SK Institute of Medical science

Srinagar, India

SK Institute of Medical science

Srinagar, India

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Dar N.A.,University Of Kashmir | Dar N.A.,Mount Sinai School of Medicine | Islami F.,Mount Sinai School of Medicine | Islami F.,Tehran University of Medical Sciences | And 9 more authors.
British Journal of Cancer | Year: 2013

Background:Several studies have suggested an association between poor oral health and esophageal squamous cell carcinoma (ESCC). We conducted a case-control study in Kashmir, a region with relatively high incidence of ESCC in north India, to investigate the association between oral hygiene and ESCC risk.Methods:We recruited 703 histologically confirmed ESCC cases, and 1664 controls individually matched to the cases for age, sex, and district of residence. Conditional logistic regression models were used to calculate odds ratios (ORs) and 95% confidence intervals (CIs).Results:We found an inverse association between teeth cleaning and ESCC risk. As compared with never cleaning teeth, the OR (95% CI) was 0.41 (0.28-0.62) for cleaning less than daily and 0.44 (0.25-0.77) for cleaning at least once a day (P for trend=0.026) in models adjusted for multiple potential confounders, including several indicators of socioeconomic status. This association persisted after we limited our analyses to never tobacco users. The inverse association between cleaning teeth and ESCC was stronger with using brushes than with using sticks/fingers. We also found an association between the number of decayed, filled, and missing teeth and ESCC risk, but the trend of the associations was not statistically significant. Avoiding solid food and cold beverages because of teeth and oral problems were also associated with ESCC risk.Conclusion:We found an association between poor oral hygiene indicators and ESCC risk, supporting the previous studies that showed the same associations. © 2013 Cancer Research UK. All rights reserved.


Bhat G.A.,University Of Kashmir | Shah I.A.,University Of Kashmir | Makhdoomi M.A.,University Of Kashmir | Iqbal B.,University Of Kashmir | And 5 more authors.
Tumor Biology | Year: 2014

The study analyzed the relationship between genetic polymorphisms of phase I xenobiotic metabolizing enzymes, cytochromes P450 (CYP) 1A1 and CYP2E1 and esophageal squamous cell carcinoma (ESCC) in Kashmir, India. The different genotypes of CYP1A1 and CYP2E1 were analyzed by polymerase chain reaction and restriction fragment length polymorphism in 526 ESCC cases and equal number of matched controls. Conditional logistic regression models were used to assess the association of various genotypes with ESCC, gene-gene, and gene-environment interactions. High risk of ESCC was found in participants who carried CYP1A1 Val/Val genotype (OR=2.87; 95 % CI=1.00-8.44) and the risk increased in such individuals when c1/c1 of CYP2E1 genotype was also present (OR=5.68; 95 % CI=1.09-29.52). Risk due to CYP1A1 Val/Val genotype was further enhanced (OR=8.55; 95 % CI=1.86-42.20) when the analysis was limited to ever smokers. Participants who carried CYP2E1 c1/c2 genotype showed an inverse relation (OR=0.27; 95 % CI=0.17-0.43) with ESCC. The inverse association of CYP2E1 c1/c2 genotype was retained when CYP1A1 Ile/Ile was also present (OR=0.18; 95 % CI=0.09-0.32), as well as when analysis was limited to ever smokers (OR=0.45; 95 % CI=0.23-0.90). Significant interaction was found between CYP1A1 (Val/Val) and CYP2E1 (c1/c1) genotypes (OR=1.30; 95 % CI=1.12-1.51; P=0.001) and between CYP1A1 (Val/Val) and smoking (OR=1.31; 95 % CI=1.01-1.69; P=0.043). The study suggests CYP1A1 Val/Val and CYP2E1 c1/c1 genotypes are significantly associated with ESCC risk. © 2014 International Society of Oncology and BioMarkers (ISOBM).


Bhat T.,New York University | Teli S.,University of Sheffield | Rijal J.,New York University | Bhat H.,SK Institute of Medical science | And 5 more authors.
Expert Review of Cardiovascular Therapy | Year: 2013

The role of inflammatory markers in cardiovascular diseases has been studied extensively and a consistent relationship between various inflammatory markers and cardiovascular diseases has been established in the past. Neutrophil to lymphocyte ratio (NLR) is a new addition to the long list of these inflammatory markers. NLR, which is calculated from complete blood count with differential, is an inexpensive, easy to obtain, widely available marker of inflammation, which can aid in the risk stratification of patients with various cardiovascular diseases in addition to the traditionally used markers. It has been associated with arterial stiffness and high coronary calcium score, which are themselves significant markers of cardiovascular disease. NLR is reported as an independent predictor of outcome in stable coronary artery disease, as well as a predictor of short- and long-term mortality in patients with acute coronary syndromes. It is linked with increased risk of ventricular arrhythmias during percutaneous coronary intervention (PCI) and higher long-term mortality in patients undergoing PCI irrespective of indications of PCI. In patients admitted with advanced heart failure, high NLR was reported with higher inpatient mortality. Recently, NLR has been reported as a prognostic marker for outcome from coronary artery bypass grafting and postcoronary artery bypass grafting atrial fibrillation. © 2013 Expert Reviews Ltd.


