Publications by authors named "Vaibhav Sahni"

28 Publications

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Active matrix metalloproteinase-8 (aMMP-8) point-of-care test (POCT) in the COVID-19 pandemic.

Expert Rev Proteomics 2021 08 11;18(8):707-717. Epub 2021 Sep 11.

Unit of Pedodontics and Preventive Dentistry, Oral Health Sciences Centre, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, India.

Introduction: Active matrix metalloproteinase (aMMP)-8 utilized in point-of-care testing (POCT) is regarded as a potential biomarker for periodontal and peri-implant diseases. Various host and microbial factors eventually influence the expression, degranulation, levels and activation of aMMP-8. The type of oral fluids (saliva, mouthrinse, gingival crevicular, and peri-implant sulcular fluids [GCF/PISF], respectively) affect the analysis.

Areas Covered: With this background, we aimed to review here the recent studies on practical, inexpensive, noninvasive and quantitative mouthrinse and GCF/PISF chair-side POCT lateral flow aMMP-8 immunoassays (PerioSafe and ImplantSafe/ORALyzer) and how they help to detect, predict, monitor the course, treatment and prevention of periodontitis and peri-implantitis. The correlations of aMMP-8 POCT to other independent and catalytic activity assays of MMP-8 are also addressed.

Expert Opinion: The mouthrinse aMMP-8 POCT can also detect prediabetes/diabetes and tissue destructive oral side-effects due to the head and neck cancers' radiotherapy. Chlorhexidine and doxycycline can inhibit collagenolytic human neutrophil and GCF aMMP-8. Furthermore, by a set of case-series we demonstrate the potential of mouthrinse aMMP-8 POCT to real-time/online detect periodontitis as a potential risk disease for coronavirus disease 2019 (COVID-19). The clinical interdisciplinary utilization of aMMP-8 POCT requires additional oral, medical, and interdisciplinary studies.
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http://dx.doi.org/10.1080/14789450.2021.1976151DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8442753PMC
August 2021

The clinical association between Periodontitis and COVID-19.

Clin Oral Investig 2021 Aug 27. Epub 2021 Aug 27.

Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.

Objectives: The study aimed to clinically assess the association between periodontitis and COVID-19-related outcomes.

Material And Methods: Data pertaining to patient demographics, medical history, blood parameters, periodontal clinical examination and aMMP-8 point-of-care diagnostics (both site-level and patient-level) was recorded for eighty-two COVID-19-positive patients. COVID-19-related outcomes such as COVID-19 pneumonia, death/survival, types of hospital admission and need of assisted ventilation were also assessed.

Results: Males were predominantly afflicted with COVID-19, with advanced age exhibiting a greater association with the presence of periodontitis. Higher severity of periodontitis led to 7.45 odds of requiring assisted ventilation, 36.52 odds of hospital admission, 14.58 odds of being deceased and 4.42 odds of COVID-19-related pneumonia. The aMMP-8 mouthrinse kit was slightly more sensitive but less specific than aMMP-8 site-specific tests.

Conclusions: Based on the findings of the present study, periodontitis seems to be related to poorer COVID-19-related outcomes. However, within the constraints of this work, a direct causality may not be established. Periodontitis, by means of skewing the systemic condition for a number of comorbidities, may eventually influence COVID-19 outcomes in an indirect manner.

Clinical Relevance: The study is the first to clinically, and by means of a validated point-of-care diagnostic methodology, assess the association between periodontal health and COVID-19-related outcomes. Assessment of the periodontal status of individuals can aid in the identification of risk groups during the pandemic along with reinforcing the need to maintain oral hygiene and seeking periodontal care.
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http://dx.doi.org/10.1007/s00784-021-04111-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8390180PMC
August 2021

Linking oral microbial proteolysis to aMMP-8 PoC diagnostics along with the stage and grade of periodontitis: A cross-sectional study.

Oral Dis 2021 Aug 17. Epub 2021 Aug 17.

Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.

