Publications by authors named "Renu Bala"

32 Publications

Estradiol correlates with the accumulation of Monocytic Myeloid-Derived Suppressor Cells in Pre-term birth: A possible explanation of immune suppression in pre-term babies.

J Reprod Immunol 2021 Jul 19;147:103350. Epub 2021 Jul 19.

Department of Molecular and Human Genetics, Institute of Science, Banaras Hindu University, Varanasi, 221005, India. Electronic address:

Synergistic interplay of immune endocrine interaction is prerequisite for an effective maternal fetal tolerance. Pre-term birth (PTB) may be a consequence of altered immune-endocrine crosstalk during third trimester resulting in early breakdown of this tolerance. Myeloid derived suppressor cells (MDSCs), a heterogenous population of immature immune cells are increased in pregnant women and healthy newborns, but their role in PTB still remains obscure. We now report that granulocytic MDSCs (G-MDSCs) is decreased in women delivering prematurely, suggesting their potential role in maintaining maternal fetal tolerance. Interestingly, in contrast statistically significant increase in MDSCs and monocytic MDSCs (M-MDSCs) along with positive correlation with cord serum estradiol (E2), and overexpressed ER-α in placental tissue suggested E2 mediated accumulation of M-MDSCs in PTB babies. MDSCs mediated immune suppression is accompanied with subsequent decline in total T cells and its subtypes: Th and Tc in PTB babies, which signifies their potential contribution towards the impaired immune system of PTB babies.
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http://dx.doi.org/10.1016/j.jri.2021.103350DOI Listing
July 2021

Hyperhomocysteinemia and low vitamin B12 are associated with the risk of early pregnancy loss: A clinical study and meta-analyses.

Nutr Res 2021 07 24;91:57-66. Epub 2021 May 24.

Department of Molecular and Human Genetics, Banaras Hindu University, Varanasi 221005, Uttar Pradesh, India. Electronic address:

One-carbon metabolism is crucial for the maintenance of healthy pregnancy and alterations in this pathway have been associated with various pregnancy-related complications. Therefore, the present study was conducted to test the hypothesis that the altered folic acid, vitamin B12 and homocysteine levels are associated with the risk of early pregnancy loss (EPL). Plasma folic acid, vitamin B12 and homocysteine levels were analyzed in 83 females with EPL and 70 healthy pregnant females in their first trimester. Further, meta-analyses of folic acid, vitamin B12 and homocysteine were also performed involving various eligible studies. Results from our case-control study and meta-analysis showed that folic acid deficiency is not associated with the risk of EPL. On the other hand, low vitamin B12 and hyperhomocysteinemia were individually found to be significant risk factors for EPL in the present study (P < .01, P < .05, respectively) and meta-analysis as well (P < .001, P < .05, respectively). Vitamin B12 deficiency in combination with hyperhomocysteinemia was a more serious risk factor for EPL (Odds Ratio = 4.98, P = 0.002). Therefore, we conclude that vitamin B12 deficiency and elevated homocysteine levels are independent risk factors for EPL, and of higher risk when combined. The assessment of vitamin B12 and homocysteine levels may serve as a good screening marker for EPL risk.
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http://dx.doi.org/10.1016/j.nutres.2021.05.002DOI Listing
July 2021

IGF-1 supplementation in semen affects mitochondrial functional and calcium status of buffalo sperm following cryopreservation.

Anim Reprod Sci 2021 Aug 29;231:106783. Epub 2021 May 29.

ICAR-Central Institute for Research on Buffaloes, Hisar, Haryana, 125001, India.

This study was designed to examine the effects of seminal insulin-like growth factor-1 (IGF-1) supplementation on structural and functional properties of buffalo sperm post cryopreservation. Semen ejaculates from buffalo bulls (n = 6) were proportioned into four aliquots and diluted with egg yolk-based extender. Prior to equilibration, IGF-1 was added to extender as four treatments: group IGF0 (no supplementation), IGF150 (150 ng/mL), IGF250 (250 ng/mL) and IGF350 (350 ng/mL). The extended semen was transferred into 0.25 mL mini-straws, equilibrated (4 °C at 4 h), and cryopreserved. Total sperm motility was greater (P < 0.05) when there was the IGF150 treatment compared with values for other groups. Furthermore, with the IGF150 treatment there was the least and greatest (P < 0.05) mitochondrial superoxide status and membrane potential, respectively. Similarly, with the IGF150 treatment there was a greater (P < 0.05) sperm membrane integrity with a lesser (P < 0.05) calcium status compared to values for the other groups. In conclusion, seminal IGF-1 supplementation affects the structural and functional properties of buffalo sperm following cryopreservation.
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http://dx.doi.org/10.1016/j.anireprosci.2021.106783DOI Listing
August 2021

Comparison of Expression of Chemokine Receptor 4 in Maternal Decidua and Chorionic Villi in Women with Spontaneous Miscarriages and Women Opting for Termination of Viable Pregnancies.

