41 results on '"Deepak Verma"'
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2. A Critical Analysis Of Bacteriogenic Lactational Mastitis (Stanyadushti)And Its Management w.s.r To KashyapaSamhita
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Deepak Verma, Anoop Kumar, Rachana Bhardwaj, and Suman Panwar
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Veterinary medicine ,medicine ,Biology ,medicine.disease ,Mastitis - Published
- 2021
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3. A clinico-epidemiological study of complicated external hernia
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Parul Yadav, Ambrav Vedprakash, Lalit Kishore, Sumit Naraniya, Deepak Verma, and Ratan Rajc
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medicine.medical_specialty ,Septic shock ,business.industry ,Incidence (epidemiology) ,General Engineering ,medicine.disease ,Surgery ,Abdominal wall ,stomatognathic diseases ,surgical procedures, operative ,medicine.anatomical_structure ,Epidemiology ,Indirect inguinal hernia ,medicine ,Hernia ,Complication ,Male to female ,business - Abstract
Background: Abdominal wall hernias are among the most commonly encountered surgical problem. Irreducibility, obstruction, and strangulation are its commonest complications which usually presents as acute emergencies. Emergency repair of complicated hernias is associated with poor prognosis and a high rate of postoperative complications even with better care, improved anesthetic management and advanced surgicaltechniques. Methods: The aim of the study was to evaluate incidence, morbidity, and mortality in complicated hernia and to compare with it non-complicated hernia. This study was conducted in the Department of General Surgery, Dr. Sampurnanand Medical College, Jodhpur, Rajasthan, from July 2018 to December 2019 on twenty-eight patients of complicated hernia and compared with similar no of uncomplicated hernia patients. Results: The mean age of the patients was 52 years with male to female ratio of 11:3 in the complicated external hernia group. The majority of the patient (60.7%) underwent herniorrhaphy, followed by hernioplasty (14.3%). Most of the patients (89.2%) survived without any post-operative morbidity, 7.1% of them developing wound sepsis while 3.5% of patients died after surgery due to septic shock. Conclusion: Complicated external hernias occur in all age groups but are more common in older age and show preponderance in males. All patients present with irreducible swelling with no cough impulse. The indirect inguinal hernia is the most common type and herniorrhaphy is the most preferred operative procedure in the complicated hernia. Wound sepsis was the most common complication. Morbidity and mortality may be attenuated with proper surgical and post-operative management. Keywords: Abdominal wall hernia; complicated hernia; herniorrhaphy; hernia
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- 2020
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4. Gastrointestinal perforation in COVID-19 patients – case series and review of the literature
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Deepak Verma, Sarthak Sharma, Aishwarya Tinaikar, and Lalit Kishore Garg
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medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,business.industry ,Perforation (oil well) ,General Engineering ,medicine.disease ,Surgery ,chemistry.chemical_compound ,Diarrhea ,Tocilizumab ,medicine.anatomical_structure ,chemistry ,Gastrointestinal perforation ,Medicine ,Respiratory system ,medicine.symptom ,business ,Complication ,Respiratory tract - Abstract
Severe acute respiratory syndrome coronavirus-2 (SARS-CoV 2) involving the respiratory tract started in 2019 in Wuhan, China but spread to almost all parts of the world to the extent that it was declared a pandemic by WHO. As more and more cases are detected, the involvement of systems other than respiratory was observed and nearly 5 to 50 % of patients have abdominal symptoms like pain and diarrhea. During the course of treatment, few patients developed a rare complication of gastrointestinal perforation. Three cases (two with colonic perforation and one with gastric perforation) of gastrointestinal perforation in COVID-19 positive patient are reported in the article with a review of the literature regarding the various hypothesis of intestinal perforation in these patients. Keywords: COVID-19; gastrointestinal perforation; severe acute respiratory syndrome coronavirus-2 (SARS-CoV 2); Tocilizumab
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- 2020
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5. Ectopic Mediastinal and Lumbar Thyroid Tissue
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Salman Khan, Mansoor Rahman, Deepak Verma, and Madeeha Subhan Waleed
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medicine.medical_specialty ,Ectopic thyroid tissue ,medicine.medical_treatment ,thyroglobulin ,Lumbar ,Internal Medicine ,Pathology ,thyroid cancer ,medicine ,Thyroid cancer ,lumbar ,thyroid nodule ,business.industry ,Thyroid ,Endocrinology/Diabetes/Metabolism ,General Engineering ,Mediastinum ,ectopic thyroid tissue ,Nodule (medicine) ,medicine.disease ,mediastinum ,medicine.anatomical_structure ,Thyroglobulin ,Radiology ,medicine.symptom ,Presentation (obstetrics) ,business - Abstract
The thyroid gland is found in the neck and corresponds to the 2-4 tracheal cartilages. It is rarely found in other sites and is termed ectopic thyroid tissue (ETT) once found. In this report, we present a case of a 19-year-old female who was diagnosed with ETT in the lumbar region and posterior mediastinal region after total thyroidectomy for a large dominant thyroid nodule. ETT has a unique presentation and physicians should be vigilant to diagnose it correctly and promptly to decrease morbidity associated with the disease.
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- 2021
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6. Soluble Guanylate Cyclase Stimulators in Heart Failure
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Nishant Gautam, Prabhat Sharma, Deepak Verma, Ashish Guragain, Sunil Yadav, Bibek Dhungana, Sajog Kansakar, and Bidit Bhattarai
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medicine.medical_specialty ,Ejection fraction ,heart failure with reduced ejection fraction (hfref) ,business.industry ,Management of heart failure ,General Engineering ,Guanylate Cyclase Stimulators ,Cardiology ,vericiguat ,heart failure ,Therapeutics ,medicine.disease ,Clinical trial ,guanylate cyclase stimulators ,Heart failure ,Internal medicine ,heart failure with preserved ejection fraction (hfpef) ,medicine ,Internal Medicine ,In patient ,Signal transduction ,business ,Heart failure with preserved ejection fraction - Abstract
Heart failure has a high global burden of morbidity and mortality. Despite significant advances in medical management of heart failure, the prognosis remains poor. This justifies the search for newer therapeutic agents. Recently, soluble guanylate stimulators have demonstrated favorable results in clinical trials. This article aims to summarize the guanylate cyclase signaling pathway, the role of soluble guanylate cyclase stimulators in heart failure, and data from recent clinical trials of these drugs. We concluded that soluble guanylate cyclase stimulators have significant benefits in reducing hospitalizations in patients with heart failure with reduced ejection fraction that are at high risk of cardiovascular events. There appears to be no benefit of these drugs in patients with heart failure with preserved ejection fraction.
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- 2021
7. Leiomyosarcoma of the Uterus: A Rare Diagnosis
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Eliza Shrestha, Deepak Verma, Bibek Dhungana, and Palak Paudel
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Leiomyosarcoma ,medicine.medical_specialty ,Hysterectomy ,uterus ,Exploratory laparotomy ,business.industry ,medicine.medical_treatment ,General Engineering ,Uterus ,menopause ,medicine.disease ,Menopause ,body regions ,medicine.anatomical_structure ,Leiomyoma ,Oncology ,leiomyoma ,medicine ,Neoplasm ,Obstetrics/Gynecology ,Radiology ,hysterectomy ,business ,neoplasm ,Histological examination - Abstract
Uterine leiomyosarcoma is a rare malignant tumor that accounts for almost 2-5% of all uterine malignancies. It has the highest prevalence during pre and perimenopause. Further, it clinically resembles benign conditions like leiomyoma, and the diagnosis is confirmed with the histologic findings of the mass. Here, we present the case of a 70-year-old female who presented with lower abdominal pain for two years. Exploratory laparotomy with hysterectomy was performed, and the diagnosis of leiomyosarcoma was confirmed after histological examination of the resected tumor.
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- 2021
8. Emerging Treatments of Cardiorenal Syndrome: An Update on Pathophysiology and Management
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Muhammad Haris, Bibek Dhungana, Barun Ray, Bibek Kc, Deepak Verma, Sameer Krishna Prasad Garlapati, Thanmay Sai Charaan Reddy Sathi, Amena Firoz, Palak Paudel, and Gunjan Shah
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medicine.medical_specialty ,medicine.medical_treatment ,Tolvaptan ,Cardiac resynchronization therapy ,Cardiology ,cardiac resynchronization therapy ,Disease ,Cardiorenal syndrome ,Sepsis ,Diabetes mellitus ,medicine ,Internal Medicine ,Intensive care medicine ,pathophysiology ,cardiorenal syndrome ,business.industry ,tolvaptan ,General Engineering ,medicine.disease ,Review article ,Clinical trial ,Nephrology ,sglt2 inhibitors ,business ,management ,medicine.drug - Abstract
Cardiorenal syndrome refers to combined cardiac and renal dysfunction that adversely impacts both organs and is also associated with severe clinical outcomes. The pathophysiology is believed to be multifactorial and complex. Increased central venous pressure and intra-abdominal pressure, overactivation of the Renin-Angiotensin-Aldosterone System (RAAS), systemic illnesses like sepsis, amyloidosis, diabetes are important factors in developing the cardiorenal syndrome. Our review article attempts to review the pathophysiology and treatment aspect of cardiorenal syndrome and explores potential therapeutic strategies that can be adopted for the management. We searched PubMed, EMBASE, Google Scholar for relevant articles using different keywords and Medical Subject Headings, and finalized 38 articles to be included in our study. Cardiorenal syndrome management aims to eliminate venous congestion and fluid retention, which leads to improved cardiorenal status. This is usually achieved using pharmacologic agents like diuretics, vasodilators, inotropes, angiotensin-converting enzyme inhibitors (ACEIs)/angiotensin II receptor blockers (ARBs), neprilysin inhibitors, and extracorporeal methods like ultrafiltration. The use of therapeutic agents such as sodium-glucose co-transporter 2 inhibitors and tolvaptan (a vasopressin V2 receptor antagonist), and cardiac resynchronization therapy has also been shown to have potential benefits in managing the disease. These agents can be instrumental in the management and require large-scale clinical trials specifically aimed at improving cardiorenal outcomes based on severity and type of cardiorenal syndrome.
