Microbiological Quality and Safety of Two Popularly Consumed Raw, Street Vended Foods in India

Abhijit Ganguli,Sunita Bansal,Namita Malik,Arun Kumar Rana,Moushumi Ghosh 한국식품과학회 2004 Food Science and Biotechnology Vol.13 No.4

Identifying Adverse Remodeling in Hypertrophic Cardiomyopathy Phenotypes Role of Left Atrial Parameters

Dutt Shivam,Tandon Rohit,Sondh Mandeep Singh,Bansal Namita,Singh Gurbhej,Mohan Bishav,Singh Bhupinder,Wander Gurpreet Singh 아시아심장혈관영상의학회 2021 Cardiovascular Imaging Asia Vol.5 No.1

Objective: Documenting adverse remodeling in absence of left ventricular outflow tract (LVOT) obstruction and mitral regurgitation in a classical hypertrophic cardiomyopathy (HCMP) phenotype is difficult. Changes in the left atrium (LA) are a consequence of progressive left ventricular (LV) fibrosis and have been shown to progress in a linear fashion. Therefore, studying LA changes for identifying adverse remodeling in HCMP patients is important. Materials and Methods: This was a prospective study which included HCMP patients and age- and gender-matched controls. Various echocardiographic parameters of adverse cardiac remodeling were investigated. Results: A total of 160 patients with HCMP and 75 age- and sex-matched controls were analyzed over a 5-year period. HCMP patients had an enlarged LA, greater segmental thickness, and mildly increased LV filling pressure. Patients with maximum LA volume >40 mL and global LA strain <21.5% showed greater maximum segmental thickness and increased ratio of pulse wave Doppler derived mitral E wave and tissue Doppler derived annular e wave with reduced LA strain and LV strain, LA emptying fraction, and strain-derived LV ejection fraction. In both groups, significant difference was not observed in age, sex, HCMP phenotype, presence or absence of LVOT obstruction, LV volume, and mitral Doppler ratio of pulse wave Doppler derived mitral E and A waves. Conclusion: Monitoring HCMP in asymptomatic patients is challenging. Assessment of adverse cardiac remodeling in classical HCMP phenotype is feasible using global LA strain and maximum LA volume. Global LA strain identifies early changes and maximum LA volume late changes of cardiac remodeling and therefore provide an early indication of disease progression in asymptomatic HCMP patients.

Trends of inflammatory bowel disease at a tertiary care center in northern India

( Ajit Sood ),( Kirandeep Kaur ),( Arshdeep Singh ),( Vandana Midha ),( Ramit Mahajan ),( Namita Bansal ),( Varun Mehta ),( Dharmatma Singh ) 대한장연구학회 2021 Intestinal Research Vol.19 No.3

Background/Aims: Inflammatory bowel disease (IBD), including ulcerative colitis (UC) and Crohn’s disease (CD), is increasingly being reported from India and other Asian countries. This study looks into the changing trends of IBD at a tertiary care center in north India over last two decades. Methods: Retrospective analysis of a prospectively maintained database of patients diagnosed with IBD between January 1991 and December 2015 was conducted. The study period was divided into five times cohorts (1991-1995, 1996-2000, 2001-2005, 2006-2010, 2011-2015). Results: During the study period, 2,467 patients (UC [n=2,137, 86.6%], CD [n=330, 13.3%], mean age 38.5±13.3 years; 55.9% males) were registered. The proportion of patients with CD increased (ratio of UC to CD declined from 15.7:1 to 4:1). The mean age at diagnosis decreased for UC (45.7±12.1 years in 1991-1995 vs. 37.6±13.0 years in 2011-2015; P=0.001) and remained consistent for CD (41.3±13.6 years in 1996-2000 vs. 41.3±16.9 years in 2011-2015, P=0.86). Patients with proctitis in UC and isolated ileal disease in CD increased over the study period (P=0.001 and P=0.007, respectively). Inflammatory CD increased (P=0.009) whereas stricturing CD decreased (P=0.01) across all cohorts. There was a trend towards less severe presentation of both UC and CD. The use of thiopurines (P=0.02) and biologics increased (P=0.001) with no significant change in trends for requirements of surgery (P=0.9). Conclusions: Increasing prevalence of CD, younger age at diagnosis, diagnosis at an earlier and milder stage, greater use of thiopurines and biologics were observed. (Intest Res 2021;19:282-290)

