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Congenital anomalies of coronary artery misdiagnosed as coronary dilatations in Kawasaki disease:A clinical predicament

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World Journal of Clinical Pediatrics 2025年第1期14卷 93-100页

作者： Rakesh Kumar Pilania Pallavi L Nadig Suprit Basu Reva Tyagi Abarna Thangaraj Ridhima Aggarwal Munish Arora Arun Sharma surjit singh Manphool singhal Pediatric Allergy Immunology Unit Department of PediatricsAdvanced Pediatrics CenterPost Graduate Institute of Medical Education and ResearchChandigarh 160012ChandīgarhIndia Department of Radiodiagnosis and Imaging Postgraduate Institute of Medical Education and ResearchChandigarh 160012ChandīgarhIndia

BACKGROUND 2D-echocardiography(2DE)has been the primary imaging modality in children with Kawasaki disease(KD)to assess coronary *** To report the presence and implications of incidental congenital coronary artery anomalies that had been misinterpreted as coronary artery abnormalities(CAAs)on *** Records of children diagnosed with KD,who underwent computed tomography coronary angiography(CTCA)at our center between 2013-2023 were *** identified 3 children with congenital coronary artery anomalies in this cohort on *** of CTCA and 2DE were compared in these 3 *** Of the 241 patients with KD who underwent CTCA,3(1.24%)had congenital coronary artery anomalies on CTCA detected *** all 3 patients,baseline 2DE had identified *** was then performed for detailed evaluation as per our unit ***(11-year-boy)amongst the 3 patients had complete KD,while the other two(3.3-year-boy;4-month-girl)had incomplete *** revealed separate origins of left anterior descending artery and left circumflex from left sinus[misinterpreted as dilated left main coronary artery(LCA)on 2DE],single coronary artery(interpreted as dilated LCA on 2DE)and dilated right coronary artery on 2DE in case of anomalous origin of LCA from the main pulmonary *** latter one was subsequently operated *** CTCA is essential for detailed assessment of coronary arteries in children with KD especially in cases where there is suspicion of congenital coronary artery *** solely on 2DE may not be sufficient in such cases,and findings from CTCA can significantly impact therapeutic decision-making.

关键词： Coronary artery abnormalities Congenital coronary artery anomalies Computed tomography coronary angiography Kawasaki disease 2-dimensional echocardiography

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Sustainability Assessment and Ranking of Run of the River(RoR) Hydropower Projects Using Analytical Hierarchy Process(AHP):A Study from Western Himalayan Region of India

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Journal of Mountain Science 2015年第5期12卷 1315-1333页

作者： Deepak KUMAR surjit singh KATOCH Centre for Energy and Environmental Engineering National Institute of Technology

In the present scenario,tapping the unutilised hydropower potential is one of the highest priorities in developing countries of the *** emphasis is being imparted to run of the river(RoR)mode of power ***,the governments are now facing the dilemma whether to promote small hydropower projects(SHPs) or encourage large hydropower projects(LHPs).RoR large hydropower projects result into large scale cutting of mountains for constructing tunnels and access roads,generation of huge quantity of muck and large scale impact on flora and fauna due to diversion of rivers/*** the other hand,though SHPs are claimed to be greener and more sustainable by a section of researchers and energy planners but,they will be required to be set up in large number to generate equivalent amount of *** aim of this study is to rank the most sustainable installed capacity range of RoR hydropower *** achieve this aim,the study proposes the use of quite popular multi-criteria decision making(MCDM)method of Operation Research named Analytical Hierarchy Process.A case study has been presented from Himachal Pradesh,a hydro rich state located in the western Himalayan *** per sustainability assessment carried out in this study,hydropower projects in the capacity range 1 to 5 MW have been ranked to be the most sustainable.

