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The evolution of sinus surgery in England in the last decade - An observational study

World Journal of Otorhinolaryngology-Head and Neck Surgery 2021年第3期7卷 240-246页

作者： Keshav kumar Gupta karan Jolly Navdeep Bhamra Max Sallis Osborne Shahzada Khuram Ahmed Department of Otolaryngology New Cross HospitalThe Royal Wolverhampton NHS TrustWolverhamptonWV100QPUnited Kingdom Department of Otolaryngology Queen Elizabeth HospitalUniversity Hospitals Birmingham NHS Foundation TrustBirminghamB152THUnited Kingdom

Background and objective::Sinus surgery has seen significant changes over the years with advancements in instruments,endoscopes and *** study aimed to use Hospital Episode Statistics(HES)data to review the total number of sinus related procedures performed in both adults and children across England and identify whether there were any trends across the study *** predicted an increase in endoscopic sinus procedures with a decline in open approaches to the paranasal ***::Data from HES was extracted for the years *** operative(OPCS-4)codes relevant to all sinus procedures between E12.1 and E17.9 were *** examination of overall sinus related procedures,further subgroup analysis was performed with regards to open or endoscopic ***::The total number of sinus procedures performed between 2010 and 2019 was 89,*** was an increase in endoscopic surgeries by 21.1%and a decrease of open surgeries 35.3%during this *** was an overall increase in maxillary,frontal and sphenoid sinus procedures,with a decrease in ethmoid sinus and lateral rhinotomy *** was an increase in the proportion of endoscopic cases overall by 5.7%and for all sinuses ***::Overall,we see an increase in sinus surgery over the last 9 years from 2010 to *** findings are in keeping with our initial *** our data set is limited by coding,and lack of patient factors,it represents most,if not all,of the data in England over a large study *** is therefore useful to add to previous studies when demonstrating the increasing popularity of endoscopic sinus surgery over open procedures.

关键词： Endoscopic sinus surgery Sphenoid Ethmoid Frontal Maxillary Sinus

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Anti-HBc screening in Indian blood donors:Still an unresolved issue

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World Journal of Gastroenterology 2008年第34期14卷 5327-5330页

作者： Hari Krishan Dhawan Neelam Marwaha Ratti Ram Sharma Yogesh Chawla Beenu Thakral karan Saluja Sanjeev kumar Sharma Manish K Thakur Ashish Jain Department of Transfusion Medicine PGIMER Department of Hepatology PGIMER

AIM:To study the seroprevalence of antibody to hepatitis B core antigen (anti-HBc) in healthy blood donors negative for HBsAg and to evaluate whether anti-HBc detection could be adopted in India as a screening assay for HBV in addition to HBsAg. METHODS: A total of 1700 serum samples collected from HBsAg-negative healthy blood donors were tested for the presence of anti-HBc antibody (IgM + IgG). All samples reactive for anti-HBc antibody were then investigated for presence of anti-HBs and for liver function tests (LFTs). One hundred serum samples reactive for anti-HBc were tested for HBV DNA by PCR method. RESULTS: Out of 1700 samples tested, 142 (8.4%) blood samples were found to be reactive for anti-HBc. It was signif icantly lower in voluntary (6.9%) as compared to replacement donors (10.4%, P = 0.011). Seventy- two (50.7%) anti-HBc reactive samples were also reactive for anti-HBs with levels > 10 mIU/mL and 70 (49.3%) samples were non-reactive for anti-HBs, these units were labeled as anti-HBc-only. These 142 anti-HBc reactive units were also tested for liver function test. HBV DNA was detected in only 1 of 100 samples tested. CONCLUSION: Keeping in view that 8%-18% of donor population in India is anti-HBc reactive, inclusion of anti- HBc testing will lead to high discard rate. Anti-HBs as proposed previously does not seem to predict clearance of the virus. Cost effectiveness of introducing universalanti-HBc screening and discarding large number of blood units versus considering ID NAT (Individual donor nuclic acid testing) needs to be assessed.

