Dnyanesh Amle | Delhi University 1 (original) (raw)

Papers by Dnyanesh Amle

Asian Journal of Medical Sciences, Oct 1, 2022

Background: Colorectal cancer is the third most common cancer worldwide. The colorectal cancer ha... more Background: Colorectal cancer is the third most common cancer worldwide. The colorectal cancer has varied presentation and often patients present in late stages of disease. Pre-operative carcinoembryonic antigen (CEA) levels are indicative of tumor stage and thus are predictive of prognosis. However, the importance of post-operative CEA value is seldom discussed and utility of this clinically relevant parameter needs to be established to predict survival of subjects after surgical resection of tumor. Aims and Objectives: This study aims to understand the colorectal malignancy in a group of population and evaluate its complexity, clinical presentations, modalities of treatment, and its complications. Furthermore, we aimed to access predictive utility of post-operative CEA levels for forecasting the long-term outcome in the patient. Materials and Methods: All subjects with diagnosed cases of colorectal malignancy were included in the study. The subjects presenting complaints were clinically examined and the observations were noted. Colonoscopy and histopathological investigations were scheduled, and based on CT findings, further management was planned. Carcinoembryonic antigen levels were assessed in pre-operative and post-operative serum sample. Follow-up was done at regular intervals. CEA levels in subjects with different outcome were compared retrospectively. Results: The most common age group of subjects with colorectal malignancies was 51-60 years. Bleeding per rectum was the most common symptom and the most common sign was per rectal palpable mass. Laparoscopic surgery had less hospital stay, less blood loss, and lower rate of wound site infection. The pre-operative CEA levels were found to be matched; however, post-operative CEA levels were found to be significantly elevated in non-survivor subjects compared to those who survived. Conclusion: Patients with high post-operative CEA values should be closely followed up for relapse and dealt with more caution to reduce the mortality.

IP Journal of Paediatrics and Nursing Science, Apr 15, 2021

Tracheostomy tube care in a pediatric age group is challenging. The systematic approach for trach... more Tracheostomy tube care in a pediatric age group is challenging. The systematic approach for tracheostomy care and guidance to the care giver and parents will reduce complications related to tracheostomy. The purpose of this article is to ensure the safety of the infants and children who have tracheostomy tube placed in the neck. Materials andMethods: The acronym (tracheostomy) was created to teach and train the care giver and nursing staff for better post tracheostomy care. All the aspects of tracheostomy care have been included in this as mentioned below Tube change-when to change? Regular cleaning-how to perform? Airway protection-what is required? Complication awareness-how to prevent? Home kit requirement-things to keep ready bedside. Emergency situations-when to call your doctor? Oral hygiene-why it is important? Stoma/skin care-what to look for? Ties care-too tight or too loose? Outer & inner tube cleaning-how to perform? Mucous problems-suctioning tips Your safety-what all you must know. Results: The acronym is easy to remember and easy to follow. Conclusion: A systematic tracheostomy care approach can give better outcomes and reduced complication rate in pediatric age group. It will be benefitted for all the health care professionals, nursing staff and the care givers involved with the children who need tracheostomy care.

Diabetes, Jun 1, 2019

Introduction: Diabetes mellitus (DM) remains the iceberg disease in rural areas with large number... more Introduction: Diabetes mellitus (DM) remains the iceberg disease in rural areas with large number of subjects remaining undiagnosed. India is the diabetes capital with home to 72.9 million diabetic people. Methodology: Our cross-sectional observational and analytical survey studied 516 subjects with uncontrolled type 2 DM (HbA1c &gt;9%) in the 9 villages (having 35,000 population) at Rural health centre, Veleru of Dr. PSIMS and RF, Krishna district, Andhra Pradesh, South India which is a predominantly rice eating population and analyzed the socio-demographic factors influencing insulin administration. Participants were assessed through a pre-tested structured questionnaire to elicit awareness regarding insulin usage. Results: Though 40.3% were prescribed insulin at some point of time, only 10.1% subjects were taking it. Awareness of diabetes was lacking in 67.8% and that of insulin in 54.1%. Commonest reason for avoiding insulin was fear of injections (31.8%), unawareness of insulin technique in 25.8%, lack of facilities to store insulin in 19.8% subjects, lack of access to pharmacy in 9.3%, unsure about correct timing in 20.2%, concerned about proper dosage measurements in 1.9%, but only 3.9% were concerned about cost. Conclusion: Proper awareness programs can significantly increase effective and regular use of insulin in diabetes subjects. Disclosure P. Mandava: None. H.R.S. Munganda: None. V. Undavalli: None. P. Satyanarayana Chowdary: None. D. Amle: None.

