MyMedR

Displaying all 12 publications

Abstract:

Sort:

A Case of Amelanotic Malignant Melanoma of the Maxillary Sinus Presented with Intraoral Extension

Singhvi A, Joshi A

Malays J Med Sci, 2015 Sep;22(5):89-92.
PMID: 28239273

Melanoma of the sinonasal cavity has a high incidence of amelanotic presentation. Its diagnosis is difficult for clinicians and pathologists because of its hidden location and lack of pigmentation at the microscopic level. We reported a case of amelanotic melanoma of the maxillary sinus that showed aggressive extension to the oral cavity after extraction of the maxillary tooth. Histologically, the lesion resembled a plasmacytoid tumour. Diagnosis was made through the positive immunohistochemical staining for S100 and HMB-45.
Secondary syphilis

Al-Bazali A, Joshi A, Manchanda DY

J Am Acad Dermatol, 2025 Mar 28.
PMID: 40158539 DOI: 10.1016/j.jaad.2025.03.064

Syphilis has been labelled as a 'Great Imitator'. The clinical manifestations of syphilis are largely mucocutaneous lesions, thus dermatologists are well placed to be able to diagnose it. However, the secondary stage of syphilis can have myriad presentations, and can easily be misdiagnosed even by an experienced dermatologist. The dermatologists should be aware of rarer morphological variants of the disease.
Fulltext Dietary glucosinolates derived isothiocyanates: chemical properties, metabolism and their potential in prevention of Alzheimer's disease

Khan F, Joshi A, Devkota HP, Subramaniyan V, Kumarasamy V, Arora J

Front Pharmacol, 2023;14:1214881.
PMID: 37554984 DOI: 10.3389/fphar.2023.1214881

Alzheimer's disease (AD) is the most prevalent form of dementia affecting millions of people worldwide. It is a progressive, irreversible, and incurable neurodegenerative disorder that disrupts the synaptic communication between millions of neurons, resulting in neuronal death and functional loss due to the abnormal accumulation of two naturally occurring proteins, amyloid β (Aβ) and tau. According to the 2018 World Alzheimer's Report, there is no single case of an Alzheimer's survivor; even 1 in 3 people die from Alzheimer's disease, and it is a growing epidemic across the globe fruits and vegetables rich in glucosinolates (GLCs), the precursors of isothiocyanates (ITCs), have long been known for their pharmacological properties and recently attracted increased interest for the possible prevention and treatment of neurodegenerative diseases. Epidemiological evidence from systematic research findings and clinical trials suggests that nutritional and functional dietary isothiocyanates interfere with the molecular cascades of Alzheimer's disease pathogenesis and prevent neurons from functional loss. The aim of this review is to explore the role of glucosinolates derived isothiocyanates in various molecular mechanisms involved in the progression of Alzheimer's disease and their potential in the prevention and treatment of Alzheimer's disease. It also covers the chemical diversity of isothiocyanates and their detailed mechanisms of action as reported by various in vitro and in vivo studies. Further clinical studies are necessary to evaluate their pharmacokinetic parameters and effectiveness in humans.
Fulltext An explainable Bi-LSTM model for winter wheat yield prediction

Joshi A, Pradhan B, Chakraborty S, Varatharajoo R, Alamri A, Gite S, et al.

