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Role of angiotensin converting enzyme and angiotensinogen gene polymorphisms in angiotensin converting enzyme inhibitor-mediated antiproteinuric action in type 2 diabetic nephropathy patients

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World Journal of Diabetes 2017年第3期8卷 112-119页

作者： Neerja Aggarwal Pawan Kumar Kare parul varshney Om Prakash Kalra Sri Venkata Madhu Basu Dev Banerjee Anil Yadav Alpana Raizada Ashok Kumar Tripathi Department of Medicine University College of Medical Sciences (University of Delhi) and Guru Teg Bahadur Hospital Department of Biochemistry University College of Medical Sciences (University of Delhi) and Guru Teg Bahadur Hospital Pt. B. D. Sharma University of Health Sciences

AIM To investigate the role of genetic variants of angiotensin converting enzyme(ACE) and angiotensinogen(AGT) genes in the antiproteinuric efficacy of ACE inhibitor therapy in diabetic nephropathy(DN) *** In the present study, 270 type 2 diabetes mellitus patients with nephropathy were enrolled and treated with ACE inhibitor(ramipril) and followed at 6 mo for renal function and albumin excretion by estimating serum creatinine, end stage renal disease, and albumin/creatinine ratio(ACR) in urine. Genotyping of ACE I/D and AGT M235 T polymorphisms were performed by using primer specific polymerase chain reaction(PCR) and PCR-RFLP techniques, respectively. RESULTS Forty-eight percent of DN patients(responders) benefited with respect to proteinuria from ACE inhibitor therapy at 6 mo follow-up. A significant reduction in ACR was observed after 6 mo treatment with ACE inhibitor irrespective of whether DN patients were micro-albuminuric(≥ 30 and < 300 mg/g creatinine) or macro-albuminuric(≥ 300 mg/g creatinine) at the time of enrollment. However, macro-albuminuric patients(55%) showed better response to therapy. A reduction in urinary ACR was found independent of genotypes of ACE I/D and AGT M235 T polymorphisms although macro-albuminuric patients having TT genotype showed statistically insignificant increased response(72%). CONCLUSION ACE inhibitor therapy reduced urinary ACR by ≥ 30% in 50% of DN patients and the response is independent of ACE I/D and AGT M235 T polymorphisms.

关键词： Diabetic nephropathy Angiotensin converting enzyme inhibitor therapy Renin-angiotensin-aldosterone system gene polymorphisms Responder Urinary albumin/creatinine ratio Albuminuria

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Diabetes is affecting everyone everywhere

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World Journal of Diabetes 2024年第2期15卷 305-307页

作者： parul Chawla Gupta Mona Duggal Arvind Kumar Morya Department of Ophthalmology Post Graduate Institute of Medical Education&ResearchChandigarh 160012PunjabIndia School of Public Health Post Graduate Institute of Medical Education and ResearchChandigarh 160002PunjabIndia Department of Ophthalmology All India Institute of Medical SciencesHyderabad 508126TelanganaIndia

The article titled“Accessibility and Utilization of Healthcare Services Among Diabetic Patients:Is Diabetes a Poor Man’s Ailment?”gave insights into a pandemic systemic disease known as diabetes *** modern-era pandemic affects everyone,regardless of their financial *** a result,diabetes is not a systemic disease which just involves people of low socioeconomic status.

关键词： Diabetes Incidence and prevalence Diabetes mellitus

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Rescue from complications after pancreaticoduodenectomies at a low-volume Caribbean center:Value of tailored peri-pancreatectomy protocols

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World Journal of Gastrointestinal Surgery 2024年第3期16卷 681-688页

作者： Shamir O Cawich Elijah Dixon parul J Shukla Shailesh V Shrikhande Rahul R Deshpande Fawwaz Mohammed Neil W Pearce Wesley Francis Shaneeta Johnson Johann Bujhawan Department of Surgery University of the West IndiesSt Augustine 000000Trinidad and Tobago Department of Surgery Faculty of MedicineUniversity of CalgaryCalgaryAlberta T2N2T9Canada Department of Surgery Weill Cornell Medical CollegeNew YorkNY 10065United States Department of Surgical Oncology Tata Memorial CenterHomi Bhabha National UniversityMumbai 400012India Department of Surgery Manchester Royal InfirmaryManchester M139WLUnited Kingdom University Surgical Unit Southampton General HospitalSouthampton SO166YDUnited Kingdom Department of Surgery University of the West IndiesNassau N-1184Bahamas Department of Surgery Morehouse School of MedicineAtlantaGA 30310United States Department of Surgery General Hospital in Port of SpainPort of Spain 000000Trinidad and Tobago