Current Issues in Molecular Biology

Type 2 diabetes (T2D) develops from insulin resistance (IR) and the dysfunction of pancreatic bet... more Type 2 diabetes (T2D) develops from insulin resistance (IR) and the dysfunction of pancreatic beta cells. The AKT2 protein is very important for the protein signaling pathway, and the non-synonymous SNP (nsSNPs) in AKT2 gene may be associated with T2D. nsSNPs can result in alterations in protein stability, enzymatic activity, or binding specificity. The objective of this study was to investigate the effect of nsSNPs on the AKT2 protein structure and function that may result in the induction of IR and T2D. The study identified 20 variants that were considered to be the most deleterious based on a range of analytical tools included (SIFT, PolyPhen2, Mut-pred, SNAP2, PANTHER, PhD-SNP, SNP&Go, MUpro, Cosurf, and I-Mut). Two mutations, p.A179T and p.L183Q, were selected for further investigation based on their location within the protein as determined by PyMol. The results indicated that mutations, p.A179T and p.L183Q alter the protein stability and functional characteristics, which coul...

Cureus, Jan 9, 2023

Background: Fructosamine (FA) has gained importance as a new biomarker for hyperglycemia in the p... more Background: Fructosamine (FA) has gained importance as a new biomarker for hyperglycemia in the past decade and may be of indispensable use in certain conditions where hemoglobin A1c (HbA1c) falls short of utility such as disorders of red blood cells, patients with rapid glycemic excursions requiring more shortterm monitoring, pregnancy, chronic kidney disease, etc. Methods: The present study was a hospital-based observational cross-sectional study conducted in the

Cureus

Cardiac troponin I (cTnI) is regarded as a gold standard investigation for the diagnosis of acute... more Cardiac troponin I (cTnI) is regarded as a gold standard investigation for the diagnosis of acute myocardial infarction (AMI). However, cTnI may be elevated in certain non-AMI cardiac conditions and even in certain noncardiac conditions. We report a case of a young female presenting with symptoms suggestive of acute cholecystitis with elevated high-sensitive cardiac troponin I (hs-cTnI). The patient developed acute chest pain during the hospital stay. On evaluation, quantitative assay for hs-cTnI was found to be elevated; however, other markers of cardiac damage such as creatinine kinase-MB (CK-MB), qualitative cTnI by card test, and even echocardiogram (ECG) were found to be negative. As the patient was a young female with no significant history of coronary diseases, the spurious elevation of hs-TnI due to a noncardiac ailment was suspected. The patient was managed with minimal cardiological management till AMI was excluded. The hs-cTnI levels returned to normal post-cholecystectomy. A patient presenting with symptoms suggestive of cholecystitis and elevated hs-cTnI must be carefully evaluated before resorting to any invasive management for AMI. In most cases, hs-cTnI will return to normal post-cholecystectomy.

