular en-dothelial growth factor, angiopoietin-2, various protein-ases and chemokines. Drugs targeting the proteinases and various chemokines are pentoxifylline, inhibitors of nuclear factor-kappa B and mammalian target of rapa-mycin and are in clinical trials for diabetic nephropathy. Commonly used drugs such as insulin, metformin, per-oxisome proliferator-activated receptors, glucagon like peptide-1 agonists and dipeptidyl peptidase-4 inhibitors also decrease inflammation. Anti-inflammatory thera-pies represent a potential approach for the therapy of diabetes and its complications.

关键词： Inflammation Insulin resistance Diabetes Neuropathy Retinopathy Nephropathy

Green Communication: An Effective Approach to Minimize Risk of Forgetfulness from Mobile Phone Usage

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E-Health Telecommunication Systems and Networks 2014年第1期3卷 1-7页

作者： Aditi Mishra neeraj kumar Tiwari Department of Computer Science and Engineering Shri Ramswaroop Memorial University Lucknow India

The usage of mobile-phone among children increased significantly. Children are in their growing phase and cells of their body are rapidly dividing, therefore propagation of electro-magnetic (EM) radiation occurs quickly in children. The aim of the present study was to evaluate the extent of mobile-phone usage as well as its possible health effect. A total number of 455 (398 children and 57 adults, 396 urban and 59 rural) students of age group ranging from 10-29 years participated in this study. An “Information Gathering Chronological (IGC) model” was used for the collection and evaluation of information. The four major parameters, i.e. demographic and public uniqueness, mobile-phone consumption patterns, grievance of the “forgetfulness” symptom to the subjects and awareness about the safety measures were included to get the concise information from participants. We have observed that the prevalence of “forgetfulness” was 23.95% among mobile-phone users. The incidence of overall “forgetfulness” symptoms was 23.59%, 17.46%, 25.00% and 37.50% in low (LU), normal (NU), moderate (MU) and heavy (HU) mobile-phone users respectively. A trend for risk for “forgetfulness” was observed in HU as compared to LU in overall mobile-phone users. Three folds and nearly five folds increased risk for “forgetfulness” was found among HU as compared to LU in children (p ≤ 0.0210) and urban area mobile-phone users respectively. No significant difference for “forgetfulness” symptoms was found in other categories (i.e. adult and rural mobile-phone users). These results suggested that the incidences of “forgetfulness” among children from urban area mobile-phone users were significantly increased.

关键词： Cellular Phone Electromagnetic Hypersensitivity (EHS) Self Reported Symptom Forgetfulness

Serum estradiol levels decrease after oophorectomy in transmasculine individuals on testosterone therapy

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Asian Journal of Andrology 2023年第3期25卷 309-313页

作者： Sahil kumar Elise Bertin Cormac O' Dwyer Amir Khorrami Richard Wassersug Smita Mukherjee neeraj Mehra Marshall Dahl Krista Genoway Alexander G Kavanagh Faculty of Medicine University of British ColumbiaVancouver V6T 1Z4British ColumbiaCanada Gender Surgery Program Vancouver Coastal HealthVancouver V5Z 1M9British ColumbiaCanada Department of Obstetrics and Gynecology University of British ColumbiaVancouver V6T 1Z4British ColumbiaCanada Division of Endocrinology Department of MedicineUniversity of British ColumbiaVancouver V6T 1Z2British ColumbiaCanada Division of Plastic and Reconstructive Surgery University of British ColumbiaVancouver V5Z 1M9British ColumbiaCanada Department of Urologic Sciences University of British ColumbiaVancouver V5Z 1M9British ColumbiaCanada