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- 2021
9. Vitiligo: The Association With Metabolic Syndrome and the Role of Simvastatin as an Immunomodulator
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Muhammad Haris, Khadija Hussain, Amena Firoz, Deepak Verma, Maham Raza, Karez S Namiq, Manel Bouchama, and Safeera Khan
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vitiligo ,obesity ,medicine.medical_specialty ,hypertension ,Dermatology ,Vitiligo ,030204 cardiovascular system & hematology ,metabolic syndrome ,03 medical and health sciences ,0302 clinical medicine ,Insulin resistance ,Diabetes mellitus ,Internal Medicine ,medicine ,simvastatin ,skin and connective tissue diseases ,integumentary system ,business.industry ,dyslipidemia ,Endocrinology/Diabetes/Metabolism ,General Engineering ,medicine.disease ,Obesity ,Simvastatin ,Rheumatoid arthritis ,Metabolic syndrome ,business ,030217 neurology & neurosurgery ,Dyslipidemia ,medicine.drug - Abstract
Vitiligo is an autoimmune condition primarily affecting the skin where there is destruction of melanocytes characterized by pinkish-white patches on the skin. It is associated with other autoimmune diseases such as thyroid disease, rheumatoid arthritis, diabetes mellitus, and metabolic syndrome. Metabolic syndrome is a constellation of disorders including insulin resistance, hypertension, dyslipidemia, and obesity, and is considered a leading cause of cardiovascular morbidity. Simvastatin is a potent hypolipidemic drug that also possesses immunomodulating properties and is a common drug used in dyslipidemia and cardiovascular diseases. This study aimed to assess the association between vitiligo and metabolic syndrome and explore the immunomodulating properties of simvastatin for use in vitiligo. We reviewed various articles from PubMed, ResearchGate, and Google Scholar using different keywords and Medical Subject Headings and finalized 33 studies to be used in our review. The articles selected showed a positive association between vitiligo and metabolic syndrome or one of the component diseases of metabolic syndrome. The benefits of using simvastatin were also addressed by few articles attributing to its antioxidant and immunomodulating effect. However, there was no concrete explanation justifying the association between vitiligo and metabolic syndrome due to a limited number of studies and smaller sample size. Large-scale clinical trials should be conducted to evaluate the use of simvastatin as an immunomodulator in vitiligo to prevent possible metabolic complications.
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- 2021
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10. Prognostic Relevance of Expression of EMP1, CASP1, and NLRP3 Genes in Pediatric B-Lineage Acute Lymphoblastic Leukemia
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Deepak Verma, Gunjan Sharma, Anita Chopra, M. Shadab Ali, Jay Singh, Jayanth Kumar Palanichamy, Sarita Kumari, Deepam Pushpam, Amar Ranjan, Sameer Bakhshi, Rajive Kumar, Archna Singh, Pranay Tanwar, Shyam S. Chauhan, and Mohit Arora
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Oncology ,Cancer Research ,medicine.medical_specialty ,lcsh:RC254-282 ,CASP1 ,NLRP3 ,Internal medicine ,Gene expression ,medicine ,Gene ,Survival analysis ,Original Research ,EMP1 ,business.industry ,prednisolone resistance ,leukemia ,B-ALL ,Hypoxia (medical) ,lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,medicine.disease ,Leukemia ,Regimen ,Prednisolone ,medicine.symptom ,business ,Glucocorticoid ,medicine.drug - Abstract
Glucocorticoid (GC), such as prednisolone, is an essential component of multidrug chemotherapy regimen for pediatric acute lymphoblastic leukemia (ALL). Resistance to GC in leukemia cells is associated with disease progression and poor prognosis. Despite the extensive use of GC for many years, molecular mechanisms underlying its resistance in ALL have not been fully uncovered. Recent studies have shown a potential role of EMP1, CASP1, and NLRP3 genes in prednisolone response. In this study on 148 pediatric B-ALL patients, we studied these three genes to assess their association with prednisolone response measured by day 8 blast count after 7 days of induction therapy with prednisolone. Intriguingly, ALL samples exhibited higher expression of EMP1 along with a low expression of CASP1 and NLRP3 compared to disease free normal bone marrow collected from patients with solid tumors. Among the three analyzed genes, only EMP1 was found to be overexpressed in prednisolone poor responders (p=0.015). Further, a comparison of gene expression between cytogenetic subtypes revealed higher expression of EMP1 in BCR-ABL subtype. Expression of EMP1 in multiple gene expression datasets was used for gene set enrichment analysis, which revealed TNF-α, IL-2-STAT5 signaling, inflammatory responses and hypoxia as the major positively associated pathways and E2F targets as negatively associated pathways. Interestingly, the clinical remission rate was higher in CASP1 high patients (p=0.048). In univariate survival analysis, higher EMP1 expression was associated with poor prognostic measures while higher expression of NLRP3 and CASP1 was associated with better prognostic measures in our data. Further, multivariate analysis revealed an independent association of high CASP1 and NLRP3 with a better prognosis. This study strengthens the available evidence that mRNA expression of EMP1, CASP1, and NLRP3 may serve as potential biomarkers for risk stratification of pediatric B-ALL patients.
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- 2021
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11. Can Targeting Iron Help in Combating Chronic Pseudomonas Infection? A Systematic Review
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Deepak Verma, Amena Firoz, Safeera Khan, Maham Raza, Karez S Namiq, Muhammad Haris, Manel Bouchama, and Khadija Hussain
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medicine.drug_class ,Antibiotics ,030204 cardiovascular system & hematology ,medicine.disease_cause ,Cystic fibrosis ,Pediatrics ,cystic fibrosis ,03 medical and health sciences ,0302 clinical medicine ,iron ,Pseudomonas infection ,medicine ,Genetics ,Internal Medicine ,cefiderocol ,iron metabolism ,gallium ,biology ,business.industry ,Pseudomonas aeruginosa ,siderophores ,iron uptake ,General Engineering ,medicine.disease ,Mucus ,Cystic fibrosis transmembrane conductance regulator ,Review article ,Immunology ,biology.protein ,biofilm formation ,Sputum ,iron chelators ,medicine.symptom ,business ,030217 neurology & neurosurgery ,pseudomonas infections - Abstract
Cystic fibrosis is an autosomal recessive disorder caused by a mutation in genes for cystic fibrosis transmembrane conductance regulator (CFTR) protein. CFTR gene is responsible for the production of sweat, digestive fluids, and mucus, and any mutation in this would lead to the thickening of these secretions. Cystic fibrosis is a multi-organ disorder, but 80% of patients suffer from respiratory problems due to chronic infections most commonly caused by Pseudomonas aeruginosa (P. aeruginosa). Eradication of these infections has become a challenge as P. aeruginosa has developed resistance to multiple antibiotics. In several studies, iron has been shown to play an integral role in biofilm formation, which is the predominant resistance mechanism used by P. aeruginosa to combat antibiotics. The increased iron content in cystic fibrosis patients' sputum samples explains their increased susceptibility to Pseudomonas infections. Hence in this review article, we have used the research data available on therapeutic agents that target iron as an adjuvant treatment for chronic Pseudomonas infection. We systematically screened three databases using focused words and Medical Subject Headings (MeSH) terms for relevant articles. Further, we applied the inclusion and exclusion criteria and performed a thorough quality appraisal. Thirty shortlisted relevant studies were meticulously reviewed. In our opinion, novel therapeutic approaches targeting iron such as iron chelators, gallium, and cefiderocol have potent anti-biofilm properties. Future studies and clinical trials using these approaches in the management of chronic Pseudomonas infection might help in decreasing morbidity and mortality in patients with cystic fibrosis. Exploring these approaches might also help to combat other resistant organisms whose survival is dependent on iron.
