88 results on '"Vyas AK"'
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2. Composite Iodine-gold Nanoparticles as a Contrast Agent in Computed Tomography
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Rezvan Ravanfar Haghighi, Fariba Zarei, Samira Moshiri, Anahita Jafari, Sabyasachi Chatterjee, Vyas Akondi, and Vani Vardhan Chatterjee
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computed tomography ,contrast agent ,nanoparticles ,Medical physics. Medical radiology. Nuclear medicine ,R895-920 - Abstract
Purpose: Solutions of iodine-based compounds, due to their high X-ray attenuation coefficient, are widely used as contrast agents in computed tomography (CT) imaging. This paper investigates the attenuation properties of iodine and gold to develop nanoparticle-based contrast agents, for example, composite nanoparticles (NPs) with layers of iodine and gold or a mixture of NPs of gold and iodine. Materials and Methods: A theoretical formula is derived that gives the Hounsfield Unit (HU) for different weight-by-weight (w/w) concentrations of a mixture of blood + iodine + gold. The range of compositions for which iodine + gold mixture can give a suitable HU ≥250 upon being mixed with blood, is formulated. These estimates are derived from experiments on the variation of HU values in different compositions of aqueous solutions of iodine and available data for gold. Results: It is seen that for an aqueous solution of iodine, the suitable HU of 250 (hence giving sufficient gray level to the CT image) can be obtained with w/w concentrations of iodine being 0.0044, 0.008, and 0.0097 for observations at 80, 100, and 120 kVp, respectively. The corresponding w/w concentrations of gold NPs would be 0.0103, 0.0131, and 0.0158. With these basic results, compositions of suitable mixtures of iodine and gold are also specified. Conclusion: Aqueous suspensions of gold NPs are suitable as contrast materials for CT imaging and can also be used as a component of a composite contrast material consisting of an iodine and gold mixture.
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- 2024
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3. Management of direct seeded rice for enhanced resource - use efficiency
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Joshi, Ekta, Kumar, Dinesh, Lal, B, Nepalia, V, Gautam, Priyanka, and Vyas, AK
- Published
- 2013
4. The Muddle of Immune Response in Coronavirus Disease-19
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Vyas Ak
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Immune system ,business.industry ,Medicine ,Disease ,business ,medicine.disease_cause ,Virology ,Coronavirus - Abstract
Coronavirus Disease-19 (COVID19) caused by the enormously spreadable SARS- CoV-2 virus has appeared as a global pandemic and leads to high mortalities. Approximately 31,243,339 people have been infected so far with this disease which has led to the death of more than 965,103patients as of 21st Sept 2020. There are many drug molecules under-trials are in phase I and II. The numerous possible candidates for vaccine development against this infectious virus are also in the pipeline. Although, so far no molecule as a therapeutics or vaccine for prevention has been approved. Recent reports have observed that severely ill patients have a differential immunological profile compared to mild COVID-19 infection. Current studies globally observed that the cytokine storm maybe leads to the severity of COVID19 infection. In this article, our focus is to describe the present knowledge and status of differential immune profile among patients infected with COVID19 infection and their association with disease progression mild to severe.
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- 2020
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5. Chemotherapy-enhanced inflammation may lead to the failure of therapy and metastasis
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Vyas D, Laput G, and Vyas AK
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lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,lcsh:RC254-282 - Abstract
Dinesh Vyas, Gieric Laput, Arpitak K Vyas College of Human Medicine, Michigan State University, East Lansing, MI, USA Abstract: The lack of therapy and the failure of existing therapy has been a challenge for clinicians in treating various cancers. Doxorubicin, 5-fluorouracil, cisplatin, and paclitaxel are the first-line therapy in various cancers; however, toxicity, resistance, and treatment failure limit their clinical use. Their status leads us to discover and investigate more targeted therapy with more efficacy. In this article, we dissect literature from the patient perspective, the tumor biology perspective, therapy-induced metastasis, and cell data generated in the laboratory. Keywords: chemotherapy, cancer, inflammation
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- 2014
6. Developmental programming: interaction between prenatal BPA and postnatal overfeeding on cardiac tissue gene expression in female sheep
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Koneva, LA, Vyas, AK, McEachin, RC, Puttabyatappa, M, H-S, Wang, Sartor, MA, and Padmanabhan, V
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endocrine system ,Sheep ,urogenital system ,Gene Expression Profiling ,Myocardium ,Body Weight ,Gestational Age ,Endocrine Disruptors ,Animal Feed ,Article ,Fetal Development ,Phenols ,Pregnancy ,Prenatal Exposure Delayed Effects ,Animals ,Birth Weight ,Female ,Gene-Environment Interaction ,Obesity ,Benzhydryl Compounds ,Transcriptome ,hormones, hormone substitutes, and hormone antagonists - Abstract
Epidemiologic studies and studies in rodents point to potential risks from developmental exposure to BPA on cardiometabolic diseases. Furthermore, it is becoming increasingly evident that the manifestation and severity of adverse outcomes is the result of interaction between developmental insults and the prevailing environment. Consistent with this premise, recent studies in sheep found prenatal BPA treatment prevented the adverse effects of postnatal obesity in inducing hypertension. The gene networks underlying these complex interactions are not known. mRNA-seq of myocardium was performed on four groups of four female sheep to assess the effects of prenatal BPA exposure, postnatal overfeeding and their interaction on gene transcription, pathway perturbations and functional effects. The effects of prenatal exposure to BPA, postnatal overfeeding, and prenatal BPA with postnatal overfeeding all resulted in transcriptional changes (85-141 significant differentially expressed genes). Although the effects of prenatal BPA and postnatal overfeeding did not involve dysregulation of many of the same genes, they affected a remarkably similar set of biological pathways. Furthermore, an additive or synergistic effect was not found in the combined treatment group, but rather prenatal BPA treatment led to a partial reversal of the effects of overfeeding alone. Many genes previously known to be affected by BPA and involved in obesity, hypertension, or heart disease were altered following these treatments, and AP-1, EGR1, and EGFR were key hubs affected by BPA and/or overfeeding. Environ. Mol. Mutagen. 58:4-18, 2017. © 2016 Wiley Periodicals, Inc.
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- 2017
7. A Study to Evaluate Association of Celiac Disease with Insulin Dependent Diabetes and Hypothyroidism in North-West Rajasthan
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Kumar S, Meena SL, Aswal VK, and Vyas AK
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Celiac Disease ,Hypothyroidism ,Diabetes - Abstract
Objective: To study association of Celiac Disease with Insulin Dependent Diabetes and Hypothyroidism in young adults in North-Western Rajasthan. Method: Total eighty-seven newly diagnosed adult patients of celiac disease were included. Sera of all patients were tested for presence of IgA tissue transglutaminase (tTG) antibody by ELISA using commercially available kits. Three to four intestinal mucosal biopsies were obtained with GI endoscopy from the second part of duodenum in patients with presence of tTG antibodies. Fasting blood glucose (FBG) was measured after overnight fasting (8 hours of fasting overnight ). Serum TSH testing was performed on automated immunoassay platforms employing advanced IMA technology. Results: In our study, out of total 87 patients, 46(52.87%) were from serum TTG group 50-200 and 41(47.12%) from serum TTG group >200. Out of total 87 patients, 14 patients had their TSH >4.2 and out of them 12 and 2 patients were from serum TTG group 50-200 and >200 respectively and the difference was statistically significant (p200 respectively. Only 10 patients had their fasting blood sugar >125 and out of them 9 and 1 were from serum TTG group 50-200 and >200 respectively and the difference was found significant (p
- Published
- 2016
8. Parametric investigation and optimization for CO2 laser cladding of AlFeCoCrNiCu powder on AISI 316
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Menghani Jyoti, Vyas Akash, More Satish, Paul Christ, and Patnaik Amar
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laser cladding ,high-entropy alloy ,microhardness ,wear ,Technology ,Chemical technology ,TP1-1185 ,Chemicals: Manufacture, use, etc. ,TP200-248 - Abstract
The purpose of the current investigation is to analyze the effect of the operating parameters of laser-assisted cladding process on clad height, clad depth, clad width and the percentage dilution in a cladding of AlFeCuCrCoNi high-entropy powder on SS-316 through CO2 laser and to optimize the cladding process parameters for optimum dilution. The experiments were designed by the full factorial method and analyzed by ANOVA. The analysis results indicate that dilution is most influenced by scanning speed followed by the powder feed rate. The outcomes of the single clad profile in terms of dilution, microhardness, composition and the microstructures produced in various cladding conditions are investigated briefly, and through which the optimum set of laser cladding operating parameters for maximum hardness of the clad material is determined. The optimum cladding conditions in the experimental range were obtained at 4 g/min powder feeding rate, 500 mm/min laser scanning speed and 1.1 kW laser beam power through multi-response optimization. Furthermore, the multi-track coating with 60% overlapping ratio was deposited using optimized parameters. The wear behavior of multi-track coating was determined using pin on disk wear apparatus with applied load of 20 N, sliding speed of 300 RPM and test duration of 15 min. The pin on disk wear test results indicates that the friction coefficient of SS-316 is larger than that of high-entropy alloy cladded SS-316. The wear resistivity of SS-316 improved by 40.35% after laser-assisted high-entropy alloy coating, which confirms that the laser cladding layer plays an essential role in enhancing the wear resistance capability of austenite steel.
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- 2021
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9. Acute sulfonylurea therapy at disease onset can cause permanent remission of KATP-induced diabetes.
