Hepatitis C virus (HCV) is a common cause of liver cirrhosis and hepatocellular carcinoma. Global... more Hepatitis C virus (HCV) is a common cause of liver cirrhosis and hepatocellular carcinoma. Globally, nearly 71 million people have chronic HCV infection, and approximately 399,000 dies annually. In patients without cirrhosis, HCV infection is treated with 12 weeks of sofosbuvir/velpatasvir combination. Results from available small, single-centre observational studies suggest that the sofosbuvir/velpatasvir combination given for 8 weeks may be as effective as the standard 12 weeks of treatment. We propose to compare the treatment response of 12 weeks versus 8 weeks of sofosbuvir/velpatasvir in non-cirrhotic people with chronic HCV infection. This multicentric, randomized, open-label, non-inferiority trial will include 880 (2 arms x 440) treatment naïve, viraemic (HCV RNA >10,000 IU/mL), non-cirrhotic adults (age >18 years) with chronic hepatitis C. People who are at high-risk for HCV reinfection such as haemophiliacs, people who inject drugs, those on maintenance hemodialysis or having HIV will be excluded. The presence or absence of cirrhosis will be determined with a combination of history, examination, ultrasound, liver stiffness measured with transient elastography, APRI, FIB-4, and esophagogastroduodenoscopy. Participants will be randomized to receive either 8-or 12-week sofosbuvir/velpatasvir treatment. A blood specimen will be collected before
Unravelling of molecular biomarkers in synaptic plasticity of Alzheimer’s Disease: Critical role of the restoration of neuronal circuits
Ageing Research Reviews
Learning and memory storage are the fundamental activities of the brain. Aberrant expression of s... more Learning and memory storage are the fundamental activities of the brain. Aberrant expression of synaptic molecular markers has been linked to memory impairment in AD. Aging is one of the risk factors linked to gradual memory loss. It is estimated that approximately 13 million people worldwide will have AD by 2050. A massive amount of oxidative stress is kept under control by a complex network of antioxidants, which occasionally fails and results in neuronal oxidative stress. Increasing evidence suggests that ROS may affect many pathological aspects of AD, including Aβ accumulation, tau hyperphosphorylation, synaptic plasticity, and mitochondrial dysfunction, which may collectively result in neurodegeneration in the brain. Further investigation into the relationship between oxidative stress and AD may provide an avenue for effective preservation and pharmacological treatment of this neurodegenerative disease. In this review, we briefly summarize the cellular mechanism underlying Aβ induced synaptic dysfunction. Since oxidative stress is common in the elderly and may contribute to the pathogenesis of AD, we also shed light on the role of antioxidant and inflammatory pathways in oxidative stress adaptation, which has a potential therapeutic target in neurodegenerative diseases.
Effect of Functional Strength Training on Sit-to-Stand and Functional-Autonomy in Older Adults
Annals of International Medical and Dental Research
Background: To objectively assess the prevalence of forward head posture and its effect on active... more Background: To objectively assess the prevalence of forward head posture and its effect on active mouth opening. Material & Methods: Correlational study design. Setting – Subjects were selected from various gyms and fitness centers located in South Delhi. Subjects were selected for the study according to the following inclusion and exclusion criteria. Method of Sampling- Sample of convenience. Instrumentation / Tools/ Scales/ Outcome Measure- Markers, UTHSCSA Software version 3.0, Calibrated Ruler, Digi Cam; 16 Mega Pixel with stand, Laptop, Liquid Disinfectant, Calibrated Ruler to measure active mouth opening. Craniovertebral angle was measured using UTHSCSA Image tool program. Statistical analysis was done using SPSS 20.0 version software. Descriptive statistics was used to compute means. The Pearson’s coefficient of correlation was used to examine the relationships between craniovertebral angle and active mouth opening. Results were considered significant at ‘p’ < 0.05. Result...
Antibody response to ChAdOx1 nCoV‐19 (Covishield®) vaccine in people on maintenance hemodialysis
Seminars in Dialysis
Introduction: People on renal replacement therapy (RRT) have a high risk of COVID‐19 infection an... more Introduction: People on renal replacement therapy (RRT) have a high risk of COVID‐19 infection and subsequent death. COVID‐19 vaccination is strongly recommended for those on RRT. Data are limited on the immune response of the ChAdOx1 nCoV‐19/AZD1222 (Covishield®) vaccine in patients on RRT. Methods: A prospective cohort of adult (age > 18 years), on RRT in the form of hemodialysis were included and received two intramuscular doses of Covishield®. A blood specimen of 5.0 mL was collected at two time points, within a few days before administering the first dose of the vaccine and at 4–16 weeks after the second dose. According to their prior COVID‐19 infection status, the participants were grouped as (i) prior symptomatic COVID‐19 infection, (ii) prior asymptomatic COVID‐19 infection, and (iii) no prior COVID‐19 infection. Results: A large proportion (81%) of participants had anti‐spike antibodies (ASAb) before vaccination, and a reasonable proportion (30%) also had neutralizing an...
