Browsing by Author "Anil Kumar Bhalla"

Now showing 1 - 3 of 3

Clinical perspectives towards improving risk stratification strategy for renal transplantation outcomes in Indian patients
(Wolters Kluwer Medknow Publications, 2022) Vijay Kher; Vivek B. Kute; Sarbeswar Sahariah; Deepak S. Ray; Dinesh Khullar; Sandeep Guleria; Shyam Bansal; Sishir Gang; Anil Kumar Bhalla; Jai Prakash; Abi Abraham; Sunil Shroff; Madan M. Bahadur; Pratik Das; Urmila Anandh; Arpita Ray Chaudhury; Manoj Singhal; Jatin Kothari; Sree Bhushan Raju; Dilip Kumar Pahari; G. Vishwanath Siddini; G. Sudhakar; Santosh Varughese; Tarun K. Saha
Graft loss and rejections (acute/chronic) continue to remain important concerns in long-term outcomes in kidney transplant despite newer immunosuppressive regimens and increased use of induction agents. Global guidelines identify the risk factors and suggest a framework for management of patients at different risk levels for rejection; however, these are better applicable to deceased donor transplants. Their applicability in Indian scenario (predominantly live donor program) could be a matter of debate. Therefore, a panel of experts discussed the current clinical practice and adaptability of global recommendations to Indian settings. They also took a survey to define risk factors in kidney transplants and provide direction toward evidence- and clinical experience-based risk stratification for donor/recipient and transplant-related characteristics, with a focus on living donor transplantations. Several recipient related factors (dialysis, comorbidities, and age, donor-specific antibodies [DSAs]), donor-related factors (age, body mass index, type - living or deceased) and transplantation related factors (cold ischemia time [CIT], number of transplantations) were assessed. The experts suggested that immunological conflict should be avoided by performing cytotoxic cross match, flow cross match in all patients and DSA-(single antigen bead) whenever considered clinically relevant. HLA mismatches, presence of DSA, along with donor/recipient age, CIT, etc., were associated with increased risk of rejection. Furthermore, the panel agreed that the risk of rejection in living donor transplant is not dissimilar to deceased donor recipients. The experts also suggested that induction immunosuppression could be individualized based on the risk stratification. © 2022 Wolters Kluwer Medknow Publications. All rights reserved.
National Consensus Statement on Role of Bisoprolol across Cardiovascular Continuum: Special Focus on Women
(Journal of Association of Physicians of India, 2025) Hriday Kumar Chopra; Kamal Kumar Sethi; Tiny Nair; Chandrashekhar Kashinath Ponde; Saumitra Ray; Sarita Rao; Shanmunga Sundaram; Dinesh K. Khullar; Navin C. Nanda; Jatinder Pal Singh Sawhney; Sarita M. Bajaj; Yatin Mehta; Arvind Kumar Pancholia; Pradeep Jain; Ashok Kumar Omar; Aditya K. Kapoor; Rishi Rishi Sethi; Atul Damodar Abhyankar; Vinod Kumar Sharma; Anil Dhall; Ajay Kumar Sinha; Shishu Shankar Mishra; Satya Narayan Rautray; Gyarsi Lal Sharma; Ashwani Mehta; Rajeev Agarwala; Rajeev Kumar Rajput; Ajay Umakant Mahajan; Sanjay C. Porwal; Ramesh K. Hotchandani; Vishal Rastogi; Rajeev Passey; Mohan Bhargava; Justin Paul Gnanaraj; Dorairaj Prabhakaran; Vivudh Pratap Singh; Vinod Mittal; Vitull Kumar Gupta; Anil Kumar Bhalla; Virender Kumar Katyal; Ishwarappa Balekundri Vijaylakshami; Asha Moorthy; Poonam Malhotra; Vanita Arora; Mona Bhatia; Prabhavathy Bhat; Shibba Takkar Chhabra; Sugandhi Gopal; Tripti Deb; Preeti Gupta; Hemlata Tewari; Anupam Goel; Rekha Mishra; Lovelina Singh; Zakia Khan; Geeta S. Sheth; Chandra Mukhi; Inder Pal Singh Kalra; Yogender Kumar Arora; Uttara Das; Kavita Tyagi; Satya Nand Pathak; Samir Kubba; Saurabh Bagga; Asha Mahilmaran; Ameet Sattur; Rohit Tandon; Dharmender Jain; Hetan C. Shah; Cecily Mary Majella; Ravi Prakash; Manish Aggarwal; Ruchi Verma; Sumit Sethi; Alka Gujral; Kanika Sood; Sonia Rawat; Varsha Kaul; Surinder S. Arora; Manjiti Arora; Veena Bhat; Anil Kumar Bali; Sanjay Sood; Shakuntala Dawesar; Bhushan K. Dawesar; Nilakshi Deka; Makarand Paithankar; Rajiv Handa; Nitish Parmar; Sheikh U. Nabi; Naveen K. Garg; Sandeep Sharma; Vivek Tandon; Manoj Pabrai; Samshad Alam; Manju Tyagi; Manisha Sahay; Manju Hotchandani; Anupama Kathpalia; Ish Kathpalia