J Hum Reprod Sci 2021 Jan-Mar;14(1):68-72. Epub 2021 Mar 30.

Department of Molecular and Human Genetics, Banaras Hindu University, Varanasi, Uttar Pradesh, India.

Background: Early pregnancy losses can be a distressing experience both for the parents and the treating clinician. We aim to explore the role of chemokine receptor 4 (CXCR4) in early pregnancy losses by comparing its expression among patients with spontaneous miscarriages and patients undergoing termination of viable pregnancies for unwanted pregnancies.

Aim: The aim of the study was to investigate the expression of CXCR4 in early pregnancy losses and correlate the various clinical parameters with differential expression of the above receptor in the chorionic villi and maternal decidua.

Study And Setting: The present study is a case-"control study done in a tertiary care center.

Methodology: Fifty patients attending outdoor and antenatal clinic of the hospital aged 18-40 years with spontaneous miscarriage under 20 weeks of gestational age were included as cases and compared with fifty females of comparable age group (18-40 years) seeking medical termination of pregnancy as controls. Chorionic villi and decidua obtained from the cases and controls were analyzed for CXCR4 expression.

Statistical Analysis: The results were analyzed using mean ± standard deviation, percentiles values, Chi-square test, and value to determine the association of CXCR4 expression in decidua and chorionic villi of cases versus controls.

Results: CXCR4 expression was significantly downregulated in cases as compared to the controls with < 0.001. The mean normalized ratio of CXCR4 expression to housekeeping gene (β Actin) expression in the case group was 1.607 ± 1.108 and in the control group, it was 2.506 ± 1.457. There was a strong correlation between the expression of CXCR4 and maternal age. With increasing age, the expression of CXCR4 was more downregulated in both the cases and control groups ( < 0.001). The expression of CXCR4 was elevated in controls as compared to cases in <30 years age group ( = 0.009). CXCR4 expression was higher in primigravida than in multigravida ( = 0.001), and as the number of previous miscarriages increased, the expression of CXCR4 was found to be decreased ( = 0.021).

Conclusion: CXCR4 expression is significantly reduced in women with spontaneous miscarriages in comparison with viable pregnancies. and possibly, therapies targeted at increasing the expression of CXCR4 can be used as a treatment modality for management of spontaneous miscarriages.
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http://dx.doi.org/10.4103/jhrs.JHRS_64_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8057149PMC
March 2021

Is addition or removal of seminal plasma able to compensate for the dilution effect of buffalo semen?

Andrologia 2021 Sep 30;53(8):e14123. Epub 2021 May 30.

Animal Physiology and Reproduction Division, ICAR-Central Institute for Research on Buffaloes, Hisar, India.

The present study aimed to compensate dilution effect using additional seminal plasma (SP) in conventional (80 million (M) spermatozoa/ml) dose and low spermatozoa/dose (8M spermatozoa/ml). We also attempted to confirm whether removal of SP before the extension of ejaculates affects post-thaw sperm quality of buffalo semen. For this, semen ejaculates (N = 15) were divided into four groups: control (CON), removal of SP by centrifugation (NSP), resuspension of the centrifuged semen pellet into SP (CEN) and extra supplementation of SP (ESP). All groups were diluted into two different semen doses to 20 and 2M spermatozoa/0.25 ml using tris egg yolk extender and subsequently cryopreserved. We found that neither addition nor removal of SP affected sperm motility, kinematics, longevity, mitochondrial superoxide production and high mitochondrial membrane potential (MMP). Further, the addition or removal of SP was not able to compensate dilution effect in 2M groups resulting in a significantly (p < .05) reduction in sperm motility, kinematics, sperm longevity, membrane integrity, MMP, and an increase production of mitochondrial superoxide. In conclusion, it appears that role of SP in the sperm cryopreservation process is insignificant.
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http://dx.doi.org/10.1111/and.14123DOI Listing
September 2021

An Observational Study in Manipur State, India on Preventive Behavior Influenced by Social Media During the COVID-19 Pandemic Mediated by Cyberchondria and Information Overload.

J Prev Med Public Health 2021 Jan 1;54(1):22-30. Epub 2020 Dec 1.

Regional Research Institute for Homoeopathy, Imphal, India.

Objectives: The coronavirus disease 2019 (COVID-19) pandemic is a public health emergency posing unprecedented challenges for health authorities. Social media may serve as an effective platform to disseminate health-related information. This study aimed to assess the extent of social media use, its impact on preventive behavior, and negative health effects such as cyberchondria and information overload.

Methods: A cross-sectional observational study was conducted between June 10, 2020 and August 9, 2020 among people visiting the outpatient department of the authors' institution, and participants were also recruited during field visits for an awareness drive. Questions were developed on preventive behavior, and the Short Cyberchondria Scale and instruments dealing with information overload and perceived vulnerability were used.