Transmasculine individuals,considering whether to undergo total hysterectomy with bilateral salpingectomy,have the option to have a concomitant *** studies have evaluated hormone changes following testosterone therapy initiation,most of those patients have not undergone *** are currently limited to support health outcomes regarding the decision to retain or remove the *** performed a retrospective chart review of transmasculine patients maintained on high-dose testosterone therapy at a single endocrine clinic in Vancouver,British Columbia,*** transmasculine individuals who underwent bilateral oophorectomy and had presurgical and postsurgical serum data were *** identified 12 transmasculine subjects as controls,who were on testosterone therapy and did not undergo oophorectomy,but additionally matched to the first group by age,testosterone dosing regimen,and body mass *** was a statistically significant decrease in the estradiol levels of case subjects postoophorectomy,when compared to presurgical estradiol levels(P=0.02).There was no significant difference between baseline estradiol levels between control and case subjects;however,the difference in estradiol levels at follow-up measurements was significant(P=0.03).Total testosterone levels did not differ between control and case subjects at baseline and follow-up(both P>0.05).Our results demonstrate that oophorectomy further attenuates estradiol levels below what is achieved by high-dose exogenous testosterone *** clinical outcomes,such as impacts on bone health,were not *** clinical implications of oophorectomy versus ovarian retention on endocrinological and overall health outcomes are currently limited.

关键词： estradiol gender-affirming surgery hysterectomy oophorectomy testosterone therapy transmasculine

Prevalence of Ringing Delusion among Mobile Phone Users

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E-Health Telecommunication Systems and Networks 2012年第4期1卷 37-42页

作者： neeraj kumar Raees A. Khan Department of Computer Science and Engineering Shri Ramswaroop Memorial University Lucknow India

The exponential application of mobile technology has led to a concern about implications of electromagnetic radiation on human health. As we are aware that mobile phone radiates EMR when users communicate to others and that time subscribers of the device are regularly exposed nearby 40% - 50% of total mobile irradiation. We analyzed the risk of "Ringing Delusion" among normal users, moderate users and heavy users when compared to low users. Although the "Ringing Delusion" has not been added in medical terminology but we found frequently such kind of symptoms among mobile phone users. "Ringing Delusion" may be considered as an imagination of ringing voice from cellular phone. The risk was also compared between urban and rural, male and female and adult and children population. The information was gathered through well designed questionnaires for cellular user’s demographic and social characteristics, adopted safety measures and calling duration. Prevalence of “Ringing Delusion” among rural users was higher than the urban users. A trend for the risk was also observed in male users in comparison to female. Study may support innovators to re-examine health effects of mobile phones.

关键词： Extensive User Mobile Phone Ringing Delusion Survey Study Questionnaire Sensitivity

COVID-19 presentation as acute pancreatitis:A case report

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Journal of Acute Disease 2022年第5期11卷 199-201页

作者： Abhyuday kumar A.Valiyaparambath neeraj kumar Amarjeet kumar Ajeet kumar Department of Anaesthesiology AIIMS PatnaBiharIndia801505 Departments of Trauma&Emergency AIIMS PatnaBiharIndia801505

Rationale:The gastrointestinal manifestations of COVID-19 include anorexia,nausea,vomiting,abdominal pain,and ***,pancreatitis as the presentation of COVID-19 is rarely ***’s Concern:A 63-year-old COVID-19 patient presented with complaints of abdominal pain and difficulty breathing for 5 ***:Contrast-enhanced computed tomography of the abdomen suggested acute interstitial pancreatitis without any biliary tract ***:The patient was resuscitated with intravenous fluids based on dynamic parameters of fluid *** patient was started on enteral feeding,analgesics,antibiotics,dexamethasone,low molecular weight heparin,and supportive ***:The patient developed severe acute respiratory distress syndrome and died 6 days after ***:Management of COVID-19 in the presence of pancreatitis is *** early fluid resuscitation is an important aspect of medical management for COVID-19 patients with pancreatitis and restrictive strategies must be *** liver enzymes and renal dysfunction in acute pancreatitis can also limit the use of specific therapies like ***,even though it has shown a beneficial effect in treating COVID-19,can have an additive effect in causing hyperglycemia in these *** should be aware of this atypical presentation of COVID-19 with pancreatitis and adjust their management strategies,keeping in mind the considerations for both diseases.

