Publications by authors named "Animesh Das"

55 Publications

Idiopathic brachial plexopathy after pacemaker implant.

Pacing Clin Electrophysiol 2021 Nov 30. Epub 2021 Nov 30.

Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India.

A middle-aged woman presented with symptomatic complete heart block and underwent an uneventful dual chamber pacemaker implantation. Three weeks post procedure, she developed left arm pain and weakness, with neurological localization to the lower trunk of left brachial plexus. Possibilities of traumatic compression by the device/leads or postoperative idiopathic brachial plexopathy were considered. After ruling out traumatic causes, she was started on oral steroids, to which she responded remarkably. This case highlights the importance of recognizing this rare cause of brachial plexopathy following pacemaker implantation, because not only does an expedited diagnosis and medical treatment lead to prompt recovery with minimal neurological deficits, but it also circumvents an unnecessary surgical re-exploration.
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http://dx.doi.org/10.1111/pace.14421DOI Listing
November 2021

Idiopathic Hypoparathyroidism Presenting As New Onset Refractory Status Epilepticus.

J Neurosci Rural Pract 2021 Oct 16;12(4):796-797. Epub 2021 Sep 16.

Department of Neurology, All India Institute of Medical Sciences, New Delhi, India.

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http://dx.doi.org/10.1055/s-0041-1735247DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8559069PMC
October 2021

Frequency of Neurologic Manifestations in COVID-19: A Systematic Review and Meta-analysis.

Neurology 2021 12 11;97(23):e2269-e2281. Epub 2021 Oct 11.

From the Department of Neurology (S.M., D.R., A.K., A.D., A.K.S., A.A.), All India Institute of Medical Sciences, New Delhi, India; Brain Health Unit (K.K., T.D.), World Health Organization, Geneva, Switzerland; Department of Clinical Research and Epidemiology (M.P.), Institute of Liver and Biliary Sciences, New Delhi, India; Columbia University Irving Medical Center-New York Presbyterian Hospital (K.T.T.), NY; Institute of Infection, Veterinary and Ecological Sciences (T.S., B.D.M., G.K.W.), University of Liverpool; Department of Neurology (T.S., B.D.M.), Walton Centre NHS Foundation Trust; NIHR Health Protection Research Unit for Emerging and Zoonotic Infection (B.D.M.), Liverpool, UK; Center for Global Health (A.S.W.), Department of Neurology, Technical University of Munich, Germany; Centre for Global Health (A.S.W.), Institute of Health and Society, University of Oslo, Norway; Istituto di Ricerche Farmacologiche Mario Negri IRCCS (E.B.), Milan, Italy; Moscow Research and Clinical Center for Neuropsychiatry and Pirogov Russian National Research Medical University (A.G.), Russia; Departments of Neurology and Pathology (C.A.P.), Johns Hopkins University School of Medicine, Baltimore, MD; University of Pittsburgh School of Medicine (S.H.-Y.C.); Department of Critical Care Medicine (E.L.F.), UPMC Children's Hospital of Pittsburgh, PA; Department of Neurology (E.S.), Medical University Innsbruck, Austria; Departments of Neurology and Otolaryngology-Head & Neck Surgery (A.K.), The Johns Hopkins Hospital, Baltimore, MD; Department of Neurology (F.K.H.), Faculty of Medicine and Health Sciences, University Putra Malaysia, Seri Kembangan; and Rajendra Institute of Medical Sciences (K.P.), Ranchi, Jharkhand, India.

Background And Objectives: One year after the onset of the coronavirus disease 2019 (COVID-19) pandemic, we aimed to summarize the frequency of neurologic manifestations reported in patients with COVID-19 and to investigate the association of these manifestations with disease severity and mortality.

Methods: We searched PubMed, Medline, Cochrane library, ClinicalTrials.gov, and EMBASE for studies from December 31, 2019, to December 15, 2020, enrolling consecutive patients with COVID-19 presenting with neurologic manifestations. Risk of bias was examined with the Joanna Briggs Institute scale. A random-effects meta-analysis was performed, and pooled prevalence and 95% confidence intervals (CIs) were calculated for neurologic manifestations. Odds ratio (ORs) and 95% CIs were calculated to determine the association of neurologic manifestations with disease severity and mortality. Presence of heterogeneity was assessed with , meta-regression, and subgroup analyses. Statistical analyses were conducted in R version 3.6.2.

Results: Of 2,455 citations, 350 studies were included in this review, providing data on 145,721 patients with COVID-19, 89% of whom were hospitalized. Forty-one neurologic manifestations (24 symptoms and 17 diagnoses) were identified. Pooled prevalence of the most common neurologic symptoms included fatigue (32%), myalgia (20%), taste impairment (21%), smell impairment (19%), and headache (13%). A low risk of bias was observed in 85% of studies; studies with higher risk of bias yielded higher prevalence estimates. Stroke was the most common neurologic diagnosis (pooled prevalence 2%). In patients with COVID-19 ≥60 years of age, the pooled prevalence of acute confusion/delirium was 34%, and the presence of any neurologic manifestations in this age group was associated with mortality (OR 1.80, 95% CI 1.11-2.91).

