Journal of Complementary and Integrative Medicine, 2016
: Polyherbalism, an alternative natural-based therapy for various disorders, has been quoted abou... more : Polyherbalism, an alternative natural-based therapy for various disorders, has been quoted about 1,300 years before in Sharangdhar Samhita. Herbal-based combination therapy stages a vital role for the treatment of type 2 diabetes mellitus (T2DM) and associated complications. The present study aims at developing an Ayurvedic-based polyherbal formulation (ADPHF6) and the assessing its antidiabetic and antioxidant property.: ADPHF6 polyherbal formulation was measured for phytochemical components by qualitative methods. The polyherbal formulation was quantitatively estimated for its phytochemical constituents, i.: ADPHF6 polyherbal formulation revealed the presence of phytochemical constituents such as alkaloids, flavonoids, phenols, tannins, terpenoids, saponins and cardiac glycosides in significant levels. Further, it also measured the higher levels of total phenols (473.3±3.05 mg/g) and flavonoid (664±5.29 mg/g) content. Polyherbal formulation also exhibited IC: Our present study demonstrates that ADPHF6 offers potent inhibitory activity against free radicals as well as digestive enzymes. However, studies should be conducted using
Plasminogen activator inhibitor-1 (PAI-1) and two-chain high molecular weight kininogen (HKa) exe... more Plasminogen activator inhibitor-1 (PAI-1) and two-chain high molecular weight kininogen (HKa) exert anti-adhesive properties in vitronectin-dependent cell adhesion. Here, the hypothesis was tested that these anti-adhesive components promote apoptosis in vascular cells. PAI-1 or HKa induced a 2- to 3-fold increase in apoptosis of human umbilical-vein endothelial cells (HUVEC) and vascular smooth muscle cells (VSMC) adherent to vitronectin, as determined by annexin V-FACS assay, similar to alphav-integrin inhibitor cyclo-(Arg-Gly-Asp-D-Phe-Val)-peptide (cRGDfV). Apoptosis occurred after 12 h incubation and was attributable to caspase 3 activation that in turn induced DNA fragmentation. Induction of apoptosis strongly correlated with the anti-adhesive effect of PAI-1 and HKa on these cells. In contrast, PAI-1 and HKa did not affect fibronectin-dependent adhesion or cell survival. uPA did not influence apoptosis in vitronectin- or fibronectin-adherent cells. In atherosclerotic vessel sections, congruent distribution of vitronectin, PAI-1, HK, and of components of the urokinase plasminogen activator/receptor system with apoptotic cells lining foam cell lesions was demonstrated by immunostaining. These results indicate that inhibition of vitronectin-dependent cell adhesion through PAI-1 and HKa correlates with apoptosis induction in vascular cells mediated through the caspase 3 pathway. Co-distribution of apoptosis with plasminogen activation system components in atherosclerosis exemplifies the significance of anti-adhesive mechanisms and apoptosis for tissue remodeling, such as in neointima development.
Although iatrogenic ischemic complications due to occlusion of the circumflex coronary artery fol... more Although iatrogenic ischemic complications due to occlusion of the circumflex coronary artery following mitral ring annuloplasty are rare, they may be fatal if not recognized and treated promptly. The study aim was to assess the implantation safety of a novel biodegradable intra-annular mitral valvuloplasty ring in ex-vivo cadaveric human hearts. Ten fresh-frozen human cadaveric hearts were washed, and filled with surgical gauze in order to mimic the heart's anatomic shape and position. Following left atriotomy, the biodegradable annuloplasty ring was implanted using the intra-annular implantation technique. Pre- and post-implantation coronary angiography was used to evaluate the dominance of the coronary circulation, and to assess coronary patency. The coronary arteries and veins were then filled with red and green latex solutions respectively, after which the hearts were fixed in 4% formaldehyde for four weeks. The distances between the annuloplasty ring, the coronary arteries...
Journal of Traditional and Complementary Medicine, 2015
There has recently been much advancement in the diagnosis, treatment, and research of metabolic d... more There has recently been much advancement in the diagnosis, treatment, and research of metabolic disorders, especially diabetes. Current research around the world is focused on finding an alternative source of treatment from natural resources for diabetic management, apart from the available synthetic medicines. The present study is a preliminary study of a polyherbal formulation using edible natural resources and an assessment of its antidiabetic activity. The formulation was screened for its phytochemical constituents, total phenols, flavonoids, and vitamin C content. It was also analyzed for its inhibitory effect against the digestive enzymes α-amylase and α-glucosidase, compared with the standard drug acarbose. The formulation showed the presence of major constituents such as steroids, cardiac glycosides, phenols, flavonoids, and saponins. It also had a high level of phenols (340 ± 2.5 mg/g), flavonoids (235.4 ± 8.3 mg/g), and vitamin C (470.8 ± 16.6 mg/g), and showed a half-maximal inhibitory concentration (IC50) value of 0.41 ± 0.03 mg/mL and 0.51 ± 0.01 mg/mL for amylase and glucosidase, respectively. The results showed that ADJ6 had a significant inhibitory activity on α-amylase and α-glucosidase; however, its inhibitory activity was less than that of acarbose. The plants that are formulated in ADJ6 possess potent antidiabetic activity. Thus, we found that ADJ6 is a potent lead for effective diabetic management; however, an evaluation of the formulation must be illustrated using an in vivo model.