Front Plant Sci, 2024;15:1491493.
PMID: 39898259 DOI: 10.3389/fpls.2024.1491493

Accurate, reliable and transparent crop yield prediction is crucial for informed decision-making by governments, farmers, and businesses regarding food security as well as agricultural business and management. Deep learning (DL) methods, particularly Long Short-Term Memory networks, have emerged as one of the most widely used architectures in yield prediction studies, providing promising results. Although other sequential DL methods like 1D Convolutional Neural Networks (1D-CNN) and Bidirectional long short-term memory (Bi-LSTM) have shown high accuracy for various tasks, including crop yield prediction, their application in regional scale crop yield prediction remains largely unexplored. Interpretability is another pressing and challenging issue in DL-based crop yield prediction, a factor that ensures the reliability of the model. Thus, this study aims to develop and implement an explainable DL model capable of accurately predicting crop yield and providing explanations for the predictions. To achieve this, we developed three state-of-the-art sequential DL models: LSTM, 1D CNN, and Bi-LSTM. We then employed three popular interpretability techniques: Local interpretable model-agnostic explanations (LIME), Integrated Gradient (IG) and Shapley Additive Explanation (SHAP) to understand the decision-making process of the models. The Bi-LSTM model outperformed other models in terms of predictive performance (R2 up to 0.88) and generalizability across locations and ranges of yield data. Explainability analysis reveals that enhanced vegetation index (EVI), temperature and precipitation at later stages of crop growth are most important in determining Winter wheat yield. Further, we demonstrated that XAI methods can also be used to understand the decision-making process of the models, to understand instances such as high- and low-yield samples, to find possible explanations for erroneous predictions, and to identify regions impacted by particular stress. By employing advanced DL techniques along with an innovative approach to explainability, this study achieves highly accurate yield prediction while providing intuitive insights into the model's decision-making process.
Transcatheter vs Surgical Aortic Valve Replacement Outcomes Among Solid Organ Transplant Patients: A Systematic Review and Meta-Analysis

Jaiswal V, Ang SP, Ishak A, Joshi A, Chia JE, Kalra K, et al.

Curr Probl Cardiol, 2023 Aug;48(8):101685.
PMID: 36931333 DOI: 10.1016/j.cpcardiol.2023.101685

The safety and clinical outcomes of transcatheter aortic valve replacement (TAVR) compared to surgical aortic valve replacement (SAVR) among patients with solid organ transplants is not well understood. This study aimed to evaluate the clinical outcomes of TAVR and SAVR among patients with a history of solid organ transplantation. We performed a systematic literature search of databases for relevant articles from inception until May 1st, 2022. Unadjusted odds ratios (OR) were pooled using a random-effect model, and a P-value of <0.05 was considered statistically significant. A total of 3240 studies were identified of which 3 studies with a total of 2960 patients were included in the final analysis. For solid organ transplants patients, the odds of in-hospital mortality (OR 0.37, 95% CI 0.20-0.71, P < 0.001), 30-day mortality (OR 0.51, 95% CI 0.35-0.74, P < 0.001), acute kidney injury (OR 0.45, 95% CI 0.35-0.59, P < 0.001), and bleeding (OR 0.35, 95% CI 0.27-0.46, P < 0.001) were significantly lower in patients undergoing TAVR compared to SAVR. In contrast, the odds of pacemaker implantation (OR 2.60, 95% CI 0.36-18.90, P = 0.34), postprocedural stroke (OR 0.36, 95% CI 0.13-1.03, P = 0.06) were similar between both groups of patients. Length of hospital stay was significantly lower in TAVR compared to SAVR patients (SMD -0.82, 95% CI -0.95 to -0.70, P < 0.001). In solid organ transplant patients, TAVR appeared to be a safe procedure with fewer postprocedure complications, shorter length of hospital stay, and lower in hospital mortality compared with SAVR.
Fulltext Percutaneous coronary intervention versus coronary artery bypass grafting among patients with left ventricular systolic dysfunction: a systematic review and meta-analysis

Jaiswal V, Ang SP, Shrestha AB, Joshi A, Ishak A, Chia JE, et al.

Ann Med Surg (Lond), 2023 Jun;85(6):2849-2857.
PMID: 37363575 DOI: 10.1097/MS9.0000000000000634