Results: The study recruited 767 participants with a mean age of about 45 years. Most of the participants (>90%) engaged in preventive behaviors, which were influenced by the extent of information received through social media platforms (β=3.297; p<0.001) and awareness of infection when a family member tested positive (β=29.082; p<0.001) or a neighbor tested positive (β=27.964; p<0.001). The majority (63.0%) of individuals often searched for COVID-19 related news on social media platforms. The mean±standard deviation scores for cyberchondria and information overload were 9.09±4.05 and 8.69±2.56, respectively. Significant and moderately strong correlations were found between cyberchondria, information overload, and perceived vulnerability to COVID-19.

Conclusions: This study provides evidence that the use of social media as an information- seeking platform altered preventive behavior. However, excessive and misleading information resulted in cyberchondria and information overload.
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http://dx.doi.org/10.3961/jpmph.20.465DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7939751PMC
January 2021

Self care practices and psychological distress among diabetic patients in Manipur during COVID-19: A scenario from the North East.

Diabetes Metab Syndr 2021 Jan-Feb;15(1):93-98. Epub 2020 Dec 7.

Regional Research Institute for Homoeopathy, (Under Central Council for Research in Homoeopathy, New Delhi), New Checkon, Opposite Tribal Colony, Imphal East, Manipur, 795001, India.

Background And Aim: Uncontrolled diabetes has emerged as one of the major risk factors for mortality in patients with coronavirus disease (COVID-19). Physical inactivity, alterations in dietary habits, and inability to seek guidance from the physician are some of the contributing factors. This study aims to assess the self-care practices and psychological distress during the pandemic among diabetic patients visiting the institute's out patient department.

Method: A convenient sampling method was used to recruit subjects from a representative clinical sample using validated scales like the Summary of Diabetes Self-Care Activities (SDSCA) and Kessler Psychological Distress Scale (K10).

Result: The study enrolled a total of 108 subjects with the mean age being 56.3 years. The everyday healthy eating plan was followed by 76.85% (N = 83) subjects and daily physical activity for at least 30 min performed by 50% (54) subjects. Only 12.04% (13) subjects tested their blood sugar and 6.48% (7) respondents checked their feet daily. There was no significant difference found between the SDSCA and psychological distress based on socio-demographic variables.

Conclusion: Participants in this study typically reported a good level of self-care behavior particularly for diet followed by exercise whereas the self-care behavior was not adequate for foot care and blood-glucose testing. People were not too anxious about COVID-19. This study highlighted the fact that people with diabetes should monitor their blood sugar levels more often along with their foot care.
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http://dx.doi.org/10.1016/j.dsx.2020.12.015DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7720010PMC
March 2021

Environment, Lifestyle, and Female Infertility.

Reprod Sci 2021 03 3;28(3):617-638. Epub 2020 Aug 3.

Department of Molecular & Human Genetics, Banaras Hindu University, Varanasi, UP, 221005, India.

Lifestyle factors, which include the practices we adopt in our daily life, have a significant role in shaping our overall health. These lifestyle choices are mainly centered on personal preferences and our surrounding social environment. In addition to lifestyle factors, we continuously interact with our environment, which impacts physiology. Several factors have been claimed to affect women's fertility; lifestyle-related factors, in particular, have received great attention in the last decade. Due to societal and professional pressure, childbearing age in women has gradually shifted to the 30s. Delayed age of childbearing along with modern lifestyle offers a wider window of opportunity for various lifestyle and genetic perturbations to penetrate to affect fertility. While clinical studies have strengthened a direct correlation between lifestyle, environment, and female reproductive health; experimental studies on animal models have investigated their mechanism of action. In most instances, these factors target the neuroendocrine pathways, resulting in metabolic derangements. This review aims to dissect the plausible interconnection of lifestyle and environmental factors with various neuroendocrine pathways and to discuss how it can affect the female physiology in the long-term, resulting in reproductive incompetence.
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http://dx.doi.org/10.1007/s43032-020-00279-3DOI Listing
March 2021

Impact of socio-demographic variables on antenatal services in eastern Uttar Pradesh, India.

Health Care Women Int 2021 23;42(4-6):580-597. Epub 2020 Jul 23.

Department of Molecular & Human Genetics, Banaras Hindu University, Varanasi, India.

We investigated the impact of socio-demographic variables on antenatal care (ANC) utilization and the low birth weight of a child. Data were collected from 300 pregnant females. Only 22.5% of females received full antenatal care (≥4 visits). Our results showed that female's age at marriage and education plays a significant role in improving ANC. We observed an overall decrease in the utilization of services provided during each antenatal visit. ANC visits from the first trimester decrease the risk of having a baby with low birth weight. Awareness programs and educating families about pregnancy care are recommended to improve ANC utilization.
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http://dx.doi.org/10.1080/07399332.2020.1789643DOI Listing
July 2020

'Semen dilution effect' on sperm variables and conception rate in buffalo.

