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Sandeep khosla

Sukhchain Singh, Mukesh Singh, Navsheen Grewal, Sandeep Khosla
BACKGROUND: The objective of this meta-analysis to evaluate safety and efficacy of transradial vs the transfemoral approach for primary percutaneous coronary intervention (PCI) in ST-segment elevation myocardial infarction (STEMI) patients. METHODS: Randomized controlled trials that compared the transfemoral vs the transradial approach in STEMI patients who underwent PCI were searched in PubMed, Embase, CENTRAL, Cumulative Index to Nursing and Allied Health Literature, and clinicaltrials...
June 2016: Canadian Journal of Cardiology
Garima Sharma, Divya Tej Sowpati, Prakruti Singh, Mehak Zahoor Khan, Rakesh Ganji, Sandeep Upadhyay, Sharmistha Banerjee, Vinay Kumar Nandicoori, Sanjeev Khosla
A mammalian cell utilizes DNA methylation to modulate gene expression in response to environmental changes during development and differentiation. Aberrant DNA methylation changes as a correlate to diseased states like cancer, neurodegenerative conditions and cardiovascular diseases have been documented. Here we show genome-wide DNA methylation changes in macrophages infected with the pathogen M. tuberculosis. Majority of the affected genomic loci were hypermethylated in M. tuberculosis infected THP1 macrophages...
2016: Scientific Reports
Sukhchain Singh, Mukesh Singh, Navsheen Grewal, Sandeep Khosla
OBJECTIVE: The authors aimed to conduct first systematic review and meta-analysis in STEMI patients evaluating vascular access site failure rate, fluoroscopy time, door to balloon time and contrast volume used with transradial vs transfemoral approach (TRA vs TFA) for PCI. METHODS: The PubMed, CINAHL,, Embase and CENTRAL databases were searched for randomized trials comparing TRA versus TFA. Random effect models were used to conduct this meta-analysis...
December 2015: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Ankur Sethi, Gurveen Malhotra, Sukhchain Singh, Param P Singh, Sandeep Khosla
BACKGROUND: In-stent restenosis (ISR) remains a difficult problem in interventional cardiology. The relative efficacy and safety of available interventions is not clear. We aimed to perform a network meta-analysis using both direct evidence and indirect evidence to compare all available interventions. METHODS AND RESULTS: We systematically searched electronic databases for randomized trials comparing ≥2 treatments for ISR. A network meta-analysis was performed using a Bayesian approach...
November 2015: Circulation. Cardiovascular Interventions
Imtiaz Ismail, Khalid Al-Khafaji, Monica Mutyala, Saurabh Aggarwal, William Cotter, Hosam Hakim, Sandeep Khosla, Rohit Arora
Lipomas of the heart are encapsulated tumors that are composed primarily of mature fat cells. Cardiac lipomas can originate either from subendocardium (approximately 50%), subpericardium (25%), or from the myocardium (25%) and may be located more frequently in left ventricle or right atrium. We report a 74-year-old female who presented with dyspnea on exertion and was found to have 5×5 cm mass occupying most of the right atrium on a transesophageal echocardiogram.
2015: Journal of Community Hospital Internal Medicine Perspectives
Sukhchain Singh, Mukesh Singh, Navsheen Grewal, Sandeep Khosla
Authors aimed to compare efficacy and safety of prasugrel, ticagrelor, and standard-dose (SD) and high-dose (HD) clopidogrel in patients undergoing percutaneous coronary intervention (PCI). PubMed, EMBASE, CENTRAL, and were searched for studies comparing prasugrel, ticagrelor, SD and HD clopidogrel in patients undergoing PCI. Frequentist and Bayesian network meta-analyses were performed besides direct pairwise comparisons. Thirty trials, comprising 34,563 person-year data, were included. Prasugrel emerged as a best drug to prevent definite or probable stent thrombosis, followed by HD clopidogrel and ticagrelor, with SD clopidogrel being the worst...
January 2016: American Journal of Therapeutics
Sukhchain Singh, Sandeep Khosla, Ankur Sethi
Accountable Care Organizations (ACOs) were created under the Affordable Care Act to deliver better quality of care at reduced cost compare with the traditional fee-for-service model. But their effectiveness in achieving healthcare quality metrics is unclear. We analyzed ACO and physician group practice (PGP) performance rates for the single coronary artery disease measure and four diabetes mellitus measures now publicly reported on the Medicare Physician Compare Web site for program year 2012. There was no statistically significant difference in reported quality measures between ACOs and PGPs...