Discussion: Up to one-third of patients with COVID-19 analyzed in this review experienced at least 1 neurologic manifestation. One in 50 patients experienced stroke. In those >60 years of age, more than one-third had acute confusion/delirium; the presence of neurologic manifestations in this group was associated with nearly a doubling of mortality. Results must be interpreted with the limitations of observational studies and associated bias in mind.

Systematic Review Registration: PROSPERO CRD42020181867.
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http://dx.doi.org/10.1212/WNL.0000000000012930DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8665434PMC
December 2021

Copper-Catalyzed Oxidative Dehydrogenative Reaction of Quinoline--Oxides with Donor-Acceptor Cyclopropanes: Installation of a Tertiary Alkyl Motif at C2 Position.

Org Lett 2021 Nov 11;23(21):8390-8395. Epub 2021 Oct 11.

Department of Chemistry, Indian Institute of Technology Guwahati, Guwahati, Assam 781039, India.

A copper-catalyzed oxidative dehydrogenative reaction of quinoline -oxides with donor-acceptor cyclopropanes has been demonstrated to construct C2-alkylated quinolines containing a γ-keto diester motif. The use of molecular oxygen as an oxidant, excellent site-selectivity, and good functional group tolerance are the important features in this process. The preliminary mechanistic studies demonstrate that the catalyst plays a dual role as a Lewis acid and a redox catalyst.
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http://dx.doi.org/10.1021/acs.orglett.1c03115DOI Listing
November 2021

A Case of Hemi-Isaac's Syndrome.

Mov Disord Clin Pract 2021 Oct 26;8(7):1126-1128. Epub 2021 Aug 26.

Department of Neurology AIIMS New Delhi India.

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http://dx.doi.org/10.1002/mdc3.13328DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8485614PMC
October 2021

Enoxaparin-induced Wunderlich syndrome in a young patient with anti-GAD 65-associated opsoclonus and limbic encephalitis: a rare complication in a rare disease.

BMJ Case Rep 2021 Oct 7;14(10). Epub 2021 Oct 7.

Neurology, All India Institute of Medical Sciences, New Delhi, India.

Wunderlich syndrome is a rare condition characterised by acute spontaneous non-traumatic renal haemorrhage into the subcapsular and perirenal spaces. Our case of anti-GAD65-associated autoimmune encephalitis (AE), aged 30 years, developed this complication following use of enoxaparin and was managed by selective glue embolisation of subsegmental branches of right renal cortical arteries. Our case had opsoclonus as one of the clinical manifestations, which has till now been described in only two patients of this AE. This patient received all forms of induction therapies (steroids, plasmapheresis, intravenous immunoglobulin and rituximab) following which she had good improvement in her clinical condition. The good response to immunotherapy is also a point of discussion as this has been rarely associated with anti-GAD65 AE.
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http://dx.doi.org/10.1136/bcr-2021-244916DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8499240PMC
October 2021

Site-Selective Deoxygenative Amination of Azine -Oxides with Carbodiimides under Catalyst-, Activator-, Base-, and Solvent-Free Conditions.

J Org Chem 2021 08 14;86(15):10762-10772. Epub 2021 Jul 14.

Department of Chemistry, Indian Institute of Technology Guwahati, Guwahati, 781039, India.

An operationally simple method for synthesizing 2-amino azines [3+2] dipolar cycloaddition of azine -oxide with carbodiimide has been demonstrated. The reaction can proceed smoothly under simple heating conditions without any transition metal catalyst, activator, base, and solvent. This transformation demonstrates a broad substrate scope and produces CO as the only co-product. The applicability of this method is highlighted by the late-stage modification of bioactive molecules, including quinine, (±)-α-tocopherol, and tryptamine modified quinoline.
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http://dx.doi.org/10.1021/acs.joc.1c00741DOI Listing
August 2021

Symmetrical white matter lesions in a patient with systemic lupus erythematosus.

Postgrad Med J 2021 May 26. Epub 2021 May 26.

Department of Neurology, All India Institute of Medical Sciences, Cardio-Neuro Sciences Centre, New Delhi, India.

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http://dx.doi.org/10.1136/postgradmedj-2021-140232DOI Listing
May 2021

Managing Non-COVID Acute Neurology Amidst the Pandemic: Challenges and Work in Progress.

Ann Indian Acad Neurol 2021 Jan-Feb;24(1):11-14. Epub 2021 Feb 9.

Department of Neurology, All India Institute of Medical Sciences, New Delhi, India.