Anim Reprod Sci 2020 Mar 28;214:106304. Epub 2020 Jan 28.

Animal Physiology and Reproduction Division, ICAR-Central Institute for Research on Buffaloes, Hisar, 125001, Haryana, India.

The study aim was to determine how to minimize effects of buffalo semen dilution by evaluating the use of egg yolk (EY), low-density lipoprotein (LDL), and OptiXcell (OC) extenders. Ejaculates (n = 18 from six bulls) were divided into three aliquots that were diluted separately with EY, LDL, and OC extenders corresponding to 20 million (M), 12 M, and 2 M sperm/dose, respectively, and cryopreserved. There were a lesser sperm motility, plasma membrane integrity, and percentage un-capacitated sperm with the 2 M sperm/dose, however, the LDL extender was more effective than OC and EY extender for cryopreservation of buffalo sperm. Excess semen dilution resulted in sustained sperm velocities (curvilinear velocity, average path velocity, and straight linear velocity), and these were greater with use of the OC than LDL and EY extenders. There was no change in amplitude of sperm lateral head displacement (ALH) with respect to dilution, but with regard to extender effects, ALH was greater in sperm extended in LDL and OC than EY. Semen dilution to 2 M sperm/dose resulted in a greater mitochondrial superoxide production. Conception rate (CR) was unaffected with 20 and 12, however, with the 2 M sperm/dose dilutions there was a lesser CR. In conclusion, buffalo semen dilution to the extent of 12 M sperm/dose did not affect most of the seminal variables and CR. Using LDL extender at 2 M sperm/dose protected sperm from the 'semen dilution effect' to a greater extent than with use of EY and OC extenders.
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http://dx.doi.org/10.1016/j.anireprosci.2020.106304DOI Listing
March 2020

Intraoperative Dexmedetomidine Maintains Hemodynamic Stability and Hastens Postoperative Recovery in Patients Undergoing Transsphenoidal Pituitary Surgery.

J Neurosci Rural Pract 2019 Oct 11;10(4):599-605. Epub 2019 Dec 11.

Department of Anesthesia, King Fahad Medical City, Riyadh, Saudi Arabia.

Transsphenoidal resection of pituitary tumors is the neurosurgical procedure of choice to excise most of the tumors of the sellar/suprasellar region. The main goals of anesthesia are maintenance of hemodynamic stability, provision of conditions that facilitate good surgical exposure, and a prompt and smooth emergence to allow neurological and visual assessment. Dexmedetomidine (Dex), a selective α-2 agonist, is known to maintain cardiovascular stability and anxiolysis and provide pain relief. Therefore, we hypothesized that intraoperative Dex will attenuate hemodynamic response to nasal speculum (NS) insertion, decrease analgesic requirement, and hasten postoperative recovery. This prospective, randomized, double-blind, placebo-controlled study was conducted in 60 adult patients of either sex, American Society of Anesthesiologists status I or II undergoing elective pituitary surgery for excision of pituitary adenoma. Randomization was done into two groups; Group D ( = 30) received Dex bolus 1 μg/kg over 10 minutes, followed by 0.5 μg/kg/h, and group control Group C ( = 30) received normal saline (0.9%) in a similar manner. A standard anesthesia technique comprising fentanyl, propofol, rocuronium, sevoflurane, nitrous oxide, and oxygen was used. Intraoperative monitoring was uniform and standardized in all the patients; cardiovascular perturbations, if any, were noted and managed appropriately. After completion of surgery, tracheal extubation was performed, and emergence time, extubation time, modified Aldrete score, sedation, pain, time for first analgesic, nausea, vomiting, and shivering were recorded. In both the groups, an increase in heart rate and blood pressure occurred at the time of laryngoscopy and intubation, NS insertion, and extubation, but it was more in Group C ( < 0.05). In Group D, intraoperative requirement of analgesic, neuromuscular relaxant, and inhalational anesthetic was lesser compared with Group C. Emergence time as well as visual analog scale at emergence was less in Group D. Intraoperative Dex infusion is a reasonable choice in patients undergoing transsphenoidal pituitary surgery.
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http://dx.doi.org/10.1055/s-0039-3399402DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6906115PMC
October 2019

Atypical presentation of thyroid storm: a diagnostic dilemma.

BMJ Case Rep 2019 Aug 26;12(8). Epub 2019 Aug 26.

Critical and Intensive Care, All India Institute of Medical Sciences, New Delhi, India.

Thyroid storm (accelerated hyperthyroidism) is an uncommon life-threatening emergency. The diagnosis is difficult and at times delayed owing to atypical presentation. Early diagnosis is the key to its successful management. We came across a patient who had presentations of acute abdomen but later diagnosed in thyroid storm. Multiorgan involvement leads all resuscitative measures futile and prevented us to salvage the patient.
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http://dx.doi.org/10.1136/bcr-2019-231090DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6721697PMC
August 2019

Duplications in 19p13.3 are associated with male infertility.

