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Hepatotoxic Alterations Induced by Subchronic Exposure of Rats to Formulated Fenvalerate (20% EC) by Nose Only Inhalation

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Biomedical and Environmental Sciences 2004年第3期17卷 309-314页

作者： U.MANI A.K.PRASAD v.sureshkumar P.KUMAR KEWAL LAL B.K.MAJI K.K.DUTTA Inhalation Toxicology Laboratory and Animal House Industrial Toxicology Research Centre M. G. Marg P. Box. No.80 Lucknow-226 001 IndiaInhalation Toxicology Laboratory and Animal House Industrial Toxicology Research Centre M. G. Marg P. Box. No.80 Lucknow-226 001 IndiaInhalation Toxicology Laboratory and Animal House Industrial Toxicology Research Centre M. G. Marg P. Box. No.80 Lucknow-226 001 India Inhalation Toxicology Laboratory and Animal House Industrial Toxicology Research Centre M. G. Marg P. Box. No.80 Lucknow-226 001 IndiaInhalation Toxicology Laboratory and Animal House Industrial Toxicology Research Centre M. G. Marg P. Box. No.80 Lucknow-226 001 India

Objective Fenvalerate (20% EC) is a synthetic pyrethroid, which is commonly used in India by farmers for the protection of many food and vegetable crops against a wide variety of insects. However, its inhalation toxicity data is very limited in the literature due to the fact that the exposure levels associated with these effects were usually not reported. Hence, inhalation exposure was carried out to investigate the hepatotoxic effects. Method Adult male rats were exposed to fen for 4 h/day, 5 days a week for 90 days by using Flow Past Nose Only Inhalation Chamber. Sham treated control rats were exposed to compressed air in the inhalation chamber for the same period. Results The results indicated hepatomegaly, increased activities of serum clinical enzymes (indicative of liver damage/dysfunction) along with pronounced histopathological damage of liver. Conclusion The hepatotoxic potential of formulated Fen (20% EC) in rats exposed by nose only inhalation is being reported for the first time and warrant adequate safety measures for human beings exposed to this insecticide, particularly by inhalation route.

关键词： Fenvalerate Rat Inhalation Hepatotoxicity

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Effect of Zr^(4+)on piezoelectric,dielectric and ferroelectric properties of barium calcium titanate lead-free ceramics

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Journal of Advanced Dielectrics 2021年第6期11卷 23-31页

作者： Prasanta Kumar Panda Benudhar Sahoo v.sureshkumar Ekaterina Dmitrievna Politova Materials Science Division CSIR-National Aerospace Laboratories KodihalliBengaluru 560017India Semenov Federal Research Centre for Chemical Physics Russian Academy of Sciences Kosygin 4Moscow 119991Russia

Ba_(0.85)Ca_(0.15)(Ti1−xZrx)O_(3)(BCTZ)ceramics with x=0.05,0.10,_(0.15),0.20,0.25,0.30 were prepared by the solid-state reaction *** of the powders was carried out at 1100°C for 4 h and the green pellets were sintered at 1400°C for 2 h.X-ray diffraction patterns of the sintered pellets showed tetragonal splitting up to x=0.10 while the mixture of the rhombohedral/cubic phase appeared at higher ZrO_(2)*** piezoelectric charge constant d33=510 pC/N and strain(S=0.103%)were measured for BCT doped by 0.10 mol ZrO_(2).Dielectric constant,remnant polarization and saturation polarization also found maxima for this *** Curie temperature(TC)of the compositions decreased with increase in ZrO_(2)concentration and reached 98°C,87°C and 36°C at x=0.05,0.10,_(0.15)mol,*** remaining compositions have TC below the room temperature;therefore,they can be used for subzero/cryogenic *** scanning electron microscopy study revealed an increase in grain size with increase in ZrO_(2)concentration and confirmed the complete solubility of ZrO_(2)in the crystal ***,low ZrO_(2)-doped BCT compositions with high d33 could be suitable for low temperature(<80°C)applications.

