Publications by authors named "Sandeep Gupta"

386 Publications

Changes to Pediatric Gastroenterology Practice during the COVID-19 Pandemic and Lessons Learned: An International Survey of Division and Group Heads.

Gastroenterology 2021 Mar 3. Epub 2021 Mar 3.

Division of Gastroenterology, Hepatology and Nutrition and the Research and Learning Institutes, The Hospital for Sick Children, Department of Paediatrics and the Wilson Centre, University of Toronto, Toronto, Ontario, Canada. Electronic address:

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http://dx.doi.org/10.1053/j.gastro.2021.02.064DOI Listing
March 2021

Derivation of dorsal spinal sensory interneurons from human pluripotent stem cells.

STAR Protoc 2021 Mar 3;2(1):100319. Epub 2021 Feb 3.

Department of Neurobiology, University of California Los Angeles, Los Angeles, CA 90095, USA.

We describe two differentiation protocols to derive sensory spinal interneurons (INs) from human embryonic stem cells (hESCs) and induced pluripotent stem cells (iPSCs). In protocol 1, we use retinoic acid (RA) to induce pain, itch, and heat mediating dI4/dI6 interneurons, and in protocol 2, RA with bone morphogenetic protein 4 (RA+BMP4) is used to induce proprioceptive dI1s and mechanosensory dI3s in hPSC cultures. These protocols provide an important step toward developing therapies for regaining sensation in spinal cord injury patients. For complete details on the use and execution of this protocol, please refer to Gupta et al. (2018).
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http://dx.doi.org/10.1016/j.xpro.2021.100319DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7890043PMC
March 2021

Clinical Practice Survey of Repeat Endoscopy in Pediatric Inflammatory Bowel Disease in North America.

J Pediatr Gastroenterol Nutr 2021 Feb 24. Epub 2021 Feb 24.

Division of Pediatric Gastroenterology, Hepatology and Nutrition, UH/Rainbow Babies and Children's Hospital, Cleveland, OH Division of Pediatric Gastroenterology, Dayton Children's Hospital, Dayton, OH Wakemed Pediatric Gastroenterology, Raleigh, NC D. Brent Polk Division of Gastroenterology, Hepatology and Nutrition, Vanderbilt University School of Medicine, Nashville, TN University Hospitals Clinical Research Center, Cleveland, OH Pediatric Gastroenterology, Indiana University; and Community Health Network, Indianapolis IN Division of Pediatric Gastroenterology, Columbia University Medical Center, New York, NY Stanford Children's Health, Stanford University, Palo Alto, CA.

Objectives: Endoscopic remission has become a standard treatment target in inflammatory bowel disease (IBD). It is unclear how widely this practice has been adopted amongst pediatric gastroenterology providers. This study determines the frequency of repeat endoscopy in pediatric IBD and evaluates for predictive baseline characteristics of providers.

Methods: We developed a cross-sectional survey which was distributed via three national email listservs to pediatric gastroenterology providers. We obtained baseline characteristics of respondents and assessed motivations and barriers for the practice of repeat endoscopy compared to none.

Results: 238 unique respondents completed the online survey. Response rate was 11% (238 of 2300 possible participants). The majority practice in an academic setting (77%) and reported participation in ImproveCareNow (63%). Overall, 65% of respondents perform repeat endoscopy to assess for endoscopic remission in pediatric IBD as part of routine clinical practice. 56% reported repeat endoscopy as individuals in the absence of a departmental protocol. "Symptoms are not sufficient to follow IBD patients" was reported by 82% of those who repeat endoscopy; conversely, "I perform endoscopy based on clinical, biomarker, and/or imaging trends" was reported by 81% of those who do not repeat endoscopy. The establishment of a pediatric-specific guideline was most commonly reported to change current practice, based on rank-order scoring.

Conclusion: A majority of representative providers repeat endoscopy to assess for endoscopic remission in pediatric IBD. Fewer years in practice favored repeating endoscopy. The need for North American pediatric guidelines with pediatric-specific evidence to support the long term benefits of endoscopic remission are highlighted in this study.
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http://dx.doi.org/10.1097/MPG.0000000000003100DOI Listing
February 2021

A double-blind, randomized, placebo-controlled trial on the effect of Ashwagandha (Withania somnifera dunal.) root extract in improving cardiorespiratory endurance and recovery in healthy athletic adults.

J Ethnopharmacol 2021 Feb 15;272:113929. Epub 2021 Feb 15.

Rajajipuram, Lucknow, 226017, Uttar Pradesh, India.

Ethnopharmacological Relevance: Ashwagandha is a reputed herb in traditional Ayurveda, used for various ailments and improving general well-being. Improved cardiorespiratory endurance can aid in attaining better physiological, metabolic, and functional abilities in humans. According to Ayurveda, Ashwagandha has such potential to improve human health.

Aim Of The Study: This study aimed to evaluate the efficacy and safety of Ashwagandha root extract in enhancing cardiorespiratory endurance in healthy athletic adults.

Materials And Methods: Fifty healthy athletic adults were selected randomly and equally allocated to Ashwagandha and placebo groups. The Ashwagandha group received 300 mg of Ashwagandha root extract capsules, twice daily, for 8-weeks. Cardiorespiratory endurance was assessed by measuring the maximum aerobic capacity (VO2 max). Estimation of stress management was done through Total Quality Recovery Scores (TQR), Recovery-Stress Questionnaire for Athletes (RESTQ), and Daily Analysis of Life Demands for Athletes (DALDA) questionnaires along with the antioxidant level measurement.