i) Background: ChAdOx1 nCoV-19 (Covishield ® ) vaccine is widely used in India. We studied the Co... more i) Background: ChAdOx1 nCoV-19 (Covishield ® ) vaccine is widely used in India. We studied the Covishield ® induced antibody response and its durability among health care workers (HCWs) (ii) Method: HCWs received two doses (0.5 mL) four weeks apart. Blood specimens, collected before each dose, day (D) 60, D150 and D270 after second dose, were tested for anti-spike antibody (ASAb) titre and neutralising antibody (%) (NAb) using Elecsys Anti-SARS-CoV-2 S (Roche) and SARS-CoV-2 NAb ELISA Kit (Invitrogen), respectively. Data are expressed as proportions and median (interquartile range) and compared using non-parametric (iii) Result: Among 135 HCWs (83 males; age 45 (37-53); 36 had pre-existing ASAb), 29 (21.5%) acquired COVID-19 after 60 (39-68) days of vaccination. ASAb titre before second dose and at D60, D150, D270 were 77.2 (19.4-329.4), 512 (114.5-9212), 149 (51.6-2283) and 2079 (433.9-8644) U/mL, respectively. Compared to those without pre-existing ASAb, titres were significantly higher before second dose (5929 vs. 41, p < 0.001), D60 (3395 vs. 234, p = 0.007) and D150 (1805 vs. 103, p < 0.001) in participants with pre-existing ASAb; NAb were also higher (80 vs. 18, p < 0.001) before second dose. Between those who acquired infection or not after vaccination, ASAb titres were comparable before second dose (77 vs. 78, p = 0.362) but significantly higher at D60 (14,019 vs. 317, p < 0.001) and D150 (2062 vs. 121, p = 0.002) in the former group, though NAb percentage were higher at D60 (87 vs. 27, p < 0.001) and D150 (79 vs. 25, p = 0.007) only (iv) Conclusions: Covishield ® induces a higher antibody titre in those with pre-existing ASAb. The vaccine induced antibody starts falling 5 months after vaccination.
Introduction: Data are limited on antibody response to the ChAdOx1 nCoV-19 vaccine (AZD1222; Covi... more Introduction: Data are limited on antibody response to the ChAdOx1 nCoV-19 vaccine (AZD1222; Covishield®) in cirrhosis. We studied the antibody response following two doses of the ChAdOx1 vaccine, given 4–12 weeks apart, in cirrhosis. Methods: Prospectively enrolled, 131 participants (71% males; age 50 (43–58); alcohol-related etiology 14, hepatitis B 33, hepatitis C 46, cryptogenic 21, autoimmune 9, others 8; Child–Turcott–Pugh class A/B/C 52/63/16). According to dose intervals, the participants were grouped as ≤6 weeks (group I), 7–12 weeks (group II), and 13–36 weeks (group III). Blood specimens collected at ≥4 weeks after the second dose were tested for anti-spike antibody titre (ASAb; positive ≥ 0.80 U/mL) and neutralizing antibody (NAb; positive ≥20% neutralization) using Elecsys Anti-SARS-CoV-2 S (Roche) and SARS-CoV-2 NAb ELISA Kit (Invitrogen), respectively. Data are expressed as number (proportion) and median (interquartile range) and compared using non-parametric tests. R...
Kidney transplant recipients (KTRs) are at a much higher risk of complications and death followin... more Kidney transplant recipients (KTRs) are at a much higher risk of complications and death following COVID-19 and are poor vaccine responders. The data are limited on the immune response to Covishield® in KTRs. We prospectively recruited a cohort of 67 KTRs aged >18 between April 2021 and December 2021. Each participant was given two intramuscular doses of Covishield®, each of 0.5 mL, at an interval of 12 weeks. A blood specimen of 5.0 mL was collected from each participant at two points within a few days before administering the first dose of the vaccine and at any time between 4–12 weeks after administering the second dose. The sera were tested for anti-RBD antibody (ARAb) titre and neutralising antibody (NAb). An ACE2 competition assay was used as a proxy for virus neutralization. According to the prior COVID-19 infection, participants were grouped as (i) group A: prior symptomatic COVID-19 infection, (ii) group B: prior asymptomatic COVID-19 infection as evidenced by detectable...