关键词： Sustainability Run of the river Hydropower project Analytical Hierarchy Process Himalaya

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Primary Immune Deficiencies e A rapidly emerging area of basic and clinical research

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Genes & Diseases 2020年第1期7卷 1-2页

作者： surjit singh Xiaodong Zhao Huijie Zhang Allergy Immunology Unit Advanced Pediatrics CentrePost Graduate Institute of Medical Education and Research(PGIMER)Chandigarh160012India Chongqing Key Laboratory of Child Infection and Immunity Ministry of Education Key Laboratory of Child Development and DisordersNational Clinical Research Center for Child Health and Disorders(Chongqing)Children’s Hospital of Chongqing Medical UniversityChongqing400014PR China Department of Rheumatology and Immunology Children’s Hospital of Chongqing Medical UniversityChongqing400014PR China The Editorial Office of Genes&Diseases Periodical Press of Chongqing Medical UniversityChongqing401331PR China

In this special issue of Genes&Diseases,Primary Immune Deficiencies(PIDs)are the main *** is an exciting and a rapidly emerging field of basic and clinical immunology wherein upwards of 400 clinical conditions,with approximately 350 defined mutations,are now *** to common perception,PIDs as a group are not *** studies show that population prevalence of PIDs is approximately 1:*** extrapolations of this figure would suggest that in a large country like China or India,approximately 1 million individuals would be expected to have a ***,at present because of lack of awareness of these conditions amongst both the laity as well as medical professionals,majority of these patients remain undiagnosed and untreated in many developing *** is clearly unfortunate.

关键词： approximate rapidly clinical

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An update on the genetics and pathogenesis of hereditary angioedema

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Genes & Diseases 2020年第1期7卷 75-83页

作者： Aaqib Zaffar Banday Anit Kaur Ankur Kumar Jindal Amit Rawat surjit singh Allergy Immunology Unit Department of PediatricsAdvanced Pediatrics CentrePostgraduate Institute of Medical Education and ResearchChandigarhIndia

Hereditary angioedema(HAE)is an uncommon genetic disorder characterized by recurrent episodes of edema involving subcutaneous tissue and *** pathogenesis of HAE reflects an intricate coordinated regulation of components of complement,kinin and hemostatic *** date,mutations in 4 different genes have been identified to cause HAE which includes serine protease inhibitor G1(SERPING1),factor XII(F12),plasminogen(PLG)and angiopoietin 1(ANGPT 1).These mutations lead to increased bradykinin 2 receptor mediated signalling via increased production of bradykinin except mutations in ANGPT1 gene that disturbs the cytoskeletal assembly of vascular endothelial *** this review we aim to summarize the recent advances in the pathogenesis and genetics of *** also provide an overview of possible future prospects in the identification of new genetic defects in HAE.

关键词： Angiopoietin 1 C1 inhibitor Factor XII Genetics Hereditary angioedema Plasminogen

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Current status and prospects of primary immunodeficiency diseases in Asia

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Genes & Diseases 2020年第1期7卷 3-11页

作者： Rakesh Kumar Pilania Himanshi Chaudhary Ankur Kumar Jindal Amit Rawat surjit singh Allergy Immunology Unit Department of PediatricsAdvanced Pediatrics CentrePostgraduate Institute of Medical Education and ResearchChandigarh160012India

Primary Immunodeficiency Diseases(PIDs)are increasingly being reported across the *** advances have been made in the diagnostic and therapeutic research related to *** increasing awareness,the field of PIDs has rapidly evolved in Asia as *** this review,we summarize the progress that has been made in the field of PIDs in Asian countries;major limitations and challenges faced by the clinicians working in this field in Asia;difference in spectrum of PIDs in Asia from rest of the World;current state of diagnostic and treatment facilities available in various countries in Asia and the future prospects of these diseases in the continent.

关键词： Asia Genetic diagnosis Hematopoietic stem cell transplant Intravenous immunoglobulin Primary immunodeficiency diseases

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An analysis of tourist’s perceptions toward tourism development:Study of cold desert destination,India

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Geography and Sustainability 2021年第1期2卷 48-58页

作者： Ravinder Jangra S.P.Kaushik surjit singh Saini Department of Geography Kurukshetra University KurukshetraHaryana 136119India DGM-GIS and Remote Sensing in Intercontinental Consultants and Technocrats Pvt.Ltd

