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Search Results: 1 - 10 of 42 matches for " Mandip Panesar "
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Renal Transplantation Is Associated with Improved Clinical Outcomes in Nephrogenic Systemic Fibrosis
Rabi Yacoub,Kiran Kandukurti,Mandip Panesar
ISRN Transplantation , 2013, DOI: 10.5402/2013/303175
Abstract: Nephrogenic systemic fibrosis is a debilitating disorder seen in chronic kidney disease patients and is characterized by stiffening of the joints and thickening of the skin. Treatment options are limited, but some patients have had an improvement of their clinical symptoms after renal transplantation and the use of immunosuppression. Although there is a variable response to renal transplantation, it is currently unknown what factors promote a favorable outcome. Our objective was to evaluate if the response to renal transplantation was superior to other treatment modalities and to determine which characteristics allowed for a positive response to occur. We retrieved the data from the literature of 298 reported patients, compared the response to renal transplantation and to other treatments, and analyzed their characteristics. We found that more patients had a higher response to renal transplantation, as determined by softening of the skin and improved joint mobility, and among those that did respond, they had a shorter dialysis vintage. We suggest that if renal transplantation is to be considered as a treatment modality, it should be initiated at the earliest possible in the course of the disease to achieve maximum clinical benefit. 1. Introduction Nephrogenic systemic fibrosis (NSF) is primarily seen in chronic kidney disease (CKD) patients and is characterized by large areas of hardened skin with slightly raised plaques, papules, and hyperpigmentation. Biopsies of the affected areas show increased numbers of fibroblasts, alteration of the normal pattern of collagen bundles, and often increased dermal deposits of mucin [1]. The skin may have a “cobblestone” [2], “woody” [3, 4], or peau d’ orange appearance [5]. These lesions may be pruritic and accompanied by sharp pain or burning sensations [3, 6]. Movement of the joints may be so severely limited by the fibrosis that the flexibility is lost. The first cases were noted between 1997 and 2000 in hemodialysis (HD) patients or patients with a failed renal allograft who developed severe skin indurations that were initially thought to be scleromyxedema [7, 8]. Since Grobner reported a correlation between the use of gadolinium (Gd) in end-stage renal disease (ESRD) patients and NSF [9], additional reports supporting this correlation have been published [10, 11]. It is now recognized that low-stability gadolinium-based contrast agents, in the presence of permissive factors, most likely trigger the disease. The prevalence of NSF after exposure to gadodiamide (Omniscan) has been reported to be between 3% and 7%
Understanding Nephrogenic Systemic Fibrosis
Tushar Chopra,Kiran Kandukurti,Silvi Shah,Raheel Ahmed,Mandip Panesar
International Journal of Nephrology , 2012, DOI: 10.1155/2012/912189
Abstract: Nephrogenic systemic fibrosis (NSF) is a rare and a debilitating disease noted uncommonly in patients with impaired renal function when exposed to low-stability gadolinium-based contrast agents (Gd-CAs). According to experimental studies, cytokines released by the stimulation of effector cells such as skin macrophages and peripheral blood monocytes activate circulating fibroblasts which play a major role in the development of NSF lesions. The presence of permissive factors, presumably, provides an environment conducive to facilitate the process of fibrosis. Multiple treatment modalities have been tried with variable success rates. More research is necessary to elucidate the underlying pathophysiological mechanisms which could potentially target the initial steps of fibrosis in these patients. This paper attempts to collate the inferences from the in vivo and in vitro experiments to the clinical observations to understand the pathogenesis of NSF. Schematic representations of receptor-mediated molecular pathways of activation of macrophages and fibroblasts by gadolinium and the final pathway to fibrosis are incorporated in the discussion. 1. Introduction Nephrogenic systemic fibrosis (NSF) is a fibrosing disorder which predominantly occurs in patients whose estimated glomerular filtration rate is below 30?mL/min/1.73?m2 or who are on dialysis [1, 2]. Clinically, these patients present with a thickening and hardening of skin which is often associated with pain, muscle weakness, bone pain, and joint contractures leading to severe disability [3]. These lesions can be found all over the body but typically occur on the lower extremities and the face is usually spared [4]. NSF, first described in 1997, can affect both children and the elderly and has an average age of onset of 46.8 years [5, 6]. No genetic or racial predisposition has been established. The most common presenting morphology is sharply demarcated plaques (58%) with irregular edges but papules (32%), nodules (17%), and rarely macules, vesicles, blisters, bullae, and ulcers have also been reported [1, 4, 5, 7]. The lesions are progressive and later can evolve into wrinkles and woody skin with a cobblestone or “peau d’orange” texture [8]. NSF skin lesions are usually hyperpigmented and erythematous (39%) but can vary from violaceous, brown, tan, yellow, pink, orange-red, and grey-brown [4, 9]. Although initially named, “Nephrogenic Fibrosing Dermopathy,” since it was thought that the lesions were limited to the skin, it is now well documented that these lesions extend beyond the dermis and can