BACKGROUND Pancreaticoduodenectomy(PD)is a technically complex operation,with a re-latively high risk for *** ability to rescue patients from post-PD complications is as a recognized quality *** protocols were instituted at our low volume facility in the year *** To document the rate of rescue from post-PD complications with tailored protocols in place as a measure of *** A retrospective audit was performed to collect data from patients who experienced major post-PD complications at a low volume pancreatic surgery unit in Trinidad and Tobago between January 1,2013 and June 30,***-dardized definitions from the International Study Group of Pancreatic Surgery were used to define post-PD complications,and the modified Clavien-Dindo classification was used to classify post-PD *** Over the study period,113 patients at a mean age of 57.5 years(standard deviation[SD]±9.23;range:30-90;median:56)underwent PDs at this *** complications were recorded in 33(29.2%)patients at a mean age of 53.8 years(SD:±7.9).Twenty-nine(87.9%)patients who experienced major morbidity were salvaged after aggre-ssive treatment of their ***(3.5%)died from bleeding pseudoaneurysm(1),septic shock secondary to a bile leak(1),anastomotic leak(1),and myocardial infarction(1).There was a significantly greater salvage rate in patients with American Society of Anesthesiologists scores≤2(93.3%vs 25%;P=0.0024).CONCLUSION This paper adds to the growing body of evidence that volume alone should not be used as a marker of quality for patients requiring *** low volumes at our facility,we demonstrated that 87.9%of patients were rescued from major *** attributed this to several factors including development of rescue protocols,the competence of the pancreatic surgery teams and continuous,and adaptive learning by the entire institution,cul-minating in the development of tailored peri-pancreatectomy protoc

关键词： Pancreas Complication Rescue Failure Morbidity Mortality Pancreaticoduodenectomy

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Predictors of cerebrospinal fluid GeneXpert MTB/RIF positivity in patients with tuberculous meningitis:A prospective cohort study

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Asian Pacific Journal of Tropical Medicine 2024年第10期17卷 465-472页

作者： Priyanka Gupta Neeraj Kumar Ravindra Kumar Garg Hardeep Singh Malhotra Imran Rizvi Rajesh Verma Praveen Kumar Sharma Ravi Uniyal Shweta Pandey Amita Jain parul Jain Department of Neurology King George’s Medical UniversityLucknowIndia Department of Microbiology King George’s Medical UniversityLucknowIndia

Objective:To identify the clinical,laboratory,and radiological markers that could predict a positive GeneXpert result in patients suspected of tuberculous ***:In this prospective,observational study,patients with tuberculous meningitis were systematically *** clinical,laboratory[including cerebrospinal fluid(CSF)microscopy,culture,and GeneXpert],and neuroimaging factors were *** participants were administered anti-tuberculous treatment and corticosteroids.A six-month follow-up was done to evaluate the ***:Of the 116 patients studied,54(46.6%)tested positive for GeneXpert,while 62(53.4%)were *** cranial nerve involvement(OR 3.71,95%CI 1.052-13.09,P=0.04)and the presence of basal exudates on neuroimaging(OR 5.22,95%CI 2.03-13.42,P=0.001)emerged as independent predictive factors for a positive GeneXpert result.A positive CSF GeneXpert result(P=0.002)and drug resistance(P=0.004)were significantly linked to adverse ***,a high score on the Medical Research Council stageⅢ(OR 5.64,95%CI 1.18-26.87,P=0.03)and elevated CSF cell counts(OR 1.002,95%CI 1.00-1.001,P=0.03)were identified as independent predictors of poor ***:Third cranial nerve involvement and the presence of basal exudates were significant indicators of a positive GeneXpert *** stageⅢdisability and elevated CSF cell counts predicted poor outcomes.