The ongoing COVID-19 pandemic has precipitated a global health crisis. Non-COVID diseases across specialties have been significantly compromised. The greatest challenge has been to continue providing care to non-COVID cases with minimum transmission risk to health care workers, patients, and caregivers. In this specter, better described as a medical holocaust, we present our experiences of dealing with acute neurological patients who could access our facility. We attempted to work on three key areas - initial screening using a more inclusive, dynamic checklist for COVID suspicion over and above the emergency triage, a mandatory initial holding on a separate floor of our inpatient service equipped with infection control strategies similar to a COVID-designated area, and daily screening of health care workers and caregivers for symptoms and possible exposures. It was a steep learning curve, a couple of close shaves, and many more lessons that went into the development of an algorithm that seems to be working well.
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http://dx.doi.org/10.4103/aian.AIAN_999_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8061500PMC
February 2021

Phosphorus containing porous organic polymers: synthetic techniques and applications in organic synthesis and catalysis.

Org Biomol Chem 2021 May 19;19(19):4174-4192. Epub 2021 Apr 19.

Department of Chemical Sciences, Indian Institute of Science Education and Research Kolkata, Mohanpur 741246, India.

The phosphorus-containing porous organic polymer is a trending material for the synthesis of heterogeneous catalysts. Decades of investigations have established phosphines as versatile ligands in homogeneous catalysis. Recently, phosphine-based heterogeneous catalysts were synthesized to exploit the same electronic properties while leveraging extra stability and reusability. In the last few decades, the catalysts were applied in diverse organic transformations, including hydroformylation, hydrogenation, C-C, C-N and C-X coupling, hydrosilylation, oxidative-carbonylation reactions, and so on. However, even though these polymers possess a multifunctional character, they face multiple synthetic issues in controlling the pore size, increasing the surface area, and creating a single type of active site. This review summarizes the developments in this field over the last few decades, highlighting the current limitation and future scope.
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http://dx.doi.org/10.1039/d1ob00137jDOI Listing
May 2021

Reductive Alkylation of Quinolines to -Alkyl Tetrahydroquinolines Catalyzed by Arylboronic Acid.

Org Lett 2021 04 12;23(7):2437-2442. Epub 2021 Mar 12.

Department of Chemistry, Indian Institute of Technology Guwahati, Guwahati 781039, Assam, India.

A boronic acid catalyzed one-pot tandem reduction of quinolines to tetrahydroquinolines followed by reductive alkylation by the aldehyde has been demonstrated. This step-economcial synthesis of -alkyl tetrahydroquinolines has been achieved directly from readily available quinolines, aldehydes, and Hantzsch ester under mild reaction conditions. The mechanistic study demonstrates the unique behavior of organoboron catalysts as both Lewis acids and hydrogen-bond donors.
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http://dx.doi.org/10.1021/acs.orglett.1c00302DOI Listing
April 2021

Amnesia Following Hot Water Bath from Gas Geyser.

Ann Indian Acad Neurol 2020 Nov-Dec;23(6):823-824. Epub 2019 Aug 2.

Department of Neurology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.

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http://dx.doi.org/10.4103/aian.AIAN_310_19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7900747PMC
August 2019

Selective Catalytic Synthesis of α-Alkylated Ketones and β-Disubstituted Ketones via Acceptorless Dehydrogenative Cross-Coupling of Alcohols.

Org Lett 2021 Feb 21;23(3):869-875. Epub 2021 Jan 21.

Department of Chemistry, Indian Institute of Technology Guwahati, Guwahati 781039, Assam, India.

Herein, a phosphine-free pincer ruthenium(III) catalyzed β-alkylation of secondary alcohols with primary alcohols to α-alkylated ketones and two different secondary alcohols to β-branched ketones are reported. Notably, this transformation is environmentally benign and atom efficient with HO and H gas as the only byproducts. The protocol is extended to gram-scale reaction and for functionalization of complex vitamin E and cholesterol derivatives.
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http://dx.doi.org/10.1021/acs.orglett.0c04098DOI Listing
February 2021

The Emergence of Palladium-Catalyzed C(sp )-H Functionalization of Free Carboxylic Acids.

Chem Asian J 2021 Mar 2;16(5):397-408. Epub 2021 Feb 2.

Indian Institute of Science Education and Research Kolkata Nadia, West Bengal, India.

Palladium-catalyzed directing group assisted C-H bond activation has emerged as a powerful tool in synthetic organic chemistry. However, only recently, among various directing groups, widely available carboxylate moiety is recognized as a versatile candidate for the regioselective transformations. Notably, palladium-catalyzed carboxylate directed C(sp )-H bond activation and diverse functionalization is highly challenging and has gained huge attention for its versatile applications. Mono- and bidentate ligands have proven to be useful for accelerating the C(sp )-H bond activation step, which helps to control reactivity and selectivity (including enantioselectivity). In this Minireview, we discuss the recent progress made in palladium-catalyzed C(sp )-H bond functionalization reactions for the construction of C-C and C-Heteroatom bonds with the direction of free carboxylic acid.
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http://dx.doi.org/10.1002/asia.202001440DOI Listing
March 2021

Resuming eye bank services during the COVID-19 pandemic: Experience and inferences.