Inflammatory bowel disease (IBD)-disk accurately predicts the daily life burden and parallels disease activity in patients with IBD

( Arshdeep Singh ),( Yogesh Kumar Gupta ),( Ashvin Singh Dhaliwal ),( Bhavjeet Kaur Kahlon ),( Vasu Bansal ),( Ramit Mahajan ),( Varun Mehta ),( Dharmatma Singh ),( Ramandeep Kaur ),( Namita Bansal ) 대한장연구학회 2023 Intestinal Research Vol.21 No.3

Background/Aims: The inflammatory bowel disease (IBD)-disk is a validated, visual, 10-item, self-administered questionnaire used to evaluate IBD-related disability. The present study aimed to evaluate IBD-disk in assessment of IBD daily life burden and its relation with disease activity. Methods: A cross-sectional study was conducted between June 2021 and December 2021. Patients with IBD were asked to complete the IBD-disk and a visual analogue scale of IBD daily-life burden (scored from 0-10, score >5 indicative of high burden). The internal consistency of IBD-disk, correlation with IBD daily life burden and disease activity (assessed by partial Mayo score and Harvey Bradshaw Index in patients with ulcerative colitis [UC] and Crohn’s disease [CD], respectively) and diagnostic performance of IBD-disk to detect high burden were analyzed. Results: Out of the 546 patients (mean age 40.33±13.74 years, 282 [51.6%] males) who completed the IBD-disk, 464 (84.98%) had UC and the remaining (n=82, 15.02%) had CD. A total of 311 patients (291 UC and 20 CD; 56.95%) had active disease. The mean IBD-disk total score and IBD daily life burden were 18.39±15.23 and 2.45±2.02, respectively. The IBD-disk total score correlated strongly with the IBD daily life burden (ρ=0.94, P< 0.001), moderately with partial Mayo score (ρ=0.50) and weakly with Harvey Bradshaw Index (ρ=0.34). The IBD-disk total score >30 predicted high IBD daily-life burden. Conclusions: The IBD-disk accurately predicts the daily life burden and parallels disease activity in patients with IBD and can be applied in clinical practice. (Intest Res 2023;21:375-384)

Maintaining infliximab induced clinical remission with azathioprine and 5-aminosalicylates in acute severe steroid-refractory ulcerative colitis has lower cost and high efficacy (MIRACLE): a multicenter study

( Ramit Mahajan ),( Arshdeep Singh ),( Saurabh Kedia ),( Kirandeep Kaur ),( Vandana Midha ),( Pabitra Sahu ),( Varun Mehta ),( Dharmatma Singh ),( Namita Bansal ),( Khushdeep Dharni ),( Sandeep Kausha 대한장연구학회 2022 Intestinal Research Vol.20 No.1

Background/Aims: Infliximab (IFX) has been used to induce and maintain remission in patients with severe steroid-refractory ulcerative colitis (UC). Long-term use of biologics in developing countries is limited by high cost and frequent side effects. An optimal maintenance strategy in these patients needs to be established. Methods: A retrospective analysis of maintenance of clinical remission with combination of azathioprine (AZA) and 5-aminosalicylates (5-ASA) in patients with severe steroid-refractory UC where IFX (5 mg/kg intravenously at weeks 0, 2, 6) had been used only as an induction therapy was done at 2 centers in India. Primary outcome was the proportion of patients maintaining corticosteroid-free sustained clinical remission (SCR) at the end of study period. Rates of relapse and cost of therapy were also analyzed. Results: Of the 137 patients who received rescue IFX induction therapy, 77 (56.2%) achieved clinical remission (mean age 34.81±13.32 years, 68.83% males, median follow-up 4 years, range 3 months to 6 years) and were included. Cumulative corticosteroid-free SCR was maintained in 68%, 59%, 42%, and 35% patients at 1, 2, 4, and 6 years respectively. Sixty-seven relapses were observed in 33 patients. Majority of the relapses (45/67, 67.16%) occurred within first 2 years of follow-up. Two relapses were managed with re-induction with IFX, one required colectomy, whereas all other responded to repeat course(s) of corticosteroids. Annual per capita maintenance therapy with 5-ASA and AZA was cheaper by US$ 4,526 compared to maintaining remission with IFX. Conclusions: Clinical remission achieved with IFX induction therapy in severe steroid-refractory UC can be sustained over long time with a combination of AZA and 5-ASA. (Intest Res 2022;20:64-71)