关键词： ZrO_(2)-doped BCT lead-free piezoelectrics high piezoelectric charge constant Curie temperature

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Emerging role of cell-free DNA in kidney transplantation

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World Journal of Experimental Medicine 2021年第5期11卷 55-65页

作者： Bhavna Chopra Kalathil K sureshkumar Nephrology and Hypertension Allegheny General HospitalPittsburghPA 15212United States Division of Nephrology Department of MedicineAllegheny General HospitalAllegheny Health NetworkPittsburghPA 15212United State

Monitoring kidney transplants for rejection conventionally includes serum creatinine,immunosuppressive drug levels,proteinuria,and donor-specific antibody(DSA).Serum creatinine is a late marker of allograft injury,and the predictive ability of DSA regarding risk of rejection is *** analysis of an allograft biopsy is the standard method for diagnosing rejection but is invasive,inconvenient,and carries risk of *** has been a long quest to find a perfect biomarker that noninvasively predicts tissue injury caused by rejection at an early stage,so that diagnosis and treatment could be pursued without delay in order to minimize irreversible damage to the *** this review,we discuss relatively novel research on identifying biomarkers of tissue injury,specifically elaborating on donor-derived cell-free DNA,and its clinical utility.

关键词： Biomarker Donor-derived cell-free DNA Kidney allograft outcomes Kidney transplant Allograft biopsy

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Effectiveness of m-health technology-enabled physical activity program on physical activity adoption and adherence in people with hypertension in India:A randomized controlled trial protocol

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Chronic Diseases and Translational Medicine 2024年第2期10卷 92-101页

作者： vidhi Thakar sureshkumar Kamalakannan v.Prakash Ashok&Rita Patel Institute of Physiotherapy Charotar University of Science and TechnologyChangaAnandGujaratIndia Department of Social Work Education and Community-WellbeingNorthumbria UniversityNewcastle upon TyneUK

Background Exercise and medication have similar benefits in reducing blood pressure(BP);however,hypertension management initiatives primarily focus on *** is due to scarce research on the effectiveness of implementation strategies for optimal exercise adoption and *** were found to be effective in delivering hypertension care and increase exercise *** this,only a small number of research projects in India have used smartphones as a strategy for managing *** We hypothesized that smartphone application-based care would lead to higher exercise adherence among adults(30–79 years)with hypertension compared to those who receive usual *** will be a multicentric,randomized controlled,parallel-design,superiority clinical *** outcome assessor and data analyst will be blinded to group *** in the intervention group will receive mobile application-based care for 6 *** in the usual care group will receive a standard *** groups will receive the same number of *** The primary outcome is the difference in the proportion of people adherent to the recommended level of physical activity evaluated using an exercise adherence rating scale in the intervention group and the control *** adoption will be measured as the percentage of eligible participants in each study setting willing to initiate the exercise *** secondary outcome includes differences in systolic and diastolic BP and self-management(evaluated using the Hypertension Self-Care Profile).The trial outcome will be accompanied by a process *** This research will inform about the comparative effectiveness of conventional and m-health interventions for exercise adoption and adherence in people with hypertension in resource-constrained settings.

关键词： hypertension low-and middle-income countries m-health physical activity adherence

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vaccinations in kidney transplant recipients: Clearing the muddy waters

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World Journal of Transplantation 2019年第1期9卷 1-13页

作者： Swati Arora Gretchen Kipp Nitin Bhanot Kalathil K sureshkumar Divisions of Nephrology and Hypertension Allegheny General HospitalAllegheny Health Network Department of Pharmacy Allegheny General HospitalAllegheny Health Network Infectious Diseases Department of MedicineAllegheny General HospitalAllegheny Health Network

vaccine preventable diseases account for a significant proportion of morbidity and mortality in transplant recipients and cause adverse outcomes to the patient and allograft. Patients should be screened for vaccination history at the time of pre-transplant evaluation and vaccinated at least four weeks prior to transplantation. For non-immune patients, dead-vaccines can be administered starting at six months post-transplant. Live attenuated vaccines are contraindicated after transplant due to concern for infectious complications from the vaccine and every effort should be made to vaccinate prior to *** transplant recipients are on life-long immunosuppression, these patients may have lower rates of serological conversion, lower mean antibody titers and waning of protective immunity over shorter period as compared to general population. Recommendations regarding booster dose in kidney transplant recipients with sub-optimal serological response are lacking. Travel plans should be part of routine post-transplant assessment and pre-travel vaccines and counseling should be provided. More studies are needed on vaccination schedules, serological response, need for booster doses and safety of live attenuated vaccines in this special population.