Fermented Dairy Products: Starter Cultures and Potential Nutritional Benefits  [PDF]
Parmjit S. Panesar
Food and Nutrition Sciences (FNS) , 2011, DOI: 10.4236/fns.2011.21006
Abstract: Fermented dairy products have long been an important component of nutritional diet. Historically, fermentation proc-ess involved unpredictable and slow souring of milk caused by the organisms inherently present in milk. However, modern microbiological processes have resulted in the production of different fermented milk products of higher nutri-tional value under controlled conditions. These products represent an important component of functional foods, and intense research efforts are under way to develop dairy products into which probiotic organisms are incorporated to make them more valuable. This article provides an overview of the different starter cultures and health benefits of fer-mented dairy products, which can be derived by the consumers through their regular intake.
Macroscopic Entanglement of a Bose Einstein Condensate on a Superconducting Atom Chip
Mandip Singh
Physics , 2007, DOI: 10.1364/OE.17.002600
Abstract: We propose and analyse a practically implementable scheme to generate macroscopic entanglement of a Bose-Einstein condensate in a micro-magnetic trap magnetically coupled to a superconducting loop. We treat the superconducting loop in a quantum superposition of two different flux states coupled with the magnetic trap to generate macroscopic entanglement. Our scheme also provides a platform to realise interferometry of entangled atoms through the Bose-Einstein condensate and to explore physics at the quantum-classical interface.
Macroscopic entanglement between a Bose Einstein condensate and a superconducting loop
Mandip Singh
Physics , 2009, DOI: 10.1364/OE.17.002600
Abstract: We theoretically study macroscopic entanglement between a magnetically trapped Bose-Einstein condensate and a superconducting loop. We treat the superconducting loop in a quantum superposition of two different flux states coupling with the magnetic trap to generate macroscopic entanglement. The scheme also provides a platform to investigate interferometry with an entangled Bose Einstein condensate and to explore physics at the quantum-classical interface.
Macroscopic quantum oscillator based on a flux qubit
Mandip Singh
Physics , 2014, DOI: 10.1016/j.physleta.2015.05.034
Abstract: In this paper a macroscopic quantum oscillator is introduced that consists of a flux qubit in the form of a cantilever. The magnetic flux linked to the flux qubit and the mechanical degrees of freedom of the cantilever are naturally coupled. The coupling is controlled through an external magnetic field. The ground state of the introduced flux-qubit-cantilever corresponds to a quantum entanglement between magnetic flux and the cantilever displacement.
Potential Applications of Immobilized β-Galactosidase in Food Processing Industries
Parmjit S. Panesar,Shweta Kumari,Reeba Panesar
Enzyme Research , 2010, DOI: 10.4061/2010/473137
Abstract: The enzyme β-galactosidase can be obtained from a wide variety of sources such as microorganisms, plants, and animals. The use of β-galactosidase for the hydrolysis of lactose in milk and whey is one of the promising enzymatic applications in food and dairy processing industries. The enzyme can be used in either soluble or immobilized forms but the soluble enzyme can be used only for batch processes and the immobilized form has the advantage of being used in batch wise as well as in continuous operation. Immobilization has been found to be convenient method to make enzyme thermostable and to prevent the loss of enzyme activity. This review has been focused on the different types of techniques used for the immobilization of β-galactosidase and its potential applications in food industry. 1. Introduction The enzyme β-galactosidase (EC.3.2.1.23), most commonly known as lactase, which hydrolyses lactose into its monomers that is glucose and galactose has potential applications in food processing industry. Because of low levels of the enzyme in intestine, large fraction of the population shows lactose intolerance and they have difficulty in consuming milk and dairy products. Lactose has a low relative sweetness and solubility, and excessive lactose in large intestine can lead to tissue dehydration due to osmotic effects, poor calcium absorption due to low acidity, and fermentation of the lactose by microflora resulting in fermentative diarrhea, bloating, flatulence, blanching and cramps, and watery diarrhea [1]. Furthermore, lactose is a hygroscopic sugar and has a strong tendency to absorb flavours and odours and causes many defects in refrigerated foods such as crystallization in dairy foods, development of sandy or gritty texture, and deposit formation [2]. Technologically, lactose gets easily crystallized, which sets the limits of its applications to certain processes in the dairy industry. Cheese manufactured from hydrolyzed milk ripens more quickly than that made from normal milk. Treatment of milk and milk products with lactase to reduce their lactose content seems to be an appropriate method to increase their potential uses and to deal with the problems of lactose insolubility and lack of sweetness. Furthermore, this treatment could make milk, a most suitable food, available to a large number of adults and children that are lactose intolerant. Moreover, the hydrolysis of whey converts lactose into a very useful product like sweet syrup, which can be used in various processes of dairy, confectionary, baking, and soft drink industries [3, 4].
