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Patibandla M.R.,Nizams Institute of Medical Sciences | Thotakura A.K.,NRI Medical College | Panigrahi M.K.,Krishna Institute of Medical science
British Journal of Neurosurgery | Year: 2014

Cavernomas constitute 5-10% of all the vascular malformations of the CNS. They commonly present during the 2nd and 5th decades of life. Intraventricular cavernomas constitute rare pathological entity, constituting 2.5-10.8% of cerebral cavernomas.1 The natural history of intraventricular cavernomas remains undefined to some extent. Those in third ventricle are different in biological nature and need more aggressive therapy. These cavernomas appear to have the ability to grow very rapidly, resulting in significant morbidity. It is not known whether waiting after acute hemorrhage from an intraventricular cavernoma improves our ability to remove the lesion safely or if waiting unnecessarily increases the risk of hydrocephalus, additional bleeding, or further lesion growth. © 2014 The Neurosurgical Foundation.

Kaul U.,Fortis Escorts Heart Institute | Bangalore S.,New York University | Seth A.,Fortis Escorts Heart Institute | Arambam P.,Fortis Escorts Heart Institute | And 9 more authors.
New England Journal of Medicine | Year: 2015

BACKGROUND The choice of drug-eluting stent in the treatment of patients with diabetes mellitus and coronary artery disease who are undergoing percutaneous coronary intervention (PCI) has been debated. Previous studies comparing paclitaxel-eluting stents with stents eluting rapamycin (now called sirolimus) or its analogues (everolimus or zotarolimus) have produced contradictory results, ranging from equivalence between stent types to superiority of everolimus-eluting stents. METHODS We randomly assigned 1830 patients with diabetes mellitus and coronary artery disease who were undergoing PCI to receive either a paclitaxel-eluting stent or an everolimus-eluting stent. We used a noninferiority trial design with a noninferiority margin of 4 percentage points for the upper boundary of the 95% confidence interval of the risk difference. The primary end point was target-vessel failure, which was defined as a composite of cardiac death, target-vessel myocardial infarction, or ischemia-driven target-vessel revascularization at the 1-year follow-up. RESULTS At 1 year, paclitaxel-eluting stents did not meet the criterion for noninferiority to everolimus-eluting stents with respect to the primary end point (rate of targetvessel failure, 5.6% vs. 2.9%; risk difference, 2.7 percentage points [95% confidence interval, 0.8 to 4.5]; relative risk, 1.89 [95% confidence interval, 1.20 to 2.99]; P = 0.38 for noninferiority). There was a significantly higher 1-year rate in the paclitaxeleluting stent group than in the everolimus-eluting stent group of target-vessel failure (P = 0.005), spontaneous myocardial infarction (3.2% vs. 1.2%, P = 0.004), stent thrombosis (2.1% vs. 0.4%, P = 0.002), target-vessel revascularization (3.4% vs. 1.2%, P = 0.002), and target-lesion revascularization (3.4% vs. 1.2%, P = 0.002). CONCLUSIONS In patients with diabetes mellitus and coronary artery disease undergoing PCI, paclitaxel-eluting stents were not shown to be noninferior to everolimus-eluting stents, and they resulted in higher rates of target-vessel failure, myocardial infarction, stent thrombosis, and target-vessel revascularization at 1 year. © 2015 Massachusetts Medical Society.

Phatak R.S.,Krishna University | Pratinidhi A.K.,Krishna University | Hendre A.S.,Krishna Institute of Medical science
Asian Journal of Pharmaceutical and Clinical Research | Year: 2015

