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3. Geoheritage Values of Ambaji Region, Gujarat: Western India

Author

Chauhan, Gaurav, Samji, Sakshi V., Joshi, Aditya, Limaye, Manoj, Patel, J. M., Thacker, Hemashri, Shah, Yash, Chavada, Bhavyata, Bhosale, Suraj, Lakhote, Abhishek, Jani, Chirag, Chauhan, Suruchi, Kothyari, Girish Ch., Prizomwala, Siddharth, Kapasya, Harish, Padia, Darshit, Bhandari, Subhash, Thakkar, M. G., Chopra, Sumer, and Chauhan, Narendra Kumar

Published
2024
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6. Short-Term Treatment Outcomes of Brolucizumab in Patients with Neovascular Age-Related Macular Degeneration: A Multicentre Indian Real-World Evidence Study

Author

Chakraborty D, Thakkar M, Venkatesh R, Roy S, Bhavsar M, and Karcher H

Subjects
anti-vegf, brolucizumab, namd, real-world evidence, india, Ophthalmology, RE1-994
Abstract

Debdulal Chakraborty,1 Milan Thakkar,2 Ramesh Venkatesh,3 Sangeeta Roy,4 Maulik Bhavsar,5 Helene Karcher6 1Disha Eye Hospital, Kolkata, West Bengal, India; 2Dr. Milan’s Retina Care Centre, Rajkot, Gujarat, India; 3Narayana Nethralaya, Bangalore, Karnataka, India; 4Susrut Eye Foundation and Research Centre, Kolkata, West Bengal, India; 5Novartis Healthcare Pvt. Ltd., Mumbai, Maharashtra, India; 6Novartis Pharma AG, Basel, SwitzerlandCorrespondence: Debdulal Chakraborty, Disha Eye Hospital, Kolkata, West Bengal, India, Email devdc@rediffmail.comObjective: To evaluate the short-term effectiveness and safety outcomes following brolucizumab treatment in patients with neovascular age-related macular degeneration (nAMD) as a part of real-world clinical practice in India.Methods: This was a retrospective, observational, multicentre study including patients (≥ 50 years old) diagnosed with nAMD. Anonymized data of the patients receiving the first dose of brolucizumab intravitreal injection (IVI) who were either treatment-naïve or previously treated with a single or a combination of other anti-VEGF IVIs were included. The present study reported the change in retinal fluid levels from baseline to month 3, best-corrected visual acuity (BCVA), central retinal thickness (CRT), and the number of injections received. The adverse events in the three months after brolucizumab treatment initiation were also monitored.Results: The study included 63 patients (65 eyes) from four study centres across India (mean age: 69.1 ± 9.7 years). A total of 82 brolucizumab injections were administered during the 3 months of study duration, with 52/65 (80.0%) eyes receiving only 1 injection. Resolution of IRF, SRF, and PED was observed in 76.9%, 64.6%, and 67.7% of eyes, respectively. Further, a significant reduction in CRT was observed (baseline: 403.5 ± 118.7 μm; month 3: 308.3 ± 73.8 μm; p < 0.001), and BCVA also improved notably from 0.7 ± 0.5 logMAR at baseline to 0.5 ± 0.4 logMAR at month 3 (p < 0.001). Adverse events (AEs) were reported in 3 eyes from 3 patients; retinal pigment epithelial rip (1) and subretinal hemorrhage (2) after the first injection of brolucizumab, however, none discontinued the treatment.Conclusion: The study reports on the short-term effectiveness and tolerability of brolucizumab therapy in the management of nAMD in both treatment-naïve and switch eyes. Brolucizumab was observed to have a favourable benefit-risk profile, and study results were within the known safety profile, with no instances of intraocular inflammation.Keywords: anti-VEGF, brolucizumab, nAMD, real-world evidence, India

Published
2023

9. Development of Cenogram Technique Over the Past Six Decades with Some Insights into the Varied Habitats Occupied by Diverse Mammalian Communities Across Spain, China, and India Transiting the Middle Miocene Climatic Optimum

