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Article ; Online: Spongiform leukoencephalopathy unveiled in an autopsy of a drug abuser

Hemlata Jangir / Govinda Balmuchu / Jhansi Lakshmi Mylapalli / Arulselvi Subramanian / Sanjeev Lalwani

Autopsy and Case Reports, Vol

2024 Volume 13

Abstract: Toxic leukoencephalopathy (TLE) is a rare neurological debilitating and fatal condition. It has been previously associated with exposure to leukotoxic offenders such as chemotherapy, cranial radiation, certain drugs, and environmental factors. Currently, ...

Abstract	Toxic leukoencephalopathy (TLE) is a rare neurological debilitating and fatal condition. It has been previously associated with exposure to leukotoxic offenders such as chemotherapy, cranial radiation, certain drugs, and environmental factors. Currently, it is a commoner white matter syndrome resulting from increased substance abuse, classically by inhaled heroin and other opioids. Herein, we report a case of fatal TLE unveiled in an autopsy of a drug abuser. A 24-year-old male was found dead on the roadside. A day before, he was located in a state of delirium. In this case, the autopsy findings and histopathology characteristics of cerebral cortex involvement particularly directed to speculate the heroine as the principal offender.
Keywords	Forensic Toxicology ; Leukoencephalopathy ; Progressive Multifocal ; Psychoses ; Substance-Induced ; Medicine ; R ; Internal medicine ; RC31-1245
Language	English
Publishing date	2024-01-01T00:00:00Z
Publisher	University of São Paulo
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: An overview of the potential sources of diagnostic errors in (classic) thromboelastography curve interpretation and preventive measures

Tapasyapreeti Mukhopadhyay / Arulselvi Subramanian

Practical Laboratory Medicine, Vol 22, Iss , Pp e00193- (2020)

2020

Abstract: Thromboelastography (TEG), a hemostatic point-of-care assay, provides global information about fibrin formation, platelet activation, and clot retraction in real-time. As it is an operator-dependent technique, error in any phase of the testing process ... ...

Abstract	Thromboelastography (TEG), a hemostatic point-of-care assay, provides global information about fibrin formation, platelet activation, and clot retraction in real-time. As it is an operator-dependent technique, error in any phase of the testing process can result in the misinterpretation of the thromboelastogram, and subsequently lead to mismanagement of the patient, wastage of blood products besides increasing the financial burden on the hospital and the patient. The present paper describes the possible errors leading to wrong thromboelastogram interpretation, and the respective preventive measure. In the light of limited resources available for operational challenges in TEG, this review paper can prove to be helpful.
Keywords	Medicine (General) ; R5-920 ; Chemistry ; QD1-999
Language	English
Publishing date	2020-11-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Knowledge, attitude and practice of health care professionals on laboratory diagnosis of COVID-19

Tapasyapreeti Mukhopadhyay / Jay Relan / Arulselvi Subramanian / Amit Lathwal

Journal of Family Medicine and Primary Care, Vol 10, Iss 5, Pp 1922-

2021 Volume 1930

Abstract: Background: Coronavirus disease-2019 (COVID-19) is currently a global public health concern. Thorough knowledge of diagnostics of COVID-19 amongst health care professionals (HCPs) is critical for timely and accurate diagnosis. The aim of the study was to ...

Abstract	Background: Coronavirus disease-2019 (COVID-19) is currently a global public health concern. Thorough knowledge of diagnostics of COVID-19 amongst health care professionals (HCPs) is critical for timely and accurate diagnosis. The aim of the study was to assess the knowledge, attitude, and practice among HCPs related to the laboratory diagnosis of COVID-19. Materials and Methods: In this cross-sectional study, participants completed a self-administered questionnaire on KAPs regarding COVID-19 laboratory diagnosis. Knowledge and practice scores were calculated and categorized based on the number of correct responses. Predictors of knowledge and practice scores were identified by logistic regression analyses. Results: In all, 347 HCPs participated. Most participants had an average knowledge score and suboptimal practice score. Independent predictors of getting an average knowledge score were being indirectly involved in laboratory diagnosis of COVID-19 (odds ratio, OR: 2.591; 95% confidence interval, CI: 1.106–6.070), and having a government website as a major source of information (OR: 6.184; 95% CI: 1.185–32.286). Of all, 66.3% thought that testing rate for COVID-19 detection in India is unsatisfactory and 67.2% feared getting infected at work due to delays in test results. Most participants (90.5%) felt that more training programs related to laboratory diagnosis are needed. Practice scores significantly differed among HCPs of opposite sexes, different professions, and different information sources. Conclusions: Our results highlight the need for planning constructive strategies to improve KAP among HCPs related to the laboratory diagnosis of COVID-19. Timely dissemination of correct information to HCPs by the health authorities is critical to win this battle against COVID-19.
Keywords	coronavirus ; healthcare worker ; laboratory medicine ; pandemic ; public health ; sars-cov-2 ; Medicine ; R
Subject code	306
Language	English
Publishing date	2021-01-01T00:00:00Z
Publisher	Wolters Kluwer Medknow Publications
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Morquio Syndrome Presenting with Dural Band Pathology