Most of the cancer cells require high quantity of arginine for sustaining their fast-metabolic ra... more Most of the cancer cells require high quantity of arginine for sustaining their fast-metabolic rates. Limiting supply of arginine to cancer cells using arginase may prove to be of great therapeutic value. The arginase produced by a micro organism isolated from soil has been used in industrial production of ornithine, however its use in anticancer activities is scarcely studied. This study optimized soybean meal supplemented basal media for Arginase production. Arginase was purified using ammonium sulphate precipitation, sephadex G-100 column chromatography and DEAE chromatography achieving 79.2% purification fold and 24.26% yield. It had 23 KD molecular weight as determined using Native PAGE and was active at considerably wide pH range of 6-10 and temperature 30-50℃. Whereas the maximum arginase activity was noticed with Mn² + ions followed by polyvinyl pyrrolidine (PVP) at 70 mM substrate concentration, the maximum inhibition of activity was caused by CuC. Streptomyces plicatus KAR 73 produced arginase on mouse mammary cell line (CID 9) was not inhibited by the arginase upto 6.5 U/mL. Significant (p< 0.001) inhibition in Mouse mammary tumor (C1271) cell lines was observed with IC 50 5.2 U/mL. The ornithine has been produced earlier with Mycoplasma and Clostridium by other researchers but production of native arginase from Streptomyces specifically for anticancer activities has not yet been reported. The present study infers that Arginase produced from native Streptomyces has shown promising results thereby enabling feasibility assessment towards cost effective industrial production of arginase.
Alzheimer's disease (AD) is one of the most prevalent neurodegenerative disorders. The etiology a... more Alzheimer's disease (AD) is one of the most prevalent neurodegenerative disorders. The etiology and pathology of AD are complicated, variable, and yet to be completely discovered. However, the involvement of inflammasomes, particularly the NLRP3 inflammasome, has been emphasized recently. NLRP3 is a critical pattern recognition receptor involved in the expression of immune responses and has been found to play a significant role in the development of various immunological and neurological disorders such as multiple sclerosis, ulcerative colitis, gout, diabetes, and AD. It is a multimeric protein which releases various cytokines and causes caspase-1 activation through the process known as pyroptosis. Increased levels of cytokines (IL-1β and IL-18), caspase-1 activation, and neuropathogenic stimulus lead to the formation of proinflammatory microglial M1. Progressive researches have also shown that besides loss of neurons, the pathophysiology of AD primarily includes amyloid beta (Aβ) accumulation, generation of oxidative stress, and microglial damage leading to activation of NLRP3 inflammasome that eventually leads to neuroinflammation and dementia. It has been suggested in the literature that suppressing the activity of the NLRP3 inflammasome has substantial potential to prevent, manage, and treat Alzheimer's disease. The present review discusses the functional composition, various models, signaling molecules, pathways, and evidence of NLRP3 activation in AD. The manuscript also discusses the synthetic drugs, their clinical status, and projected natural products as a potential therapeutic approach to manage and treat NLRP3 mediated AD.
Hepatitis C re-treatment with first line direct acting antiviral drugs
Journal of Clinical and Experimental Hepatology
Serological immune response following ChAdOx1 nCoV-19 vaccine (Covishield) in patients with liver cirrhosis
Journal of Clinical and Experimental Hepatology
Liver Stiffness is Reduced to Normal After Successful Renal Transplantation: A Prospective Cohort Study
Journal of Clinical and Experimental Hepatology
Use of Sofosbuvir/Velpatasvir/Voxilaprevir for Sofosbuvir Nonresponder Genotype 3 HCV Infection in India
Journal of Clinical and Experimental Hepatology, 2021
In India, hepatitis C virus (HCV) infection is treated with sofosbuvir in combination with NS5A i... more In India, hepatitis C virus (HCV) infection is treated with sofosbuvir in combination with NS5A inhibitor (Daclatasvir, Ledipasvir, or Velpatasvir). A small proportion of them fail to achieve sustained virological response at 12 weeks (SVR12) and need retreatment. Triple-drug combination (Sofosbuvir/Velpatasvir/Voxilaprevir) is one of the options for retreatment. Here we describe a patient with cirrhosis and genotype 3a infection who was successfully treated with a triple-drug combination after relapse with two courses of Sofosbuvir-containing regimens.