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Remedi MS, Agapova SE, Vyas AK, Hruz PW, Nichols CG, Remedi, Maria Sara, Agapova, Sophia E, Vyas, Arpita K, Hruz, Paul W, and Nichols, Colin G
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GLUCOSE metabolism ,ANIMAL experimentation ,BLOOD sugar ,DIABETES ,HYPOGLYCEMIC agents ,HYPOGLYCEMIC sulfonylureas ,INSULIN resistance ,ISLANDS of Langerhans ,MICE ,GENETIC mutation ,RESEARCH funding ,MEMBRANE transport proteins ,SULFONYLUREAS ,THERAPEUTICS - Abstract
Objective: Neonatal diabetes mellitus (NDM) can be caused by gain-of-function ATP-sensitive K(+) (K(ATP)) channel mutations. This realization has led to sulfonylurea therapy replacing insulin injections in many patients. In a murine model of K(ATP)-dependent NDM, hyperglycemia and consequent loss of β-cells are both avoided by chronic sulfonylurea treatment. Interestingly, K(ATP) mutations may underlie remitting-relapsing, transient, or permanent forms of the disease in different patients, but the reason for the different outcomes is unknown.Research Design and Methods: To gain further insight into disease progression and outcome, we examined the effects of very early intervention by injecting NDM mice with high-dose glibenclamide for only 6 days, at the beginning of disease onset, then after the subsequent progression with measurements of blood glucose, islet function, and insulin sensitivity.Results: Although ∼70% of mice developed severe diabetes after treatment cessation, ∼30% were essentially cured, maintaining near-normal blood glucose until killed. Another group of NDM mice was initiated on oral glibenclamide (in the drinking water), and the dose was titrated daily, to maintain blood glucose <200 mg/dL. In this case, ∼30% were also essentially cured; they were weaned from the drug after ∼4 weeks and again subsequently maintained near-normal blood glucose. These cured mice maintain normal insulin content and were more sensitive to insulin than control mice, a compensatory mechanism that together with basal insulin secretion may be sufficient to maintain near-normal glucose levels.Conclusions: At least in a subset of animals, early sulfonylurea treatment leads to permanent remission of NDM. These cured animals exhibit insulin-hypersensitivity. Although untreated NDM mice rapidly lose insulin content and progress to permanently extremely elevated blood glucose levels, early tight control of blood glucose may permit this insulin-hypersensitivity, in combination with maintained basal insulin secretion, to provide long-term remission. [ABSTRACT FROM AUTHOR]- Published
- 2011
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10. Early- to mid-gestational testosterone excess leads to adverse cardiac outcomes in postpartum sheep.
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Alkhatib B, Ciarelli J, Ghnenis A, Pallas B, Olivier N, Padmanabhan V, and Vyas AK
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- Animals, Female, Pregnancy, Sheep, Testosterone blood, Ventricular Function, Left, Testosterone Propionate toxicity, Cytokines blood, Cytokines metabolism, Cardiac Output, Gestational Age, Postpartum Period
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Cardiovascular dysfunctions complicate 10-20% of pregnancies, increasing the risk for postpartum mortality. Various gestational insults, including preeclampsia are reported to be associated with adverse maternal cardiovascular outcomes. One such insult, gestational hyperandrogenism increases the risk for preeclampsia and other gestational morbidities but its impact on postpartum maternal health is not well known. We hypothesize that gestational hyperandrogenism such as testosterone (T) excess will adversely impact the maternal heart in the postpartum period. Pregnant ewes were injected with T propionate from day 30 to day 90 of gestation (term 147 days). Three months postpartum, echocardiograms, plasma cytokine profiles, cardiac morphometric, and molecular analysis were conducted [control (C) n = 6, T-treated (T) n = 7 number of animals]. Data were analyzed by two-tailed Student's t test and Cohen's effect size ( d ) analysis. There was a nonsignificant large magnitude decrease in cardiac output (7.64 ± 1.27 L/min vs. 10.19 ± 1.40, P = 0.22, d = 0.81) and fractional shortening in the T ewes compared with C (35.83 ± 2.33% vs. 41.50 ± 2.84, P = 0.15, d = 0.89). T treatment significantly increased 1 ) left ventricle (LV) weight-to-body weight ratio (2.82 ± 0.14 g/kg vs. 2.46 ± 0.08) and LV thickness (14.56 ± 0.52 mm vs. 12.50 ± 0.75), 2 ) proinflammatory marker [tumor necrosis factor-alpha (TNF-α)] in LV (1.66 ± 0.35 vs. 1.06 ± 0.18), 3 ) LV collagen (Masson's Trichrome stain: 3.38 ± 0.35 vs. 1.49 ± 0.15 and Picrosirius red stain: 5.50 ± 0.32 vs. 3.01 ± 0.23), 4 ) markers of LV apoptosis, including TUNEL (8.3 ± 1.1 vs. 0.9 ± 0.18), bcl-2-associated X protein (Bax)+-to-b-cell lymphoma 2 (Bcl2)+ ratio (0.68 ± 0.30 vs. 0.13 ± 0.02), and cleaved caspase 3 (15.4 ± 1.7 vs. 4.4 ± 0.38). These findings suggest that gestational testosterone excess adversely programs the maternal LV, leading to adverse structural and functional consequences in the postpartum period. NEW & NOTEWORTHY Using a sheep model of human translational relevance, this study provides evidence that excess gestational testosterone exposure such as that seen in hyperandrogenic disorders adversely impacts postpartum maternal hearts.
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- 2024
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11. Developmental programming: An exploratory analysis of pancreatic islet compromise in female sheep resulting from gestational BPA exposure.
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Ciarelli J, Thangaraj SV, Sun H, Domke S, Alkhatib B, Vyas AK, Gregg B, Sargis RM, and Padmanabhan V
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- Animals, Female, Pregnancy, Sheep, Endocrine Disruptors toxicity, Insulin-Secreting Cells drug effects, Insulin-Secreting Cells metabolism, Insulin-Secreting Cells pathology, Maternal Exposure adverse effects, Insulin metabolism, Fetus drug effects, Glucagon-Secreting Cells drug effects, Glucagon-Secreting Cells metabolism, Glucagon-Secreting Cells pathology, Benzhydryl Compounds toxicity, Phenols toxicity, Prenatal Exposure Delayed Effects chemically induced, Prenatal Exposure Delayed Effects pathology, Islets of Langerhans drug effects, Islets of Langerhans metabolism, Islets of Langerhans pathology
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Developmental exposure to endocrine disruptors like bisphenol A (BPA) are implicated in later-life metabolic dysfunction. Leveraging a unique sheep model of developmental programming, we conducted an exploratory analysis of the programming effects of BPA on the endocrine pancreas. Pregnant ewes were administered environmentally relevant doses of BPA during gestational days (GD) 30-90, and pancreata from female fetuses and adult offspring were analyzed. Prenatal BPA exposure induced a trend toward decreased islet insulin staining and β-cell count, increased glucagon staining and α-cell count, and increased α-cell/β-cell ratio. Findings were most consistent in fetal pancreata assessed at GD90 and in adult offspring exposed to the lowest BPA dose. While not assessed in fetuses, adult islet fibrosis was increased. Collectively, these data provide further evidence that early-life BPA exposure is a likely threat to human metabolic health. Future studies should corroborate these findings and decipher the molecular mechanisms of BPA's developmental endocrine toxicity., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)
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- 2024
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12. Developmental programming: Testosterone excess masculinizes female pancreatic transcriptome and function in sheep.
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Halloran KM, Saadat N, Pallas B, Vyas AK, Sargis R, and Padmanabhan V
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- Animals, Female, Sheep, Pregnancy, Male, Prenatal Exposure Delayed Effects metabolism, Insulin Resistance, Hyperandrogenism metabolism, Hyperandrogenism genetics, Fetal Development drug effects, Sex Characteristics, Testosterone, Transcriptome drug effects, Transcriptome genetics, Pancreas metabolism, Pancreas drug effects
- Abstract
Hyperandrogenic disorders, such as polycystic ovary syndrome, are often associated with metabolic disruptions such as insulin resistance and hyperinsulinemia. Studies in sheep, a precocial model of translational relevance, provide evidence that in utero exposure to excess testosterone during days 30-90 of gestation (the sexually dimorphic window where males naturally experience elevated androgens) programs insulin resistance and hyperinsulinemia in female offspring. Extending earlier findings that adverse effects of testosterone excess are evident in fetal day 90 pancreas, the end of testosterone treatment, the present study provides evidence that transcriptomic and phenotypic effects of in utero testosterone excess on female pancreas persist after cessation of treatment, suggesting lasting organizational changes, and induce a male-like phenotype in female pancreas. These findings demonstrate that the female pancreas is susceptible to programmed masculinization during the sexually dimorphic window of fetal development and shed light on underlying connections between hyperandrogenism and metabolic homeostasis., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)
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- 2024
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13. Multicenter Analysis of Cardiometabolic-Related Diagnoses in Youth with Congenital Adrenal Hyperplasia: a PEDSnet study.
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Chen LM, Valentine A, Davis SM, Graber E, Fechner PY, Furniss A, Nahata L, Pyle L, Vyas AK, Vogiatzi MG, and Nokoff NJ
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Context: Small cohorts of youth with congenital adrenal hyperplasia (CAH) demonstrate increased risk of obesity and poor cardiometabolic health., Objective: To determine the odds of cardiometabolic-related diagnoses in youth with CAH compared to matched controls in a cross-sectional analysis in a large, multisite database (PEDSnet)., Design: Electronic health record data (2009-2019) were used to determine odds of cardiometabolic-related outcomes based on diagnosis, anthropometric and laboratory data using logistic regression among youth with CAH vs. controls., Setting: Six PEDSnet sites., Patients or Other Participants: Youth with CAH and >1 outpatient visit in PEDSnet (n=1,647) were propensity-score matched on 8 variables to controls (n=6,588). A subset of youth with classic CAH (n=547, with glucocorticoid and mineralocorticoid prescriptions) were matched to controls (n=2,188)., Intervention(s): N/A., Main Outcome Measure(s): Odds of having cardiometabolic-related diagnoses among youth over 2 years with CAH compared to matched controls., Results: Outcomes were calculated for all individuals with CAH (median age at last visit 12.9 years [7.3, 17.6]) and a subset with classic CAH (median age at last visit 11.6 years [4.7, 17.5]) compared to their matched controls. All patients with CAH had higher odds of overweight/obesity (odds ratio [95% confidence interval] 3.63 [3.24,4.07]), hypertension (3.07 [2.60,3.64]), dysglycemia (1.95 [1.35,2.82], dyslipidemia (2.28 [1.79,2.91]) and liver dysfunction (2.30 [1.91,2.76]) compared to matched controls. Patients with classic CAH had higher odds of overweight/obesity (3.21 [2.61,3.93]), hypertension (8.22 [6.71,10.08]), and liver dysfunction (2.11 [1.55,2.89]) compared to matched controls., Conclusions: Overall, youth with CAH are at increased risk of diagnoses related to worse cardiometabolic health., (© The Author(s) 2024. Published by Oxford University Press on behalf of the Endocrine Society. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)
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- 2024
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14. Functional Outcome following Phrenic Nerve Transfer in Brachial Plexus Injury.