Multimedia manual of cardiothoracic surgery : MMCTS / European Association for Cardio-Thoracic Surgery, 2012
The final step in mitral valve repair is usually the implantation of an annuloplasty ring which r... more The final step in mitral valve repair is usually the implantation of an annuloplasty ring which remodels the dilated annulus and improves the long-term durability of repair. Conventional annuloplasty rings remain as a permanent foreign body on the atrio-ventricular annulus, thus presenting an increased risk for thromboembolic complications. Furthermore, currently available conventional rings are adapted for the adult population, with no annuloplasty ring specifically developed for the paediatric population. A new intra-annular ring that undergoes gradual degradation by hydrolysis has been developed for use both in adults and in children. The resultant inflammatory reaction induces fibrosis, thereby remodelling the posterior mitral annulus. Contrary to the conventional rings that are implanted 'onto' the annulus, the intra-annular ring is implanted 'into' the annulus, and hence prevents direct contact with the circulating blood, thereby reducing the risk of thrombo-em...
World journal for pediatric & congenital heart surgery, 2014
Little data are available in late-presenting children with unobstructed totally anomalous pulmona... more Little data are available in late-presenting children with unobstructed totally anomalous pulmonary venous connection. Eleven patients underwent repair at a median age of 6.5 months using a modified transseptal approach to improve access and avoid circulatory arrest. There were no early or late deaths, and none of the patients presented pulmonary venous stenosis at a median follow-up of 8.7 years.
Texas Heart Institute journal / from the Texas Heart Institute of St. Luke's Episcopal Hospital, Texas Children's Hospital, 2012
Structural degeneration is an important long-term disadvantage of biologic prostheses. However, e... more Structural degeneration is an important long-term disadvantage of biologic prostheses. However, early failure of these prostheses is uncommon and is usually caused by rapid calcification. We report the successful management of a rare case of early failure of a stentless aortic bioprosthesis (within 4 months of implantation). The patient presented with severe noncalcific aortic regurgitation secondary to prolapse of the noncoronary leaflet. In consideration of the acute nature of failure in this new-generation bioprosthesis and its unclear cause, we believe that this report, albeit of a single case, warrants some attention.
Although iatrogenic ischemic complications due to occlusion of the circumflex coronary artery fol... more Although iatrogenic ischemic complications due to occlusion of the circumflex coronary artery following mitral ring annuloplasty are rare, they may be fatal if not recognized and treated promptly. The study aim was to assess the implantation safety of a novel biodegradable intra-annular mitral valvuloplasty ring in ex-vivo cadaveric human hearts. Ten fresh-frozen human cadaveric hearts were washed, and filled with surgical gauze in order to mimic the heart's anatomic shape and position. Following left atriotomy, the biodegradable annuloplasty ring was implanted using the intra-annular implantation technique. Pre- and post-implantation coronary angiography was used to evaluate the dominance of the coronary circulation, and to assess coronary patency. The coronary arteries and veins were then filled with red and green latex solutions respectively, after which the hearts were fixed in 4% formaldehyde for four weeks. The distances between the annuloplasty ring, the coronary arteries...
In sickle cell disease, cardiopulmonary bypass may induce red cell sickling. Partial exchange tra... more In sickle cell disease, cardiopulmonary bypass may induce red cell sickling. Partial exchange transfusion reduces the circulating haemoglobin S level. We report the management of a child with sickle cell disease who required surgical closure of a ventricular septal defect. Preoperative exchange transfusion of 50% of the total blood volume was performed with fresh packed red cells over three days. Further exchange transfusion was performed as cardiopulmonary bypass commenced. The haemoglobin S level was reduced from 76% to 37%. The blood removed from the patient during the exchanges was processed allowing storage and re-infusion of the patient's plasma and platelets. Combined preoperative and intraoperative exchange transfusions, instead of a single stage 50% volume exchange, was effective and potentially avoids larger haemodynamic effects. Cardiopulmonary bypass was conducted at normothermia and cold cardioplegia was avoided (fibrillatory arrest was used during the surgical repa...