Results: At the end of the study, a statistically significant improvement in VO2 max outcome was observed in the Ashwagandha group when compared to the placebo group (P = 0.0074). The subjects in the Ashwagandha group also displayed a statistically significant increase at the end of the study when compared to the baseline (P < 0.0001). Significantly improved TQR scores were observed in the Ashwagandha group members compared to their placebo counterparts (P < 0.0001). DALDA questionnaire analysis in the Ashwagandha group was found statistically significant (P < 0.0001) compared to the placebo group. RESTQ assessment also yielded better outcomes, especially for fatigue recovery (P < 0.0001), lack of energy (P < 0.0001), and fitness analysis (P < 0.0001). The enhanced antioxidant level was significant (P < 0.0001) in the Ashwagandha group.

Conclusion: The present findings suggest that Ashwagandha root extract can successfully enhance cardiorespiratory endurance and improve the quality of life in healthy athletic adults. No adverse events were reported by any of the subjects in this study.
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http://dx.doi.org/10.1016/j.jep.2021.113929DOI Listing
February 2021

Assessment of various endodontic instrumentation systems on the amount of apically extruded bacteria - An study.

J Conserv Dent 2020 May-Jun;23(3):270-274. Epub 2020 Dec 4.

Department of Oral and Maxillofacial Surgery, Dr. Harvansh Singh Judge Institute of Dental Sciences and Hospital, Chandigarh, India.

Aim: The objective of this study was to assess the effect of different endodontic instrumentation systems on the amount of apically extruded bacteria.

Materials And Methods: One hundred and twenty freshly extracted human mandibular premolars with single canal were collected. Endodontic access cavities were prepared and then contaminated with an suspension (ATCC 29212). After incubation at 37°C for 24 h, the root canals were instrumented with K flare files, F360 Single file system, K3XF files, Heroshaper files, Protaper Next files, and Hyflex EDM Single file system. During instrumentation, apically extruded bacteria were collected in the vials containing 0.9% NaCl. Samples were taken from the vials and incubated in brain-heart infusion agar medium for 24 h.

Statistical Analysis: The number of colony-forming units was determined, and data were statistically analyzed using one-way analysis of variance and Tukey test.

Conclusions: Both rotary and hand instrumentation systems extruded intracanal bacteria through the apical foramen, Group 1 (Hand K Flare files) showed maximum, whereas, Group 5 (Protaper Next) and Group 6 (Hyflex EDM) showed the least extrusion.
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http://dx.doi.org/10.4103/JCD.JCD_298_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7861082PMC
December 2020

Recombinase polymerase amplification assay combined with a dipstick-readout for rapid detection of Mycoplasma ovipneumoniae infections.

PLoS One 2021 4;16(2):e0246573. Epub 2021 Feb 4.

Animal Health, AgResearch, Hopkirk Research Institute, Grasslands Research Centre, Palmerston North, New Zealand.

Mycoplasma ovipneumoniae infects both sheep and goats causing pneumonia resulting in considerable economic losses worldwide. Current diagnosis methods such as bacteriological culture, serology, and PCR are time consuming and require sophisticated laboratory setups. Here we report the development of two rapid, specific and sensitive assays; an isothermal DNA amplification using recombinase polymerase amplification (RPA) and a real-time PCR for the detection of M. ovipneumoniae. The target for both assays is a specific region of gene WP_069098309.1, which encodes a hypothetical protein and is conserved in the genome sequences of ten publicly available M. ovipneumoniae strains. The RPA assay performed well at 39°C for 20 min and was combined with a lateral flow dipstick (RPA-LFD) for easy visualization of the amplicons. The detection limit of the RPA-LFD assay was nine genome copies of M. ovipneumoniae per reaction and was comparable to sensitivity of the real-time PCR assay. Both assays showed no cross-reaction with 38 other ovine and caprine pathogenic microorganisms and two parasites of ruminants, demonstrating a high degree of specificity. The assays were validated using bronchoalveolar lavage fluid and nasal swab samples collected from sheep. The positive rate of RPA-LFD (97.4%) was higher than the real-time PCR (95.8%) with DNA as a template purified from the clinical samples. The RPA assay was significantly better at detecting M. ovipneumoniae in clinical samples compared to the real-time PCR when DNA extraction was omitted (50% and 34.4% positive rate for RPA-LFD and real-time PCR respectively). The RPA-LFD developed here allows easy and rapid detection of M. ovipneumoniae infection without DNA extraction, suggesting its potential as a point-of-care test for field settings.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0246573PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7861559PMC
February 2021

Gastrointestinal Food Allergies and Intolerances.

Gastroenterol Clin North Am 2021 Mar;50(1):41-57

Community Health Network, 6626 E 75th Street, Suite 400, Indianapolis, IN 46250, USA; Section of Pediatric Gastroenterology, Hepatology, Nutrition, Riley Hospital for Children at IU Health, Indiana University School of Medicine, ROC 4210, 705 Riley Hospital Drive, Indianapolis, IN 46202, USA. Electronic address:

Adverse reactions to food include immune-mediated food allergies, celiac disease, and nonimmune-mediated food intolerances. Differentiating between these many disorders is important to guide us toward appropriate testing and management. Double-blind placebo-controlled food challenges are the gold standard for food allergy diagnosis but are difficult and time-consuming. In place of this, strong clinical history, other supportive tests, and oral food challenges are helpful. Some commonly available tests for food allergy and intolerances lack sufficient evidence for efficacy. Food intolerance diagnosis is largely based on history and supported by symptom improvement with appropriate dietary manipulation.
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http://dx.doi.org/10.1016/j.gtc.2020.10.006DOI Listing
March 2021

Severe Enteritis as the Sole Manifestation of Novel Coronavirus Disease 2019 (COVID-19) in Adolescent Patients.

