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Liver transplantation in acute liver failure:Dilemmas and challenges

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World Journal of Transplantation 2021年第6期11卷 187-202页

作者： ramesh Kumar Utpal Anand Rajeev Nayan Priyadarshi Department of Gastroenterology All India Institute of Medical SciencesPatna 801507BiharIndia Department of Surgical Gastroenterology All India Institute of Medical SciencesPatna 801507BiharIndia Department of Radiodiagnosis All India Institute of Medical SciencesPatna 801507BiharIndi

Acute liver failure(ALF)refers to a state of severe hepatic injury that leads to altered coagulation and sensorium in the absence of pre-existing liver *** has different causes,but the clinical characteristics are strikingly *** clinical practice,however,inconsistency in the definition of ALF worldwide and confusion regarding the existence of pre-existing liver disease raise diagnostic *** mortality rates used to be over 80%in the past;however,survival rates on medical treatment have significantly improved in recent years due to a greater understanding of pathophysiology and advances in critical care *** survival rates in acetaminophen-associated ALF have become close to the post-transplant survival *** that liver transplantation(LT)is an expensive treatment that involves a major surgical operation in critically ill patients and lifelong immunosuppression,it is very important to select accurate patients who may benefit from ***,emergency LT remains a lifesaving procedure for many ALF ***,there is a lack of consistency in current prognostic models that hampers the selection of transplant candidates in a timely and precise *** other problems associated with LT in ALF are the shortage of graft,development of contraindications on the waiting list,vaguely defined delisting criteria,time constraints for pre-transplant evaluation,ethical concerns,and comparatively poor post-transplant outcomes in ***,there is a desperate need to establish accurate prognostic models and explore the roles of evolving adjunctive and alternative therapies,such as liver support systems,plasma exchange,stem cells,auxiliary LT,and so on,to enhance transplant-free survival and to fill the void created by the graft shortage.

关键词： Acute liver failure Fulminant hepatic failure Prognosis Kings college criteria Liver transplantation Acetaminophen

Comparison of conventional and supported liquid extraction methods for the determination of sitagliptin and simvastatin in rat plasma by LC-ESI-MS/MS

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Journal of Pharmaceutical Analysis 2015年第3期5卷 161-168页

作者： B.ramesh N.Manjula S.R.Bijargi v.U.M.Sarma P.Sita Devi Natural Products Chemistry Division Indian Institute of Chemical Technology Medicinal Chemistry & Pharmacology Division Indian Institute of Chemical Technology

Three extraction methods were compared for their efficiency to analyze sitagliptin and simvastatin in rat plasma by LC-MS/MS, including （1） liquid-liquid extraction （LLE）, （2） solid phase extraction （SPE） and （3） supported liquid extraction （SLE）. Comparison of recoveries of analytes with different extraction methods revealed that SLE was the best extraction method. The detection was facilitated with ion trap-mass spectrometer by multiple reactions monitoring （MRM） in a positive ion mode with ESI. The transitions monitored were m./z 441.1→325.2 for simvastatin, 408.2→235.1 for sitagliptin and 278.1→260.1 for the IS. The lower limit of quantification （LLOQ） was 0.2 ng/mL for sitagliptin and 0.1 ng/mL for simvastatin. The effective SLE offers enhanced chromatographic selectivity, thus facilitating the potential utility of the method for routine analysis of biological samples along with pharmacokinetic studies.

关键词： Rat plasma Simvastatin Sita#'ptin Supported liquid extraction

Lymphatic dysfunction in advanced cirrhosis:Contextual perspective and clinical implications

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World Journal of Hepatology 2021年第3期13卷 300-314页

The lymphatic system plays a very important role in body fluid homeostasis,adaptive immunity,and the transportation of lipid and waste *** patients with liver cirrhosis,capillary filtration markedly increases,primarily due to a rise in hydrostatic pressure,leading to enhanced production of ***,lymphatic vasculature expansion helps to prevent fluid from accumulating by returning it back to the systemic ***,the lymphatic functions become compromised with the progression of cirrhosis and,consequently,the lymphatic compensatory mechanism gets overwhelmed,contributing to the development and eventual worsening of ascites and *** changes,low-grade chronic inflammation,and compounding effects of predisposing factors such as old age,obesity,and metabolic syndrome appear to play a significant role in the lymphatic dysfunction of *** portal hypertension can contribute to the development of intestinal lymphangiectasia,which may rupture into the intestinal lumen,resulting in the loss of protein,chylomicrons,and lymphocyte,with many clinical ***,due to high pressure,the rupture of the subserosal lymphatics into the abdomen results in the formation of chylous *** being highly significant,lymphatic dysfunctions in cirrhosis have largely been ignored;its mechanistic pathogenesis and clinical implications have not been studied in *** recommendation exists for the diagnostic evaluation and therapeutic strategies,with respect to lymphatic dysfunction in patients with *** article discusses the perspectives and clinical implications,and provides insights into the management strategies for lymphatic dysfunction in patients with cirrhosis.

