1.Effect of gestational diabetes mellitus and its management on the histological and histomorphometric structure of umbilical cord:a comparative study
Seema Valsalan ENNAZHIYIL ; Akshara Venmalassery RAJEEV ; Mahesh Kumar DAMODARAN ; Tintu Thottiyil SUKUMARAN ; Chitra SRINIVASAN ; Ramakrishnan Panicker KUNNATHU
Anatomy & Cell Biology 2025;58(1):22-34
		                        		
		                        			
		                        			 The umbilical cord lacks vasavasorum and is prone for hypoxic injuries. Gestational diabetes mellitus (GDM) causes structural changes with in umbilical cord blood vessels. Knowledge of which would be helpful for the gynecologist and obstetricians to assess the prognosis and prevent the complications. The present study was concentrated from December 2016 to December 2019 on 50 normal and 56 GDM umbilical cords. GDM group included 23 GDM mothers managed by diet (GDM-Diet) and 33 GDM mothers managed by drugs (GDM-Drug). Placentas along with the attached umbilical cords were collected and stored in 10% formaline. Tissue processing, slide preparation and stainings were done using standard protocols.A significant reduction was observed in the number of Hoboken nodules of umbilical arteries of GDM-Diet. Reduction of myofibroblasts with an increase in the empty spaces was observed in the Wharton’s jelly of both GDM cases. Similarly, smooth muscle disintegration and migration of smooth muscles to intima was significantly higher in GDM umbilical arteries and veins than normal umbilical vessels. The total wall thickness and tunica media was significantly thicker in the umbilical arteries of GDM-Drug group only. The umbilical venous lumen was found significantly wider in GDM groups compared to normal. The elastin fibers were significantly found reduced in the tunics of umbilical arteries and veins in GDM. However, a significant difference in these parameters was not observed between the GDM-Diet and GDM-Drug groups except for total wall and tunica media thickness of umbilical arteries. 
		                        		
		                        		
		                        		
		                        	
2.Effect of gestational diabetes mellitus and its management on the histological and histomorphometric structure of umbilical cord:a comparative study
Seema Valsalan ENNAZHIYIL ; Akshara Venmalassery RAJEEV ; Mahesh Kumar DAMODARAN ; Tintu Thottiyil SUKUMARAN ; Chitra SRINIVASAN ; Ramakrishnan Panicker KUNNATHU
Anatomy & Cell Biology 2025;58(1):22-34
		                        		
		                        			
		                        			 The umbilical cord lacks vasavasorum and is prone for hypoxic injuries. Gestational diabetes mellitus (GDM) causes structural changes with in umbilical cord blood vessels. Knowledge of which would be helpful for the gynecologist and obstetricians to assess the prognosis and prevent the complications. The present study was concentrated from December 2016 to December 2019 on 50 normal and 56 GDM umbilical cords. GDM group included 23 GDM mothers managed by diet (GDM-Diet) and 33 GDM mothers managed by drugs (GDM-Drug). Placentas along with the attached umbilical cords were collected and stored in 10% formaline. Tissue processing, slide preparation and stainings were done using standard protocols.A significant reduction was observed in the number of Hoboken nodules of umbilical arteries of GDM-Diet. Reduction of myofibroblasts with an increase in the empty spaces was observed in the Wharton’s jelly of both GDM cases. Similarly, smooth muscle disintegration and migration of smooth muscles to intima was significantly higher in GDM umbilical arteries and veins than normal umbilical vessels. The total wall thickness and tunica media was significantly thicker in the umbilical arteries of GDM-Drug group only. The umbilical venous lumen was found significantly wider in GDM groups compared to normal. The elastin fibers were significantly found reduced in the tunics of umbilical arteries and veins in GDM. However, a significant difference in these parameters was not observed between the GDM-Diet and GDM-Drug groups except for total wall and tunica media thickness of umbilical arteries. 
		                        		
		                        		
		                        		
		                        	
3.Effect of gestational diabetes mellitus and its management on the histological and histomorphometric structure of umbilical cord:a comparative study
Seema Valsalan ENNAZHIYIL ; Akshara Venmalassery RAJEEV ; Mahesh Kumar DAMODARAN ; Tintu Thottiyil SUKUMARAN ; Chitra SRINIVASAN ; Ramakrishnan Panicker KUNNATHU
Anatomy & Cell Biology 2025;58(1):22-34
		                        		
