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| 1 | Diabetic cardiomyopathy:Pathophysiology,diagnostic evaluation and management显示文摘Diabetes affects every organ in the body and cardiovascular disease accounts for two-thirds of the mortality in the diabetic population.Diabetes-related heart disease occurs in the form of coronary artery disease(CAD),cardiac autonomic neuropathy or diabetic cardiomyopathy(DbCM).The prevalence of cardiac failure is high in the diabetic population and DbCM is a common but underestimated cause of heart failure in diabetes.The pathogenesis of diabetic cardiomyopathy is yet to be clearly defined.Hyperglycemia,dyslipidemia and inflammation are thought to play key roles in the generation of reactive oxygen or nitrogen species which are in turn implicated.The myocardial interstitium undergoes alterations resulting in abnormal contractile function noted in DbCM.In the early stages of the disease diastolic dysfunction is the only abnormality,but systolic dysfunction supervenes in the later stages with impaired left ventricular ejection fraction.Transmitral Doppler echocardiography is usually used to assess diastolic dysfunction,but tissue Doppler Imaging and Cardiac Magnetic Resonance Imaging are being increasingly used recently for early detection of DbCM.The management of DbCM involves improvement in lifestyle,control of glucose and lipid abnormalities,and treatment of hypertension and CAD,if present.The role of vasoactive drugs and antioxidants is being explored.This review discusses the pathophysiology,diagnostic evaluation and management options of DbCM. | Joseph M Pappachan George I Varughese Rajagopalan Sriraman Ganesan Arunagirinathan | 2013 | World Journal of Diabetes2013，4，5： | 57 |
| 2 | Diabetes mellitus and stroke: A clinical update显示文摘Cardiovascular disease including stroke is a major complication that tremendously increases the morbidity and mortality in patients with diabetes mellitus(DM). DM poses about four times higher risk for stroke. Cardiometabolic risk factors including obesity, hypertension, and dyslipidaemia often co-exist in patients with DM that add on to stroke risk. Because of the strong association between DM and other stroke risk factors, physicians and diabetologists managing patients should have thorough understanding of these risk factors and management. This review is an evidence-based approach to the epidemiological aspects, pathophysiology, diagnostic work up and management algorithms for patients with diabetes and stroke. | Nyo Nyo Tun Ganesan Arunagirinathan Sunil K Munshi Joseph M Pappachan | 2017 | World Journal of Diabetes2017，8，6： | 15 |
| 3 | Gastrointestinal complications of diabetes mellitus显示文摘Diabetes mellitus affects virtually every organ system in the body and the degree of organ involvement depends on the duration and severity of the disease,and other co-morbidities.Gastrointestinal(GI) involvement can present with esophageal dysmotility,gastro-esophageal reflux disease(GERD),gastroparesis,enteropathy,non alcoholic fatty liver disease(NAFLD) and glycogenic hepatopathy.Severity of GERD is inversely related to glycemic control and management is with prokinetics and proton pump inhibitors.Diabetic gastroparesis manifests as early satiety,bloating,vomiting,abdominal pain and erratic glycemic control.Gastric emptying scintigraphy is considered the gold standard test for diagnosis.Management includes dietary modifications,maintaining euglycemia,prokinetics,endoscopic and surgical treatments.Diabetic enteropathy is also common and management involves glycemic control and symptomatic measures.NAFLD is considered a hepatic manifestation of metabolic syndrome and treatment ismainly lifestyle measures,with diabetes and dyslipidemia management when coexistent.Glycogenic hepatopathy is a manifestation of poorly controlled type 1 diabetes and is managed by prompt insulin treatment.Though GI complications of diabetes are relatively common,awareness about its manifestations and treatment options are low among physicians.Optimal management of GI complications is important for appropriate metabolic control of diabetes and improvement in quality of life of the patient.This review is an update on the GI complications of diabetes,their pathophysiology,diagnostic evaluation and management. | Babu Krishnan Shithu Babu Jessica Walker Adrian B Walker Joseph M Pappachan | 2013 | World Journal of Diabetes2013，4，3： | 10 |