关键词： Lymphatic dysfunction Cirrhosis Lymphedema Lymphangiectasia Chylous ascites Refractory ascites

Field cancerisation in colorectal cancer:A new frontier or pastures past?

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World Journal of Gastroenterology 2015年第13期21卷 3763-3772页

作者： Abhilasha Patel Gyanendra Tripathi Kishore Gopalakrishnan Nigel Williams ramesh P Arasaradnam Department of Colorectal Surgery University Hospitals of Coventry and Warwickshire NHS TrustCoventry CV2 2DXUnited Kingdom University of Warwick Coventry CV4 7ALUnited Kingdom Department of Pathology University Hospitals of Coventry and Warwickshire NHS TrustCoventry CV2 2DXUnited Kingdom

Despite considerable advances in our understanding of cancer biology, early diagnosis of colorectal cancer remains elusive. Based on the adenoma-carcinoma sequence, cancer develops through the progressive accumulation of mutations in key genes that regulate cell growth. However, recent mathematical modelling suggests that some of these genetic events occur prior to the development of any discernible histological abnormality. Cells acquire pro-tumourigenic mutations that are not able to produce morphological change but predispose to cancer formation. These cells can grow to form large patches of mucosa from which a cancer arises. This process has been termed "field cancerisation". It has received little attention in the scientific literature until recently. Several studies have now demonstrated cellular, genetic and epigenetic alterations in the macroscopically normal mucosa of colorectal cancer patients. In some reports, these changes were effectively utilised to identify patients with a neoplastic lesion suggesting potential application in the clinical setting. In this article, we present the scientific evidence to support field cancerisation in colorectal cancer and discuss important limitations that require further investigation. Characterisation of the field defect is necessary to enable early diagnosis of colorectal cancer and identify molecular targets for chemoprevention. Field cancerisation offers a promising prospect for experimental cancer research and has potential to improve patient outcomes in the clinical setting.

关键词： Colorectal cancer Carcinogenesis Biomarkers Epigen

Novel generation of 9H-furo[3,2-b]chromen-9-ones from (E)-3-hydroxy-2-styrylchromones by excited state intramolecular proton transfer

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Chinese Chemical Letters 2008年第7期19卷 780-782页

作者： Surinder Berar Urmila Berar Satish C.Gupta ramesh C.Kamboj Department of Chemistry Kurukshetra UniversityKurukshetra 136119India

Photocyclisation of substituted （E）-3-hydroxy-2-（v-methyl-2＇-phenylvinyl）-4-oxo-4H-1-benzopyrans to yield linear novel tricyclic 9H-furo[3,2-b]chromen-9-ones and angular fused tetracyclic xanthenones is described.

关键词： 9H-Furo(3,2-b)chromen-9-one Photocyclisation Xanthenones

Baicalin provides protection against fluoxetine-induced hepatotoxicity by modulation of oxidative stress and inflammation

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World Journal of Hepatology 2022年第4期14卷 729-743页

作者： Risha Ganguly ramesh Kumar Abhay K Pandey Department of Biochemistry University of AllahabadPrayagraj 211002India