关键词： Tuberculous meningitis Mycobacterium tuberculosis Cerebrospinal fluid Ziehl-Neelsen staining GeneXpert

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MATHEMATICAL MODELING OF QUINTIC DUFFING EQUATION AND NUMERICAL SIMULATION USING MULTIPLE SCALES MODIFIED LINDSTEDT–POINCARE METHOD

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International Journal of Modeling, Simulation, and Scientific Computing 2012年第3期3卷 21-37页

作者： MANOJ KUMAR parul Department of Mathematics Motilal Nehru National Institute of Technology Allahabad-211004 U.P.India

A perturbation algorithm Multiple Scales Modified Lindstedt–Poincare(MSMLP),combination of method of Multiple Scales and modified Lindstedt–Poincare is proposed for the solution of Quintic Duffing equation which combines the advantages of both the *** obtained by the MSMLP method is compared with the Multiple Scales method and accurate closed form approximate solution of the Quintic Duffing *** proposed method produces better results for a wide range of amplitude values of oscillations and strong *** simulation has been performed in MATHEMATICA 7.0.

关键词： Perturbation methods multiple scales method modified Lindstedt-Poincare method perturbation problems.

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Current and New Drugs for COVID-19 Treatment and Its Effects on the Liver

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Journal of Clinical and Translational Hepatology 2021年第3期9卷 436-446页

作者： Sandeep Satsangi Nitin Gupta parul Kodan Department of Apollo comprehensive Liver Care Apollo HospitalBangaloreKarnatakaIndia Department of Infectious Diseases Kasturba Medical CollegeManipal Academy of Higher EducationManipalKarnatakaIndia Department of Medicine All India Institute of Medical SciencesNew DelhiIndia

Corona virus disease(COVID)-19 is caused by the novel severe acute respiratory syndrome coronavirus-2(commonly referred to as SARS-CoV-2).In March 2020,the World Health Organization declared the COVID-19 outbreak a *** the target organ for the virus is primarily the lungs,with the recent understanding of the pathobiology of this disease and the immune dysregulation associated with it,it is now clear that COVID-19 affects multiple organ *** drugs and therapies have been tried or repurposed to combat the wrath posed by this *** October 22,2020,the USA Food and Drug Administration approved remdesivir for use in adults and pediatric patients(12 years of age and older).Several of the drugs being tried against COVID-19 have hepatotoxicity as their potential side *** review aims to provide the latest insights on various drugs being used in the treatment of COVID-19 and their effects on the liver.

关键词： COVID-19 Drugs Liver Drug-induced liver injury

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Development of a physiologically relevant dripping analytical method using simulated nasal mucus for nasal spray formulation analysis

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Journal of Pharmaceutical Analysis 2016年第5期6卷 283-291页

作者： Tina Masiuk parul Kadakia Zhenyu Wang Respiratory Product Development Merck Research Laboratories Merck & Co.Inc.

Current methods for nasal spray formulations have been elementary evaluating the dripping characteristics of a formulation and have not assessed the behavior of the nasal formulation in the presence of varying types of mucus depending on the indication or diseased state. This research investigated the effects of nasal mucus on the dripping behavior of nasal formulations and focused on developing an improved in vitro analytical test method that is more physiologically relevant in characterizing nasal formulation dripping behavior. Method development was performed using simulated nasal mucus preparations for both healthy and diseased states as coatings for the dripping experiment representing a wide range of viscosity. Factors evaluated during development of this in vitro test method included amount of mucus, application of mucus, drying times, and compatibility of the mucus on a C18 Thin Layer Chromatography(TLC) substrate. The dripping behavior of nasal formulations containing a range of 1%Avicel to 3.5% Avicel was assessed by actuating the nasal spray on a perpendicular TLC plate coated with either healthy or diseased simulated nasal mucus. After actuation of the nasal spray, the dripping of the formulation on the coated TLC plate was measured after the plate was repositioned vertically. The method that was developed generated reproducible results on the dripping behavior of nasal formulations and provided critical information about the compatibility of the formulation with the nasal mucus for different diseased states, aiding in nasal spray formulation development and physical characterization of the nasal spray.