J Assist Reprod Genet 2019 Oct 16;36(10):2171-2179. Epub 2019 Aug 16.

Department of Molecular & Human Genetics, Banaras Hindu University, Varanasi, 221005, India.

Purpose: To identify genomic imbalances and candidate loci in idiopathic male infertility.

Methods: Affymetrix CytoScan 750K Array was used to analyze genomic imbalances and candidate loci in 34 idiopathic infertile cases of different phenotypes (hypo-spermatogenesis, n = 8; maturation arrest, n = 7; and Sertoli cell-only syndrome, n = 13, severe oligozoospermia, n = 6, and 10 normozoospermic fertile men). Ten ethnically matched controls were screened for comparison.

Results: The cytogenetic array analysis detected a genomic gain at the 19p13.3 region in 9 (26.47%) cases, with the highest frequency in patients with Sertoli cell-only syndrome (SCOS) (38%). Its complete absence in the control group suggests its likely pathogenic nature. In addition to Y-classical, micro, and partial deletions, the duplication in 19p13.3 could serve as a unique biomarker for evaluation of infertility risk. The common region across the individuals harboring the duplication identified STK11, ATP5D, MIDN, CIRBP, and EFNA2 genes which make them strong candidates for further investigations. The largest duplicated region identified in this study displayed a major network of 7 genes, viz., CIRBP, FSTL3, GPX4, GAMT, KISS1R, STK11, and PCSK4, associated with reproductive system development and function. The role of chance was ruled out by screening of ethnically matched controls.

Conclusion: The result clearly indicates the significance of 19p13.3 duplication in infertile men with severe testicular phenotypes. The present study underlines the utility and significance of whole genomic analysis in the cases of male infertility which goes undiagnosed due to limitations in the conventional cytogenetic techniques and for identifying genes that are essential for spermatogenesis.
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http://dx.doi.org/10.1007/s10815-019-01547-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6823329PMC
October 2019

A study to evaluate effect of PEEP and end-tidal carbon dioxide on optic nerve sheath diameter.

Indian J Anaesth 2019 Jul;63(7):537-543

Department of Anaesthesiology and Critical Care, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India.

Background And Aims: PEEP is commonly used to improve postoperative respiratory outcomes in surgical and ICU patients. It is thought to increase ICP by impending CSF outflow and cerebral venous drainage. Hyperventilation is used to decrease ICP in patients having intracranial hypertension. We investigated the effect of various levels of PEEP and EtCO on ONSD as an indirect predictor of ICP in patients undergoing surgery under GA.

Methods: After induction, different levels of PEEP and EtCO were applied to 50 patients. Sonographic ONSD was measured 5 minutes after stabilization of each new setting. Haemodynamic parameters like pulse, SpO, BP were also recorded. Quantitative variables were expressed as Mean ± SD and compared across between follow-ups using paired -test. Qualitative variables were expressed in number and percentage.

Results: Baseline ONSD was 0.44 ± 0.06 cm. It increased significantly to 0.45 ± 0.07 cm, 0.47 ± 0.07 cm and 0.49 ± 0.07 cm after applying PEEP of 8, 12 and 15 cm HO PEEP, respectively. It significantly decreased to 0.42 ± 0.06 cm, 0.41 ± 0.06 cm and 0.40 ± 0.06 cm after hyperventilation, EtCO range 35-37, 32-34 and 29-31 mm Hg. Results were statistically significant but clinically not significant.

Conclusion: We conclude that there are acute and dynamic alterations in ONSD in response to hyperventilation and presence of PEEP in anaesthetised patients. Ocular sonography may be used as a reliable indicator of acute variations in ICP.
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http://dx.doi.org/10.4103/ija.IJA_861_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6644203PMC
July 2019

Comparative Evaluation of Pregabalin and Clonidine as Preemptive Analgesics for the Attenuation of Postoperative Pain Following Thoracolumbar Spine Surgery.

Asian Spine J 2019 Dec 30;13(6):967-975. Epub 2019 Jul 30.

Department of Orthopaedics, Pt. Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, India.

Study Design: Prospective, randomized, double blind, placebo-controlled study.

Purpose: To compare clonidine and pregabalin with placebo for the attenuation of postoperative pain after thoracolumbar spinal surgery and instrumentation.

Overview Of Literature: Spine surgery is associated with moderate to severe postoperative pain that needs to be controlled to improve patient's outcome. Alpha 2 agonists (e.g., clonidine) and gabapentenoids (e.g., pregabalin) are successfully used as part of a multimodal analgesic regimen.

