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  • 1
    Language: English
    In: Journal of cellular biochemistry, 2013-03, Vol.114 (3), p.532-540
    Description: Neutrophils/polymorphonuclear leukocytes (PMNs), an important component of innate immune system, release extracellular traps (NETs) to eliminate invaded pathogens; however understanding of the role of signaling molecules/proteins need to be elucidated. In the present study role of p38 MAPK and extracellular signal regulated kinase (ERK) against phorbol 12‐myristate 13‐acetate (PMA) induced reactive oxygen species (ROS) generation and NETs formation has been investigated. Human neutrophils were treated with PMA to induce free radical generation and NETs release, which were monitored by NBT reduction and elastase/DNA release, respectively. PMA treatment led to the time dependent phosphorylation of p38 MAPK and ERK in PMNs. Pretreatment of PMNs with SB202190 or U0126 did not significantly reduce PMA induce free radical generation, but prevented NETs release. Pretreatment of PMNs with NADPH oxidase inhibitor (diphenyleneiodonium chloride) significantly reduced free radical generation, p38 MAPK and ERK phosphorylation as well as NETs release, suggesting that p38 MAPK and ERK activation was downstream to free radical generation. The present study thus demonstrates ROS dependent activation of ERK and p38 MAPK, which mediated PMA induced NETs release from human neutrophils. J. Cell. Biochem. 114: 532–540, 2013. © 2012 Wiley Periodicals, Inc.
    Subject(s): NEUTROPHIL EXTRACELLULAR TRAPS ; SUPEROXIDE ; NADPH‐OXIDASE ; p38 MAPK ; FREE RADICALS ; ERK ; Butadienes - pharmacology ; Phosphorylation ; Tetradecanoylphorbol Acetate ; Reactive Oxygen Species - metabolism ; Nitriles - pharmacology ; Humans ; NADPH Oxidases - antagonists & inhibitors ; Neutrophils - drug effects ; NADPH Oxidases - metabolism ; Imidazoles - pharmacology ; Extracellular Signal-Regulated MAP Kinases - metabolism ; Onium Compounds - pharmacology ; MAP Kinase Signaling System - drug effects ; Pyridines - pharmacology ; p38 Mitogen-Activated Protein Kinases - metabolism ; Enzyme Activation ; Neutrophils - metabolism ; Oxidases ; Proteins ; Superoxide ; Index Medicus
    ISSN: 0730-2312
    E-ISSN: 1097-4644
    Source: Alma/SFX Local Collection
    Source: © ProQuest LLC All rights reserved〈img src="https://exlibris-pub.s3.amazonaws.com/PQ_Logo.jpg" style="vertical-align:middle;margin-left:7px"〉
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  • 2
    Language: English
    In: Global journal of transfusion medicine, 2017-01-01, Vol.2 (1), p.8-18
    Description: Thromboelastography (TEG) is a novel viscoelastic method which provides a comprehensive assessment of hemostasis from clot initiation and development to fibrinolysis involving both cellular and plasmatic components of hemostatic system. Apart from surgery its role is expanding into medical specialties with increasing integration into laboratory settings. TEG complements the conventional coagulation tests in assessment of bleeding disorders. Further hemotherapy based on TEG results has been shown to reduce transfusion requirements in varied clinical settings besides helping in identifying coagulopathies in patients with major bleedings. This review article addresses briefly the methodology, clinical applications, interpretation of TEG results including authors' own experience of TEG in different clinical scenarios and limitations of TEG. Overall, this technique seems to be helpful for evaluation of hypercoagulable state and in detecting fibrinolysis which are difficult to be detected with conventional coagulation tests. Kaolin activated citrated blood samples analyzed within 30-60 min of sampling can provide reliable results in a laboratory setting. However, multiple assays using different activators or modifiers may be required for accurate results in selected cases. The operator should be aware about the various preanalytical and analytical variables which can affect the results including limitations of this technique. The tracing of the thromboelastography should be interpreted cautiously taking into consideration the clinical picture of the patient and results of other laboratory tests. With improved model and availability of more assays it is hoped that TEG and other such hemostasis analyzers would bring in the paradigm shift in the hemostasis monitoring and treatment of patients in future.
