Publications by authors named "Venkatesh Kumar"

27 Publications

  • Page 1 of 1

Effect of a novel technique of posterior reconstruction of pubourethralis on 'early' return of continence after robot assisted radical prostatectomy (RARP): A comparative study.

Urologia 2021 Mar 29:3915603211007052. Epub 2021 Mar 29.

Urology, New Delhi, India.

Objective: To study the after robot assisted radical prostatectomy (RARP).

Materials And Methods: The study included 206 patients of organ confined prostate cancer managed at our centre between March 2014 and December 2018.The patients were randomly distributed into two comparable groups with respect to age, height, weight and BMI, with 100 patients in control and 106 patients in study group. After standard excision of the specimen, the posterior reconstruction in the form of Rocco stitch was done in control group while in addition to Rocco stitch pubourethralis was approximated posteriorly in midline at the proposed site of vesicourethral anastomosis in study group. Continence was defined as the need to use 0-1 pad in 24 h. The data was collected on day 0, 3, 7, 15, 30, 90 and 180 after removal of catheter.

Results:

Conclusion: Despite small number of patients in this study the results with respect to early return of continence are encouraging in the reconstruction group and there by in favour of this technique .Furthermore the technique is easily reproducible and may be seen as one more additional step to be applied in order to enhance the recovery of continence after RARP. However it is necessary to further validate the efficacy of this procedure through multicenteric controlled trials.
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http://dx.doi.org/10.1177/03915603211007052DOI Listing
March 2021

Characterization, biological evaluation and molecular docking of mulberry fruit pectin.

Sci Rep 2020 12 11;10(1):21789. Epub 2020 Dec 11.

Department of Microbiology, Babasaheb Bhimrao Ambedkar University, Vidya Vihar, Raibareli Road, Lucknow, 226025, India.

Contemplating the exemplary benefits of pectin on human health, we precisely characterized and evaluated the antibacterial and anticancer activities from purified Mulberry Fruit Pectins (MFP). Here, we tested BR-2 and S-13 varieties of mulberry fruit pectins against six bacterial strains and two human cancer cell lines (HT-29 and Hep G-2), using MIC and an in vitro cell-based assay respectively. The BR-2 mulberry fruit pectin performs superior to S-13 by inhibiting strong bacterial growth (MIC = 500-1000 μg/mL) against tested bacterial strains and cytotoxic activities at the lowest concentration (10 µg/ml) against the Hep G-2 cell line. However, both tested drugs failed to exhibit cytotoxicity on the human colon cancer cell line (HT-29). Based on molecular interaction through docking, pectin binds effectively with the receptors (1e3g, 3t0c, 5czz, 6j7l, 6v40, 5ibs, 5zsy, and 6ggb) and proven to be a promising antimicrobial and anti-cancer agents. The pursuit of unexploited drugs from mulberry fruit pectin will potentially combat against bacterial and cancer diseases. Finally, future perspectives of MFP for the treatment of many chronic diseases will help immensely due to their therapeutic properties.
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http://dx.doi.org/10.1038/s41598-020-78086-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7732840PMC
December 2020

Posttraumatic thoracic epidural capillary hemangioma - A rare case report.

Surg Neurol Int 2020 11;11:179. Epub 2020 Jul 11.

Department of Spine Surgery, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India.

Background: Capillary hemangiomas are benign vascular lesions commonly seen in subcutaneous tissues. The most common site of origin is from the vertebral body, and only a few cases of isolated lesions in thoracic epidural space, especially after trauma, have been reported in the literature.

Case Description: We report a case of 63-yearold male with progressive bilateral lower limb weakness and exaggerated lower limb deep tendon reflexes without bowel and bladder involvement. His history revealed T7 fracture with paraparesis which was treated surgically, and implants were removed a year later. MRI showed an epidural lesion from T6-T8 extending into the right T7-8 foramen which showed hypointensity on T1, hyperintensity on T2, and homogenous enhancement in contrast images with severe cord compression. Laminectomy was done and the lesion was removed . Histopathological examination revealed it to be capillary hemangoma. The neurology came back to normal after 3 months.

Conclusion: Although capillary hemangiomas are rare lesions, it has to be considered in the differential diagnosis of epidural spaceoccupying lesions which require early surgical removal to prevent a progressive and permanent neurological deficit.
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http://dx.doi.org/10.25259/SNI_567_2019DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7395521PMC
July 2020

Does Type II Diabetes Induce Early Senescence and Degeneration in Human Intervertebral Discs? A Tissue Biomarker Evaluation.

Int J Spine Surg 2020 Jun 30;14(3):341-346. Epub 2020 Jun 30.

Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India.

Background: Diabetes mellitus is one of the leading causes of morbidity resulting in multi-organ dysfunction. Animal studies have shown that hyperglycemia results in stress-induced senescence through the p16-pRb pathway, thereby accelerating early disc degeneration. There is a paucity of literature on the effect of hyperglycemia in human intervertebral disc cells. We aimed to analyze the effect of diabetes mellitus in human intervertebral disc cells.

Methods: This is a prospective study done in patients with degenerative disc disease. Patients were categorized into a control group (no diabetes: 26 patients) and a study group (type 2 diabetes for > 3 years: 24 patients). All patients underwent either discectomy or transforaminal lumbar interbody fusion and the removed disc was transported to pathology department. Tissue was prepared and histopathological grading was done followed by immunohistochemistry studies using antibodies for MMP-1, p21, p16, and pRb.

Results: Samples from diabetic patients had severe (grade 2) degenerative changes compared with the control group (grade 1). Changes were more intense in the nucleus pulposus with increased cellularity and clustering of chondrocytes, and disorganization and loss of nuclear matrix. Immunohistochemical staining for MMP1, p16, and pRb was more intense (Q score = 4) whereas the staining for p21 was less intense (Q score = 1) in the diabetic group compared with the control group.