Lactose Hydrolysis in Whole Milk Using Immobilized Kluyveromyces marxianus Cells
Parmjit S. Panesar
American Journal of Food Technology , 2007,
Abstract: To overcome the problem of enzyme extraction and poor permeability of cell membrane to lactose, permeabilization of Kluyveromyces marxianus cells was carried. Permeabilized whole cells can also be advantageous over more pure enzyme preparations due to increased stability maintained by the intracellular environment. In view of the advantages of immobilized cell system over free cell system, the permeabilized yeast cells were immobilized by entrapment in calcium alginate gel. Different process parameters (alginate concentration, bead size, biomass load, temperature, agitation, incubation time) were optimized to enhance the lactose hydrolysis. Maximum lactose hydrolysis (84.8%) was observed with yeast cells immobilized in 2% (w/v) alginate concentration after 150 min of treatment time. The developed system was highly stable and the alginate entrapped yeast cells can be recycled up to 7th cycle without any significant decrease in their ability to carry out the lactose hydrolysis.
Practical approach to management of respiratory complications in neurological disorders
Mangera Z, Panesar K, Makker H
International Journal of General Medicine , 2012, DOI: http://dx.doi.org/10.2147/IJGM.S26333
Abstract: actical approach to management of respiratory complications in neurological disorders Review (2387) Total Article Views Authors: Mangera Z, Panesar K, Makker H Published Date March 2012 Volume 2012:5 Pages 255 - 263 DOI: http://dx.doi.org/10.2147/IJGM.S26333 Received: 19 September 2011 Accepted: 23 November 2011 Published: 21 March 2012 Zaheer Mangera, Kirat Panesar, Himender Makker Respiratory Medicine, North Middlesex University Hospital, London, UK Abstract: Patients with certain neurological diseases are at increased risk of developing chest infections as well as respiratory failure due to muscular weakness. In particular, patients with certain neuromuscular disorders are at higher risk. These conditions are often associated with sleep disordered breathing. It is important to identify patients at risk of respiratory complications early in the course of their disease, although patients with neuromuscular disorders often present in the acute setting with respiratory involvement. This review of the respiratory complications of neurological disorders, with a particular focus on neuromuscular disorders, explores why this happens and looks at how to recognize, investigate, and manage these patients effectively.
Practical approach to management of respiratory complications in neurological disorders
Mangera Z,Panesar K,Makker H
International Journal of General Medicine , 2012,
Abstract: Zaheer Mangera, Kirat Panesar, Himender MakkerRespiratory Medicine, North Middlesex University Hospital, London, UKAbstract: Patients with certain neurological diseases are at increased risk of developing chest infections as well as respiratory failure due to muscular weakness. In particular, patients with certain neuromuscular disorders are at higher risk. These conditions are often associated with sleep disordered breathing. It is important to identify patients at risk of respiratory complications early in the course of their disease, although patients with neuromuscular disorders often present in the acute setting with respiratory involvement. This review of the respiratory complications of neurological disorders, with a particular focus on neuromuscular disorders, explores why this happens and looks at how to recognize, investigate, and manage these patients effectively.Keywords: respiratory failure, respiratory muscle weakness
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