Tourism impacts on society are complex and ***,they are vital to diverse societies,clusters,and individuals dependent upon their morals,attitudes,and resources existing for tourism *** tourism also brings many ***,tourist experience is fundamental for destination image and *** research examines tourist perceptions and attitudes toward tourism impacts in Chitkul,Kalpa,and Nako in *** sampling has been used to measure tourist responses on a range of indicators related to tourism *** scale responses were analyzed using factor analysis,ANOVA,Mann-Whitney U-test,Kolmogorov test,and descriptive *** results confirmed that tourists do not perceive any type of pollu-tion or societal *** observed that natural magnetism and the socio-cultural milieu of the destination is what attracts ***,tourists are not satisfied with‘networking services’,‘organization efforts’,‘sup-plementary conveniences’,and‘carriage concerns’at selected destinations in ***,Chitkul emerged as the top tourist destination in *** the destination would emerge as a hub of tourist activities shortly considering the congestion and exploitation of nearby tourist destinations at Kulu-Manali-Rohtang in Beas ***,the assessment of tourist perceptions can be used as an indicator of tourism destination competitiveness and can assist in developing appropriate tourism policies and infrastructure upgrades.

关键词： Cold desert Kinnaur Tourist perceptions Factor analysis ANOVA Kolmogorov-Smirnov test

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Platelets in Kawasaki disease:Is this only a numbers game or something beyond?

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Genes & Diseases 2020年第1期7卷 62-66页

作者： Kanika Arora Sandesh Guleria Ankur Kumar Jindal Amit Rawat surjit singh Allergy Immunology Unit Department of PediatricsAdvanced Pediatrics CentrePostgraduate Institute of Medical Education and ResearchChandigarhIndia

Kawasaki disease(KD)is a medium vessel vasculitis with predilection to cause coronary artery *** is now the most common cause of acquired heart disease in developed *** is consistently found in patients with KD,usually in 2nd to 3rd week of *** has occasionally been reported in the acute phase of *** increase or decrease in platelet number in patients with KD was initially considered to be a benign ***,recent literature on platelet biology in KD has suggested that platelets are not only increasing but are rather *** phenomenon has been found to increase the risk of thrombosis in these *** a fall in platelet counts during acute stage of KD has also been found to be associated with increased severity of *** this review,we update on the current best understanding about pathogenic role of platelets in patients with KD.

关键词： Aspirin CD40 ligand Kawasaki disease Platelet derived microparticles Platelets Thrombosis

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Emerging role of computed tomography coronary angiography in evaluation of children with Kawasaki disease

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World Journal of Clinical Pediatrics 2023年第3期12卷 97-106页

作者： Manphool singhal Rakesh Kumar Pilania Pankaj Gupta Nameirakpam Johnson surjit singh Departments of Radiodiagnosis and Imaging Postgraduate Institute of Medical Education and ResearchChandigarh 160012ChandigarhIndia Pediatric Allergy Immunology Unit Department of PaediatricsAdvanced Pediatrics CenterPostgraduate Institute of Medical Education and ResearchChandigarh 160012ChandigarhIndia

Coronary artery abnormalities are the most important complications in children with Kawasaki disease(KD).Two-dimensional transthoracic echocardiography currently is the standard of care for initial evaluation and follow-up of children with ***,it has inherent limitations with regard to evaluation of mid and distal coronary arteries and,left circumflex artery and the poor acoustic window in older children often makes evaluation difficult in this age *** angiography(CA)is invasive,has high radiation exposure and fails to demonstrate abnormalities beyond *** limitations of echocardiography and CA necessitate the use of an imaging modality that overcomes these *** recent years advances in computed tomography technology have enabled explicit evaluation of coronary arteries along their entire course including major branches with optimal and acceptable radiation exposure in *** tomography coronary angiography(CTCA)can be performed during acute as well as convalescent phases of *** is likely that CTCA may soon be considered the reference standard imaging modality for evaluation of coronary arteries in children with KD.