Indian J Ophthalmol 2021 Feb;69(2):391-394

Cornea and Refractive Surgery Services, Dr. Shroff's Charity Eye Hospital, New Delhi, India.

Purpose: The aim of this study was to formulate a methodological approach for resuming eye bank services during COVID-19 pandemic.

Methods: Eye bank operations were temporarily halted in March after the government-mandated "Lockdown" in response to COVID-19 pandemic. Before restarting eye bank operations in May, we studied sources of exposure, performed risk assessment, instituted additional process validations and redefined the Standard Operating Procedures (SOPs) in consultation with the guidelines published by the Eye bank Association of India and All India Ophthalmological Society. The eye bank staff were rigorously trained before and after operations were restarted. We conducted a survey at the end of July to gauge staff attitude and reaction.

Results: Eye banks services resumed on 20 May 2020. Since reopening till the end of July total 41 keratoplasties have been done. 91.75% of all keratoplasties done were therapeutic surgeries and 17% of the surgeries were done using glycerine preserved tissues. No staff had COVID-19 symptoms when the operations restarted and none developed symptoms up to the end of July. All eye bank staff were aware of COVID-19 pandemic and 86% said they felt safe working at the eye bank. 86% of the staff said that they received adequate training and 66% of the staff expressed that they always received proper PPE and kits. Overall, 93% of the staff expressed that the measures taken by the eye bank ensured their safety.

Conclusion: Based on our experience we suggest the following activities for planned resumption of eye bank services during the pandemic: Exposure Risk Analysis, Personal Protective Equipment usage training, SOP Revision and staff training on modified SOPs. Criteria based selection of donor sources, participatory planning involving the staff and double-checking at critical process junctions helped us in managing a smooth transition.
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http://dx.doi.org/10.4103/ijo.IJO_2617_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7933853PMC
February 2021

Mercury(II) Complexes of Anionic -Heterocyclic Carbene Ligands: Steric Effects of the Backbone Substituent.

Molecules 2020 Aug 16;25(16). Epub 2020 Aug 16.

Department of Chemistry and Biochemistry, The University of Texas at Arlington, Arlington, TX 76019, USA.

Mercury(II) complexes (Me-maloNHC)HgCl (), (-Bu-maloNHC)HgCl () and (-Bu-maloNHC)HgMe () supported by anionic -heterocyclic carbenes have been obtained in good yields from the reaction of the potassium salt of -heterocyclic carbene ligand precursors and mercury(II) salts, HgCl and MeHgI. These molecules have been characterized by H-NMR, C-NMR and IR spectroscopy and elemental analysis. X-ray crystal structures of and are also presented. Interestingly, complex is polymeric {(Me-maloNHC)HgCl} in the solid state, as a result of inter-molecular Hg-O contacts, and features rare three coordinate mercury sites with a T-shaped arrangement, whereas the (-Bu-maloNHC)HgCl () is monomeric and has a linear, two-coordinate mercury center. The formation of T-shaped structure and the aggregation of complex is attributable to the reduced steric demand of the -heterocyclic carbene ligand backbone substituent.
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http://dx.doi.org/10.3390/molecules25163741DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7464600PMC
August 2020

Intracerebral Hemorrhage and SARS-CoV-2: Association or Causation.

Ann Indian Acad Neurol 2020 May-Jun;23(3):261-264. Epub 2020 Jun 5.

Department of Neurology, AIIMS, New Delhi, India.

Background: Recent respiratory infection including SARS-CoV-2 is an independent risk factor for acute cerebrovascular disease.

Purpose: There have been reports linking haemorrhagic strokes to SARS-CoV-2 infection during this pandemic, which lead us to evaluate if SARS-CoV-2 infection could be associated with increased risk of intracerebral haemorrhage (ICH).

Methods: A retrospective observational study evaluating all stroke cases admitted in our centre in the past one month.

Results: More than half (56%) had ICH, compared to 22% last year. Two patients with ICH were SARS-CoV-2 positive and they had no or mild respiratory symptoms and had higher occurrence of renal dysfunction.

Conclusion: There could be possible association between ICH and SARS-CoV-2 infections. However, a prospective study with larger sample size is needed to elucidate the pathogenesis.
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http://dx.doi.org/10.4103/aian.AIAN_362_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7313569PMC
June 2020

Practical use of rubric for assessment of eye bank professionals for eye retrieval and its role in improving eye retrieval process in eye banks: An Indo-American experience.

Indian J Ophthalmol 2020 06;68(6):1037-1039

Manager Eye Bank, Dr. Shroff's Charity Eye Hospital, New Delhi, India.

Purpose: To study the practical use of the Rubric for Assessment of Eye Bank Professionals for Eye Retrieval (RAEPER) as a competency assessment tool by organizing a workshop in two eye banks - one in India and other in America.