		                        			
		                        			 The umbilical cord lacks vasavasorum and is prone for hypoxic injuries. Gestational diabetes mellitus (GDM) causes structural changes with in umbilical cord blood vessels. Knowledge of which would be helpful for the gynecologist and obstetricians to assess the prognosis and prevent the complications. The present study was concentrated from December 2016 to December 2019 on 50 normal and 56 GDM umbilical cords. GDM group included 23 GDM mothers managed by diet (GDM-Diet) and 33 GDM mothers managed by drugs (GDM-Drug). Placentas along with the attached umbilical cords were collected and stored in 10% formaline. Tissue processing, slide preparation and stainings were done using standard protocols.A significant reduction was observed in the number of Hoboken nodules of umbilical arteries of GDM-Diet. Reduction of myofibroblasts with an increase in the empty spaces was observed in the Wharton’s jelly of both GDM cases. Similarly, smooth muscle disintegration and migration of smooth muscles to intima was significantly higher in GDM umbilical arteries and veins than normal umbilical vessels. The total wall thickness and tunica media was significantly thicker in the umbilical arteries of GDM-Drug group only. The umbilical venous lumen was found significantly wider in GDM groups compared to normal. The elastin fibers were significantly found reduced in the tunics of umbilical arteries and veins in GDM. However, a significant difference in these parameters was not observed between the GDM-Diet and GDM-Drug groups except for total wall and tunica media thickness of umbilical arteries. 
		                        		
		                        		
		                        		
		                        	
4.Effect of gestational diabetes mellitus and its management on the histological and histomorphometric structure of umbilical cord:a comparative study
Seema Valsalan ENNAZHIYIL ; Akshara Venmalassery RAJEEV ; Mahesh Kumar DAMODARAN ; Tintu Thottiyil SUKUMARAN ; Chitra SRINIVASAN ; Ramakrishnan Panicker KUNNATHU
Anatomy & Cell Biology 2025;58(1):22-34
		                        		
		                        			
		                        			 The umbilical cord lacks vasavasorum and is prone for hypoxic injuries. Gestational diabetes mellitus (GDM) causes structural changes with in umbilical cord blood vessels. Knowledge of which would be helpful for the gynecologist and obstetricians to assess the prognosis and prevent the complications. The present study was concentrated from December 2016 to December 2019 on 50 normal and 56 GDM umbilical cords. GDM group included 23 GDM mothers managed by diet (GDM-Diet) and 33 GDM mothers managed by drugs (GDM-Drug). Placentas along with the attached umbilical cords were collected and stored in 10% formaline. Tissue processing, slide preparation and stainings were done using standard protocols.A significant reduction was observed in the number of Hoboken nodules of umbilical arteries of GDM-Diet. Reduction of myofibroblasts with an increase in the empty spaces was observed in the Wharton’s jelly of both GDM cases. Similarly, smooth muscle disintegration and migration of smooth muscles to intima was significantly higher in GDM umbilical arteries and veins than normal umbilical vessels. The total wall thickness and tunica media was significantly thicker in the umbilical arteries of GDM-Drug group only. The umbilical venous lumen was found significantly wider in GDM groups compared to normal. The elastin fibers were significantly found reduced in the tunics of umbilical arteries and veins in GDM. However, a significant difference in these parameters was not observed between the GDM-Diet and GDM-Drug groups except for total wall and tunica media thickness of umbilical arteries. 
		                        		
		                        		
		                        		
		                        	
5.Effect of gestational diabetes mellitus and its management on the histological and histomorphometric structure of umbilical cord:a comparative study
Seema Valsalan ENNAZHIYIL ; Akshara Venmalassery RAJEEV ; Mahesh Kumar DAMODARAN ; Tintu Thottiyil SUKUMARAN ; Chitra SRINIVASAN ; Ramakrishnan Panicker KUNNATHU
Anatomy & Cell Biology 2025;58(1):22-34
		                        		
		                        			
		                        			 The umbilical cord lacks vasavasorum and is prone for hypoxic injuries. Gestational diabetes mellitus (GDM) causes structural changes with in umbilical cord blood vessels. Knowledge of which would be helpful for the gynecologist and obstetricians to assess the prognosis and prevent the complications. The present study was concentrated from December 2016 to December 2019 on 50 normal and 56 GDM umbilical cords. GDM group included 23 GDM mothers managed by diet (GDM-Diet) and 33 GDM mothers managed by drugs (GDM-Drug). Placentas along with the attached umbilical cords were collected and stored in 10% formaline. Tissue processing, slide preparation and stainings were done using standard protocols.A significant reduction was observed in the number of Hoboken nodules of umbilical arteries of GDM-Diet. Reduction of myofibroblasts with an increase in the empty spaces was observed in the Wharton’s jelly of both GDM cases. Similarly, smooth muscle disintegration and migration of smooth muscles to intima was significantly higher in GDM umbilical arteries and veins than normal umbilical vessels. The total wall thickness and tunica media was significantly thicker in the umbilical arteries of GDM-Drug group only. The umbilical venous lumen was found significantly wider in GDM groups compared to normal. The elastin fibers were significantly found reduced in the tunics of umbilical arteries and veins in GDM. However, a significant difference in these parameters was not observed between the GDM-Diet and GDM-Drug groups except for total wall and tunica media thickness of umbilical arteries. 
		                        		
