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Fulltext Ruptured Aortic Aneurysm Secondary to Psoas abscess after Intravesical Bacilli Calmette-Guérin

Khandelwal A, Gupta A, Virmani V, Khandelwal K

Med J Malaysia, 2012 Oct;67(5):534-5.
PMID: 23770877

Bacillus Calmette-Guérin (BCG) is a live attenuated strain of Mycobacterium bovis that has been used as effective treatment for early-stage transitional carcinoma of the urinary bladder. We present a case of a 68 year old man who had an abdominal aortic aneurysm following BCG therapy for bladder cancer. Contrast enhanced computerized tomogram (CECT) of abdomen and pelvis revealed bilateral hypodense lesions suggestive of psoas abscesses. In addition, a saccular abdominal aortic aneurysm measuring 4x3.6 cm involving infrarenal aorta with surrounding hematoma was seen. At surgery, he was found to have a psoas abscess and hemorrhage. He underwent ligation of the aorta and an axillary-bifemoral bypass. He was given one year of anti-tubercular therapy to which he responded clinically.
Fulltext Internal Pudendal Artery Injury Following An Open Book Pelvic Fracture: A Case Report

Elhence A, Gahlot N, Gupta A, Garg P

Malays Orthop J, 2020 Nov;14(3):180-183.
PMID: 33403083 DOI: 10.5704/MOJ.2011.030

Arterial haemorrhage is a potentially life threatening complication in severe pelvic ring injuries such as "open book" fractures. These injuries mostly implicate the posterior branches of the internal iliac artery. However, we report an unusual case wherein the source of bleeding was identified to be the internal pudendal artery and its branches. Patient was a 27-year-old male who presented to the emergency following an alleged history of road traffic accident and was diagnosed as a case of pelvic fracture (Young and Burgess Antero-Posterior Compression II) with sacral fracture (Denis type 2) with suspected urethral injury. Computerised Tomography (CT) angiogram revealed contrast extravasation from the right internal pudendal artery. However, digital subtraction angiography (DSA) was normal indicating spontaneous closure of the arterial bleeder. Surgical stabilisation of the fracture was carried out and subsequently, patient was discharged. This report serves to highlight that although uncommon, internal pudendal artery can be injured in hemodynamically unstable "open book" pelvic fractures and hence, must be always ruled out.
Fulltext End stage renal failure mimicking as acute renal failure in developing countries

Lal C, Gupta A, Khaira A, Tiwari SC

Med J Malaysia, 2009 Jun;64(2):184.
PMID: 20058588

Sir, We here are highlighting the scenario of presentation of renal dysfunction in developing countries like India where a large number of patients present clinically as acute renal failure (ARF) but on thorough evaluation found to have advanced stages of chronic kidney disease (CKD stages 4 and 5)1 . Historically these patients are symptomatic for few days prior to presenting. Preceding slight unwell-ness is ignored either by patient or his family physician. They are often being treated with non-specific medications like analgesics and multivitamins which act as placebo. Iron deficiency anemia is unevaluated for a renal cause. Non-standardized laboratories under diagnose early CKD. Ultrasound imaging too is of poor quality. All the more there are no nationalized health screening programmes. To add to the dismal scenario, at the tertiary care centres they are initially admitted as ARF, with a hope of significant recovery. But later on they turn out to be CKD 5.
Of "Cotton Balls" and "Owl's eyes"

Misra S, Gupta A, Saran RK

Malays J Pathol, 2020 Dec;42(3):487-490.
PMID: 33361734

Report of a 3-month old girl child who died due to multi-systemic infection of cytomegalovirus (CMV) involving the lungs, liver and kidneys along with pneumocystis jiroveci pneumonia (PJP). The mother of the child tested positive for CMV IgG and HIV with a very low CD4 count (160/ μl). Co-infection of cytomegalovirus and pneumocystis jiroveci always occurs in the setting of immunocompromise. Congenital CMV infection is transmitted through the placenta, especially during the first trimester and causes severe multi-systemic disease whereas perinatal infection is acquired during childbirth/ breastfeeding where the babies have maternal protective antibodies leading to much milder or asymptomatic infection. PJP is more common in infancy and presents as hypoxic pneumonia. CMV causes cyto-nucleomegaly and classic "owl's eye" inclusions on histology while PJP presents with characteristic fluffy "cotton ball" alveolar exudates.
Fulltext Estimating the Impact of Daily Weather on the Temporal Pattern of COVID-19 Outbreak in India