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Vyas AK, Gupta A, Dhanjani B, Batajoo S, and Misra S
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Background: Brachial plexus injuries are debilitating injuries resulting in paralyzed shoulder to global paralysis of the upper extremity. Treatment strategies have evolved over the years with nerve transfer forming the mainstay of surgical management. Phrenic nerve provides certain advantages as donor over other options but has been less preferred due to fear of pulmonary complications. In this study, we assess the functional outcomes of phrenic nerve transfer in brachial plexus injuries., Materials and Methods: A retrospective study was performed on 18 patients operated between 2012 and 2017. The mean duration of injury to surgery was 4.56 months and mean follow-up was for 3.66 years. Phrenic nerve was used as donor to neurotize either biceps and brachialis branch of musculocutaneous nerve or suprascapular nerve. Assessment was done through Waikakul score for elbow flexion and Medical Research Council grading for shoulder abduction. Respiratory function assessment was done through questionnaire., Results: Twelve (80%) patients recovered grade 3 and above elbow flexion with 6 patients having a positive endurance test according to Waikakul and a "very good" result. In phrenic to suprascapular transfer group (3 patients), all patients had more than grade 3 recovery of shoulder abduction. No patient complained of respiratory problems., Conclusion: Phrenic nerve can be used as a reliable donor with suitable patient selection with good results in regaining muscle power without any anticipated effects on respiratory function., (© 2024 Published by Elsevier B.V. on behalf of Society for Indian Hand Surgery and Micro Surgeons.)
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- 2024
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15. Th2-predominant immune response underlies the pathogenesis of Dengue.
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Kale D, Vyas AK, Bhatt GC, Yadav AK, Singh AK, Nema S, and Biswas D
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- Humans, Chemokine CXCL10, Chemokine CCL3, Interleukin-4, Interleukin-8, Biomarkers, Cytokines metabolism, Immunity, RNA, Messenger, Interleukin-10, Dengue
- Abstract
Background: Dengue is a rapidly emerging pandemic-prone disease, whose manifestations range from asymptomatic infection to life-threatening complications like Dengue Hemorrhagic Fever and Dengue Shock Syndrome. This study investigates and compares the immune response in clinically defined cohorts of Dengue with and without warning signs, with the aim of identifying immunological correlates of clinical disease and potential markers of disease severity., Methods: Blood samples, collected from study participants fulfilling the WHO definition of Dengue with and without warning signs and healthy volunteers, were analyzed using flow cell-based fluorometric methods for cytokines and chemokines. Gene expression analysis, using RT-PCR, was conducted on T helper cell subset-specific transcription factors and cytokines. Demographic details, virological markers, serotype distribution, and hematological parameters were also investigated in all the subjects., Results: The 35 participants recruited in the study, included 11 healthy volunteers and 12 patients each fulfilling the WHO criteria of Dengue with and without warning signs. While the demographic characteristics and serotype distribution was similar in Dengue with and without warning signs cohorts of the disease, platelet counts and Aspartate Aminotransferase (AST) levels changed significantly between Dengue with and without warning signs patients. Plasma cytokine analysis showed up-regulation of IL-4, IL-10, IP-10, and MCP-1 in Dengue patients compared to healthy volunteers. Disease severity was associated with elevated levels of IL-10, IP-10, IL-4, MCP-1, and MIP-1α. IL-8 and MIP-1α were significantly up-regulated in Dengue with warning sign compared to Dengue without warning signs cases. Transcription factor analysis indicated increased expression of RORα, FoxP3, and GATA3 in Dengue patients. mRNA expression of TGFβ and IL-4 was also elevated in Dengue patients. A positive correlation between mRNA expression of IL-4 and plasma IL-4 was observed., Conclusion: The study reveals a Th2-predominant immune response in all Dengue patients, regardless of disease severity, with overexpression of IL-8 and MIP-1α being observed in patients with warning signs., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier Ltd.)
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- 2024
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16. Comparative lipidome study of maternal plasma, milk, and lamb plasma in sheep.
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Thangaraj SV, Ghnenis A, Pallas B, Vyas AK, Gregg B, and Padmanabhan V
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- Female, Animals, Sheep, Humans, Milk, Human metabolism, Nutritional Status, Plasma, Lipids, Milk metabolism, Lipidomics
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Lipids play a critical role in neonate development and breastmilk is the newborn's major source of lipids. Milk lipids directly influence the neonate plasma lipid profile. The milk lipidome is dynamic, influenced by maternal factors and related to the maternal plasma lipidome. The close inter-relationship between the maternal plasma, milk and neonate plasma lipidomes is critical to understanding maternal-child health and nutrition. In this exploratory study, lipidomes of blood and breast milk from Suffolk sheep and matched lamb blood (n = 13), were profiled on day 34 post birth by untargeted mass spectrometry. Comparative multivariate analysis of the three matrices identified distinct differences in lipids and class of lipids amongst them. Paired analysis identified 346 differential lipids (DL) and 31 correlated lipids (CL) in maternal plasma and milk, 340 DL and 32 CL in lamb plasma and milk and 295 DL and 16 CL in maternal plasma and lamb plasma. Conversion of phosphatidic acid to phosphatidyl inositol was the most active pathway in lamb plasma compared to maternal plasma. This exploratory study illustrates the partitioning of lipids across maternal plasma, milk and lamb plasma and the dynamic relationship between them, reiterating the need to study these three matrices as one biological system., (© 2024. The Author(s).)
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- 2024
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17. Gestational testosterone excess early to mid-pregnancy disrupts maternal lipid homeostasis and activates biosynthesis of phosphoinositides and phosphatidylethanolamines in sheep.
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Saadat N, Pallas B, Ciarelli J, Vyas AK, and Padmanabhan V
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- Pregnancy, Female, Sheep, Animals, Phosphatidylethanolamines, Phosphatidylinositols, Testosterone, Fatty Acids, Homeostasis, Hyperandrogenism, Hyperinsulinism, Cardiovascular Diseases
- Abstract
Gestational hyperandrogenism is a risk factor for adverse maternal and offspring outcomes with effects likely mediated in part via disruptions in maternal lipid homeostasis. Using a translationally relevant sheep model of gestational testosterone (T) excess that manifests maternal hyperinsulinemia, intrauterine growth restriction (IUGR), and adverse offspring cardiometabolic outcomes, we tested if gestational T excess disrupts maternal lipidome. Dimensionality reduction models following shotgun lipidomics of gestational day 127.1 ± 5.3 (term 147 days) plasma revealed clear differences between control and T-treated sheep. Lipid signatures of gestational T-treated sheep included higher phosphoinositides (PI 36:2, 39:4) and lower acylcarnitines (CAR 16:0, 18:0, 18:1), phosphatidylcholines (PC 38:4, 40:5) and fatty acids (linoleic, arachidonic, Oleic). Gestational T excess activated phosphatidylethanolamines (PE) and PI biosynthesis. The reduction in key fatty acids may underlie IUGR and activated PI for the maternal hyperinsulinemia evidenced in this model. Maternal circulatory lipids contributing to adverse cardiometabolic outcomes are modifiable by dietary interventions., (© 2024. The Author(s).)
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- 2024
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18. Modulation of CD8 + T cells, NK cells and Th1cytokines by metabolic milieu in decline of HBV-viremia in pregnant women treated with tenofovir-disoproxil from second trimester of pregnancy.
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Pahwa P, Vyas AK, Sevak JK, Singh R, Maras JS, Patra S, Sarin SK, and Trehanpati N
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- Child, Female, Humans, Pregnancy, CD8-Positive T-Lymphocytes, DNA, Viral, Hepatitis B Surface Antigens, Killer Cells, Natural, NAD, Pregnancy Trimester, Second, Pyruvates, Tenofovir, Hepatitis B virus, Infectious Disease Transmission, Vertical, Pregnancy Complications, Infectious drug therapy, Viremia immunology, Hepatitis B immunology, Hepatitis B transmission
- Abstract
High HBV DNA levels predispose to mother to child transmission (MTCT) of HBV. Early nucleotide analogue (NA) therapy can reduce HBV DNA and minimize MTCT. We analysed immune-metabolic profile in pregnant mothers who received NA from 2nd trimester compared with untreated mothers. In 2nd trimester, there was no difference in immune profiles between Gr.1 and Gr.2 but high viral load women had downregulated pyruvate, NAD+ metabolism but in 3rd trimester, Gr.1 had significant reduction in HBV-DNA, upregulated pyruvate and NAD with increased IFN-2αA, CD8Tcells, NK cells and decreased Tregs, IL15, IL18, IL29, TGFβ3 compared to Gr.2. In Gr.1, three eAg-ve women showed undetectable DNA and HBsAg. At delivery, Gr.1 showed no MTCT, with undetectable HBV DNA, HBsAg, high CD8 and NK cells in two women. We conclude, that starting NA from second trimester, reduces HBV load and MTCT, modulates NAD, induces immunity and suggest use of NA in early gestation in future trials., Competing Interests: Declaration of Competing Interest The authors declare no known conflict of interest and have approved the manuscript. All authors are agreeing with this submission. No personal relationships appeared to influence this work., (Copyright © 2024. Published by Elsevier B.V.)
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- 2024
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19. Sex-Specific Perturbation of Systemic Lipidomic Profile in Newborn Lambs Impacted by Prenatal Testosterone Excess.