January 2015: Journal of Medical Practice Management: MPM
Sukhchain Singh, Ankur Sethi, Mukesh Singh, Kavia Khosla, Navsheen Grewal, Sandeep Khosla
Association of inter-arm systolic blood pressure difference (IASBPD) with cardiovascular (CV) morbidity and mortality remains controversial. We aimed to thoroughly examine all available evidence on inter-limb blood pressure (BP) difference and its association with CV risk and outcomes. We searched PubMed, EMBASE, CINAHL, Cochrane library, and Ovid for studies reporting bilateral simultaneous BP measurements in arms or legs and risk of peripheral arterial disease (PAD), coronary artery disease, cerebrovascular disease, subclavian stenosis, or mortality...
August 2015: Journal of the American Society of Hypertension: JASH
Imtiaz Ismail, Khalid Al-Khafaji, Monica Mutyala, Saurabh Aggarwal, Nawfal Al-Khafaji, Daniela Kovacs, Sandeep Khosla, Rohit Arora
Moyamoya disease is a rare neurological condition that affects children and adults of all ages. It is characterized by chronic, progressive stenosis of the circle of Willis that ultimately leads to the development of extensive collateral vessels. Presenting symptoms are usually due to cerebral ischemia or hemorrhage. The Japanese term moyamoya (meaning puffy or obscure) was coined to describe the characteristic 'smoke in the air' appearance of these vessels on cerebral angiography. Moyamoya has the highest recorded incidence in Japan (0...
2015: Journal of Community Hospital Internal Medicine Perspectives
Sarabjeet Singh, Rohit R Arora, Mukesh Singh, Sandeep Khosla
Vascular inflammation is a key component involved in the process of arthrosclerosis, which in turn increases the risk for cardiovascular injury. In the last 10 years, there have been many trials that looked at omega-3 fatty acids as a way to reduce cardiovascular risk. These trials observed the effects of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) on the traditional lipid panel and found that both EPA and DHA reduce triglyceride (TG) level and increase high-density lipoprotein cholesterol (HDL-C) levels but also increase the low-density lipoprotein cholesterol (LDL-C) levels...
May 2016: American Journal of Therapeutics
Garima Sharma, Sandeep Upadhyay, M Srilalitha, Vinay K Nandicoori, Sanjeev Khosla
To effectively modulate the gene expression within an infected mammalian cell, the pathogen Mycobacterium tuberculosis would need to bring about epigenetic modifications at appropriate genomic loci. Working on this hypothesis, we show in this study that the mycobacterial protein Rv2966c is a 5-methylcytosine-specific DNA methyltransferase that is secreted out from the mycobacterium and gets localized to the nucleus in addition to the cytoplasm inside the host cell. Importantly, Rv2966c binds to specific DNA sequences, methylates cytosines predominantly in a non-CpG context and its methylation activity is positively influenced by phosphorylation...
April 30, 2015: Nucleic Acids Research
Sukhchain Singh, Ankur Sethi, Mukesh Singh, Sandeep Khosla
Prevalence of interarm systolic blood pressure difference and clinical and demographic characteristics associated with interarm systolic blood pressure difference (IASBPD) have been a matter of debate. We aimed to ascertain the prevalence of IASBPD and clinical and demographic characteristics associated with it. We searched PubMed, EMBASE, and CINAHL, Ovid and Cochrane Library, and Google Scholar. Twenty-seven studies meeting all inclusion criteria were included in the analysis. Weighted average cumulative prevalence of simultaneous IASBPD of 10, 15, and 20 mmHg or greater was 9...
August 2015: Blood Pressure Monitoring
Sarabjeet Singh, Mukesh Singh, Daniela Kovacs, Daniel Benatar, Sandeep Khosla, Harpreet Singh
INTRODUCTION: Primary tumors of the heart are exceedingly rare, accounting for less than 5% of all cardiac tumors; the remaining 95% of tumors are metastatic tumors to the heart. The most common primary cardiac tumors in adults are myxomas (usually occurring in the left atrium) followed by papillary fibroelastomas and lipomas with rhabdomyoma the most common in children. PRESENTATION OF CASE: We are presenting a case of a 74-years-old female who initially presents with dizziness...
2015: International Journal of Surgery Case Reports
Imtiaz Ismail, Anushree Agarwal, Saurabh Aggarwal, Nawfal Al-Khafaji, Navdeep Gupta, Hani Badi, Aashish Chopra, Sandeep Khosla, Rohit Arora
Aortic atherosclerotic plaques are usually seen in males older than 55 years who are known to have risk factors of atherosclerosis. Recent large series of consecutive stroke patients reported that the prevalence of aortic atheromatous plaques in patients with stroke is about 21%-27%, which is in the same magnitude when compared with the prevalence of carotid disease (10%-13%) and atrial fibrillation (18%-30%). Atheromatous plaques are composed of a lipid pool, a fibrous cap, smooth muscle cells, and mononuclear cell infiltration with calcification...