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http://dx.doi.org/10.1111/odi.14008DOI Listing
August 2021

On the accuracy, sensitivity, and grading of mouthrinse active matrix metalloproteinase-8 (aMMP-8) point-of-care testing (POCT).

J Clin Periodontol 2021 Nov 19;48(11):1495-1498. Epub 2021 Aug 19.

Department of Oral and Maxillofacial Diseases, Helsinki University and University Hospital, Helsinki, Finland.

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http://dx.doi.org/10.1111/jcpe.13521DOI Listing
November 2021

Are there any significant craniomaxillofacial manifestations of COVID-19?

Authors:
Vaibhav Sahni

Evid Based Dent 2021 01;22(2):72-73

Panjab University, Chandigarh, Vasant Kunj, New Delhi, India.

Data sources PubMed/Medline, Biomed Central, Embase, Thai Journals and the Cochrane library.Study selection Reports or studies dealing with the craniomaxillofacial (CMF) manifestations of COVID-19 were selected.Data extraction and synthesis The reviewers extracted data from the included studies; however, being a meta-narrative review, it was not deemed fit to contact authors for unpublished work, conduct a meta-analysis, search for unpublished data or search for studies in languages different from English, German, French and Thai. The primary variable for prediction was set as the COVID-19 infection, with the primary outcome variable being manifestation in the CMF region. Parameters of a clinical, demographic, investigative and therapeutic nature were the other included variables. Subsequently, the reports and abstracted data were reviewed for study design, author names, country, size of the sample, level of evidence, signs/symptoms, treatment undertaken and investigations conducted. Studies exhibiting the highest level of evidence were included eventually. As deemed appropriate, uni/bivariate and descriptive statistics were applied.Results Cumulatively, 101 publications were included in the meta-narrative after due screening, the data of which was further divided into five groups of: 1) nose/paranasal sinus/skull base; 2) mouth/throat; 3) periorbital/ocular tissue; 4) skin; and 5) ear.Conclusions The majority of data pertaining to CMF manifestations of COVID-19 qualifies as a low level of evidence. With the exception of taste/smell dysfunction, most CMF manifestations are nonspecific and can be diagnosed by CMF surgeons and dentists, which underscores their role in battling the pandemic.
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http://dx.doi.org/10.1038/s41432-021-0177-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8226332PMC
January 2021

Buccal swabs as non-invasive specimens for detection of severe acute respiratory syndrome coronavirus-2.

J Int Med Res 2021 May;49(5):3000605211016996

Department of Virology, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, India.

Introduction: The current gold standard for detection of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) RNA involves subjecting nasopharyngeal or oropharyngeal swabs to reverse transcription quantitative PCR (RT-qPCR). However, both sample types need to be collected by trained professionals. Using self-collected buccal swabs as an alternative could simplify and accelerate diagnosis of coronavirus disease 2019 (COVID-19).

Objective: To assess self-collected buccal swab samples as an alternative method for SARS-CoV-2 detection in patients with COVID-19.

Methods: Buccal swab samples were self-collected by 73 patients with COVID-19. Total RNA was extracted using Qiagen kits. RNA encoding the SARS-CoV-2 Env protein and human RNase P as an internal control was amplified using the TRUPCR SARS-CoV-2 RT-qPCR kit version 2.1 and a Bio-Rad CFX96 Real-Time Detection System.

Result: The sensitivity of RT-qPCR from buccal swabs was 58.9% (43/73; 95% confidence interval [CI] 46.77%-70.27%) and that of RT-qPCR from saliva was 62.90% (39/62; 95% CI 49.69%-74.84%) taking positive SARS-CoV-2 RT-qPCR from nasopharyngeal swabs as the gold standard.

Conclusion: Self-collected buccal swabs are promising alternatives to nasopharyngeal or oropharyngeal swabs for SARS CoV-2 detection.
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http://dx.doi.org/10.1177/03000605211016996DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8142533PMC
May 2021

An aMMP-8 Point-of-Care and Questionnaire Based Real-Time Diagnostic Toolkit for Medical Practitioners.

Diagnostics (Basel) 2021 Apr 15;11(4). Epub 2021 Apr 15.

Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, 00014 Helsinki, Finland.

The aim of this cross-sectional study is to propose an efficient strategy based on biomarkers adjunct with an interview/questionnaire covering risk factors for periodontitis for the identification of undiagnosed periodontitis by medical professionals. Active matrix metalloproteinase (aMMP)-8 levels in mouthrinse were analyzed by a point-of-care (PoC)/chairside lateral-flow immunotest, and salivary total MMP-8, total MMP-9 and calprotectin levels were analyzed by enzyme-linked immunosorbent assays (ELISAs) and active MMP-9 by gelatin zymography for 149 Greek patients. Patients underwent a full-mouth oral health examination for diagnosis according to the 2018 classification system of periodontal diseases. In addition, patient characteristics (risk factors: age, gender, education level, smoking and body mass index) were recorded. Receiver operating curve (ROC) analysis indicated better diagnostic precision to identify undiagnosed periodontitis for oral fluid biomarkers in adjunct with an interview/questionnaire compared with a plain questionnaire (i.e., risk factors): aMMP-8 AUC (95% confidence interval) = 0.834 (0.761-0.906), total MMP-8 = 0.800 (0.722-0.878), active MMP-9 = 0.787 (0.704-0.870), total MMP-9 = 0.773 (0.687-0.858) and calprotectin = 0.773 (0.687-0.858) vs. questionnaire = 0.764 (0.676-0.851). The findings of this study suggest that oral fluid biomarker analysis, such as a rapid aMMP-8 PoC immunotest, could be used as an adjunct to an interview/questionnaire to improve the precision of timely identification of asymptomatic, undiagnosed periodontitis patients by medical professionals. This strategy appears to be viable for referring patients to a dentist for diagnosis and treatment need assessment.
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http://dx.doi.org/10.3390/diagnostics11040711DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8071538PMC
April 2021

POEMS syndrome in the maxillofacial region.

Authors:
Vaibhav Sahni

Oral Oncol 2021 03 2;114:105054. Epub 2020 Nov 2.

Dept. of Medical Health and Family Welfare, Government of Uttarakhand, India. Electronic address:

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http://dx.doi.org/10.1016/j.oraloncology.2020.105054DOI Listing
March 2021

Battle ready for maxillofacial injuries.

Authors:
Vaibhav Sahni

Injury 2020 10 20;51(10):2325. Epub 2020 Jul 20.

Panjab University, Chandigarh, India. Electronic address:

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http://dx.doi.org/10.1016/j.injury.2020.07.042DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7370908PMC
October 2020

A protocol for the management of maxillofacial injuries in the wake of the COVID-19 pandemic.

Authors:
Vaibhav Sahni

Injury 2020 Oct 25;51(10):2326-2328. Epub 2020 Jun 25.

Panjab University, Chandigarh, 160014, India. Electronic address:

The oral & maxillofacial region and by that virtue surgery of the same is correlated to an increased risk of the transfer of the SARS CoV-2. In times of a pandemic it is imperative to institute a protocol based management of maxillofacial injuries based on currently available literature which is suggestive, simplistic, executable and amenable to modifications should the rapidly changing situation demand the same. The author, in the present study conducted a review of literature to undertake the task of forming a simplistic protocol which is readily applicable for the management of maxillofacial injuries which would not only provide the clinician guidance on what to do now but caution towards the future implications of his/her present decision.
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http://dx.doi.org/10.1016/j.injury.2020.06.037DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7315162PMC
October 2020

The intriguing commonality of NETosis between COVID-19 & Periodontal disease.

Med Hypotheses 2020 Nov 7;144:109968. Epub 2020 Jun 7.

Panjab University, Chandigarh, India.

NETosis, being an alternative form of cell death is the creation of web-like chromatin decondensates by suitably primed neutrophils as a response to stimulus aimed at containing and eliminating the same. In certain situations, it causes more harm than benefit in the form of bystander damage directly or via activation of autoimmune mechanisms. Such pathophysiology finds evidence in both Periodontal disease and COVID-19. Coupled with impaired removal, NETs have been implicated in both these disease forms to promote a state of inflammation and be a source of constant harm to the tissues involved. This potentially forms groundwork to implicate Periodontal disease as predisposing towards adverse COVID-19 related outcomes.
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http://dx.doi.org/10.1016/j.mehy.2020.109968DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7276117PMC
November 2020

COVID-19 & Periodontitis: The cytokine connection.

