Browsing by Author "Nishtha Singh"

Now showing 1 - 5 of 5

Gross congenital abnormalities induced by leflunomide in mice embryos
(Sociedad Anatomica Espanola, 2023) Krishna Pandey; Nishtha Singh; Amit Nayak; C. Mohanty
Leflunomide is an antirheumatic drug commonly used by females, as this disease is common in females and there are chances of pregnancy while taking this medication in initial months of pregnancy this commonly prescribed drug lacks studies related to its teratogenic potential. Present study was conducted to know about its teratogenicity in mice embryos. Pregnant mice were exposed to Leflunomide by oral route on gestational days 6 to 11 either as single dose in one of the gestational days or continuous doses. The embryos were collected on day 19 of gestation, were measured and examined for external anomalies. Findings suggested that Leflunomide was embryo lethal when given as continuous dose as there were 100% resorption of embryos. In the single dose group, maximum resorptions were found when was given in early pregnancy. Other anomalies included malrotated limbs, open eyes, kinking of tails, defect in anterior abdominal wall and visceroptosis and anencephaly. these anomalies were noted in embryos exposed to leflunomide only on gestational days 7 and 8. The above findings suggest that leflunomide interferes with embryonic growth It also interferes with neural tube closure leading to anencephaly. Findings of open eyes and kinking tails suggest that the drug may affect epithelial and mesodermal growth. Leflunomide perhaps interferes with the lateral folding of the embryo leading to defect in the anterior abdominal wall and visceroptosis. The present study concludes that Leflunomide is teratogenic and embryolethal in mice and should be avoided in human pregnancy. © 2023 Sociedad Anatomica Espanola. All rights reserved.
Hypersensitivity pneumonitis and its correlation with ambient air pollution in urban India
(European Respiratory Society, 2019) Sheetu Singh; Bridget F. Collins; Mohan Bairwa; Jyotsna M. Joshi; Deepak Talwar; Nishtha Singh; Jai K. Samaria; Daya K. Mangal; Virendra Singh; Ganesh Raghu
[No abstract available]
Hypersensitivity pneumonitis: Clinical manifestations-Prospective data from the interstitial lung disease-India registry
(Wolters Kluwer Medknow Publications, 2019) Sheetu Singh; Bridget Collins; Bharat Sharma; Jyotsana Joshi; Deepak Talwar; Sandeep Katiyar; Nishtha Singh; Lawrence Ho; Jai Samaria; Parthasarthi Bhattacharya; Sudhir Chaudhari; Tejraj Singh; Khushboo Pilania; Sudhakar Pipavath; Jitesh Ahuja; Ravindran Chetambath; Aloke Ghoshal; Nirmal Jain; H. Gayathri Devi; Surya Kant; Parvaiz Koul; Raja Dhar; Rajesh Swarnakar; Subodh Katiyar; Arpita Jindal; Daya Mangal; Virendra Singh; Ganesh Raghu
Context: Multiple environmental factors are associated with development of hypersensitivity pneumonitis (HP), and diagnostic algorithms for the diagnosis of HP have been proposed in recent perspectives. Aims: We analyzed the data of patients with HP from interstitial lung disease (ILD)-India registry. The analysis was performed to (1) find the prevalence of HP, (2) reclassify HP as per a recently proposed classification criterion to assess the level of diagnostic certainty, and (3) identify the causative agents for HP. Setting and Designs: This was a prospective multicenter study of consecutive, consenting adult patients with new-onset ILD from 27 centers across India (March 2012-April 2015). Materials and Methods: The diagnoses were based on prespecified working clinical criteria and multidisciplinary discussions. To assess strength of diagnosis based on available clinical information, patients with HP were subclassified into definite HP, HP with high level of confidence, and HP with low level of confidence using a recent classification scheme. Results: Five hundred and thirteen of 1084 patients with new-onset ILD were clinically diagnosed with HP and subclassified as HP with high level of confidence (380, 74.1%), HP with low level of confidence (106, 20.7%), and definite HP (27, 5.3%). Exposures among patients with HP were birds (odds ratios [OR]: 3.52, P < 0.001), air-conditioners (OR: 2.23, P < 0.001), molds (OR: 1.79, P < 0.001), rural residence (OR: 1.64, P < 0.05), and air-coolers (OR: 1.45, P < 0.05). Conclusions: About 47.3% of patients with new-onset ILD in India were diagnosed with HP, the majority of whom were diagnosed as HP with a high level of confidence. The most common exposures were birds, cooling devices, and visible molds. © 2019 Indian Chest Society.