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- 2021
12. Irreducible Femur Head Fracture-Dislocation Treatment With Kocher-Langenbeck Approach With Flip Trochanteric Osteotomy: A Novel Approach
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Sudarsan Behera, Himansu Behera, Deepak Verma, Binod Raulo, and Rajesh Rana
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medicine.medical_specialty ,medicine.medical_treatment ,Avascular necrosis ,030204 cardiovascular system & hematology ,Trauma ,03 medical and health sciences ,Fixation (surgical) ,Femoral head ,0302 clinical medicine ,medicine ,Internal fixation ,Femur ,trochanteric flip osteotomy ,Femoral neck ,femoral neck fracture ,pipkin classification ,business.industry ,General Engineering ,Soft tissue ,medicine.disease ,Surgery ,medicine.anatomical_structure ,Orthopedics ,Pipkin classification ,Medical Education ,femoral head fracture-dislocation ,business ,irreducible ,030217 neurology & neurosurgery ,avascular necrosis of head - Abstract
Femoral head fracture-dislocations are rare, and irreducible cases are even less frequent. Truly irreducible fracture-dislocations must be differentiated from incomplete reduction due to incarcerated bone or soft tissue interposition. The Pipkin classification is commonly used to classify femoral head fractures. An urgent reduction is required in traumatic hip dislocations to reduce the risk of avascular necrosis (AVN) of the femoral head. However, in femoral head fractures, the dislocated hip cannot be reduced easily due to incarcerated bone or soft tissue. In an irreducible fracture hip dislocation, It is not advisable to attempt to reduce it repeatedly because sometimes femoral head fracture-dislocation is associated with the impacted fracture of the femoral neck. It may lead to iatrogenic femoral neck fracture. Hence, in such cases, immediate open reduction and internal fixation are recommended. The Kocher-Langenbeck approach can be used for reduction and safe surgical dislocation with flip trochanteric osteotomy for fixation as a novel approach.
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- 2020
13. STUDY OF PREOPERATIVE CLINICAL AND INVESTIGATIVE FACTORS PREDICTING DIFFICULT LAPAROSCOPIC CHOLECYSTECTOMY
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Ratan, Nemi Chand, and Deepak Verma
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medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,General surgery ,Prediction ,Difficult ,Laparoscopic Cholecystectomy ,Jaundice ,medicine.disease ,Radiological weapon ,medicine ,Cholecystitis ,Pancreatitis ,medicine.symptom ,Liver function tests ,business ,Pathological ,Laparoscopic cholecystectomy ,Abdominal surgery - Abstract
Background: Laparoscopic cholecystectomy is one of the most commonly performed surgical procedure with the advantage of short hospital stay, cosmetic, less post-operative pain and early return to work and thus ultimately cost effective. However, certain factors can make the procedure difficult and such patients many do not enjoy benefit of laparoscopic procedure particularly longer hospital stay. Aim: To determine various factors on clinical, pathological and radiological grounds to predict difficult laparoscopic cholecystectomy. Material and Method: 200 patients admitted in surgical ward with a diagnosis of Chronic Calculus cholecystitis to be selected for laparoscopic cholecystectomy were subject of this study. Age, Sex, BMI, number of previous attack, previous abdominal surgery, past history of pancreatitis and jaundice, signs of acute cholecystitis, leucocytosis, CRP, Liver function tests, serum amylase and lipase, GB wall thickness, presence of pericholecystic fluid , status of GB and anatomical variation were various factors studied. Results: Age > 50 years, male sex, BMI>30, more than 4 attacks, signs of cholecystitis, leucocytosis > 11,000/cu mm, increased GB wall thickness, presence of pericholecystic fluid and overdistended or contracted gall bladder are associated with difficult laparoscopic cholecystectomy.
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- 2020
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14. Genetic variants of the folate metabolic system and mild hyperhomocysteinemia may affect ADHD associated behavioral problems
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Anirban Ray, Kanchan Mukhopadhyay, Usha Rajamma, Deepak Verma, Swagata Sinha, Mahasweta Chatterjee, and Tanusree Saha
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Male ,0301 basic medicine ,Proband ,Hyperhomocysteinemia ,Genotype ,Pilot Projects ,5-Methyltetrahydrofolate-Homocysteine S-Methyltransferase ,03 medical and health sciences ,Folic Acid ,0302 clinical medicine ,Gene Frequency ,Humans ,Medicine ,Attention deficit hyperactivity disorder ,Replication Protein C ,Allele ,Child ,Homocysteine ,Alleles ,Methylenetetrahydrofolate Reductase (NADPH2) ,Biological Psychiatry ,Cognitive deficit ,Problem Behavior ,Pharmacology ,Genetics ,biology ,business.industry ,Genetic Variation ,medicine.disease ,MTRR ,Ferredoxin-NADP Reductase ,030104 developmental biology ,Betaine-Homocysteine S-Methyltransferase ,Attention Deficit Disorder with Hyperactivity ,Case-Control Studies ,Methylenetetrahydrofolate reductase ,biology.protein ,Female ,medicine.symptom ,business ,030217 neurology & neurosurgery ,Signal Transduction - Abstract
An etiologically complex disorder, Attention Deficit Hyperactivity Disorder (ADHD), is often associated with various levels of cognitive deficit. Folate/vitamin B9 is crucial for numerous biochemical pathways including neural stem cell proliferation and differentiation, regulation of gene expression, neurotransmitter synthesis, myelin synthesis and repair, etc. and a scarcity has often been linked to cognitive deficit. Our pilot study in the field revealed significant association of few genetic variants with ADHD. Mild hyperhomocysteinemia and vitamin B12 deficiency was also noticed in the probands. In the present study additional genetic variants, folate and vitamin B6, which may affect folate-homocysteine metabolic pathway, were investigated in 866 individuals including nuclear families with ADHD probands (N=221) and ethnically matched controls (N=286) to find out whether ADHD associated traits are affected by these factors. Population based analysis revealed significant over representation of MTRR rs1801394 "G" allele and "GG" genotype in all as well as male probands. Stratified analysis showed significantly higher frequency of RFC1 rs1051266 and BHMT rs3733890 "AG" genotypes in full term and prematurely delivered ADHD probands respectively. Probands with rs1801394 "GG" genotype and BHMT rs3733890 "G" allele showed association with hyperhomocysteinemia. MTHFR rs1801131, MTR rs1805087 and BHMT rs3733890 also showed association with ADHD index. While rs1051266, rs1801131, and rs1805087 showed association with behavioral problems, rs3733890 was associated with ODD score. Conduct problem exhibited association with RFC1 rs1051266, MTHFR rs1801133 and MTRR rs1801394. Gene-gene interaction analysis revealed positive synergistic interactions between rs1051266, rs1801131 and rs1801394 in the probands as compared to the controls. It can be inferred from the data obtained that folate system genetic variants and mild hyperhomocysteimenia may affect ADHD associated traits by attenuating folate metabolism.
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- 2018
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15. Vaccine Development Strategies, Progresses and Challenges for Human Immunodeficiency Virus (HIV): A Review
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Deepak Verma, Nega Berhane, Mesfin Tsegaw, and Tekeba Sisay
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0301 basic medicine ,medicine.medical_specialty ,Transmission (medicine) ,business.industry ,030230 surgery ,medicine.disease ,Vaccine efficacy ,Virus ,Vaccination ,Clinical trial ,03 medical and health sciences ,030104 developmental biology ,0302 clinical medicine ,Acquired immunodeficiency syndrome (AIDS) ,medicine ,Infection control ,HIV vaccine ,Intensive care medicine ,business - Abstract
Human immunodeficiency virus is classified under the Retroviridae family and identified as a causative agent of acquired immunodeficiency syndrome (AIDS).Since Human immunodeficiency virus (HIV) is identified as causative agent of AIDS, about 39 million people have been died and 78 million people have been infected worldwide. Despite tremendous efforts are being made to develop successful diagnosis, treatment and prevention methods, and to develop HIV vaccine the effort remains great challenge for researchers, due to extreme genetic variability of the virus. Even though vaccination of HIV is the most promising, cost effective and feasible intervention strategy to control and eradicate HIV disease route and transmission, still now we are struggling to find an elusive vaccine after thirty years and disappointing results are recorded from previous clinical trials, except the promising RV144 HIV vaccine which is phase III clinical trial with the modest vaccine efficacy. The contribution of this study is to reveal the challenges to found potent HIV vaccine during the last decades, significant lessons learnt about the basic virology, pathogenesis, immunology, HIV/AIDS treatment and HIV infection prevention and significant findings and clinical trials progresses which are currently open the way to some extent to hope that HIV vaccine development is possible.
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- 2018
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16. Clinical profile of pediatric neurotuberculosis patients at a tertiary care center of Western India
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Maryam Naveed, Mridula Preetham Talari, Deepak Verma, Varsha Kulkarni, Ranvijay Singh, and Nishitha Shetty
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Pediatrics ,medicine.medical_specialty ,Tuberculosis ,Tuberculin ,lcsh:RX1-681 ,protein-energy malnutrition ,03 medical and health sciences ,0302 clinical medicine ,Cerebrospinal fluid ,lcsh:Homeopathy ,medicine ,030212 general & internal medicine ,lcsh:RT1-120 ,lcsh:Nursing ,business.industry ,Medical record ,Cranial nerves ,medicine.disease ,Hydrocephalus ,pediatric ,Vomiting ,Tuberculoma ,Neurotuberculosis ,medicine.symptom ,business ,030217 neurology & neurosurgery - Abstract
Aim: The aim of this study is to determine the clinical profile of neurotuberculosis in the age group of 6 months to 10 years and its association with biochemical analysis of cerebrospinal fluid (CSF) and neuroradiological findings. Methods: Retrospective assessment of the medical records of confirmed cases of neurotuberculosis from January 2010 to June 2014 was carried out. Results: Of the 46 cases studied, mean age at presentation was 3.4 years. Male-to-female ratio was 1.55:1. Fever, vomiting, headache, seizures, and focal neurological deficits were the most common presenting clinical symptoms. Protein–energy malnutrition (PEM) was detected in 39 cases. On systemic examination, the order of involvement of cranial nerves was VII, II, III, IV, VI, and V. Positive Mantoux test was present in only 11 cases. CSF findings showed lymphocytic predominance, raised protein levels with a decreased to normal glucose levels. Neuroimaging by computed tomography scan/magnetic resonance imaging of the brain gave a definite diagnosis in thirty cases of which hydrocephalus, basal exudates, tuberculoma, and infarctions were the most common findings. The primary focus of tuberculosis was found in the lungs on chest roentgenogram in 12 cases. Conclusions: Neurotuberculosis occurs with increased frequency in the age group of 1–5 years. Fever may be of short duration at presentation in contradiction to current medical literature. PEM is a predisposing factor for the development of the disease. A tuberculin sensitivity test may be negative in cases of neurotuberculosis. CSF analysis and neuroimaging are pivotal in the establishment of a diagnosis.