关键词： Coronary artery abnormalities Computed tomography coronary angiography 2D-echocardiography Kawasaki disease Imaging modality Acquired heart disease

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Adipocytokine profile in children with Kawasaki disease at a mean follow-up period of 5.5 years: A study from North India

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World Journal of Clinical Pediatrics 2022年第4期11卷 360-368页

作者： Dibya Lochan Praharaj Amit Rawat Anju Gupta Kanika Arora Rakesh Kumar Pilania Sagar Bhattad surjit singh Pediatric Allergy and Immunology Unit Advanced Pediatrics CentrePost Graduate Institute of Medical Education and ResearchChandigarh 160012India

BACKGROUND Kawasaki disease(KD)is an acute self-limited vasculitis with a predilection for coronary *** with KD may have altered lipid metabolism and abnormal lipid profiles that may last for prolonged ***,there is a paucity of literature on the role of adipocytokines in *** To estimate the levels of adipocytokines(adiponectin,leptin and resistin)during the convalescent phase of *** Twenty children,who had KD at least three years earlier,were enrolled in this *** addition,20 healthy controls were also *** and laboratory profiles of patients were obtained from hospital *** adiponectin,leptin and resistin levels were estimated by enzyme-linked immunosorbent *** Mean age of the patients in the study group was 10.15±3 years and the male:female ratio was 1.5:*** serum resistin levels in patients with KD(27.77 ng/mL;[IQR:18.66,48.90])were decreased compared to controls(21.20 ng/mL;[IQR:14.80,27.00])(P=0.04).Median serum leptin levels in cases and controls were 1.83 ng/mL;(IQR:1.13,3.80),and 1.10 ng/mL;(IQR:0.41,2.88),respectively(P=0.09).Median serum adiponectin levels were similar in both cases(12.20μg/mL;[IQR:9.76,17.97])and controls(13.95μg/mL;[IQR:11.17,22.58]);(P=0.18).There was no significant difference in all 3 adipocytokines between children with(4/20)and without coronary artery abnormalities(16/20).CONCLUSION Serum resistin levels were significantly elevated in patients with KD during the convalescent phase compared to *** leptin levels appeared to be higher in patients with KD,although the difference was not statistically *** levels were similar in both cases and *** resistin and leptin levels may partially explain lipid perturbations observed during the convalescent phase of KD.

关键词： Adipocytokines Adiponectin Resistin Leptin Lipid metabolism Kawasaki disease Convalescent phase

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Radiation dose analysis of computed tomography coronary angiography in Children with Kawasaki disease

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World Journal of Clinical Pediatrics 2023年第4期12卷 230-236页

作者： Mahesh Chandra Bhatt Manphool singhal Rakesh Kumar Pilania Subhash Chand Bansal Niranjan Khandelwal Pankaj Gupta surjit singh Department of Radiodiagnosis and Imaging Postgraduate Institute of Medical Education and ResearchChandigarh 160012India Pediatric Allergy Immunology Unit Department of PediatricsAdvanced Pediatrics CentrePost Graduate Institute of Medical Education and ResearchChandigarh 160012India

BACKGROUND There is evolving role of computed tomography coronary angiography(CTCA)in non-invasive evaluation of coronary artery abnormalities in children with Kawasaki disease(KD).Despite this,there is lack of data on radiation dose in this group of children undergoing *** To audit the radiation dose of CTCA in children with *** Study(December 2013-February 2018)was performed on dual source CT scanner using adaptive prospective *** dose length product(DLP in ***)was *** radiation dose(millisieverts-mSv)was calculated by applying appropriate age adjusted conversion factors as per recommendations of International Commission on Radiological *** dose was compared across the groups(0-1,1-5,5-10,and>10 years).RESULTS Eighty-five children(71 boys,14 girls)with KD underwent *** median age was 5 years(range,2 mo-11 years).Median DLP and effective dose was 21 ***,interquartile ranges(IQR)=15(13,28)and 0.83 mSv,IQR=0.33(0.68,1.01)*** DLP increased significantly across the age *** effective dose in infants(0.63 mSv)was significantly lower than the other age groups(1-5 years 0.85 mSv,5-10 years 1.04 mSv,and>10 years 1.38 mSv)(P<0.05).There was no significant difference in the effective dose between the other groups of *** the CTCA studies were of diagnostic *** child required a repeat *** CTCA is feasible with submillisievert radiation dose in most children with ***,CTCA has the potential to be an important adjunctive imaging modality in children with KD.

关键词： Computed tomography coronary angiography Coronary artery abnormalities Dual source computed tomography Kawasaki disease Radiation exposure

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