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Saadat N, Ciarelli J, Pallas B, Padmanabhan V, and Vyas AK
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- Pregnancy, Animals, Sheep, Female, Male, Animals, Newborn, Lipidomics, Testosterone pharmacology, Phosphatidylcholines, Cholesterol, Hyperandrogenism, Cardiovascular Diseases
- Abstract
Gestational hyperandrogenism adversely impacts offspring health. Using an ovine model, we found that prenatal testosterone (T) excess adversely affects growth and cardiometabolic outcomes in female offspring and produces sex-specific effects on fetal myocardium. Since lipids are essential to cardiometabolic function, we hypothesized that prenatal T excess leads to sex-specific disruptions in lipid metabolism at birth. Shotgun lipidomics was performed on the plasma samples collected 48 hours after birth from female (F) and male (M) lambs of control (C) and (T) sheep (CF = 4, TF = 7, CM = 5, TM = 10) and data were analyzed by univariate analysis, multivariate dimensionality reduction modeling followed by functional enrichment, and pathway analyses. Biosynthesis of phosphatidylserine was the major pathway responsible for sex differences in controls. Unsupervised and supervised models showed separation between C and T in both sexes with glycerophospholipids and glycerolipids classes being responsible for the sex differences between C and T. T excess increased cholesterol in females while decreasing phosphatidylcholine levels in male lambs. Specifically, T excess: 1) suppressed the phosphatidylethanolamine N-methyltransferase (PEMT) phosphatidylcholine synthesis pathway overall and in TM lambs as opposed to suppression of carnitine levels overall and TF lambs; and 2) activated biosynthesis of ether-linked (O-)phosphatidylethanolamine and O-phosphatidylcholine from O-diacylglycerol overall and in TF lambs. Higher cholesterol levels could underlie adverse cardiometabolic outcomes in TF lambs, whereas suppressed PEMT pathway in TM lambs could lead to endoplasmic reticulum stress and defective lipid transport. These novel findings point to sex-specific effects of prenatal T excess on lipid metabolism in newborn lambs, a precocial ovine model of translational relevance., (© The Author(s) 2023. Published by Oxford University Press on behalf of the Endocrine Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
- Published
- 2023
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20. Placental assessment using spectral analysis of the envelope of umbilical venous waveforms in sheep.
- Author
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Rubin JM, Pinter SZ, Halloran KM, Pallas BD, Fowlkes JB, Vyas AK, Padmanabhan V, and Kripfgans OD
- Subjects
- Sheep, Pregnancy, Animals, Female, Humans, Umbilical Veins, Arteries, Umbilical Arteries, Fetal Growth Retardation veterinary, Placenta blood supply, Fetus blood supply
- Abstract
Introduction: This study was designed to test the efficacy of an ultrasound flow measurement method to evaluate placental function in a hyperandrogenic sheep model that produces placental morphologic changes and an intrauterine growth restriction (IUGR) phenotype., Materials and Methods: Pregnant ewes were assigned randomly between control (n = 12) and testosterone-treatment (T-treated, n = 22) groups. The T-treated group was injected twice weekly intramuscularly (IM) with 100 mg testosterone propionate. Control sheep were injected with corn oil vehicle. Lambs were delivered at 119.5 ± 0.48 days gestation. At the time of delivery of each lamb, flow spectra were generated from one fetal artery and two fetal veins, and the spectral envelopes examined using fast Fourier transform analysis. Base 10 logarithms of the ratio of the amplitudes of the maternal and fetal spectral peaks (LRSP) in the venous power spectrum were compared in the T-treated and control populations. In addition, we calculated the resistive index (RI) for the artery defined as ((peak systole - min diastole)/peak systole). Two-tailed T-tests were used for comparisons., Results: LRSPs, after removal of significant outliers, were -0.158 ± 0.238 for T-treated and 0.057 ± 0.213 for control (p = 0.015) animals. RIs for the T-treated sheep fetuses were 0.506 ± 0.137 and 0.497 ± 0.086 for controls (p = 0.792) DISCUSSION: LRSP analysis distinguishes between T-treated and control sheep, whereas RIs do not. LRSP has the potential to identify compromised pregnancies., Competing Interests: Declaration of competing interest Submission of this work verifies that the work described herein has not been published previously (except in the form of an abstract), and it is not under consideration for publication elsewhere. The publication has been approved by all authors, and approved by the University of Michigan Medical School through the Institutional Animal Care and Use Committee (IACUC), and if accepted, it will not be published elsewhere in the same form in English or any other language, including electronically without consent of the copyright holder., (Copyright © 2023 Elsevier Ltd. All rights reserved.)
- Published
- 2023
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21. Role of real-time polymerase chain reaction in diagnosing Hepatitis E, the commonest cause of acute hepatitis in adult patients seeking institutional care.
- Author
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Namdeo D, Shrivastava P, Garg G, Vyas AK, Nema RK, Singhai A, Nema S, and Biswas D
- Subjects
- Adult, Humans, Real-Time Polymerase Chain Reaction, Cross-Sectional Studies, RNA, Viral, Hepatitis Antibodies, Acute Disease, Immunoglobulin M, Hepatitis E diagnosis, Hepatitis E epidemiology, Hepatitis E virus genetics
- Abstract
Background: This cross-sectional study was performed with the aim of determining the prevalence of hepatitis E virus (HEV) infection among acute hepatitis patients attending a tertiary care teaching hospital in a developing country and to determine the relative performance of prevalent diagnostic assays in establishing its diagnosis., Materials and Methods: A total of 46 adult patients were included in this study, all of whom presented with jaundice of <4 weeks' duration and elevation of AST and ALT above 500 U/L. The prevalence of HEV among patients with acute hepatitis was calculated on the basis of the proportion of recruited patients reacting positively in serum anti-HEV immunoglobulin M (IgM) and real-time polymerase chain reaction (RT-PCR) assays., Results: Among the recruited patients, 11 (23.91%) and 15 (32.6%) patients were positive for anti-HEV IgM and RT-PCR, respectively. The two tests demonstrated poor inter-test agreement, thereby implying the necessity of performing both tests for reliable diagnosis of acute HEV virus infection. We also observed a significant difference in the duration of illness between RT-PCR positive and negative patients (P = 0.008). The mean (±SD) duration of illness in the two groups was 8.6 (±3.50) and 11.66 (± 5.15) days, respectively. Combining the results of IgM ELISA and RT-PCR, we observed that 23 out of 46 patients (50%) had evidence of acute HEV virus infection among our patients., Conclusion: Our study suggests that HEV is the commonest cause of acute hepatitis in adult patients attending a tertiary care teaching hospital and that the diagnostic algorithm for its confirmation should include both IgM ELISA and RT-PCR assays.
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- 2023
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22. Overcoming the challenges of eliminating viral hepatitis in low- and middle-income countries.
- Author
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Vyas AK
- Subjects
- Humans, World Health Organization, Global Health, Developing Countries, Hepatitis, Viral, Human epidemiology, Hepatitis, Viral, Human prevention & control
- Published
- 2023
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23. Immune drivers of HBsAg loss in HBeAg-negative CHB patients after stopping nucleotide analog and administration of Peg-IFN.
- Author
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Islam M, Kumar K, Sevak JK, Jindal A, Vyas AK, Ramakrishna G, Kottilil S, Sharma MK, Sarin SK, and Trehanpati N
- Subjects
- Humans, Antiviral Agents therapeutic use, Hepatitis B e Antigens, DNA, Viral, Interferon-alpha therapeutic use, Nucleosides therapeutic use, Nucleotides therapeutic use, Hepatitis B Surface Antigens, Hepatitis B, Chronic drug therapy
- Abstract
Background: The stoppage of nucleoside analog (NA) can lead to immune flare and loss of HBsAg in a proportion of HBeAg-negative chronic hepatitis B (CHB) patients. HBsAg loss could be improved by instituting Peg-Interferon therapy in those who show an immune flare after the stoppage of NA. We investigated the immune drivers of HBsAg loss in NA-treated HBeAg-negative CHB patients after stopping NAs and administration of Peg-IFN-α2b therapy., Methods: Fifty-five NA-treated eAg-ve, HBV DNA not detected CHB patients were subjected to stopping NA therapy. Twenty-two (40%) patients relapsed (REL-CHBV) within 6 months (HBV DNA ≥2000 IU/mL, ALT ≥2XULN) and were started on Peg-IFN-α2b (1.5 mcg/kg) for 48 weeks (PEG-CHBV). Cytokine levels, immune responses, and T-cell functionality were assessed., Results: Only 22 (40%) of 55 patients clinically relapsed, of which 6 (27%) cleared HBsAg. None of the 33 (60%) nonrelapsers cleared HBsAg. REL-CHBV patients had significantly increased IL-6 (p=0.035), IFN-γ (p=0.049), Th1/17 (p=0.005), CD4 effector memory (EM) (p=0.01), Tfh1/17 (p=0.005), and mature B cells (p=0.04) compared with CHBV. Six months after Peg-IFN therapy, immune resetting with a significant increase in CXCL10 (p=0.042), CD8 (p=0.01), CD19 (p=0.001), and mature B cells (p=0.001) was observed. HBV-specific T-cell functionality showed increased Tfh-secreting IFN-γ (p=0.001), IL-21 (p=0.001), and TNF-α (p=0.005) in relapsers and IFN-γ-secreting CD4 T cell (p=0.03) in PEG-CHBV., Conclusions: Stopping NA therapy induces flare in about 40% of HBeAg-negative patients. Peg-IFN therapy given to such patients causes immune restoration with HBsAg loss in one fourth of them., (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Association for the Study of Liver Diseases.)
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- 2023
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24. Impact of Adverse Gestational Milieu on Maternal Cardiovascular Health.
