Browsing by Author "Arvind Pratap"

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A Randomized, Placebo-controlled, Double-blind Clinical Trial of Bacteriophage Cocktails in Chronic Wound Infections
(SAGE Publications Inc., 2024) Subhash Lal Karn; Satyanam Kumar Bhartiya; Arvind Pratap; Sanjay Kumar Saroj; Rajesh Kumar; Minakshi Sahu; Mayank Gangwar; Gopal Nath
Background: Chronic wounds are prevalent globally at endemic proportions. The common features associated with chronic wounds are prolonged inflammatory phase, infection with multidrug-resistant (MDR) bacteria, and subsequent biofilm formation. The present randomized-controlled trial (RCT) study was undertaken on chronic wounds of ≥6 weeks longer duration using customized phages to evaluate the efficacy and safety of bacteriophage therapy. Methods: The study was conducted from December 2021 to August 2023. Thirty patients in each of the arms (placebo and bacteriophage) were recruited with chronic wounds. The patients, both arms, received the conventional treatment of wound debridement, local antiseptics, and local and systemic antibiotics at the discretion of the treating surgeon. However, before applying the customized bacteriophage cocktail or placebo, the wound surface was thoroughly washed to remove the residual antiseptics. The phage cocktails or placebo were applied on alternate days. The wounds were evaluated using the Bates-Jensen Wound Assessment Tool for the progress of wound healing. Results: A total of 93.3% of the wound became sterile in 39 days (median sterility time), followed by complete healing by the end of 90 days in the phage group. Contrary to this, 83.3% of those on placebo therapy remained colonized by original bacteria or additional new bacteria without healing for up to 90 days. Conclusion: With the well-designed RCT, we could conclude that customized bacteriophage therapy using bacteriophage cocktails will definitely cure the chronic wound, irrespective of age, sex, diabetes status, and infection by MDR bacteria. © The Author(s) 2024.
A Study of Arginase Expression in Chronic Non-healing Wounds
(SAGE Publications Inc., 2023) Ruhi Dixit; Abhik Debnath; Suman Mishra; Rajnikant Mishra; Satyanam K. Bhartiya; Arvind Pratap; Vijay K. Shukla
Arginase expression has been recently shown to increase in numerous disease states like neurodegeneration, inflammation, and malignancies. Although it has been found to be functionally important in various disease pathologies, little is known about its role in wound healing. Here, we look at the expression of arginase and its isoforms in chronic non-healing wounds and also study the expression of nitric oxide synthase (NOS) and oxidative stress enzymes in them. Wound tissues and blood samples were collected at the time of index presentation and follow-up from 61 chronic non-healing wound cases. The expression patterns of arginase isoenzymes, NOS, superoxide dismutases (SOD), lactic acid dehydrogenase (LDH), and catalase were examined by using enzyme-linked immunosorbent assay, immunohistochemistry, and western blot analysis at the transcript and protein level. We reported a significant decrease of serum arginase levels in chronic nonhealing wounds in the progress of wound healing. Interestingly, tissue arginase levels were found to be increased with improved wound condition at follow-up. Tissue NOS, LDH, and catalase activity were also found to be increased with the progress of healing, whereas SOD levels were downregulated. Our findings reported increased expression at the transcript level of arginase-I and arginase-II in chronic non-healing wounds for the first time. In conclusion, we observed decreased serum arginase levels in completely healed patients as compared to non-healed cases. Our study findings support the hypothesis that inhibition of the activity of arginase delays wound healing. Arginase and iNOS may also find their place in the future as possible biomarkers for wound healing. © The Author(s) 2021.
Analysis of SET and MYND Domain-Containing Protein 3 (SMYD3) Expression in Gallbladder Cancer: a Pilot Study
(Springer, 2021) Pushkar Chandra; Ruhi Dixit; Arvind Pratap; Suman Mishra; Rajnikant Mishra; Vijay Kumar Shukla
The Suvar, Enhancer of zeste, and Trithorax (SET) and myeloid-Nervy-DEAF-1 (MYND) domain-containing protein 3 (SMYD3) is a histone lysine methyltransferase and has been recently unveiled to play significant roles in the progression of human cancer via regulating various key cancer-associated genes and pathways. The role of SMYD3 in gallbladder cancer (GBC) still needs to be studied. In the present study, we examined the SMYD3 gene expression at mRNA and protein level to look its impact on risk for developing gallbladder carcinogenesis. SMYD3 expression was evaluated by immunohistochemistry and reverse transcriptase PCR (RT-PCR) from 30 cases each of GBC and cholelithiasis patients. The expression was compared with different clinicopathological parameters. The SMYD3 expression was found to be significantly upregulated in GBC than cholelithiasis group (p < 0.05). The SMYD3 with increased expression level was observed in 73.3% of the GBC cases (p < 0.05). Moreover, mRNA SMYD3 expression was observed in 73.3% of GBC and 10% of control (p < 0.05). Our results indicated that the overexpression of SMYD3 plays an important role in the GBC progression, and SMYD3 may represent useful biomarker for gallbladder cancer patients. © 2020, Indian Association of Surgical Oncology.