Saloni Gupta / Kangana Sengar / Arulselvi Subramanian / Gurudatta Satyarthee

Journal of Laboratory Physicians, Vol 12, Iss 04, Pp 285-

A Case Report

2020 Volume 288

Abstract: Morquio syndrome is caused by the deficiency of N-acetylgalactosamine-6-sulfate sulfatase (GALNS) enzyme, which is required for the catabolism of glycosaminoglycans (namely, chondroitin-6-sulfate and keratan sulfate). Pathogenic accumulation of these ... ...

Abstract	Morquio syndrome is caused by the deficiency of N-acetylgalactosamine-6-sulfate sulfatase (GALNS) enzyme, which is required for the catabolism of glycosaminoglycans (namely, chondroitin-6-sulfate and keratan sulfate). Pathogenic accumulation of these glycosaminoglycans occurs throughout the body. The various organs and tissues affected are bones, cartilage, tendon, teeth, trachea and lungs, heart, cornea, skin and connective tissues. Here, we present a case of Morquio syndrome. A 16-year-old boy presented with multiple skeletal abnormalities, including cervicomedullary compression by dorsal dural band in foramen magnum. The dural band was resected during the surgery to relieve compression and sent for histopathological examination. This case report not only reviews the clinical features and shows rare dural band histopathological findings but also mentions a note on the future therapies of this syndrome.
Keywords	cervicomedullary compression ; dural calcification ; morquio syndrome ; Medicine ; R
Language	English
Publishing date	2020-12-01T00:00:00Z
Publisher	Thieme Medical and Scientific Publishers Pvt. Ltd.
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Characterization of analytical errors in thromboelastography interpretation

Tapasyapreeti Mukhopadhyay / Arulselvi Subramanian / Hara Prasad Pati / Renu Saxena

Practical Laboratory Medicine, Vol 23, Iss , Pp e00196- (2021)

2021

Abstract: Introduction: Interpretation of Thromboelastography (TEG) curve involves correlating patient’s clinical profile with TEG parameters and the tracing, keeping in mind the potential sources of errors, and hence requires expertise. We aimed to analyse the ... ...

Abstract	Introduction: Interpretation of Thromboelastography (TEG) curve involves correlating patient’s clinical profile with TEG parameters and the tracing, keeping in mind the potential sources of errors, and hence requires expertise. We aimed to analyse the analytical errors in TEG interpretation due to paucity of literature in this regard. Material and methods: The retrospective study was conducted in an apex trauma center in North India. Five months of data was reviewed by two laboratory physicians, with differences resolved by consensus. Cases with pre-analytical errors, missing data and TEG runs lasting <10 min were excluded. The analytical errors were classified into: preventable, potentially preventable, non-preventable, and non-preventable but care could have been improved. Results: Out of 440 TEG tracings reviewed, 70 were excluded. An analytical error was present in 60/370 (16.2%) tracings. There were six types analytical errors, of which, tracings of severe hypocoagulable states showing k-time = 0 (33.3%) was the commonest, followed by tracings with spikes at irregular intervals (30%). Of all the analytical errors, 29/60 (48.2%) were preventable and 5/60 (8.3%) were potentially preventable. Conclusion: Analytical variables that lead to errors in TEG interpretation were identified in about one-sixth of the cases and almost half of them were preventable. Awareness about the common errors amongst clinicians and laboratory physicians is critical to prevent treatment delay and safeguard patient safety.
Keywords	Diagnostic delay ; Laboratory error ; Patient safety ; Turnaround time ; TEG misinterpretation ; Medicine (General) ; R5-920 ; Chemistry ; QD1-999
Subject code	710
Language	English
Publishing date	2021-01-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Variation in Laboratory Utilization and Correlation with Hospital Bed Utilization

Tapasyapreeti Mukhopadhyay / Narinder Kumar / Shivam Pandey / Arulselvi Subramanian / Nirupam Madaan / Rajesh Malhotra

Journal of Laboratory Physicians, Vol 14, Iss 02, Pp 210-

Experience of a Trauma-Care Hospital during the COVID-19 Pandemic

2022 Volume 217

Abstract: Objectives The present study was planned with the following objectives: (i) to calculate the difference in frequency of laboratory test ordered and use of consumables between the prepandemic and pandemic phases, (ii) to determine and compare the monthly ... ...