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- 2018
17. Gender-Specific Effect of 5-HT and 5-HIAA on Threshold Level of Behavioral Symptoms and Sex-Bias in Prevalence of Autism Spectrum Disorder
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Barnali Chakraborti, Deepak Verma, Subhrangshu Guhathakurta, Preeti Jaiswal, Asem Surindro Singh, Swagata Sinha, Saurabh Ghosh, Kanchan Mukhopadhyay, Kochupurackal P. Mohanakumar, and Usha Rajamma
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Proband ,medicine.medical_specialty ,5-HT ,autism spectrum disorder ,lcsh:RC321-571 ,03 medical and health sciences ,0302 clinical medicine ,Neurochemical ,Internal medicine ,mental disorders ,gender ,medicine ,Platelet ,lcsh:Neurosciences. Biological psychiatry. Neuropsychiatry ,5-HT receptor ,Original Research ,behavior ,business.industry ,General Neuroscience ,5-HIAA ,medicine.disease ,030227 psychiatry ,Endocrinology ,Autism spectrum disorder ,Concomitant ,Childhood Autism Rating Scale ,Serotonin ,business ,030217 neurology & neurosurgery ,Neuroscience - Abstract
Platelet hyperserotonemia in a subset of Autism Spectrum Disorder (ASD) probands, efficacy of selective serotonin reuptake inhibitors (SSRIs) in reducing behavioral deficits and gender-bias in normal serotonin (5-hydroxy tryptamine or 5-HT) synthesis suggest disruption in stringent regulation of serotonin metabolism in ASD. Therefore, we investigated the changes in 5-HT and 5-hydroxy indole acetic acid (5-HIAA) in ASD probands to assess its effect on the behavior of male and female probands. ASD cases (n = 215) were examined using childhood autism rating scale (CARS). Platelet 5-HT (104 cases and 26 controls) and platelet/plasma 5-HIAA (73 cases and 17 controls) were estimated using high performance liquid chromatography coupled with electrochemical detector (HPLC-ECD). In male probands, we observed increase in platelet 5-HT content in association with increase in the score for adaptive responses and increase in platelet 5-HIAA levels with concomitant decline in the score for intellectual response. Age did not influence the neurochemical parameters, but imitation, listening responses and nonverbal communication scores decreased with age. Conversely in female probands, plasma 5-HIAA level significantly attenuated with age, when platelet 5-HT content remained unchanged. Interestingly, platelet/plasma 5-HT and plasma 5-HIAA were higher in female controls. Female probands displayed severe autism-associated behaviors. Overall results indicate gender-bias in 5-HT and 5-HIAA regulation, which probably increases the threshold level of ASD phenotypes in the females, thereby affecting ASD prevalence in a sex-specific manner.
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- 2020
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18. Prognostic significance of CD45 antigen expression in pediatric acute lymphoblastic leukemia
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Pranay Tanwar, Amar Singh, Deepak Verma, Anita Chopra, Rajive Kumar, Jay Singh, Priyavadhana Balasubramanian, and Sameer Bakhshi
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Male ,0301 basic medicine ,Median Fluorescence Intensity ,medicine.medical_specialty ,Percentile ,Gastroenterology ,03 medical and health sciences ,0302 clinical medicine ,Risk groups ,Pediatric Acute Lymphoblastic Leukemia ,Antigen ,Bone Marrow ,Internal medicine ,medicine ,Humans ,Lymphocytes ,Child ,Molecular Biology ,B cell ,business.industry ,Cancer ,Cell Biology ,Hematology ,Precursor Cell Lymphoblastic Leukemia-Lymphoma ,Prognosis ,medicine.disease ,Survival Analysis ,030104 developmental biology ,medicine.anatomical_structure ,Leukocyte Common Antigens ,Molecular Medicine ,Female ,business ,Leukemic Blasts ,030215 immunology - Abstract
Objectives The treatment of pediatric acute lymphoblastic leukemias (ALL) has seen remarkable advances recently. However, relapse occurs in approximately 20% of cases which necessitates identifying additional high risk parameters for treatment intensification. The aim of this study is to assess the prognostic significance of CD45 antigen expression in pediatric ALL. Methods We studied 363 pediatric patients with B cell precursor-ALL (BCP-ALL) (n = 313) and T-ALL (n = 50). The ratio of median fluorescence intensity of CD45 expressed in leukemic blasts and normal lymphocytes was calculated. The 75th percentile was taken as cut-off to categorise patients into CD45 high and CD45 low groups. Results The 75th percentile was 0.141 in BCP-ALL and 0.548 in T-ALL. In BCP-ALL, there was a statistically significant association of age (≥10 years) (p = 0.027) and National Cancer Institute high risk group (p = 0.001) with high CD45 expression but not in T-ALL. Worse event-free survival (EFS) was seen with high CD45 expression in BCP-ALL (42.17% versus 60.83%, p = 0.0053). In T-ALL, there was no association between CD45 expression and EFS (CD45 high 40.40% versus low 67.35%, p = 0.414). The overall survival (OS) was 70% versus 60% (p = 0.38) in BCP-ALL and the OS was 82% versus 68% (p = 0.16) in T-ALL for CD45 low versus CD45 high groups, respectively. Conclusion We conclude that high CD45 surface expression is associated with worse EFS in pediatric BCP-ALL.
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- 2021
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19. Genetic variants of MAOB affect serotonin level and specific behavioral attributes to increase autism spectrum disorder (ASD) susceptibility in males
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Deepak Verma, Debarshi Paul, C K Panda, Aritrika Sanyal, Asem Surindro Singh, Arijit Karmakar, Subhrangshu Guhathakurta, Saurabh Ghosh, Swagata Sinha, Barnali Chakraborti, Kanchan Mukhophadhyay, Preeti Jaiswal, Usha Rajamma, Kochupurackal P. Mohanakumar, and Anirban Roychowdhury
- Subjects
Adult ,Male ,0301 basic medicine ,Serotonin ,medicine.medical_specialty ,Adolescent ,Autism Spectrum Disorder ,Population ,India ,Quantitative trait locus ,Serotonergic ,Polymorphism, Single Nucleotide ,Young Adult ,03 medical and health sciences ,Sex Factors ,0302 clinical medicine ,medicine ,Humans ,Genetic Predisposition to Disease ,Allele ,Child ,education ,Psychiatry ,Monoamine Oxidase ,Biological Psychiatry ,Genetic association ,Psychiatric Status Rating Scales ,Pharmacology ,Genetics ,education.field_of_study ,Mental Disorders ,medicine.disease ,030104 developmental biology ,Autism spectrum disorder ,Case-Control Studies ,Child, Preschool ,Childhood Autism Rating Scale ,Female ,Monoamine oxidase B ,Psychology ,030217 neurology & neurosurgery - Abstract
Serotonergic system participates in various developmental processes and modulation of behaviour. Autism Spectrum Disorder (ASD) is characterized by a range of behavioral symptoms scaling from mild to severe. Abnormal 5-HT synthesis and signalling, platelet hyperserotonemia and amelioration of repetitive behaviours by SSRI are some of the key findings, which reinforced the hypothesis that serotonergic genes might act as ASD susceptible genes. Therefore, genes encoding monoamine oxidases A/B (MAOA/MAOB) received special attention as these genes are located on the X-chromosome and the gene products are responsible for 5-HT degradation. In the present study, we conducted population-based association analysis of eight markers of MAOB with ASD in a study cohort of 203 cases and 236 controls form India and examined its effect on platelet 5-HT content and behaviour. Gender-specific changes were observed for the contrasting LD between pair of markers among cases and controls. Case-control analysis demonstrated over-distribution of major C allele of rs2283728 and rs2283727 in male and female ASD cases respectively. Haplotypic distribution and interaction among markers showed more robust effect in male cases. Interestingly, male ASD cases displayed higher platelet 5-HT content in comparison to the respective controls. Quantitative trait analysis revealed significant correlation of genetic variants and haplotypes of MAOB markers, rs1799836 and rs6324 with increased platelet 5-HT level and CARS scores for specific behavioral symptoms respectively in males. This study suggests that MAOB increases ASD risk in males, possibly through its sex-specific regulatory effect on 5-HT metabolism and behavior.