Author

Kapur, Vivesh V., García Yelo, Blanca A., Thakkar, M. G., Tripathi, Satish C., Series Editor, Phartiyal, Binita, editor, Mohan, Rahul, editor, Chakraborty, Supriyo, editor, Dutta, Venkatesh, editor, and Gupta, Anil Kumar, editor

Published
2022
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37. Development of cenogram technique over the past six decades with some insights into the varied habitats occupied by diverse mammalian communities across Spain, China, and India transiting the middle miocene climatic optimum

Author

Phartiyal, B., Mohan, R., Chakraborty, S., Dutta, V., Gupta, A.K., Kapur, Vivesh V., García Yelo, Blanca Ana, Thakkar, M. G., Phartiyal, B., Mohan, R., Chakraborty, S., Dutta, V., Gupta, A.K., Kapur, Vivesh V., García Yelo, Blanca Ana, and Thakkar, M. G.

Abstract

The climatic evolution of the Neogene, with long-term cooling disrupted by the Middle Miocene Climatic Optimum (MMCO; ~17–14.75 Ma), arises as a suitable baseline to analyze the effects of these transcendent climatic changes on the mammalian community structures. The present investigation is an attempt to examine the palaeohabitat of a Neogene (Middle Miocene: ~15–11.5 Ma) geographically distant (i.e., from Spain, China, and India) extinct mammalian communities utilizing the cenogram approach (in both qualitative and quantitative framework). The detailed statistical analyses (presented herein) incorporating a total of eight mammalian communities allows us to infer predominance of Tropical Deciduous Forest environments between ~15 and ~11.5 Ma interval, with several pulses of distinctive aridity experienced by some communities thriving within the Iberian region. On the contrary, stable forested conditions were witnessed by the middle Miocene communities of Asia [i.e., the ~11.5 million-year-old mammalian community of Laogou (China), and the ~13.5 million-year-old mammalian community of Ramnagar (north India)]. Our present investigation also infers that additional mammalian remains (particularly of body mass of <35 kg) are warranted to decipher the habitat (based on cenogram approach) of the Middle Miocene (~13 Ma) mammalian community of Kalagarh (Himalayan Foreland Basin, north India) and the Middle Miocene (~14 Ma) mammalian community of Palasava (Kutch Basin, western India). Nonetheless, the Cenogram technique (being continuously developed over the past six decades) may become an important tool to decipher any habitat change(s) of western India’s mammalian communities considering renewed palaeontological efforts within the Neogene of the region.

Published
2022

46. Chlorhexidine versus povidone–iodine skin antisepsis before upper limb surgery (CIPHUR) : an international multicentre prospective cohort study

