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  1. Article ; Online: Prognostication in Pediatric Acute Liver Failure Using CHALF Score-"Perspective From the Opposite Shore".

    Yadav, Deepika / Lal, Bikrant Bihari / Sood, Vikrant / Khanna, Rajeev / Alam, Seema

    Transplantation

    2024  Volume 108, Issue 4, Page(s) e64–e65

    MeSH term(s) Child ; Humans ; Liver Failure, Acute/diagnosis
    Language English
    Publishing date 2024-03-23
    Publishing country United States
    Document type Letter
    ZDB-ID 208424-7
    ISSN 1534-6080 ; 0041-1337
    ISSN (online) 1534-6080
    ISSN 0041-1337
    DOI 10.1097/TP.0000000000004935
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Alert: Not All Acute Hepatitis with Raised INR is Acute Liver Failure!

    Kaur, Prabhsaran / Lal, Bikrant Bihari / Sood, Vikrant / Khanna, Rajeev / Alam, Seema

    Indian journal of pediatrics

    2023  Volume 90, Issue 7, Page(s) 732

    MeSH term(s) Humans ; International Normalized Ratio ; Hepatitis ; Liver Failure, Acute ; Acute Disease
    Language English
    Publishing date 2023-04-19
    Publishing country India
    Document type Letter
    ZDB-ID 218231-2
    ISSN 0973-7693 ; 0019-5456
    ISSN (online) 0973-7693
    ISSN 0019-5456
    DOI 10.1007/s12098-023-04602-z
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Appropriate Treatment of Cholangitis Can Prevent Successful Kasai Portoenterostomy Progressing to Liver Transplantation.

    Lal, Bikrant Bihari / Verma, Snigdha / Sood, Vikrant / Khanna, Rajeev / Alam, Seema

    Journal of pediatric gastroenterology and nutrition

    2023  Volume 77, Issue 5, Page(s) e70

    MeSH term(s) Humans ; Infant ; Liver Transplantation ; Biliary Atresia/surgery ; Portoenterostomy, Hepatic ; Cholangitis/etiology ; Cholangitis/surgery ; Treatment Outcome ; Retrospective Studies
    Language English
    Publishing date 2023-07-07
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 603201-1
    ISSN 1536-4801 ; 0277-2116
    ISSN (online) 1536-4801
    ISSN 0277-2116
    DOI 10.1097/MPG.0000000000003880
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Adherence to Immunosuppression in Indian Children after Liver Transplant.

    Bhardwaj, Garima / Khanna, Rajeev / Verma, Madhavi / Sood, Vikrant / Pamecha, Viniyendra / Kumar, Guresh

    Indian journal of pediatrics

    2022  Volume 89, Issue 9, Page(s) 928

    MeSH term(s) Asians ; Child ; Humans ; Immunosuppression Therapy ; Immunosuppressive Agents/therapeutic use ; Liver Transplantation
    Chemical Substances Immunosuppressive Agents
    Language English
    Publishing date 2022-07-04
    Publishing country India
    Document type Letter
    ZDB-ID 218231-2
    ISSN 0973-7693 ; 0019-5456
    ISSN (online) 0973-7693
    ISSN 0019-5456
    DOI 10.1007/s12098-022-04292-z
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article: Association of HLA DRB1 Allele Profile with Pediatric Autoimmune Liver Disease in India.

    Maria, Arjun / Sood, Vikrant / Khanna, Rajeev / Lal, Bikrant B / Trehanpati, Nirupama / Alam, Seema

    Journal of clinical and experimental hepatology

    2023  Volume 13, Issue 3, Page(s) 397–403

    Abstract: Objectives: The aim of this study is to study the association of human leukocyte antigen (HLA) DRB1 alleles with treatment response in Indian children with autoimmune liver disease (AILD).: Methods: HLA DRB1 alleles of 71 Indian children with ... ...