Journal of Complementary and Integrative Medicine, 2016
: Polyherbalism, an alternative natural-based therapy for various disorders, has been quoted abou... more : Polyherbalism, an alternative natural-based therapy for various disorders, has been quoted about 1,300 years before in Sharangdhar Samhita. Herbal-based combination therapy stages a vital role for the treatment of type 2 diabetes mellitus (T2DM) and associated complications. The present study aims at developing an Ayurvedic-based polyherbal formulation (ADPHF6) and the assessing its antidiabetic and antioxidant property.: ADPHF6 polyherbal formulation was measured for phytochemical components by qualitative methods. The polyherbal formulation was quantitatively estimated for its phytochemical constituents, i.: ADPHF6 polyherbal formulation revealed the presence of phytochemical constituents such as alkaloids, flavonoids, phenols, tannins, terpenoids, saponins and cardiac glycosides in significant levels. Further, it also measured the higher levels of total phenols (473.3±3.05 mg/g) and flavonoid (664±5.29 mg/g) content. Polyherbal formulation also exhibited IC: Our present study demonstrates that ADPHF6 offers potent inhibitory activity against free radicals as well as digestive enzymes. However, studies should be conducted using
Plasminogen activator inhibitor-1 (PAI-1) and two-chain high molecular weight kininogen (HKa) exe... more Plasminogen activator inhibitor-1 (PAI-1) and two-chain high molecular weight kininogen (HKa) exert anti-adhesive properties in vitronectin-dependent cell adhesion. Here, the hypothesis was tested that these anti-adhesive components promote apoptosis in vascular cells. PAI-1 or HKa induced a 2- to 3-fold increase in apoptosis of human umbilical-vein endothelial cells (HUVEC) and vascular smooth muscle cells (VSMC) adherent to vitronectin, as determined by annexin V-FACS assay, similar to alphav-integrin inhibitor cyclo-(Arg-Gly-Asp-D-Phe-Val)-peptide (cRGDfV). Apoptosis occurred after 12 h incubation and was attributable to caspase 3 activation that in turn induced DNA fragmentation. Induction of apoptosis strongly correlated with the anti-adhesive effect of PAI-1 and HKa on these cells. In contrast, PAI-1 and HKa did not affect fibronectin-dependent adhesion or cell survival. uPA did not influence apoptosis in vitronectin- or fibronectin-adherent cells. In atherosclerotic vessel sections, congruent distribution of vitronectin, PAI-1, HK, and of components of the urokinase plasminogen activator/receptor system with apoptotic cells lining foam cell lesions was demonstrated by immunostaining. These results indicate that inhibition of vitronectin-dependent cell adhesion through PAI-1 and HKa correlates with apoptosis induction in vascular cells mediated through the caspase 3 pathway. Co-distribution of apoptosis with plasminogen activation system components in atherosclerosis exemplifies the significance of anti-adhesive mechanisms and apoptosis for tissue remodeling, such as in neointima development.
Although iatrogenic ischemic complications due to occlusion of the circumflex coronary artery fol... more Although iatrogenic ischemic complications due to occlusion of the circumflex coronary artery following mitral ring annuloplasty are rare, they may be fatal if not recognized and treated promptly. The study aim was to assess the implantation safety of a novel biodegradable intra-annular mitral valvuloplasty ring in ex-vivo cadaveric human hearts. Ten fresh-frozen human cadaveric hearts were washed, and filled with surgical gauze in order to mimic the heart's anatomic shape and position. Following left atriotomy, the biodegradable annuloplasty ring was implanted using the intra-annular implantation technique. Pre- and post-implantation coronary angiography was used to evaluate the dominance of the coronary circulation, and to assess coronary patency. The coronary arteries and veins were then filled with red and green latex solutions respectively, after which the hearts were fixed in 4% formaldehyde for four weeks. The distances between the annuloplasty ring, the coronary arteries...
Journal of Traditional and Complementary Medicine, 2015
There has recently been much advancement in the diagnosis, treatment, and research of metabolic d... more There has recently been much advancement in the diagnosis, treatment, and research of metabolic disorders, especially diabetes. Current research around the world is focused on finding an alternative source of treatment from natural resources for diabetic management, apart from the available synthetic medicines. The present study is a preliminary study of a polyherbal formulation using edible natural resources and an assessment of its antidiabetic activity. The formulation was screened for its phytochemical constituents, total phenols, flavonoids, and vitamin C content. It was also analyzed for its inhibitory effect against the digestive enzymes α-amylase and α-glucosidase, compared with the standard drug acarbose. The formulation showed the presence of major constituents such as steroids, cardiac glycosides, phenols, flavonoids, and saponins. It also had a high level of phenols (340 ± 2.5 mg/g), flavonoids (235.4 ± 8.3 mg/g), and vitamin C (470.8 ± 16.6 mg/g), and showed a half-maximal inhibitory concentration (IC50) value of 0.41 ± 0.03 mg/mL and 0.51 ± 0.01 mg/mL for amylase and glucosidase, respectively. The results showed that ADJ6 had a significant inhibitory activity on α-amylase and α-glucosidase; however, its inhibitory activity was less than that of acarbose. The plants that are formulated in ADJ6 possess potent antidiabetic activity. Thus, we found that ADJ6 is a potent lead for effective diabetic management; however, an evaluation of the formulation must be illustrated using an in vivo model.