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- 2016
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20. Hearing impairment in patients of hypothyroidism in sub Himalayan region
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Vandana, Vidhu Sharma, Kuldeep Thakur, Deepak Verma, Sunder Singh Dogra, Pardeep Bansal, and Vikasdeep Gupta
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medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Hearing loss ,Tympanometry ,Audiology ,medicine.disease ,Thyroid function tests ,Medicine ,Outpatient clinic ,Sensorineural hearing loss ,Pure tone audiometry ,medicine.symptom ,Audiometry ,business ,Decibel - Abstract
Background: The objective of the study was to assess the hearing impairment in patients of hypothyroidism.Methods: A prospective clinical study has done at a referral centre included 33 diagnosed patients of hypothyroidism in the age group of 15 to 65 years, fulfilling the inclusion and exclusion criteria who attended the outpatient department. The diagnosis of hypothyroidism was confirmed by thyroid function tests i.e., serum T3, T4 and TSH levels while hearing assessment was done using tuning fork tests, pure tone audiometry, impedance audiometry and otoacoustic emissions. Hearing impairment was measured in decibels of hearing loss, or dB HL and graded as mild, moderate, moderately severe, severe, or profound. Results: Percutaneous transluminal angioplasty showed 42.7% of the patients had high frequency sensorineural type of hearing loss. The air bone gap was not significant. On tympanometry, all the patients had type A graph and distortion product otoacoustic emissionss in all patients were pass.Conclusions: Acquired hypothyroidism affects primarily high frequency hearing thresholds causing high frequency sensorineural hearing loss, with little or no effect on lower frequencies.
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- 2020
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21. Transoral Laser Microsurgery for Isolated Uvula & Soft Palate Malignancy-A Single Centre Experience
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Deepak Verma
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Single centre ,medicine.medical_specialty ,medicine.anatomical_structure ,Soft palate ,business.industry ,medicine ,Transoral laser microsurgery ,business ,Malignancy ,medicine.disease ,Surgery - Published
- 2018
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22. Nucleophosmin mutation analysis in acute myeloid leukaemia: Immunohistochemistry as a surrogate for molecular techniques
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Ajay Gogia, Haraprasad Pati, Anita Chopra, Deepak Verma, Dev Kumar, Sameer Bakhshi, Rajive Kumar, Suman Kumar, Garima Vishwakama, Sushant Soni, and Rahul Diwedi
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Adult ,Male ,NPM1 ,Myeloid ,Adolescent ,DNA Mutational Analysis ,AML - ASO-PCR - exon 12 mutation - immunohistochemistry - molecular surrogate - NPM1 ,molecular surrogate ,lcsh:Medicine ,Gene mutation ,Biology ,General Biochemistry, Genetics and Molecular Biology ,03 medical and health sciences ,0302 clinical medicine ,AML ,Allele-specific oligonucleotide ,medicine ,Humans ,Child ,Nucleophosmin ,lcsh:R ,Antibodies, Monoclonal ,Nuclear Proteins ,General Medicine ,Middle Aged ,medicine.disease ,Molecular biology ,Immunohistochemistry ,exon 12 mutation ,Leukemia ,Leukemia, Myeloid, Acute ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Mutation testing ,Female ,Original Article ,ASO-PCR ,030215 immunology - Abstract
Background & objectives: Mutation of nucleophosmin (NPM1) gene in the absence of FLT3-ITD (FMS related tyrosine kinase 3 - internal tandem duplications) mutation carries a good prognosis in cytogenetically normal acute myeloid leukaemia (AML). NPM1, a multifunctional nucleolar phosphoprotein that shuttles between nucleus and cytoplasm, gets trapped in the cytoplasm when mutated. Immunohistochemical (IHC) demonstration of its aberrant cytoplasmic location (NPMc+) has been suggested as a simple substitute for the standard screening molecular method. This study was aimed to assess the diagnostic utility of IHC on formalin fixed bone marrow biopsies in comparison with the reference molecular method (allele specific oligonucleotide - polymerase chain reaction; ASO-PCR) to predict NPM1 mutation status in AML patients. Methods: NPM protein IHC was performed using mouse anti-NPM monoclonal antibody on 35 paraffin-embedded bone marrow biopsies of patients with primary AML of any French-American-British (FAB) subtype. Results of IHC were compared with those of ASO-PCR. Results: Of the 35 AML patients, 21 (60%) were positive for NPM1 exon 12 gene mutation by ASO-PCR, 19 (90.47%) of these 21 were NPMc+. Thirteen of the 35 patients were negative by both the methods. One NPMc+ patient was not detected by ASO-PCR. IHC had a sensitivity and specificity of 90 and 93 per cent, respectively, compared to the molecular screening gold standard. Interpretation & conclusions: Mutation of NPM1 determined by the widely available and inexpensive IHC agrees closely with results of the standard molecular methods. Thus, technically and financially not well endowed laboratories can provide the prognostically and potentially therapeutically important information on NPM1 mutation using IHC.
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- 2016
23. Synchronous Ossiculoplasty with Ossicular Replacement Prosthesis during Canal Wall Down Mastoidectomy for Advanced Cholesteatoma: Anatomical and Audiological Outcomes
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Gul Motwani, Mohamed Shareef, Noor Ul Din Malik, Santosha Ram Choudhary, and Deepak Verma
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Canal wall down mastoidectomy ,medicine.medical_specialty ,Ossicular replacement prosthesis ,Otorhinolaryngology ,business.industry ,medicine ,Cholesteatoma ,Dentistry ,medicine.disease ,business ,Surgery - Abstract
Objectives To evaluate the anatomical and audiological outcomes of synchronous ossiculoplasty with ossicular replacement prosthesis during canal wall down mastoidectomy for advanced cholesteatoma. Methods The prospective study was done at a tertiary referral institute included 30 patients of cholesteatoma who underwent canal wall down mastoidectomy. Ossicular reconstruction was performed using polytetrafluoroethylene (PTFE) (teflon) partial or total ossicular replacement prosthesis. Patients were assessed at 1st, 3rd and 6th postoperative months for graft uptake and hearing evaluation using pure tone audiometry (PTA) in which air bone gap (ABG) closure and mean ABG was calculated and compared with the mean preoperative ABG. Results The mean ABG [both total occicular replacement prosthesis (TORP) and partial occicular replacement prosthesis (PORP) groups combined] considerably reduced from 34.33 ± 4.10 dB preoperatively to 15.47 ± 7.65 dB postoperatively at 6 months. There was a 46.29% of closure of ABG in 1st month, which closed more (53.89%) in 3rd month and even more (55.34%) in 6th postoperative month. p < 0.001 showed the ABG closure ratio and reduction in the mean ABG was statistically significant in the postoperative period. Conclusion Ossicular reconstruction with ossicular replacement prosthesis offers good functional results when performed during canal wall down surgery for advanced cholesteatoma, as a single-stage procedure. How to cite this article Shareef M, Motwani G, Verma D, Malik NUD, Choudhary SR. Synchronous Ossiculoplasty with Ossicular Replacement Prosthesis during Canal Wall Down Mastoidectomy for Advanced Cholesteatoma: Anatomical and Audiological Outcomes. Int J Otorhinolaryngol Clin 2015;7(3):109-113.
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- 2015
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24. Imatinib resistance in chronic myeloid leukemia due to a rare mutation
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Anita Chopra, Akash Kumar, Atul Sharma, Priyavadhana Balasubramanian, Rajive Kumar, Indresh K. Singh, and Deepak Verma
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Cancer Research ,Mutation ,Imatinib resistance ,business.industry ,Myeloid leukemia ,Hematology ,medicine.disease ,medicine.disease_cause ,Fusion protein ,Fusion gene ,03 medical and health sciences ,0302 clinical medicine ,Oncology ,hemic and lymphatic diseases ,030220 oncology & carcinogenesis ,Cancer research ,Medicine ,Kinase activity ,business ,Myeloproliferative neoplasm ,030215 immunology ,Chronic myelogenous leukemia - Abstract
Chronic myelogenous leukemia (CML) is a myeloproliferative neoplasm that is characterized by the BCR-ABL1 fusion gene, which encodes a chimeric protein with increased tyrosine kinase activity. Imat...