Abstract	Objectives The present study was planned with the following objectives: (i) to calculate the difference in frequency of laboratory test ordered and use of consumables between the prepandemic and pandemic phases, (ii) to determine and compare the monthly average number of tests ordered per patient between the prepandemic and pandemic phases, and (iii) to correlate the monthly test ordering frequency with the monthly bed occupancy rate in both phases. Materials and Methods Records of laboratory tests ordered and use of consumables were collected for the prepandemic phase (1.8.2019 to 31.3.2020) and the pandemic phase (1.4.2020 to 31.10.2020). The absolute and relative differences were calculated. Monthly average number of tests ordered per patient and bed occupancy rate between prepandemic and pandemic phases was determined, compared, and correlated. Statistical Analysis The absolute and the relative differences between the two periods were calculated. The continuous variables were analyzed between groups using Mann–Whitney U test. Spearman correlation was used to correlate the monthly test ordering frequency with the monthly bed occupancy rate in both phases. Results A total of 946,421 tests were ordered, of which 370,270 (39%) tests were ordered during the pandemic period. There was a decrease in the number of the overall laboratory tests ordered (12%), and in the use of blood collection tubes (34%), and an increase in the consumption of sanitizers (18%), disinfectants (3%), masks (1633%), and gloves (7011%) during the pandemic period. Also, the monthly average number of tests ordered per patients significantly reduced (p-value < 0.001). Test ordering frequency had strong positive correlation with bed occupancy rate during pandemic (Spearman co-efficient = 0.73, p-value = 0.03). Conclusions An overall decline in laboratory utilization during pandemic period was observed. Understanding and correlating the trends with hospital bed utilization can maximize the productivity of the laboratory and help in better ...
Keywords	bed occupancy ; hospital information system ; biosafety ; laboratories ; pandemic ; sars-cov-2 ; traumatology ; Medicine ; R
Subject code	660
Language	English
Publishing date	2022-06-01T00:00:00Z
Publisher	Thieme Medical and Scientific Publishers Pvt. Ltd.
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: The Convalescent Plasma Craze! Where Does India Stand?

Priyadarsini, Arcot J / Karan, Kumar / Arulselvi, Subramanian

Journal of laboratory physicians

2021 Volume 13, Issue 2, Page(s) 183–191

Abstract: India becomes the country with second highest number of coronavirus disease 2019 (COVID-19) cases (59,03,932) as of September 2020. As the world debates various treatment options, the current pandemic has led to the resurgence of an ancient technique, ... ...

Abstract	India becomes the country with second highest number of coronavirus disease 2019 (COVID-19) cases (59,03,932) as of September 2020. As the world debates various treatment options, the current pandemic has led to the resurgence of an ancient technique, namely convalescent plasma therapy. Although it has been in use from the late 19th century, it is an uncharted territory for most developing nations. In this article, we have discussed the pros and cons of convalescent plasma transfusion in COVID-19 patients. Articles discussed in this review have been obtained from search engines, namely PubMed, Scopus, and Embase. We have also expressed our viewpoint on the feasibility and logistical challenges of convalescent plasma use in India.
Language	English
Publishing date	2021-06-16
Publishing country	Germany
Document type	Journal Article ; Review
ZDB-ID	2461120-7
ISSN	0974-7826 ; 0974-2727
ISSN (online)	0974-7826
ISSN	0974-2727
DOI	10.1055/s-0041-1730753
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Cold agglutinin disease in childhood: a case series with review of literature.

Gaur, Malvika / Sehgal, Tushar / Bharti, Ginni / J, Hemapriya / Chandra Pandey, Hem / Dawan, Rishi / Khan, Maroof / Arulselvi, Subramanian

Recenti progressi in medicina

2023 Volume 114, Issue 11, Page(s) 680–686

Abstract: Cold agglutinins are autoantibodies that target RBC antigens at temperatures below average core body temperature. They produce RBC agglutination and cold agglutinin disease (CAD), a rare form of autoimmune haemolytic anaemia. Due to it's under ... ...

Abstract	Cold agglutinins are autoantibodies that target RBC antigens at temperatures below average core body temperature. They produce RBC agglutination and cold agglutinin disease (CAD), a rare form of autoimmune haemolytic anaemia. Due to it's under recognition, there is a delay between the start of symptoms and the diagnosis. With an emphasis on the laboratory approach, we provide the clinical and analytical findings from five cases of childhood CAD.
MeSH term(s)	Humans ; Anemia, Hemolytic, Autoimmune/diagnosis ; Anemia, Hemolytic, Autoimmune/therapy ; Laboratories ; Child
Language	English
Publishing date	2023-10-06
Publishing country	Italy
Document type	Case Reports ; Journal Article ; Review
ZDB-ID	138266-4
ISSN	2038-1840 ; 0034-1193
ISSN (online)	2038-1840
ISSN	0034-1193
DOI	10.1701/4133.41272
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Article ; Online: Hyperactive behaviour of growth differentiation factor- 15 (GDF-15) in conjunction with iron trafficking transporters and suppression of Nrf-2 gene in diabetes and metabolic syndrome.