Multimedia manual of cardiothoracic surgery : MMCTS / European Association for Cardio-Thoracic Surgery, 2012
The final step in mitral valve repair is usually the implantation of an annuloplasty ring which r... more The final step in mitral valve repair is usually the implantation of an annuloplasty ring which remodels the dilated annulus and improves the long-term durability of repair. Conventional annuloplasty rings remain as a permanent foreign body on the atrio-ventricular annulus, thus presenting an increased risk for thromboembolic complications. Furthermore, currently available conventional rings are adapted for the adult population, with no annuloplasty ring specifically developed for the paediatric population. A new intra-annular ring that undergoes gradual degradation by hydrolysis has been developed for use both in adults and in children. The resultant inflammatory reaction induces fibrosis, thereby remodelling the posterior mitral annulus. Contrary to the conventional rings that are implanted 'onto' the annulus, the intra-annular ring is implanted 'into' the annulus, and hence prevents direct contact with the circulating blood, thereby reducing the risk of thrombo-em...
World journal for pediatric & congenital heart surgery, 2014
Little data are available in late-presenting children with unobstructed totally anomalous pulmona... more Little data are available in late-presenting children with unobstructed totally anomalous pulmonary venous connection. Eleven patients underwent repair at a median age of 6.5 months using a modified transseptal approach to improve access and avoid circulatory arrest. There were no early or late deaths, and none of the patients presented pulmonary venous stenosis at a median follow-up of 8.7 years.
Texas Heart Institute journal / from the Texas Heart Institute of St. Luke's Episcopal Hospital, Texas Children's Hospital, 2012
Structural degeneration is an important long-term disadvantage of biologic prostheses. However, e... more Structural degeneration is an important long-term disadvantage of biologic prostheses. However, early failure of these prostheses is uncommon and is usually caused by rapid calcification. We report the successful management of a rare case of early failure of a stentless aortic bioprosthesis (within 4 months of implantation). The patient presented with severe noncalcific aortic regurgitation secondary to prolapse of the noncoronary leaflet. In consideration of the acute nature of failure in this new-generation bioprosthesis and its unclear cause, we believe that this report, albeit of a single case, warrants some attention.
Although iatrogenic ischemic complications due to occlusion of the circumflex coronary artery fol... more Although iatrogenic ischemic complications due to occlusion of the circumflex coronary artery following mitral ring annuloplasty are rare, they may be fatal if not recognized and treated promptly. The study aim was to assess the implantation safety of a novel biodegradable intra-annular mitral valvuloplasty ring in ex-vivo cadaveric human hearts. Ten fresh-frozen human cadaveric hearts were washed, and filled with surgical gauze in order to mimic the heart's anatomic shape and position. Following left atriotomy, the biodegradable annuloplasty ring was implanted using the intra-annular implantation technique. Pre- and post-implantation coronary angiography was used to evaluate the dominance of the coronary circulation, and to assess coronary patency. The coronary arteries and veins were then filled with red and green latex solutions respectively, after which the hearts were fixed in 4% formaldehyde for four weeks. The distances between the annuloplasty ring, the coronary arteries...
In sickle cell disease, cardiopulmonary bypass may induce red cell sickling. Partial exchange tra... more In sickle cell disease, cardiopulmonary bypass may induce red cell sickling. Partial exchange transfusion reduces the circulating haemoglobin S level. We report the management of a child with sickle cell disease who required surgical closure of a ventricular septal defect. Preoperative exchange transfusion of 50% of the total blood volume was performed with fresh packed red cells over three days. Further exchange transfusion was performed as cardiopulmonary bypass commenced. The haemoglobin S level was reduced from 76% to 37%. The blood removed from the patient during the exchanges was processed allowing storage and re-infusion of the patient's plasma and platelets. Combined preoperative and intraoperative exchange transfusions, instead of a single stage 50% volume exchange, was effective and potentially avoids larger haemodynamic effects. Cardiopulmonary bypass was conducted at normothermia and cold cardioplegia was avoided (fibrillatory arrest was used during the surgical repa...
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