Bhat T.,Staten Island University Hospital | Teli S.,University of Sheffield | Bhat H.,SK Institute of Medical science | Akhtar M.,Staten Island University Hospital | And 3 more authors.
Expert Review of Cardiovascular Therapy | Year: 2012

Transradial access for cardiac catheterization is now widely accepted among the invasive cardiology community as a safe and viable approach with a markedly reduced incidence of major access-related complications compared with the transfemoral approach. As this access technique is now being used more commonly for cardiac catheterization, it is of paramount importance to be aware of its complications and to understand their prevention and management. Some of the common complications of transradial access include asymptomatic radial artery occlusion, nonocclusive radial artery injury and radial artery spasm. Among these complications, radial artery spasm is still a significant challenge. Symptomatic radial arterial occlusion, pseudoaneurysm and radial artery perforation are rarely reported complications of the transradial approach. Early identification of these rare complications and their immediate management is of vital importance. Arteriovenous fistula, minor nerve damage and complex regional pain syndrome are very rare but have been reported. Recently, granulomas have been reported to be associated with the use of a particular brand of hydrophilic sheaths during the procedure. Generally, access-site complications can be minimized by avoiding multiple punctures, selection of smaller sheaths, gentle catheter manipulation, adequate anticoagulation, use of appropriate compression devices and avoiding prolonged high-pressure compression. In addition, careful observation for any ominous signs such as pain, numbness and hematoma formation during and in the immediate postprocedure period is essential in the prevention of catastrophic hand ischemia. © 2012 Expert Reviews Ltd.


Molvi S.N.,Government Lal Ded Hospital for Women | Mir S.,Government Lal Ded Hospital for Women | Rana V.S.,SK Institute of Medical science | Jabeen F.,Government Lal Ded Hospital for Women | Rauoof Malik A.,SK Institute of Medical science
Archives of Gynecology and Obstetrics | Year: 2012

Background Pregnancy-induced hypertension (PIH) is associated with adverse fetal and maternal outcome. The role of medication to control blood pressure (BP) in mild to moderate PIH is controversial. Aims We conducted a prospective study to investigate whether pharmacological treatment of mild to moderate PIH is effective in improving maternal and fetal outcomes. Methods A total of 150 consecutive pregnant women without proteinuria and with physician-recorded systolic BP of 140-160 mmHg and/or diastolic BP of 90-105 mmHg on two occasions ≥6 h apart between 20 and 38 weeks of gestation were randomly allocated to receive either labetalol or methyldopa (50 patients each) plus standard care (treatment group) or only standard care (50 patients) (control group). Results and conclusions As compared to the control group, the treatment group had lower rates of severe PIH (28% vs. 10%, P = 0.005), proteinuria (28% vs. 12%, P = 0.016), hospitalization before term (28% vs. 14%, P = 0.041), and delivery by cesarean section (38% vs. 22%, P = 0.042). In a multivariable logistic regression model that adjusted for maternal age, weight, parity, previous PIH, and baseline hemoglobin, resting heart rate, and BP levels, antihypertensive therapy was associated with a lower incidence of adverse maternal events (P = 0.011). Compared to the control group, the treatment group had lower incidence of SGA babies (40% vs.23%,P = 0.033), preterm birth (36% vs. 14%, P =0.002), and admission to neonatal unit (30% vs. 15%, P = 0.036). After adjustment for maternal age, weight, baseline hemoglobin, resting heart rate, BP level, parity and previous history of PIH, fetal death, preterm delivery or SGA baby, antihypertensive therapy was associated with a lower incidence of adverse perinatal events (P = 0.016). Maternal and perinatal mortality rates were not significantly different between treatment and control groups. In conclusion, pharmacological treatment of mild to moderate PIH is associated with lower rate of some maternal and fetal-neonatal non-fatal adverse events compared to no routine use of antihypertensive therapy. © 2012 Springer-Verlag.


Mir F.A.,SK Institute of Medical science
Results in Physics | Year: 2014

Recently, we carried out structural, optical and dielectric studies on micro-crystals of Oxypeucedanin (C16H14O5), isolated from the roots of plant Prangos pabularia (Mir et al. (2014) [3,4]). The obtained trend in frequency exponent (s) with frequency (ω) indicates that the universal dynamic response is followed by this compound. From optical absorption spectroscopy, the optical band gap (Eg) was estimated around 3.76eV and system is showing indirect allowed transition. Using Eg in certain relation of s, a close value of s (as much close obtained by fitting ac conductivity) was obtained. This method was further used for other similar systems and again same trend was obtained. So a general conclusion was made that the high transmitting wide band insulators or semiconductors may follow bipolaron hopping transport mechanism. © 2014 The Author.