Methods: Total 75 patients were enrolled and randomly allocated into three groups. Group P received pregabalin (150 mg), group C received clonidine (150 mcg), and group N received placebo 90 minutes preoperatively. A standard anesthesia protocol comprising fentanyl, thiopentone, vecuronium, nitrous oxide, and oxygen in isoflurane was used for all patients. Postoperative recovery profile, pain, time for first analgesic, 24-hour analgesic requirement, sedation, and hemodynamic parameters were noted.

Results: Recovery profile was similar in all three groups; however, the patients in group P and C were more sedated (p<0.05). Group N patients had a higher Visual Analog Scale (VAS) score (p<0.05) and the time for first analgesic was also lower (p=0.02). Postoperative (24-hour) analgesic requirement was maximum in group N, followed by that in group C and group P. The VAS score was highest in the control group; however, after 12 hours, it was similar in all groups.

Conclusions: Postoperative pain and analgesic requirement is significantly attenuated by preoperative administration of a single dose of clonidine (150 mcg) or pregabalin (150 mg); pregabalin was more effective. Thus, their use offers a reasonable strategy for pain management in patients undergoing spine surgery.
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http://dx.doi.org/10.31616/asj.2019.0031DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6894979PMC
December 2019

Correction to: Study of biological and thermo-chemical pretreatment of organic fraction of municipal solid waste for enhanced biogas yield.

Environ Sci Pollut Res Int 2020 08;27(22):27305-27306

Department of Chemical Engineering and Technology, Indian, Institute of Technology (Banaras Hindu University), Varanasi, Uttar Pradesh, 221005, India.

The original publication of this paper contains an error.
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http://dx.doi.org/10.1007/s11356-019-05933-1DOI Listing
August 2020

Study of biological and thermo-chemical pretreatment of organic fraction of municipal solid waste for enhanced biogas yield.

Environ Sci Pollut Res Int 2020 Aug 28;27(22):27293-27304. Epub 2019 Jun 28.

Department of Chemical Engineering and Technology, Indian Institute of Technology (Banaras Hindu University), Varanasi, Uttar Pradesh, 221005, India.

Biogas production from organic fraction of municipal solid waste (OFMSW) not only helps in solid waste management but also combat the food vs fuel dilemma. The presence of lignocellulosic material and other complex compounds in OFMSW hinder biogas production. Therefore, pretreatment is an essential step to increase the hydrolysis rate by converting complex compounds to simpler ones. This work was aimed at effective pretreatment of OFMSW by biological and thermo-chemical means. For biological pretreatment lignin degrading fungal strains, Phanerochaete chrysosporium and Pleurotus ostreatus were employed. Thermo-chemical treatment resulted in higher solubilisation yield in terms of sCOD and VFA making it a more effective method as compared with biological pretreatment. The optimisation of thermo-chemical pretreatment was done by the Box-Behnken design of response surface methodology (RSM). The interactive effect of influencing factors NaOH dose, temperature and time were studied on the response of sCOD, VFA and phenolic content. The sCOD and VFA values were significantly increased by increasing the NaOH concentration, temperature and time to a certain limit. The optimised condition from RSM for maximum solubilisation yield in terms of sCOD, VFA and phenolic content was found to be NaOH dose of 4.72 g/L, temperature 180 °C and time 30.3 min. Biogas production was increased by 169.5% after pretreatment at RSM optimised conditions as compared with untreated OFMSW.
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http://dx.doi.org/10.1007/s11356-019-05695-wDOI Listing
August 2020

Pretreatment optimisation and kinetics of batch anaerobic digestion of liquidised OFMSW treated with NaOH: Models verification with experimental data.

J Environ Manage 2019 May 25;237:313-321. Epub 2019 Feb 25.

Department of Chemical Engineering and Technology, Indian Institute of Technology (Banaras Hindu University), Varanasi, 221005, Uttar Pradesh, India. Electronic address:

The enormous generation of municipal solid waste (MSW) due to increased urbanization is causing threat to the environment. MSW is a mixed waste and it comprises of organic fraction as the key fraction called organic fraction of municipal solid waste (OFMSW) along with other fractions. The pretreatment of OFMSW is necessary step to increase the biogas yield. In the present work, NaOH hydrolysis of mechanically liquidised OFMSW was carried out to reduce its complexity and improve the biogas production. Furthermore, hydrolysis parameters were optimised by RSM model for NaOH pretreatment. Optimised conditions achieved from RSM analysis were 0.46 N NaOH loading, 72 h reaction time and 36.05 °C operating temperature. The RSM predicted values of response sCOD and VFA at optimum condition were in good agreement with experimental data signifying the model adequacy. The kinetic of batch anaerobic digestion of OFMSW treated with NaOH at different concentrations and optimised condition had been studied to see the suitability of first order model and modified Gompartz model. The experimental results obtained were best fitted using normalized root mean square error analysis. Biogas production after pretreatment at 0.1, 0.5, 0.9 N NaOH concentration and RSM optimised condition was 369.24, 435.24, 327.84 and 465.67 NL/kg VS, respectively.
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http://dx.doi.org/10.1016/j.jenvman.2019.02.083DOI Listing
May 2019

Venous Air Embolism During Endoscopic Third Ventriculostomy.

