1.Implications of oxidative stress in chronic kidney disease: a review on current concepts and therapies
Sagar VERMA ; Priyanka SINGH ; Shiffali KHURANA ; Nirmal Kumar GANGULY ; Ritushree KUKRETI ; Luciano SASO ; Devinder Singh RANA ; Vibha TANEJA ; Vinant BHARGAVA
Kidney Research and Clinical Practice 2021;40(2):183-193
Moderate levels of endogenous reactive oxygen species (ROS) are important for various cellular activities, but high levels lead to toxicity and are associated with various diseases. Levels of ROS are maintained as a balance between oxidants and antioxidants. Accumulating data suggest that oxidative stress is a major factor in deterioration of renal function. In this review, we highlight the possible mechanism by which oxidative stress can lead to chronic kidney disease (CKD). This review also describes therapies that counter the effect of oxidative stress in CKD patients. Numerous factors such as upregulation of genes involved in oxidative phosphorylation and ROS generation, chronic inflammation, vitamin D deficiency, and a compromised antioxidant defense mechanism system cause progressive detrimental effects on renal function that eventually lead to loss of kidney function. Patients with renal dysfunction are highly susceptible to oxidative stress, as risk factors such as diabetes, renal hypertension, dietary restrictions, hemodialysis, and old age predispose them to increased levels of ROS. Biomolecular adducts (DNA, proteins, and lipids) formed due to reaction with ROS can be used to determine oxidative stress levels. Based on the strong correlation between oxidative stress and CKD, reversal of oxidative stress is being explored as a major therapeutic option. Xanthine oxidase inhibitors, dietary antioxidants, and other agents that scavenge free radicals are gaining interest as treatment modalities in CKD patients.
2.Implications of oxidative stress in chronic kidney disease: a review on current concepts and therapies
Sagar VERMA ; Priyanka SINGH ; Shiffali KHURANA ; Nirmal Kumar GANGULY ; Ritushree KUKRETI ; Luciano SASO ; Devinder Singh RANA ; Vibha TANEJA ; Vinant BHARGAVA
Kidney Research and Clinical Practice 2021;40(2):183-193
Moderate levels of endogenous reactive oxygen species (ROS) are important for various cellular activities, but high levels lead to toxicity and are associated with various diseases. Levels of ROS are maintained as a balance between oxidants and antioxidants. Accumulating data suggest that oxidative stress is a major factor in deterioration of renal function. In this review, we highlight the possible mechanism by which oxidative stress can lead to chronic kidney disease (CKD). This review also describes therapies that counter the effect of oxidative stress in CKD patients. Numerous factors such as upregulation of genes involved in oxidative phosphorylation and ROS generation, chronic inflammation, vitamin D deficiency, and a compromised antioxidant defense mechanism system cause progressive detrimental effects on renal function that eventually lead to loss of kidney function. Patients with renal dysfunction are highly susceptible to oxidative stress, as risk factors such as diabetes, renal hypertension, dietary restrictions, hemodialysis, and old age predispose them to increased levels of ROS. Biomolecular adducts (DNA, proteins, and lipids) formed due to reaction with ROS can be used to determine oxidative stress levels. Based on the strong correlation between oxidative stress and CKD, reversal of oxidative stress is being explored as a major therapeutic option. Xanthine oxidase inhibitors, dietary antioxidants, and other agents that scavenge free radicals are gaining interest as treatment modalities in CKD patients.
3.Major enteropathogens in humans, domestic animals, and environmental soil samples from the same locality: prevalence and transmission considerations in coastal Odisha, India
Arpit Kumar SHRIVASTAVA ; Nirmal Kumar MOHAKUD ; Swagatika PANDA ; Saumya Darshana PATRA ; Subrat KUMAR ; Priyadarshi Soumyaranjan SAHU
Epidemiology and Health 2020;42():e2020034-
Objectives:
Regions with limited sanitation facilities have higher rates of infections with various enteric pathogens. It is therefore important to identify different hosts and their relative contribution to pathogen shedding into the environment, and to assess the subsequent health risks to humans.
Methods:
In this study, human faecal (n=310), animal faecal (n=150), and environmental (soil) samples (n=40) were collected from the same locality and screened for selected enteric pathogens by immunochromatography and/or polymerase chain reaction.
Results:
At least 1 microbial agent was detected in 49.0%, 44.7%, and 40.0% of the samples from human, animals, and soil, respectively. Among humans, rotavirus was predominantly detected (17.4%) followed by enteropathogenic Escherichia coli (EPEC) (15.4%), Shigella (13.8), and Shiga toxin-producing E. coli (STEC) (9.7%). Among animals, STEC was detected most frequently (28.0%), and EPEC was the major enteric pathogen detected in soil (30.0%). The detection rate of rotavirus was higher among younger children (≤2 years) than among older children. Single infections were more commonly detected than multiple infections in humans (p<0.01), unlike the observations in animal and soil samples. For diarrhoeagenic E. coli and Shigella, most of the human and animal isolates showed close relatedness, suggesting possible cross-infection between humans and domesticated animals in the area studied.