    Abstract Objectives: The aim of this study is to study the association of human leukocyte antigen (HLA) DRB1 alleles with treatment response in Indian children with autoimmune liver disease (AILD).
    Methods: HLA DRB1 alleles of 71 Indian children with pediatric AILD (pAILD) were analyzed along with 25 genetically confirmed patients with Wilson disease as controls. After 1 year of therapy, all those who failed to normalize aspartate & alanine transferase (AST/ ALT) (below 1.5 times of upper limit of normal) and/or failed to normalize IgG levels, or who had >2 relapses (AST/ALT levels >1.5 times of upper limit of normal) while on treatment, were labeled as difficult to treat (DTT).
    Results: HLA DRB1∗3 was found to be significantly associated with AIH type 1 (46.2% vs. 4% in controls;
    Conclusion: HLA DRB1∗14 is independently associated with treatment response in pAILD and HLA DRB1∗3 is associated with AIH type 1. HLA DRB1 alleles may thus provide supportive information for diagnosis and prognosis of AILD.
    Language English
    Publishing date 2023-01-05
    Publishing country India
    Document type Journal Article
    ISSN 0973-6883
    ISSN 0973-6883
    DOI 10.1016/j.jceh.2023.01.001
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article: Severe Acute Hepatitis of Unknown Etiology Presenting as Pediatric Acute Liver Failure: Analysis of Likely Etiology, Clinical Course and Outcome.

    Lal, Bikrant B / Sood, Vikrant / Gupta, Ekta / Agarwal, Reshu / Khanna, Rajeev / Alam, Seema

    Journal of clinical and experimental hepatology

    2023  

    Abstract: Adenovirus, adeno-associated virus, and severe acute respiratory syndrome-coronavirus-2 (SARS-COV2) have been recently implicated as probable causative agents of severe acute hepatitis of unknown etiology reported from most of Europe. High mortality and ... ...

    Abstract Adenovirus, adeno-associated virus, and severe acute respiratory syndrome-coronavirus-2 (SARS-COV2) have been recently implicated as probable causative agents of severe acute hepatitis of unknown etiology reported from most of Europe. High mortality and liver transplantation (LT) rates have been observed in those presenting with acute liver failure (ALF). Such cases have not been reported from the Indian subcontinent. We analyzed the etiologies, clinical course, and in-hospital outcomes of cases of severe acute hepatitis with ALF presenting to us between May and October 2022. A total of 178 children presented with severe acute hepatitis of known/unknown etiology including 28 presenting as ALF. Eight of them fulfilled the definition of severe acute hepatitis of unknown etiology presenting as ALF. Adenovirus was not associated with cases of ALF in these children. SARS-COV2 antibodies were detected in 6 (75%) of them. Children with severe acute hepatitis of unknown etiology presenting as ALF were young (median age 4 years), had hyper-acute presentation with a predominance of gastrointestinal symptoms, and a fulminant course with worse outcomes (native liver survival 25%). Expedited evaluation of these children for LT would be the key to management.
    Language English
    Publishing date 2023-05-26
    Publishing country India
    Document type Case Reports
    ISSN 0973-6883
    ISSN 0973-6883
    DOI 10.1016/j.jceh.2023.05.014
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Midodrine reduces new-onset acute kidney injury and hyponatremia in children with cirrhosis and ascites awaiting liver transplantation: Results from an open-label RCT.

    Ashritha, A / Lal, Bikrant B / Khanna, Rajeev / Sood, Vikrant / Sood, Arun K / Alam, Seema

    Journal of pediatric gastroenterology and nutrition

    2023  Volume 78, Issue 2, Page(s) 350–359

    Abstract: Objectives: Midodrine, an oral α-1-adrenergic receptor agonist, counters arterial hypovolemia and reduces complications in adult patients with cirrhosis. This randomized controlled trial (RCT) aimed to assess the efficacy and safety of midodrine in ... ...