Case Rep Infect Dis 2020 23;2020:8823622. Epub 2020 Dec 23.

Pediatric Infectious Diseases, Department of Pediatrics, St. Joseph's Children's Hospital, 703 Main Street, Paterson, New Jersey 07503, USA.

Enteritis as the only manifestation of novel coronavirus disease 2019 (COVID-19) in adolescents without features of multisystem inflammatory syndrome in children (MIS-C) or a prior history of inflammatory bowel disease (IBD) has not been described. We report two adolescent patients (a 14-year-old male and a 20-year-old pregnant female) presenting to tertiary-care centers in the United States with severe enteritis as the only manifestation of COVID-19 caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The patients were hospitalized with acute abdominal pain and gastrointestinal (GI) bleeding, with no evidence of MIS-C, and were previously healthy with no history of IBD. The patients' nasopharyngeal swabs were positive for SARS-CoV-2 infection by reverse transcription polymerase chain reaction (RT-PCR), and testing for other infectious etiologies was negative. Both patients received intravenous corticosteroids and recovered without short-term complications. None of the patients died. This report highlights the need for keeping a high index of suspicion for SARS-CoV-2 infection in adolescents presenting solely with gastrointestinal manifestations, in the absence of respiratory symptoms or multisystem involvement, for prompt recognition and timely management.
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http://dx.doi.org/10.1155/2020/8823622DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7771253PMC
December 2020

Type 2 Immunity and Age Modify Gene Expression of COVID19 Receptors in Eosinophilic Gastrointestinal Disorders.

J Pediatr Gastroenterol Nutr 2020 Dec 23;Publish Ahead of Print. Epub 2020 Dec 23.

Department of Bioengineering, Department of Pediatrics, University of California Division of Allergy, Immunology, Department of Pediatrics, University of California, San Diego, Rady Children's Hospital, San Diego Division of Allergy, Immunology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati Division of Gastroenterology and Hepatology, Scripps Clinic Department of Pediatrics, Division of Gastroenterology, Children's Hospital of Philadelphia Center for Esophageal Diseases and Swallowing, Division of Gastroenterology and Hepatology, University of North Carolina School of Medicine, Chapel Hill, NC Division of Gastroenterology, Department of Medicine, Feinberg School of Medicine, Northwestern University, Division of Gastroenterology, Indiana University School of Medicine, Riley Hospital for Children ????? Digestive Health Institute, Section of Pediatric Gastroenterology, Hepatology and Nutrition, Children's Hospital Colorado, Gastrointestinal Eosinophilic Disease Program, Mucosal Inflammation Program, University of Colorado School of Medicine, Aurora, CO Division of Allergy, Immunology, Department of Medicine, University of California, San Diego Appendix 1.

Abstract: Infection with SARS-CoV-2 can lead to COVID-19. The gastrointestinal tract is now an appreciated portal of infection. SARS-CoV-2 enters host cells via angiotensin converting enzyme-2 (ACE2) and the serine protease TMPRSS2. Eosinophilic gastrointestinal disorders are inflammatory conditions caused by chronic type 2 (T2) inflammation. However, the effects of the T2 atopic inflammatory milieu on SARS-COV-2 viral entry gene expression in the GI tract is poorly understood. We analyzed tissue ACE2 and TMPRSS2 gene expression in pediatric eosinophilic esophagitis (EoE), eosinophilic gastritis (EG) and in normal adult esophagi using publicly available RNA sequencing datasets. Similar to findings evaluating the airway, there was no difference in tissue ACE2/TMPRSS2 expression in EoE or EG when compared to control non-EoE/EG esophagus/stomach. ACE2 gene expression was significantly lower in esophagi from children with or without EoE and from adults with EoE as compared to normal adult esophagi. Type 2 immunity and pediatric age could be protective for infection by SARS-CoV-2 in the gastrointestinal tract due to decreased expression of ACE2.
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http://dx.doi.org/10.1097/MPG.0000000000003032DOI Listing
December 2020

Self-assembled particulate vaccine elicits strong immune responses and reduces Mycobacterium avium subsp. paratuberculosis infection in mice.

Sci Rep 2020 12 18;10(1):22289. Epub 2020 Dec 18.

Grasslands Research Centre, AgResearch, Hopkirk Research Institute, Private Bag 11008, Palmerston North, 4442, New Zealand.