Background: India is endowed with enormous varieties of spices grown in the majority of the country and one of the largest exporters of spices in the world. Many household spices are being used integrally in the Indian foods. Spices are normally added in the food to impart flavor. They are naturally occurring antioxidants, which have the potential capacity to counteract aging process in the body, to stabilize the cell membrane by scavenging free radicals in small doses. Objectives: The current study was designed to determine antioxidant potential of some selected spices and their mixture based on the established scientific evidences and oxygen radical absorbance capacity values using different in vitro models and correlating. Methods: The powder of assigned spices and their mixture were alcoholically extracted by a simple maceration method. They were evaluated for their total phenolic and flavonoid contents. Antioxidative abilities of the extracts of spices individually and their mixtures extracts were analyzed by phosphomolybdenum assay, cupric ions reducing antioxidant capacity (CUPRAC) and ferric ions reducing ability power methods. The free radical scavenging activities such as hydrogen peroxide, ABTS, anti-peroxidation like TBARS (thiobarbituric acid reactive substance), crocin bleaching and metal chelation capacity were assayed through in vitro models. Results and Discussion: Antioxidant and antiradical effects of the selected spices extracts and spices mixture extract (SME) was ascertained through different in vitro models. Results of individual tests demonstrated good correlation among themselves. CUPRAC has strong correlation with all other assays except to diphenyl-1-picrylhydrazyl (DPPH) and thiobarbituric acid reactive substances (TBARS). DPPH and TBARS were correlated with each other however they demonstrated no relationship with other assays. Conclusion: Extracts of selected Indian spices extracts and SME have shown dissimilarity to each other. Study for the 1st time establishes aggregate index for evaluation of Indian spices. On basis of aggregate index, nutmeg has highest value among the selected spices and no significant synergistic effect has been found in SME. CUPRAC as antioxidant assay and hydroxyl free radical scavenging assay by using Smirnoff reagent are most appropriate assays to ascertain antioxidative and free scavenger properties of natural products. © 2015, Asian Journal of Pharmaceutical and Clinical Research. All rights reserved.

Panigrahi M.,Krishna Institute of Medical science | Das P.K.,Indraprastha Apollo Hospital | Parikh P.M.,A+ Network
Indian Journal of Cancer | Year: 2011

Glioblastoma is a rapidly progressive and extremely fatal form of brain tumor with poor prognosis. It is the most common type of primary brain tumor. Even with the most aggressive conventional treatment that comprises surgery followed by radiotherapy and chemotherapy, most patients die within a year of diagnosis. Developments in molecular and cell biology have led to better understanding of tumor development, leading to novel treatment strategies including biological therapy and immunotherapy to combat the deadly disease. Targeted drug delivery strategies to circumvent the blood-brain barrier have shown efficiency in clinical trials. Gliadel wafer is a new approach to the treatment of glioblastoma, which involves controlled release delivery of carmustine from biodegradable polymer wafers. It has shown promising results and provides a silver lining for glioblastoma patients.

Das U.N.,UND Life science | Das U.N.,Krishna Institute of Medical science
Cancer and Metastasis Reviews | Year: 2011

Stem cells are pluripotent and expected to be of benefit in the management of coronary heart disease, stroke, diabetes mellitus, cancer, and Alzheimer's disease in which pro-inflammatory cytokines are increased. Identifying endogenous bioactive molecules that have a regulatory role in stem cell survival, proliferation, and differentiation may aid in the use of stem cells in various diseases including cancer. Essential fatty acids form precursors to both pro- and anti-inflammatory molecules have been shown to regulate gene expression, enzyme activity, modulate inflammation and immune response, gluconeogenesis via direct and indirect pathways, function directly as agonists of a number of G protein-coupled receptors, activate phosphatidylinositol 3-kinase/Akt and p44/42 mitogen-activated protein kinases, and stimulate cell proliferation via Ca 2+, phospholipase C/protein kinase, events that are also necessary for stem cell survival, proliferation, and differentiation. Hence, it is likely that bioactive lipids play a significant role in various diseases by modulating the proliferation and differentiation of embryonic stem cells in addition to their capacity to suppress inflammation. Ephrin Bs and reelin, adhesion molecules, and microRNAs regulate neuronal migration and cancer cell metastasis. Polyunsaturated fatty acids and their products seem to modulate the expression of ephrin Bs and reelin and several adhesion molecules and microRNAs suggesting that bioactive lipids participate in neuronal regeneration and stem cell proliferation, migration, and cancer cell metastasis. Thus, there appears to be a close interaction among essential fatty acids, their bioactive products, and inflammation and cancer growth and its metastasis. © 2011 Springer Science+Business Media, LLC.

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