    Abstract Objectives: Midodrine, an oral α-1-adrenergic receptor agonist, counters arterial hypovolemia and reduces complications in adult patients with cirrhosis. This randomized controlled trial (RCT) aimed to assess the efficacy and safety of midodrine in preventing complications and improving survival in children with cirrhosis and ascites who are awaiting liver transplantation (LT).
    Methods: This open-label RCT conducted from January 2022 to May 2023 included children under 18 years with cirrhosis and ascites. Patients were randomized to receive either midodrine plus standard medical therapies (SMTs) or SMT alone. The primary outcome measure was the incidence of cirrhosis-related complications within 6 months.
    Results: Thirty-five subjects were enrolled and randomized. Patients in the midodrine arm had a lower incidence of new-onset acute kidney injury (AKI) compared with the SMT arm (11.1% vs. 41.2%). Patients in the midodrine arm showed a decline in serum creatinine and improvement in glomerular filtration rate, whereas no changes were observed in the SMT arm. There was a lower incidence of new-onset hyponatremia in the midodrine arm (20% vs. 56%). Midodrine led to reduction in plasma rennin activity (PRA) and improvement in systemic hemodynamics. There was no difference in the rate of resolution of ascites, recurrence of ascites, requirement of therapeutic paracentesis, cumulative albumin infusion requirement, episodes of spontaneous bacterial peritonitis, and hepatic encephalopathy between the two arms.
    Conclusion: Midodrine, when added to SMT, was effective in reducing the incidence of new-onset AKI and hyponatremia in pediatric cirrhotics awaiting LT. It also improved systemic hemodynamics and showed a trend towards reducing PRA.
    MeSH term(s) Adult ; Humans ; Child ; Adolescent ; Midodrine/therapeutic use ; Liver Transplantation/adverse effects ; Ascites/drug therapy ; Ascites/etiology ; Hyponatremia/complications ; Hyponatremia/drug therapy ; Treatment Outcome ; Liver Cirrhosis/complications ; Liver Cirrhosis/surgery ; Acute Kidney Injury/etiology ; Acute Kidney Injury/prevention & control
    Chemical Substances Midodrine (6YE7PBM15H)
    Language English
    Publishing date 2023-12-11
    Publishing country United States
    Document type Randomized Controlled Trial ; Journal Article
    ZDB-ID 603201-1
    ISSN 1536-4801 ; 0277-2116
    ISSN (online) 1536-4801
    ISSN 0277-2116
    DOI 10.1002/jpn3.12077
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article: Adequate Chelation and Cupriuresis in Hepatic Wilson Disease Patients Under Combination (Chelator + Zinc) Therapy at 2 Years of Follow-up.

    Panda, Kalpana / Lal, Bikrant B / Sood, Vikrant / Khanna, Rajeev / Alam, Seema

    Journal of clinical and experimental hepatology

    2023  Volume 14, Issue 2, Page(s) 101284

    Abstract: Background & aim: Role of 24-h urinary copper excretion (UCE) in monitoring Wilson disease (WD) on combination (chelator + Zinc) therapy is not well studied, especially in the pediatric population. Hence, the present study is conducted with an aim to ... ...

    Abstract Background & aim: Role of 24-h urinary copper excretion (UCE) in monitoring Wilson disease (WD) on combination (chelator + Zinc) therapy is not well studied, especially in the pediatric population. Hence, the present study is conducted with an aim to evaluate UCE and its role in deciding therapeutic adequacy in pediatric WD on long-term follow-up.
    Methods: All WD patients <18 years of age and on combination therapy with at least one UCE available after the first year of treatment were included. Liver biochemistries, UCE, and serum non-ceruloplasmin bound copper (NCC) were assessed at diagnosis and various follow-ups. For assessment of treatment efficacy, criteria for adequate chelation (CAC) were defined as fulfillment of both (i) AST & ALT ≤1.5 times upper limit of normal, serum albumin >35 gm/L, INR <1.5 and (ii) UCE <500 mcg/day.
    Results: Of the 74 included children, 70 (94.5%), 45 (60.8%), 28 (37.8%) and 21 (28.3%) completed 2-, 3-, 5-, and 7-year follow-up, respectively. Liver biochemistries improved significantly within 1 year of treatment. UCE (mcg/day) decreased significantly from baseline of 654.08 ± 803.78 to 308.23 ± 175.93 at 2 years with no further change at 3- and 5-years follow-up. UCE (mcg/day) at 2 years was <200 in 28.5%, 200-500 in 55.7%, and >500 in 15.7%. 61% achieved CAC in 2 years. On multivariate cox regression, treatment compliance was predictor for CAC achievement (Odds ratio: 3.48, 95%CI: 1.36-8.86.
    Conclusion: UCE declines significantly from baseline to <500 mcg/day within 2 years. Majority of treatment-compliant patients achieve CAC within 2 years of combination therapy.
    Language English
    Publishing date 2023-09-16
    Publishing country India
    Document type Journal Article
    ISSN 0973-6883
    ISSN 0973-6883
    DOI 10.1016/j.jceh.2023.09.005
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article: A comparative analysis of distal locked and unlocked long proximal femoral nail antirotation (PFNA-II) in the fixation of stable intertrochanteric fractures.