| 4 | Diabetic heart disease:A clinical update显示文摘Diabetes mellitus(DM) significantly increases the risk of heart disease,and DMrelated healthcare expenditure is predominantly for the management of cardiovascular complications.Diabetic heart disease is a conglomeration of coronary artery disease(CAD),cardiac autonomic neuropathy(CAN),and diabetic cardiomyopathy(DCM).The Framingham study clearly showed a 2 to 4-fold excess risk of CAD in patients with DM.Pathogenic mechanisms,clinical presentation,and management options for DM-associated CAD are somewhat different from CAD among nondiabetics.Higher prevalence at a lower age and more aggressive disease in DM-associated CAD make diabetic individuals more vulnerable to premature death.Although common among diabetic individuals,CAN and DCM are often under-recognised and undiagnosed cardiac complications.Structural and functional alterations in the myocardial innervation related to uncontrolled diabetes result in damage to cardiac autonomic nerves,causing CAN.Similarly,damage to the cardiomyocytes from complex pathophysiological processes of uncontrolled DM results in DCM,a form of cardiomyopathy diagnosed in the absence of other causes for structural heart disease.Though optimal management of DM from early stages of the disease can reduce the risk of diabetic heart disease,it is often impractical in the real world due to many reasons.Therefore,it is imperative for every clinician involved in diabetes care to have a good understanding of the pathophysiology,clinical picture,diagnostic methods,and management of diabetes-related cardiac illness,to reduce morbidity and mortality among patients.This clinical review is to empower the global scientific fraternity with up-to-date knowledge on diabetic heart disease. | Jake Rajbhandari Cornelius James Fernandez Mayuri Agarwal Beverly Xin Yi Yeap Joseph M Pappachan | 2021 | World Journal of Diabetes2021，12，4： | 8 |
| 5 | Osteoclast precursor differentiation by MCPIP via oxidative stress,endoplasmic reticulum stress,and autophagy显示文摘Osteoclasts(OCs)are responsible for bone resorption in inflammatory joint diseases.Monocyte chemotactic protein-1(MCP-1)has been shown to induce differentiation of monocytes to OC precursors,but nothing is known about the underlying mechanisms.Here,we elucidate how MCPIP,induced by MCP-1,mediates this differentiation.Knockdown of MCPIP abolished MCP-1-mediated expression of OC markers,tartrate-resistant acid phosphatase,and serine protease cathepsin K.Expression of MCPIP induced p47PHOX and its membrane translocation,reactive oxygen species formation,and induction of endoplasmic reticulum(ER)stress chaperones,up-regulation of autophagy marker,Beclin-1,and lipidation of LC3,and induction of OC markers.Inhibition of oxidative stress attenuated ER stress and autophagy,and suppressed expression of OC markers.Inhibition of ER stress by a specific inhibitor or by knockdown of IRE1 blocked autophagy and induction of OC markers.ER stress inducers,tunicamycin and thapsigargin,induced expression of OC markers.Autophagy inhibition by 3′-methyladenine,LY294002,wortmannin or by knockdown of Beclin-1 or Atg 7 inhibited MCPIP-induced expression of OC markers.These results strongly suggest that MCP-1-induced differentiation of OC precursor cells is mediated via MCPIP-induced oxidative stress that causes ER stress leading to autophagy,revealing a novel mechanistic insight into the role of MCP-1 in OCs differentiation. | Kangkai Wang Jianli Niu Hyunbae Kim Pappachan E.Kolattukudy | 2011 | Journal of Molecular Cell Biology2011，3，6： | 6 |
| 6 | Incretin manipulation in diabetes management显示文摘Incretin-based therapies have revolutionized the medical management of type 2 diabetes mellitus(T2DM) in the 21 st century. Glucagon-like peptide-1(GLP-1) suppresses appetite and gastric motility, and has trophic effects on pancreas, cardio-protective and renal effects. GLP-1 analogues and dipeptidyl peptidase-4 inhibitors form the incretin-based therapies. Significant reduction of hemoglobin A1 c when used as monotherapy and in combination regimens, favorable effects on body weight, and low risk of hypoglycemia are their unique therapeutic benefits. Their safety and tolerability are comparable to other anti-diabetic medications. Concern about elevated risk of pancreatitis has been discarded by two recent meta-analyses. This article discusses the therapeutic manipulation of incretin system for the management of T2 DM. | Joseph M Pappachan AV Raveendran Rajagopalan Sriraman | 2015 | World Journal of Diabetes2015，6，6： | 6 |