Gupta A, Pradhan B, Maulud KNA

Earth Syst Environ, 2020;4(3):523-534.
PMID: 34723072 DOI: 10.1007/s41748-020-00179-1

The COVID-19 pandemic has spread obstreperously in India. The increase in daily confirmed cases accelerated significantly from ~ 5 additional new cases (ANC)/day during early March up to ~ 249 ANC/day during early June. An abrupt change in this temporal pattern was noticed during mid-April, from which can be inferred a much reduced impact of the nationwide lockdown in India. Daily maximum (T Max), minimum (T Min), mean (T Mean) and dew point temperature (T Dew), wind speed (WS), relative humidity, and diurnal range in temperature and relative humidity during March 01 to June 04, 2020 over 9 major affected cities are analyzed to look into the impact of daily weather on COVID-19 infections on that day and 7, 10, 12, 14, 16 days before those cases were detected (i.e., on the likely transmission days). Spearman's correlation exhibits significantly lower association with WS, T Max, T Min, T Mean, T Dew, but is comparatively better with a lag of 14 days. Support Vector regression successfully estimated the count of confirmed cases (R 2 > 0.8) at a lag of 12-16 days, thus reflecting a probable incubation period of 14 ± 02 days in India. Approximately 75% of total cases were registered when T Max, T Mean, T Min, T Dew, and WS at 12-16 days previously were varying within the range of 33.6-41.3 °C, 29.8-36.5 °C, 24.8-30.4 °C, 18.7-23.6 °C, and 4.2-5.75 m/s, respectively. Thus, we conclude that coronavirus transmission is not well correlated (linearly) with any individual weather parameter; rather, transmission is susceptible to a certain weather pattern. Hence multivariate non-linear approach must be employed instead.
Eco-friendly bio-based adhesive for plywood from natural rubber latex (NRL)-blended isocyanate cross-linked starch

Soubam T, Gupta A, Jamari SS

Environ Sci Pollut Res Int, 2023 Dec;30(60):124610-124618.
PMID: 35610450 DOI: 10.1007/s11356-022-20788-9

Synthetic adhesives used in the production of plywood are a matter of concern because of the emission of carcinogenic gas formaldehyde, increased environmental pollution, and the depletion of fossil fuels. In this study, a bioadhesive composed of natural rubber latex (NRL) and rice starch was developed. However, rice starch has low moisture resistance, resulting in low adhesion. Thus, to enhance the effectiveness of NRL-blended rice starch-based bioadhesive, rice starch was cross-linked with polymeric 4,4″-diphenylmethane diisocyanate (pMDI) resin, which is an environment-friendly, formaldehyde free, and moisture resistant that is highly compatible with starch. The chemical interaction, viscosity, solid content, and gel time of the developed NRL-isocyanate cross-linked rice starch-based bioadhesive was investigated. The efficacy of the formulated bioadhesive was demonstrated by the fabrication of plywood. The presence of isocyanate and urethane capabilities in the bioadhesive formulations was confirmed by Fourier transform infrared spectroscopy (FTIR). The bioadhesive type Iso-A was discovered to have the highest viscosity of 8270 mPa.s, whereas Iso-B has the shortest gel time of 3.46 min and the highest solid content of 44%; the higher solid content accelerates the gel time. In terms of physical and mechanical properties of plywood, Iso-B has the lowest thickness swelling (TS) value of 13%, lowest water absorption (WA) value of 52% and shear strength value of 1.92 MPa, which corresponds to the ISO 12466-2-2007 standard requirements. Based on the results, NRL-blended isocyanate starch-based bioadhesive could be a good potential raw material for eco-friendly plywood industries with adequate accuracy.
Fulltext Esophageal ulcer in a HIV-seropositive patient co-infected by herpes simplex and cytomegalovirus

Srilatha PS, Suvarna N, Gupta A, Bhat G

Indian J Pathol Microbiol, 2011 Jan-Mar;54(1):219-20.
PMID: 21393929 DOI: 10.4103/0377-4929.77420
Fulltext Deep penetrating nevus: a distinct variant of melanocytic nevus