Mycobacterium avium subspecies paratuberculosis (MAP) causes chronic progressive granulomatous enteritis leading to diarrhoea, weight loss, and eventual death in ruminants. Commercially available vaccines provide only partial protection against MAP infection and can compromise the use of bovine tuberculosis diagnostic tests. Here, we report the development of a protein-particle-based vaccine containing MAP antigens Ag85A-SOD-Ag85B-74F as a fusion ('MAP fusion protein particle'). The fusion antigen displayed on protein particles was identified using mass spectrometry. Surface exposure and accessibility of the fusion antigen was confirmed by flow cytometry and ELISA. The MAP fusion protein particle vaccine induced strong antigen-specific T-cell immune responses in mice, as indicated by increased cytokine (IFN-γ and IL-17A) and costimulatory signals (CD40 and CD86) in these animals. Following MAP-challenge, a significant reduction in bacterial burden was observed in multiple organs of the mice vaccinated with the MAP fusion protein particle vaccine compared with the PBS group. The reduction in severity of MAP infection conferred by the MAP fusion protein particle vaccine was similar to that of Silirum and recombinant protein vaccines. Overall, the results provide evidence that MAP antigens can be engineered as a protein particulate vaccine capable of inducing immunity against MAP infection. This utility offers an attractive platform for production of low-cost particulate vaccines against other intracellular pathogens.
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http://dx.doi.org/10.1038/s41598-020-79407-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7749150PMC
December 2020

Safety of Ashwagandha Root Extract: A Randomized, Placebo-Controlled, study in Healthy Volunteers.

Complement Ther Med 2020 Dec 15;57:102642. Epub 2020 Dec 15.

M V Hospital and Research Centre, 314/30 Mirza Mandi, Post Office, Chowk, Lucknow, 226003, Uttar Pradesh, India. Electronic address:

Background: Ashwagandha (Withania somnifera) is a well-established and reputed herb in Ayurvedic medicine. It has been used as a "Rasayana" (rejuvenator), nootropic, and as a powerful natural adaptogen. The herb extract is extensively used for general wellbeing and in specific ailments. However, only a few studies have investigated the safety and tolerability of Ashwagandha in humans. This study evaluated the safety of Ashwagandha root extract consumption in healthy adults.

Methods: In this randomized, double-blind, placebo-controlled, and parallel-group study, 80 healthy participants (40 males, 40 females) were randomized in a 1:1 ratio to receive either Ashwagandha 300 mg or a placebo of the same dosage, twice daily, orally for 8 weeks. The study was conducted at MV Hospital, and King George Medical University, Lucknow, India. The primary safety outcomes considered were laboratory assessment of hematological parameters, serum biochemistry analysis including hepatotoxicity evaluation, and thyroid function parameters. The secondary outcomes of this study were the clinical adverse events and the vital parameters. The within and between the groups' datasets were compared using the Wilcoxon signed-rank test and the Mann Whitney U test, respectively.

Results: A detailed evaluation of the vital signs such as body weight, body temperature, pulse rate, respiratory rate, systolic and diastolic blood pressure, and Body Mass Index (BMI) were conducted for each participant at the baseline and the end of the study for treatment and placebo groups. Similarly, hematological and biochemical parameters were evaluated at the baseline and at the end of study. The outcome did not indicate any untoward effects in any of the treated volunteers. No statistically significant change or abnormality was observed in the considered parameters including thyroid hormonal profile in both the groups. No adverse events were reported by any of the participants in this study.

Conclusions: Ashwagandha is being consumed since time immemorial following the Ayurvedic medicine practices. Modern science requires evidence of the safety and efficacy of the Ashwagandha extract before mass consumption for various health issues and as a supplement. The present study revealed that the consumption of Ashwagandha root extract for 8 weeks was safe in both males and females volunteers. However, long term study and varying dosage ranges should be investigated in the future.
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http://dx.doi.org/10.1016/j.ctim.2020.102642DOI Listing
December 2020

The World is One Family.

Authors:
Sandeep K Gupta

J Pediatr Gastroenterol Nutr 2021 Jan;72(1)

Academic Affairs/Community Health Network, Indianapolis, IN; and Section of Pediatric Gastroenterology, Hepatology, Nutrition, Riley Hospital for Children/Indiana University School of Medicine, Indianapolis, IN.

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http://dx.doi.org/10.1097/MPG.0000000000002989DOI Listing
January 2021

Complete mitogenome of Ganges river dolphin, Platanista gangetica gangetica and its phylogenetic relationship with other cetaceans.

Mol Biol Rep 2021 Jan 9;48(1):315-322. Epub 2020 Dec 9.

Wildlife Institute of India, Chandrabani, Dehradun, Uttarakhand, 248 001, India.

The Ganges river dolphin, Platanista gangetica gangetica is one of the endangered cetaceans. Due to increasing anthropogenic activities, it has faced a significant reduction in distribution range since the late 1800s and has even gone extinct from most of the early localities. The investigation of complete mitogenome holds significant relevance for identifying evolutionary relationships and monitoring the endangered species. Herein, we report and characterize for the first time the 16,319 bp complete mitochondrial genome of P. g. gangetica. It comprises 13 protein-coding genes, 22 transfer RNA (tRNA) genes, two ribosomal RNA genes, and one control region (CR). The genome composition was A + T biased (59.6%) and exhibited a positive AT-skew (0.104) and negative GC-skew (- 0.384). All the genes were encoded on the heavy strand, except eight tRNAs and the ND6 gene. In the CR, an 18 bp tandem repeat sequence was observed. Our Bayesian Inference (BI) and Maximum Likelihood (ML) based phylogenetic analysis indicated that studied river dolphins were polyphyletic and the placement of Platanista was to be more basal than other river dolphins (Lipotes, Inia and Pontoporia). The pairwise genetic distance of Platanista with other cetaceans was varied, with an overall close affinity with whales. The model-based BI and ML phylogenetic analysis indicated that Platanista clustering with Ziphiidae with high to moderate supportive values (PP/BP = 98/68). The results of this study provide insights important for the conservation genetics and further evolutionary studies of the freshwater river dolphins.
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http://dx.doi.org/10.1007/s11033-020-06048-4DOI Listing
January 2021

Molecular investigation of three leopards death: A case of suspicious revenge killing.