Conclusions
The present study provides an improved understanding of the distribution of major enteric pathogens coexisting in humans and animals in the region, thereby suggesting a high potential for possible transmission among livestock and communities residing in the studied locality.
4.Major enteropathogens in humans, domestic animals, and environmental soil samples from the same locality: prevalence and transmission considerations in coastal Odisha, India
Arpit Kumar SHRIVASTAVA ; Nirmal Kumar MOHAKUD ; Swagatika PANDA ; Saumya Darshana PATRA ; Subrat KUMAR ; Priyadarshi Soumyaranjan SAHU
Epidemiology and Health 2020;42():e2020034-
Objectives:
Regions with limited sanitation facilities have higher rates of infections with various enteric pathogens. It is therefore important to identify different hosts and their relative contribution to pathogen shedding into the environment, and to assess the subsequent health risks to humans.
Methods:
In this study, human faecal (n=310), animal faecal (n=150), and environmental (soil) samples (n=40) were collected from the same locality and screened for selected enteric pathogens by immunochromatography and/or polymerase chain reaction.
Results:
At least 1 microbial agent was detected in 49.0%, 44.7%, and 40.0% of the samples from human, animals, and soil, respectively. Among humans, rotavirus was predominantly detected (17.4%) followed by enteropathogenic Escherichia coli (EPEC) (15.4%), Shigella (13.8), and Shiga toxin-producing E. coli (STEC) (9.7%). Among animals, STEC was detected most frequently (28.0%), and EPEC was the major enteric pathogen detected in soil (30.0%). The detection rate of rotavirus was higher among younger children (≤2 years) than among older children. Single infections were more commonly detected than multiple infections in humans (p<0.01), unlike the observations in animal and soil samples. For diarrhoeagenic E. coli and Shigella, most of the human and animal isolates showed close relatedness, suggesting possible cross-infection between humans and domesticated animals in the area studied.
Conclusions
The present study provides an improved understanding of the distribution of major enteric pathogens coexisting in humans and animals in the region, thereby suggesting a high potential for possible transmission among livestock and communities residing in the studied locality.
5.Awareness of Mother’s Regarding Under Five Danger Signs in a Selected Rural Community of West Bengal, India
Baisakhi Sarkar ; Anima Haldar ; Nirmal Kumar Mandal ; Md.Gousuddin
Malaysian Journal of Medicine and Health Sciences 2020;16(Supp 10, November):79-83
Introduction: The first five years of life constitute the foundations of the child's physical, mental growth and development. Mortality and morbidity are high during this age group. Early detection of danger signs is very crucial to
prevent this. The objectives were to assess the knowledge of mothers regarding under-five danger signs and explore
the association between the effects of knowledge with selected factors. Method: A descriptivestudy was conducted
in a rural community of West Bengal from Jan’2018 to Sept’2018. Total study sample was 110 mothers having under
five children. Door to door data collection was done through interview and data was analyzed both manually and
by computer feeding. Results: Out of total study sample, majority (60%) belongs to age group 18-25 years followed
by 31% among 26-33 age group, then 16% were more than 33 years. Out of total mothers, majority (40%) belongs
to higher educated group, (37%) secondary group, followed by 10% with primary education and 13%were illiterate.
Knowledge score was more than 50% among higher educated group (64%). Out of total respondents 61 (55.5%)
mothers were not able to identify any danger signs whereas, 35.5 % mothers identified 1-2 danger signs and 9%
mothers were able to identify 3-4 danger signs. Knowledge score about danger signs was more who visited antenatal
clinic more than 4 times (61%). Conclusion: Awareness regarding under five danger signs are more among higher
educated mothers. Number of antenatal visits also influences knowledge score.
6.Nanotechnology in reproductive medicine: Opportunities for clinical translation
Ruchita SHANDILYA ; Neelam PATHAK ; Nirmal Kumar LOHIYA ; Radhey Shyam SHARMA ; Pradyumna Kumar MISHRA
Clinical and Experimental Reproductive Medicine 2020;47(4):245-262
In recent years, nanotechnology has revolutionized global healthcare and has been predicted to exert a remarkable effect on clinical medicine. In this context, the clinical use of nanomaterials for cancer diagnosis, fertility preservation, and the management of infertility and other pathologies linked to pubertal development, menopause, sexually transmitted infections, and HIV (human immunodeficiency virus) has substantial promise to fill the existing lacunae in reproductive healthcare. Of late, a number of clinical trials involving the use of nanoparticles for the early detection of reproductive tract infections and cancers, targeted drug delivery, and cellular therapeutics have been conducted. However, most of these trials of nanoengineering are still at a nascent stage, and better synergy between pharmaceutics, chemistry, and cutting-edge molecular sciences is needed for effective translation of these interventions from bench to bedside. To bridge the gap between translational outcome and product development, strategic partnerships with the insight and ability to anticipate challenges, as well as an in-depth understanding of the molecular pathways involved, are highly essential. Such amalgamations would overcome the regulatory gauntlet and technical hurdles, thereby facilitating the effective clinical translation of these nano-based tools and technologies. The present review comprehensively focuses on emerging applications of nanotechnology, which holds enormous promise for improved therapeutics and early diagnosis of various human reproductive tract diseases and conditions.