Asian J Neurosurg 2018 Apr-Jun;13(2):431-432

Department of Neuroanaesthesia, C N Center, AIIMS, New Delhi, India.

Neuroendoscopic procedures are increasingly performed nowadays due to the significant technological improvement of endoscopic instrumentation. It carries various advantages such as speed, simplicity, avoidance of implants, and no brain dissection or retraction. Although considered to be safe, it is associated with a host of complications. We hereby report a case of venous air embolism in an infant who was undergoing endoscopic third ventriculostomy. The complication occurred at the completion of surgery when surgeons were withdrawing the endoscope. The successful management of this uncommon event is being discussed.
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http://dx.doi.org/10.4103/1793-5482.185072DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5898123PMC
April 2018

Should end-tidal carbon dioxide monitoring be mandatory for surgeries under spinal anaesthesia?

Indian J Anaesth 2018 Feb;62(2):147-148

Department of Anaesthesiology, PGIMS, Rohtak, Haryana, India.

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http://dx.doi.org/10.4103/ija.IJA_630_17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5827485PMC
February 2018

Airway obstruction following cervical spine surgery: A diagnostic dilemma.

J Anaesthesiol Clin Pharmacol 2017 Apr-Jun;33(2):266-267

Department of Anaesthesia, PGIMS, Rohtak, Haryana, India.

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http://dx.doi.org/10.4103/joacp.JOACP_33_16DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5520610PMC
August 2017

Ultrasonographic measurement of optic nerve sheath diameter: A point of care test helps in prognostication of Intensive Care Unit patients.

Indian J Anaesth 2017 Mar;61(3):262-265

Department of Anaesthesiology, Pt. B.D. Sharma, PGIMS, Rohtak, Haryana, India.

Early identification of elevated intracranial pressure (ICP) is critical to ensuring timely and appropriate management to improve patient outcome. Measurement of the optic nerve sheath diameter by ultrasound is a well studied modality for noninvasive assessment of ICP. Recent studies have shown it to correlate with invasively measured ICP. We utilized this technique in our ICU and found it to be of great help in guiding patient management and predicting the prognosis. A case series of four patients is reported illustrating its utility in ICU patients.
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http://dx.doi.org/10.4103/ija.IJA_473_16DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5372409PMC
March 2017

Prevalence, Specificity and Titration of Red Cell Alloantibodies in Multiparous Antenatal Females at a Tertiary Care Centre from North India.

Indian J Hematol Blood Transfus 2016 Sep 29;32(3):307-11. Epub 2015 Sep 29.

Department of Transfusion Medicine, Government Medical College, Jammu, Jammu and Kashmir India.

Screening and detection of clinically significant antibodies among antenatal women plays an important role in transfusion safety and preventing hemolytic disease of fetus and newborn. Routine screening of antenatal women for antibodies is not done in all blood centres of our country and so immunization rates are not known in pregnant women. We studied the prevalence of alloantibodies and titration of Anti D among antenatal multiparous women in Jammu region. In present prospective study, 750 antenatal multiparous women attending antenatal clinics were typed for ABO and D antigens. Alloantibody screening was done, if positive, specificity of alloantibody was ascertained by using commercially available red cell panel by tube method. Rate of alloimmunization was correlated with Rh D status, gravida, previous transfusion history and bad obstetric history. Titration of alloantibody D was done in first and third trimester of pregnancy. In present study most common blood group detected was B positive (38.4 %). Rh D negative cases constituted 7.6 % of total cases. Rate of alloimmunization was 2 %. A significant correlation was seen between Rh D-negative and alloimmunization (21 % in D-negative and 0.45 % in D-positive). There is significant increasing degree of alloimmunization with increase in Gravida. Alloimmunization in females with bad obstetric history was high (4.41 %) as compared to females with no bad obstetric history showing only 1.76 %. Alloantibodies detected were Anti-D, Anti-E, Anti-C and Anti-K. Anti-D constituted 80 % of all alloantibodies detected. Six women in their third trimester had raised titers of anti-D. Most common alloantibody detected was anti-D (80 %). Alloantibodies to other Rh antigens and Kell blood group systems were also identified. To minimize alloimmunization in Rh D negative women, proper Anti D immunoprophylaxis should be implemented.
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http://dx.doi.org/10.1007/s12288-015-0593-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4930762PMC
September 2016

Intralesional Ethanol Injection in Lumbar Hemangioma Leading to Renal Failure: A Rare Complication.

J Neurosurg Anesthesiol 2017 07;29(3):374-375

*Department of Anaesthesiology & Critical Care, Pt BDS PGIMS, Rohtak Haryana †Department of Neuroanaesthesia, CN Center, AIIMS, New Delhi, India.