Forensic Sci Int Genet 2021 Mar 12;51:102425. Epub 2020 Nov 12.

Wildlife Institute of India, Dehra Dun, India.

We report a case study wherein we established the putative cause of the death of three leopards by identifying the species and number of individual prey species from the gut contents using molecular tools. In a National Park within Northern part of India, the suspicious death of three leopards (Panthera pardus) was reported from different localities on the same day. The gut contents from the three leopard carcasses were collected during postmortem and sent to us to confirm the prey species. We used mitochondrial DNA cytochrome b (Cyt b) and control region (CR), and nuclear microsatellites for molecular identification of species and individual identification, respectively, from the gut contents. Mitochondrial sequences confirmed that the undigested remnants collected from the gut contents were of the domestic dog (Canis lupus familiaris). Furthermore, the microsatellite analysis of the gut contents highlighted the consumption of the same dog by all the three deceased leopards. Since the National Park was one of the major human-wildlife interaction zones, consuming the same dog by the leopards implies suspicious poisoning for revenge. The use of dog carcass for the possible poisoning for the mass-scale killing of the protected species is a severe wildlife offense.
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http://dx.doi.org/10.1016/j.fsigen.2020.102425DOI Listing
March 2021

Complete mitogenome of Kashmir musk deer (Moschus cupreus) and its comparative phylogenetic relationships.

Mol Biol Rep 2020 Dec 20;47(12):9757-9763. Epub 2020 Nov 20.

Wildlife Institute of India, Chandrabani, Dehra Dun, U.K., 248 001, India.

Kashmir musk deer, Moschus cupreus (KMD) is one the most threatened species endemic to the Himalayan region of Kashmir, Pakistan and Afghanistan. Herein, we have sequenced, annotated and characterized the complete mitogenome of M. cupreus. The investigation and comparison of the mitogenome provide crucial information for phylogenetic analysis to understand the evolutionary relationships. The mitogenome of KMD was 16,354 bp long, comprising 13 protein-coding genes (PCGs), 22 transfer RNA genes (tRNAs), two ribosomal RNA genes (rRNAs) and non-coding control region. Its composition was highly A+T biased 68.42%, and exhibited a positive AT-skew (0.082) and negative GC-skew (- 0.307). The phylogenetic analysis suggested that KMD was a primitive and extant species in the genus Moschus, whereas Alpine musk deer (M. chrysogaster) and Himalayan musk deer (M. leucogaster) were the closest relatives. It indicated the placement of M. cupreus within the monotypic family Moschidae of musk deer. Hence, it provides a better understanding of lineage identification and musk deer evolution for further research.
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http://dx.doi.org/10.1007/s11033-020-06002-4DOI Listing
December 2020

A Randomized Study Comparing the Efficacy of Ultrasound Guided Lumbar Plexus Block and Epidural Anesthesia for Postoperative Analgesia in Patients Undergoing Total Hip Replacement.

Asian J Anesthesiol 2020 Nov 3. Epub 2020 Nov 3.

Department of Orthopaedics, Government Medical College and Hospital, Chandigarh, India.

Background: Patients undergoing total hip replacement (THR) experience severe postoperative pain. The advantage of pain relief by continuous epidural anesthesia (CEA) is offset by various adverse effects. Ultrasound guided (USG) continuous lumbar plexus block (LPB) has emerged as an alternative approach for postoperative analgesia in patients undergoing THR, especially where epidural is difficult or contraindicated.

Methods: This randomized controlled trial compared USG-LPB with CEA for postoperative pain relief until 48 hours in patients undergoing THR, with 0.5% ropivacaine (15 mL) used as boluses for both CEA and LPB.

Results: The mean time to the first bolus was 380.60 ± 77.66 min in the LPB group whereas it was 307.40 ± 83.60 min in the epidural group (P = 0.002). Thus, patients in the LPB group took more than one hour longer than the epidural group to take their first bolus, which is clinically meaningful besides being statistically significant. The pain score on movement was also significantly lower, and patient satisfaction higher, in the LPB group. There were no significant intergroup differences about motor power, pain at rest, total ropivacaine consumption, and adverse effects.

Conclusion: USG-LPB is an effective alternative to CEA combined with general anesthesia for postoperative analgesia after THR.
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http://dx.doi.org/10.6859/aja.202010/PP.0002DOI Listing
November 2020

A Multicentre, Multinational, Open-Label, 52-Week Extension Study of Gemigliptin (LC15-0444) Monotherapy in Patients with Type 2 Diabetes Mellitus.

Diabetes Metab J 2020 Sep 9. Epub 2020 Sep 9.

Department of Endocrinology, Korea University Guro Hospital, Seoul, Korea.