| 7 | Metabolic complications of hepatitis C virus infection显示文摘Hepatitis C virus(HCV) infection is a systemic disease that is implicated in multiple extrahepatic organ dysfunction contributing to its protean manifestations. HCV is associated with diverse extrahepatic disorders including atherosclerosis, glucose and lipid metabolic disturbances, alterations in the iron metabolic pathways, and lymphoproliferative diseases over and above the traditional liver manifestations of cirrhosis and hepatocellular carcinoma. The orchestration between HCV major proteins and the liver-muscle-adipose axis, poses a major burden on the global health of human body organs, if not adequately addressed. The close and inseparable associations between chronic HCV infection, metabolic disease, and cardiovascular disorders are specifically important considering the increasing prevalence of obesity and metabolic syndrome, and their economic burden to patients, the healthcare systems, and society. Cellular and molecular mechanisms governing the interplay of these organs and tissues in health and disease are therefore of significant interest. The coexistence of metabolic disorders and chronic hepatitis C infection also enhances the progression to liver fibrosis and hepatocellular carcinoma. The presence of metabolic disorders is believed to influence the chronicity and virulence of HCV leading to liver disease progression. This comprehensive review highlights current knowledge on the metabolic manifestations of hepatitis C and the potential pathways in which these metabolic changes can influence the natural history of the disease. | Rahul Chaudhari Sherouk Fouda Ashik Sainu Joseph M Pappachan | 2021 | World Journal of Gastroenterology2021，27，13： | 3 |
| 8 | Inflammation, Endoplasmic Reticulum Stress, Autophagy, and the Monocyte Chemoattractant Protein-1/CCR2 Pathway显示文摘 | Pappachan E. Kolattukudy Jianli Niu | 2012 | Circulation Research2012，，1： | 3 |
| 9 | Hemoglobin A1c in early postpartum screening of women with gestational diabetes显示文摘AIM:To assess the utility of hemoglobin A1c(HbA1c) in the early postpartum screening of women with gestational diabetes mellitus(GDM).METHODS:Over a 3 years period,HbA1c estimations were undertaken in addition to and simultaneously with the traditional oral glucose tolerance test(OGTT),in 203 women with GDM as a part of early postpartum screening for dysglycaemia,at 6 wk post-partum.World Health Organization criteria was used for diagnosing diabetes:fasting blood glucose(FBG) ≥ 7.0 mmol/Land/or 2-h postprandial blood glucose(PPBG) ≥ 11.1 mmol/L and/or HbA1c ≥ 48 mmol/mol;and impaired glycaemiastate:impaired fasting glucose 6.1-6.9 mmol/L and/or impaired glucose tolerance 7.8-11.0 mmol/L and/or HbA1c:42-47 mmol/mol.RESULTS:Mean FBG,2-h PPBG and HbA1c were 4.9 ± 0.7 mmol/L,5.6 ± 2.0 mmol/L and 38 ± 5 mmol/mol respectively.FBG,2-h PPBG and HbA1c detected 6(3%),7(3.5%) and 11(5.4%) cases of diabetes respectively,and 11(5.4%),25(12.3%) and 23(11.3%) cases of pre-diabetes state respectively.HbA1c values ≥ 48 mmol/mol(≥ 6.5%) showed a diagnostic sensitivity of 71.4% and specificity of 98.5% for diabetes in comparison to OGTT in receiver operating characteristics curve analysis.At HbA1c cut-off 44 mmol/mol,sensitivity and specificity were 100% and 92.3% respectively [area under the curve:0.98(95%CI:0.96-1.00)].Sensitivity and specificity for detecting high risk 'impaired glycaemia' state [HbA1c 42 mmol/mol(6.0%)] were 28% and 80%,respectively.CONCLUSION:HbA1c level ≥ 48 mmol/mol(≥ 6.5%) has reasonable sensitivity and high specificity in comparison to OGTT for early postpartum screening of diabetes in GDM.At 6 th week postpartum screening,if FBG is normal and HbA1c < 44 mmol/mol OGTT is not recommended. | Mahesh V Katreddy Joseph M Pappachan Sarah E Taylor Radha Indusekhar Ananth U Nayak Alan M Nevill | 2013 | World Journal of Diabetes2013，4，3： | 2 |