关键词： Immunizations Kidney transplant vaccines Transplant outcomes Serological response

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Update on kidney transplantation in human immunodeficiency virus infected recipients

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World Journal of Nephrology 2016年第4期5卷 300-307页

作者： Khaled Nashar Kalathil K sureshkumar Division of Nephrology and Hypertension Department of MedicineAllegheny General HospitalPittsburghPA 15212United States

Improved survival of human immunodefciency virus （HIv） infected patients with chronic kidney disease following the introduction of antiretroviral therapy resulted in the need to revisit the topic of kidney transplantation in these patients. Large cohort studies have demonstrated favorable outcomes and proved that transplantation is a viable therapeutic option. However, HIv-infected recipients had higher rates of rejection. Immunosuppressive therapy did not negatively impact the course of HIv infection. Some of the immunosuppressive drugs used following transplantation exhibit antiretroviral effects. A close collaboration between infectious disease specialists and transplant professionals is mandatory in order to optimize transplantation outcomes in these patients. Transplantation from HIv＋ donors to HIv＋ recipients has been a subject of intense debate. The HIv Organ Policy Equity act provided a platform to research this area further and to develop guidelines. The frst HIv＋ to HIv＋ kidney transplant in the United States and the frst HIv＋ to HIv＋ liver transplant in the world were recently performed at the Johns Hopkins University Medical Center.

关键词： End-stage kidney disease Human immunodeficiency virus Antiretroviral therapy Kidney transplantation

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Kidney transplantation in older recipients:Preemptive high KDPI kidney vs lower KDPI kidney after varying dialysis vintage

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World Journal of Transplantation 2018年第4期8卷 102-109页

作者： Bhavna Chopra Kalathil K sureshkumar Division of Nephrology and Hypertension Department of Medicine Allegheny General Hospital Allegheny Health Network

AIM To evaluate the outcomes of transplanting marginal kidneys preemptively compared to better-quality kidneys after varying dialysis vintage in older *** Using OPTN/United Network for Organ Sharing database from 2001-2015, we identified deceased donor kidney(DDK) transplant recipients > 60 years of age who either underwent preemptive transplantation of kidneys with kidney donor profile index(KDPI) ≥ 85%(marginal kidneys) or received kidneys with KDPI of 35%-84%(better quality kidneys that older wait-listed patients would likely receive if waited longer) after being on dialysis for either 1-4 or 4-8 years. Using a multivariate Cox model adjusting for donor, recipient and transplant related factors-overall and death-censored graft failure risks along with patient death risk of preemptive transplant recipients were compared to transplant recipients in the 1-4 and 4-8 year dialysis vintage *** The median follow up for the whole group was 37 mo(interquartile range of 57 mo). A total of 6110 DDK transplant recipients above the age of 60 years identified during the study period were found to be eligible to be included in the analysis. Among these patients350 received preemptive transplantation of kidneys with KDPI ≥ 85. The remaining patients underwent transplantation of better quality kidneys with KDPI 35-84% after being on maintenance dialysis for either 1-4 years(n = 3300) or 4-8 years(n = 2460). Adjusted overall graft failure risk and death-censored graft failure risk in preemptive high KDPI kidney recipients were similar when compared to group that received lower KDPI kidney after being on maintenance dialysis for either 1-4 years(HR 1.01, 95%CI: 0.90-1.14, P = 0.84 and HR 0.96, 95%CI: 0.79-1.16, P = 0.66 respectively) or 4-8 years(HR 0.82, 95%CI: 0.63-1.07, P = 0.15 and HR 0.81, 95%CI: 0.52-1.25, P = 0.33 respectively). Adjusted patient death risk in preemptive high KDPI kidney recipients were similar when compared to groups that received l

关键词： Preemptive kidney transplantation Kidney donor profile index Dialysis vintage Kidney transplant outcomes Older recipients Waiting list

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Changing organ allocation policy for kidney transplantation in the United States

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World Journal of Transplantation 2015年第2期5卷 38-43页

作者： Bhavna Chopra Kalathil K sureshkumar Division of Nephro-logy and Hypertension Department of Medicine Allegheny General Hospital

The new kidney allocation scheme(KAS) in effect since December 4th 2014 was designed to overcome the shortcomings of previous system. A key feature of the new KAS is preferential allocation of best quality organs to wait-list candidates with the longest predictivesurvival in a concept called longevity matching. Highly sensitized recipients would get extra points and enjoy widespread sharing of organs in order to increase accessibility to transplant. Wait-list candidates with blood group B will be offered organs from donors with A2 and A2 B blood type in order to shorten their wait-list time. Time on the wait list will start from day of listing or date of initiation of dialysis whichever comes first which should benefit candidates with limited resources who might be late to get on the transplant list. Pay back system has been eliminated in the new KAS. These changes in organ allocation policy may lead to increase in median half-life of the allograft and increase the number of transplants; thus resulting in better utilization of a scarce resource. There could be unintended negative consequences which may become evident over time.