Gupta A, Srilatha PS, Suvarna N, Rao L

Indian J Pathol Microbiol, 2011 Jan-Mar;54(1):156-7.
PMID: 21393904 DOI: 10.4103/0377-4929.77384

Deep penetrating nevus (DPN) is a variant of melanocytic nevus which goes unrecognized due to its relative rarity and may be misinterpreted as malignant melanoma. It commonly presents in young adults as a dark pigmented lesion on the face, neck, or shoulder. A 60-year-old lady presented with a mole over the left arm of 8 years duration. A biopsy of the lesion was performed under the clinical impression of a compound nevus with suspicion of malignancy. Based on the histologic features, a diagnosis of DPN was put forward.
Fulltext Isolated fallopian tube torsion in prepubertal females

Gupta A, Thida W, Nazir B, Yeo CS, Low Y, Ong CL

Med J Malaysia, 2015 Aug;70(4):259-62.
PMID: 26358026

Isolated fallopian tube torsion is an uncommon diagnosis. It is particularly rare in the paediatric and post-menopausal age groups. It lacks pathognomonic symptoms, signs and imaging findings, yet each of these diagnostic steps plays a crucial role in early diagnosis. We describe two cases of isolated fallopian tube torsion in prepubertal females.
Minimally traumatic extraction techniques in nonrestorable endodontically treated teeth: A comparative study

Sharma SD, Gupta A, Bansal P, Alexander M, Vidya B, Gupta H

Natl J Maxillofac Surg, 2022 Aug;13(Suppl 1):S91-S96.
PMID: 36393928 DOI: 10.4103/njms.njms_309_21

Aim: The goal of this study was to assess the effectiveness of piezotome as compared to periotome extractions of nonrestorable endodontic treatment of teeth in terms of operational time, pain control, and postoperative bone loss considering the prosthetic rehabilitation in future.
Materials and Methods: A double-blind, randomized controlled trial was conducted with 100 patients who wanted single-rooted teeth to be extracted (which failed endodontically). The participants have been randomized into two equal groups named as - (i) a periotome group (ii) and a piezotome group. Duration of the surgery, postoperative pain within 7 days, complications (if any) associated with the extraction process were performed as a part of clinical assessment. Bone loss has been analyzed 6 months after the surgery radiographically. The data have been recorded and analyzed using the version 22.0 of the SPSS software package.
Results: All parameters in the periotome category (P < 0.05) were statistically significant except for bone loss and gingival laceration in comparison to piezotome group. In the piezotome group, a longer time was observed for surgery and delayed pain control was achieved. In our study, we found statistically significant more marginal bone loss in piezotome group in comparison with periotome group.
Conclusion: The findings of this study indicate that for intraoperative and postoperative comfort periotome could be used as a safer and cheaper option for atraumatic extractions but piezosurgery may prove as a better choice soon for surgeries in the maxillofacial region to maintain soft-tissue integrity.
Keratin based bioplastic film from chicken feathers and its characterization

Ramakrishnan N, Sharma S, Gupta A, Alashwal BY

Int J Biol Macromol, 2018 May;111:352-358.
PMID: 29320725 DOI: 10.1016/j.ijbiomac.2018.01.037

Plastics have been one of the highly valued materials and it plays an significant role in human's life such as in food packaging and biomedical applications. Bioplastic materials can gradually work as a substitute for various materials based on fossil oil. The issue like sustainability and environmental challenges which occur due to manufacturing and disposal of synthetic plastics can be conquering by bio-based plastics. Feathers are among the most inexpensive abundant, and renewable protein sources. Feathers disposal to the landfills leads to environmental pollutions and it results into wastage of 90% of protein raw material. Keratin is non-burning hydrophilic, and biodegradable due to which it can be applicable in various ways via chemical processing. Main objective of this research is to synthesis bioplastic using keratin from chicken feathers. Extracted keratin solution mixed with different concentration of glycerol (2 to 10%) to produce plastic films. The mixture was stirred under constant magnetic stirring at 60 °C for 5 h. The mixtures are then poured into aluminum weighing boat and dried in an oven at 60 °C for 24 h. The mechanical properties of the samples were tested and the physic-chemical properties of the bioplastic were studied. According to the results, Scanning Electron Microscopy test showed good compatible morphologies without holes, cavity and edge. The difference in chemical composition was analyzed using Fourier transform infrared spectroscopy (FTIR). The samples were also characterized by thermo gravimetric analysis (TGA), differential scanning calorimetry (DSC), X-Ray diffraction (XRD) to check the thermal and crystallinity properties. Other than that, bioplastic made up from keratin with 2% of glycerol has the best mechanical and thermal properties. According to biodegradability test, all bioplastic produced are proven biodegradable. Therefore, the results showed possible application of the film as an alternative to fossil oil based materials which are harmful to the environment.
Characterisation and in vitro antimicrobial activity of biosynthetic silver-loaded bacterial cellulose hydrogels