关键词： Hepatitis B core antigen Hepatitis B surface antigen Hepatitis B virus Transfusion-associated hepatitis B virus Blood donors

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Assessment of quadriceps muscle thickness using bedside ultrasonography by nurses and physicians in the intensive care unit:Intra- and inter-operator agreement

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World Journal of Critical Care Medicine 2019年第7期8卷 127-134页

作者： Rohit kumar Tajamul Hussain Shah Vijay Hadda Pawan Tiwari Saurabh Mittal karan Madan Maroof Ahmad Khan Anant Mohan Department of Pulmonary Critical Care and Sleep MedicineAll India Institute of Medical SciencesNew Delhi 110029India Department of Biostatistics All India Institute of Medical SciencesNew Delhi 110029India

BACKGROUND Data regarding the agreement among multiple operators for measurement of quadriceps muscle thickness by bedside ultrasonography(USG)are *** To statistically assess the agreement among 5 operators for measurement of quadriceps muscle thickness on bedside *** This was a cross-sectional observational *** 5 operators of varied experience(comprised of 1 critical care consultant,2 fellows,and 2 nurses)independently measured quadriceps muscle thickness in triplicate for 45 critically ill patients each,using ***-and interrater agreement rates among the 5 operators were assessed using intraclass correlation coefficient(ICC)and expressed with 95%confidence interval(CI).RESULTS The 5 operators produced a total of 135 readings and 675 observations for ICC calculations to determine the intraoperator and interoperator variations *** intraoperator agreement,the overall ICC(95%CI)was 0.998(0.997,0.999)for operator 1,0.998(0.997,0.999)for operator 2,0.997(0.995,0.999)for operator 3,0.999(0.998,0.999)for operator 4,and 0.998(0.997,0.999)for operator *** interoperator agreement,the overall ICC(95%CI)was 0.977(0.965,0.986;P<0.001)for reading 1,0.974(0.960,0.984;P<0.001)for reading 2,and 0.975(0.961,0.985;P<0.001)for reading *** USG measurement of quadriceps muscle thickness was not dependent on clinical experience,supporting training for nurses in it.

关键词： Agreement Intensive care unit Critical illness Muscle thickness Quadricepsmuscle Ultrasonography

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Compartmentalized Metabolic Engineering for Artemisinin Biosynthesis and Effective Malaria Treatment by Oral Delivery of Plant Cells

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Molecular Plant 2016年第11期9卷 1464-1477页

作者： karan Malhotra Mayavan Subramaniyan Khushboo Rawat Md. Kalamuddin M. Irfan Qureshi Pawan Malhotra Asif Mohmmed Katrina Cornish Henry Daniell Shashi kumar1 Metabolic Engineering Group Malaria Research Group International Centre for Genetic Engineering and Biotechnology Aruna Asaf Ali Marg New Delhi 110067 India Department of Biotechnology Jamia Millia Islamia New Delhi 110025 India Department of Horticulture and Crop Science The Ohio State University Wooster OH 44691 USA Department of Biochemistry School of Dental Medicine University of Pennsylvania Philadelphia PA 19104 USA

Artemisinin is highly effective against drug-resistant malarial parasites, which affects nearly half of the global population and kills 〉500 000 people each year. The primary cost of artemisinin is the very expensive process used to extract and purify the drug from Artemisia annua. Elimination of this apparently unnecessary step will make this potent antimalarial drug affordable to the global population living in endemic regions. Here we reported the oral delivery of a non-protein drug artemisinin biosynthesized （~0.8 mg/g dry weight） at clinically meaningful levels in tobacco by engineering two metabolic pathways targeted to three different cellular compartments （chloroplast, nucleus, and mitochondria）. The doubly transgenic lines showed a three-fold enhancement of isopentenyl pyrophosphate, and targeting AACPR, DBR2, and CYP71AV1 to chloroplasts resulted in higher expression and an efficient photo-oxidation of di- hydroartemisinic acid to artemisinin. Partially purified extracts from the leaves of transgenic tobacco plants inhibited in vitro growth progression of Plasmodium falciparum-infected red blood cells. Oral feeding of whole intact plant cells bioencapsulating the artemisinin reduced the parasitemia levels in challenged mice in comparison with commercial drug. Such novel synergistic approaches should facilitate low-cost production and delivery of artemisinin and other drugs through metabolic engineering of edible plants.