关键词： New kidney allocation scheme Longevity matching Highly sensitized Kidney donor profile index Expected post-transplant survival

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Quality indicators in respiratory therapy

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World Journal of Critical Care Medicine 2024年第2期13卷 116-125页

作者： Manjush Karthika sureshkumar vanajakshy Kumaran Praveen Beekanahaali Mokshanatha Research and Innovation Council Srinivas Institute of Medical Sciences and Research CenterSrinivas UniversityMangalore 574146India Department of Health and Medical Sciences Liwa CollegeAbu DhabiUnited Arab Emirates Healthcare Management Tata Institute of Social SciencesMumbai 400088India Medical Administration NS Memorial Institute of Medical SciencesKollam 691020India Research and Innovation Council Srinivas UniversityMangalore 574146India

Quality indicators in healthcare refer to measurable and quantifiable parameters used to assess and monitor the performance,effectiveness,and safety of healthcare *** indicators provide a systematic way to evaluate the quality of care offered,and thereby to identify areas for improvement and to ensure that patient care meets established standards and best *** therapists play a vital role in areas of clinical administration such as infection control practices and quality improvement *** indicators serve as essential metrics for respiratory therapy departments to assess and enhance the overall quality of *** systematically tracking and analyzing indicators related to infection control,treatment effectiveness,and adherence to protocols,respiratory care practitioners can identify areas to improve and implement evidence-based *** article reviewed how to identify,implement,and monitor quality indicators specific to the respiratory therapy departments to set benchmarks and enhance patient outcomes.

关键词： Healthcare Quality indicators Structure Process Outcome Respiratory therapy Department Respiratory therapists

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Role of steroid maintenance in sensitized kidney transplant recipients

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World Journal of Transplantation 2015年第3期5卷 102-109页

作者： Kalathil K sureshkumar Richard J Marcus Bhavna Chopra Division of Nephrology and Hypertension Department of Medi-cineAllegheny General Hospital

AIM: To evaluate whether there is a threshold sensitization level beyond which benefits of chronic steroid maintenance(CSM) emerge. METHODS: Using Organ Procurement and Transplant Network/United Network of Organ Sharing database, we compared the adjusted graft and patient survivals for CSM vs early steroid withdrawal(ESW) among patients who underwent deceased-donor kidney(DDK) transplantation from 2000 to 2008 who were stratified by peak-panel reactive antibody(peak-PRA) titers(0%-30%, 31%-60% and > 60%). All patients received perioperative induction therapy and maintenance immunosuppression based on calcineurin inhibitor(CNI) and mycophenolate mofetil(MMF).RESULTS: The study included 42851 patients. In the 0%-30% peak-PRA class, adjusted over-all graft-failure(HR 1.11, 95%CI: 1.03-1.20, P = 0.009) and patientdeath(HR 1.29, 95%CI: 1.16-1.43, P vs ESW(n = 7399). Over-all(HR 1.04, 95%CI: 0.85-1.28, P = 0.70) and death-censored(HR 0.97, 95%CI: 0.78-1.21, P = 0.81) graft-failure risks were similar and patient-death risk(HR 1.39, 95%CI: 1.03-1.87, P = 0.03) higher for CSM(n = 3495) vs ESW(n = 850) groups for 31%-60% peak-PRA class. In the > 60% peak-PRA class, adjusted overall graft-failure(HR 0.90, 95%CI: 0.76-1.08, P = 0.25) and patientdeath(HR 0.92, 95%CI: 0.71-1.17, P = 0.47) risks were similar and death-censored graft-failure risk lower(HR 0.84, 95%CI: 0.71-0.99, P = 0.04) for CSM(n = 4966)vs ESW(n = 923).CONCLUSION: In DDK transplant recipients who underwent perioperative induction and CNI/MMF maintenance, CSM appears to be associated with increased risk for death with functioning graft in minimally-sensitized patients and improved death-censored graft survival in highly-sensitized patients.

关键词： Sensitization Kidney transplantation Graft survival Steroid withdrawal Older kidney transplant recipients

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