The purpose of this extension study was to assess the long-term efficacy and safety of gemigliptin 50 mg in patients with type 2 diabetes mellitus (T2DM). Patients with T2DM who had completed the initial 24-week study comparing gemigliptin monotherapy with placebo were eligible to enrol. In the open-label, 28-week extension study, all enrolled patients received gemigliptin, regardless of the treatment received during the initial 24-week study period. The mean reduction±standard deviation (SD) in glycosylated hemoglobin (HbA1c) observed after 24 weeks of treatment (-0.6%±1.1%) was further decreased for the gemi-gemi group and the mean change in HbA1c at week 52 from baseline was -0.9%±1.2% (P<0.0001). For the pbo-gemi group, HbA1c decreased after they were switched to gemigliptin, and the mean change in HbA1c at week 52 from baseline was -0.7%±1.2% (P<0.0001). Furthermore, the overall incidence of adverse events demonstrated that gemigliptin was safe and well tolerated up to 52 weeks.
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http://dx.doi.org/10.4093/dmj.2020.0047DOI Listing
September 2020

Molecular and morphometric divergence of four species of butterflies (Nymphalidae and Pieridae) from the Western Himalaya, India.

Mol Biol Rep 2020 Nov 18;47(11):8687-8699. Epub 2020 Oct 18.

Wildlife Institute of India, Chandrabani, Dehradun, Uttarakhand, India.

Morphometric and molecular divergence among four butterfly species of the families Nymphalidae and Pieridae from the western Himalaya region were investigated using molecular tools, traditional morphometric measures and a truss network system. The considered species were Danaus chrysippus, Vanessa cardui, Pieris brassicae and Pieris canidia. Traditional taxonomy is sometimes unable to discriminate cryptic species or species that have close morphological features. Although taxonomists carefully examine external body features to differentiate the species; however, there is a risk for misidentification during a visual assessment of cryptic species. Therefore, we aimed to use the truss network system of 14 morphological landmarks interconnected to yield 90 variables about molecular taxonomy. Principal component analysis (PCA), discriminant function analysis (DFA) and cluster analysis (CA) were employed to determine morphometric variations. In the traditional analysis, 79, 68, 16 and 5 characters out of 90 were found significant (p < 0.05) for D. chrysippus, V. cardui, P. brassicae and P. canidia, respectively. One to seven principal components were extracted through PCA; they explained 87.5-100% of the total variance in samples. Notably, DFA correctly classified 100% of the original grouped cases and 100% of the cross-validated grouped cases. However, the variations were not the same for the two different methods (truss and traditional) employed for the analysis. We correctly identified all the species; the interspecies sequence divergence was between 0.1034 and 0.1398, and the intra-species sequence divergence range was 0.0001 to 0.0128 using the Cytochrome c oxidase subunit-I (COI) gene. The present study provides useful information about the application and complementary role of traditional with truss morphometric analysis for the precise identification and classification of the selected species.
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http://dx.doi.org/10.1007/s11033-020-05913-6DOI Listing
November 2020

Management and outcomes of patients hospitalized with severe COVID-19 at a tertiary care center in midwestern United States.

Monaldi Arch Chest Dis 2020 Oct 8;90(4). Epub 2020 Oct 8.

Division of Pulmonary, Critical Care and Sleep Medicine, Unity Point Health at St. Luke's Regional Medical Center, Sioux City, IA.

Knowledge of treatment regimens and outcomes for novel coronavirus disease 2019 (COVID-19) is evolving. Recent studies have reported mortality rates ranging from 39-50% among hospitalized patients with COVID-19. We report our experience ofmanagement and outcomes of hospitalized patients with COVID-19 at a large tertiary-care center in Midwestern United States. Of 658 patients presenting to our tertiary care center, 217 needed hospitalization, majority (77%) of whom were severely sick requiring admission to the intensive care unit (ICU). All received corticosteroids, and 78% of the patients received tocilizumab. More than two-thirds of the patients received anticoagulation and 80% of patients in the ICU had prone-positioning. The median duration of hospitalization was 12 days (interquartile range, 8 to16), median duration of intensive care unit stay was 7 days (interquartile range, 5 to 9) and requirement of mechanical ventilation was 6 days (interquartile range, 5 to 8) in our cohort. Of the 217 patients, 27 died (12% mortality). The majority of our patients received corticosteroids, tocilizumab, anticoagulation and prone positioning. While higher mortality rates of >30% have been reported in various studies among hospitalized patients with COVID-19, the majority of hospitalized patients in our cohort survived with a low mortality rate. The majority of our patients received corticosteroids, tocilizumab, anticoagulation and prone positioning. While higher mortality rates of >30% have been reported in various studies among hospitalized patients with COVID-19, the majority of hospitalized patients in our cohort survived with a low mortality rate.
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http://dx.doi.org/10.4081/monaldi.2020.1592DOI Listing
October 2020

Identification of anuran species diversity of the Panna Tiger Reserve, Central India, using an integrated approach.

Zootaxa 2020 Sep 11;4851(3):zootaxa.4851.3.2. Epub 2020 Sep 11.

Wildlife Institute of India, P. O. Box 18, Chandrabani-248001, Uttarakhand, India.

We present a comprehensive inventory of amphibians from Panna Tiger Reserve in Madhya Pradesh based on morphological, molecular and bioacoustic data. Representatives of 15 anuran species were collected, corresponding to roughly four fifths of the known amphibian species of Madhya Pradesh. The main results of this study are: (1) Description of advertisement calls of eleven species, including the first-time description of advertisement calls of Sphaerotheca pashchima. (2) Identification of cryptic species using acoustic and molecular techniques. (3) Five new significant range extensions and new state records. (4) Description of geographical variation in call properties in three anuran species. This study also provides morphological descriptions with ecological and natural history notes for each species that may be useful in management planning for amphibian conservation in Panna Tiger Reserve.
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http://dx.doi.org/10.11646/zootaxa.4851.3.2DOI Listing
September 2020

Enhancing the barrier height for Yb(III) single-ion magnets by modulating axial ligand fields.