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Alkhatib B, Salimi S, Jabari M, Padmanabhan V, and Vyas AK
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- Pregnancy, Female, Humans, Pregnancy Outcome, Postpartum Period, Cardiovascular Diseases etiology, Hyperandrogenism complications, Diabetes, Gestational
- Abstract
Cardiovascular disease affects 1% to 4% of the nearly 4 million pregnancies in the United States each year and is the primary cause of pregnancy-related mortality. Adverse pregnancy outcomes are associated with cardiovascular complications during pregnancy persisting into the postpartum period. Recently, investigations have identified an altered sex hormone milieu, such as in the case of hyperandrogenism, as a causative factor in the development of gestational cardiovascular dysfunction. The mechanisms involved in the development of cardiovascular disease in postpartum women are largely unknown. Animal studies have attempted to recapitulate adverse pregnancy outcomes to investigate causal relationships and molecular underpinnings of adverse gestational cardiac events and progression to the development of cardiovascular disease postpartum. This review will focus on summarizing clinical and animal studies detailing the impact of adverse pregnancy outcomes, including preeclampsia, gestational diabetes mellitus, and maternal obesity, on gestational cardiometabolic dysfunction and postpartum cardiovascular disease. Specifically, we will highlight the adverse impact of gestational hyperandrogenism and its potential to serve as a biomarker for maternal gestational and postpartum cardiovascular dysfunctions., (© The Author(s) 2023. Published by Oxford University Press on behalf of the Endocrine Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
- Published
- 2023
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25. Immune predictors of hepatitis B surface antigen seroconversion in patients with hepatitis B reactivation.
- Author
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Islam M, Sevak JK, Sharma MK, Jindal A, Vyas AK, Bajpai M, Ramakrishna G, Sarin SK, and Trehanpati N
- Subjects
- Humans, Hepatitis B Surface Antigens, Hepatitis B virus genetics, DNA, Viral, Seroconversion, Hepatitis A Virus Cellular Receptor 2 therapeutic use, Hepatitis B e Antigens, Antiviral Agents therapeutic use, Hepatitis B drug therapy, Hepatitis B, Chronic drug therapy
- Abstract
Background: Hepatitis B surface antigen (HBsAg) seroconversion is sometimes observed in hepatitis B reactivation (rHBV), probably due to immune resetting and differentiation., Aims: To investigate sequential immune differentiation and abrogation of tolerance in patients with rHBV who achieved HBsAg seroconversion., Methods: We included 19 patients with chronic hepatitis B (CHBV; HBV DNA log10
3-8 ), 67 with rHBV (raised ALT [>5XULN], HBV DNAlog104-8 ) and 10 healthy controls. Immune differentiation, tolerance and functional status of CD4, CD8, T regulatory cells (Tregs), B cells and follicular T helper (Tfh) cells were assessed at baseline and 24 weeks., Results: At 24 weeks, 81% rHBV (n = 67) lost HBV DNA and HBeAg (41%), and 12 (19%) lost HBsAg and made anti-HBs titers >10 IU/ml. rHBV patients had higher Th1/17, TEM , Tfh, Tfh1/17, plasma and ATM B cells, and lower Tregs, Th2, Th17 and TEMRA expression. rHBV showed lower PD1, TIM3, LAG3, SLAM and TOX compared to CHBV. There was a significant increase in CD8, CD8EM, Tfh, Tfh1/17 and plasma B cells in seroconverters than non-seroconverters. At 24 weeks, we also observed increased plasma B cell frequency in seroconverters. While non-seroconverters showed higher expression of PD1, TIM3, LAG3, SLAM and TOX on CD4/CD8 T cells, blockade of PD1, TIM3, LAG3 and CTLA4 significantly enhanced IFN-γ, TNF-α, IL-4 and IL-21 expression on CD4/CD8 and Tfh cells in non-seroconverters., Conclusions: Non-seroconverters have increased inhibitory markers on CD4/CD8 T cells. There is a critical play of CD8, Tfh and B cells and subsets in seroclearance, along with checkpoint molecules as a potential therapy for non-seroconverters in HBV infection., (© 2022 John Wiley & Sons Ltd.)- Published
- 2023
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26. Developmental programming: adverse sexually dimorphic transcriptional programming of gestational testosterone excess in cardiac left ventricle of fetal sheep.
- Author
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Ramamoorthi Elangovan V, Saadat N, Ghnenis A, Padmanabhan V, and Vyas AK
- Subjects
- Pregnancy, Humans, Sheep, Animals, Female, Male, Heart Ventricles metabolism, Testosterone pharmacology, Fetus metabolism, Myocytes, Cardiac metabolism, Hyperandrogenism chemically induced, Prenatal Exposure Delayed Effects chemically induced
- Abstract
Adverse in-utero insults during fetal life alters offspring's developmental trajectory, including that of the cardiovascular system. Gestational hyperandrogenism is once such adverse in-utero insult. Gestational testosterone (T)-treatment, an environment of gestational hyperandrogenism, manifests as hypertension and pathological left ventricular (LV) remodeling in adult ovine offspring. Furthermore, sexual dimorphism is noted in cardiomyocyte number and morphology in fetal life and at birth. This study investigated transcriptional changes and potential biomarkers of prenatal T excess-induced adverse cardiac programming. Genome-wide coding and non-coding (nc) RNA expression were compared between prenatal T-treated (T propionate 100 mg intramuscular twice weekly from days 30 to 90 of gestation; Term: 147 days) and control ovine LV at day 90 fetus in both sexes. Prenatal T induced differential expression of mRNAs in the LV of female (2 down, 5 up) and male (3 down, 1 up) (FDR < 0.05, absolute log2 fold change > 0.5); pathways analysis demonstrated 205 pathways unique to the female, 382 unique to the male and 23 common pathways. In the male, analysis of ncRNA showed differential regulation of 15 lncRNAs (14 down, 1 up) and 27 snoRNAs (26 down and 1 up). These findings suggest sexual dimorphic modulation of cardiac coding and ncRNA with gestational T excess., (© 2023. The Author(s).)
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- 2023
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27. Role of Streptococcus pneumoniae extracellular glycosidases in immune evasion.
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Mathew BJ, Gupta P, Naaz T, Rai R, Gupta S, Gupta S, Chaurasiya SK, Purwar S, Biswas D, Vyas AK, and Singh AK
- Subjects
- Humans, Immune Evasion, Glycoside Hydrolases metabolism, Polysaccharides metabolism, Bacterial Proteins metabolism, Streptococcus pneumoniae, Pneumococcal Infections microbiology
- Abstract
Streptococcus pneumoniae (pneumococcus) typically colonizes the human upper airway asymptomatically but upon reaching other sites of the host body can cause an array of diseases such as pneumonia, bacteremia, otitis media, and meningitis. Be it colonization or progression to disease state, pneumococcus faces multiple challenges posed by host immunity ranging from complement mediated killing to inflammation driven recruitment of bactericidal cells for the containment of the pathogen. Pneumococcus has evolved several mechanisms to evade the host inflicted immune attack. The major pneumococcal virulence factor, the polysaccharide capsule helps protect the bacteria from complement mediated opsonophagocytic killing. Another important group of pneumococcal proteins which help bacteria to establish and thrive in the host environment is surface associated glycosidases. These enzymes can hydrolyze host glycans on glycoproteins, glycolipids, and glycosaminoglycans and consequently help bacteria acquire carbohydrates for growth. Many of these glycosidases directly or indirectly facilitate bacterial adherence and are known to modulate the function of host defense/immune proteins likely by removing glycans and thereby affecting their stability and/or function. Furthermore, these enzymes are known to contribute the formation of biofilms, the bacterial communities inherently resilient to antimicrobials and host immune attack. In this review, we summarize the role of these enzymes in host immune evasion., Competing Interests: ShG is employed by 3B Blackbio Biotech India Ltd. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Mathew, Gupta, Naaz, Rai, Gupta, Gupta, Chaurasiya, Purwar, Biswas, Vyas and Singh.)
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- 2023
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28. Artificial neural network based models for predicting the effluent quality of a combined upflow anaerobic sludge blanket and facultative pond: Performance evaluation and comparison of different algorithms.
- Author
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Khatri N, Vyas AK, Abdul-Qawy ASH, and Rene ER
- Subjects
- Anaerobiosis, Bioreactors, Ponds, Neural Networks, Computer, Algorithms, Nitrogen, Sewage, Waste Disposal, Fluid methods
- Abstract
The main objective of this work was to test different artificial neural network (ANN) based models, i.e. the ANN feed forward back propagation (ANN-FFBP), deep feed forward backpropagation (DFFBP), and deep cascade forward back propagation (DCFBP) models, for predicting the effluent quality of an upflow anaerobic sludge blanket-facultative pond (UASB-FP) system. The overall removal efficiency in the UASB-FP was >84% at organic loading rates of ∼26 kg d
-1 . The chemical oxygen demand (COD), ammonical nitrogen (AN), total suspended solids (TSS), biochemical oxygen demand (BOD), total Kjeldahl nitrogen (TKN), and total phosphorus (TP) were inputs to each model, while the water quality characteristics of the UASB-FP effluent was used as the output. The dataset of 180 samples, collected over a one-year period, was utilized to train, test, and validate the developed models. Compared to ANN-FFBP and DFFBP, the DCFBP network demonstrated the strongest capacity for prediction. The correlation coefficient RTrain and the root-mean-squared error (RMSE) for the selected DCFBP model (3 hidden layers and 11 neurons/layer) in the training data set were 0.997 and 6.018, respectively. The sensitivity analysis of the DCFBP model shows that the model's performance is very sensitive to BOD followed by AN, COD, TP, TSS and TKN, respectively. The results of this study will be helpful to wastewater treatment (WWTP) plant managers in their pursuit of data-driven UASB-FP based WWTP management., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier Inc. All rights reserved.)- Published
- 2023
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29. Developmental changes of the fetal and neonatal thyroid gland and functional consequences on the cardiovascular system.