7.“Free Hand” or Wire Guide: To the Editor
Nirmal Kumar SINHA ; Amit BHARDWAJ
Clinics in Orthopedic Surgery 2019;11(4):495-495
No abstract available.
8.Distal femoral physeal crush injury with metaphyseal comminution - A report of two cases and a new perspective to physeal injury.
Prateek BEHERA ; Nirmal Raj GOPINATHAN ; Avinash KUMAR ; Balaji SAIBABA ; Pebam SUDESH ; Rakesh JOHN
Chinese Journal of Traumatology 2017;20(6):366-369
The physis of a long bone may get 'sandwiched' and crushed between the metaphysis and the epiphysis if it is traumatically loaded along its long axis. Such a physeal injury may lead to complications like angular deformities and growth restrictions and hence, management of such injuries requires adequate planning and attentive execution. Two patients with distal femoral physeal crush injury were treated using a ring fixator such that one ring had the wires passing through the epiphysis and the other through the femoral shaft. On table image intensifier controlled distraction of the crushed physis was done to bring the height of the physis similar to that of the opposite limb. Patients were followed up for more than two years clinically and radiologically. There was no clinical or radiological angular deformity of the operated limbs. MRI scans showed intact physes with no physeal bar formation in either of the two patients. The distraction obtained by the ring fixator appears to have provided ample 'breathing space' to the compressed physis and that the growth potential may have been re-gained by the procedure. However, two years is a relatively short duration of follow-up and further follow-up of longer duration and in greater number of patients is needed to gauge the actual effectiveness of the technique used by us.
9.Epigenetics: A key paradigm in reproductive health.
Neha BUNKAR ; Neelam PATHAK ; Nirmal Kumar LOHIYA ; Pradyumna Kumar MISHRA
Clinical and Experimental Reproductive Medicine 2016;43(2):59-81
It is well established that there is a heritable element of susceptibility to chronic human ailments, yet there is compelling evidence that some components of such heritability are transmitted through non-genetic factors. Due to the complexity of reproductive processes, identifying the inheritance patterns of these factors is not easy. But little doubt exists that besides the genomic backbone, a range of epigenetic cues affect our genetic programme. The inter-generational transmission of epigenetic marks is believed to operate via four principal means that dramatically differ in their information content: DNA methylation, histone modifications, microRNAs and nucleosome positioning. These epigenetic signatures influence the cellular machinery through positive and negative feedback mechanisms either alone or interactively. Understanding how these mechanisms work to activate or deactivate parts of our genetic programme not only on a day-to-day basis but also over generations is an important area of reproductive health research.
Cues
;
DNA Methylation
;
Epigenomics*
;
Family Characteristics
;
Histone Code
;
Humans
;
Inheritance Patterns
;
MicroRNAs
;
Nucleosomes
;
Reproductive Health*
10.The trends in maternal mortality between 1996 and 2009 in Guizhou, China: ethnic differences and associated factors.
Qing DU ; Wu LIAN ; Øyvind NAESS ; Espen BJERTNESS ; Bernadette Nirmal KUMAR ; Shu-hua SHI
Journal of Huazhong University of Science and Technology (Medical Sciences) 2015;35(1):140-146
China bears a large burden of global maternal mortality, and the largest burden of maternal deaths in China is in poor western provinces. This study aimed to investigate the trends in maternal mortality and its associated factors in Guizhou province of western China between 1996 and 2009, and examine differences between minority and non-minority counties. A population-based, longitudinal, retrospective study was performed in a poor western province of China with a considerably large ethnic minority population. All 86 counties/districts of Guizhou were included with population at county, township and village level. Maternal mortality data were collected from routine reporting database of Guizhou Provincial Health Bureau. Trend and comparative analyses and multivariate linear regression analyses were performed using SPSS 17.0. Maternal mortality ratio (MMR) and its change over time, differences between ethnic groups were analyzed. A declining trend in maternal mortality and rising trend in hospital delivery in Guizhou was observed; ethnic differences between two ethnic groups persisted. The reduction in maternal mortality between 1996 and 2009 was related with increased gross domestic product, decreased male illiteracy rate, and increased hospital delivery rate. We found the declining trends in maternal mortality in Guizhou with persisting ethnic differences. The declining trends are related with economic development, hospital delivery and male illiteracy. Effective health education on maternal health is urgently needed for the minority groups, and basic education for the new generation should be enhanced to eradicate the illiteracy.
China
;
epidemiology
;
Ethnic Groups
;
Female
;
Humans
;
Maternal Mortality
;
Pregnancy


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