Chem Commun (Camb) 2020 Oct;56(79):11879-11882

Department of Chemistry, Indian Institute of Technology Bombay, Mumbai-400076, India.

The effect of systematic modification of the axial ligand field X on Ueff values in Yb(iii)-based SIMs, [Yb(Ph3PO)4X2]X' (X, X' = NO3 (1), OTf (2) and X = I/Br/Cl; X' = I3 (3)), whose equatorial Ph3PO ligation remains unchanged, has been investigated. Combined magnetic studies coupled with ab initio calculations reveal weakening of the axial ligand fields leading to the increase in the energy barrier, apart from suggesting the operation of different relaxation pathways.
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http://dx.doi.org/10.1039/d0cc01370fDOI Listing
October 2020

Short Communication: Oral Administration of Heat-killed KB290 in Combination with Retinoic Acid Provides Protection against Influenza Virus Infection in Mice.

Nutrients 2020 Sep 24;12(10). Epub 2020 Sep 24.

AgResearch Ltd., Hopkirk Research Institute, Grasslands Research Centre, Private Bag 11008, Palmerston North 4442, New Zealand.

Influenza virus type A (IAV) is a seasonal acute respiratory disease virus with severe symptoms, and an effective preventive measure is required. Despite many reports describing the potentially protective effects of lactic acid bacteria, few studies have investigated the effects of nutritional supplement combinations. This study reports the effect of the combined intake of heat-killed KB290 (KB290) and vitamin A (VA) on mice challenged with a sublethal dose of IAV. For 2 weeks, five groups of mice were fed either placebo, KB290, VA, or a combination of KB290 and VA (KB290+VA). After subsequent IAV challenge, bodyweight and general health were monitored for up to 2 weeks. Viral titres were determined in the lungs of animal subgroups euthanised at days 3, 7, and 14 after IAV challenge. A significant loss was observed in the bodyweights of IAV-infected animals from day 1 post-IAV challenge, whereas the mice fed KB290+VA did not lose any weight after IAV infection, indicating successful protection from the infection. Additionally, mice in the KB290+VA group showed the highest reduction in lung viral titres. In conclusion, the combination of KB290 and VA could be a useful food supplement relevant for protection against seasonal influenza virus infection in humans.
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http://dx.doi.org/10.3390/nu12102925DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7600661PMC
September 2020

A Systematic Review of Multisystem Inflammatory Syndrome in Children Associated With SARS-CoV-2 Infection.

Pediatr Infect Dis J 2020 11;39(11):e340-e346

Department of Pediatrics, Dr. Rajendra Prasad Government Medical College, Kangra, Himachal Pradesh, India.

Background: Recently, severe manifestations associated with coronavirus disease 2019 (COVID-19) called multisystem inflammatory syndrome in children (MIS-C) have been recognized. Analysis of studies for this novel syndrome is needed for a better understanding of effective management among affected children.

Methods: An extensive search strategy was conducted by combining the terms multisystem inflammatory syndrome in children and coronavirus infection or using the term multisystem inflammatory syndrome in children in bibliographic electronic databases (PubMed, EMBASE, and CINAHL) and in preprint servers (BioRxiv.org and MedRxiv.org) following the Preferred Reporting Items for Systematic Reviews and Metaanalyses guidelines to retrieve all articles published from January 1, 2020, to July 31, 2020. Observational cross-sectional, cohort, case series, and case reports were included.

Results: A total of 328 articles were identified. Sixteen studies with 655 participants (3 months-20 years of age) were included in the final analysis. Most of the children in reported studies presented with fever, gastrointestinal symptoms, and Kawasaki Disease-like symptoms. Sixty-eight percent of the patients required critical care; 40% needed inotropes; 34% received anticoagulation; and 15% required mechanical ventilation. More than two-thirds of the patients received intravenous immunoglobulin and 49% received corticosteroids. Remdesivir and convalescent plasma were the least commonly utilized therapies. Left ventricular dysfunction was reported in 32% of patients. Among patients presenting with KD-like symptoms, 23% developed coronary abnormalities and 26% had circulatory shock. The majority recovered; 11 (1.7%) children died.

Conclusions: This systematic review delineates and summarizes clinical features, management, and outcomes of MIS-C associated with SARS-CoV-2 infection. Although most children required intensive care and immunomodulatory therapies, favorable outcomes were reported in the majority with low-mortality rates.
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http://dx.doi.org/10.1097/INF.0000000000002888DOI Listing
November 2020

Recent developments in COVID-19 therapeutics & current evidence for COVID-19-associated multisystem inflammatory syndrome.

Indian J Med Res 2020 Jul & Aug;152(1 & 2):149-151

Department of Pediatrics, Indira Gandhi Medical College, Shimla 171 001, Himachal Pradesh, India.

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http://dx.doi.org/10.4103/ijmr.IJMR_2785_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7853286PMC
September 2020

Cyclic (Alkyl)(Amino)Carbene-Stabilized Aluminum and Gallium Radicals Based on Amidinate Scaffolds.

Inorg Chem 2020 Aug 3;59(16):11253-11258. Epub 2020 Aug 3.

Institut für Anorganische Chemie, Universität Göttingen, Tammannstrasse 4, Göttingen 37077, Germany.