Burden of Chronic Nonhealing Wounds: An Overview of the Worldwide Humanistic and Economic Burden to the Healthcare System
(SAGE Publications Inc., 2024) Aditya Sharma; Ravi Shankar; Ashish Kumar Yadav; Arvind Pratap; Mumtaz Ahmad Ansari; Vivek Srivastava
Chronic wounds have long been a significant public health concern, but the true impact of these wounds is unknown since research designs and measuring techniques vary, leading to inconsistent estimates. The definition of a wound is a loss of epithelial continuity caused by damage to the tissue. The following conditions can cause chronic wounds: panniculitis, pyoderma gangrenosum, traumatic, neurological, metabolic, hematologic, neoplastic, or infection-related. The growing global incidence of diabetes and the aging population necessitate greater attention to chronic wounds. Regrettably, it is sad that significant healthcare institutions have overlooked wound research. The study of health-related illnesses and occurrences in particular populations, including their distribution, frequency, and determinants, and the application of this research to control health problems. © The Author(s) 2024.
Comparison of Erector Spinae Plane Block and Serratus Anterior Plane Block for Modified Radical Mastectomy: A Prospective Randomised Study; [Modifiye Radikal Mastektomi Hastalarında Erektör Spina Plan Bloğu ve Serratus Anterior Plan Bloğunun Karşılaştırılması: Prospektif Randomize Çalışma]
(Anestezi Dergisi, 2022) Saurabh Sagar; Sandeep Loha; Anil Paswan; Arvind Pratap; Shashi Prakash; Amrita Rath
Objective: Breast cancer is one of the most commonly diagnosed malignancies among females. In this study, we compared the analgesic efficacy of ultrasound-guided (USG) erector spinae plane block (ESPB) with serratus anterior plane block (SAPB) after modified radical mastectomy (MRM) for unilateral breast cancer. Methods: After obtaining clearance from the institute’s ethical committee, this prospective double-blinded clinical study was conducted from August 2021 to April 2022. Females aged between 18 and 65 years with body mass index ≤30 kg m-2 and ASA I and II who were scheduled for MRM for breast cancer were included in this study. Forty patients were randomly divided into two groups: Group E (USG-ESPB was administered) and Group S (USG-SAPB was administered). Both the groups received 0.4 mL kg-1 of 0.25% bupivacaine. Duration of analgesia of the patients, intra-operative and post-operative hemodynamic changes, intra-operative opioid & post-operative analgesic consumption, Numerical Rating Scale (NRS) pain scores and adverse effects like vascular puncture, hypotension, pleural puncture or pneumothorax or local anaesthetic toxicity were recorded. Results: The mean duration of analgesia was significantly prolonged in Group E as compared to Group S and was statistically significant (p<0.001). The mean NRS score was found to be significantly lower in Group E as compared to Group S at 2,4,8 and 12 hours which was statistically significant (p<0.005). Though the intraoperative opioid requirement was comparable among both groups, the postoperative analgesic consumption was significantly lower in the Group E compared to the Group S (p<0.05). Conclusion: In our study, we concluded that USG-ESPB is superior to USG-SAPB in the post-operative period in patients undergoing unilateral MRM. © 2022 Anestezi Dergisi. All rights reserved.