Med Hypotheses 2020 Nov 30;144:109908. Epub 2020 May 30.

Post Graduate Institute of Medical Education & Research, Chandigarh, India.

COVID-19 is now recognized as a pandemic throughout the world, leading to a scramble in order to gather knowledge as well as evidence regarding the 'novel' corona virus which causes this disease. Chemokines are a family of cytokines which are chemotactic in nature and cause the recruitment of cells of inflammation. Periodontitis has long been attributed to having its pathophysiology rooted in a cytokine response. The recent COVID-19 pandemic has been reported to have adverse outcomes related to the establishment of a cytokine storm, many of the components of which are common with the cytokine expression profile of periodontitis. This communication explores the connection between COVID-19 and periodontal disease through their cytokine connection to form a translational basis for recommending maintenance of oral hygiene in the COVID era and to red flag patients with periodontitis as having an increased risk of exhibiting COVID related adverse outcomes.
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http://dx.doi.org/10.1016/j.mehy.2020.109908DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7832148PMC
November 2020

Guerin's sign reflecting pterygoid plate dysjunction.

Authors:
Vaibhav Sahni

J R Army Med Corps 2019 Dec 3;165(6):454. Epub 2019 Jan 3.

Department of Medical Health and Family Welfare, Government of Uttarakhand, Dehradun, Uttarakhand 248013, India

A case of panfacial trauma is reported comprising of multiple facial fractures and a clearly evident Guerin's sign along with an oronasal communication. The case reinforces the importance of recognising this sign and its classical presentation.
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http://dx.doi.org/10.1136/jramc-2018-001125DOI Listing
December 2019

Psychological Impact of Facial Trauma.

Authors:
Vaibhav Sahni

Craniomaxillofac Trauma Reconstr 2018 Mar 12;11(1):15-20. Epub 2017 Jun 12.

Department of Oral and Maxillofacial Surgery, Christian Medical College and Hospital, Ludhiana, Punjab, India.

Examination of the mental state of patients suffering from facial trauma is rarely ever recorded, let alone screening them for posttraumatic stress disorders (PTSDs) or generalized anxiety disorder. Providing early support to the patient in light of such psychological conditions can improve the overall quality of life. The aim of this study was to perform a literature review to assess the relation of mental state disorders to facial trauma in terms of their prevalence, assess screening methodology, and also to evaluate the prognosis of individuals subjected to psychological intervention/screening at an early stage of clinical examination. Research databases such as ScienceDirect, Google Scholar, PubMed, and Medline were searched using the keywords "psychological trauma," "facial trauma," and "PTSD." Only meta-analyses, systematic reviews, and original research articles in the English language were included in the study. Correspondence to journal editors and clinician opinions were excluded from the study. Out of a total of 459 results, only 8 articles satisfied the inclusion criteria of the study. The literature review showed that patients suffering from orofacial trauma had significantly increased levels of mental state disorders such as PTSD and generalized anxiety disorder, more so in victims of assault. The results of this literature review clearly point toward an increased prevalence of mental state disorders in patients suffering from facial trauma, which warrants for early intervention in this regard to improve the quality of life of these patients.
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http://dx.doi.org/10.1055/s-0037-1603464DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5790551PMC
March 2018

Dental considerations in anaesthesia.

Authors:
Vaibhav Sahni

JRSM Open 2016 Dec 1;7(12):2054270416675082. Epub 2016 Dec 1.

Maharishi Markandeshwar College of Dental Sciences and Research, Haryana 133203, India.