Interstitial lung disease in India results of a prospective registry
(American Thoracic Society, 2017) Sheetu Singh; Bridget F. Collins; Bharat B. Sharma; Jyotsna M. Joshi; Deepak Talwar; Sandeep Katiyar; Nishtha Singh; Lawrence Ho; Jai Kumar Samaria; Parthasarathi Bhattacharya; Rakesh Gupta; Sudhir Chaudhari; Tejraj Singh; Vijay Moond; Sudhakar Pipavath; Jitesh Ahuja; Ravindran Chetambath; Aloke G. Ghoshal; Nirmal K. Jain; H.J. Gayathri Devi; Surya Kant; Parvaiz Koul; Raja Dhar; Rajesh Swarnakar; Surendra K. Sharma; Dhrubajyoti J. Roy; Kripesh R. Sarmah; Bhavin Jankharia; Rodney Schmidt; Santosh K. Katiyar; Arpita Jindal; Daya K. Mangal; Virendra Singh; Ganesh Raghu
Rationale: Interstitial lung disease (ILD) is a heterogeneous group of acute and chronic inflammatory and fibrotic lung diseases. Existing ILD registries have had variable findings. Little is known about the clinical profile of ILDs in India. Objectives: To characterize new-onset ILDs in India by creating a prospective ILD using multidisciplinary discussion (MDD) to validate diagnoses. Methods: Adult patients of Indian origin living in India with new-onset ILD (27 centers, 19 Indian cities,March 2012-June 2015) without malignancy or infection were included. All had connective tissue disease (CTD) serologies, spirometry, and high-resolution computed tomography chest. ILD pattern was defined by high-resolution computed tomography images. Three groups independently made diagnoses after review of clinical data including that from prompted case report forms: Local site investigators, ILD experts at the National Data Coordinating Center(NDCC;Jaipur, India)withMDD,and experienced ILDexperts at the Center for ILD (CILD; Seattle, WA) withMDD. Cohen's k was used to assess reliability of interobserver agreement. Measurements and Main Results: A total of 1,084 patients were recruited. Final diagnosis: Hypersensitivity pneumonitis in 47.3%(n = 513; exposure, 48.1% air coolers), CTD-ILD in 13.9%, and idiopathic pulmonary fibrosis in 13.7%. Cohen's k: 0.351 site investigator/CILD, 0.519 site investigator/NDCC, and 0.618 NDCC/CILD. Conclusions: Hypersensitivity pneumonitis was the most common new-onset ILD in India, followed by CTD-ILD and idiopathic pulmonary fibrosis; diagnoses varied between site investigators and CILD experts, emphasizing the value of MDD in ILD diagnosis. Prompted case report forms including environmental exposures in prospective registries will likely provide further insight into the etiology and management of ILD worldwide. © 2017 by the American Thoracic Society.
Management of interstitial lung diseases: A consensus statement of the Indian Chest Society (ICS) and National College of Chest Physicians (NCCP)
(Wolters Kluwer Medknow Publications, 2020) Sheetu Singh; Bharat Sharma; Mohan Bairwa; Dipti Gothi; Unnati Desai; Jyotsna Joshi; Deepak Talwar; Abhijeet Singh; Raja Dhar; Ambika Sharma; Bineet Ahluwalia; Daya Mangal; Nirmal Jain; Khushboo Pilania; Vijay Hadda; Parvaiz Koul; Shanti Luhadia; Rajesh Swarnkar; Shailender Gaur; Aloke Ghoshal; Amita Nene; Arpita Jindal; Bhavin Jankharia; Chetambath Ravindran; Dhruv Choudhary; Digambar Behera; D. Christopher; Gopi Khilnani; Jai Samaria; Harpreet Singh; Krishna Gupta; Manju Pilania; Manohar Gupta; Narayan Misra; Nishtha Singh; Prahlad Gupta; Prashant Chhajed; Raj Kumar; Rajesh Chawla; Rajendra Jenaw; Rakesh Chawla; Randeep Guleria; Ritesh Agarwal; R. Narsimhan; Sandeep Katiyar; Sanjeev Mehta; Sahajal Dhooria; Sushmita Chowdhury; Surinder Jindal; Subodh Katiyar; Sudhir Chaudhri; Neeraj Gupta; Sunita Singh; Surya Kant; Zarir Udwadia; Virendra Singh; Ganesh Raghu
Background: Interstitial lung disease (ILD) is a complex and heterogeneous group of acute and chronic lung diseases of several known and unknown causes. While clinical practice guidelines (CPG) for idiopathic pulmonary fibrosis (IPF) have been recently updated, CPG for ILD other than IPF are needed. Methods: A working group of multidisciplinary clinicians familiar with clinical management of ILD (pulmonologists, radiologist, pathologist, and rheumatologist) and three epidemiologists selected by the leaderships of Indian Chest Society and National College of Chest Physicians, India, posed questions to address the clinically relevant situation. A systematic search was performed on PubMed, Embase, and Cochrane databases. A modified GRADE approach was used to grade the evidence. The working group discussed the evidence and reached a consensus of opinions for each question following face-to-face discussions. Results: Statements have been made for each specific question and the grade of evidence has been provided after performing a systematic review of literature. For most of the questions addressed, the available evidence was insufficient and of low to very low quality. The consensus of the opinions of the working group has been presented as statements for the questions and not as an evidence-based CPG for the management of ILD. Conclusion: This document provides the guidelines made by consensus of opinions among experts following discussion of systematic review of evidence pertaining to the specific questions for management of ILD other than IPF. It is hoped that this document will help the clinician understand the accumulated evidence and help better management of idiopathic and nonidiopathic interstitial pneumonias. © 2020 Wolters Kluwer Medknow Publications. All rights reserved.