Conclusion: Our study demonstrates that type 2 diabetes mellitus accelerates stress-induced senescence in human intervertebral discs resulting in early disc degeneration. Also, the severity of disc degeneration is severe compared with the normal subjects.

Clinical Relevance: Hyperglycemia can affect the intervertebral discs similar to other organs and hence adequate control of blood glucose in diabetics can prevent the disc degeneration, which is the initiator of degeneration cascade in spine.
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http://dx.doi.org/10.14444/7045DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7343256PMC
June 2020

A rare case of inter-compartmental giant lipoma of right distal forearm dorsal compartment invading anterior compartment via breaching inter-osseous membrane.

J Clin Orthop Trauma 2020 Jul-Aug;11(4):668-671. Epub 2020 Mar 13.

Department of Orthopedics, ESI-PGIMSR Model Hospital, Basaidarapur, New Delhi, India.

Lipomas are benign soft masses of adipose cells, which are often encapsulated by a thin layer of fibrous tissue and are most commonly present in head, neck, shoulders, and backs of patients. The tumors typically lie in the subcutaneous tissues of patients. Inter-muscular lipomas however, are rare and always occur deep within muscle compartments comprising 0.3% of all lipomas. Deep lipomas are most commonly found in the lower limbs followed by trunk, shoulders and arm. We present a rare case of deep dorsal inter-compartmental inter-muscular giant lipoma (>8cm) of right distal forearm leading to the formation of ganglion in the tendon sheath of Flexor Carpi Radialis (FCR) of anterior compartment as a result of breaching of inter-osseous membrane. MRI findings were indicative of a benign inter-compartmental lipoma of dorsal aspect of right distal forearm that erodes through distal inter-osseous membrane to enter the distal volar aspect of the wrist and therefore we did an excision biopsy and histo-pathological examination of the swelling reported an encapsulated tumour composed of mature adipose cells, which were uniformly arranged without high variations in size, consistent with benign lipoma. To the best of our knowledge, after an extensive search of literature we present this rare case of deep dorsal inter-muscular lipoma of forearm crossing over to the volar compartment resulting in ganglion formation in FCR tendon sheath.
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http://dx.doi.org/10.1016/j.jcot.2020.03.005DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7355075PMC
March 2020

Long-read amplicon denoising.

Nucleic Acids Res 2019 10;47(18):e104

Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm 17177, Sweden.

Long-read next-generation amplicon sequencing shows promise for studying complete genes or genomes from complex and diverse populations. Current long-read sequencing technologies have challenging error profiles, hindering data processing and incorporation into downstream analyses. Here we consider the problem of how to reconstruct, free of sequencing error, the true sequence variants and their associated frequencies from PacBio reads. Called 'amplicon denoising', this problem has been extensively studied for short-read sequencing technologies, but current solutions do not always successfully generalize to long reads with high indel error rates. We introduce two methods: one that runs nearly instantly and is very accurate for medium length reads and high template coverage, and another, slower method that is more robust when reads are very long or coverage is lower. On two Mock Virus Community datasets with ground truth, each sequenced on a different PacBio instrument, and on a number of simulated datasets, we compare our two approaches to each other and to existing algorithms. We outperform all tested methods in accuracy, with competitive run times even for our slower method, successfully discriminating templates that differ by a just single nucleotide. Julia implementations of Fast Amplicon Denoising (FAD) and Robust Amplicon Denoising (RAD), and a webserver interface, are freely available.
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http://dx.doi.org/10.1093/nar/gkz657DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6765106PMC
October 2019

Slow Delivery Immunization Enhances HIV Neutralizing Antibody and Germinal Center Responses via Modulation of Immunodominance.

Cell 2019 05 9;177(5):1153-1171.e28. Epub 2019 May 9.

Division of Vaccine Discovery, La Jolla Institute for Immunology (LJI), La Jolla, CA 92037, USA; Center for HIV/AIDS Vaccine Immunology and Immunogen Discovery (Scripps CHAVI-ID), The Scripps Research Institute, La Jolla, CA 92037, USA; Department of Medicine, University of California, San Diego, La Jolla, CA 92037, USA. Electronic address:

Conventional immunization strategies will likely be insufficient for the development of a broadly neutralizing antibody (bnAb) vaccine for HIV or other difficult pathogens because of the immunological hurdles posed, including B cell immunodominance and germinal center (GC) quantity and quality. We found that two independent methods of slow delivery immunization of rhesus monkeys (RMs) resulted in more robust T follicular helper (T) cell responses and GC B cells with improved Env-binding, tracked by longitudinal fine needle aspirates. Improved GCs correlated with the development of >20-fold higher titers of autologous nAbs. Using a new RM genomic immunoglobulin locus reference, we identified differential IgV gene use between immunization modalities. Ab mapping demonstrated targeting of immunodominant non-neutralizing epitopes by conventional bolus-immunized animals, whereas slow delivery-immunized animals targeted a more diverse set of epitopes. Thus, alternative immunization strategies can enhance nAb development by altering GCs and modulating the immunodominance of non-neutralizing epitopes.
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http://dx.doi.org/10.1016/j.cell.2019.04.012DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6619430PMC
May 2019

Analysis of factors influencing ligamentum flavum thickness in lumbar spine - A radiological study of 1070 disc levels in 214 patients.

Clin Neurol Neurosurg 2019 07 2;182:19-24. Epub 2019 May 2.

Spine Surgery Department, Sri Ramachandra Medical University, Chennai, Tamil Nadu, India. Electronic address:

Objective: The pathomechanism and factors influencing hypertrophy of the Ligamentum flavum in the lumbar spine still requires a confident specificity. We aimed to analyse the association between various factors and Ligamentum Flavum Thickness (LFT) and also to investigate the major contributor for Ligamentum Flavum Hypertrophy (LFH) at various levels in the lumbar spine.

