Browsing by Author "Sushil Kumar Aggarwal"

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Case Report: Rhino-orbital Mucormycosis Related to COVID-19: A Case Series Exploring Risk Factors
(American Society of Tropical Medicine and Hygiene, 2022) Sushil Kumar Aggarwal; Upinder Kaur; Dolly Talda; Akshat Pandey; Sumit Jaiswal; Ahalya Kanakan; Anshuman Singh; Sankha Shubhra Chakrabarti
There has been a surge of rhino-orbital mucormycosis cases in India in the wake of the second wave of the COVID-19 pandemic. It has been widely suggested that dysglycemia resulting from diabetes which is a common comorbidity in COVID-19 patients, and indiscriminate steroid use has resulted in this surge. We report a series of 13 cases of rhino-orbital mucormycosis in COVID-19 patients admitted to our center between mid-April and early June 2021. The cases showed a male preponderance, two patients had loss of vision, and four of them showed intracranial extension of disease. Twelve patients had received steroids and 12 had preexisting or newly diagnosed diabetes, both steroid use and diabetes being the most common identified risk factors. Considering other possible risk factors, immunosuppressed state, antiviral or ayurvedic (Indian traditional) medications, and oxygen therapy were not associated with a definite risk of mucormycosis, because they were not present uniformly in the patients. We propose that COVID-19 itself, through molecular mechanisms, predisposes to mucormycosis, with other factors such as dysglycemia or steroid use increasing the risk. © 2022 American Society of Tropical Medicine and Hygiene. All rights reserved.
Comparative study of tympanoplasty and its outcome in various age groups using the middle ear risk index scale
(Wolters Kluwer Medknow Publications, 2020) Sushil Kumar Aggarwal; Reskey Dev
Introduction: Otitis media is an important and a highly prevalent disease of the middle ear and poses serious health problem world-wide especially in developing countries where large percentage of the population lacks specialized medical care. With a large number of patients frequently undergoing tympanoplasty for chronic suppurative otitis media (CSOM), it is important to assess the severity of the disease and predict the outcome of the surgical management. Aims and Objectives: To study the efficiency of MERI in predicting the outcome of tympanoplasty in all age-groups. Materials and Methods: A prospective study was carried out in the department of Ear Nose and Throat (ENT), Banaras Hindu University (BHU), Varanasi, where all cases of chronic suppurative otitis media in the age-group of 8-40 years were included from September, 2017 to December, 2018. Total 74 patients with unilateral or bilateral perforation of tympanic membrane were included and these were followed-up for 4 months after surgery. Results: Maximum cases fell under MERI 1-3 (mild disease) and these patients had the best prognosis after tympanoplasty. Patients with unilateral perforation had better success rate as compared to patients with bilateral perforation. Conclusion: Our study showed that myringoplasty is a good treatment modality in the paediatric population and MERI scoring can be useful in predicting the outcome of tympanoplasty in all age-groups. © 2020 Wolters Kluwer Medknow Publications. All rights reserved.
Epoxyazadiradione exhibit activities in head and neck squamous cell carcinoma by targeting multiple pathways
(Springer, 2020) Vipin Rai; Sushil Kumar Aggarwal; Sumit Singh Verma; Nikee Awasthee; Anupam Dhasmana; Sadhna Aggarwal; Satya N. Das; Mangalam S. Nair; Sanjay Yadav; Subash C. Gupta
The head and neck squamous cell carcinoma (HNSCC) constitute about 90% of all head and neck cancers. HNSCC falls in the top 10 cancers in men globally. Epoxyazadiradione (EPA) and Azadiradione (AZA) are the limonoids derived from the medicinal plant Azadirachta indica (popularly known as Neem). Whether or not the limonoids exhibit activities against HNSCC and the associated mechanism remains elusive. Herein, we demonstrate that EPA exhibits stronger activity in HNSCC in comparison to AZA. The limonoids obeyed the Lipinski’s rule of 5. EPA exhibited activities in a variety of HNSCC lines like suppression of the proliferation and the induction of apoptosis. The limonoid suppressed the level of proteins associated with anti-apoptosis (survivin, Bcl-2, Bcl-xL), proliferation (cyclin D1), and invasion (MMP-9). Further, the expression of proapoptotic Bax and caspase-9 cleavage was induced by the limonoid. Exposure of EPA induced reactive oxygen species (ROS) generation in the FaDu cells. N-acetyl-L-cysteine (ROS scavenger) abrogated the down-regulation of tumorigenic proteins caused by EPA exposure. EPA induced NOX-5 while suppressing the expression of programmed death-ligand 1 (PD-L1). Further, hydrogen peroxide induced NF-κB-p65 nuclear translocation and EPA inhibited the translocation. Finally, EPA modulated the expression of lncRNAs in HNSCC lines. Overall, these results have shown that EPA exhibit activities against HNSCC by targeting multiple cancer related signalling molecules. Currently, we are evaluating the efficacy of this molecule in mice models. © 2020, Springer Science+Business Media, LLC, part of Springer Nature.