关键词： Nasal spray Nasal spray dripping method Nasal mucus Nasal formulation dripping

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Pathways of nanotoxicity:Modes of detection,impact,and challenges

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Frontiers of Materials Science 2021年第4期15卷 512-542页

作者： Deepshikha GUPTA parul YADAV Devesh GARG Tejendra K.GUPTA Amity Institute of Applied Sciences Amity University Uttar PradeshNoida 201301India

Nanotoxicology has become the subject of intense research for more than two *** of articles have been published but the space in understanding the nanotoxicity mechanism and the assessment is still *** researches clearly show potential benefits of nanomaterials(NMs)in diagnostics and treatment,targeted drug delivery,and tissue engineering owing to their excellent physicochemical ***,these NMs display hazardous health effect then to the greater part of the materials because of small size,large surface area-to-volume ratio,quantum size effects,and environmental ***,a large number of NMs are used in industrial products including several medical applications,consumer,and healthcare ***,they came into the environment without any safety *** measurement of toxicity level has become important because of increasing toxic effects on living *** realistic mechanism-based strategies are still needed to determine the toxic effects of *** the assessment of NMs toxicity,reliable and standardized procedures are *** review article provides systematic studies on toxicity of NMs involving manufacturing,environmental factors,eco-toxic and genotoxic effects,some parameters which have been ignored of NMs versus their biological counterparts,cell heterogeneity,and their current challenges and future perspectives.

关键词： nanomaterial nanotoxicity cytotoxicity,genotoxicity in-vivo and in-vitro toxicity reactive oxygen species

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Role of endoscopy in inflammatory bowel disease

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Gastroenterology Report 2018年第2期6卷 75-82,I0001页

作者： Shishira Bharadwaj Neeraj Narula parul Tandon Mohammad Yaghoobi Department of Gastroenterology/Hepatology Beth Israel Deaconess Medical Center330 Brookline AveBostonMA 02215USA Division of Gastroenterology McMaster University1280 Main St WHamiltonON L8S 4L8Canada Department of Medicine The Ottawa Hospital501 Smyth RdOttawaON K1H 8L6Canada

Crohn’s disease(CD)and ulcerative colitis(UC)constitute the twomost common phenotypes of inflammatory bowel disease(IBD).Ileocolonoscopy with biopsy has been considered the gold standard for the diagnosis of *** diagnosis of CD and UC is important,as theirmedical and surgical treatmentmodalities and prognoses can be ***,approximately 15%of patients with IBD aremisdiagnosed as IBD unclassified due to the lack of diagnostic certainty of CD or ***,there has been increased recognition of the role of the therapeutic endoscopist in the field of *** imaging techniques have been developed to aid in the differentiation of UC vs ***,endoscopic balloon dilation and stenting have become an integral part of the therapeutic armamentariumof CD *** ultrasound has been recognized as beingmore accurate thanmagnetic resonance imaging in detecting perianal fistulae in patientswith ***,chromoendoscopymay help to detect dysplasia earlier compared with white-light ***,interventional endoscopy has become a cornerstone in the diagnosis,treatment andmanagement of IBD *** role of endoscopy in the field of IBD has significantly evolved in recent years fromsmall-bowel imaging to endoscopic balloon dilation and use of chormoendoscopy in dysplasia *** this reviewarticle,we discuss the current evidence on interventional endoscopy in the diagnosis,treatment andmanagement of IBD compications.

关键词： Inflammatory bowel disease small-bowel imaging therapeutic endoscopy chromoendoscopy endoscopic balloon dilation

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Determination of Some Ethnomedicinally Important Constituents of Aegle marmelos Fruit During Different Stages of Ripening

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中国天然药物 2011年第3期9卷 204-209页

作者： Nisha Yadav parul Singh Ranjana Mehrotra Quantum Optics and Photon Physics National Physical Laboratory(Council of Scientific and Industrial Research)K.S.Krishnan MargNew Delhi 110012India

AIM:Aegle marmelos is a medicinal herb belonging to the Rutacae *** fruit of *** at each stage of ripening is used as ethnomedicine to cure various *** aim of the present study was to determine the components contributing to the medicinal value of the *** fruit at different stages of ***:High-performance liquid chromatography(HPLC)was used to determine polyphenol,vitamins,organic acids and sugars in *** fruit at different stages of ***:Tannin,a polyphenol responsible for astringent and antimicrobial properties of *** fruit was found to increase during ***,a vital medicinal component was detected in traceable amount only in full-ripe *** ***-vin contributes towards body growth,reproduction and red cell *** content of ascorbic acid(vitamin C)which is useful in preventing scurvy decreased significantly as fruit ***:The difference in the medicinal effect of *** fruit at each stage of ripening might be due to the presence of different amount of polyphenol,vitamins and organic acids.

关键词： Aegle marmelos Ripening HPLC Tannin Vitamins

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