关键词： bioencapsulation oral delivery of plant material dihydroartemisinic acid isopentenyl pyrophosphate,plant transformation drug biosynthesis

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Ameliorative Effects of Paclobutrazol via Physio-Biochemical and Molecular Manifestation in Rice under Water Deficit Stress

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Rice science 2024年第5期31卷 603-616,I0065页

作者： Chirag MAHESHWARI Nitin kumar GARG Archana SINGH Aruna TYAGI Indian Council of Agricultural Research-Indian Agricultural Research Institute New Delhi 110012India Sri karan Narendra Agricultural University JobnerRajasthan 303329India

To comprehensively explore the physio-biochemical and molecular changes of paclobutrazol(PBZ) at the ideal dose under water deficit stress(WDS) conditions, we investigated the effects of 100 mg/kg PBZ applied via drenching on various physio-biochemical and molecular parameters in three rice varieties(N22, IR64, and IR64 DTY1.1) under both mild [75%-80% relative water content(RWC)] and severe(60%-65% RWC) WDS conditions. The results showed that PBZ treatment positively influenced the physio-biochemical parameters, significantly increasing dry matter(16.27%-61.91%), RWC(6.48%-16.34%), membrane stability index(4.37%-10.35%), and total chlorophyll content(8.97%-29.09%) in the rice varieties under both mild and severe WDS. Moreover, PBZ treatment reduced drought susceptibility(0.83-0.95) and enhanced drought tolerance efficiency(60.92%-86.78%), indicating its potential as a stress-mitigating agent. Global methylation analysis revealed changes in DNA methylation patterns, indicating the regulatory influence of PBZ on gene expression. The expression analysis of genes involved in the diversification of geranylgeranyl pyrophosphate towards the biosynthesis of abscisic acid, gibberellin acid, and chlorophyll showed alterations in their expression levels, suggesting the involvement of PBZ in the isoprenoid pathway. Overall, this study provides valuable insights into the potential mechanisms by which PBZ modulates physiological and molecular responses in rice plants under WDS. The findings highlight the importance of PBZ as a promising agent for enhancing drought tolerance in rice and offer valuable information for future research in crop stress management.

关键词： rice paclobutrazol drought stress abscisic acid gibberellic acid

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Nonselective beta‐blockers reduce mortality in patients with acute‐on‐chronic liver failure

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Portal Hypertension & Cirrhosis 2022年第1期1卷 15-22页

作者： Anand V.Kulkarni Madhumita Premkumar karan kumar Juned A.Khan Baqar A.Gora Sowmya Tirumalle Sameer Shaik Mithun Sharma Rajesh Gupta Nageshwar D.Reddy Padaki N.Rao Department of Hepatology AIG HospitalsHyderabadIndia Department of Hepatology PGIMERChandigarhIndia Department of Hepatology Mahatma Gandhi HospitalsJaipurIndia Department of Hepatology Hopewell HospitalLucknowIndia

Aim:Nonselective beta‐blockers(NSBBs)can reduce the incidence of complications in patients with cirrhosis and prolong *** safety and efficacy of NSBBs in real‐world settings in patients with acute‐on‐chronic liver failure(ACLF)identified by the Asian Pacific Association for the Study of Liver criteria are *** study aimed to assess the safety and efficacy of NSBBs in patients with Asian Pacific Association for the Study of Liver(APASL)‐defined ACLF Methods:In this retrospective,multicenter study,patients with ACLF with complete 30 days follow‐up from January 2019 to December 2021 were *** primary objective was to compare 30‐day mortality among standard of care(SOC)and NSBB(+SOC)*** secondary objectives were to compare the incidence of infection,variceal bleed,and recompensation among both the ***:A total of 346 patients were *** 26%(n=89)of them received NSBBs,while 74%(n=257)received only *** Kaplan-Meier analysis,the incidence of mortality was 21%(95%confidence interval[CI]:16.20-26.50)in SOC group compared to only 8%(95%CI:3.22-15.53)in NSBB group at Day 30(p=0.005).Similarly,mortality in SOC group was 63%(95%CI:56.81-69.00)compared to 46%(95%CI:35.44-57.00)in NSBB group at 1 year(p=0.001).NSBB therapy could not reduce the incidence of infections or variceal ***‐seven percent of patients in the SOC group and 73%of patients in the NSBB group(p<0.001)*** was prescribed in 77.5%and propranolol in 22.5%of ***:NSBBs reduce mortality without any effect on infection or variceal bleed in patients with ***,only one in four ACLF patients are suitable for NSBB therapy.

关键词： ACLF infection portal hypertension variceal bleed

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