    Subject(s): hemostasis monitoring ; viscoelastic tests ; Conventional coagulation tests ; thromboelastography
    ISSN: 2468-8398
    E-ISSN: 2455-8893
    Source: Directory of Open Access Journals
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  • 3
    Article
    Article
    2014
    ISSN: 0019-5049 
    Language: English
    In: Indian journal of anaesthesia, 2014-09, Vol.58 (5), p.543-551
    Description: The acute blood transfusion reactions are responsible for causing most serious adverse events. Awareness about various clinical features of acute and delayed transfusion reactions with an ability to assess the serious reactions on time can lead to a better prognosis. Evidence-based medicine has changed today's scenario of clinical practice to decrease adverse transfusion reactions. New evidence-based algorithms of transfusion and improved haemovigilance lead to avoidance of unnecessary transfusions perioperatively. The recognition of adverse events under anaesthesia is always challenging. The unnecessary blood transfusions can be avoided with better blood conservation techniques during surgery and with anaesthesia techniques that reduce blood loss. Better and newer blood screening methods have decreased the infectious complications to almost negligible levels. With universal leukoreduction of red blood cells (RBCs), selection of potential donors such as use of male donors only plasma and restriction of RBC storage, most of the non-infectious complications can be avoided.
    Subject(s): Blood transfusions ; Antigens ; Plasma ; Blood platelets ; Laboratories ; Mortality ; Surgery ; Classification ; Blood banks ; blood transfusion ; Review ; Adverse events ; complications ; non-infectious ; anaesthesia
    ISSN: 0019-5049
    E-ISSN: 0976-2817
    Source: Academic Search Ultimate
    Source: PubMed Central
    Source: Directory of Open Access Journals
    Source: © ProQuest LLC All rights reserved〈img src="https://exlibris-pub.s3.amazonaws.com/PQ_Logo.jpg" style="vertical-align:middle;margin-left:7px"〉
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  • 4
    Language: English
    In: Indian journal of community medicine, 2018-12-01, Vol.43 (5), p.6-11
    Description: Background: India has been at the forefront of designing adolescent health (AH) policies. The National Adolescent Reproductive and Sexual Health policy (2006), the Reproductive, Maternal, Newborn Child, and AH strategy (2013), and the "Rashtriya Kishor Swasthya Karyakram (RKSK)" (2014) have been the critical milestones in this direction. However, despite policies being available, the AH outcomes need improvement through operationalization of focused and need-based AH interventions. Objectives: The objectives of this study were to improve services for RKSK interventions across select geographies of India. Materials and Methods: USAID's VRIDDHI Project has been providing technical support at the national level and in six focus states to improve uptake of evidence-based high-impact reproductive, maternal, newborn, child, and AH interventions. To improve AH services and outcomes, two approaches were implemented, namely (a) strengthen the functioning of adolescent-friendly health clinics in 95 high caseload health facilities in 26 high priority districts across six states and (b) demonstrate other operational strategies outlined in RKSK program including strengthening of district committees on AH, undertaking formative research for developing adolescent-focused communication strategy, and operationalizing weekly iron and folic acid supplementation program. Results: As a result of ongoing technical support over 2-year period (January 2016-December 2017), improvements were noted across multiple AH indicators. In addition, evidence-based learnings were also generated from the demonstration models for potential scale up to other geographies. Conclusion: The project was successful in improving AH services in the intervention facilities through an integrated approach which is replicable, sustainable, and scalable for driving the AH program in India.