Indian Journal of Otolaryngology and Head & Neck Surgery

Cureus

Introduction The cycle threshold (Ct) value in real-time reverse transcription-polymerase chain r... more Introduction The cycle threshold (Ct) value in real-time reverse transcription-polymerase chain reaction (RT-PCR) serves as a criterion to diagnose coronavirus disease 2019 (COVID-19) and is inversely proportional to viral load. Levels of inflammatory markers such as aspartate aminotransferase (AST), ferritin, D-dimer, high sensitivity C-reactive protein (hs-CRP), and lactate dehydrogenase (LDH) are used as quantitative measures of COVID-19 severity. We examined the association between these markers and Ct values. Methodology This retrospective data analysis included 400 patients with positive RT-PCR results for COVID-19 who were admitted to a tertiary care hospital. Clinical and biochemical data were accessed from the hospital information management system. Associations of clinical parameters and markers of disease severity (e.g., polymorph, AST, hs-CRP, D-dimer, LDH, and ferritin levels) with Ct values were assessed. Observations LDH, ferritin, D-dimer, and hs-CRP were found to be significantly higher in moderate and severe groups than in the mild COVID-19 group. AST, ferritin, and hs-CRP levels were also significantly higher in severe COVID-19 subjects, compared to moderate COVID-19 subjects. Ct values for the E (envelop) gene and ORF (open reading frame) 1b gene were found to be significantly higher in those with severe COVID-19. Polymorph counts in subjects with Ct values of 25 or higher were significantly increased, compared to those with Ct values under 30. LDH, D-dimer, and hs-CRP levels in subjects with Ct values over 30 were significantly lower than for those with Ct values under 30. Ferritin was the best independent predictor of non-survival in study subjects, with an area under the curve (AUC) of 85.5% (95% confidence interval = 73.2-95.9). The Ct value for the E gene had an AUC of 75.1%, and the ORF1b gene had an AUC of 64.5%. However, no significant correlation was detected between any parameter and Ct value. Conclusion Polymorph, LDH, ferritin, D-dimer, and hs-CRP levels were significantly elevated in subjects with low E gene Ct values. Also, these subjects were at risk of severe disease and fatality. Ct values for the E gene thus could serve as an early indicator for patients at risk of severe disease and death.

Cureus

Background Ischemia-modified albumin (IMA) is looked upon as a newer marker of myocardial ischemi... more Background Ischemia-modified albumin (IMA) is looked upon as a newer marker of myocardial ischemia. There is a paucity of literature however with regard to studies correlating levels of IMA in patients with hypertensive disorders of pregnancy. The present study therefore aimed at estimating the levels of IMA in patients with gestational hypertension and assessing its utility in predicting hypertensive disorders of pregnancy. Methods The present study was a hospital-based case-control study conducted in the Department of Biochemistry, All India Institute of Medical Sciences (AIIMS), Nagpur. IMA was estimated in 30 controls (Group I) and 20 cases of gestational hypertension (Group II) using a spectrophotometric assay detecting free unbound Cobalt left behind. The clinical data and lab results were presented as mean ± SD. Student's t-test was applied and Pearson's correlation coefficient was calculated. A value of p < 0.05 was taken as statistically significant. The ROC (Receiver Operator Characteristic) curve was used to establish the cutoff of serum IMA levels in pregnancy-induced hypertension (PIH). Results There was no significant difference in age and period of gestation (POG) at the time of sample collection between the groups. There was a significant difference in the systolic and diastolic blood pressures (BPs) of both groups. The mean level of serum IMA was significantly higher in cases of gestational hypertension (0.88 ± 0.14 absorbance units {ABSU}) as compared to controls (0.69 ± 0.08 ABSU) (p<0.001). On correlation analysis, the systolic and diastolic BPs were found to be highly positively correlated with serum IMA levels (p<0.001). ROC curve analysis suggested that at a cutoff of 0.73 ABSU, IMA has 85% sensitivity and 80% specificity for predicting gestational hypertension. Conclusion Statistically significant results of serum IMA levels obtained in gestational hypertension which falls on the lesser severe spectrum of the disease imply that serum IMA can be used for early diagnosis of gestational hypertension and impending Pre-eclampsia (PE) and Eclampsia.

Journal of Personalized Medicine

Background: Immune dysregulation has been linked to morbidity and mortality in COVID-19 patients.... more Background: Immune dysregulation has been linked to morbidity and mortality in COVID-19 patients. Understanding the immunology of COVID-19 is critical for developing effective therapies, diagnostics, and prophylactic strategies to control the disease. Aim: The aim of this study was to correlate cytokine and chemokine serum levels with COVID-19 disease severity and mortality. Subjects and Methods: A total of 60 hospitalized patients from the Tabuk region of Saudi Arabia with confirmed COVID-19 were included in the study. At hospital admission, the IL-1 β, IL-2, IL-8, IL-10, LT-B4, and CCL-2 serum levels were measured. The cytokine levels in COVID-19 patients were compared to the levels in 30 healthy matched control subjects. Results: The IL-1 β, IL-2, LTB-4, CCL-2, and IL-8 levels (but not IL-10) were significantly higher in all COVID-19 patients (47 survivors and 13 non-survivors) compared with the levels in the healthy control group. In the non-survivor COVID-19 patients, patients’...