Methods: Two-day workshop was conducted in two eye banks - named Shroff's Charity Eye Hospital (SCEH) in India and Miracles in Sight (MIS) in America. Day 1 of workshop comprised of didactic lectures and discussions and day 2 was eye retrieval assessment done on human eyes in a wet lab setting. Assessment was done using RAEPER by two independent senior eye bank managers.

Results: MIS had 27 participants, 15 males and 12 females (mean age: 38.8 years, range: 28-55) and SCEH had 11 participants, 10 males and 1 female (mean age: 48 years, range: 22-68). All participants were in house technicians, who had a minimal experience of at least 150 eye retrievals. At MIS, step 19 (crystalline lens check) got a score of 3 (Competent) 93.5% of the time. At SCEH, step 6 (conjunctival removal) and step 4 (Irrigation of cornea with sterile saline) were high scoring with 90.11% and 72.7% scoring 3, respectively.

Conclusion: India's cornea blind population is expected to reach 10 million by 2020. Steps need to be taken to improve cornea retrieval rates in the country and make various eye banks self-sufficient. Incorporating such training modules not only improves the cornea utilization rates, but also helps standardize the entire eye banking process.
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http://dx.doi.org/10.4103/ijo.IJO_1482_19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7508069PMC
June 2020

Steroid Responsiveness in Duchenne Muscular Dystrophy - Predictive Value of Epigenetic Regulator Histone Deacetylase 2.

Indian J Pediatr 2020 09 20;87(9):692-698. Epub 2020 Apr 20.

Department of Immunology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.

Objective: To find the role of an epigenetic regulator histone deacetylase (HDAC-2) in predicting steroid responsiveness in patients with Duchenne muscular dystrophy (DMD).

Methods: Peripheral blood mononuclear cells were isolated from three milliliters of venous blood sample of patients with DMD for estimation of HDAC-2 levels. The patients were then given prednisolone at 0.75 mg/kg/d and followed up for response. Improvement in muscle power and timed function tests were evaluated 2 monthly for 6 mo. Side- effects of steroids were also noted.

Results: HDAC-2 values showed a linear correlation with improvement in muscle power at 6 mo as reflected in direct assessment and in various functional tests. When ≥3 point change from baseline was considered in power of various muscle groups at 6 mo as cut off to distinguish good responders (GR) from poor responders (PR) of steroid, a HDAC-2 value of ≥4.40 seemed to be 92.6% sensitive and 100% specific to distinguish GRs.

Conclusions: The degree of improvement in power and various timed function tests at 6 mo could be predicted from the HDAC-2 value of the individual patient recorded at baseline. HDAC-2 levels at baseline might be a good biomarker for predicting steroid response in patients with DMD.
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http://dx.doi.org/10.1007/s12098-020-03183-5DOI Listing
September 2020

Neurocysticercosis or tuberculoma - Which one has more epileptic potential?

Seizure 2020 May 16;78:91-95. Epub 2020 Mar 16.

Department of Neurology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Raebareily Road, Lucknow, Uttar Pradesh, 226014, India. Electronic address:

Purpose: The duration of antiepileptic drug (AED) treatment in the management of seizures due to ring enhancing lesions (REL) remains a matter of debate. We undertook a prospective cohort study to look into the seizure patterns and incidence of recurrence in association with two of the most common causes of RELs after gradually stopping AEDs at least 18 months after acheiving seizure control.

Methods: Ninety patients with neurocysticercosis (NCC) and twenty-nine patients with tuberculoma were treated with anti-helminthic and anti-tubercular drugs according to current recommended guidelines, and followed up for a minimum of 2 years after the last seizure free day. In every patient included in the study, AEDs were tapered within six months of attaining a seizure-free interval of 18 months. We looked at the incidence of recurrent seizures after stopping AEDs in both groups of patients.

Results: The frequency of baseline seizures (2.1 vs 1.5 per year, p < 0.001) and number of antiepileptic drugs (2.12 vs 1.48, p < 0.001) were greater in patients with NCC than those with tuberculoma. Patients with NCC had a greater incidence of recurrent seizures (1.17 vs 0.07 in the next six months, p < 0.001) after stopping the AEDs. The median interval to seizure recurrence after stopping AEDs was 2.2 months in patients with NCC.

Conclusions: Among RELs, NCC lesions have a greater epileptogenic potential than tuberculomas. AEDs can be tapered in patients with tuberculoma after a seizure free period of 18 months with a very low risk of recurrence.
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http://dx.doi.org/10.1016/j.seizure.2020.03.007DOI Listing
May 2020

Palladium-catalyzed remote C-H functionalization of 2-aminopyrimidines.

Chem Commun (Camb) 2020 Apr 17;56(31):4284-4287. Epub 2020 Mar 17.

Department of Chemical Sciences, Indian Institute of Science Education and Research Kolkata, Mohanpur 741246, India.