Patients And Methods: The following were evaluated at L1-L2,L2-L3,L3-L4,L4-L5 and L5-S1 levels in MRI of 1070 lumbar disc levels of 214 subjects: Pfirrmann's grade of the disc, anterior and posterior disc height, disc volume, facet tropism and LFT. LFT > 0.4 cm was considered as hypertrophy.Correlation between LFT and other parameters was done and values with p < 0.05 was considered statistically significant.

Results: 112 male and 102 female were included. There was an increase in the anterior disc height (0.98 cm to 1.50 cm), posterior disc height (0.84 cm to 0.96 cm), disc volume (7.17cm to 14.6cm), facetal angle and LFT on both sides from L1-2 to L5-S1 levels. Highest frequency of LFT was seen at L4-5.Pfirrmann's grade of the disc and anterior disc height had a statistically significant positive correlation with LFT at L1-L2,L2-L3,L3-L4,L4-L5 levels whereas facet tropism was strongly associated with LFT at L5-S1 level.

Conclusion: Higher Pfirrmann's grade and decreased anterior disc height can lead to ligamentum flavum hypertrophy at L1-L2, L2-L3,L3-L4,L4-L5 levels.Whereas at L5-S1 level, it is the presence of facet tropism which can cause LFH. Hence, patients with the presence of above mentioned factors at those respective levels have higher preponderance to develop Lumbar canal stenosis.
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http://dx.doi.org/10.1016/j.clineuro.2019.04.023DOI Listing
July 2019

Full-Length Envelope Analyzer (FLEA): A tool for longitudinal analysis of viral amplicons.

PLoS Comput Biol 2018 12 13;14(12):e1006498. Epub 2018 Dec 13.

Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California San Diego, La Jolla, CA, USA.

Next generation sequencing of viral populations has advanced our understanding of viral population dynamics, the development of drug resistance, and escape from host immune responses. Many applications require complete gene sequences, which can be impossible to reconstruct from short reads. HIV env, the protein of interest for HIV vaccine studies, is exceptionally challenging for long-read sequencing and analysis due to its length, high substitution rate, and extensive indel variation. While long-read sequencing is attractive in this setting, the analysis of such data is not well handled by existing methods. To address this, we introduce FLEA (Full-Length Envelope Analyzer), which performs end-to-end analysis and visualization of long-read sequencing data. FLEA consists of both a pipeline (optionally run on a high-performance cluster), and a client-side web application that provides interactive results. The pipeline transforms FASTQ reads into high-quality consensus sequences (HQCSs) and uses them to build a codon-aware multiple sequence alignment. The resulting alignment is then used to infer phylogenies, selection pressure, and evolutionary dynamics. The web application provides publication-quality plots and interactive visualizations, including an annotated viral alignment browser, time series plots of evolutionary dynamics, visualizations of gene-wide selective pressures (such as dN/dS) across time and across protein structure, and a phylogenetic tree browser. We demonstrate how FLEA may be used to process Pacific Biosciences HIV env data and describe recent examples of its use. Simulations show how FLEA dramatically reduces the error rate of this sequencing platform, providing an accurate portrait of complex and variable HIV env populations. A public instance of FLEA is hosted at http://flea.datamonkey.org. The Python source code for the FLEA pipeline can be found at https://github.com/veg/flea-pipeline. The client-side application is available at https://github.com/veg/flea-web-app. A live demo of the P018 results can be found at http://flea.murrell.group/view/P018.
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http://dx.doi.org/10.1371/journal.pcbi.1006498DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6314628PMC
December 2018

Improving Diagnosis of Primary Prostate Cancer With Combined Ga-Prostate-Specific Membrane Antigen-HBED-CC Simultaneous PET and Multiparametric MRI and Clinical Parameters.

AJR Am J Roentgenol 2018 12 9;211(6):1246-1253. Epub 2018 Oct 9.

2 Department of Urology and Andrology, Indraprastha Apollo Hospitals, SaritaVihar, New Delhi, India.

Objective: The current study was designed to test the diagnostic performance of Ga-prostate-specific membrane antigen (PSMA) PET and multiparametric MRI along with clinical parameters in the characterization of prostatic lesions.

Materials And Methods: Eighty-two men with 63 malignant and 21 benign histologically proven prostate lesions who underwent complete clinical workup were included in this retrospective study. All patients underwent simultaneous whole-body Ga-PSMA PET/MRI with dedicated multiparametric MRI. Prostate Imaging-Reporting and Data System (PI-RADS) version 2 assessment was used for predicting the likelihood of cancer. Uptake of Ga-PSMA was recorded by adopting the copy-and-paste function of ROIs defined on MR images. ROC and combined ROC analyses were performed to test the diagnostic accuracy of individual and combined parameters. Spearman analysis was used to assess the correlations.

Results: PSMA uptake (maximum standardized uptake value) was significantly different among tumors with Gleason scores of 7, 8, and 9, with the lowest uptake in tumors with a score of 7 and the highest uptake in tumors with a score of 9. There was a significant difference between early- and delayed-phase PSMA uptake in malignant prostatic lesions (p < 0.01). Significant correlations were observed between delayed and differential PSMA uptake and PI-RADS category (p < 0.01 and < 0.01, respectively), digital rectal examination findings (p = 0.01 and < 0.01, respectively), Gleason score (p = 0.05 and < 0.05, respectively), and prostate-specific antigen levels (p = 0.01 for both). Combined ROC analysis of prostate-specific antigen levels, digital rectal examination findings, multiparametric MRI, and differential PSMA uptake were able to characterize prostatic lesions with a mean (± SD) AUC of 0.94 ± 0.03, compared with their individual AUCs of 0.77, 0.70, 0.82, and 0.88.

Conclusion: Gallium-68-PSMA PET combined with multiparametric MRI showed high diagnostic accuracy for prostate cancer diagnosis compared with either multiparametric MRI or PET alone or with clinical factors (e.g., digital rectal examination or prostate-specific antigen level) alone, and the combination further improves characterization of prostatic lesions.
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http://dx.doi.org/10.2214/AJR.18.19585DOI Listing
December 2018

Clinical and Radiological Outcomes of Modified Mini-Open and Open Transforaminal Lumbar Interbody Fusion: A Comparative Study.