    Subject(s): Intervention ; Health facilities ; Clinics ; Anemia ; Quality ; Teenagers ; Beneficiaries ; State government ; Communication ; Rashtriya Kishor Swasthya Karyakram ; Adolescent friendly health clinics ; reproductive maternal newborn child and adolescent health ; Original ; adolescent health
    ISSN: 0970-0218
    E-ISSN: 1998-3581
    Source: Academic Search Ultimate
    Source: PubMed Central
    Source: Directory of Open Access Journals
    Source: Alma/SFX Local Collection
    Source: © ProQuest LLC All rights reserved〈img src="https://exlibris-pub.s3.amazonaws.com/PQ_Logo.jpg" style="vertical-align:middle;margin-left:7px"〉
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  • 5
    Language: English
    In: Leukemia, 2018-11, Vol.32 (11), p.2316-2325
    Description: The survival of pediatric patients with multiply relapsed and/or refractory (R/R) B-cell acute lymphoblastic leukemia has historically been very poor; however, data are limited in the current era. We conducted a retrospective study to determine the outcome of multiply R/R childhood B-ALL treated at 24 TACL institutions between 2005 and 2013. Patient information, treatment, and response were collected. Prognostic factors influencing the complete remission (CR) rate and event-free survival (EFS) were analyzed. The analytic set included 578 salvage treatment attempts among 325 patients. CR rates (mean ± SE) were 51 ± 4% for patients with bone marrow R/R B-ALL who underwent a second salvage attempt, 37 ± 6% for a third attempt, and 31 ± 6% for the fourth through eighth attempts combined. For patients achieving a CR after their second, third, and fourth through eighth attempts, the 2 year EFS was 41 ± 6%, 13 ± 7%, and 27 ± 13% respectively. Our results showed slight improvement when compared to previous studies. This is the largest and most recent study to date that evaluates the outcome of this patient population. Our data will provide detailed reference for the evaluation of new agents being developed for childhood B-ALL.
    ISSN: 0887-6924
    E-ISSN: 1476-5551
    Source: Nature Open Access
    Source: Alma/SFX Local Collection
    Source: © ProQuest LLC All rights reserved〈img src="https://exlibris-pub.s3.amazonaws.com/PQ_Logo.jpg" style="vertical-align:middle;margin-left:7px"〉
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  • 6
    Language: English
    In: Leukemia, 2020-09, Vol.34 (9), p.2473-2478
    Subject(s): Precursor B-Cell Lymphoblastic Leukemia-Lymphoma - genetics ; Antibodies, Bispecific - therapeutic use ; Recurrence ; Precursor B-Cell Lymphoblastic Leukemia-Lymphoma - drug therapy ; Humans ; Adolescent ; Child, Preschool ; Female ; Male ; Antineoplastic Agents - therapeutic use ; Child ; Philadelphia Chromosome ; Pediatrics ; Health aspects ; Children ; Index Medicus ; Letter ; Acute lymphocytic leukaemia ; Cancer
    ISSN: 0887-6924
    E-ISSN: 1476-5551
    Source: Nature Open Access
    Source: Alma/SFX Local Collection
    Source: © ProQuest LLC All rights reserved〈img src="https://exlibris-pub.s3.amazonaws.com/PQ_Logo.jpg" style="vertical-align:middle;margin-left:7px"〉
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  • 7
    Language: English
    In: Indian journal of hematology & blood transfusion, 2014-12, Vol.30 (4), p.301-308
    Description: Study of the factors responsible for red cell alloimmunization can help in adopting appropriate strategy to minimize alloimmunization. However data for thalassemia patients from our region is limited. Therefore, a study was conducted to find out the frequency and the factors associated with red cell allo and autoimmunization in thalassemia patients at our center so as to enable us to take appropriate action to reduce alloimmunization. Clinical, demographic, allo and autoantibody and transfusion records of 280 thalassemia patients at our hospital were studied. Patients with and without alloantibodies were compared to find significant differences for age, gender, race, age at start of regular transfusions and splenectomy. Red cell antigen frequencies in thalassemia patients and published antigen frequencies in blood donors from the same center were compared to look antigen differences as a risk factor for alloimmunization. Twenty four thalassemia patients (8.6 %) developed 28 clinically significant alloantibodies. 18 (65 %) of the alloantibodies were of Rh system. The three most common antibodies detected was anti E (11, 39.3 %) followed by anti K (6, 21.4 %) and anti c (10.8 %). Five (1.8 %) of the 280 patients developed autoantibodies. Patient age was found to be significantly higher in alloimmunized patients than in non alloimmunized patients. Red cell antigen frequencies between blood donor and recipient populations were found to be homogenous for most of the relevant RBC antigens. The frequency of red cell alloimmunization in thalassemia patients from our center is moderate. In this setting of red cell phenotype concordant donor–recipient population requirement of extended phenotype matched transfusions may not be cost effective.