关键词： Pancreatitis COVID-19 APACHE II Remdesivir Fluid

Sudden cardiac death in a case of Crohn's disease with COVID-19: A case report

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Journal of Acute Disease 2022年第3期11卷 123-126页

作者： neeraj kumar Subhajit Ghosh Abhyuday kumar Sanjeev kumar Prem kumar Departments of Trauma&Emergency All India Institute of Medical SciencesPatnaIndia Departments of Anaesthesiology All India Institute of Medical SciencesPatnaIndia Departments of CTVS All India Institute of Medical SciencesPatnaIndia Departments of Radiology All India Institute of Medical SciencesPatnaIndia

Rationale:The mechanism of sudden cardiac death in COVID-19 can be *** hypersensitivity to 5-ASA therapy leading to myocarditis has been reported in some *** storm syndrome and idiosyncratic reaction with mesalazine use may lead to sudden cardiac death in *** of immunosuppressants in hospitalized COVID-19 patients should be continued with caution,especially in patients with inflammatory bowel ***’s concern:A 75-year-old man who was tested positive for SARS-CoV-2 was admitted with a history of shortness of breath for the last two *** was a known case of Crohn’s disease treated with ***:COVID-19 pneumonia with underlying Crohn’s disease leading to sudden cardiac ***:Remdesivir,antibiotics,steroids,low molecular weight heparin,tablet zinc,tab vitamin C,and other supportive treatment were *** of increased inflammatory markers,itolizumab was given to the patient on the 2nd ***:On the 5th day of the intensive care unit,the patient complained of sudden chest pain with respiratory distress leading to bradycardia and asystole and could not be ***:Causes for sudden cardiac death in COVID-19 pneumonia patients with Crohn’s disease is *** mesalazine may be a safe and effective drug in the management of inflammatory bowel disease,it can induce sytokine strom syndrome and idiosyncratic reactions that could be one of the reasons of sudden cardic ***,we should be aware of its serious and potentially life-threatening complications,especially in COVID-19 infected patients.

关键词： COVID-19 Sudden cardiac death Chron’s disease

Cope's sign and complete heart block secondary to acute cholecystitis: A case report

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Journal of Acute Disease 2020年第4期9卷 176-178页

作者： neeraj kumar Pankaj kumar Prakash K Dubey Abhyuday kumar Amarjeet kumar Department of Trauma and Emergency AIIMS Patna Bihar India Department of Emergency Medicine Paras Global HospitalDarbhangaBiharIndia Department of Anaesthesiology&Critical Care IGIMS Patna Bihar India Department of Anesthesiology AIIMS Patna Bihar India

Rationale: Cope's sign is reflex bradycardia seen in the patient presenting with symptoms of acute cholecystitis. This bradycardia may be due to vagally mediated cardio-biliary reflex. Many of these reflexes due to acute cholecystitis have similar clinical features (some electrocardiographic changes like bradycardia, complete heart block, and asystole) mimicking that of acute coronary syndrome. Patient's concern: A 60-year old male presented with symptoms of acute cholecystitis and referred to the emergency department with complete heart block and abdominal pain with hypotension requiring an emergency temporary pacemaker. Diagnosis: Cope's sign and complete heart block. Intervention: Emergency temporary cardiac pacemaker insertion. Outcomes: The patient was discharged after three days with regular follow-up and advice for laparoscopic cholecystectomy. Lessons: Complete heart block or any symptomatic bradycardia associated with abdominal pain should be under consideration of cholecystitis that may be associated with either presence or absence of gall stones due to cardio biliary reflex.