Asian Spine J 2018 Jun 4;12(3):544-550. Epub 2018 Jun 4.

Department of Spine Surgery, Sri Ramachandra Medical University, Chennai, India.

Study Design: Retrospective cohort study.

Purpose: To compare the clinical and radiological outcomes of modified mini-open transforaminal lumbar interbody fusion (modMOTLIF) and open TLIF (OTLIF).

Overview Of Literature: Minimally invasive transforaminal lumbar interbody fusion (MTLIF) is associated with less blood loss, shorter hospital stay, and less pain. However, it has concerns like increased radiation exposure, steep learning curve, and instrumentation cost. We modified the MTLIF technique by direct freehand insertion of pedicle screws using stab incisions without tubular retractors.

Methods: The study included 24 patients in the modMOTLIF group and 27 patients in the OTLIF group. The average follow-up period was 25.6 months. Clinical outcomes were measured using Visual Analog Scale (VAS) and Oswestry Disability Index (ODI) scores. Serial X-rays were acquired at 1, 3, 6, 12, and 24 months to assess the union and presence of instability. We also compared blood loss and length of hospital stay in both groups.

Results: All patients showed progressive improvement in VAS and ODI scores. No differences were observed in the preoperative and postoperative ODI and VAS leg scores between the groups. The immediate postoperative VAS back score was significantly higher in the OTLIF group than in the modMOTLIF group; however, no difference was observed at 1 and 2 years. Radiological analysis showed nonunion in one and two patients in the OTLIF and modMOTLIF groups, respectively. The average blood loss was 63 mL in the mod-MOTLIF group and 254 mL in the OTLIF group. The mean hospital stay was 3 days for the modMOTLIF group and 5 days for the OTLIF group.

Conclusions: modMOTLIF was associated with reduced blood loss and shorter hospital stay compared with OTLIF. No significant differences were observed in the clinical and radiological outcomes between the groups after 2 years despite reduced back pain in the immediate postoperative period in patients who underwent modMOTLIF.
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http://dx.doi.org/10.4184/asj.2018.12.3.544DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6002170PMC
June 2018

Evaluation of the Antidiabetic Properties of S-1708 Mulberry Variety.

Pharmacogn Mag 2017 Jul 11;13(Suppl 2):S280-S288. Epub 2017 Jul 11.

Department of Applied Animal Sciences, Sericulture Laboratory, Babasaheb Bhimrao Ambedkar University, Lucknow, Uttar Pradesh, India.

Background: Diabetes is a metabolic disease prevalent worldwide in all age group of people. The source of diabetes is due to an oxidation process that can produce free radicals. An increase in oxidative free radicals in the body is reported to be one of the several causes of diabetes. The best remedy to combat oxidative stress is the use of antioxidants, which inhibit and scavenge free radicals.

Aim: This study has been undertaken to evaluate the antioxidant activity and antidiabetic effect of mulberry leaf extract in diabetic mice.

Materials And Methods: Antioxidant activity of mulberry leaves was determined by 2,2-diphenyl-1-picryl-hydrazyl (DPPH) and ferric reducing/antioxidant power (FRAP) assay. Antidiabetic assay of mulberry leaf extract was analyzed by oral administration of leaf extract up to 3 weeks in diabetic mice induced by streptozotocin.

Results: antioxidant activity in both DPPH and FRAP assays showed significantly ( < 0.05) higher inhibition of free radicals than that with ascorbic acid. Diabetic mice fed with mulberry leaf extract showed increment (+25.88%) in body weight and a significant reduction in blood glucose concentration (-71.58%). Further, glucose-6-phosphate dehydrogenase enzyme activity was significantly ( < 0.05) increased, whereas activities of other enzymes particularly catalase, serum glutamic oxaloacetic transaminase, serum glutamic pyruvic transaminase were decreased in diabetic mice after oral administration of mulberry leaf extracts. Histology of liver revealed regeneration of hepatocytes, central vein, and nucleus.

Conclusion: This study demonstrated that S-1708 mulberry variety has a potential therapeutic value in diabetes and related complications.

Summary: Diabetes mellitus is a grave metabolic deviations and responsible for many complications affecting various organs in the human body. In spite of the known antidiabetic medicine available in the market, diabetes and the associated impediments sustained to be a major medical crisis. Medicinal plants have been proven to be useful in diabetes due to their rich therapeutic value. In the current study, S-1708 mulberry variety not only authenticated the earlier results obtained from other medicinal plants but also turn out to be known as a potential source for treating diabetes by demonstrating tremendous ant- diabetic properties. S-1708, DPPH, FRAP.
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http://dx.doi.org/10.4103/pm.pm_490_16DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5538167PMC
July 2017

Legal Terms Used in Reception Order and their Relevance to Judicial Process.

Indian J Psychol Med 2016 Sep-Oct;38(5):431-437

Institute of Mental Health, Madras Medical College, Chennai, Tamil Nadu, India.

Introduction: Law governs the admission and management of involuntary admissions of mentally ill persons who are admitted under the provisions of the mental health act. The court directs the doctor to take charge of such persons. In the further dealings of such person the medical officer of the psychiatric facility comes across legal terms, which require understanding so that patients could be dealt with properly. Various terms such as accused, under police custody, judicial custody, remand prisoner, or under trial prisoner are used to denote their legal status. It is imperative for the medical officer to understand the nuances in the meanings of these terms. There are many times when the relevant section under which the admission is ordered is not found in the reception order. In these cases the terminology by which the patient is mentioned throws a light on the status of the patient. Towards this aim a study was carried out to assess the awareness and understanding of such terms by the faculty and post- graduates of a tertiary care hospital that deals with the admission and care of such patients.

Method: They were administered a questionnaire containing these terms and asked to provide the meaning of these terms.