Dental trauma as a result of anaesthesia practice is a relevant issue concerning morbidity and litigation. The investigator aimed to consolidate pertinent information on this issue to aid in the redressal of such an occurrence. A review of this relevant literature alongwith the author's suggestions towards the management of the various kinds of dental trauma sustained as a result of anaesthesia practice is presented.
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http://dx.doi.org/10.1177/2054270416675082DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5140041PMC
December 2016

The Lazarus phenomenon.

Authors:
Vaibhav Sahni

JRSM Open 2016 Aug 1;7(8):2054270416653523. Epub 2016 Aug 1.

Maharishi Markandeshwar College of Dental Sciences and Research, MMU, Haryana 133203, India.

The Lazarus phenomenon or the unassisted return of spontaneous circulation after cardiac arrest is a grossly underreported phenomenon in medical literature which essentially implies the 'resurrection' of an individual after cardiac arrest. Although there have been a handful of such cases reported, the clinical incidence and significance may be underestimated. Because of the presumed infrequency of this condition, there are no studies specifically researching Lazarus phenomenon in scientific literature. This review intends to systematically present current and past knowledge on this rare but definitive phenomenon. Research databases namely Google Scholar, Science Direct, Medline and PubMed were utilized. Only articles which identified cases where the return of spontaneous circulation occurred after cessation of Cardiopulmonary Resuscitation (CPR), and review articles on the entity were included. The mentioned databases were searched using the terms 'Lazarus phenomenon', 'cardiopulmonary resuscitation' and 'return of spontaneous circulation'. A literature review was synthesised based on articles meeting the eligibility criteria to better understand the phenomenon of return of spontaneous circulation.
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http://dx.doi.org/10.1177/2054270416653523DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4973403PMC
August 2016

Maxillofacial trauma scoring systems.

Authors:
Vaibhav Sahni

Injury 2016 Jul 16;47(7):1388-92. Epub 2016 Feb 16.

Maharishi Markandeshwar College of Dental Sciences & Research, Mullana, Ambala, Haryana 133203, India. Electronic address:

The changing complexity of maxillofacial fractures in recent years has created a situation where classical systems of classification of maxillofacial injuries fall short of defining trauma particularly that observed with high-velocity collisions where more than one region of the maxillofacial skeleton is affected. Trauma scoring systems designed specifically for the maxillofacial region are aimed to provide a more accurate assessment of the injury, its prognosis, the possible treatment outcomes, economics, length of hospital stay, and triage. The evolution and logic of such systems along with their merits and demerits are discussed. The author also proposes a new system to aid users in quickly and methodically choosing the system best suited to their needs without having to study a plethora of literature available in order to isolate their choice.
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http://dx.doi.org/10.1016/j.injury.2016.02.001DOI Listing
July 2016

Potential benefits of alkali therapy to prevent GFR loss: time for a palatable 'solution' for the management of CKD.

Kidney Int 2010 Dec;78(11):1065-7

Division of Nephrology and Hypertension, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois 60611, USA.

There is increasing evidence that alkali therapy can retard progression of chronic kidney disease (CKD). We summarize recent studies and discuss a mechanism whereby alkali therapy may neutralize acid production associated with typical Western diets, which generate acid. We emphasize the rationale for using alkali therapy early in the course of CKD, even in the absence of overt metabolic acidosis, and we urge the pharmaceutical industry to develop palatable alkali-containing solutions.
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http://dx.doi.org/10.1038/ki.2010.364DOI Listing
December 2010

Chemotherapy-associated renal dysfunction.

Nat Rev Nephrol 2009 Aug 30;5(8):450-62. Epub 2009 Jun 30.

Drexel University College of Medicine, Philadelphia, PA 19102-1192, USA.

The presence of renal dysfunction in a patient receiving chemotherapy can be devastating. Although many patients with cancer have underlying compromised renal function, some chemotherapeutic agents can actually induce renal abnormalities. An understanding of which traditional and newer chemotherapy agents can affect renal function is useful for physicians so that they can monitor patients for renal abnormalities and initiate preventive strategies to minimize renal complications. This Review highlights renal abnormalities associated with current chemotherapy agents and provides suggestions for preventive measures.
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http://dx.doi.org/10.1038/nrneph.2009.97DOI Listing
August 2009

Effect of pharmacological suppression of secondary hyperparathyroidism on cardiovascular hemodynamics in predialysis CKD patients: A preliminary observation.