Neutral, mononuclear aluminum and gallium radicals, stabilized by cyclic (alkyl)(amino)carbene (cAAC), were synthesized. LMCl upon reduction with KC in the presence of cAAC afforded the radicals LMCl(cAAC), where L = PhC(NBu) and M = Al (), Ga (). The radicals were characterized by X-ray crystallography, electron paramagnetic resonance (EPR) spectroscopy, and mass spectrometry. EPR, SQUID measurement, and computational calculations confirmed paramagnetism of the radicals with unpaired spin mainly on cAAC.
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http://dx.doi.org/10.1021/acs.inorgchem.0c01913DOI Listing
August 2020

Rapid determination and optimisation of berberine from Himalayan by soxhlet apparatus using CCD-RSM and its quality control as a potential candidate for COVID-19.

Nat Prod Res 2020 Aug 13:1-6. Epub 2020 Aug 13.

cGMP-Chemical Engineering Division and Academy of Scientific & Innovative Research (AcSIR), CSIR-Indian Institute of Integrative Medicine, Jammu, India.

SARS-CoV-2 (or COVID-19) has become a global risk and scientists are attempting to investigate antiviral vaccine. are important plants due to the presence of bioactive phytochemicals, especially berberine from the protoberberine group of benzylisoquinoline and recent studies have shown its potential in treating COVID-19. Royle growing in subtropical regions of Asia had wide applications in Indian system of medicine. Rapid determination and novel optimisation method for berberine extraction has been developed by Soxhlet extraction utilising central composite design-response surface methodology (CCD-RSM). Berberine was detected by high-performance liquid chromatography (HPLC), and the highest yield (13.39%) was obtained by maintaining optimal extraction conditions i.e., extraction time (7.28 hrs), ethyl alcohol (52.21%) and solvent to sample ratio (21.78 v/w). Investigation of two geographic regions (Ramnagar and Srinagar) showed high berberine content in lower altitude. This novel optimisation technique has placed berberine as a potential candidate for developing pharmaceutical products for human health care.
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http://dx.doi.org/10.1080/14786419.2020.1806274DOI Listing
August 2020

Food-induced immediate response of the esophagus-A newly identified syndrome in patients with eosinophilic esophagitis.

Allergy 2021 01 19;76(1):339-347. Epub 2020 Aug 19.

Department of Gastroenterology and Hepatology, University Hospital Zurich, Zurich, Switzerland.

Background: Dysphagia is the main symptom of adult eosinophilic esophagitis (EoE). We describe a novel syndrome, referred to as "food-induced immediate response of the esophagus" (FIRE), observed in EoE patients.

Methods: Food-induced immediate response of the esophagus is an unpleasant/painful sensation, unrelated to dysphagia, occurring immediately after esophageal contact with specific foods. Eosinophilic esophagitis experts were surveyed to estimate the prevalence of FIRE, characterize symptoms, and identify food triggers. We also surveyed a large group of EoE patients enrolled in the Swiss EoE Cohort Study for FIRE.

Results: Response rates were 82% (47/57) for the expert and 65% (239/368) for the patient survey, respectively. Almost, 90% of EoE experts had observed the FIRE symptom complex in their patients. Forty percent of EoE patients reported experiencing FIRE, more commonly in patients who developed EoE symptoms at a younger age (mean age of 46.4 years vs 54.1 years without FIRE; P < .01) and in those with high allergic comorbidity. Food-induced immediate response of the esophagus symptoms included narrowing, burning, choking, and pressure in the esophagus appearing within 5 minutes of ingesting a provoking food that lasted less than 2 hours. Symptom severity rated a median 7 points on a visual analogue scale from 1 to 10. Fresh fruits/vegetables and wine were the most frequent triggers. Endoscopic food removal was significantly more commonly reported in male patients with vs without FIRE (44.3% vs 27.6%; P = .03).

Conclusions: Food-induced immediate response of the esophagus is a novel syndrome frequently reported in EoE patients, characterized by an intense, unpleasant/painful sensation occurring rapidly and reproducibly in 40% of surveyed EoE patients after esophageal contact with specific foods.
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http://dx.doi.org/10.1111/all.14495DOI Listing
January 2021

Forebrain roof plate morphogenesis and hippocampus development in the chick embryo.

Int J Dev Biol 2020 ;64(1-2-3):247-257

University of California Los Angeles, USA.

The forebrain roof plate undergoes dramatic morphogenetic changes to invaginate, and this leads to formation of the two cerebral hemispheres. While many genetic factors are known to regulate this process, the mechanism of forebrain roof plate invagination remains unknown. In a recent study we have identified retinoic acid as a signal from the dorsal mesenchyme that regulates the invagination of the roof plate. This has brought into focus the importance of the interaction between the dorsal mesenchyme and the underlying roof plate. One of the structures derived from the dorso-medial forebrain after roof plate invagination is the hippocampus. While the functions of the hippocampus are conserved between birds and mammals, there are distinct structural differences. We have studied hippocampus development in the chick embryo and uncovered several similarities and differences between the process in mammals and birds. This study has also lent support to one of the prevalent models of structural homology between the avian and mammalian hippocampus. In this review, we have underscored the importance of the chick embryo as a model for studying forebrain roof plate morphogenesis and hippocampus development.
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http://dx.doi.org/10.1387/ijdb.190143jsDOI Listing
January 2020