A straightforward strategy was developed for the arylation and olefination at the C5-position of the N-(alkyl)pyrimidin-2-amine core with readily available aryl halides and alkenes, respectively. This approach was highly regioselective, and the transformation was achieved based on two different (Pd(ii)/Pd(iv)) and (Pd(0)/Pd(ii)) catalytic cycles.
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http://dx.doi.org/10.1039/d0cc00575dDOI Listing
April 2020

Step-Headache: A Distinct Symptom of Migraine.

J Neurosci Rural Pract 2020 Jan 27;11(1):89-94. Epub 2020 Jan 27.

Department of Medical Genetics, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.

 The diagnosis of migraine depends on various characteristics of headache with their associated constitutional symptoms such as nausea, vomiting, photophobia, and phonophobia. Relatively severe intensity, throbbing character, unilaterality, and aggravation with physical activity are the key features of migraine headache. We did this study to describe a new symptom (step-headache) in migraine in which some patients complained of uncomfortable or painful thump over the head with each footstep during walking or running.  Self-designed proforma was filled in each clinically diagnosed patient of migraine or tension-type headache in an outpatient clinic setting. The symptom designated here as step-headache was evaluated in 150 patients of migraine including 26 patients with overlapping headache and 244 patients of tension-type headache. Binary logistic regression was used for association analysis of step-headache with subgroups of migraine and with other migraine features.  Frequency distributions were expressed as numbers (percentages) or mean ± standard deviation. Binary logistic regression was used for association analysis of step-headache with subgroups of migraine and with other migraine features.  Step-headache was experienced by 97 (64.67%) migraine patients with nearly equal distribution among the two clinical subtypes (61.5% for migraine with aura and 65.3% for migraine without aura) but with high prevalence among perimenopausal onset migraine. Of all the patients who had this symptom, 77.32% experienced it during all the migraine attacks. The step-headache was differentiable from throbs of migraine and their exacerbation during physical activity by its synchrony with footsteps and its presence during nonpulsatile headaches or nonheadache phases of migraine. Sensitivity of this symptom was 64.67% while specificity was 100%.  Among primary headaches, step-headache is a less well-known but common and distinct symptom of migraine. It has good sensitivity and high specificity for migraine.
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http://dx.doi.org/10.1055/s-0039-3400197DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7055603PMC
January 2020

Boric acid catalyzed chemoselective reduction of quinolines.

Org Biomol Chem 2020 02 30;18(6):1214-1220. Epub 2020 Jan 30.

Department of Chemistry, Indian Institute of Technology Guwahati, Guwahati, 781039, Assam, India.

Boric acid promoted transfer hydrogenation of substituted quinolines to synthetically versatile 1,2,3,4-tetrahydroquinolines (1,2,3,4-THQs) was described under mild reaction conditions using a Hantzsch ester as a mild organic hydrogen source. This methodology is practical and efficient, where isolated yields are excellent and reducible functional groups are well tolerated in the N-heteroarene moiety. The reaction parameters and tentative mechanistic pathways are demonstrated by various control experiments and NMR studies. The present work can also be scaled up to obtain gram quantities and the utility of the developed process is illustrated by the transformation of 1,2,3,4-THQs into a series of biologically important molecules including the antiarrhythmic drug nicainoprol.
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http://dx.doi.org/10.1039/c9ob02673hDOI Listing
February 2020

Impact of quality assurance on utilization of corneal tissues in a community Eye Bank.

J Curr Ophthalmol 2019 Dec 2;31(4):387-393. Epub 2019 Aug 2.

Dr. Shroff's Charity Eye Hospital, New Delhi, India.

Purpose: To determine the linkage between Quality Assurance Program (QAP) and increase in utilization of donor corneas at a community Eye Bank.

Methods: A donor cornea is defined as utilized when it is used for cornea transplant. Two metrics, utilization rate (UR) and non-utilization rate (NUR), were defined. The Eye Bank implemented QAP from 2011. As a part of QAP, detailed gap analysis of tissue utilization was performed. Four major categories causing non-utilization of recovered corneas were identified. These categories were poor "Tissue Quality", "Seropositive" donor blood sample, "Medical History" of donor, and donor "Blood Sample Issues." The years 2008-2011 were labelled the pre-intervention period, and the years 2012-2017 were labelled the post-intervention period. Annual UR and annual NUR for the four categories of non-utilization from the pre and the post-intervention periods were statistically compared.

Results: In the pre-intervention period, the Eye Bank recovered 1425 donor corneas in total and transplanted 762. In the post-intervention period, the Eye Bank recovered 6661 corneas in total and transplanted 4393. The UR improved from 53.47% (762/1425) in the pre-intervention period to 65.95% (4393/6661) in the post-intervention period ( < 0.001). NUR in "Tissue Quality" category decreased from 34.32% to 29.7% from the pre to the post-intervention period ( < 0.001). NUR in "Blood Sample Issues" category reduced from 3.23% to 0.32% from the pre to the post-intervention period ( < 0.001). NUR in "Medical History" category decreased from 5.68% to 0.33% from the pre to the post-intervention period ( < 0.001).