- Author
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Kotsopoulou I, Vyas AK, Cory MJ, Chan CS, Jagarapu J, Gill S, Mudduluru M, and Angelis D
- Subjects
- Humans, Infant, Newborn, Fetus, Heart, Thyroid Gland, Thyroid Hormones
- Abstract
Thyroid hormones play an important role in the development and function of the cardiac myocyte. Dysregulation of the thyroid hormone milieu affects the fetal cardiac cells via complex molecular mechanisms, either by altering gene expression or directly by affecting post-translational processes. This review offers a comprehensive summary of the effects of thyroid hormones on the developing cardiovascular system and its adaptation. Furthermore, we will highlight the gaps in knowledge and provide suggestions for future research., (© 2022. The Author(s), under exclusive licence to Springer Nature America, Inc.)
- Published
- 2022
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30. Presence of entry receptors and viral markers suggest a low level of placental replication of hepatitis B virus in a proportion of pregnant women infected with chronic hepatitis B.
- Author
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Garg G, Meenu MN, Patel K, Singh R, Gupta P, Purwar S, Mukhopadhyay S, Mishra N, Gupta S, Rawat SK, Goel H, Kumar R, Tanwar P, Singh J, Nema S, Biswas D, Trehanpati N, Singh AK, and Vyas AK
- Subjects
- Female, Humans, Pregnancy, Hepatitis B virus genetics, Hepatitis B e Antigens, Hepatitis B Surface Antigens, DNA, Viral genetics, Pregnant Women, Hepatitis B Core Antigens, Receptors, LH, Placenta, Virus Replication genetics, Biomarkers, RNA, Hepatitis B, Chronic, Hepatitis B
- Abstract
The transplacental route of vertical transmission of Hepatitis B Virus (HBV) has been known for over a decade. Here we present evidence which suggest HBV can replicate in placenta. Forty-one HBsAg positive and 10 control pregnant women were enrolled in the study after obtaining informed consent. HBV positives were further divided in the High Viral Load (HVL) Group and Low Viral Load (LVL) Group according to INASL guidelines 2018. The Presence of the HBV DNA and expression of NTCP in the placenta was analyzed by qPCR/RT-qPCR and/or immunohistochemistry (IHC). The presence of cccDNA was assessed using Digital Droplet PCR while the presence of pre-genomic (pg) RNA was assessed through qRT-PCR and sequencing. The presence of HBeAg and HBcAg in the placenta was assessed by IHC. Immunostaining of NTCP, HBeAg and HBcAg on trophoblasts along with the presence of total HBV DNA, cccDNA and pgRNA indicated, that these cells are not only susceptible to HBV infection but may also support viral replication. This is further supported by the finding that trophoblasts of the several HBeAg seronegative samples harbored the HBeAg. Although, we did not find any correlation in NTCP expression and viral markers with viral load indicates placental replication may not aping hepatocytes. The presence of the HBV receptor, NTCP along with the presence of cccDNA, pgRNA, and HBeAg in placenta of HBV infected females without circulating HBeAg suggest that placenta act as a replication host., (© 2022. The Author(s).)
- Published
- 2022
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31. Impact of maternal substance use on offspring's cardiovascular health.
- Author
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Janardhan N, Roy PG, and Vyas AK
- Subjects
- Female, Heart, Humans, Pregnancy, Prenatal Exposure Delayed Effects, Substance-Related Disorders epidemiology
- Abstract
Substance use (SU) during pregnancy is on the rise, posing significant risks to the developing fetus. The adverse impact of maternal alcohol and nicotine use during the perinatal period on offspring health has been well established, including their associations with adverse cardiovascular health in offspring. However, limited studies examine the impact of other well-known SU utilized during pregnancy on offspring's cardiovascular health. This review summarizes the proposed mechanism of action of four commonly utilized substances: cocaine, marijuana, methamphetamine, and opioids, and their cardiovascular impact. Furthermore, we will review the current understanding of the adverse impact of substance use during pregnancy on offspring's cardiovascular system based on existing studies. This review will also highlight possible molecular mechanisms underlying the in-utero adverse programming of offspring's cardiovascular system secondary to SU in pregnancy and address the gaps in current understanding of how SU adversely impacts the developing cardiovascular system of offspring in utero., (Copyright © 2022 Elsevier Inc. All rights reserved.)
- Published
- 2022
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32. Concerns and Safety of Add-on Versus Switch Peginterferon Therapy for Chronic Hepatitis B.
- Author
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Vyas AK and Jindal A
- Subjects
- Antiviral Agents adverse effects, Drug Therapy, Combination, Hepatitis B e Antigens, Humans, Interferon-alpha adverse effects, Polyethylene Glycols adverse effects, Recombinant Proteins therapeutic use, Treatment Outcome, Hepatitis B, Chronic drug therapy
- Published
- 2022
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33. Letter: sPD-1 as a predictor for HBsAg seroconversion-shed light on inactive carriers with chronic hepatsitis B.
- Author
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Vyas AK and Jindal A
- Subjects
- DNA, Viral, Heterozygote, Humans, Seroconversion, Hepatitis B Surface Antigens, Hepatitis B virus genetics
- Published
- 2022
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34. The Analysis of Pain Research through the Lens of Artificial Intelligence and Machine Learning.
- Author
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Nagireddi JN, Vyas AK, Sanapati MR, Soin A, and Manchikanti L
- Subjects
- Algorithms, Forecasting, Humans, Infant, Newborn, Pain diagnosis, Artificial Intelligence, Machine Learning
- Abstract
Background: Traditional pain assessment methods have significant limitations due to the high variability in patient reported pain scores and perception of pain by different individuals. There is a need for generalized and automatic pain detection and recognition methods. In this paper, state-of-the-art machine learning (ML) and deep learning methods in this field are analyzed as well as pain management techniques., Objective: The objective of the study is to analyze the current use of artificial intelligence (AI) and ML in the analysis and management of pain and to disseminate this knowledge prompting future utilization by medical professionals., Study Design: A narrative review of the literature focusing on the latest algorithms in AI and ML for pain assessment and management., Methods: Research studies were collected using a literature search on PubMed, Science Direct and IEEE Xplore between 2018 and 2020., Results: The results of our assessment resulted in the identification of 47 studies meeting inclusion criteria. Pain assessment was the most studied subject with 11 studies, followed by automated measurements with 10 studies, spinal diagnosis with 8 studies, facial expression with 7 studies, pain assessment in special settings evaluated in 5 studies, 4 studies described treatment algorithms, and 2 studies assessed neonatal pain. These studies varied from simple to highly complex methodology. The majority of the studies suffered from inclusion of a small number of patients and without replication of results. However, considering AI and ML are dynamic and emerging specialties, the results shown here are promising. Consequently, we have described all the available literature in summary formats with commentary. Among the various assessments, facial expression and spinal diagnosis and management appear to be ready for inclusion as we continue to progress., Limitations: This review is not a systematic review of ML and AI applications in pain research. This review only provides a general idea of the upcoming techniques but does not provide an authoritative evidence-based conclusive opinion of their clinical application and effectiveness., Conclusion: While a majority of the studies focused on classification tasks, very few studies have explored the diagnosis and management of pain. Usage of ML techniques as support tools for clinicians holds an immense potential in the field of pain management.
- Published
- 2022
35. Mannitol Is Comparable to Hypertonic Saline for Raised Intracranial Pressure in Acute Liver Failure (MAHAL Study): A Randomized Controlled Trial.
- Author
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Kalal CR, Maiwall R, Choudhary A, Premkumar M, Kumar G, Vyas AK, and Sarin SK
- Subjects
- Humans, Intracranial Pressure, Mannitol adverse effects, Saline Solution, Hypertonic adverse effects, Intracranial Hypertension drug therapy, Intracranial Hypertension etiology, Liver Failure, Acute therapy
- Abstract
Background: Raised intracranial pressure (ICP) due to cerebral edema (CE) is central to development of hepatic encephalopathy in acute liver failure (ALF). Mannitol (MT) and hypertonic saline (HS) have been shown to improve CE. We compared the efficacy and safety of the 2 modalities., Methods: ALF with CE was prospectively randomized in an open study to receive either 5 mL/kg of either 3% HS, as continuous infusion; titrated every 6 hourly to achieve serum sodium of <160 (Group A; n = 26) or 1 g/kg of 20% MN as a IV bolus, repeated every 6 hourly (Group B; n = 25) in addition to standard ALF care. Primary end-point was reduction of ICP defined as optic nerve sheath diameter <5 mm and middle cerebral arterial pulsatility index <1.2 at 12 h., Results: Fifty-one patients with ALF, hepatitis E being commonest (33.3%), median jaundice to HE interval of 8 (1-16) days, were randomized to HS (n = 26) or MN (n = 25). Baseline characteristics were comparable including King's college criteria (>2: 38.4% vs.40%). Overall, 61.5% patients in the HS and 56% in the MN group showed reduction in ICP at 12 h (p = 0.25). Rebound increase in ICP indices was noted in 5 (20%) patients in MT and none in HS (p < 0.05) group. New onset acute kidney injury was common in the MT group than in the HS group. The ICU stay and 28-day transplant-free survival were not different between the groups., Conclusions: While both agents had comparable efficacy in reducing ICP and mortality in ALF patients was comparable, HS was significantly better in preventing reducing rebound CE with lower renal dysfunction., (© 2021 S. Karger AG, Basel.)
- Published
- 2022
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36. Gestational microbiome: metabolic perturbations and developmental programming.
- Author
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Han S, Ellberg CC, Olomu IN, and Vyas AK
- Subjects
- Female, Humans, Obesity metabolism, Pregnancy, Diabetes Mellitus, Type 2, Diabetes, Gestational metabolism, Microbiota, Prenatal Exposure Delayed Effects metabolism
- Abstract
A growing body of research suggests that alterations to the human microbiome are associated with disease states, including obesity and diabetes. During pregnancy, these disease states are associated with maternal microbial dysbiosis. This review discusses the current literature regarding the typical maternal and offspring microbiome as well as alterations to the microbiome in the context of obesity, type 2 diabetes mellitus, and gestational diabetes mellitus. Furthermore, this review outlines the proposed mechanisms linking associations between the maternal microbiome in the aforementioned disease states and offspring microbiome. Additionally, this review highlights associations between alterations in offspring microbiome and postnatal health outcomes.