Saroj, Manish / Prakash, Shyam / Vikram, Naval K / Saraya, Anoop / Priyatma / Ganie, Mohd Ashraf / Arulselvi, Subramanian / Pandey, Shivam

Molecular and cellular biochemistry

2023

Abstract: Multiple parallel factors are frequently interrogated with various toxic radicals which are abundantly generated in the liver, heart, and pancreas in stress conditions. They are actively involved in the development of diabetes and metabolic aberrations. ... ...

Abstract	Multiple parallel factors are frequently interrogated with various toxic radicals which are abundantly generated in the liver, heart, and pancreas in stress conditions. They are actively involved in the development of diabetes and metabolic aberrations. However, whether over-activation of GDF-15mRNA and influxes of iron-by-iron trafficking genes are directly suppressing the Nrf-2 gene in patients with diabetes and metabolic aberrations in context with undiagnosed individuals with diabetes and metabolic aberrations? Therefore, we have investigated inter and intra- related Zip8/14 mRNA, GDF-15mRNA, and Nrf-2 mRNA expressions in diabetes and metabolic syndrome as it is expected to be up to 134 million by 2045 in India. We recruited 120 subjects from the Department of Medicine, Endocrinology and Metabolic Clinic, All India Institute of Medical Sciences, New Delhi, India. Various investigations related to anthropometry, nutritional, hematological, biochemical, cytokine, and oxidative stress were measured in diabetes, metabolic syndrome, diabetes with metabolic aberration, and healthy controls. Relative expression of GDF-15, ZIP8, ZIP14, Nrf-2, and housekeeping genes was done in all subjects. Stress-responsive cytokines are highly expressed in patients with metabolic aberration with respect to body weight, IR, waist circumference, and fat mass. IL-1β, TNF-α, and IL-6 levels were significantly higher in metabolic syndrome, whereas Adiponectin levels were profoundly lower side. MDA levels were significantly raised in diabetes with metabolic syndrome while SOD activities were lowered (p = 0.001). GDF-15 mRNA expression was 1.79-fold upregulated in group III as compared with Group I while 2-threefold down-regulation of Nrf-2 expression was observed in diabetes with metabolic aberration groups. Zip 8 mRNA expressions were downregulated (p = 0.014), and Zip 14 mRNA expressions were upregulated (p = 0.06) in diabetes and metabolic aberrations. The association of GDF-15 and Nrf-2 mRNA expression was found contradictory and highly interlinked with ROS. Zip 8/14mRNA expressions were also dysregulated in diabetes and metabolic-associated complications.
Language	English
Publishing date	2023-06-20
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	184833-1
ISSN	1573-4919 ; 0300-8177
ISSN (online)	1573-4919
ISSN	0300-8177
DOI	10.1007/s11010-023-04782-4
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Article: The Convalescent Plasma Craze! Where Does India Stand?

Priyadarsini, Arcot J. / Karan, Kumar / Arulselvi, Subramanian

Journal of Laboratory Physicians

2021 Volume 13, Issue 02, Page(s) 183–191

Abstract	India becomes the country with second highest number of coronavirus disease 2019 (COVID-19) cases (59,03,932) as of September 2020. As the world debates various treatment options, the current pandemic has led to the resurgence of an ancient technique, namely convalescent plasma therapy. Although it has been in use from the late 19th century, it is an uncharted territory for most developing nations. In this article, we have discussed the pros and cons of convalescent plasma transfusion in COVID-19 patients. Articles discussed in this review have been obtained from search engines, namely PubMed, Scopus, and Embase. We have also expressed our viewpoint on the feasibility and logistical challenges of convalescent plasma use in India.
Keywords	COVID-19 ; convalescent plasma ; India ; challenges
Language	English
Publishing date	2021-06-01
Publisher	Thieme Medical and Scientific Publishers Pvt. Ltd.
Publishing place	Stuttgart ; New York
Document type	Article
ZDB-ID	2461120-7
ISSN	0974-7826 ; 0974-2727 ; 0974-7826
ISSN (online)	0974-7826
ISSN	0974-2727 ; 0974-7826
DOI	10.1055/s-0041-1730753
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