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- 2016
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25. Modification of Step in Difficult Laparoscopic Cholecystectomy to Minimize the Conversion Rate
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Parul Yadav, Mahesh Malani, Sarthak Sharma, Nemi Chand, and Deepak Verma
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medicine.medical_specialty ,Common bile duct ,business.industry ,medicine.medical_treatment ,Incidence (epidemiology) ,Perforation (oil well) ,Postoperative complication ,medicine.disease ,Asymptomatic ,Surgery ,medicine.anatomical_structure ,medicine ,Cholecystectomy ,Hernia ,medicine.symptom ,business ,Abdominal surgery - Abstract
Gall stone disease is a common gastrointestinal surgical problem and symptomatic patients needs appropriate and timely treatment in the form of cholecystectomy else the disease process becomes complicated because of recurrent chronic infection, dislodgement of stone to common bile duct, acute infection and more severe complications like perforation of gall bladder. In recent years, Laparoscopic Cholecystectomy is considered as gold standard treatment for symptomatic as well as for few categories of asymptomatic cholelithiasis. Reduced postoperative pain, early return of mobility and to work, cosmetic results and brief hospital stay are distinct advantages of the procedure. Laparoscopic Cholecystectomy becomes difficult in patients with male sex, age above 50 years, obese, history of previous hospitalization due to attacks, previous abdominal surgery scar, palpable gall bladder, impacted stone, overdistended/contracted gall bladder. Various scoring systems have been reported to predict difficult laparoscopic cholecystectomy preoperatively. These difficult cases required longer operating time and hospital stay. The incidence of postoperative complications are also higher as compared to easy Laparoscopic Cholecystectomy Of the total 430 cases included in this study, 200 (46.5%) cases were difficult cases. For performing Laparoscopic Cholecystectomy in these patients successfully i.e. with minimum conversion to open, certain modifications in the classical four-port technique were done. As a result, conversion rate in difficult laparoscopic cholecystectomy could be limited to 7% only. Postoperative complication were pyrexia (21.5%), paralytic ileus (9.5%), bile stained subhepatic discharge (6.5%), port site infection (8%) and respiratory complications (8%). Late complication was port-site hernia (0.5%). Operating time 58.7+12.4 minutes in difficult laparoscopic cholecystectomy as compared to 36.5+9.2 minutes in easy cases and postoperative hospital stay was of 6.9+1.8 days against 2.3+0.8 days as compared to easy cases. Unclear anatomy (3%), haemorrhage (4%), dense adhesions (2%) and anaesthesia issue (1%) were the reasons of conversion to open cholecystectomy. It is concluded from this study that preoperative difficult laparoscopic cholecystectomy can be predicted and modifications of the steps of four-port cholecystectomy can be done to minimize the conversion rate.
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- 2020
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26. Vitamin D Deficiency in Rural Area of Gautam Buddh Nagar:An Observational Study
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Ajai Kumar Garg, Vijay Deepak Verma, Suresh Chandra Babu, and Ashish Satyarthi
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business.industry ,Environmental health ,Public Health, Environmental and Occupational Health ,Medicine ,Observational study ,Rural area ,business ,medicine.disease ,vitamin D deficiency - Published
- 2020
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27. Sexual dimorphic effect in the genetic association of monoamine oxidase A (MAOA) markers with autism spectrum disorder
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Deepak Verma, Arijit Karmakar, Kanchan Mukhopadhyay, Asem Surindro Singh, Anindita Chatterjee, Swagata Sinha, Tirthankar Bandyopadhyay, Saurabh Ghosh, Barnali Chakraborti, Usha Rajamma, and Kochupurackal P. Mohanakumar
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Adult ,Genetic Markers ,Male ,Linkage disequilibrium ,Adolescent ,Population ,Biology ,Polymorphism, Single Nucleotide ,Linkage Disequilibrium ,Young Adult ,medicine ,Humans ,Genetic Predisposition to Disease ,Allele ,Child ,education ,Monoamine Oxidase ,Alleles ,Genetic Association Studies ,Biological Psychiatry ,Genetic association ,Pharmacology ,Genetics ,Sex Characteristics ,education.field_of_study ,medicine.disease ,Testis determining factor ,Haplotypes ,Child Development Disorders, Pervasive ,Autism spectrum disorder ,Case-Control Studies ,Child, Preschool ,biology.protein ,Autism ,Female ,Monoamine oxidase A - Abstract
Autism spectrum disorders are heritable and behaviorally-defined neurodevelopmental disorders having skewed sex ratio. Serotonin as modulator of behavior and implication of serotonergic dysfunction in ASD etiology corroborates that serotonergic system genes are potential candidates for autism susceptibility. In the current study X-chromosomal gene, MAOA responsible for degradation of serotonin is investigated for possible association with ASD using population-based approach. Study covers analysis of 8 markers in 421 subjects including cases and ethnically-matched controls from West Bengal. MAOA marker, rs6323 and various haplotypes formed between the markers show significant association with the disorder. Stratification on the basis of sex reveals significant genetic effect of rs6323 with low activity T allele posing higher risk in males, but not in females. Haplotypic association results also show differential effect both in males and females. Contrasting linkage disequilibrium pattern between pair of markers involving rs6323 in male cases and controls further supports the sex-bias in genetic association. Bioinformatic analysis shows presence of Y-encoded SRY transcription factor binding sites in the neighborhood of rs1137070. C allele of rs1137070 causes deletion of GATA-2 binding site and GATA-2 is known to interact with SRY. This is the first study highlighting male-specific effect of rs6323 marker and its haplotypes in ASD etiology and it suggests sexual dimorphic effect of MAOA in this disorder. Overall results of this study identify MAOA as a possible ASD susceptibility locus and the differential genetic effect in males and females might contribute to the sex ratio differences and molecular pathology of the disorder.
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- 2014
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28. Abstract 5233: MEF2C dysregulation is associated with immature T cell immunophenotype, absence of biallelic deletion of TCR-gamma and inferior survival
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Rachna Seth, Sameer Bakhshi, Anita Chopra, Jayanth Kumar, Rajive Kumar, Atul Sharma, Jay Singh, and Deepak Verma
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Oncology ,Cancer Research ,medicine.medical_specialty ,biology ,CD117 ,business.industry ,Cancer ,medicine.disease ,Minimal residual disease ,medicine.anatomical_structure ,Immunophenotyping ,Internal medicine ,medicine ,biology.protein ,Bone marrow ,CD5 ,business ,Survival analysis ,CD8 - Abstract
T-cell acute lymphoblastic leukemia (T-ALL) is an aggressive hematological malignancy affecting both children & adults. Unlike B-ALL, the prognostic markers are not clearly defined in T-ALL. In this study, we evaluated the correlation of MEF2C gene expression in T-ALL with immunophenotype & absence of biallelic deletion of TCR-gamma (ABD) & tested its potential significance as prognostic marker. A total of 106 T-ALL patients, including 75 children & 31 adults (males 93; females 13) were included. Immunophenotyping was done in all cases at diagnosis on bone marrow/peripheral blood samples using CD3, CD7, CD4, CD2, CD45, CD5, CD8, CD1a, CD13, CD33, CD117, HLA-DR, CD34, CD65 & CD11b antibodies. The patients were categorized into immature (pre & pro T-ALL; n=48), cortical (n=47) & mature (n=11) T-ALL based on immunophenotypic features. MEF2C gene expression was quantified by RQ-PCR. ABD was done in 90 patients in which DNA was available by quantitative DNA PCR (Q-PCR) for TCR-gamma rearrangements using the protocol described before1. Minimal residual disease in bone marrow samples at the end of induction therapy was also measured. Kruskal-Wallis test was performed to determine the correlation of MEF2C expression with immunophenotypes & TCR-gamma chain status. Kaplan Meier survival analysis was done to evaluate the significance of MEF2C dysregulation on event free survival & overall survival. We found MEF2C gene to be significantly overexpressed (p=0.013) in patients with immature T-ALL as compared to cortical & mature T-ALL cases. It was significantly overexpressed in early T-cell precursor (ETP-ALL) cases (n=15) versus non ETP-ALL (p=0.03). By qPCR, 29 of 90 patients (32.22%) were classified as ABD, 44 (48.89%) as non-ABD & 17 (18.89%) as indeterminate. MEF2C expression was higher in ABD patients (p=0.011). Minimal residual disease was found more frequently in MEF2C dysregulated patients (p=0.033). On Kaplan Meier survival analysis, event free survival (EFS) was not significantly different between two groups (p=0.33). Overall survival (OS) was worse in MEF2C dysregulated patients as compared to others (p=0.017). ETP-immunophenotype was associated with poorer EFS (p=0.013). ABD did not correlate with EFS & OS. To conclude, MEF2C dysregulation was associated with immature T-immunophenotype, ABD & inferior survival at diagnosis. MEF2C gene expression can be used as potential candidate to risk stratify T-ALL cases. Reference 1. Gutierrez A, Dahlberg SE et al. Absence of biallelic TCRgamma deletion predicts early treatment failure in pediatric T-cell acute lymphoblastic leukemia. J Clin Oncol. 2010;28:3816-23. Citation Format: Anita Chopra, Jay Singh, Deepak Verma, Rajive Kumar, Sameer Bakhshi, Jayanth Kumar, Rachna Seth, Atul Sharma. MEF2C dysregulation is associated with immature T cell immunophenotype, absence of biallelic deletion of TCR-gamma and inferior survival [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 5233.
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- 2019
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29. Persistent Left Superior Vena Cava: A Rare Case with Clinical Significance
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Sankalp Yadav, Gautam Rawal, Deepak Verma, and Raj Kumar
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medicine.medical_specialty ,Heart block ,medicine.medical_treatment ,Clinical Biochemistry ,Population ,lcsh:Medicine ,030204 cardiovascular system & hematology ,Asymptomatic ,vascular malformation ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Medicine ,030216 legal & forensic medicine ,Persistent left superior vena cava ,education ,Coronary sinus ,education.field_of_study ,Internal Medicine Section ,coronary sinus ,business.industry ,Vascular malformation ,lcsh:R ,computed tomography ,General Medicine ,medicine.disease ,echocardiogram ,Catheter ,Cardiology ,cardiovascular system ,medicine.symptom ,business ,Central venous catheter - Abstract
Persistent Left Superior Vena Cava (PLSVC) is a rare congenital vascular anomaly (incidence of 0.3-0.5% of the general population) which being mostly asymptomatic in its presentation, is usually detected incidentally. There are many practical clinical implications associated with it including arrhythmias. We report a rare case of PLSVC with absent Right Superior Vena Cava (RSVC) (isolated PLSVC), in a 55- year-old lady who had complete heart block followed by sepsis and was diagnosed to have this condition during the permanent cardiac pacemaker implantation and central venous catheter insertion showing an abnormal path of the catheter/pacing leads. The authors also give an insight into its clinical relevance.