Results: The results showed that nearly half the faculty and students were not having clarity in awareness or understanding of the terms.

Discussion: Hence these terms and their meanings were gleaned from various judgments. The proper meaning of these terms and their use in judicial process and their importance is discussed.
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http://dx.doi.org/10.4103/0253-7176.191377DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5052956PMC
November 2016

A review of reception order in the management of mentally ill persons in a psychiatric institute.

Indian J Psychiatry 2016 Apr-Jun;58(2):171-7

Institute of Mental Health, Madras Medical College, Kilpauk, Chennai, Tamil Nadu, India.

Background: Mentally ill prisoners, when requiring admission in a psychiatric facility, have to be admitted only by a reception order of a judicial magistrate and convicts by warrants issued by the Government to jail superintendents and the superintendent of the hospital. Both can be only under Section 27 of The Mental Health Act, 1987.

Materials And Methods: A study of the contents of reception order and warrants regarding the acts and section under which they were issued over 1 year period for the admission of the patients in the criminal ward of the Institute of Mental Health was carried out.

Results: Only three reception orders quoted Section 27 out of 54 patients admitted under a reception order. Nineteen patients were admitted by the jail superintendents.

Discussion: Various issues that were found in the reception order and their consequences are discussed, and a possible response to these issues is mooted.

Conclusion: Almost none of the reception orders were found to be proper. This deficit needs to be rectified by sensitizing the various authorities.
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http://dx.doi.org/10.4103/0019-5545.183787DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4919961PMC
July 2016

An inflammatory pseudotumor in the thoracic epidural space presenting with progressive paraplegia: a histopathological diagnosis with clinical and radiological uncertainty. Case report with literature review.

Eur Spine J 2016 05 9;25 Suppl 1:75-9. Epub 2015 Jul 9.

Department of Orthopaedics and Spine Surgery, PSG Institute of Medical Sciences and Research, Coimbatore, 641 004, India.

Introduction: Inflammatory pseudotumors (IPTs) are benign lesions with unknown etiology, probably an immunological reaction to a traumatic or an infective insult or sometimes considered as an IgG4-related autoimmune disorder. It can occur as an isolated or multi-centric lesion and are reported to involve almost all parts of the human body. Although lung and orbital IPTs are reported commonly, central nervous system involvement is a rare occurrence. Only seven cases of spinal epidural IPTs have been reported to date. These are clinically and radiologically a diagnosis of exclusion. It is an exclusive histopathological diagnosis.

Case Report: We present here a 49-year-old female with 2 months history of progressive weakness in lower limbs, with no history suggestive of any traumatic, infective, inflammatory, or neoplastic pathology. Both clinical and radiological investigations were inconclusive. There was a mass lesion in the epidural space (predominantly in the posterior and right lateral space) at T1-T3 vertebral levels compressing the thoracic spinal cord. Considering the progressive nature of her neurological deficit, an emergency decompressive laminectomies of T1-T3 vertebrae were done with excision of the compressive mass lesion. Histopathological examination showed a rich lympho-plasmacytic cell infiltrates with storiform spindle cells and dense fibrosis, which was diagnostic of IPT. Post-operatively there was a rapid recovery in neurology and she became ambulatory at the end of 2 weeks. The purpose of this case report is to discuss the clinical, histopathological and radiological features, differential diagnosis, management, and prognosis of spinal IPT on the background of relevant literature review.
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http://dx.doi.org/10.1007/s00586-015-4106-8DOI Listing
May 2016

Dual inhibition of arachidonic acid pathway by mulberry leaf extract.

Inflammopharmacology 2015 Feb 10;23(1):65-70. Epub 2014 Dec 10.

Department of Applied Plant Sciences, SB&BT, Babasaheb Bhimrao Ambedkar University, Raebareli Road, Vidya Vihar, Lucknow, 226 025, Uttar Pradesh, India.

The present work investigates the anti-inflammatory, analgesic and antipyretic activity of methanolic extract of mulberry leaves of variety S-1, S-13 and S-146. The S-146 extract was further evaluated for its efficacy against adjuvant arthritis in albino rats followed by inhibitory potential for COX 1, COX 2 and 5 LOX. The HPLC analysis enumerated the presence of morin, reversterol, scopoletin and 7-hydroxy coumarin as the major constituents. The anti-inflammatory, antipyretic and analgesic activity observed in the present experiment could be accredited to the dual inhibition in the AA pathway. The inhibition of COX and LOX enzymes could be imparted to the presence of resveraterol, morin, scopoletin and 7-hydroxy coumarin.
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http://dx.doi.org/10.1007/s10787-014-0223-yDOI Listing
February 2015

A novel 11β-hydroxysteroid dehydrogenase type1 inhibitor CNX-010-49 improves hyperglycemia, lipid profile and reduces body weight in diet induced obese C57B6/J mice with a potential to provide cardio protective benefits.

BMC Pharmacol Toxicol 2014 Aug 7;15:43. Epub 2014 Aug 7.

Connexios Life Sciences Pvt Ltd, Bangalore, India.

Background: 11ß-hydroxysteroid dehydrogenase type1 (11β-HSD1) converts inactive glucocorticoids to active glucocorticoids which, in excess, leads to development of the various risk factors of the metabolic syndrome. Recent studies clearly suggest that both increased expression and activity of 11β-HSD1 in metabolically active tissues such as liver, muscle and adipose are implicated in tissue specific dysregulation which collectively contribute to the whole body pathology seen in metabolic syndrome. In the present study we have evaluated CNX-010-49, a highly potent, selective and 'pan tissue' acting 11β-HSD1 inhibitor, for its potential to modulate multiple risk factors of the metabolic syndrome.