- Published
- 2021
- Full Text
- View/download PDF
37. Sex-Specific Impacts of Exercise on Cardiovascular Remodeling.
- Author
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Islam RA, Khalsa SSS, Vyas AK, and Rahimian R
- Abstract
Cardiovascular diseases (CVD) remain the leading cause of death in men and women. Biological sex plays a major role in cardiovascular physiology and pathological cardiovascular remodeling. Traditionally, pathological remodeling of cardiovascular system refers to the molecular, cellular, and morphological changes that result from insults, such as myocardial infarction or hypertension. Regular exercise training is known to induce physiological cardiovascular remodeling and beneficial functional adaptation of the cardiovascular apparatus. However, impact of exercise-induced cardiovascular remodeling and functional adaptation varies between males and females. This review aims to compare and contrast sex-specific manifestations of exercise-induced cardiovascular remodeling and functional adaptation. Specifically, we review (1) sex disparities in cardiovascular function, (2) influence of biological sex on exercise-induced cardiovascular remodeling and functional adaptation, and (3) sex-specific impacts of various types, intensities, and durations of exercise training on cardiovascular apparatus. The review highlights both animal and human studies in order to give an all-encompassing view of the exercise-induced sex differences in cardiovascular system and addresses the gaps in knowledge in the field.
- Published
- 2021
- Full Text
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38. Omega-3 fatty acid lipid emulsions are safe and effective in reducing endotoxemia and sepsis in acute-on-chronic liver failure: An open-label randomized controlled trial.
- Author
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Kulkarni AV, Anand L, Vyas AK, Premkumar M, Choudhury AK, Trehanpati N, Benjamin J, Kumar G, Joshi YK, and Sarin SK
- Subjects
- Emulsions, Humans, Toll-Like Receptor 4, Acute-On-Chronic Liver Failure, Endotoxemia etiology, Endotoxemia prevention & control, Fatty Acids, Omega-3, Sepsis etiology, Sepsis prevention & control
- Abstract
Background and Aim: Sepsis is an important determinant of the outcome of acute-on-chronic liver failure (ACLF) patients. Omega-3 fatty acids (FAs) are known to suppress inflammation, reduce morbidity, and mortality in postoperative and critically ill patients. We aimed to evaluate the effect of intravenous omega-6 and omega-3 FA lipid emulsions in ACLF patients., Methods: Ninety ACLF patients were randomly allocated to three groups: Gr. A received no lipid emulsions, Gr. B received omega-6 FAs, and Gr. C received omega-3 FAs. The primary and secondary aims were to compare the effects of lipid emulsions on immune modulation, the incidence of bacterial sepsis, and mortality at day 28., Results: The baseline characteristics of the patients were comparable. Serum endotoxin levels remained suppressed by 22% in Gr. C compared with a 4% and 12% rise in Gr. B and A (P < 0.001). Omega-3 FAs also suppressed C-reactive protein levels and neutrophil-to-lymphocyte ratio in Gr. C. Compared with Gr. A, omega-3 FAs reduced sepsis by 86% (HR, 0.14; 95% CI 0.04-0.43; P < 0.001). Omega-3 FAs significantly increased the expression of TLR2 and TLR4 on both CD14
+ and CD16+ monocytes, and TLR4, on macrophages and neutrophils. There were no serious adverse events, except transient flushing in 20% and 16.6% of patients receiving omega-6 FAs and omega-3 FAs, respectively., Conclusion: Omega-3 FAs are safe and effective in reducing systemic inflammation, endotoxemia, and sepsis in patients with ACLF. These lipid emulsions could also be considered as effective sources of immunonutrition in such sick patients., (© 2021 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.)- Published
- 2021
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39. Gut Dysbiosis and IL-21 Response in Patients with Severe COVID-19.
- Author
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Khan M, Mathew BJ, Gupta P, Garg G, Khadanga S, Vyas AK, and Singh AK
- Abstract
Background: The disease severity, ranging from being asymptomatic to having acute illness, and associated inflammatory responses has suggested that alterations in the gut microbiota may play a crucial role in the development of chronic disorders due to COVID-19 infection. This study describes gut microbiota dysbiosis in COVID-19 patients and its implications relating to the disease., Design: A cross sectional prospective study was performed on thirty RT-PCR-confirmed COVID-19 patients admitted to the All India Institute of Medical Sciences, Bhopal, India, between September 10 and 20, 2020. Ten healthy volunteers were recruited as the control group. IFN, TNF, and IL-21 profiling was conducted using plasma samples, and gut bacterial analysis was performed after obtaining the metagenomics data of stool samples., Results: Patients with a variable COVID-19 severity showed distinct gut microflora and peripheral interleukin-21 levels. A low Firmicute/Bacteroidetes ratio, caused by the depletion of the fibre-utilizing bacteria, F. prausnitzii , B. Plebius , and Prevotella , and an increase in Bacteroidetes has associated gut microbiota dysbiosis with COVID-19 disease severity., Conclusions: The loss of the functional attributes of signature commensals in the gut, due to dysbiosis, is a predisposing factor of COVID-19 pathophysiology.
- Published
- 2021
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- View/download PDF
40. Coronavirus disease 2019 in pregnancy: Case report on maternal death in Sagar City of Central India.
- Author
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Rawat SK, Saad T, Jindal A, and Vyas AK
- Subjects
- Adult, COVID-19 complications, COVID-19 diagnosis, COVID-19 therapy, Fatal Outcome, Female, Humans, India, Pregnancy, Pregnancy Complications, Infectious diagnosis, Pregnancy Complications, Infectious therapy, Pregnancy Complications, Infectious virology, Retrospective Studies, SARS-CoV-2, COVID-19 physiopathology, Pregnancy Complications, Infectious physiopathology
- Abstract
Background: The infection by SARS-COV-2 leading to coronavirus disease has become a worldwide pandemic. It is not clear whether the coronavirus disease (COVID-19) and its severity differ in pregnant compared to the nonpregnant outcome., Concerns: Out of four, three pregnant women were discharged with mild symptoms but one pregnant woman admitted at 24 weeks gestation with 3 days of vomiting, breathlessness, and cough had fatal outcome., Diagnoses: After the medical staff prepared for isolation and protection, the patients quickly underwent with series of diagnostic tests, such as laboratory, imaging, and SARS-COV-2 nucleic-acid examinations., Outcomes: Among all four SARS CoV-2 infected pregnant women, three discharged after recovery and delivered healthy babies but one had severe COVID-19 disease. The women began to exhibit fever, reduced blood oxygen saturation, and despite the interventions, she could not be saved and succumbed to death. There is an early requirement of effective management strategies for pregnant women with COVID-19., (© 2021 Japan Society of Obstetrics and Gynecology.)
- Published
- 2021
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41. The role and delicate balance of Host Immunity in Coronavirus Disease-19.
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Vyas AK, Varma V, Garg G, Gupta P, and Trehanpati N
- Subjects
- Age Factors, Antiviral Agents therapeutic use, COVID-19 mortality, COVID-19 therapy, COVID-19 virology, COVID-19 Vaccines therapeutic use, Comorbidity, Cytokine Release Syndrome immunology, Cytokine Release Syndrome virology, Host-Pathogen Interactions, Humans, Immunity, Humoral, Immunocompromised Host, Prognosis, Risk Assessment, Risk Factors, Severity of Illness Index, COVID-19 Drug Treatment, Adaptive Immunity drug effects, COVID-19 immunology, Immunity, Innate drug effects, SARS-CoV-2 immunology
- Abstract
Severe Acute Respiratory Syndrome (SARS) associated with SARS-CoV-2, causes a severe form of the respiratory illness known as Coronavirus Disease-19 (COVID-19). COVID-19 has emerged as a worldwide pandemic with a high number of fatalities. Approximately 112,654,202 people have been infected so far with this disease which has led to the death of more than one point seven million (2,496,749) till 24th Feb, 2021. Measures to counter this disease have led to a global economic slowdown. Multiple drug trials are ongoing and several putative candidates for vaccination against the virus have been approved and are in the pipeline. Many studies have also characterized the immunological profile of patients infected with COVID-19. Some studies suggest that the severity of the COVID-19 infection is directly associated with the cytokine storm. In this review, we aim to compile the available knowledge and describe the nature of immune responses in patients infected with COVID-19 in different age groups, comorbidity, and immune-compromised state and their association with disease severity.
- Published
- 2021
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42. Laboratory diagnosis of COVID-19: current status and challenges.
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Mathew BJ, Vyas AK, Khare P, Gupta S, Nema RK, Nema S, Gupta S, Chaurasiya SK, Biswas D, and Singh AK
- Abstract
The magnitude and pace of global affliction caused by Coronavirus Disease-19 (COVID-19) is unprecedented in the recent past. From starting in a busy seafood market in the Chinese city of Wuhan, the virus has spread across the globe in less than a year, infecting over 76 million people and causing death of close to 1.7 million individuals worldwide. As no specific antiviral treatment is currently available, the major strategy in containing the pandemic is focused on early diagnosis and prompt isolation of the infected individuals. Several diagnostic modalities have emerged within a relatively short period, which can be broadly classified into molecular and immunological assays. While the former category is centered around real-time PCR, which is currently considered the gold standard of diagnosis, the latter aims to detect viral antigens or antibodies specific to the viral antigens and is yet to be recommended as a stand-alone diagnostic tool. This review aims to provide an update on the different diagnostic modalities that are currently being used in diagnostic laboratories across the world as well as the upcoming methods and challenges associated with each of them. In a rapidly evolving diagnostic landscape with several testing platforms going through various phases of development and/or regulatory clearance, it is prudent that the clinical community familiarizes itself with the nuances of different testing modalities currently being employed for this condition., (Copyright © 2021 The Authors. Published by Tehran University of Medical Sciences.)
- Published
- 2021
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43. Impact of SARS-CoV-2 Infection on Patients Suffering from Liver Injury.
- Author
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Vyas AK and Singh A
- Published
- 2021
- Full Text
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44. Humoral Immune Responses and Hepatitis B Infection.