Gupta A, Low WL, Radecka I, Britland ST, Mohd Amin MC, Martin C

J Microencapsul, 2016 Dec;33(8):725-734.
PMID: 27781557 DOI: 10.1080/02652048.2016.1253796

Wounds that remain in the inflammatory phase for a prolonged period of time are likely to be colonised and infected by a range of commensal and pathogenic microorganisms. Treatment associated with these types of wounds mainly focuses on controlling infection and providing an optimum environment capable of facilitating re-epithelialisation, thus promoting wound healing. Hydrogels have attracted vast interest as moist wound-responsive dressing materials. In the current study, biosynthetic bacterial cellulose hydrogels synthesised by Gluconacetobacter xylinus and subsequently loaded with silver were characterised and investigated for their antimicrobial activity against two representative wound infecting pathogens, namely S. aureus and P. aeruginosa. Silver nitrate and silver zeolite provided the source of silver and loading parameters were optimised based on experimental findings. The results indicate that both AgNO3 and AgZ loaded biosynthetic hydrogels possess antimicrobial activity (p
Fulltext Statistical investigation of extraction parameters of keratin from chicken feather using Design-Expert

Kamarudin NB, Sharma S, Gupta A, Kee CG, Chik SMSBT, Gupta R

3 Biotech, 2017 Jun;7(2):127.
PMID: 28573397 DOI: 10.1007/s13205-017-0767-9

Uncontrolled disposal of feathers from the poultry industry and slaughterhouses is environmentally undesirable. The feathers are composed of approximately 90% of keratin which is an important ingredient of cosmetics, shampoos and hair treatment creams. This study aimed to determine the optimum conditions for the extraction of keratin from chicken feathers. The extraction of keratin using various reducing agents was studied using statistical experimental design. In the extraction process, pH, temperature, ratio of reducing agents, mass of chicken feathers and incubation time were analyzed. The keratin in the total extracted protein was purified by size exclusion chromatography, sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) and further characterized using amino acids profile analysis. The surface morphology and chemical composition were studied by scanning electron microscopy (SEM) and Fourier transform infrared spectroscopy (FTIR) analysis. Sodium sulfide (Na2S) yielded 84.5% of keratin as compared to sodium hydroxide (43.8), urea mixture (50.6), mixture of sodium dodecyl sulfate (SDS) and sodium bisulfite (18.3) and a mixture of Na2S and sodium hydroxide (41.5%) under optimized conditions. The optimum yield of keratin was achieved at 80.9 °C in 9.5 h with 0.05 M sodium sulfide using response surface methodology (RSM). Among the five parameters screened, pH was found not to be significant because the p value was greater than 0.05.
Characterization of keratin microparticles from feather biomass with potent antioxidant and anticancer activities

Sharma S, Gupta A, Chik SMST, Kee CG, Mistry BM, Kim DH, et al.

Int J Biol Macromol, 2017 Nov;104(Pt A):189-196.
PMID: 28596005 DOI: 10.1016/j.ijbiomac.2017.06.015