| 10 | Epidemiological link between obesity,type 2 diabetes mellitus and cancer显示文摘There exists a complex interaction between obesity,type 2 diabetes mellitus(T2DM)and cancer,and an increase in the incidence of cancer is expected with the growing obesity-diabetes pandemic.The association of cancer with diabetes mellitus and obesity appears to be site-specific,the highest risk being for postmenopausal breast cancer,endometrial cancer,and colorectal cancer.Moreover,there is worsening of hyperglycaemia with the onset of cancer,evidencing a bidirectional link between cancer and diabetes mellitus and the need for monitoring for diabetes in cancer survivors.In this review,we look at the epidemiological evidence from observational studies and Mendelian randomization studies linking obesity,diabetes,and cancer,as well as the complex pathophysiological mechanisms involved,including insulin resistance with associated hyperinsulinaemia,the effect of chronic low-grade inflammation,and the effect of various adipokines that are associated with obesity and T2DM.Additionally,we describe the novel therapeutic strategies,based on their role on the discrete pathophysiological mechanisms involved in the tumourigenesis. | Cornelius J Fernandez Annu Susan George Nikhila A Subrahmanyan Joseph M Pappachan | 2021 | World Journal of Methodology2021，11，3： | 2 |
| 11 | Discrepancies in the clinical and radiological profiles of COVID-19:A case-based discussion and review of literature显示文摘The current gold standard for the diagnosis of coronavirus disease-19(COVID-19)is a positive reverse transcriptase polymerase chain reaction(RT-PCR)test,on the background of clinical suspicion.However,RT-PCR has its limitations;this includes issues of low sensitivity,sampling errors and appropriate timing of specimen collection.As pulmonary involvement is the most common manifestation of severe COVID-19,early and appropriate lung imaging is important to aid diagnosis.However,gross discrepancies can occur between the clinical and imaging findings in patients with COVID-19,which can mislead clinicians in their decision making.Although chest X-ray(CXR)has a low sensitivity for the diagnosis of COVID-19 associated lung disease,especially in the earlier stages,a positive CXR increases the pre-test probability of COVID-19.CXR scoring systems have shown to be useful,such as the COVID-19 opacification rating score which helps to predict the need of tracheal intubation.Furthermore,artificial intelligence-based algorithms have also shown promise in differentiating COVID-19 pneumonia on CXR from other lung diseases.Although costlier than CXR,unenhanced computed tomographic(CT)chest scans have a higher sensitivity,but lesser specificity compared to RT-PCR for the diagnosis of COVID-19 pneumonia.A semi-quantitative CT scoring system has been shown to predict short-term mortality.The routine use of CT pulmonary angiography as a first-line imaging modality in patients with suspected COVID-19 is not justifiable due to the risk of contrast nephropathy.Scoring systems similar to those pioneered in CXR and CT can be used to effectively plan and manage hospital resources such as ventilators.Lung ultrasound is useful in the assessment of critically ill COVID-19 patients in the hands of an experienced operator.Moreover,it is a convenient tool to monitor disease progression,as it is cheap,non-invasive,easily accessible and easy to sterilise.Newer lung imaging modalities such as magnetic resonance imaging(MRI)for safe imaging among children,adolescents and pregnant women are rapidly evolving.Imaging modalities are also essential for evaluating the extra-pulmonary manifestations of COVID-19:these include cranial imaging with CT or MRI;cardiac imaging with ultrasonography(US),CT and MRI;and abdominal imaging with US or CT.This review critically analyses the utility of each imaging modality to empower clinicians to use them appropriately in the management of patients with COVID-19 infection. | Hemant Kumar Cornelius James Fernandez Sangeetha Kolpattil Mohamed Munavvar Joseph M Pappachan | 2021 | World Journal of Radiology2021，13，4： | 2 |
| 12 | Application of bilateral pedicled buccal fat pad in wide primary cleft palate 显示文摘 | Pappachan B Vasant R | 2008 | Br J Oral Maxillofac Surg2008，46，4： | 1 |
| 13 | Monocyte Chemoattractant Protein-1 Induces a Novel Transcription Factor That Causes Cardiac Myocyte Apoptosis and Ventricular Dysfunction显示文摘 | Limei Zhou Asim Azfer Jianli Niu Sarabeth Graham Mahua Choudhury Frances M. Adamski Craig Younce Phillip F. Binkley Pappachan E. Kolattukudy | 2006 | Circulation Research2006，，9： | 1 |