Current guidelines have shown the superiority of coronary artery bypass grafting (CABG) over medical therapy. However, there is a paucity of data evaluating the optimal revascularization strategy in patients with ischemic left ventricular systolic dysfunction (LVSD).
OBJECTIVE: The authors aimed to evaluate the clinical outcomes of postpercutaneous coronary intervention (PCI) and CABG among patients with LVSD.
METHODS: The authors performed a systematic literature search using the PubMed, Embase, Scopus, and the Cochrane Libraries for relevant articles from inception until 30 November 2022. Outcomes were reported as pooled odds ratio (OR), and their corresponding 95% CI using STATA (version 17.0, StataCorp).
RESULTS: A total of 10 studies with 13 324 patients were included in the analysis. The mean age of patients in PCI was 65.3 years, and 64.1 years in the CABG group. The most common comorbidities included: HTN (80 vs. 78%) and DM (49.2 vs. 49%). The mean follow-up duration was 3.75 years. Compared with CABG, the PCI group had higher odds of all-cause mortality (OR 1.15, 95% CI 1.01-1.31, P=0.03), repeat revascularization (OR 3.57, 95% CI 2.56-4.97, P<0.001), MI (OR 1.92, 95% CI 1.01-3.86, P=0.048) while the incidence of cardiovascular mortality (OR 1.23, 95% CI 0.98-1.55, P=0.07), stroke (OR 0.73 95% CI: 0.51-1.04, P=0.08), major adverse cardiovascular and cerebrovascular events (OR 1.36, 95% CI 0.99-1.87, P=0.06), and ventricular tachycardia (OR 0.79, 95% CI 0.22-2.86, P=0.72) was comparable between both the procedures.
CONCLUSION: The results of this meta-analysis suggest that CABG is superior to PCI for patients with LVSD. CABG was associated with a lower risk of all-cause mortality, repeat revascularization, and incidence of myocardial infarction compared with PCI in patients with LVSD.
Trends and projections of type 2 diabetes mellitus in South Asia: a three-decade analysis and forecast through 2031 using global burden of disease study (1990 - 2021)

Kumar V, Zahiruddin QS, Jena D, R R, Kaur M, Srivastava M, et al.

Expert Rev Endocrinol Metab, 2025 Jan;20(1):99-106.
PMID: 39763434 DOI: 10.1080/17446651.2024.2448790

BACKGROUND: The rapid rise of non-communicable diseases, particularly type 2 diabetes mellitus (T2DM), poses a significant global public health challenge, with South Asia experiencing an increasingly severe burden. This study aimed to analyse historical trends of T2DM across South Asia from 1990 to 2021 and forecast incidence through 2031.
RESEARCH DESIGN AND METHODS: We carried out analysis based on the data from the 2021 Global burden of disease study. Joinpoint regression was used to identify significant changes in trends over time, and ARIMA models were applied to forecast incidence rates.
RESULTS: Between 1990 and 2021, the average annual percentage change (AAPC) of age-standardized prevalence rates and incidence rates increased by 2.15 and 1.72 respectively. The age-standardized mortality rate rose more slowly, at 1.05 AAPC, with females experiencing a slightly higher AAPC than males. ARIMA forecasts suggest that by 2031, T2DM incidence rates will continue to rise significantly across all South Asian countries.
CONCLUSIONS: This study highlights the need for public health policies focused on preventing obesity, promoting physical activity, and improving healthcare access. It also calls for addressing regional disparities in T2DM prevalence and mortality to better allocate resources and prioritize policies to combat the diabetes epidemic inSouth Asia.
Fulltext A Practitioner's Toolkit for Insulin Motivation in Adults with Type 1 and Type 2 Diabetes Mellitus: Evidence-Based Recommendations from an International Expert Panel

Kalra S, Bajaj S, Sharma SK, Priya G, Baruah MP, Sanyal D, et al.

Diabetes Ther, 2020 Mar;11(3):585-606.
PMID: 31981212 DOI: 10.1007/s13300-020-00764-7

AIM: To develop an evidence-based expert group opinion on the role of insulin motivation to overcome insulin distress during different stages of insulin therapy and to propose a practitioner's toolkit for insulin motivation in the management of diabetes mellitus (DM).
BACKGROUND: Insulin distress, an emotional response of the patient to the suggested use of insulin, acts as a major barrier to insulin therapy in the management of DM. Addressing patient-, physician- and drug-related factors is important to overcome insulin distress. Strengthening of communication between physicians and patients with diabetes and enhancing the patients' coping skills are prerequisites to create a sense of comfort with the use of insulin. Insulin motivation is key to achieving targeted goals in diabetes care. A group of endocrinologists came together at an international meeting held in India to develop tool kits that would aid a practitioner in implementing insulin motivation strategies at different stages of the journey through insulin therapy, including pre-initiation, initiation, titration and intensification. During the meeting, emphasis was placed on the challenges and limitations faced by both physicians and patients with diabetes during each stage of the journey through insulinization.
REVIEW RESULTS: After review of evidence and discussions, the expert group provided recommendations on strategies for improved insulin acceptance, empowering behavior change in patients with DM, approaches for motivating patients to initiate and maintain insulin therapy and best practices for insulin motivation at the pre-initiation, initiation, titration and intensification stages of insulin therapy.
CONCLUSIONS: In the management of DM, bringing in positive behavioral change by motivating the patient to improve treatment adherence helps overcome insulin distress and achieve treatment goals.
Fulltext Individualizing Time-in-Range Goals in Management of Diabetes Mellitus and Role of Insulin: Clinical Insights From a Multinational Panel

Kalra S, Shaikh S, Priya G, Baruah MP, Verma A, Das AK, et al.