Electronics Letters, 1993

IP Journal of Paediatrics and Nursing Science, 2021

Sickle cell anemia is a complex pathophysiologic single gene defect genetic disorder with a wide ... more Sickle cell anemia is a complex pathophysiologic single gene defect genetic disorder with a wide spectrum in the severity of the disease. Decomposing stature into its major components is a useful strategy to assess antecedents of disease, morbidity, and death in adulthood. CORMIC INDEX is calculated as (Sitting Height / Height) × 100. Leg length relative to total body proportions is a good indicator of overall growth reserve capacity of a person or a group of people. Previous studies in sickle cell patients have shown evidence of growth failure and are associated with delayed puberty. There is no study correlating growth pattern in sickle cell disease patients with the CORMIC index, in our study we tried to do this. The main conclusion in which we arrived is that "there is no significant correlation between the severity of sickle cell anemia and cormic index", however, sickle cell affects many growth parameters i.e. height, weight, and sitting height.

Background Diabetic nephropathy (DN) is the leading cause of chronic kidney disease in patients b... more Background Diabetic nephropathy (DN) is the leading cause of chronic kidney disease in patients being prescribed renal replacement therapy [1] and is associated with increased cardiovascular mortality [2]. 20%-40 % of patients with type 2 diabetes mellitus (DM) ultimately develop nephrop-athy, but the reason why only some and not all patients with diabetes develop this complication is unknown [3,4]. Previously glycemic control and duration of diabetes were said to be the two principle causes of progression to DN, but variable outcomes in patients with relatively same glycemic status and duration of DM have indicated role of environmental factors and genetic susceptibility to the condition [5]. Hyperglycaemia induced complex inter-actions between metabolic and hemodynamic changes, along with variable genetic predisposition, sets the stage for kidney injury, as for other diabetic complications [6]. Relatively earlier onset of diabetes as compared to their European counterparts and inc...

Clinical Cardiology, 2009

Neutrophil to lymphocyte ratio (N/L ratio) has been shown to predict long-term mortality in patie... more Neutrophil to lymphocyte ratio (N/L ratio) has been shown to predict long-term mortality in patients undergoing percutaneous coronary intervention (PCI). African Americans have been shown to have lower mean neutrophil counts compared to whites. The usefulness of the N/L ratio in predicting long-term mortality in African Americans undergoing PCI is unknown. Methods: We evaluated a total of 372 African American patients (327 patients with lower N/L ratio [<3.5] and 45 patients with higher N/L ratio [≥3.5]) who underwent PCI during January 2003 to August 2005. The primary endpoint was all-cause mortality at a median follow-up to 3.6 years. Results: During the median (± SD) follow-up period of 3.6 ± 1 years, there were a total of 48 deaths. The mortality rate was 10.4% in the group with a lower N/L ratio and 31.1% in the group with a higher N/L ratio (unadjusted p<0.001). After adjustment for covariates with significant impact on mortality, N/L ratio was still a strong and independent predictor of long-term mortality with a hazard ratio (HR) of 2.1 (95% confidence interval [CI]: 1.1-4; p = 0.02). N/L ratio was also found to be a strong and independent predictor of long-term mortality even when analyzed as a categorical variable with 3 groups (HR of 0.39 for lower tertile compared to the upper tertile, 95% CI: 0.19-0.81; p = 0.012) and as a continuous variable (p = 0.002). Conclusion: N/L ratio is a powerful independent predictor of long-term mortality in African Americans undergoing PCI.

Asian Journal of Medical Sciences, Oct 1, 2022

IP Journal of Paediatrics and Nursing Science, Apr 15, 2021

Diabetes, Jun 1, 2019

Current Issues in Molecular Biology

Cureus, Jan 9, 2023

Cureus

Indian Journal of Otolaryngology and Head & Neck Surgery

Cureus

Journal of Personalized Medicine

Electronics Letters, 1993

IP Journal of Paediatrics and Nursing Science, 2021

Clinical Cardiology, 2009