    Hegde, Atmananda / Khanna, Vikrant / Mane, Prajwal / Shetty, Chethan / Joseph, Nitin

    Chinese journal of traumatology = Zhonghua chuang shang za zhi

    2022  Volume 26, Issue 2, Page(s) 111–115

    Abstract: Purpose: Long proximal femoral nail anti-rotation (PFNA-II) is a preferred implant in recent years for fixation of pertrochanteric fractures, especially in osteoporotic patients. The purpose of this study is to prospectively investigate the effect of ... ...

    Abstract Purpose: Long proximal femoral nail anti-rotation (PFNA-II) is a preferred implant in recent years for fixation of pertrochanteric fractures, especially in osteoporotic patients. The purpose of this study is to prospectively investigate the effect of distal locking in long PFNA-II fixation of stable intertrochanteric fractures.
    Methods: A total of 58 patients with isolated stable intertrochanteric fractures and treated in our hospital during the study period of 2017-2019 by distal locked or unlocked long PFNA-II fixation were included in this study. Patients who had multiple injuries or open fractures were excluded. There were 40 female and 18 male patients, with 33 affecting the left side and 25 the right side. Of them, 31 belonged to the distal locked group (group A) and 27 to the unlocked group (group B). Surgical procedures and implants used in both groups were similar except for the distal locking of the nails. General data (age, gender, fracture side, etc.) showed no significant difference between two groups (all p > 0.05). The intraoperative parameters like operative time, radiation exposure and follow-up parameters like functional and radiological outcomes were recorded and compared. Statistical tests like the independent samples t-test Fischer's exact and Chi-square test were used to analyze association.
    Results: The distribution of the fractures according to AO/OTA classification and 31A1.2 type of intertrochanteric fractures were most common in our study. All the included fractures united and the average functional outcome in both groups were good and comparable at the end of one year. The operative time (mL, 107.1 ± 12.6 vs. 77.0 ± 12.0, p < 0.001) and radiation exposure (s, 78.6 ± 11.0 vs. 40.3 ± 9.3, p < 0.001) were significantly less among the patients in group B. Fracture consolidation, three months after the operative procedures, was seen in a significantly greater proportion of patients in group B (92.6% vs. 67.7%, p = 0.025). Hardware irritation because of distal locking bolt was exclusively seen in group A, however this was not statistically significant (p = 0.241).
    Conclusion: We conclude that, in fixation of stable intertrochanteric fractures by long PFNA-II nail, distal locking not only increases the operative time and radiation exposure but also delays the fracture consolidation and increases the chances of hardware irritation, and hence is not required.
    MeSH term(s) Humans ; Male ; Female ; Fracture Fixation, Intramedullary/methods ; Bone Nails ; Treatment Outcome ; Retrospective Studies ; Hip Fractures/surgery ; Hip Fractures/etiology ; Femoral Fractures/etiology
    Language English
    Publishing date 2022-12-14
    Publishing country China
    Document type Journal Article
    ZDB-ID 2276839-7
    ISSN 1008-1275
    ISSN 1008-1275
    DOI 10.1016/j.cjtee.2022.12.007
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Novel Variations in MYO5B Presenting as Isolated Intrahepatic Cholestasis: Long-Term Outcome after Partial Internal Biliary Diversion.

    Lal, Bikrant Bihari / Sood, Vikrant / Khanna, Rajeev / Alam, Seema

    Indian journal of pediatrics

    2021  Volume 88, Issue 10, Page(s) 1052

    MeSH term(s) Biliary Tract ; Biliary Tract Surgical Procedures ; Cholestasis, Intrahepatic/diagnosis ; Cholestasis, Intrahepatic/etiology ; Humans ; Myosin Heavy Chains ; Myosin Type V ; Treatment Outcome
    Chemical Substances MYO5B protein, human ; Myosin Type V (EC 3.6.1.-) ; Myosin Heavy Chains (EC 3.6.4.1)
    Language English
    Publishing date 2021-07-22
    Publishing country India
    Document type Letter
    ZDB-ID 218231-2
    ISSN 0973-7693 ; 0019-5456
    ISSN (online) 0973-7693
    ISSN 0019-5456
    DOI 10.1007/s12098-021-03848-9
    Database MEDical Literature Analysis and Retrieval System OnLINE

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