In the present study chicken feathers were hydrolyzed by chemical treatment in alkaline conditions. The pH value of feather hydrolyzed solution was amended accordingly the iso-electric precipitation. Two types of keratin microparticles KM1, KM2 were synthesized under acidic conditions at 3.5 and 5.5pH respectively. The synthesized keratin microparticles possessed uniform and round surface by scanning electron microscopy (SEM). The thermal degradation of microparticles were examined by thermogravimetry (TGA). Fourier transform infrared spectroscopy (FTIR) revealed that the extracted keratin retained the most of protein backbone. The microparticles were screened for their in vitro anticancer activities by SRB bioassay towards HeLa, SK-OV-3 and A549 cancer cell lines. Futhermore, their cytotoxicity towards healthy cell lines was analyzed having Malin Darby canine kidney (MDCK) cell lines along with in vitro antioxidant activity using DPPH and ABTS methods KM1 and KM2 showed 200.31±1.01 and 139.73±0.94, 214.16±0.29 and 153.92±0.61, 328.92±3.46 and 200.33±2.48μg/mL of IC50 levels against HeLa, SK-OV-3, and A549 cell lines, respectively. Moreover, KM1 and KM2 demonstrated significant antioxidant potency with IC50 levels 13.15 and 9.02μg/mL as well as 8.96 and 5.60μg/mL in DPPH and ABTS radical scavenging bioassay, respectively.
Fulltext Machine learning assisted hepta band THz metamaterial absorber for biomedical applications

Jain P, Chhabra H, Chauhan U, Prakash K, Gupta A, Soliman MS, et al.

Sci Rep, 2023 Jan 31;13(1):1792.
PMID: 36720922 DOI: 10.1038/s41598-023-29024-x

A hepta-band terahertz metamaterial absorber (MMA) with modified dual T-shaped resonators deposited on polyimide is presented for sensing applications. The proposed polarization sensitive MMA is ultra-thin (0.061 λ) and compact (0.21 λ) at its lowest operational frequency, with multiple absorption peaks at 1.89, 4.15, 5.32, 5.84, 7.04, 8.02, and 8.13 THz. The impedance matching theory and electric field distribution are investigated to understand the physical mechanism of hepta-band absorption. The sensing functionality is evaluated using a surrounding medium with a refractive index between 1 and 1.1, resulting in good Quality factor (Q) value of 117. The proposed sensor has the highest sensitivity of 4.72 THz/RIU for glucose detection. Extreme randomized tree (ERT) model is utilized to predict absorptivities for intermediate frequencies with unit cell dimensions, substrate thickness, angle variation, and refractive index values to reduce simulation time. The effectiveness of the ERT model in predicting absorption values is evaluated using the Adjusted R2 score, which is close to 1.0 for nmin = 2, demonstrating the prediction efficiency in various test cases. The experimental results show that 60% of simulation time and resources can be saved by simulating absorber design using the ERT model. The proposed MMA sensor with an ERT model has potential applications in biomedical fields such as bacterial infections, malaria, and other diseases.
Fulltext Assessment and valuation of health impacts of fine particulate matter during COVID-19 lockdown: a comprehensive study of tropical and sub tropical countries

Bherwani H, Kumar S, Musugu K, Nair M, Gautam S, Gupta A, et al.

Environ Sci Pollut Res Int, 2021 Aug;28(32):44522-44537.
PMID: 33852112 DOI: 10.1007/s11356-021-13813-w

A novel coronavirus disease (COVID-19) continues to challenge the whole world. The disease has claimed many fatalities as it has transcended from one country to another since it was first discovered in China in late 2019. To prevent further morbidity and mortality associated with COVID-19, most of the countries initiated a countrywide lockdown. While physical distancing and lockdowns helped in curbing the spread of this novel coronavirus, it led to massive economic losses for the nations. Positive impacts have been observed due to lockdown in terms of improved air quality of the nations. In the current research, ten tropical and subtropical countries have been analysed from multiple angles, including air pollution, assessment and valuation of health impacts and economic loss of countries during COVID-19 lockdown. Countries include Brazil, India, Iran, Kenya, Malaysia, Mexico, Pakistan, Peru, Sri Lanka, and Thailand. Validated Simplified Aerosol Retrieval Algorithm (SARA) binning model is used on data collated from moderate resolution imaging spectroradiometer (MODIS) for particulate matters with a diameter of less than 2.5 μm (PM2.5) for all the countries for the month of January to May 2019 and 2020. The concentration results of PM2.5 show that air pollution has drastically reduced in 2020 post lockdown for all countries. The highest average concentration obtained by converting aerosol optical depth (AOD) for 2020 is observed for Thailand as 121.9 μg/m3 and the lowest for Mexico as 36.27 μg/m3. As air pollution is found to decrease in the April and May months of 2020 for nearly all countries, they are compared with respective previous year values for the same duration to calculate the reduced health burden due to lockdown. The present study estimates that cumulative about 100.9 Billion US$ are saved due to reduced air pollution externalities, which are about 25% of the cumulative economic loss of 435.9 Billion US$.
Fulltext A prospective, multi-centre, observational study to examine kidney disease progression in adults with chronic kidney disease - CKDOD - Study design and preliminary results

Shah B, Kirpalani A, Sunder S, Gupta A, Khanna U, Chafekar D, et al.