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- 2016
30. Hospital Pediatric Dentistry
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Priya Gupta, Deepak Verma, and Amitha Hegde
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medicine.medical_specialty ,business.industry ,Emergency medicine ,medicine ,Medical emergency ,business ,medicine.disease - Published
- 2016
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31. Lifetime suicide intent, executive function and insight in schizophrenia and schizoaffective disorders
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Mandvi Srivastava, Deepak Verma, Smita N. Deshpande, Sunil Kumar Singh, and Triptish Bhatia
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medicine.medical_specialty ,Poison control ,Neuropsychological Tests ,Suicide prevention ,Article ,03 medical and health sciences ,Executive Function ,0302 clinical medicine ,mental disorders ,Injury prevention ,medicine ,Humans ,Psychiatry ,Suicidal ideation ,Biological Psychiatry ,Problem Solving ,Human factors and ergonomics ,Cognition ,medicine.disease ,030227 psychiatry ,Psychiatry and Mental health ,Suicide ,Psychotic Disorders ,Schizophrenia ,medicine.symptom ,Psychology ,Neurocognitive ,030217 neurology & neurosurgery ,Clinical psychology - Abstract
Objectives Lack of insight and neurocognitive deficits are often seen in schizophrenia patients. While there are several studies investigating the relationship between suicidal ideation, executive function and insight, there are relatively fewer investigating the triangular relationship between suicide intent, insight and cognitive competence in schizophrenia. The aim of our study was to address this issue.
- Published
- 2015
32. Prognostic impact of CD56 in pediatric AML
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Deepak Verma, Rajive Kumar, Sameer Bakhshi, A. K. Vishwanath, Anita Chopra, Sushant Soni, and Sandeep Rai
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Oncology ,Chromosome Aberrations ,medicine.medical_specialty ,Myeloid ,business.industry ,Biochemistry (medical) ,Clinical Biochemistry ,MEDLINE ,Hematology ,General Medicine ,Kaplan-Meier Estimate ,medicine.disease ,Prognosis ,Pediatric AML ,CD56 Antigen ,Leukemia ,Leukemia, Myeloid, Acute ,medicine.anatomical_structure ,Internal medicine ,medicine ,Biomarkers, Tumor ,Humans ,business - Published
- 2015
33. Laparoscopic versus open surgical management of idiopathic varicocele: a study on 100 patients
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Deepak Verma, Manoj Sirwi, Avdhesh Sharma, and Chhanwar Lal
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Andrology ,medicine.medical_specialty ,business.industry ,Varicocele ,medicine ,medicine.disease ,business ,Surgery - Abstract
Background: Idiopathic varicocele is common condition encountered in surgical practice requiring surgical correction. Open surgical technique had been in use for long but laparoscopic varicocelectomy is another choice for its management.Methods: This is a prospective study on 100 patients. 70 patients were subjected to laparoscopic and 30 to open inguinal varicocelectomy.Results: Majority of patients were between 16 to 25 years of age. 55% were asymptomatic and 10% had infertility. Grade II varicocele was observed in 50% patients. All patients had left side involvement with bilateral varicocele in 2% patients. Mean operating was 13.8 min in unilateral and 17.3 min in bilateral laparoscopic varicocelectomy whereas it was 27.55 min in unilateral and 49.7 min in bilateral open varicocelectomy. 5.7% and 6.6% had secondary hydrocele and hospital stay was 1.25 and 3.4 days in laparoscopic and open group respectively.Conclusions: Laparoscopic varicocelectomy is safe, effective procedure with less post-operative pain and analgesic requirement. It also has shorter operating time and post-operative hospital stay. Procedures like opposite varicocele, herniotomy, adhesiolysis or orchiopexy can also be done.
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- 2017
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34. SLC6A4 markers modulate platelet 5-HT level and specific behaviors of autism: a study from an Indian population
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Preeti Jaiswal, Merina Varghese, Usha Rajamma, Kochupurackal P. Mohanakumar, Swagata Sinha, Deepak Verma, Saurabh Ghosh, Mritunjay Pandey, Subhrangshu Guhathakurta, and Asem Surindro Singh
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Male ,Serotonin ,Genotype ,Population ,Statistics as Topic ,India ,Quantitative trait locus ,Polymorphism, Single Nucleotide ,Severity of Illness Index ,Young Adult ,Gene Frequency ,mental disorders ,medicine ,Humans ,Genetic Predisposition to Disease ,Allele ,Autistic Disorder ,education ,Child ,Biological Psychiatry ,Serotonin transporter ,Genetic Association Studies ,Pharmacology ,Genetics ,Serotonin Plasma Membrane Transport Proteins ,education.field_of_study ,biology ,Mental Disorders ,Transmission disequilibrium test ,medicine.disease ,5-HTTLPR ,Case-Control Studies ,Child, Preschool ,Immunology ,biology.protein ,Childhood Autism Rating Scale ,Autism ,Female - Abstract
Presence of platelet hyperserotonemia and effective amelioration of behavioral dysfunctions by selective serotonin reuptake inhibitors (SSRI) in autism spectrum disorders (ASD) indicate that irregularities in serotonin (5-HT) reuptake and its homeostasis could be the basis of behavioral impairments in ASD patients. SLC6A4, the gene encoding serotonin transporter (SERT) is considered as a potential susceptibility gene for ASD, since it is a quantitative trait locus for blood 5-HT levels. Three functional polymorphisms, 5-HTTLPR, STin2 and 3'UTR-SNP of SLC6A4 are extensively studied for possible association with the disorder, with inconclusive outcome. In the present study, we investigated association of these polymorphisms with platelet 5-HT content and symptoms severity as revealed by childhood autism rating scale in ASD children from an Indian population. Higher 5-HT level observed in ASD was highly significant in children with heterozygous and homozygous genotypes comprising of minor alleles of the markers. Quantitative transmission disequilibrium test demonstrated significant genetic effect of STin2 allele as well as STin2/3'UTR-SNP and 5-HTTLPR/3'UTR-SNP haplotypes on 5-HT levels, but no direct association with overall CARS score and ASD phenotype. Significant genetic effect of the markers on specific behavioral phenotypes was observed for various sub-phenotypes of CARS in quantitative trait analysis. Even though the 5-HT level was not associated with severity of behavioral CARS score, a significant negative relationship was observed for 5-HT levels and level and consistency of intellectual response and general impression in ASD children. Population-based study revealed higher distribution of the haplotype 10/G of STin2/3'UTR-SNP in male controls, suggesting protective effect of this haplotype in male cases. Overall results of the study suggest that SLC6A4 markers have specific genetic effect on individual ASD behavioral attributes, might be through the modulation of 5-HT content.
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- 2014
35. Potential contribution of monoamine oxidase a gene variants in ADHD and behavioral co-morbidities: scenario in eastern Indian probands
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Swagata Sinha, R. Usha, Arijit Karmakar, Kanchan Mukhopadhyay, Kochupurackal P. Mohanakumar, Deepak Verma, Rishov Goswami, Subhamita Maitra, Barnali Chakraborti, and Paramita Ghosh
- Subjects
Proband ,Conduct Disorder ,Male ,medicine.medical_specialty ,Poison control ,India ,Comorbidity ,Minisatellite Repeats ,Impulsivity ,behavioral disciplines and activities ,Biochemistry ,White People ,Cellular and Molecular Neuroscience ,Internal medicine ,mental disorders ,medicine ,Attention deficit hyperactivity disorder ,Humans ,Psychiatry ,Monoamine Oxidase ,biology ,Haplotype ,General Medicine ,medicine.disease ,Endocrinology ,Haplotypes ,Conduct disorder ,Attention Deficit Disorder with Hyperactivity ,Attention Deficit and Disruptive Behavior Disorders ,biology.protein ,Female ,Monoamine oxidase A ,medicine.symptom ,Psychology - Abstract
Attention deficit hyperactivity disorder (ADHD) is the most frequently diagnosed behavioral disorder in children with a high frequency of co-morbid conditions like conduct disorder (CD) and oppositional defiant disorder (ODD). These traits are controlled by neurotransmitters like dopamine, serotonin and norepinephrine. Monoamine oxidase A (MAOA), a mitochondrial enzyme involved in the degradation of amines, has been reported to be associated with aggression, impulsivity, depression, and mood changes. We hypothesized that MAOA can have a potential role in ADHD associated CD/ODD and analyzed 24 markers in a group of Indo-Caucasoid subjects. ADHD probands and controls (N = 150 each) matched for ethnicity and gender were recruited following the Diagnostic and Statistical Manual for Mental Disorders-IV. Appropriate scales were used for measuring CD and ODD traits. Markers were genotyped by PCR-based methods and data obtained analyzed using the Cocaphase program under UNPHASED. Only eight markers were found to be polymorphic. rs6323 “G” allele showed higher frequencies in ADHD (P = 0.0023), ADHD + CD (P = 0.03) and ADHD + ODD (P = 0.01) as compared to controls. Haplotype analysis revealed statistically significant difference for three haplotypes in ADHD cases (P
- Published
- 2013
36. Laparoscopic Herniotomy – A Single Centre Study of 150 Cases
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Nemi Chand, Deva Ram, Mukteshwar Gupta, and Deepak Verma
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medicine.medical_specialty ,Intraoperative Complication ,business.industry ,Patent processus vaginalis ,General Medicine ,medicine.disease ,Surgery ,Single centre ,Inguinal hernia ,Short stay ,Congenital hydrocele ,Suture (anatomy) ,Medicine ,business ,Complication - Abstract
Pediatric patients presenting as inguinal hernia or congenital hydrocele is common ailment encountered in surgical practice and herniotomy is a very common surgical procedure performed. Open procedure is gradually being replaced by laparoscopic approach because of the distinct advantages of early recovery, short stay and better cosmetic results. 150 pediatric patients of inguinal hernia or congenital hydrocele were subject of this study. These patients were subjected to laparoscopic herniotomy performed at the neck of the sac and proximal part of peritoneum was closed with non-absorbable polypropyelene suture with aspiration of scrotal sac, if required. Average age of patients was 6.5 year with 93.35% male. 70.6% had inguinal hernia and 29.4% had congenital hydrocele). 68% patients had right sided and 10.6% clinically bilateral lesion. Operating time was 25 minutes in unilateral and 34.8 minutes in bilateral procedure. Postoperative stay was 1.06 days. No intraoperative complication was noted. Recurrence rate was 1.33% and conversion rate was 0.66%. Laparoscopic herniotomy is safe, well tolerated and effective procedure with early recovery, short operating time, less postoperative pain, free of complication, shorter post-operative hospital stay and very low recurrence. It can detect contralateral patent processus vaginalis and bilateral closure of it can be done through same approach.