| 14 | Boron-lined proportional counters with improved neutron sensitivity显示文摘 | P.M. Dighe D.N. Prasad K.R. Prasad S.K. Kataria S.N. Athavale A.L. Pappachan A.K. Grover | 2002 | Nuclear Inst and Methods in Physics Research A2002，，1： | 1 |
| 15 | Microalbumin- uriain patients with essential hypertension and its rela- tionship to target organdamage :an Indian experience 显示文摘 | Hitha B Pappachan JM Pillai HB | 2012 | Saudi J Kidney Dis Transpl2012，19，3： | 1 |
| 16 | Global epidemiology of pediatric severe sepsis: the sepsis prevalence, outcomes, and therapies study显示文摘 | Weiss SL Fitzgerald JC Pappachan J | 2015 | Am J Respir Crit Care Med2015，191，10： | 1 |
| 17 | Omega-3fatty acids : A comprehensive review of their role in health anddisease 显示文摘 | Yashodhara B M Umakanth S Pappachan J | 2009 | Postgraduate Medical Journal2009，85，： | 1 |
| 18 | Diabetes and cognitive function:An evidence-based current perspective显示文摘Several epidemiological studies have clearly identified diabetes mellitus(DM)as a major risk factor for cognitive dysfunction,and it is going to be a major public health issue in the coming years because of the alarming rise in diabetes prevalence across the world.Brain and neural tissues predominantly depend on glucose as energy substrate and hence,any alterations in carbohydrate metabolism can directly impact on cerebral functional output including cognition,executive capacity,and memory.DM affects neuronal function and mental capacity in several ways,some of which include hypoperfusion of the brain tissues from cerebrovascular disease,diabetes-related alterations of glucose transporters causing abnormalities in neuronal glucose uptake and metabolism,local hyper-and hypometabolism of brain areas from insulin resistance,and recurrent hypoglycemic episodes inherent to pharmacotherapy of diabetes resulting in neuronal damage.Cognitive decline can further worsen diabetes care as DM is a disease largely self-managed by patients.Therefore,it is crucial to understand the pathobiology of cognitive dysfunction in relation to DM and its management for optimal long-term care plan for patients.A thorough appraisal of normal metabolic characteristics of the brain,how alterations in neural metabolism affects cognition,the diagnostic algorithm for patients with diabetes and dementia,and the management and prognosis of patients when they have this dangerous combination of illnesses is imperative in this context.This evidence-based narrative with the backup of latest clinical trial reviews elaborates the current understanding on diabetes and cognitive function to empower physicians to manage their patients in day-to-day clinical practice. | Meghna Julian Sebastian Shahanas KA Khan Joseph M Pappachan Mohammad Sadiq Jeeyavudeen | 2023 | World Journal of Diabetes2023，14，2： | 1 |
| 19 | Microalbuminuria in patients with essential hypertension and its relationship to target organ damage: an Indian experience显示文摘 | Hitha B Pappachan JM Pillai HB | 2008 | Saudi J Kidney Dis Transpl2008，19，3： | 1 |
| 20 | Metabolic surgery: A paradigm shift in type 2 diabetes management显示文摘Obesity and type 2 diabetes mellitus(T2DM) are major public health issues globally over the past few decades. Despite dietary interventions, lifestyle modifications and the availability of several pharmaceutical agents, management of T2 DM with obesity is a major challenge to clinicians. Metabolic surgery is emerging as a promising treatment option for the management of T2 DM in the obese population in recent years. Several observational studies and a few randomised controlled trials have shown clear benefits of various bariatric procedures in obese individuals in terms of improvement or remission of T2 DM and multiple other health benefits such as improvement of hypertension, obstructive sleep apnoea, osteoarthritis and non-alcoholic fatty liver disease. Uncertainties about the long-term implications of metabolic surgery such as relapse of T2 DM after initial remission, nutritional and psychosocial complications and the optimal body mass index for different ethnic groups exist. The article discusses the major paradigm shift in recent years in the management of T2 DM after the introduction of metabolic surgery. | Joseph M Pappachan Ananth K Viswanath | 2015 | World Journal of Diabetes2015，6，8： | 1 |
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