Diabetes is fast gaining the status of a potential epidemic in India with more than 62 million di... more Diabetes is fast gaining the status of a potential epidemic in India with more than 62 million diabetic individuals currently diagnosed with the disease. Proprioception is the ability to perceive position and movement. Proprioception can help in joint stability, postural correction (control) and many other conscious sensations. The aim is to identify the effect of blood sugar levels, both Fasting and Post Prandial sugar levels on Proprioception in Diabetic individual. It is a cross-sectional study with total of 30 subjects aged 45-59 years with a 5-10 years of diabetic history were included in the study and their blood sugar levels were examined using glucometer. Lower limb proprioception was assessed by Isokinetic Dynamometer. The results of data analysis demonstrated that fall in Blood sugar level leads to poor lower limb Proprioception in diabetic individuals. The Result came out to be significant at p<0.05.The results demonstrated that changes in blood sugar levels is signifi...
Major issues in wireless sensors network is reducing network life time and increasing the number ... more Major issues in wireless sensors network is reducing network life time and increasing the number of dead nodes. Number of dead node depends on supervision of the energy saving in each sensor's node. Research in this field is to increase network lifetime and also increase the number of alive node. There are many algorithms in wireless sensor network but best is clustering based algorithm. Clustering based algorithm is increase a lot of significance in decreasing the number of dead nodes of each network. This research paper proposed "Energy Sensitive Energy Alert Hierarchical Protocol" (ESEAHP) protocol technique in which every sensor node has energy levels of heterogeneity ordered network which autonomously selects itself as a cluster head.CH based on its initial energy relative to that of other nodes. The network life was increased as compared to increase and decrease in number of alive and dead nodes respectively. Increased throughput due to two type of Nodes heteroge...
Attacker and different security scheme in Delay Tolerant Wireless Ad hoc Network
2016 International Conference on ICT in Business Industry & Government (ICTBIG), 2016
Mobile Ad Hoc Networks (MANETs) are collections of mobile nodes that can communicate with one ano... more Mobile Ad Hoc Networks (MANETs) are collections of mobile nodes that can communicate with one another using multi hop wireless links. MANETs are often deployed in the environments, where there is no fixed infrastructure and centralized management. They are attractive and more popular these days. The reason of popularity of this kind of network is its easy establishment at any place. The nodes of mobile ad hoc networks are susceptible to compromise. In such a scenario, designing an efficient, trustworthy and secure routing protocol has been a major challenge over the last many years. The bundle of messages or data sent in dynamic network is called Delay Tolerant Network (DTN). One major issue on this network is security. Ad hoc On-demand Distance Vector (AODV) routing protocol has been modified to implement TSDRP for making it secure to thwart attacks like Blackhole attack and DoS attack. Much effort are required to improve the various demands of network security inconsistency with the demands on mobile networks and the nature of the mobile devices like low processing and communication in open environment. This article is mainly focused on the security issues related to DTN routing protocols. The routing in DTN remains a key issue because without accurately functioning of routing protocols, the network will not work efficiently, it's intended to. Regrettably, routing is also most difficult to protect against attacks of malicious activities due to absence of centralized authority in DTN. This paper also presents the main protection menace involved in routing with dynamic network as well as the recent solutions against different attacks in Wireless Ad hoc DTN.
International Journal for Scientific Research and Development, 2013
the design of VLSI circuits can be achieved at many different refinement levels from the most det... more the design of VLSI circuits can be achieved at many different refinement levels from the most detailed layout to the most abstract architectures. VLSI design has been the study of electronic design automation and related semiconductor science, and many software tools have been written to solve one or more problems associated with the VLSI design flow. VLSI CAD tools have emerged as a boon in assisting VLSI Design engineers to choose and optimize various design models and technology. The importance of CAD tool can be understood by seeing its complex algorithms, data structures and modeling assumptions used in each of the following steps namely logic synthesis, logic verification, layout synthesis, timing verification and many others. Thus a number of standard tools have emerged to design and analyze VLSI chip from one step of the flow to another. Computer-aided design (CAD) is the use of computer systems to assist in the creation, modification, analysis, or optimization of a design. ...
This review focuses the prevalence of Tuberculosis in patients of diabetes. Tuberculosis & Diabet... more This review focuses the prevalence of Tuberculosis in patients of diabetes. Tuberculosis & Diabetes are very joint infections & both are showing an increasing trend. Tuberculosis is a infection and the pathogen responsible for this is Mycobacterium tuberculosis. The Mycobacterium is the bacteria primarily responsible for lung infection and this infection some times might be spread in other organ system beyond the lungs. Diabetes mellitus is a category of a typical metabolic disorder responsible for increased blood sugar level in a person . In diabetes the body is not having ability to produce sufficient insulin or the cells of the body do not respond in a proper way to the insulin that is produced inside body. Most of the time patients of diabetes are very much susceptible against different types of infections & tuberculosis is one of most important amongst them. Prevalence of tuberculosis is three to five times more in patients of diabetes than the non-diabetic people. There is mor...
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