Cardiovascular diseases (CVDs) represent a significant health concern worldwide, with women facing distinct challenges in the prevention, diagnosis, and management of these conditions. In India, hypertension is a prevalent cardiovascular (CV) risk factor, affecting nearly one-third of adults, and women experience a disproportionately high burden across all age-groups. The CV continuum, which spans from risk factors to CV events and ultimately to heart failure (HF), demonstrates how the progression of CVD impacts women at each stage differently due to gender-specific mechanisms like hormonal influences, pregnancy complications and the effects of menopause. This manuscript aims to present a set of consensus statements developed by an expert panel in India, focusing on the role of bisoprolol across the CV continuum with special attention to women. The consensus was formed based on a thorough review of clinical experiences, existing clinical data and alignment with both global and regional clinical guidelines. The manuscript highlights the gender-specific CV risks faced by women, their higher mortality rates following acute cardiac events, delayed diagnoses and less aggressive treatments. It also discusses bisoprolol as an effective therapy for managing hypertension, HF and other CV conditions in women. Bisoprolol's benefits include consistent blood pressure (BP) control, improved outcomes in HF and reduced CV risks, particularly in postmenopausal women and those with comorbidities. The manuscript underscores the need for gender-tailored approaches to the CV continuum, from prevention through to management, to address these challenges and improve outcomes for women. © The Author(s).
The Promise of Cilnidipine in Hypertension with Comorbidities: National Consensus Statement
(Journal of Association of Physicians of India, 2024) Hirday Kumar Chopra; Gurpreet S. Wander; Chandrashekhar K. Ponde; Navin C. Nanda; Dinesh Khullar; K. Venugopal; Saumitra Ray; Tiny Nair; D.S. Rana; Vijay Kher; J.P.S. Sawhney; R.R. Kasliwal; Jabir Abdullakutty; Rabin Chakraborty; Praveen Chandra; Sandeep Bansal; Viveka Kumar; Arvind K. Pancholia; Aditya Kapoor; Sunil Prakash; Anil Saxena; Vishal Rastogi; Vinod Sharma; Y.K. Arora; Arup Dasbiswas; Mohan Bhargava; Aparna Jaswal; Kartikeya Bhargava; Mona Bhatia; Ashok K. Omar; Narendra Nath Khanna; Rajiv Passey; Dilip Bhalla; I.B. Vijayalakshmi; Anil Kumar Bhalla; Asha Moorthy; Harmohander S. Isser; S.S. Mishra; Satyanarayan Routray; Vivek Tandon; Ajay Sinha; Manish Bansal; Praveen Jain; Ramesh Hotchandani; Dharmendra Jain; V.K. Katyal; Sanjiv Gulati; Rohit Tandon; Shalini Jaggi; Blessy Sehgal; Vitull Gupta; Rahul Mehrotra; N.C. Krishnamani; S.N. Pathak; M.S. Yadav; Rajeev Chawla; N.R. Shastry; Nandini Chatterjee; Shambo Samrat Samajdar; Jyotirmoy Pal; Mangesh Tiwaskar
The rapidly increasing burden of hypertension is responsible for premature deaths from cardiovascular disease (CVD), renal disease, and stroke, with a tremendous public health and financial burden. Hypertension detection, treatment, and control vary worldwide; it is still low, particularly in low- and middle-income countries (LMICs). High blood pressure (BP) and CVD risk have a strong, linear, and independent association. They contribute to alarming numbers of all-cause and CVD deaths. A major culprit for increased hypertension is sympathetic activity, and further complications of hypertension are heart failure, ischemic heart disease (IHD), stroke, and renal failure. Now, antihypertensive interventions have emerged as a global public health priority to reduce BP-related morbidity and mortality. Calcium channel blockers (CCB) are highly effective vasodilators. and the most common drugs used for managing hypertension and CVD. Cilnidipine, with both L- and N-type calcium channel blocking activity, is a promising 4th generation CCB. It causes vasodilation via L-type calcium channel blockade and inhibits the sympathetic nervous system (SNS) via N-type calcium channel blockade. Cilnidipine, which acts as a dual L/N-type CCB, is linked to a reduced occurrence of pedal edema compared to amlodipine, which solely blocks L-type calcium channels. The antihypertensive properties of cilnidipine are very substantial, with low BP variability and long-acting properties. It is beneficial for hypertensive patients to deal with morning hypertension and for patients with abnormal nocturnal BP due to exaggerated sympathetic nerve activation. Besides its BP-lowering effect, it also exhibits organ protection via sympathetic nerve inhibition and renin–angiotensin–aldosterone system inhibition; it controls heart rate and proteinuria. Reno-protective, neuroprotective, and cardioprotective effects of cilnidipine have been well-documented and demonstrated. © 2024 Journal of Association of Physicians of India. All rights reserved.