Publications by authors named "A Kumar"

25,011 Publications

The impact of treatment with bile acid sequestrants on quality of life in patients with bile acid diarrhoea.

BMC Gastroenterol 2022 Jul 2;22(1):325. Epub 2022 Jul 2.

The Royal Wolverhampton NHS Trust, Wolverhampton Road, Wolverhampton, WV10 0QP, UK.

Background: Bile acid diarrhoea (BAD) can be severely debilitating and negatively affect patients' quality of life (QoL). We carried out a multi-centre prospective study exploring QoL outcomes in patients with BAD after treatment with colesevelam.

Methods: Patients with or without a positive 23-seleno-25-homotaurocholic acid (SeHCAT) scan were recruited and categorised into four groups: SeHCAT negative control group (CG), idiopathic BAD, post-cholecystectomy (PC) and post-terminal ileal resection for Crohn's disease (CD). Patients with a positive SeHCAT were treated with colesevelam and dosing was titrated to symptomatic response. Patients were reviewed at 4- and 8-weekly intervals and QoL was evaluated by EQ-5D-3L, SF-36, IBDQ-32 at each visit (where relevant). Patients with a negative SeHCAT (CG cohort) completed one set of questionnaires before being discharged from the study.

Results: 47 patients (BAD = 24, PC = 12, CD = 11) completed paired QoL questionnaires before and after treatment and 30 CG patients completed a baseline questionnaire. There was a significant improvement in IBDQ-32 mean scores before and after treatment in CD patients [134.6 (95%CI 112.5-156.6) and 158.4 (136.1-180.6), respectively (p = 0.007). Following treatment, BAD patients had significantly improved mean SF-36 scores in the "Role limitation due to physical health" dimension (p = 0.02) and in the overall mental component summary (p = 0.03). Prior to starting treatment, BAD patients had the lowest scores in the 'activity' dimension of the EQ-5D-3L (p = 0.04), which improved significantly after treatment (p = 0.002). Overall, the BAD and CD cohort showed improved mean scores with treatment in all components of the SF-36 and EQ-5D-3L, while the PC cohort showed a general decline in mean scores after treatment. 55% of patients clinically responded to treatment of which 41.7%, 58.3% and 81.8% responded from the BAD, PC and CD groups respectively. Correlations between those deemed as responders with improvements on the SF-36 and EQ-5D dimensions were not statistically significant.

Conclusion: Our results demonstrate improved QoL in the BAD and CD cohort with treatment. Further larger studies are recommended specifically investigating the PC cohort and whether patients may improve with newer treatments such as FXR agonists. Trial registration Ethical approval REC Ref: 16/LO/1325.
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http://dx.doi.org/10.1186/s12876-022-02404-9DOI Listing
July 2022

Corrigendum to "Evaluation of the immunomodulatory and anti-inflammatory activity of Bakuchiol using RAW 264.7 macrophage cell lines and in animal models stimulated by lipopolysaccharide (LPS)" [Int. Immunopharmacol. 91 (2021) 107264].

Int Immunopharmacol 2022 Jun 28:109003. Epub 2022 Jun 28.

Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, India; Mutagenicity Laboratory, CSIR-Indian Institute of Integrative Medicine, Canal Road, Jammu 180001, India; Laboratory Animal Facility, CSIR-Indian Institute of Integrative Medicine, Canal Road, Jammu 180001, India. Electronic address:

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http://dx.doi.org/10.1016/j.intimp.2022.109003DOI Listing
June 2022

The U-shaped association of post-lung transplant mortality with pretransplant eGFR underscores possible limitations of creatinine-based estimation equations for risk stratification.

J Heart Lung Transplant 2022 Jun 4. Epub 2022 Jun 4.

Department of Internal Medicine, University of Iowa, Iowa City, Iowa; Veterans Affairs Medical Center, Iowa City, Iowa.

Background: Pre-existing chronic kidney disease (CKD) may have an impact on post-lung transplant survival and the development of end stage kidney disease (ESKD).

Methods: We analyzed the US transplant database from 2006 to 2020. Adult patients who received their first lung transplant and were not on dialysis were included. Multivariable Cox regression was used to assess the effect of pretransplant eGFR on mortality and cumulative incidence competing risk was used to explore the effect on ESKD.

Results: The adjusted hazard ratio (aHR) for mortality showed a "U" shaped association with eGFR with a rising mortality at <60 and >100 ml/min/1.73m. The increase in mortality with higher eGFR was only seen in those <30 year and were primarily in whites with a lower body mass index and in patients with cystic fibrosis (CF). The aHR for ESKD increased below an eGFR of 100 rising to 1.74 at an eGFR of 60. Any decrease in eGFR between listing and transplant >10% was associated with higher risk of ESKD.

Conclusions: The U-shaped association of pretransplant eGFR with post-transplant mortality correlated with younger age, lower BMI and a diagnosis of CF. The aHR for ESKD following lung transplantation increased exponentially with worsening eGFR pretransplant.
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http://dx.doi.org/10.1016/j.healun.2022.05.018DOI Listing
June 2022

Host genetics associated with gut microbiota and methane emission in cattle.

Mol Biol Rep 2022 Jul 1. Epub 2022 Jul 1.

Animal Genetics Division, Indian Council of Agricultural Research (ICAR)-Indian Veterinary Research Institute, Bareilly, 243122, India.

In livestock sector, dairy animals alone produce 18% of the total greenhouse gas emissions globally as methane (CH). This Enteric methane is the largest component of total carbon footprints produced by livestock production system and its reduction is today's new challenge to make livestock farming sustainable for earth's environment. The production of enteric methane in ruminants is a complex phenomena involving different host factors like host genotype, rumen microbiome, host physiology along with dietary factors. Efforts have been made to reduce methane emissions largely through nutritional interventions and dietary supplements, but permanent reductions can be obtained through genetic means by selecting and breeding of low methane emitting animals. From genome-wide association studies, many important genomic QTL regions and single nucleotide polymorphisms involved in shaping the composition of the ruminal microbiome and thus their carbon footprints have been recognised, implying that methane emission traits are quantitative traits. The major bottleneck in implementation of reduced methane emission traits in the breeding programs is wide variation at phenotypic level, lack of precise methane measurements at individual level. Overall, the heritability for CH production traits is moderate, and it can be used in breeding programmes to target changes in microbial composition to reduce CH emission in the dairy industry for far-reaching environmental benefits at the cost of a minor reduction in genetic gain in production traits.
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http://dx.doi.org/10.1007/s11033-022-07718-1DOI Listing
July 2022

'Gull-wing' appearance in osteoarthritis of hands.

QJM 2022 Jul 1. Epub 2022 Jul 1.

Department of Rheumatology, Fortis Flt. Lt. Rajan Dhall Hospital, New Delhi, India.

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http://dx.doi.org/10.1093/qjmed/hcac160DOI Listing
July 2022
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