关键词： Cope sign Complete heart block Temporary pacemaker insertion

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不同三尖瓣修复技术的临床效果分析

不同三尖瓣修复技术的临床效果分析

作者： neeraj kumar Ram 吉林大学

学位级别：硕士

Background and Aim: It has been widely acknowledged, that tricuspid valve repair is not solely done, and itis done along with accompanying repair procedures. Tricuspid valve disease has a directimpact on the severity of the disease. Identifying the risk of the disease or severity of valvelesions which is related to the outcome of the patient, and increase in life span has animportant role in surgical practice. Moreover, location and size of the lesion plays a key rolein the management of the valve to attain the best surgical approach. Several literature hasshown, that patients undergoing concomitant surgical procedures has a less impact ontricuspid valve than mitral and aortic valves, also described as a forgotten valve.[14,15,16]Logically, the patients become asymptomatic during the early onset of disease as the severityof the disease progress symptoms will appear, and the doctors also anonymous to its signsand symptoms so, this disease is hidden until the disease approaches in its severe stages. Andthese diseases also get less importance or attention than left sided heart diseases. Diseaseclassification is depends on the pathology of the valve. In heart, tricuspid valve plays a keyrole in distributing the deoxygenated blood to lungs. The tricuspid valve has three leaflets orcusps which access the regulation of blood flow and maintain the way of systemic *** tricuspid valve damages, the deoxygenated blood regressing back to the right atrium whichalters in pressure and influences pulmonary circulation and systemic circulation. Not onlywith this, tricuspid valve shows major consequences while the patient is having left-sidedheart disorders. The orifice of tricuspid valve is rough and triangular, and is also larger thanthe mitral valve. Chordae tendineae originates from papillary muscles, which attaches to thecusps of the valve. During systole, right ventricle contracts, and the tricuspid valve closes,papillary muscles come in action to pull the chordae

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COVID-19-associated mucormycosis and treatments

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Asian Pacific Journal of Tropical Medicine 2021年第9期14卷 401-409页

作者： Vetriselvan Subramaniyan Shivkanya Fuloria Hari kumar Darnal Dhanalekshmi Unnikrishnan Meenakshi Mahendran Sekar Rusli Bin Nordin Srikumar Chakravarthi Kathiresan V.Sathasivam Shah Alam Khan Yuan Seng Wu Usha kumari Kalvatala Sudhakar Rishabha Malviya Vipin kumar Sharma neeraj kumar Fuloria Faculty of Medicine Bioscience and NursingMAHSA UniversityJalan SP 2Bandar Saujana Putra42610 Jenjarom SelangorMalaysia Faculty of Pharmacy&Centre of Excellence for Biomaterials Engineering AIMST UniversityBedong 08100KedahMalaysia Jeffrey Cheah School of Medicine&Health Sciences Monash UniversitySelangor 47500Malaysia College of Pharmacy National University of Science and Technology130 MuscatSultanate of Oman Department of Pharmaceutical Chemistry Faculty of Pharmacy and Health SciencesUniversiti Kuala Lumpur Royal College of Medicine PerakIpoh 30450Malaysia Faculty of Applied Science&Centre of Excellence for Biomaterials Engineering AIMST UniversityKedahBedong 08100Malaysia Centre for Virus and Vaccine Research&Department of Biological Sciences School of Medical and Life SciencesSunway UniversitySelangor 47500Malaysia Faculty of Medicine AIMST UniversityKedah 08100Malaysia School of Pharmaceutical Sciences(LIT-Pharmacy) Lovely Professional UniversityJalandhar 144411India Department of Pharmacy SMASGalgotias UniversityGreater Noida 203201India Department of Pharmaceutical Sciences Gurukul KangriHaridwarUttarakhand 249404India

In the current pandemic,COVID-19 patients with predisposing factors are at an increased risk of mucormycosis,an uncommon angioinvasive infection that is caused by fungi with Mucor genus which is mainly found in plants and *** development in COVID-19 patient is related to various factors,such as diabetes,immunocompromise and *** use of glucocorticoids for the treatment of critically ill COVID-19 patients also leads to opportunistic infections,such as pulmonary ***-19 patients with mucormycosis have a very high mortality *** review describes the pathogenesis and various treatment approaches for mucormycosis in COVID-19 patients,including medicinal plants,conventional therapies,adjunct and combination therapies.

关键词： Mucormycosis COVID-19 Immunosuppression Pathogenesis Treatment