Diabetes Ther, 2021 Feb;12(2):465-485.
PMID: 33367983 DOI: 10.1007/s13300-020-00973-0

Diabetes mellitus is a global health concern associated with significant morbidity and mortality. Inadequate control of diabetes leads to chronic complications and higher mortality rates, which emphasizes the importance of achieving glycemic targets. Although glycated hemoglobin (HbA1c) is the gold standard for measuring glycemic control, it has several limitations. Therefore, in recent years, along with the emergence of continuous glucose monitoring (CGM) technology, glycemic control modalities have moved beyond HbA1c. They encompass modern glucometrics, such as glycemic variability (GV) and time-in-range (TIR). The key advantage of these newer metrics over HbA1c is that they allow personalized diabetes management with person-centric glycemic control. Basal insulin analogues, especially second-generation basal insulins with properties such as longer duration of action and low risk of hypoglycemia, have demonstrated clinical benefits by reducing GV and improving TIR. Therefore, for more effective and accurate diabetes management, the development of an integrated approach with second-generation basal insulin and glucometrics involving GV and TIR is the need of the hour. With this objective, a multinational group of endocrinologists and diabetologists reviewed the existing recommendations on TIR, provided their clinical insights into the individualization of TIR targets, and elucidated on the role of the second-generation basal insulin analogues in addressing TIR.
Fulltext Correction to: Individualizing Time-in-Range Goals in Management of Diabetes Mellitus and Role of Insulin: Clinical Insights From a Multinational Panel

Kalra S, Shaikh S, Priya G, Baruah MP, Verma A, Das AK, et al.

Diabetes Ther, 2021 Sep;12(9):2627-2629.
PMID: 34363138 DOI: 10.1007/s13300-021-01120-z
Fulltext 'Trichophyton indotineae' is an inaccurate and pejorative term

Verma SB, Khurana A, Bosshard PP, Kargl A, Singal A, Saraswat A, et al.

Indian J Dermatol Venereol Leprol, 2025;91(2):277-280.
PMID: 39912159 DOI: 10.25259/IJDVL_1793_2024
Fulltext The International Natural Product Sciences Taskforce (INPST) and the power of Twitter networking exemplified through #INPST hashtag analysis

Singla RK, De R, Efferth T, Mezzetti B, Sahab Uddin M, Sanusi, et al.

Phytomedicine, 2023 Jan;108:154520.
PMID: 36334386 DOI: 10.1016/j.phymed.2022.154520

BACKGROUND: The development of digital technologies and the evolution of open innovation approaches have enabled the creation of diverse virtual organizations and enterprises coordinating their activities primarily online. The open innovation platform titled "International Natural Product Sciences Taskforce" (INPST) was established in 2018, to bring together in collaborative environment individuals and organizations interested in natural product scientific research, and to empower their interactions by using digital communication tools.
METHODS: In this work, we present a general overview of INPST activities and showcase the specific use of Twitter as a powerful networking tool that was used to host a one-week "2021 INPST Twitter Networking Event" (spanning from 31st May 2021 to 6th June 2021) based on the application of the Twitter hashtag #INPST.
RESULTS AND CONCLUSION: The use of this hashtag during the networking event period was analyzed with Symplur Signals (https://www.symplur.com/), revealing a total of 6,036 tweets, shared by 686 users, which generated a total of 65,004,773 impressions (views of the respective tweets). This networking event's achieved high visibility and participation rate showcases a convincing example of how this social media platform can be used as a highly effective tool to host virtual Twitter-based international biomedical research events.

Filters

Please provide feedback to Administrator (afdal@afpm.org.my)

External Links