January 2016: American Journal of Therapeutics
Ankur Sethi, Anurag Bajaj, Gurveen Malhotra, Rohit R Arora, Sandeep Khosla
BACKGROUND: Recently, high-sensitive troponin (hsTrop) assays consistent with professional societies' recommendations became available. We aimed to summarize the evidence on the diagnostic accuracy of hsTrop on presentation. METHODS: We searched electronic databases for studies evaluating the diagnostic accuracy of hsTrop in suspected acute coronary syndrome (ACS) patients. Random effect meta-analyses and meta-regression were performed. Primary and secondary analyses were restricted to studies using conventional Trop and hsTrop in the reference standard, respectively...
2014: Vascular Health and Risk Management
Ankur Sethi, Anurag Bajaj, Sandeep Khosla, Rohit R Arora
During last 2 decades, multiple studies have evaluated omega-3 polyunsaturated fatty acids (ω-3 PUFA) supplementation for cardiovascular prevention. The benefit found in previous studies was not demonstrated in more contemporary trials. We aimed to investigate effect of study characteristics, particularly concomitant statin therapy on results of randomized controlled trials. We systematically searched electronic databases for randomized controlled trials evaluating ω-3 PUFA supplementation and reporting clinical outcomes...
May 2016: American Journal of Therapeutics
Tejaskumar Shah, Mukesh Singh, Rohit Bhuriya, Daniela Kovacs, Sandeep Khosla
We report a rare clinical scenario of chronic mesenteric ischemia (CMI) patient with obstruction of all the three major gut vessels including celiac, superior mesenteric artery (SMA), and inferior mesenteric artery (IMA) with a sole artery supplying the collaterals through marginal artery of left colon (the "wandering artery of Drummond"). A 70-year-old man was presented to hospital with acute onset of dyspnea, diaphoresis, severe epigastric pain, nausea, and vomiting that started after lunch. Initially, patient was diagnosed and treated for non-ST elevation myocardial infarction (NSTEMI)...
December 2013: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
Hemang B Panchal, Tejaskumar Shah, Parthavkumar Patel, Kais Albalbissi, Janos Molnar, Brandon Coffey, Sandeep Khosla, Vijay Ramu
BACKGROUND: The recent literature has shown that triple antiplatelet therapy with cilostazol in addition to the standard dual antiplatelet therapy with aspirin and clopidogrel may reduce platelet reactivity and improve clinical outcomes following percutaneous coronary intervention. The purpose of this meta-analysis is to compare the efficacy of triple antiplatelet therapy and dual antiplatelet therapy in regard to on-treatment platelet reactivity. METHODS: Nine studies (n = 2179) comparing on-treatment platelet reactivity between dual antiplatelet therapy (n = 1193) and triple antiplatelet therapy (n = 986) in patients undergoing percutaneous coronary intervention were included...
November 2013: Journal of Cardiovascular Pharmacology and Therapeutics
Mukesh Singh, Param Singh, Puneet Grewal, Daniela Kovacs, Janos Molnar, Rohit Arora, Sandeep Khosla
Percutaneous coronary intervention (PCI) is a standard of care in the management of coronary artery disease in patients with renal insufficiency (RI). However, outcomes of PCI in these patients remain suboptimal with high cardiovascular morbidity and mortality. The studies comparing target vessel revascularization (TVR) after PCI in patients with mild and moderate RI have shown conflicting results. Hence, a meta-analysis of these studies comparing 30-day and 1-year outcomes after PCI was performed. A systematic review of literature revealed 5 studies involving 16,262 patients...
May 2014: American Journal of Therapeutics
Ankur Sethi, Amol Bahekar, Rohit Bhuriya, Anurag Bajaj, Daniela Kovacs, Aziz Ahmed, Sandeep Khosla
BACKGROUND: Drug-eluting stents (DES) are associated with a decreased frequency of repeat revascularization compared with bare metal stents (BMS) in patients with coronary artery disease; however, uncertainty over their long-term safety, especially in high-risk patients, such as those with ST elevation myocardial infarction (STEMI), persists. OBJECTIVE: To evaluate the safety and efficacy of DES compared with BMS in STEMI patients at a follow-up of three years or longer...
2012: Experimental and Clinical Cardiology
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