Author

Wade, Ryckie G., Bourke, Gráinne, Wormald, Justin C. R., Totty, Joshua Philip, Stanley, Guy Henry Morton, Lewandowski, Andrew, Rakhra, Sandeep Singh, Gardiner, Matthew D., Bindra, R., Sher, M., Thomas, M., Morgan, S. D. J., Hwang, B., Santucci, W., Tran, P., Kopp, L., Kunc, V., Hamdi, A., Grieve, P. P., Mukhaizeem, S. A., Blake, K., Cuggy, C., Dolan, R., Downes, E., Geary, E., Ghadge, A., Gorman, P., Jonson, M., Jumper, N., Kelly, S., Leddy, L., McMahon, M. E., McNamee, C., Miller, P., Murphy, B., O'Halloran, L., O’Shea, K., Skeens, J., Staunton, S., Timon, F., Woods, J., Cortinovis, U., Sala, L., Zingarello, V., Jusoh, M. H., Sadagatullah, A. N., Georgieva, G., Pejkova, S., Nikolovska, B., Srbov, B., Hamid, H. K. S., Mustafa, M., Abdelrahman, M., Amin, S. M. M., Bhatti, D., Rahman, K. M. A., Jumabhoy, I., Kiely, J., Kieran, I., Lo, A. C. Q., Wong, K Y., Allan, A. Y., Armes, H., Horwitz, M. D., Ioannidi, L., Masterton, G., Chu, H., Talawadekar, G. D., Tong, K. S., Chan, M., Tredgett, M., Hardie, C., Powell-Smith, E., Gilham, N., Prokopenko, M., Ahmad, R., Davies, J., Zhen, S., Dargan, D., Pinder, R. M., Koziara, M., Martin, R., Reay, E., Cochrane, E., Elbatawy, A., Green, F., Griffiths, T., Higginbotham, G., Louette, S., McCauley, G., Natalwala, I., Salt, E., Ahmed, R., Goon, P., Manton, R., Segaren, N., Cheung, G., Mahoney, R., Sen, S., Clarkson, D., Collins, M., Bolt, A., Lokanathan, P., Ng, A., Jones, G., Jones, J. W. M., Kabariti, R., Rhee, S. J., Herron, J., Kay, A., Cheung, L. K., Thomson, D., Jugdey, R. S., Yoon, H., L, Z., Southgate, J., Brennan, C., Kiani, S., Zabaglo, M., Haider, Z. A., Poulter, R., Sheik-Ali, A., Watts, A., Jemec, B., Redgrave, N., Dupley, L., Greenhalgh, M., Vella, J., Harris, H., Robinson, A. V., Dupre, S., Teelucksingh, S., Gargan, A., Hettiaratchy, S., Jain, A., Kwasnicki, R., Lee, A., Thakkar, M., Berwick, D., Ismail, N., Mahdi, M., Rodrigues, Jeremy, Liew, C., Saadya, A., Clarkson, M., Brady, C., Harrison, R., Rayner, A., Nolan, G., Phillips, B., Madhusudan, N., and HASH(0x5651c97f7e70)

Subjects
Adult, AcademicSubjects/MED00910, Chlorhexidine, Bjs/2, Antisepsis, General Medicine, Upper Extremity, Preoperative Care, Humans, Original Article, Prospective Studies, AcademicSubjects/MED00010, Child, Povidone-Iodine, RA, RD
Abstract

Introduction Surgical site infection (SSI) is the most common and costly complication of surgery. International guidelines recommend topical alcoholic chlorhexidine (CHX) before surgery. However, upper limb surgeons continue to use other antiseptics, citing a lack of applicable evidence, and concerns related to open wounds and tourniquets. This study aimed to evaluate the safety and effectiveness of different topical antiseptics before upper limb surgery. Methods This international multicentre prospective cohort study recruited consecutive adults and children who underwent surgery distal to the shoulder joint. The intervention was use of CHX or povidone–iodine (PVI) antiseptics in either aqueous or alcoholic form. The primary outcome was SSI within 90 days. Mixed-effects time-to-event models were used to estimate the risk (hazard ratio (HR)) of SSI for patients undergoing elective and emergency upper limb surgery. Results A total of 2454 patients were included. The overall risk of SSI was 3.5 per cent. For elective upper limb surgery (1018 patients), alcoholic CHX appeared to be the most effective antiseptic, reducing the risk of SSI by 70 per cent (adjusted HR 0.30, 95 per cent c.i. 0.11 to 0.84), when compared with aqueous PVI. Concerning emergency upper limb surgery (1436 patients), aqueous PVI appeared to be the least effective antiseptic for preventing SSI; however, there was uncertainty in the estimates. No adverse events were reported. Conclusion The findings align with the global evidence base and international guidance, suggesting that alcoholic CHX should be used for skin antisepsis before clean (elective upper limb) surgery. For emergency (contaminated or dirty) upper limb surgery, the findings of this study were unclear and contradict the available evidence, concluding that further research is necessary., This international study recruited 2454 children and adults undergoing surgery on their upper limb (arm or hand), from 42 hospitals worldwide. The overall risk of infection after surgery was 3.5 per cent. Before planned (elective) surgery, if surgeons cleaned the skin with alcoholic chlorhexidine, then the risk of infection was reduced by 70 per cent.

Published
2021

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