Hemodial Int 2007 Oct;11(4):417-23

Division of Nephrology, Maulana Azad Medical College and Associated Lok Nayak Hospital, G. B. Pant Hospital and Guru Nanak Eye Hospital, New Delhi, India.

Cardiovascular events are the principal cause of mortality in patients with chronic kidney disease (CKD). Secondary hyperparathyroidism (SHPT), a common complication of CKD, contributes to cardiac dysfunction. This study is an attempt to demonstrate the effects of parathyroid hormone suppression with oral calcitriol on cardiovascular hemodynamics. Twenty predialysis CKD patients with SHPT were given calcitriol therapy for 12 weeks. Ten similar patients received placebo. Echocardiographic assessment of cardiac function was performed at baseline and after 12 weeks of treatment. Calcitriol therapy effectively suppressed SHPT. Baseline left ventricular (LV) end diastolic diameter and LV end systolic diameter were 4.86+/-0.48 and 2.86+/-0.33 cm, and the mean FS was 41.02+/-4.79%. Left ventricular end systolic and end diastolic volumes were normal (42.30+/-9.07 and 91.40+/-19.68 mL). The ejection fraction was slightly reduced (53.54+/-3.57%). Pretreatment Doppler indices including E velocity (0.816+/-0.087 m/s), A velocity (0.696+/-0.089 m/s), and E/A ratio (1.193+/-0.210) were significantly impaired. After 12 weeks of calcitriol therapy, there was no significant change in the LV dimensions or ejection fraction, but there was a significant improvement in the diastolic parameters, namely the A velocity (0.680+/-0.084) and E/A ratio (1.238+/-0.180). Secondary hyperparathyroidism is an important factor in the pathogenesis of cardiovascular complications in CKD. There is evidence to support that correction of hyperparathyroidism can improve the systolic dysfunction seen in advanced kidney disease. This study shows that diastolic dysfunction seen in predialysis CKD patients may also be possibly improved with calcitriol therapy.
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http://dx.doi.org/10.1111/j.1542-4758.2007.00211.xDOI Listing
October 2007

Unusual complications of heroin abuse: transverse myelitis, rhabdomyolysis, compartment syndrome, and ARF.

Clin Toxicol (Phila) 2008 Feb;46(2):153-5

Department of Internal Medicine, Drexel University College of Medicine, Philadelphia, Pennsylvania, USA.

Introduction: Heroin overdose can cause various rare neurological complications like spongiform leukoencephalopathy, seizures, stroke, toxic amblyopia, transverse myelopathy, mononeuropathy, plexopathy, acute inflammatory demyelinating polyradiculoneuropathy, rhabdomyolysis, compartment syndrome, fibrosing myopathy, and acute bacterial myopathy. We report here the simultaneous presentation of multiple complications of heroin toxicity.

Case Report: A young heroin addict was found unarousable lying in the lotus posture. Examination showed quadriplegia and left leg gangrene. He subsequently developed heroin-induced transverse myelitis, rhabdomyolysis, left leg compartment syndrome, and myoglobin-induced acute renal failure.

Discussion: This case leads us to consider a common linked or systemic mechanism of injury rather than a local mechanism when multiple simultaneous organ failure occurs complicating heroin abuse.
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http://dx.doi.org/10.1080/15563650701639071DOI Listing
February 2008

Acute demyelinating encephalitis after jequirity pea ingestion (Abrus precatorius).

Clin Toxicol (Phila) 2007 ;45(1):77-9

Dept. of Internal Medicine, Drexel University College of Medicine, Philadelphia, Pennsylvania, USA.

Introduction: Castor and jequirity beans are uncommon causes of poisoning. The more common but less severe castor poisoning is well described, but jequirity bean (Abrus Precatorius) poisoning is rare. The toxicity is attributed to toxalbumins (ricin and abrin) that act by inhibiting protein synthesis. Their use as agents of biological warfare, mechanisms of action, and clinical features of poisoning are summarized.