Methods: Male C57B6/J mice on high fat diet (DIO mice) were orally dosed with CNX-010-49 (30 mg/kg twice daily; n = 8) or vehicle for 10 weeks. Fasting glucose, triglycerides, glycerol, free fatty acids, body weight and feed intake were measured at selected time points. At the end of the treatment an OGTT and subsequently organ histology was performed. In vitro, CNX-010-49 was evaluated in 3T3-L1 preadipocytes to assess impact on adipocytes differentiation, hypertrophy and lipolysis whereas in fully differentiated C2C12 cells and in primary mouse hepatocytes to assess the impact on glucose metabolism and hepatic glucose output respectively.

Results: CNX-010-49 a highly potent and selective pan tissue acting 11β-HSD1 inhibitor (EC50 = 6 nM) significantly inhibits glucocorticoids and isoproterenol mediated lipolysis in mature 3T3-L1 adipocytes, improves muscle glucose oxidation, reduces proteolysis and enhances mitochondrial biogenesis. Also a significant inhibition of gluconeogenesis in primary mouse hepatocytes was observed. The treatment with CNX-010-49 resulted in a significant decrease in fasting glucose, improved insulin sensitivity and glucose tolerance. Treatment also resulted in a significant decrease in serum triglycerides levels and a complete inhibition of body weight gain without affecting feed consumption. A significant reduction in the serum biomarkers like Plasminogen activator inhibitor-1 (PAI-1), interleukin 6 (IL-6) and Fetuin-A with CNX-010-49 treatment was observed indicating a potential to modulate processes implicated in cardiovascular benefits.

Conclusions: These results indicate that inhibition of 11β-HSD1 with CNX-010-49 can give a potential benefit in the management of metabolic dysregulations that are seen in type 2 diabetes.
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http://dx.doi.org/10.1186/2050-6511-15-43DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4127523PMC
August 2014

Antibacterial activity of essential oils of edible spices, Ocimum canum and Xylopia aethiopica.

J Food Sci 2014 May 23;79(5):M972-7. Epub 2014 Apr 23.

CSIR-Central Inst. of Medicinal and Aromatic Plants, Lucknow, 226015, India; Babasaheb Bhimrao Ambedkar Univ, Lucknow, 226025, India.

Unlabelled: The essential oils of 2 Cameroonian spices, namely, Xylopia aethiopica and Ocimum canum, were chemically investigated and screened for their antibacterial activity. The essential oils were analyzed by means of GC, GC/MS, and NMR. X. aethiopica oil contained myrtenol (12%), a monoterpenoid in highest concentration. The essential oil of O. canum belonged to the known linalool (44%) rich chemotype. The results of the antibacterial screening against the food spoiling bacteria revealed a significant and broad spectrum of activity for these essential oils. The present material of X. aethiopica, which is having myrtenol in relatively higher concentration, has shown moderate antibacterial activity. The bioassay-guided fractionation of Ocimum canum oil through flash chromatography showed that minor compounds, namely, α-terpineol, chavicol, chavibetol, and trans-p-mentha-2,8-dien-ol, significantly contributed for the overall activity observed. Hence, these results evidenced the possible potential of the essential oil of O. canum as a suitable antibacterial for controlling food-borne pathogens whereas the X. aethiopica oil has moderate possibility.

Practical Application: There is a strong global demand for the microbe-free, safe, and healthy foods. In this study, we showed that the essential oil of O. canum (wild basil) can be used as antibacterial for food items. Also, we showed that a value addition in the antibacterial potential of O. canum oil can be done by processing the essential oil through flash chromatographic separations.
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http://dx.doi.org/10.1111/1750-3841.12457DOI Listing
May 2014

Prospective comparative study between straight and curved probe for pedicle screw insertion.

Eur Spine J 2014 Oct 23;23(10):2161-5. Epub 2014 Apr 23.

Spine Surgery, HOSMAT Hospital, Bangalore, India,

Purpose: To evaluate difference in accuracy of pedicle screw insertion in thoracic and lumbosacral spine using a straight pedicle probe vis-à-vis a curved one.

Methods: Prospective, comparative, non-randomized, single-blind study. Straight and curved pedicle probes used on opposite sides of same vertebra in patients undergoing thoracolumbar pedicle screw fixation for various indications. Postoperative blinded evaluation for pedicle breaches done with a CT scan. Pedicle breaches graded as grade 0: no breach, grade 1: <2 mm, grade 2: 2-4 mm and grade 3: >4 mm breach.

Results: After appropriate statistical power analysis, 300 screws inserted in 59 patients from T4-L5 levels. No significant differences noted between the two probes in terms of screw length [two-tailed p = 0.16]; grade 0 screws [two-tailed p = 0.49] or screws with grade 2/3 breaches [two-tailed p = 0.68]. With the right-hand-dominant operating-surgeon standing to left of patient during surgery, no difference noted between the two probes for either the right or left-side pedicle screw insertion [two-tailed p = 1]. Repeating these tests in the subset of thoracic pedicle screws too, revealed no significant difference.

Conclusions: No significant difference in outcome of pedicle screw insertion with either a straight or a curved pedicle probe.
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http://dx.doi.org/10.1007/s00586-014-3310-2DOI Listing
October 2014

Role of HCMV miR-UL70-3p and miR-UL148D in overcoming the cellular apoptosis.

Mol Cell Biochem 2014 Aug 16;393(1-2):89-98. Epub 2014 Apr 16.

Department of Biotechnology, Babasaheb Bhimrao Ambedkar University, Lucknow, 226 025, India,

The studies into the pathophysiology of viral miRNAs are still in infancy; the interspecies regulation at the miRNA level fuels the spark of the investigation into the repertoire of virus-host interactions. Reports pertaining to the viral miRNAs role in modulating/evading the host immune response are surging up; we initiated this in silico study to speculate the role of human cytomegalovirus (HCMV)-encoded miRNAs on human antiviral mechanisms such as apoptosis and autophagy. The results indicate that both the above mechanisms were targeted by the HCMV miRNAs, located in the unique long region of the HCMV genome. The proapoptotic genes MOAP1, PHAP, and ERN1 are identified to be the potential targets for the miR-UL70-3p and UL148D, respectively. The ERN1 gene plays a role in the initiation of Endoplasmic reticulum stress-induced apoptosis as well as autophagosome formation. This study shows that HCMV employs its miRNA repertoire for countering the cellular apoptosis and autophagy, particularly the mitochondrial-dependent intrinsic pathway of apoptosis. In addition, the homology studies reveal no HCMV miRNA bears sequence homology with human miRNAs.
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http://dx.doi.org/10.1007/s11010-014-2049-8DOI Listing
August 2014

Aromatase and glycosyl transferase inhibiting acridone alkaloids from fruits of Cameroonian Zanthoxylum species.