Conclusions: The study indicates that QAP improves UR of recovered corneas. In countries with a shortage of donor corneas, increasing utilization of recovered corneas can lead to an increase in corneal transplants. Implementation of QAP at the Eye Bank can be a means of achieving this outcome.
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http://dx.doi.org/10.1016/j.joco.2019.07.001DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6896459PMC
December 2019

Cardiovascular and sudomotor dysfunction in Hirayama disease.

Acta Neurol Belg 2021 Apr 12;121(2):545-553. Epub 2019 Dec 12.

Department of Neurology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, 226014, India.

Hirayama disease is a disease of young males causing atrophy of small muscles of the affected hand and forearm. Localized autonomic dysfunction of the affected upper limb such as cold skin and excessive sweating has been described in some patients. In this study, we looked for local as well as systemic involvement of autonomic nervous system in patients with Hirayama disease. Forty-four patients with a median duration of illness of 3 years were included in the study. Assessment of symptom profile and evaluation of autonomic nervous system were done at the time of enrolment. The mean age at presentation was 21.9 (10-32) years, with a delay in seeking medical attention of around 3 (1-11) years. Localized clinical autonomic dysfunction was present in 39 (88.6%) patients, while objective generalized autonomic dysfunction was present in 33 (75%) patients. Cold skin and excessive sweating showed good correlation with the presence of objective autonomic dysfunction (P < 0.05). In three patients, sympathetic skin response (SSR) could not be recorded in one of the four limbs. Compared to controls, the SSR results in patients with Hirayama disease showed increased latency (1.64 ± 0.21 vs. 1.57 ± 0.14, P 0.04) and decreased amplitude in upper limbs (0.65 ± 0.19 vs. 0.86 ± 0.40, P 0.01). Hirayama disease has both localized and systemic dysautonomia. Careful longitudinal evaluation during the progressive phase of the disease may help in diagnosing subtle systemic autonomic dysfunction.
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http://dx.doi.org/10.1007/s13760-019-01253-wDOI Listing
April 2021

Awareness regarding eye donation among staff of a tertiary eye care hospital in North India.

Int Ophthalmol 2020 Mar 25;40(3):649-658. Epub 2019 Nov 25.

Samagra Development Associates Pvt Ltd., New Delhi, India.

Purpose: To assess the awareness, knowledge and attitude regarding eye donation in staff of a tertiary eye care hospital in North India.

Methods: A prospective, cross-sectional study was conducted on the employees of a tertiary eye care centre (urban area) along with its four secondary centres (rural area). Socio-demographic profile, awareness, knowledge and attitude of 507 employees regarding eye donation were evaluated through a pretested, self-administered questionnaire. Knowledge-based questions were scored.

Results: Of the 507 participants, 327 (64.5%) participants were from medical/paramedical field (Group 1) and 180 (35.5%) were from non-medical field (Group 2). Awareness about eye donation was 99%. Twenty (3.95%) participants scored poor (0-8), 90 (17.75%) had a fair score (9-16) and 397 (78.30%) had a good score (17-24). Good knowledge was found in significantly more (P = 0.01) participants in Group 1 (77.37%) as compared to Group 2 (70.1%). Four hundred and fifty-seven (90.13%) participants were willing to pledge their eyes for donation, the prime motivational force being spreading vision to the blind [346 (68.24%)]. The perceived reasons for not pledging were religious [28 (5.52%)], thought of family getting upset [29 (5.72%)] and scepticism regarding proper usage of tissue [64 (12.62%)].

Conclusion: The study demonstrated that although there is a substantial awareness about eye donation, there are certain lacunae in the knowledge and perceptions among staff of an eye care hospital. With the correct knowledge and attitude, they can contribute by creating awareness and motivating the people for eye donation while carrying out their routine hospital activities.
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http://dx.doi.org/10.1007/s10792-019-01225-2DOI Listing
March 2020

Cluster Headache in a Case of Ophthalmic Cysticercosis.

Neurol India 2019 Sep-Oct;67(5):1365-1366

Department of Neurology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.

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http://dx.doi.org/10.4103/0028-3886.271258DOI Listing
June 2020

Antibody Negative Autoimmune Encephalitis- Does it Differ from Definite One?

Ann Indian Acad Neurol 2019 Oct-Dec;22(4):401-408. Epub 2019 Oct 25.

Department of Neurology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Raebareli Road, Lucknow, Uttar Pradesh, India.

Context: Autoimmune encephalitis (AE) is an emerging cause of non-infective encephalitis, presentations of which vary widely. Traditionally the diagnosis of AE is based on detection of antibodies in a patient with clinical picture suggestive of AE.