BACKGROUND Fluoxetine is one of the most widely prescribed anti-depressant drugs belonging to the category of selective serotonin reuptake ***-term fluoxetine treatment results in ***,a natural compound obtained from the Chinese herb Scutellaria baicalensis is known to have antioxidant,hepatoprotective and anti-inflammatory ***,the beneficial effects of baicalin against fluoxetine-induced hepatic damage have not previously been *** To evaluate the protective action of baicalin in fluoxetine-induced liver toxicity and *** Male albino Wistar rats were divided into seven *** 1 was the normal *** fluoxetine was administered at 10 mg/kg body weight to groups 2,3,4 and *** addition,groups 3 and 4 were also co-administered oral baicalin(50 mg/kg and 100 mg/kg,respectively)while group 5 received silymarin(100 mg/kg),a standard hepatoprotective compound for *** 6 and 7 were used as a positive control for baicalin(100 mg/kg)and silymarin(100 mg/kg),*** treatments were carried out for 28 *** sacrifice of the rats,biomarkers of oxidative stress[superoxide dismutase(SOD),catalase(CAT),reduced glutathione(GSH),glutathione-S-transferase(GST),advanced oxidation protein products(AOPP),malondialdehyde(MDA)],and liver injury[alanine transaminase(ALT),aspartate transaminase(AST),alkaline phosphatase(ALP),total protein,albumin,bilirubin]were studied in serum and tissue using standard protocols and diagnostic *** markers[tumor necrosis factor(TNF-α),interleukin(IL)-6,IL-10 and interferon(IFN)-γ]in serum were evaluated using ELISA-based *** effect of baicalin on liver was also analyzed by histopathological examination of tissue *** Fluoxetine-treated rats showed elevated levels of the serum liver function markers(total bilirubin,ALT,AST,and ALP)and inflammatory markers(TNF-α,IL-6,IL-10 and IFN-γ),with a decline in total protein and albumin

关键词： Fluoxetine Hepatotoxicity Oxidative stress Baicalin Anti-inflammatory Hepatoprotective and antioxidant

A Prospective Study of Knowledge and Perception towards the Efficacy of Anti-Aging Cosmetics among Female Population of Ras Al Khaimah, UAE

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Journal of Cosmetics, Dermatological Sciences and Applications 2017年第3期7卷 275-289页

作者： Fasiha Shah Omar Sarheed K.v.R. ramesh Department of Pharmaceutics College of Pharmacy RAK Medical & Health Sciences University Ras Al khaimah UAE

Introduction: Cosmeceutical is a term used to describe cosmetics with antiaging effects these days. The aim of the current study was to determine the efficacy of different type of antiaging dermatological products based on consumer self-assessment and to identify those driving factors that influence women’s purchase of these products and to have an insight into their perception and knowledge about these products. Methods: A prospective study was conducted about the use of antiaging cosmetics, consumer satisfaction, skin concerns related with age, importance of younger looking skin and socioeconomic status. Results and Discussion: It was observed in the study that such products do work to improve skin conditions but the claim that wrinkles could be cured completely could not be determined. Participant reported discrepancies between ideal and real effect of antiaging cosmetics. Even if such cosmetic products are expensive people like to spend on these to fulfill the human dream of looking younger.

关键词： Cosmeceutical Wrinkles Anti-Aging Efficacy Appearance Skin Concerns

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DeNOx Study in Diesel Engine Exhaust Using Barrier Discharge Corona Assisted by v_2O_5/TiO_2 Catalyst

作者： (Hoffer Jeffrey A.)霍弗 (ramesh v.)拉梅什 (Topi Heikki)托皮

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Plasma Science and Technology 2004年第4期6卷 2411-2415页

作者： B.S.Rajanikanth v.Ravi Indian Institute of Science Bangalore 560012IndiaIndian Institute of ScienceBangalore 560012India

A plasma-assisted catalytic reactor was used to remove nitrogen oxides (NOx)from diesel engine exhaust operated under different load conditions. Initial studies were focused onplasma reactor (a dielectric barrier discharge reactor) treatment of diesel exhaust at varioustemperatures. The nitric oxide (NO) removal efficiency was lowered when high temperature exhaust wastreated using plasma reactor. Also, NO removal efficiency decreased when 45% load exhaust wastreated. Studies were then made with plasma reactor combined with a catalytic reactor consisting ofa selective catalytic reduction (SCR) catalyst, v_2O_5/TiO_2. Ammonia was used as a reducing agentfor SCR process in a ratio of 1:1 to NOx. The studies were focused on temperatures of the SCRcatalytic reactor below 200℃. The plasma-assisted catalytic reactor was operated well to remove NOxunder no-load and load conditions. For an energy input of 96 J/l, the NOx removal efficienciesobtained under no-load and load conditions were 90% and 72% respectively at an exhaust temperatureof 100 ℃.

关键词： non-thermal plasma DeNOx barrier discharge diesel exhaust