Chem Cent J 2013 18;7:125. Epub 2013 Jul 18.

Babasaheb Bhimrao Ambedkar University, Lucknow 226025, India.

Background: Zanthoxylum zanthoxyloides and Z. leprieurii fruits are commonly used in traditional system of medicine for diarrhea, pain, wound healing, etc. in Cameroon, Africa. Z. leprieurii fruits have been chemically studied for its bioactive compounds whereas the investigation on Z. zanthoxyloides fruits is lacking.

Results: After a detailed chemical analysis of the fruits of Z. leprieurii and Z. zanthoxyloides, a series of new acridone alkaloids, namely, 3-hydroxy-1,5,6-trimethoxy-9-acridone (1), 1,6-dihydroxy-3-methoxy-9-acridone (2), 3,4,5,7-tetrahydroxy-1-methoxy-10-methyl-9-acridone (3), 4-methoxyzanthacridone (8), 4-hydroxyzanthacridone (9), 4-hydroxyzanthacridone oxide (2,4') (10) have been isolated. The known acridones which have been characterized are, helebelicine A (4), 1-hydroxy-3-methoxy-10-methyl-9-acridone (5), 1,3-dihydroxy-4-methoxy-10-methyl-9-acridone (6) and tegerrardin A (7). The in vitro antibacterial and cytotoxic screening of these acridones reveal that compound 3 has a moderate antibacterial activity (MIC 125 μg/mL) against Micrococcus luteus and Pseudomonas aeruginosa while compound 1 shows a moderate cytotoxic effect (IC50 of 86 μM) against WRL-68 (liver cancer cell line). Furthermore, the molecular modeling of these acridones predicted the structural basis for their mode of action and binding affinity for aromatase, quinone reductase and WAAG, a glycosyltransferase involved in bacterial lipopolysaccharide synthesis. Computational approaches, quantitative SAR and modeling studies predicted that acridones 1, 2, 3, 4, 9 and 10 were the inhibitors of glycosyltransferase while 1, 8, 9 and 10, the inhibitors of aromatase.

Conclusions: A total of 10 acridones have been isolated out of which 6 are new (1, 2, 3, 8, 9 and 10). Alkaloids 8, 9 and 10, having novel tetracyclic acridone structure with new carbon skeleton, have now been named as zanthacridone. The quantitative SAR and molecular modeling studies suggested that the compounds 1, 9 and 10 are inhibitors of both aromatase and glycosyltransferase.
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http://dx.doi.org/10.1186/1752-153X-7-125DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3750308PMC
May 2014

Zantholic acid, a new monoterpenoid from Zanthoxylum zanthoxyloides.

Nat Prod Res 2013 26;27(21):1994-8. Epub 2013 Jun 26.

a CSIR-Central Institute of Medicinal and Aromatic Plants , Lucknow , 226015 , India.

From the extract of Zanthoxylum zanthoxyloides fruits, a new menthane monoterpenoid, (4R,7R)-8-carboxy-7,9-dihydroxy-trans-menthane, tentatively, named as zantholic acid along with several known compounds was isolated. Its structure was determined using spectroscopic methods. The cytotoxic activity of zantholic acid against a panel of cancer cell lines was evaluated using the MTT assay. The results show that zantholic acid possesses a selective cytotoxic activity towards breast cancer cell lines.
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http://dx.doi.org/10.1080/14786419.2013.811662DOI Listing
July 2014

Antibacterial, cytotoxic activities and chemical composition of fruits of two Cameroonian Zanthoxylum species.

J Ethnopharmacol 2013 Jun 6;148(1):74-80. Epub 2013 Apr 6.

CSIR - Central Institute of Medicinal and Aromatic Plants, Lucknow 226015, India.

Ethnopharmacological Relevance: Zanthoxylum leprieurii (Syn. Fagara leprieurii) is a plant extensively used by traditional healers in Cameroon for the treatment of stomach disorders, gonorrhea, intestinal parasites and sterility. The infusion from the fruit is taken in Cameroon for the treatment of sickle cell anemia, as well. Similarly, the roots of Zanthoxylum zanthoxyloides (Syn. Fagara zanthoxyloides) are also used for wound dressing, sickle cell anemia and as pain reliever, in addition to the uses mentioned for Zanthoxylum leprieurii.

Aim Of The Study: To scientifically validate their traditional use, the in vitro antimicrobial and anticancer assays were performed. In addition, chemical compositions of their fruit extracts and essential oils were also studied.

Material And Methods: The chemical compositions of their essential oils and methanol extracts were studied. GC and GC-MS were used for analyzing the essential oils while various chromatographic methods were used to isolate the pure compounds from methanol extracts. MTT assay was used for the cytotoxic studies of methanol extracts, their fractions and some pure compounds. Antimicrobial activity of methanol extracts, some isolated compounds as well as essential oils was tested against a panel of human pathogenic bacteria by diffusion and dilution methods.

Results: The principal constituents of the essential oil of Zanthoxylum zanthoxyloides were identified as citronellol and geraniol whereas Zanthoxylum leprieurii was rich in E-β-ocimene. Furthermore, we report for the first time, the presence of 7,8-dimethoxycoumarin and sinapic acid in the methanol extract of Zanthoxylum leprieurii. In vitro bioassays reveal that the methanol extracts, essential oil and some of the isolated compounds from fruits of both the plants exhibit moderate anticancer and antimicrobial activities.