Aim: To evaluate the clinical characteristics and response to immunotherapy in patients with antibody negative autoimmune encephalitis and to compare them with definite cases.

Settings And Design: A prospective follow-up study was done in patients presenting with presumptive symptoms of AE from January 2017 to January 2019. The study was done in a tertiary care institute of Northern India.

Patients And Methods: Demographic and clinical parameters were noted and relevant investigations for management were done according to well-defined protocol. The patients were treated with immunomodulatory therapy in the form of steroids and/or intravenous immunoglobulins (IVIg). They were followed up for treatment response and relapse at 2 monthly intervals.

Statistical Analysis Used: The data was expressed as either proportions or mean/median. Chi-square test/Independent T test was used to compare antibody positive and antibody negative group.

Results: Out of 31 patients with presumptive AE, 16 patients tested positive for autoimmune antibodies (definite AE). Incidences of seizure, behavioral abnormalities, dementia and altered sensorium were similar between the 2 groups ( > 0.05). Complete or partial response was seen in all treated patients in both groups with no significant difference ( 0.716). CSF protein concentration and cellularity were higher in the definite group although only high protein concentration could reach statistical significance ( 0.002). Malignancy could be confirmed after extensive search in 2 out of 16 patients with definite AE and in 1 out of 15 antibody negative AE patients.

Conclusions: Clinical presentation of antibody negative cases does not differ significantly from definite ones. Since treatment response is also similar in both the groups, starting immunotherapy in a patient presenting with presumptive symptoms of AE, while ruling out other common mimickers, seems to be the need of the hour in the management of this evolving entity.
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http://dx.doi.org/10.4103/aian.AIAN_206_19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6839299PMC
October 2019

Eye donation in north India: Trends, awareness, influences and barriers.

Indian J Ophthalmol 2019 10;67(10):1570-1574

Cornea, Cataract and Refractive Surgery, Dr. Shroff's Charity Eye Hospital, New Delhi, India.

Purpose: To understand trends, awareness, influences and barriers to eye donation in Indian society.

Methods: This cross sectional study was conducted in Delhi from March 2017 to February 2018. About 10 hospitals collaborated with the Eye Bank under Human Cornea Retrieval Program (HCRP). Eye Bank recruited Eye Donation Counselors (EDCs) to approach family members of the deceased. A pretested questionnaire was used for this study. Irrespective of whether the next of kin of the deceased consented for eye donation or not, the option of participating in the survey was given.

Results: Out of 473 potential donors identified, 407 (86%) next of kin consented to participate in the study. Of these, 388 (95.3%) were males and 19 (4.7%) were females. About 168 (41%) consented for eye donation and were assigned to donor group, while 239 (59%) participants refused eye donation and were assigned to non-donor group. Majority of the participants were siblings 170 (41.8%) of the deceased and the mean age of the deceased was 42.71 ± 17.56 years. The foremost concern before decision-making was transparency in how the cornea would be used (32.25%). The concern with regards to whether the body would remain intact after eye donation significantly decreased the probability of consent for eye donation.

Conclusion: The study highlights that barriers to eye donation in India are not cultural or religious but more due to misinformation and proper utilization of the donated tissue. This study also emphasizes the pivotal role of EDC's in facilitating the eye donation movement.
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http://dx.doi.org/10.4103/ijo.IJO_2151_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6786220PMC
October 2019

Intravenous Steroid Days and Predictors of Early Oral Steroid Administration in Tuberculous Meningitis: A Retrospective Study.

Am J Trop Med Hyg 2019 11;101(5):1083-1086

Department of Biostatistics, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.

Intravenous (IV) dexamethasone is recommended for 14 days in stage 1 and 28 days in stage 2/3 tuberculous meningitis (TBM). We used a different steroid protocol. We shifted TBM patients to oral steroids after 48 hours of sustained improvement on IV steroids (oral group). Patients who worsened after shifting to oral steroids were reinitiated on IV steroids. Once they showed a consistent improvement for 48 hours, the IV steroids were overlapped with oral steroids for 7-10 days to taper off IV steroids (overlap group). We compared total IV steroid days in our patients with the recommended treatment and identified predictors that favored the oral group. This was a retrospective study. We included 98 patients with TBM (66 in the overlap group and 32 in the oral group) from January 2013 to July 2018. The median IV steroid days were 9 days (interquartile range of 4-12; 2-3.5 days in the oral group and 10-11.5 days in the overlap group). The mortality rate was 6.1%. The logistic regression model showed that TBM patients with basal exudate, tuberculoma, and modified Rankin scale (mRS) < 3 had a higher probability for going to the oral group. We conclude that total IV steroid days can be reduced in TBM patients by our method of steroid use. Presence of basal exudates and tuberculoma may favor early shifting from IV to oral steroid, whereas higher mRS may require a relatively longer course of IV steroid.
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http://dx.doi.org/10.4269/ajtmh.19-0416DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6838556PMC
November 2019
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