Publications by authors named "Gopal P"

Background: Monitoring vital signs in hospitalized patients is crucial for evaluating their clinical condition. While early warning scores like the modified early warning score (MEWS) are typically calculated 3 to 4 times daily through spot checks, they might not promptly identify early deterioration. Leveraging technologies that provide continuous monitoring of vital signs, combined with an early warning system, has the potential to identify clinical deterioration sooner.

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Background: Sepsis is a life-threatening condition arising from a dysregulated host response to infection leading to organ dysfunction. Traditional clinical signs are often unreliable for detecting sepsis, necessitating the exploration of more accurate biomarkers. Furthermore, currently, recommended screening scores perform poorly, necessitating more effective biomarkers to identify sepsis.

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Histopathologic evaluation of liver biopsy has played a longstanding role in the diagnosis and management of liver disease. However, the utility of liver biopsy has been questioned by some, given the improved imaging modalities, increased availability of noninvasive serologic tests, and development of artificial intelligence over the past several years. In this review, we discuss the current and future role of liver biopsy in both non-neoplastic and neoplastic liver diseases in the era of improved noninvasive laboratory, radiologic, and digital technologies.

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Small-for-size syndrome is a clinical syndrome of early allograft dysfunction usually following living donor liver transplantation due to a mismatch between recipient metabolic and functional requirements and the graft's functional capacity. While graft size relative to the recipient size is the most commonly used parameter to predict risk, small-for-size syndrome is multifactorial and its development depends on a number of inter-dependant factors only some of which are modifiable. Intra-operative monitoring of portal haemodynamics and portal flow modulation is widely recommended though there is wide variation in clinical practice.

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Objective: To compare early patency and outcomes of single outflow (SOT) and double outflow (DOT) reconstruction in right lobe living donor liver transplantation (RtLDLT) in a multicenter open-labelled randomized controlled trial.

Summary Background Data: Optimum graft venous outflow is a key factor in determining outcomes of RtLDLT. There is no data directly comparing SOT and DOT technique of graft outflow reconstruction.

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Background: Worldwide, hepatocellular carcinoma (HCC) is the second most lethal cancer, although early-stage HCC is amenable to curative treatment and can facilitate long-term survival. Early detection has proved difficult, as proteomics, transcriptomics, and genomics have been unable to discover suitable biomarkers.

Methods: To find new biomarkers of HCC, we utilized a spatial omics N-glycan imaging method to identify altered glycosylation in cancer tissue (n = 53) and in paired serum of individuals with HCC (n = 23).

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Patients with oesophageal motility disorders may present with dysphagia, regurgitation or chest pain. High-resolution manometry (HRM) is the current gold-standard modality for the diagnosis of oesophageal motility disorders. The data from HRM are analysed and interpreted to form a diagnosis based on the Chicago classification.

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Article Synopsis
  • The study examined how age and comorbidity affect the prognosis of patients with hepatocellular carcinoma (HCC), focusing on outcomes like early-stage diagnosis, treatment, and survival rates.
  • Data from 2002 patients showed that older age increases the risk of worse survival outcomes, with younger patients having significantly better median survival rates across various stages of HCC and treatment types.
  • While higher comorbidity was linked to receiving curative treatment, it did not significantly affect overall survival, suggesting that age is a more critical factor than comorbidity in determining HCC prognosis.
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Background: Sepsis is a global health problem with high morbidity and mortality. Low- and middle-income countries have a higher incidence and poorer outcome with sepsis. Large epidemiological studies in sepsis using Sepsis-3 criteria, addressing the process of care and deriving predictors of mortality are scarce in India.

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  • Acute phlegmonous esophagitis (APE) is a rare bacterial infection of the esophagus that primarily affects its deeper layers, causing symptoms like chest pain, difficulty swallowing, and fever, making it hard to diagnose.
  • Two young female cases highlighted: one with a history of surgery that may have led to the infection, and the other with uncontrolled diabetes.
  • Diagnosis was supported by CT imaging showing thickening of the esophagus, and both patients received intravenous antibiotics and supportive care; early diagnosis and treatment are crucial due to APE's high mortality rate.
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  • Parkinson's disease (PD) is linked to inflammation, and researchers studied brain cells in late-stage PD using advanced techniques to understand vulnerabilities.
  • They analyzed brain samples from six PD patients and six healthy controls, identifying distinct changes in eight cell types, including increased T cells in PD and marked alterations in excitatory neurons.
  • Comparisons with Alzheimer's disease revealed that while neuron changes were different, both diseases shared some changes in glial cells, indicating unique underlying mechanisms for neuronal vulnerability in PD versus AD.
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Altered RNA metabolism and misregulation of transactive response DNA-binding protein of 43 kDa (TDP-43), an essential RNA-binding protein (RBP), define amyotrophic lateral sclerosis (ALS). Intermediate-length polyglutamine (polyQ) expansions of Ataxin-2, a like-Sm (LSm) RBP, are associated with increased risk for ALS, but the underlying biological mechanisms remain unknown. Here, we studied the spatiotemporal dynamics and mRNA regulatory functions of TDP-43 and Ataxin-2 ribonucleoprotein (RNP) condensates in rodent (rat) primary cortical neurons and mouse motor neuron axons in vivo.