    Subject(s): Human Genetics ; Red cell antigens ; Hemoglobinopathies ; Transfusion ; Medicine & Public Health ; Hematology ; Oncology ; Thalassemia ; Blood Transfusion Medicine ; Phenotype frequency ; Alloimmunization ; Autoimmunity ; Autoantibodies ; Risk factors ; Blood donors ; Monoclonal antibodies ; Genetic disorders ; Health risk assessment ; Cells ; Original
    ISSN: 0971-4502
    ISSN: 0974-0449
    E-ISSN: 0974-0449
    Source: PubMed Central
    Source: Alma/SFX Local Collection
    Source: © ProQuest LLC All rights reserved〈img src="https://exlibris-pub.s3.amazonaws.com/PQ_Logo.jpg" style="vertical-align:middle;margin-left:7px"〉
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  • 8
    Language: English
    In: Pediatric blood & cancer, 2013-11, Vol.60 (11), p.1890-1895
    Description: Background While there is increasing evidence supporting the choice of subcutaneous ports (SPs) over external venous catheters (EVCs) in pediatric oncology patients, prior conflicting studies exist and little data have been gathered as to which type of central line is preferred from the patient/family perspective. Procedure We performed a single institution, 10 years, retrospective analysis of central lines in pediatric oncology patients (n = 878) to evaluate unplanned early removal and cause of removal while simultaneously obtaining a cross sectional survey of 143 of the primary caretakers/parents of these patients to evaluate their overall satisfaction with the line. Results EVCs have significantly higher odds of unplanned early removal in comparison to SPs (6.7% of SPs vs. 27.3% of EVCs, odds ratio (OR) = 6.3, P 〈 0.0001 when controlling for age and diagnosis) secondary to increased infection, malfunction and patient preference. Patients with SPs felt like their central line was easier to care for, had less daily impact in their life, and were overall more satisfied with their central line compared to patients with EVCs, even when controlling for early removal (P 〈 0.0001 for all). SP patients were much more likely to state that they would choose the same type of line again (OR = 15, P 〈 0.0001) than EVC patients. Conclusion SPs demonstrated lower removal rates and greater patient satisfaction than EVCs. These data should be considered when choosing a central line for pediatric cancer patients. Pediatr Blood Cancer 2013;60:1890–1895. © 2013 Wiley Periodicals, Inc.
    Subject(s): early unplanned removal ; central line ; patient survey ; Device Removal ; Medical Oncology ; Pediatrics ; Cross-Sectional Studies ; Humans ; Retrospective Studies ; Antineoplastic Agents - administration & dosage ; Catheterization, Central Venous - instrumentation ; Child ; Catheterization, Central Venous - adverse effects ; Neoplasms - drug therapy ; Comparative analysis ; Index Medicus
    ISSN: 1545-5009
    E-ISSN: 1545-5017
    Source: Alma/SFX Local Collection
    Source: © ProQuest LLC All rights reserved〈img src="https://exlibris-pub.s3.amazonaws.com/PQ_Logo.jpg" style="vertical-align:middle;margin-left:7px"〉
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  • 9
    Language: English
    In: Asian journal of transfusion science, 2016-07-01, Vol.10 (2), p.111-112
    Description: In view of poor morphological parameters as indicated by low pH and absent swirling, it was decided to test the functional quality by thromboelastography (TEG, 5000 series, Haemonetics Corp., Braintree, MA, USA) which is available in the department for monitoring of hemostasis and blood component therapy in the patients using citrated whole blood sample. [2],[3] The change in color in the bag may be seen due to hemolysis, lipemia, icterus, drug, or in bacterial contamination; however, slight color change may not be appreciated as color perception is subjective. [...]swirling, color change, or any perceived opacity may not entirely or necessarily correlate with platelet quality markers.