Emergence of drug-resistant Klebsiella pneumoniae phylogroups (K. quasipneumoniae and K. variicola) causing human infections
(American Society for Microbiology, 2025) Kajal Mishra; Banerjee Tuhina; Ghanshyam Yadav; Ashok Kumar; Arvind Pratap; Sandhya Chaurasiya; Pue Rakshit
This prospective, cross-sectional study was undertaken to identify the emerging K. pneumoniae phylogeny groups (KpI, KpII, KpIII) and characterize their drug resistance. Phylogeny groups of 150 clinical isolates of biochemically identified K. pneumoniae were detected by targeting their chromosomal class A, β-lactamase genes blaSHV, blaLEN, and blaOKP, respectively, and their flanking gene (deoR). Antimicrobial susceptibility testing was done by disk diffusion and broth microdilution methods and statistically analyzed. Carbapenemases (Classes A, B, and D) were detected by multiplex PCR. Colistin resistance mechanisms to detect alteration in PhoP/PhoQ, pmrAB two-component signaling pathways, and mgrB were done by PCR and sequencing. Of the total, KpI, K. pneumoniae were 93 (62%), KpII, K. quasipneumoniae were 36 (24%), and KpIII, K. variicola were 21 (14%). Carbapenem resistance was in 77 (51.3%); 52 (55.9%), 17 (47.2%), and 8 (38%) in KpI, KpII, and KpIII, respectively. Colistin resistance was in 16 (10.6%), 11 (68.75%) in KpI and 5 (31.25%) in KpIII. K. variicola was resistant to polymyxin B as compared with KpI (P = 0.0008). blaNDM (63, 81.8%) was the commonest. Co-harboring of multiple carbapenemase genes was significant in all the phylogroups (P < 0.001). The majority of the cases of K. variicola were males (P = 0.0139) and in the intensive care unit (P = 0.0091). Several non-synonymous mutations were observed in the colistin-resistant isolates in PhoP and PhoQ genes, with the phylogenetic tree revealing different evolutionary relationships among the isolates. There is considerable emergence of K. quasipneumoniae and K. variicola as prominent human pathogens along with drug resistance, which requires attention. © © 2025 Mishra et al.
Malignant transformation of a pilonidal sinus
(2009) Deborshi Sharma; Arvind Pratap; Amrita Ghosh; Vijay K. Shukla
[No abstract available]
Poor Glycemic Control Is Associated With Lower Interleukin-2 (IL-2) Levels and Low Macrophage Viability in Chronic Diabetic Foot Ulcers (DFUs)
(SAGE Publications Inc., 2023) Tuhina Banerjee; Shailendra Rai; Aradhana Singh; Aakansha Giri Goswami; Mumtaz Ahmed Ansari; Arvind Pratap; Somprakas Basu; Vijay Kumar Shukla
Low macrophage viability in chronic diabetic foot ulcers (DFUs) may lead to inadequate interleukin (IL) expression and the persistence of infection. This study evaluates the association between macrophage function, IL-2 expression, and wound microflora in chronic DFUs. Diabetic patients with DFUs (group 1, n = 40) and without DFUs (group 2, n = 40) were compared for macrophage function in serum by viability testing. Immunological response was measured by serum IL-1β, IL-2β, and IL-10 levels. The aerobic and anaerobic microflora of the DFUs were assessed by culture and molecular methods. Demographic, clinical, and biochemical factors were statistically analyzed by χ2 test and Student t test. Multiple correspondence analysis (MCA) was used to detect the pattern of association between glycosylated hemoglobin (hemoglobin A1c), serum IL-2 levels, and macrophage viability. Of the total DFU cases, 22 (55%) showed the presence of polymicrobial microflora. Low macrophage viability with predominant Gram-negative flora was seen in 10 (25%) cases in group 1. Serum IL-2 levels were significantly lower (P =.004) in patients in group 1 along with elevated levels of hemoglobin A1c (P =.038). MCA showed an association between low viability of macrophages and lower IL-2 levels and elevated hemoglobin A1c levels with lower serum IL-2 levels. As compared to group 2, the low viability of macrophages was significantly associated (P =.007) with lower IL-2 levels in group 1. Elevated hemoglobin A1c levels are strongly associated with lower IL-2 levels and low macrophage viability. This might be a contributing factor to the persistence of infections in chronic DFUs. © The Author(s) 2023.
Role of Bovine Colostrum Dressing on Chronic Non-Healing Wounds in Comparison to Conventional Dressing: A Case-Control Study
(SAGE Publications Inc., 2024) Vikas Mandloi; Tuhina Banerjee; Aditya Sharma; Arvind Pratap; Mumtaz Ahmad Ansari; Vivek Srivastava
Colostrum has been shown to be suitable for oral and/or topical applications. Colostrum decreases the amount of discharge from wounds and also accelerates healing, leading to a decrease in the number of dressings. In this study, 40 patients with chronic non-healing wounds were divided into two groups, considering the inclusion and exclusion criteria. Group I included 15 patients with conventional dressings, and Group II included 25 patients with added topical colostrum dressings. All patients were assessed at the time of presentation and after 21 days. The results of the present study indicate that colostrum powder dressings may be used as an adjunct in the management of chronic non-healing wounds. © The Author(s) 2024.