Clinical spectrum of elderly-onset inflammatory bowel disease in India

Yogesh Kumar Gupta,Arshdeep Singh,Vikram Narang,Vandana Midha,Ramit Mahajan,Varun Mehta,Dharmatma Singh,Namita Bansal,Madeline Vithya Barnaba Durairaj,Amit Kumar Dutta,Ajit Sood 대한장연구학회 2023 Intestinal Research Vol.21 No.2

Background/Aims: Inflammatory bowel disease (IBD) is increasingly being recognized in elderly patients. Data on clinical spectrum of elderly-onset IBD patients is lacking from India. Methods: A cross-sectional retrospective analysis of a prospectively maintained database of patients diagnosed with IBD was conducted at 2 centers in India. The clinical spectrum of elderly-onset IBD including demographic profile (age and sex), clinical presentation, disease characteristics (disease behavior and severity, extent of disease), and treatment were recorded and compared with adult-onset IBD. Results: During the study period, 3,922 (3,172 ulcerative colitis [UC] and 750 Crohn’s disease [CD]) patients with IBD were recorded in the database. A total of 186 patients (4.74%; 116 males [62.36%]) had elderly-onset IBD (69.35% UC and 30.64% CD). Diarrhea, blood in stools, nocturnal frequency and pain abdomen were the commonest presentations for UC, whereas pain abdomen, weight loss and diarrhea were the most frequent symptoms in CD. For both elderly onset UC and CD, majority of the patients had moderately severe disease. Left-sided colitis was the commonest disease location in UC. Isolated ileal disease and inflammatory behavior were the most common disease location and behavior, respectively in CD. 5-Aminosalicylates were the commonest prescribed drug for both elderly onset UC and CD. Thiopurines and biologics were used infrequently. Prevalence of colorectal cancer was higher in elderly onset IBD. Conclusions: Elderly onset IBD is not uncommon in India. Both the elderly onset UC and CD were milder, with no significant differences in disease characteristics (disease extent, location and behavior) when compared to adult-onset IBD. Colorectal cancer was more common in elderly onset IBD.

Low prevalence of primary sclerosing cholangitis in patients with inflammatory bowel disease in India

Arshdeep Singh,Vandana Midha,Vikram Narang,Saurabh Kedia,Ramit Mahajan,Pavan Dhoble,Bhavjeet Kaur Kahlon,Ashvin Singh Dhaliwal,Ashish Tripathi,Shivam Kalra,Narender Pal Jain,Namita Bansal,Rupa Banerje 대한장연구학회 2023 Intestinal Research Vol.21 No.4

Background/Aims: Primary sclerosing cholangitis (PSC) represents the most common hepatobiliary extraintestinal manifestation of inflammatory bowel disease (IBD), including ulcerative colitis (UC) and Crohn’s disease (CD). Limited data exist on PSC in patients with IBD from India. We aimed to assess the prevalence and disease spectrum of PSC in Indian patients with IBD. Methods: Database of IBD patients at 5 tertiary care IBD centers in India were analyzed retrospectively. Data were extracted and the prevalence of PSC-IBD was calculated. Results: Forty-eight patients out of 12,216 patients with IBD (9,231 UC, 2,939 CD, and 46 IBD unclassified) were identified to have PSC, resulting in a prevalence of 0.39%. The UC to CD ratio was 7:1. Male sex and pancolitis (UC) or colonic CD were more commonly associated with PSC-IBD. The diagnosis of IBD preceded the diagnosis of PSC in most of the patients. Majority of the patients were symptomatic for liver disease at diagnosis. Eight patients (16.66%) developed cirrhosis, 5 patients (10.41%), all UC, developed malignancies (3 colorectal cancer [6.25%] and 2 cholangiocarcinoma [4.16%]), and 3 patients died (2 decompensated liver disease [4.16%] and 1 cholangiocarcinoma [2.08%]) on follow-up. None of the patients mandated surgical therapy for IBD. Conclusions: Concomitant PSC in patients with IBD is uncommon in India and is associated with lower rates of development of malignancies.