    Subject(s): Conflicts of interest ; Blood platelets ; Blood banks ; Quality ; Morphology ; Illustration
    ISSN: 0973-6247
    E-ISSN: 1998-3565
    Source: Academic Search Ultimate
    Source: PubMed Central
    Source: Directory of Open Access Journals
    Source: © ProQuest LLC All rights reserved〈img src="https://exlibris-pub.s3.amazonaws.com/PQ_Logo.jpg" style="vertical-align:middle;margin-left:7px"〉
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  • 10
    Language: English
    In: Indian journal of critical care medicine, 2017-05, Vol.21 (5), p.268-273
    Description: Thromboelastography (TEG) is a global test of coagulation which analyzes the whole coagulation process. TEG is popular in trauma, liver transplant, and cardiac surgeries, but studies in sepsis are limited. We have assessed the utility of TEG for evaluating coagulopathy in nonbleeding patients with sepsis. A prospective, observational study was done in 12-bedded Intensive Care Unit (ICU) of a tertiary care hospital in North India, during May 2014-November 2014. After ethical clearance, all patients at ICU admission with sepsis were included in the study. Exclusion criteria were age 〈18 years, plasma/platelet transfusion before admission, patients on oral antiplatelets/anticoagulants, or with underlying hematological disorders. At admission, blood samples for TEG were analyzed by kaolin-based TEG analyzer within an hour of collecting 2.7 ml citrated blood from arterial line. TEG parameters included reaction time (R), K time (K), alpha angle (a), maximum amplitude (MA), coagulation index (CI), and lysis index (LY 30). In TEG, mean values of R, K, a, MA, CI, and LY30 were 6.45 ± 2.59 (min), 1.67 ± 0.96 (min), 66.37 ± 10.44 ( ), 67.08 ± 10.33 (mm), 0.63 ± 3.46, and 2.23 ± 4.08 (%), respectively. In conventional coagulation assay (CCA), mean values of international normalized ratio (INR), platelet, and fibrinogen were 1.63 ± 0.57, 153.96 ± 99.16 (×10 /mm ), and 301.33 ± 112.82 (mg/dl), respectively. In those with deranged INR (INR ≥1.6), 60% were normocoagulable and 20% were hypercoagulable. Similarly, 81% patients with thrombocytopenia (platelet count 〈1,00,000/mL) were normocoagulable. TEG could differentiate among normocoagulant, hypocoagulant, hypercoagulant states (unlike CCAs). Patients with septic shock had trend toward hypocoagulant state while those without shock had trend toward hypercoagulant state.
    Subject(s): Infection ; Transplantation of organs, tissues, etc ; Computer software industry ; Analysis ; Ethical aspects ; Medicine ; Anticoagulants ; Intensive care ; Illnesses ; Blood products ; Hematology ; Laboratories ; Heart surgery ; Mortality ; Critical care ; Sepsis ; septic shock ; Coagulopathy ; sepsis ; thromboelastography
    ISSN: 0972-5229
    E-ISSN: 1998-359X
    Source: Academic Search Ultimate
    Source: PubMed Central
    Source: © ProQuest LLC All rights reserved〈img src="https://exlibris-pub.s3.amazonaws.com/PQ_Logo.jpg" style="vertical-align:middle;margin-left:7px"〉
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