		                        		
		                        		
		                        	
6.Polygenic Risk Score for Cardiovascular Diseases in Artificial Intelligence Paradigm: A Review
Narendra N KHANNA ; Manasvi SINGH ; Mahesh MAINDARKAR ; Ashish KUMAR ; Amer M. JOHRI ; Laura MENTELLA ; John R LAIRD ; Kosmas I. PARASKEVAS ; Zoltan RUZSA ; Narpinder SINGH ; Mannudeep K. KALRA ; Jose Fernandes E. FERNANDES ; Seemant CHATURVEDI ; Andrew NICOLAIDES ; Vijay RATHORE ; Inder SINGH ; Jagjit S. TEJI ; Mostafa AL-MAINI ; Esma R. ISENOVIC ; Vijay VISWANATHAN ; Puneet KHANNA ; Mostafa M. FOUDA ; Luca SABA ; Jasjit S. SURI
Journal of Korean Medical Science 2023;38(46):e395-
		                        		
		                        			
		                        			 Cardiovascular disease (CVD) related mortality and morbidity heavily strain society. The relationship between external risk factors and our genetics have not been well established.It is widely acknowledged that environmental influence and individual behaviours play a significant role in CVD vulnerability, leading to the development of polygenic risk scores (PRS). We employed the PRISMA search method to locate pertinent research and literature to extensively review artificial intelligence (AI)-based PRS models for CVD risk prediction.Furthermore, we analyzed and compared conventional vs. AI-based solutions for PRS. We summarized the recent advances in our understanding of the use of AI-based PRS for risk prediction of CVD. Our study proposes three hypotheses: i) Multiple genetic variations and risk factors can be incorporated into AI-based PRS to improve the accuracy of CVD risk predicting. ii) AI-based PRS for CVD circumvents the drawbacks of conventional PRS calculators by incorporating a larger variety of genetic and non-genetic components, allowing for more precise and individualised risk estimations. iii) Using AI approaches, it is possible to significantly reduce the dimensionality of huge genomic datasets, resulting in more accurate and effective disease risk prediction models. Our study highlighted that the AI-PRS model outperformed traditional PRS calculators in predicting CVD risk. Furthermore, using AI-based methods to calculate PRS may increase the precision of risk predictions for CVD and have significant ramifications for individualized prevention and treatment plans. 
		                        		
		                        		
		                        		
		                        	
7.A prospective study of fully covered self-expandable metal stents for refractory benign pancreatic duct strictures
Bhavik Bharat SHAH ; Gajanan Ashokrao RODGE ; Usha GOENKA ; Shivaraj AFZALPURKAR ; Mahesh Kumar GOENKA
Clinical Endoscopy 2022;55(6):793-800
		                        		
		                        			 Background/Aims:
		                        			Fully covered self-expanding metal stents (FCSEMSs) are a relatively novel option for treating painful main pancreatic duct refractory strictures in patients with chronic pancreatitis. Herein, we aimed to assess the efficacy, feasibility, and safety of FCSEMSs in this patient group. 
		                        		
		                        			Methods:
		                        			This prospective single-center study included patients who underwent endoscopic retrograde pancreatography with FCSEMS placement. The primary endpoints were the technical and clinical success rates. A reduction in visual analog scale pain score of >50% compared with that before stent placement was defined as clinical success. Secondary endpoints were resolution of pancreatic strictures on fluoroscopy during endoscopic retrograde pancreatography and the development of stent-related adverse events. 
		                        		
		                        			Results:
		                        			Thirty-six patients were included in the analysis. The technical success rate was 100% (n=36) and the clinical success rate was 86.1% (n=31). There was a significant increase in stricture diameter from 1.7 mm to 3.5 mm (p<0.001) after stent removal. The mean visual analog scale pain score showed statistically significant improvement. At 19 months of follow-up, 55.6% of the patients were asymptomatic. Stent migration (16.7%), intolerable abdominal pain (8.3%), development of de novo strictures (8.3%), and mild pancreatitis (2.8%) were the most common adverse events. 
		                        		
		                        			Conclusions
		                        			FCSEMS placement showed good technical and clinical success rates for achieving pain relief in patients with refractory main pancreatic duct strictures. 
		                        		