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Vyas AK, Lslam M, Garg G, Singh AK, and Trehanpati N
- Subjects
- DNA, Viral, Hepatitis B Surface Antigens, Hepatitis B virus, Humans, Immunity, Humoral, Hepatitis B, Hepatitis B, Chronic drug therapy
- Abstract
Background: Chronicity or seroclearance of hepatitis B virus (HBV) antigens is determined by the host immune responses. Current approaches to treat HBV patients are based on inhibition of replication using different antivirals (nucleoside or nucleotide analogs) as monotherapy, or along with immune modulators as combination therapy is being used worldwide for reducing the viral load. Understanding the role of immune cellular therapies with currently available treatments for persistent viral-mediated responses in HBV patients is unexplored. However, the generation of antibodies against a surface (HBs) and envelop (HBe) antigen of hepatitis B remains an issue for future studies and needs to be explored., Summary: Humoral immunity, specifically T follicular helper (TFh) cells, may serve as a target for therapy for HBsAg seroconversion. In this review, we have been engrossed in the importance and role of the humoral immune responses in CHBV infection and vertical transmission. Key Message: TFh cells have been suggested as the potential target of immunotherapy which lead to seroconversion of HBe and HBs antigens of HBV. HBsAg seroconversion and eradication of covalently closed circular DNA are the main challenges for existing and forthcoming therapies in HBV infection., (© 2021 S. Karger AG, Basel.)
- Published
- 2021
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45. Liddle Syndrome due to a Novel c.1713 Deletion in the Epithelial Sodium Channel β-Subunit in a Normotensive Adolescent.
- Author
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Brower RK, Ghlichloo IA, Shabgahi V, Elsholz D, Menon RK, and Vyas AK
- Abstract
Objective: Liddle syndrome (LS) is a rare autosomal dominant condition secondary to a gain-of-function mutation affecting the epithelial sodium channels (ENaCs) in the distal nephron. It presents with early-onset hypertension, hypokalemia, and metabolic alkalosis in the face of hyporeninemia and hypoaldosteronism. We report a novel mutation affecting the ENaCs in a normotensive adolescent with LS., Methods: We describe a pediatric case of LS with a novel mutation and review the condition's presentation and management. To date, 31 different mutations in the β- or γ-subunit of ENaCs have been reported as associated with LS., Results: We describe a 16-year-old girl presenting with muscle cramps with a strong family history of hypertension and hypokalemia. Initial investigations revealed hypokalemia together with hypoaldosteronism and hyporeninemia. Subsequent genetic testing revealed a novel mutation in SCNN1B (deletion: c.1713delC), leading to the premature termination of the sodium channel epithelial 1 subunit-β protein and the LS phenotype. Treatment with triamterene (50 mg, twice daily) and potassium chloride (20 mEq, once daily) normalized the serum potassium and led to resolution of her muscle cramps., Conclusion: It is essential to consider investigating the presence of rare genetic syndromes, like LS, when a patient presents with hypokalemia. Further studies are needed to understand the variable presentation of this condition., (© 2020 AACE. Published by Elsevier Inc.)
- Published
- 2020
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46. Variation in Utilization of Intensive Care for Pediatric Diabetic Ketoacidosis.
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Vyas AK, Chan YM, and Oud L
- Subjects
- Child, Critical Care, Humans, Intensive Care Units, Length of Stay, Reproducibility of Results, Retrospective Studies, Diabetic Ketoacidosis epidemiology, Diabetic Ketoacidosis therapy
- Abstract
Objective: To examine the hospital-level variation in intensive care unit (ICU) utilization and quantify the relative contribution of patient and hospital characteristics versus individual hospital factors to the variation in ICU admission rates among pediatric hospitalizations with diabetic ketoacidosis (DKA)., Methods: The Texas Inpatient Public Use Data File was used to identify hospitalizations of state residents aged 1 month to 19 years with a primary diagnosis of DKA between 2005 and 2014. Multilevel, mixed-effects logistic regression modeling was performed to examine the association of patient- and hospital-level factors with ICU admission. Risk and reliability adjustment was then performed to assess hospital-level variation in ICU utilization. Intraclass correlation coefficient was used to quantify variation in use of ICU attributable to individual hospitals. The association between adjusted rates of ICU admission and total hospital charges and length of stay was examined using linear regression., Results: Of the 23 585 DKA hospitalizations, 14 638 (62.1%) were admitted to ICU. On multilevel analysis, the odds of ICU admission progressively decreased with rising volume of DKA hospitalizations (adjusted odds ratio: 0.08 [highest vs lowest quartile]; 95% confidence interval [CI]: 0.03-0.24). The crude median (interquartile range [IQR]; range) of ICU admissions across hospitals was 82.6% (73%-90%; 11.1%-100%). The median (IQR) risk- and reliability-adjusted ICU admission rate was 81.0% (73.0%-86.9%), ranging from 11.2% to 94%. Following risk and reliability adjustment, the intraclass correlation coefficient was 0.005 (95% CI: 0.004-0.006). For each 10% increase in adjusted ICU admission rate, total hospital charges rose by 7% (95% CI: 3%-11%). There was no association between ICU admission rates and hospital length of stay., Conclusion: Although high variation in ICU utilization was noted across hospitals among pediatric DKA hospitalizations, the proportion of variation attributable to individual hospitals was negligible, once adjusted for patient mix and hospital characteristics.
- Published
- 2020
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47. Host phospholipase C-γ1 impairs phagocytosis and killing of mycobacteria by J774A.1 murine macrophages.
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Paroha R, Chourasia R, Rai R, Kumar A, Vyas AK, Chaurasiya SK, and Singh AK
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- Animals, Cells, Cultured, Mice, Mycobacterium tuberculosis immunology, Phospholipase C gamma metabolism, RNA Interference, RNA, Small Interfering genetics, Signal Transduction immunology, Chemokine CCL5 metabolism, Macrophages immunology, Mycobacterium smegmatis immunology, Phagocytosis immunology, Phospholipase C gamma genetics
- Abstract
Macrophages represent the first line of defense against invading Mycobacterium tuberculosis (Mtb). In order to enhance intracellular survival, Mtb targets various components of the host signaling pathways to limit macrophage functions. The outcome of Mtb infection depends on various factors derived from both host and pathogen. A detailed understanding of such factors operating during interaction of the pathogen with the host is a prerequisite for designing new approaches for combating mycobacterial infections. This work analyzed the role of host phospholipase C-γ1 (PLC-γ1) in regulating mycobacterial uptake and killing by J774A.1 murine macrophages. Small interfering RNA mediated knockdown of PLC-γ1 increased internalization and reduced the intracellular survival of both Mtb and Mycobacterium smegmatis (MS) by macrophages. Down-regulation of the host PLC-γ1 was observed during the course of mycobacterial infection within these macrophages. Finally, Mtb infection also suppressed the expression of pro-inflammatory cytokine tumor necrosis factor-α and chemokine (C-C motif) ligand 5 (RANTES) which was restored by knocking down PLC-γ1 in J774A.1 cells. These observations suggest a role of host PLC-γ1 in the uptake and killing of mycobacteria by murine macrophages., (© 2020 The Societies and John Wiley & Sons Australia, Ltd.)
- Published
- 2020
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48. Letter: programmed death-1-a predictor for anti-viral treatment in chronic hepatitis B.
- Author
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Vyas AK
- Subjects
- B7-H1 Antigen therapeutic use, Hepatitis B virus, Humans, Viral Load, Antiviral Agents therapeutic use, Hepatitis B, Chronic drug therapy
- Published
- 2020
- Full Text
- View/download PDF
49. Timing of hepatitis B virus DNA quantification and treatment approach during pregnancy.
- Author
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Vyas AK, Singh AK, Mishra N, and Kumar A
- Subjects
- Female, Humans, Infectious Disease Transmission, Vertical, Pregnancy, Viral Load, DNA, Viral, Hepatitis B virus
- Published
- 2020
- Full Text
- View/download PDF
50. Developmental programming: Sex-specific programming of growth upon prenatal bisphenol A exposure.
- Author
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Vyas AK, Veiga-Lopez A, Ye W, Abi Salloum B, Abbott DH, Yang S, Liao C, Kannan K, and Padmanabhan V
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- Animals, Female, Male, Pregnancy, Sheep, Benzhydryl Compounds toxicity, Endocrine Disruptors toxicity, Fetal Development drug effects, Organogenesis drug effects, Phenols toxicity, Prenatal Exposure Delayed Effects chemically induced, Sex Characteristics
- Abstract
In both human and animals, in utero exposure to bisphenol A (BPA), an endocrine-disrupting chemical used in the production of plastics and epoxy resins, has been shown to affect offspring reproductive and metabolic health during adult life. We hypothesized that the effect of prenatal exposure to environmentally relevant doses of BPA will be evident during fetal organogenesis and fetal/postnatal growth trajectory. Pregnant ewes were administered BPA subcutaneously from 30 to 90 days of gestation (term 147 days). Fetal organ weight, anthropometric measures, maternal/fetal hormones and postnatal growth trajectory were measured in both sexes. Gestational BPA administration resulted in higher accumulation in male than female fetuses only at fetal day 65, with minimal impact on fetal/maternal steroid milieu in both sexes at both time points. BPA-treated male fetuses were heavier than BPA-treated female fetuses at fetal day 90 whereas this sex difference was not evident in the control group. At the organ level, liver weight was reduced in prenatal BPA-treated female fetuses, while heart and thyroid gland weights were increased in BPA-treated male fetuses relative to their sex-matched control groups. Prenatal BPA treatment also altered the postnatal growth trajectory in a sex-specific manner. Males grew slower during the early postnatal period and caught up later. Females, in contrast, demonstrated the opposite growth trend. Prenatal BPA-induced changes in fetal organ differentiation and early life growth strongly implicate translational relevance of in utero contributions to reproductive and metabolic defects previously reported in adult female offspring., (© 2019 John Wiley & Sons, Ltd.)
- Published
- 2019
- Full Text
- View/download PDF
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