Significant in-Vitro and in-Vivo Antimicrobial and Antibiofilm Activity of Colloidal Silver Nanoparticles (cAgNPs) in Chronic Diabetic Foot Ulcers
(SAGE Publications Inc., 2022) Aradhana Singh; Swati Sharma; Tuhina Banerjee; Arvind Pratap; Vijay Kumar Shukla
Infection is a foremost challenge in the cases of wound care, especially in cases of chronic wounds. The present study was conducted to determine the antimicrobial and antibiofilm activity of the colloidal silver nanoparticles (cAgNPs) on Gram positive organisms and to evaluate the in-vivo response of cAgNPs on patients of chronic diabetic foot ulcers (DFUs). cAgNPs were tested against selected Gram-positive organisms like methicillin-sensitive and resistant Staphylococcus aureus (MSSA, MRSA), Enterococcus faecalis and vancomycin resistant enterococci (VRE) using microbroth dilution assay to estimate minimum inhibitory/bactericidal concentration (MIC/MBC). Biofilm inhibition capacity and time kill assay was performed. Further, the in-vivo response of topical application of cAgNPs was evaluated on patients of DFUs. The susceptibility testing demonstrated the MIC and MBC values of the cAgNPs ranging from 0.5μg/ml to 1.0 μg/ml and 1.0 μg/ml to 8 μg/ml against the tested organisms respectively. The cAgNPs showed inhibition of biofilm formation in the low, medium and high biofilm producers by 91%, 83% and 75% respectively at the highest concentration (52ppm). The time kill kinetics showed significant reduction in the number of viable cells (p < 0.0001). Significant reduction in microbial load (p = 0.0062) and in the number of moderate to strong biofilm producing organisms (p = 0.0069) after treatment with cAgNPs was seen. cAgNPs exhibited significant in-vitro bactericidal and bacteriostatic activity against MRSA, MSSA and VRE respectively along with anti-biofilm activity. Additionally, cAgNPs showed significant reduction in microbial load of the chronic DFUs. © The Author(s) 2022.
Significant in-Vitro and in-Vivo Antimicrobial and Antibiofilm Activity of Colloidal Silver Nanoparticles (cAgNPs) in Chronic Diabetic Foot Ulcers
(SAGE Publications Inc., 2025) Aradhana Singh; Swati Sharma; Banerjee Tuhina; Arvind Pratap; Vijay Kumar Shukla
Infection is a foremost challenge in the cases of wound care, especially in cases of chronic wounds. The present study was conducted to determine the antimicrobial and antibiofilm activity of the colloidal silver nanoparticles (cAgNPs) on Gram positive organisms and to evaluate the in-vivo response of cAgNPs on patients of chronic diabetic foot ulcers (DFUs). cAgNPs were tested against selected Gram-positive organisms like methicillin-sensitive and resistant Staphylococcus aureus (MSSA, MRSA), Enterococcus faecalis and vancomycin resistant enterococci (VRE) using microbroth dilution assay to estimate minimum inhibitory/bactericidal concentration (MIC/MBC). Biofilm inhibition capacity and time kill assay was performed. Further, the in-vivo response of topical application of cAgNPs was evaluated on patients of DFUs. The susceptibility testing demonstrated the MIC and MBC values of the cAgNPs ranging from 0.5μg/ml to 1.0 μg/ml and 1.0 μg/ml to 8 μg/ml against the tested organisms respectively. The cAgNPs showed inhibition of biofilm formation in the low, medium and high biofilm producers by 91%, 83% and 75% respectively at the highest concentration (52ppm). The time kill kinetics showed significant reduction in the number of viable cells (p < 0.0001). Significant reduction in microbial load (p = 0.0062) and in the number of moderate to strong biofilm producing organisms (p = 0.0069) after treatment with cAgNPs was seen. cAgNPs exhibited significant in-vitro bactericidal and bacteriostatic activity against MRSA, MSSA and VRE respectively along with anti-biofilm activity. Additionally, cAgNPs showed significant reduction in microbial load of the chronic DFUs. © The Author(s) 2022.