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- 2017
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37. Adenocarcinoma in Choledochal Cyst—a Case Report
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Nirupama Kothari, Neeraj Kumar, Kamlesh Damor, and Deepak Verma
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Magnetic resonance cholangiopancreatography ,medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Biliary cirrhosis ,Case Report ,Malignancy ,medicine.disease ,medicine ,Adenocarcinoma ,Pancreatitis ,Surgery ,Cyst ,Choledochal cysts ,Radiology ,Neurosurgery ,business - Abstract
Choledochal cyst is a rare congenital condition and can present at any age with female preponderance. Incidence is high in Asian as compared to Western countries [1]. Clinical presentation is nonspecific, and complications include pancreatitis, cholangitis, biliary cirrhosis, spontaneous rupture, and malignancy [2]. Incidence of malignancy increases with age. Imaging with contrast enhanced computerized tomography (CECT) and magnetic resonance cholangiopancreatography (MRCP) has facilitated the preoperative suspicion of malignancy, and surgical treatment has evolved from cystoenterostomy to primary cyst excision with bilioenteric drainage [2]. We are reporting a preoperatively suspected case of choledochal cyst with malignancy.
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- 2014
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38. Diagnostic Adjuncts in Oral Cancer: a Review
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Akhtar Riaz, Mudita Chaturvedi, Sunny Mittal, Deepak Verma, Renuka Verma, and Litik Mittal
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medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Cancer ,Early detection ,Physical examination ,medicine.disease ,Diagnostic aid ,medicine ,Oral Cancers ,Biopsy material ,Intensive care medicine ,business ,Biomedical engineering - Abstract
Oral cancers are one of the most common cancers worldwide today. Early detection and prompt treatment offer the best chance for cure. The detection and diagnosis are currently based on clinical examination, histopathological evaluation of the biopsy material and molecular methods. Several diagnostic aids have been developed over the years for early detection of oral cancer. The purpose of this article is to outlines the available and developing diagnostic adjuncts for detection and diagnosis of oral cancer.
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- 2015
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39. Primary cutaneous amoebiasis: case report with review of the literature
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Ashok Sharma, Sanjeev Parshad, PS Grover, Anuradha Sharma, and Deepak Verma
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Adult ,Male ,medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Abdominal Wall ,Entamoeba histolytica ,Dermatology ,Amebiasis ,Cutaneous amoebiasis ,medicine.disease ,Skin Diseases ,Surgery ,Abdominal wall ,medicine.anatomical_structure ,Bedside test ,Medicine ,Skin grafting ,Oral metronidazole ,Proper treatment ,Animals ,Humans ,business - Abstract
Background Primary cutaneous amoebiasis is a rare clinical entity. The lesions can be successfully treated if suspected and correctly diagnosed. We report an interesting case with review of the literature. Methods A 25-year-old man presenting with primary cutaneous amoebiasis with extensive involvement of the anterior abdominal wall is described. Correct diagnosis eluded us for 2 years. Clinical suspicion and a simple bedside test (wet drop preparation examination) were sufficient to diagnose the lesion. Successful treatment was achieved with oral Metronidazole followed by split skin grafting. Only six cases of primary cutaneous amoebiasis could be traced in the literature. Conclusions Primary cutaneous amoebiasis is extremely rare. Diagnosis is usually not suspected because of its rarity. Cutaneous amoebiasis responds readily to proper treatment, yet, if unrecognized and neglected, produces significant morbidity and may be fatal.
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- 2002
40. Yoga can Improve Migraine and Related Stress Disorders-A Study from Meerut, North India
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Basanti Mukerjee, Vishwas Jain, Rajesh Misra, Deepak Verma, Asuthosh Bhardwaj, Archana Aggarwal, Sankalan Sarkar, and Naveen Sethi
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medicine.medical_specialty ,Migraine ,business.industry ,Stress disorders ,Medicine ,business ,Psychiatry ,medicine.disease ,North india - Published
- 2014
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41. Monoamine oxidase B gene variants associated with attention deficit hyperactivity disorder in the Indo-Caucasoid population from West Bengal
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Deepak Verma, Arijit Karmakar, Swagata Sinha, Kanchan Mukhopadhyay, Usha Rajamma, Barnali Chakraborti, Subhamita Maitra, and Kochupurackal P. Mohanakumar
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Male ,Indo-Caucasoid population ,0301 basic medicine ,Linkage disequilibrium ,Adolescent ,Genotype ,Multifactor dimensionality reduction ,MAOB ,Population ,India ,rs56220155 ,Linkage Disequilibrium ,White People ,03 medical and health sciences ,0302 clinical medicine ,Gene Frequency ,medicine ,Genetics ,Humans ,ADHD ,Attention deficit hyperactivity disorder ,Genetics(clinical) ,Conduct problems ,Allele ,Child ,education ,Monoamine Oxidase ,Allele frequency ,Genetics (clinical) ,education.field_of_study ,biology ,Haplotype ,Genetic Variation ,medicine.disease ,Phenotype ,030104 developmental biology ,Attention Deficit Disorder with Hyperactivity ,Child, Preschool ,biology.protein ,Female ,Monoamine oxidase B ,Monoamine oxidase A ,030217 neurology & neurosurgery ,Research Article - Abstract
Background Attention deficit hyperactivity disorder (ADHD) is characterized by symptoms of inattention, excessive motor activity and impulsivity detected mostly during childhood. These traits are known to be controlled by monoamine neurotransmitters, chiefly dopamine, serotonin and norepinephrine. Monoamine oxidase A (MAOA) and B (MAOB), two isoenzymes bound to the outer membrane of mitochondria, are involved in the degradation of monoamines and were explored for association with ADHD in different ethnic groups. In the present study, few exonic as well as intronic MAOB variants were analyzed in ADHD probands (N = 150) and ethnically matched controls (N = 150) recruited following the Diagnostic and Statistical Manual for Mental Disorders-4th edition (DSM-IV). Appropriate scales were used for measuring the behavioural attributes. Gene variants were analyzed by amplification of target sites followed by DNA sequencing and data obtained were analyzed by population based statistical methods. Results Out of 34 variants present in the analyzed sites, only seven functional variants, rs4824562, rs56220155, rs2283728, rs2283727, rs3027441, rs6324 and rs3027440, were found to be polymorphic. rs2283728 ‘C’ (P = 3.45e-006) and rs3027440 ‘T’ (P = 0.02) alleles showed higher frequencies in ADHD probands as compared to controls. rs56220155 ‘A’ (P = 0.04) allele and ‘GA’ (P = 0.04) genotype showed higher frequencies in the male and female ADHD probands respectively as compared to sex-matched controls. Analysis of pairwise linkage disequilibrium revealed striking differences between probands and controls. Haplotype analysis revealed significantly higher occurrence of different haplotypes in the ADHD probands while some haplotypes were detected in the controls only. Higher scores for conduct problems were found to be associated with rs56220155 ‘A’ (P = 0.05) allele in the male ADHD probands. Multifactor dimensionality reduction analysis showed independent as well as interactive effects of polymorphic variants which were more robust in the male probands. Conclusions Since all the polymorphic variants analyzed were functional, it may be inferred that MAOB gene variants are contributing to the etiology of ADHD in the Indo-Caucasoid population from eastern India which merits further in depth analysis. Electronic supplementary material The online version of this article (doi:10.1186/s12863-016-0401-6) contains supplementary material, which is available to authorized users.
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