Conclusion: Altogether, the present findings justify the traditional use of Zanthoxylum zanthoxyloides and Zanthoxylum leprieurii in the treatment of stomach disorders and cancer disease. The antimicrobial properties in the essential oil of Zanthoxylum zanthoxyloides are of additional significance.
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http://dx.doi.org/10.1016/j.jep.2013.03.069DOI Listing
June 2013

Characterization of major zinc containing myonecrotic and procoagulant metalloprotease 'malabarin' from non lethal trimeresurus malabaricus snake venom with thrombin like activity: its neutralization by chelating agents.

Curr Top Med Chem 2011 ;11(20):2578-88

Department of Studies in Biochemistry, University of Mysore, Manasagangotri, Mysore-57006, Karnataka, India.

A major myonecrotic zinc containing metalloprotease 'malabarin' with thrombin like activity was purified by the combination of gel permeation and anion exchange chromatography from T. malabaricus snake venom. MALDI-TOF analysis of malabarin indicated a molecular mass of 45.76 kDa and its N-terminal sequence was found to be Ile-Ile-Leu- Pro(Leu)-Ile-Gly-Val-Ile-Leu(Glu)-Thr-Thr. Atomic absorption spectral analysis of malabarin raveled the association of zinc metal ion. Malabarin is not lethal when injected i.p. or i.m. but causes extensive hemorrhage and degradation of muscle tissue within 24 hours. Sections of muscle tissue under light microscope revealed hemorrhage and congestion of blood vessel during initial stage followed by extensive muscle fiber necrosis with elevated levels of serum creatine kinase and lactate dehydrogenase activity. Malabarin also exhibited strong procoagulant action and its procoagulant action is due to thrombin like activity; it hydrolyzes fibrinogen to form fibrin clot. The enzyme preferentially hydrolyzes Aα followed by B subunits of fibrinogen from the N-terminal region and the released products were identified as fibrinopeptide A and fibrinopeptide B by MALDI. The myonecrotic, fibrinogenolytic and subsequent procoagulant activities of malabarin was neutralized by specific metalloprotease inhibitors such as EDTA, EGTA and 1, 10-phenanthroline but not by PMSF a specific serine protease inhibitor. Since there is no antivenom available to neutralize local toxicity caused by T. malabaricus snakebite, EDTA chelation therapy may have more clinical relevance over conventional treatment.
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http://dx.doi.org/10.2174/156802611797633375DOI Listing
April 2012

Purification and characterization of 'Trimarin' a hemorrhagic metalloprotease with factor Xa-like Activity, from Trimeresurus malabaricus snake venom.

Thromb Res 2010 Nov 17;126(5):e356-64. Epub 2010 Sep 17.

Department of Studies in Bioscience, University of Mysore, Hemagangotri, Hassan-573201, Karnataka, India.

In the present study, we describe the purification and characterization of a metalloprotease 'trimarin' from Trimeresurus malabaricus snake venom. Trimarin is a single-chain basic protein, with a molecular mass of 29.6kDa. Trimarin showed proteolytic activity towards casein and fibrinogen, which was irreversibly inhibited by EDTA and 1,10-phenanthroline. The metal ion associated with trimarin was found to be Zn(2+). Trimarin exhibited pharmacological activities including hemorrhage, myotoxicity, procoagulant and factor Xa-like activities. The hemorrhage and myotoxicity correlated with degradation of extracellular protein components type-IV collagen and fibronectin. Myotoxicity due to muscle tissue necrosis was substantiated with increased serum CK activity. Trimarin showed procoagulant activity with reduced re-calcification time of citrated human plasma. Trimarin shortened the activated partial thromboplastin time (aPTT) and prothrombin time (PT), suggesting its involvement in common pathway of blood coagulation. Trimarin coagulated the citrated human plasma in the absence of CaCl(2), but it was lacking thrombin like activity as it did not clot the purified fibrinogen. Remarkably, the enzyme clotted the factor X deficient human plasma, suggesting that trimarin has factor Xa-like activity. Thus, trimarin may play a key role in the pathophysiological conditions that occur during T. malabaricus envenomation, and may be used as a biological tool to explore many facets of hemostasis.
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http://dx.doi.org/10.1016/j.thromres.2010.07.025DOI Listing
November 2010

Cysteine proteases from the Asclepiadaceae plants latex exhibited thrombin and plasmin like activities.

J Thromb Thrombolysis 2009 Oct 1;28(3):304-8. Epub 2008 Nov 1.

Department of Studies in Biochemistry, University of Mysore, Manasagangothri, Mysore, India.

In the present study we evaluated the presence of cysteine protease from the latex of four plants Asclepias curassavica L., Calotropis gigantea R.Br., Pergularia extensa R.Br. and Cynanchum puciflorum R.Br. belongs to the family Asclepiadaceae. Cysteine proteases from these plants latex exhibited both thrombin and plasmin like activities. Latex enzyme fraction in a concentration dependent manner induced the formation of clot in citrated blood plasma. Direct incubation of fibrinogen with latex enzyme fraction resulted in the formation of fibrin clot similar to thrombin enzyme. However prolonged incubation resulted in degradation of the formed fibrin clot suggesting plasmin like activity. Latex enzyme fraction preferentially hydrolyzed Aalpha and Bbeta chains of fibrinogen to form fibrin clot. Latex enzyme fraction also hydrolyzed the subunits of fully cross linked fibrin efficiently, the order of hydrolysis was alpha-polymer > alpha-chains > beta-chain and gamma-gamma dimer. Cysteine proteases from all the four Asclepiadaceae plants latex exhibited similar action on fibrinogen and fibrin. This study scientifically validate the use of plant latex in stop bleeding and wound healing by traditional healers all over the world.
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http://dx.doi.org/10.1007/s11239-008-0290-2DOI Listing
October 2009