		                        		
		                        		
		                        	
8.Refunctionalization of Decellularized Organ Scaffold of Pancreas by Recellularization: Whole Organ Regeneration into Functional Pancreas
K. Uday CHANDRIKA ; Rekha TRIPATHI ; Y. KAMESHWARI ; Nandini RANGARAJ ; J. Mahesh KUMAR ; Shashi SINGH
Tissue Engineering and Regenerative Medicine 2021;18(1):99-112
		                        		
		                        			BACKGROUND:
		                        			Tissue engineering centers on creating a niche similar to the natural one, with a purpose of developing an organ construct. A natural scaffold can replace none while creating a scaffold unique to each tissue in composition, architecture and cues that regulate the character of cells. 
		                        		
		                        			METHODS:
		                        			Whole pancreas from mouse was decellularized using detergent and enzymes, followed by recellularizing with MSC from human placenta. This construct was transplanted in streptozotocin induced diabetic mice. Histopathology of both decellularized and recellularized transplanted pancreas and qPCR analysis were performed to assess its recovery. 
		                        		
		                        			RESULTS:
		                        			Decellularization removes the cells leaving behind extracellular matrix rich natural scaffold. After reseeding with mesenchymal stem cells, these cells differentiate into pancreas specific cells. Upon transplantation in streptozotocin induced diabetic mice, this organ was capable of restoring its histomorphology and functioning. Restoration of endocrine (islets), the exocrine region (acinar) and vascular network was seen in transplanted pancreas. The process of functional recovery of endocrine system took about 20 days when the mice start showing blood glucose reduction, though none achieved gluconormalization. 
		                        		
		                        			CONCLUSION
		                        			Natural decellularized scaffolds of soft organs can be refunctionalized using recipient’s mesenchymal stem cells to restore structure and function; and counter immune problems arising during transplantation.
		                        		
		                        		
		                        		
		                        	
9.Refunctionalization of Decellularized Organ Scaffold of Pancreas by Recellularization: Whole Organ Regeneration into Functional Pancreas
K. Uday CHANDRIKA ; Rekha TRIPATHI ; Y. KAMESHWARI ; Nandini RANGARAJ ; J. Mahesh KUMAR ; Shashi SINGH
Tissue Engineering and Regenerative Medicine 2021;18(1):99-112
		                        		
		                        			BACKGROUND:
		                        			Tissue engineering centers on creating a niche similar to the natural one, with a purpose of developing an organ construct. A natural scaffold can replace none while creating a scaffold unique to each tissue in composition, architecture and cues that regulate the character of cells. 
		                        		
		                        			METHODS:
		                        			Whole pancreas from mouse was decellularized using detergent and enzymes, followed by recellularizing with MSC from human placenta. This construct was transplanted in streptozotocin induced diabetic mice. Histopathology of both decellularized and recellularized transplanted pancreas and qPCR analysis were performed to assess its recovery. 
		                        		
		                        			RESULTS:
		                        			Decellularization removes the cells leaving behind extracellular matrix rich natural scaffold. After reseeding with mesenchymal stem cells, these cells differentiate into pancreas specific cells. Upon transplantation in streptozotocin induced diabetic mice, this organ was capable of restoring its histomorphology and functioning. Restoration of endocrine (islets), the exocrine region (acinar) and vascular network was seen in transplanted pancreas. The process of functional recovery of endocrine system took about 20 days when the mice start showing blood glucose reduction, though none achieved gluconormalization. 
		                        		
		                        			CONCLUSION
		                        			Natural decellularized scaffolds of soft organs can be refunctionalized using recipient’s mesenchymal stem cells to restore structure and function; and counter immune problems arising during transplantation.
		                        		
		                        		
		                        		
		                        	
10.Injuries in survivors of elephant attack: Report of three cases.
Pradeep Kumar SINGH ; S Manwar ALI ; Mahesh SETHI ; Das Birendra MANOHAR
Chinese Journal of Traumatology 2021;24(6):394-396
		                        		
		                        			
		                        			Human-elephant conflict (HEC) in India is becoming a growing health problem causing many fatalities every year. Elephants produce injuries by trampling, stomping, squeezing, tossing in the air, or crushing/targeting the head and chest commonly. The adult elephants are most aggressive in their mating season, leading to maximum incidences of HECs in this period. These attacks are mostly unprovoked, though most HECs are provoked. In this case series, the authors described the injuries sustained by three survivors in a short span of one month due to the sudden and unprovoked elephant attack. All the injuries were mild to moderate in severity and involved the chest in common. Timely rescue and prompt initiation of treatment were pivotal in their survival. The authors also want to create awareness about the mating season of elephants to minimize these unfortunate events in the future.
		                        		
		                        		
		                        		
		                        			Animals
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		                        			Elephants
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		                        			Humans
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		                        			India
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		                        			Seasons
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		                        			Survivors
		                        			
		                        		
		                        	
            
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