Significant presence of biofilm-producing gut-derived bacteria in anal fistula of chronic duration
(John Wiley and Sons Inc, 2021) Prakhar Jaiswal; Swati Sharma; Arvind Pratap; Mumtaz Ansari; Vijay K Shukla; Somprakas Basu; Tuhina Banerjee
Fistula-in-ano though not a life-threatening condition, yet its symptoms often significantly impact patients' social, intimate, and work lives. There is an established role of bacterial microflora in acute infections. However, we proposed that biofilm-forming organisms might be present in the microflora of anal fistula of prolonged duration. This aspect has rarely been studied earlier. Therefore, the study describes the microbiology of anal fistula and the biofilm-forming capacity of the isolated organisms. A total of 30 patients were included in the study as per the criteria. Anal fistula tissue sample, tissue fluid, and blood samples were collected from each individual. The collected specimens were detected for the presence of aerobic and anaerobic microflora through standard microbiological method and polymerase chain reaction. Furthermore, the role of biofilm formation by microtitre plate assay and serum matrix metalloproteinases-9 was also studied. The result showed significant predominance of gut-derived microflora with high-to-moderate biofilm-producing ability in anal fistulas of prolonged duration. The study emphasises the presence of biofilm-forming bacteria in chronic, non-healing fistula. © 2021 The Authors. International Wound Journal published by Medicalhelplines.com Inc (3M) and John Wiley & Sons Ltd.
Study on Blood Serum Levels of Heavy and Trace Metals in Chronic Non-Healing Wounds
(SAGE Publications Inc., 2024) Ruhi Dixit; Naveen Kumar Chaudhary; Pradeep Kumar Mishra; Pradeep Srivastava; Satyanam Kumar Bhartiya; Arvind Pratap; Somprakas Basu; Vijay Kumar Shukla
Wound healing is a complex, highly regulated process that is important in sustaining the skin barrier function. The etiologic relation of specific metals is not adequately described for chronic non-healing wounds. The aim of this study was to estimate heavy and trace metals in chronic non-healing wound and their association with wound healing. The levels of zinc, selenium, copper, magnesium, chromium, cadmium, iron, and lead were estimated in serum of chronic non-healing wound patients using atomic absorption spectrophotometry. The tests were carried out in 50 patients with chronic non-healing wound and thirty healthy volunteers as control. The serum levels of elements namely zinc, selenium, copper, magnesium, and chromium were significantly reduced in chronic non-healing wounds (P <.001) as compared to control. Lead and cadmium levels had shown the significantly increasing trend in chronic non-healing wound cases (P <.001). The present study demonstrated a significant decrease in serum, levels of selenium, zinc, copper, magnesium, iron, and chromium levels in patients with chronic non-healing wound indicating an association between these elements and wound healing. To summarize the findings of our research, hence trace elements were decreasing in chronic non-healing wound patients suggesting their role in wound healing. © The Author(s) 2022.
Unconsidered cause of bowel obstruction--gossypiboma.
(2008) Deborshi Sharma; Arvind Pratap; Ashutosh Tandon; Ram Chandra Shukla; Vijay K Shukla
[No abstract available]
Wandering Spleen and Acute Gastric Volvulus in an Elderly Woman with Acute Abdomen: A Case Report
(Dove Medical Press Ltd, 2023) Somprakas Basu; Arvind Pratap; Satyanam Kumar Bhartiya; Vijay Kumar Shukla
Gastric volvulus is an uncommon clinical condition with the potentially life-threatening complication of acute gastric necrosis. A wandering spleen may also be associated with gastric volvulus and can produce a diagnostic dilemma as the cause of an acute abdomen. We present a case of an elderly woman who presented with acute abdominal symptoms. She did not have the classical Borchardt triad to diagnose gastric volvulus and had a coexisting wandering spleen. Although torsion and ischemia of the wandering spleen were initially thought to be the cause of acute abdomen, a subsequent contrast-enhanced CT (CECT) scan confirmed a coexistent mesenteric-axial gastric volvulus with gangrenous changes. We present this case to highlight a rare combination of pathologies, either of which can confuse the diagnosis or cause a delay in management. Early diagnosis with CECT is emphasized, and segmental resection is feasible when the rest of the viscus can be preserved. © 2023 Basu et al. This work is published and licensed by Dove Medical Press Limited.