PubMed | University of Sheffield, SK Institute of Medical Science and New York University
Type: Journal Article | Journal: Vascular | Year: 2016

Transradial access for cardiac catheterization is a safe and viable approach with significantly lower incidence of major access-related complications compared with the transfemoral approach. As this form of access is getting wider acceptance among interventional cardiologists, awareness of its complications is of vital importance. Asymptomatic radial artery occlusion, non-occlusive radial artery injury and radial artery spasm are commonly reported complication of this approach. Symptomatic radial arterial occlusion, pseudoaneurysm and radial artery perforation are rarely reported complications of transradial approach. Early identification of these uncommon complications and their urgent management is of significant importance. We present the case of an 80-year-old lady who developed pseudoaneurysm a week after transradial cardiac catheterization managed with surgical excision with no long-term sequela.


Bhat T.,Staten Island University Hospital | Baydoun H.,Staten Island University Hospital | Asti D.,Staten Island University Hospital | Rijal J.,Staten Island University Hospital | And 4 more authors.
Expert Review of Cardiovascular Therapy | Year: 2014

Atrial fibrillation (AF) is the most common symptomatic and sustained cardiac arrhythmia. It affects approximately 2-3 million people in the USA alone with an increased incidence and prevalence worldwide. It is associated, in addition to worsening quality of life, with increased morbidity and mortality especially in poorly controlled AF, affecting mostly those older than 65 years of age. Radiofrequency ablation was found to be a good strategy for focal isolation of pulmonary veins triggering from the vulnerable atrial substrate but is a time-consuming procedure and carries the risk of multiple complications like tamponade which could be fatal, atrioesophageal fistula and local thrombus formation at the site of ablation. Cryoballoon ablation with pulmonary vein isolation has emerged in the past few years as a breakthrough novel technology for the treatment of drug-refractory AF. It is a relatively simple alternative for point-by-point radiofrequency ablation of paroxysmal AF and is associated with fewer incidences of fatal complications such as cardiac perforation. As experience with this new tool accumulates, the field faces new challenges in the form of rare compilations including gastroparesis, phrenic nerve palsy, atrioesophageal fistula, pulmonary vein stenosis, thromboembolism pericardial effusion, and tamponade. © 2014 Informa UK, Ltd.


PubMed | SK Institute of Medical science and University Of Kashmir
Type: Journal Article | Journal: Tumour biology : the journal of the International Society for Oncodevelopmental Biology and Medicine | Year: 2016

The association of nucleotide excision repair (NER) gene polymorphisms with esophageal squamous cell carcinoma (ESCC) is inconclusive. The aim of the current study was to assess the association of repair gene xeroderma pigmentosum A (XPA) (rs-1800975) and xeroderma pigmentosum C (XPC) (rs-2228000) polymorphisms with ESCC risk as well as modifying effects of environmental factors. The genotyping was done in 450 confirmed ESCC cases and equal number of individually matched controls by the polymerase chain reaction and restriction fragment length polymorphism (PCR-RFLP) and direct sequencing methods. Conditional logistic regression models were used to assess the genotypic associations and interactions. A high ESCC risk was found in subjects who carried the homozygous minor allele of XPA (odds ratio (OR)=3.57; 95% confidence interval (CI)=1.76-7.23), and the risk was higher when analysis was limited to participants who were ever smokers (OR=4.22; 95% CI=2.01-8.88), lived in adobe houses (OR=8.42; 95% CI=3.74-18.95), consumed large volumes of salt tea (OR=7.42; 95% CI=3.30-16.69), or had a positive family history of cancer (FHC) (OR=9.47; 95% CI=4.67-19.20). In case of XPC, a homozygous minor allele also showed strong association with ESCC risk (OR=4.43; 95% CI=2.41-8.16). We again observed a very strong effect of the above environmental factors in elevating the risk of ESCC. Further, the variant genotypes of both genes in combination showed an increased risk towards ESCC (OR=7.01; 95% CI=3.14-15.64) and such association was synergistically significant. Salt tea consumption showed an interaction with genotypes of XPA and XPC. However, an interaction with FHC was significant in the case of XPA genotype only. XPA and XPC genotypes are associated with an increased risk of ESCC, and such association was reasonably modulated by different exposures.


PubMed | SK Institute of Medical science and University Of Kashmir
Type: Journal Article | Journal: The breast journal | Year: 2016

Genetic polymorphisms in metastatic suppressor genes like MKK4 and NME1 are not well studied in breast cancer. Hence, we analyzed the relationship between MKK4 and NME1 polymorphisms and breast cancer risk in Kashmir, India. The different genotypes of NME1 and MKK4 genes were analyzed by polymerase chain reaction and restriction fragment length polymorphism in 130 breast cancer cases and 200 age- and sex-matched controls. Conditional logistic regression models were used to assess the association of various genotypes with breast cancer. In this study, we found an inverse association between MKK4 promoter polymorphism and breast cancer risk. As compared to TT (wild) genotype, individuals with TG (heterozygous) (OR = 0.32; 95% CI = (0.17-0.58) and GG (mutant) (OR = 0.13; CI = 0.04-0.40) genotypes showed decreased risk of breast cancer. When participants were classified on the basis of lymph node involvement, a strong association between NME1 heterozygous genotype (OR = 3.82; CI = (1.54-9.44) and breast cancer was found.

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