BMC Nephrol, 2015;16:215.
PMID: 26696239 DOI: 10.1186/s12882-015-0191-5

The objective of this article is to describe the organisation of an international, clinical registry, the Chronic Kidney Disease Observational Database (CKDOD), the processes of enrolling patients and entering data and preliminary results to date.
Extraction and application of keratin from natural resources: a review

Chilakamarry CR, Mahmood S, Saffe SNBM, Arifin MAB, Gupta A, Sikkandar MY, et al.

3 Biotech, 2021 May;11(5):220.
PMID: 33968565 DOI: 10.1007/s13205-021-02734-7

Over recent years, keratin has gained great popularity due to its exceptional biocompatible and biodegradable nature. It has shown promising results in various industries like poultry, textile, agriculture, cosmetics, and pharmaceutical. Keratin is a multipurpose biopolymer that has been used in the production of fibrous composites, and with necessary modifications, it can be developed into gels, films, nanoparticles, and microparticles. Its stability against enzymatic degradation and unique biocompatibility has found their way into biomedical applications and regenerative medicine. This review discusses the structure of keratin, its classification and its properties. It also covers various methods by which keratin is extracted like chemical hydrolysis, enzymatic and microbial treatment, dissolution in ionic liquids, microwave irradiation, steam explosion technique, and thermal hydrolysis or superheated process. Special emphasis is placed on its utilisation in the form of hydrogels, films, fibres, sponges, and scaffolds in various biotechnological and industrial sectors. The present review can be noteworthy for the researchers working on natural protein and related usage.
Extracranial internal carotid artery calcium volume measurement using computer tomography

Baradaran H, Ng CR, Gupta A, Noor NM, Al-Dasuqi KW, Mtui EE, et al.

Int Angiol, 2017 Oct;36(5):445-461.
PMID: 28541017 DOI: 10.23736/S0392-9590.17.03811-1

BACKGROUND: The extent of calcium volume in the carotid arteries of contrast-based computer tomography (CT) is a valuable indicator of stroke risk. This study presents an automated, simple and fast calcium volume computation system. Since the high contrast agent can sometimes obscure the presence of calcium in the CT slices, it is therefore necessary to identify these slices before the corrected volume can be estimated.
METHODS: The system typically consists of segmenting the calcium region from the CT scan into slices based on Hounsfield Unit-based threshold, and subsequently computing the summation of the calcium areas in each slice. However, when the carotid volume has intermittently higher concentration of contrast agent, a dependable approach is adapted to correct the calcium region using the neighboring slices, thereby estimating the correct volume. Furthermore, mitigation is provided following the regulatory constraints by changing the system to semi-automated criteria as a fall back solution. We evaluate the automated and semi-automated techniques using completely manual calcium volumes computed based on the manual tracings by the neuroradiologist.
RESULTS: A total of 64 patients with calcified plaque in the internal carotid artery were analyzed. Using the above algorithm, our automated and semi-automated system yields correlation coefficients (CC) of 0.89 and 0.96 against first manual readings and 0.90 and 0.96 against second manual readings, respectively. Using the t-test, there was no significant difference between the automated and semi-automated methods against manual. The intra-observer reliability was excellent with CC 0.98.
CONCLUSIONS: Compared to automated method, the semi-automated method for calcium volume is acceptable and closer to manual strategy for calcium volume. Further work evaluating and confirming the performance of our semi-automated protocol is now warranted.
Fulltext Embedded research to advance primary health care

Swaminathan S, Sheikh K, Marten R, Taylor M, Jhalani M, Chukwujekwu O, et al.

BMJ Glob Health, 2020 12;5(12).
PMID: 33355263 DOI: 10.1136/bmjgh-2020-004684

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