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http://dx.doi.org/10.1097/ANA.0000000000000328DOI Listing
July 2017

How Ultrasonographic Measurement of Optic Nerve Sheath Diameter (ONSD) Aids in Diagnosis of Cerebrovascular Accident in a Patient on Ventilator?

J Neurosurg Anesthesiol 2017 07;29(3):364-365

Department of Anaesthesiology & Critical Care, Pt BD Sharma PGIMS Rohtak, Haryana.

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http://dx.doi.org/10.1097/ANA.0000000000000299DOI Listing
July 2017

High arch palate: A bane for ProSeal laryngeal mask airway but a boon for I-gel.

J Anaesthesiol Clin Pharmacol 2015 Oct-Dec;31(4):568

Department of Neuroanaesthesiology, Neurosciences Centre, All India Institute of Medical Sciences, New Delhi, India.

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http://dx.doi.org/10.4103/0970-9185.169098DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4676256PMC
December 2015

An unusual presentation of deltamethrin poisoning.

Indian J Crit Care Med 2015 Jul;19(7):435-7

Department of Anaesthesiology and Critical Care, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, UHS, Rohtak, Haryana, India.

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http://dx.doi.org/10.4103/0972-5229.160305DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4502505PMC
July 2015

Anesthetic management in children with Hurler's syndrome undergoing emergency ventriculoperitoneal shunt surgery.

Saudi J Anaesth 2012 Apr;6(2):178-80

Department of Neuroanaesthesiology, All India Institute of Medical Sciences (A.I.I.M.S.), New Delhi, India.

Mucopolysaccharidoses (MPSs) are a group of lysosomal storage disorder characterized by progressive multiorgan accumulation of glycosaminoglycans. Patients with MPS I (Hurler's syndrome) present as one of the most difficult airway problems to be managed by anesthesiologists. Hydrocephalus with increased intracranial pressure is a frequent complication seen in these patients. The rarity of the syndrome accounts for the small number of case reports and anecdotal information on the intracranial manifestations of this syndrome. We describe the successful anesthetic management of 2 children with Hurler's syndrome who underwent ventriculoperitoneal shunt surgery for acute hydrocephalus.
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http://dx.doi.org/10.4103/1658-354X.97036DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3385265PMC
April 2012

Exchange and correlation effects on density excitation spectra of metallic quantum wires at finite temperature.

J Phys Condens Matter 2012 Jun 18;24(24):245302. Epub 2012 May 18.

Centre for Advanced Study in Physics, Panjab University, Chandigarh, India.

We have studied the effect of exchange and correlations on the density excitation spectra of metallic quantum wires at finite temperature. The correlations are treated by incorporating the first-order self and exchange contributions into the random-phase approximation (RPA). Numerical results are presented for the spectra of the density response function and the plasmon dispersion for the gold wire on Si(557) substrate-a system studied recently by Nagao et al. (2006 Phys. Rev. Lett. 97 116802) for plasmons using electron energy loss spectroscopy. Our results for plasmons are found to agree with the experimental data. Though the first-order correction is small at currently accessible wire parameters, it becomes significant with increasing coupling parameter r(s). The effect of temperature on plasmons is found to be small for the wire system investigated experimentally. However, temperature has a significant effect on the spectra of the response function. We have also calculated the static structure factor, the pair-correlation function and the correlation energy at zero temperature in the first-order theory to check its applicability in dealing with correlations. Results are compared directly with the available Monte Carlo simulation data. It is found that the static correlation functions improve significantly over the RPA with the increase of r(s). On the other hand, the correlation energy shows very good agreement for r(s) ≤ 5 and wire widths b ≥ a(0). For smaller b, the agreement is good up to relatively smaller r(s).
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http://dx.doi.org/10.1088/0953-8984/24/24/245302DOI Listing
June 2012

An unusual case of sciatic neuropraxia due to melorheostosis.

Joint Bone Spine 2010 Dec 1;77(6):614-5. Epub 2010 Jul 1.

Department of Orthopaedics, Paraplegia and Rehabilitation, Pt. BD Sharma Post Graduate Institute of Medical Sciences, H. No. 19/11J, Medical Campus, PGIMS, 124001 Rohtak, Haryana, India.

Melorrheostosis is a rare osteosclerotic bone dysplasia of obscure etiology. The typical radiographic features are flowing candle wax, sub-periosteal bone and streaky endosteal bone formation in diaphyseal and epiphyseal area with sclerotomal pattern mainly involving appendicular skeleton. It is rarely associated with nerve palsies. The authors report a case of melorrheostotic mass causing sciatic neuropraxia and to the best of their knowledge it is the first case reported in the English language literature.
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http://dx.doi.org/10.1016/j.jbspin.2010.04.006DOI Listing
December 2010
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