Case Report: A 30-year-old previously healthy female presented with bloody diarrhea and deep coma following ingestion of 3-4 seeds of a plant called 'ratti.' Investigations, including an MRI brain scan, showed evidence of acute demyelinating encephalitis. The patient died three days later due to progressive central nervous system depression.

Discussion: This is a previously unreported manifestation of jequirity bean poisoning. Demyelination is immune-mediated, and Abrus is a well-known immuno-modulator and stimulator. A possible immunological pathogenic mechanism is hypothesized.
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http://dx.doi.org/10.1080/15563650601006116DOI Listing
March 2007

Spontaneous bacterial peritonitis in isolated splenic vein thrombosis with portal hypertension.

Indian J Gastroenterol 2006 Sep-Oct;25(5):263-4

Department of Medicine, Maulana Azad Medical College and associated Lok Nayak Hospital and G B Pant Hospital, New Delhi 110 002, India.

Spontaneous bacterial peritonitis (SBP) is a known complication of ascites due to cirrhosis; it has also been reported in some non-cirrhotic conditions with ascites. We report a 50-year-old lady with isolated splenic vein thrombosis who developed SBP due to E. coli .
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December 2006

Effect of improvement in anemia on electroneurophysiological markers (P300) of cognitive dysfunction in chronic kidney disease.

Hemodial Int 2006 Jul;10(3):267-73

Department of Medicine, Maulana Azad Medical College, Lok Nayak Hospital, New Delhi, India.

Our aim is to study the effect of improvement in anemia on event-related potentials (ERPs; P300) as markers of cognitive dysfunction in predialysis and dialysis patients of chronic kidney disease (CKD). Thirty anemic patients of CKD (hemoglobin [Hb] < 9 g%), 15 in the predialysis group (Group A), and 15 patients on biweekly hemodialysis (Group B) were recruited for the study. Patients of uremic encephalopathy, dyselectrolytemia, and those with hearing problems were excluded. Both groups were given recombinant human erythropoietin (rhuEPO) 100 IU/kg biweekly for 6 weeks by the subcutaneous route. No intervention was performed in the third control group (Group C), which consisted of 30 normal healthy volunteers. The improvement in Hb was assessed every 2 weeks, and the amplitude and latency of the P300 component of the ERPs were studied before initiating treatment and after 6 weeks of rhuEPO administration. There was a significant increase in Hb in both the study groups without any significant alteration in kidney functions. A significant reduction in P300 latency was noted in both the study groups after intervention. Similarly, the amplitude of P300 also increased in both study groups, but attained statistical significance for the dialysis group only. No significant changes were observed in the control group. Administration of EPO in patients of anemia with CKD resulted in a significant improvement in the electrophysiological markers of cognitive function in the form of increased amplitudes and decreased latencies of P300 in both predialysis and dialysis patients.
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http://dx.doi.org/10.1111/j.1542-4758.2006.00107.xDOI Listing
July 2006

Rare thoracic mass lesion--myofibrobastoma.

Indian J Cancer 2005 Jul-Sep;42(3):161-4

Department of Medicine, Maulana Azad Medical College and Associated Lok Nayak Hospital, G. B. Pant Hospital and Guru Nanak Eye Hospital, New Delhi-110 002, India.

Mesenchymal soft tissue masses are uncommon tumours of the chest. Myofibroblastoma is a recently described entity consisting of cells with origin from the myoepethelial cell, mostly seen as benign well-circumscribed neoplasms of the breast tissue. Though usually classified as a benign lesion, rarely it can be multifocal and prone to recurrence. We describe below the case of a 26-year-old female who presented with exertional dyspnoea and evidence of a massive mass lesion in the left hemithorax causing mediastinal displacement to the opposite side. On histological and immunophenotypic analysis, a diagnosis of the very rare thoracic myofibroblastoma was made. The incidence, salient features, pathological differential diagnoses and treatment are reviewed.
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http://dx.doi.org/10.4103/0019-509x.17063DOI Listing
February 2006
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