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Article Synopsis
  • - The study aimed to differentiate between reactive atypia and dysplasia in cholecystectomy specimens using immunostains for IMP3, p53, and S100P in a sample of 54 cases.
  • - Results indicated that normal and reactive atypia cases mostly showed negative IMP3 and wild-type p53, while dysplasia cases had significant positivity in IMP3 and aberrant p53 patterns.
  • - The findings suggest that positive IMP3 or abnormal p53 expression could help pathologists distinguish dysplasia from reactive atypia in challenging cases.
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Purpose: To compare charcoal-containing dentifrices (CDs) to non-charcoal containing dentifrices (NCDs) through the following experiments: potentially available fluoride, 1-minute fluoride release, pH, cytotoxicity, heavy metals, enamel fluoride uptake (EFU) and relative dentin abrasivity (RDA).

Methods: Nine fluoride dentifrices; six CDs and three NCDs were tested (n= 3) for available fluoride, the amount of fluoride released within 1 minute, pH cytotoxicity, heavy metals, EFU and RDA. Four CDs and 1 NCD contained sodium fluoride (NaF) as the active ingredient whereas two dentifrices contained stannous fluoride (SnF₂; 1 CD and 1 NCD), and two dentifrices contained disodium monofluorophosphate (Na₂FPO₃, or Na₂MFP; 1 CD and 1 NCD).

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High-quality discharge summaries are essential for promoting patient safety during transitions between care settings. When the diagnosis list in the discharge summary is not accurate, the subsequent care provider will not have the latest medical history list and the care and safety of the patient will be compromised. Discrepancies in the secondary diagnosis capture rates have been identified in close to 30% of patients admitted to Sengkang Community Hospital (SKCH) during internal audits.

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This work intended to improve the precision and machining efficiency of Magnesium alloy (Mg-Li-Sr) using Wire electrical discharge machining (WEDM). Mg-Li-Sr alloy is prepared through inert gas assisted stir casting route. Taguchi approach is used for experimental design for WEDM parameter such as pulse OFF time, pulse ON time, wire feed rate, servo voltage and current.

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Although neuroendocrine tumors (NETs) can occur in any organ, the majority of them occur in the gastrointestinal (GI) tract. We present the case of a 27-year-old female who presented with ascites. She underwent an ascitic fluid analysis, an esophagogastroduodenoscopy (EGDscopy) with biopsies, and a positron emission tomography (PET) scan, all of which culminated in a diagnosis of a poorly differentiated gastric NET (small cell type) with peritoneal metastasis.

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The laboratory diagnosis of cytokine storm syndromes (CSSs), i.e., hemophagocytic lymphohistiocytosis (HLH) and macrophage activation syndrome (MAS), is often challenging.

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Background: Although curcumin is a blood-brain-barrier permeable molecule with the ability to bind and segregate β-amyloid plaques and neurofibrillary tangles of hyperphosphorylated tau proteins, its poor oral bioavailability, rapid biotransformation to inactive metabolites, fast elimination from the systemic circulation, and hence the poor neuronal uptake has been limiting its clinical efficacy under neurodegenerative conditions.

Objective: We hypothesized that the highly bioavailable CurQfen-curcumin (CGM), which has been shown to possess significant blood-brain-barrier permeability and brain bioavailability, would ameliorate dementia in neurodegenerative conditions.

Methods: In the present double-blinded placebo-controlled 3-arm 3-sequence comparative study, 48 subjects characterized with moderate dementia due to the onset of Alzheimer's disease were randomized into three groups ( = 16/group) and supplemented with 400 mg × 2/day of either placebo (MCC), unformulated standard curcumin complex with 95% purity (USC), or CGM as a sachet for six months.

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Background: Dietary restrictions or reductions such as fasting for weight loss are often difficult to adhere to due to increased appetite and food cravings. Recently, gastrointestinal delivery of bitter hops has been shown to be effective at reducing appetite in men. Our aim was to determine the effect of a bitter hop extract on appetite and cravings in women, using a 24 h, water-only fast.

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Background: Ingestion of yellow phosphorus-containing rodenticides (YPR) or firecrackers is an important cause of acute liver failure (ALF) in young adults and children, particularly in South and South-East Asia and South America. Emergency liver transplantation is indicated in cases refractory to intensive supportive therapy, including low-volume plasma exchange. There are no published reports on the feasibility of auxiliary partial orthotopic liver transplantation (APOLT) for YPR-induced ALF.

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Article Synopsis
  • * Differentiating between enteric fever and tuberculosis can be challenging, but colonoscopy and biopsy are useful diagnostic tools.
  • * In three described cases, colonoscopy showed unique characteristics in the ileal mucosa, and lesions resolved completely after treatment, highlighting the need for careful diagnosis.
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