Fungal Rhinosinusitis Caused by Uncommon Scedosporium Apiospermum Fungus species: A Case Report and Review of Literature
(Springer, 2025) Ragini Tilak; Sushil Kumar Aggarwal; Abhirami Prasad; Munesh Kumar Gupta; Aishwarya Nikhil; Shradha Choudhury; Dolly Talda
We report a case of rhinosinusitis caused by Scedosporium apiospermum in a 35-year-old male who presented with nasal discharge. Diagnosis was made by demonstration of hyaline hyphae in the tissue biopsy and culture characteristics. The patient was managed by surgical debridement and oral voriconazole. The patient responded well to the treatment. This case signifies the importance of culture isolation and antifungal minimal inhibitory concentration (MIC) in each case of fungal rhinosinusitis. © Association of Otolaryngologists of India 2025.
Molecular Diagnostics in Pancreatic Cancer
(Springer Singapore, 2019) Shruti Mishra; Vipin Rai; Abhai Kumar; Sushil Kumar Aggarwal; Subash Chandra Gupta
[No abstract available]
The Pathogenetic Dilemma of Post-COVID-19 Mucormycosis in India
(International Society on Aging and Disease, 2022) Sankha Shubhra Chakrabarti; Upinder Kaur; Sushil Kumar Aggarwal; Ahalya Kanakan; Adesh Saini; Bimal Kumar Agrawal; Kunlin Jin; Sasanka Chakrabarti
There has been a surge of mucormycosis cases in India in the wake of the second wave of COVID19 with more than 40000 cases reported. Mucormycosis in patients of COVID-19 in India is at variance to other countries where Aspergillus, Pneumocystis, and Candida have been reported to be the major secondary fungal pathogens. We discuss the probable causes of the mucormycosis epidemic in India. Whereas dysglycaemia and inappropriate steroid use have been widely suggested as tentative reasons, we explore other biological, iatrogenic, and environmental factors. The likelihood of a two-hit pathogenesis remains strong. We propose that COVID-19 itself provides the predisposition to invasive mucormycosis (first hit), through upregulation of GRP78 and downregulation of spleen tyrosine kinase involved in anti-fungal defense, as also through inhibition of CD8+ Tcell mediated immunity. The other iatrogenic and environmental factors may provide the second hit which may have resulted in the surge. Copyright: © 2021 Chakrabart SS. et al.
To Study the Incidence of Biofilm Formation, its Microbiology and its Effect on the Development of Acute and Chronic Rhinosinusitis- A Prospective Study
(Springer, 2025) Akshat Pandey; Ramraj Yadav; Vivek Mishra; Akanksha Sharma; Sanjay Kumar Saroj; Rahul Yadav; Jeffrey Oswin Rynjah; Srishti Bhansali; Anjalika Sharma; Gundra Chandra Shekar; Sishupal Yadav; Arpit Goyal; Ragini Tilak; Sushil Kumar Aggarwal
Bacterial biofilms are organised complex structures having polymicrobial nature in a single community, which provide protection to bacteria from antibiotics by various means. The aim of our study was to determine the prevalence of biofilm-forming bacteria in clinical isolates of acute and chronic rhinosinusitis (ARS and CRS) patients with sinonasal mucopurulence. To know the incidence of bacterial biofilms in patient with ARS and CRS, to study the microbiology of bacterial biofilms in ARS and CRS, to assess the role and effects of biofilm in ARS and CRS and to correlate the association between the formation of the biofilm and development of rhinosinusitis. This prospective study was carried out at a tertiary care centre in Eastern part of India, in which 60 patients were taken as sample size. All patients of rhinosinusitis between age-group of 10 to70 years, who came to our out-patient department, were taken for our study. Biofilm formation was observed in 50% cases and were absent in 50% cases of chronic rhinosinusitis in our study. 83.3% (50) of patients out of 60 patients got improved after treatment and recurrence was observed in only 16.6% (10) of patients. Recurrence was more at 3 months follow-up as compared to follow-up at 1 month, though it was not statistically significant. Though our study highlighted the incidence and role of biofilms in the development of chronic rhinosinusitis, but few more randomized controlled studies involving larger sample sizes should be done to exactly determine the pathophysiological role of biofilms in the development and recurrence of acute and chronic rhinosinusuitis. © Association of Otolaryngologists of India 2024.