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| 1 | Histopathological differences utilizing the nonalcoholic fatty liver disease activity score criteria in diabetic(type 2 diabetes mellitus) and non-diabetic patients with nonalcoholic fatty liver disease显示文摘AIM: To study clinical and histopathological features of nonalcoholic fatty liver disease(NAFLD) in patients with and without type 2 diabetes mellitus(T2DM) using updated nonalcoholic steatohepatitis clinical research network(NASH-CRN) grading system.METHODS: We retrospectively analyzed data of 235 patients with biopsy proven NAFLD with and without T2 DM.This database was utilized in the previously published study comparing ethnicity outcomes in NAFLD by the same corresponding author.The pathology database from University of Chicago was utilized for enrolling consecutive patients who met the criteria for NAFLD and their detailed clinical and histopathology findings were obtained for comparison.The relevant clinical profile of patients was collected from the Electronic Medical Records around the time of liver biopsy and the histology was read by a single well-trained histopathologist.The updated criteria for type 2 diabetes have been utilized for analysis.Background data of patients with NASH and NAFLD has been included.The mean differences were compared using χ2 and t-test along with regression analysis to evaluate the predictors of NASH and advanced fibrosis.RESULTS: Patients with NAFLD and T2 DM were significantly older(49.9 vs 43.0,P < 0.01),predominantly female(71.4 vs 56.3,P < 0.02),had higher rate of metabolic syndrome(88.7 vs 36.4,P < 0.01),had significantly higher aspartate transaminase(AST)/alanine transaminase(ALT) ratio(0.94 vs 0.78,P < 0.01) and Fib-4 index(1.65 vs 1.06,P < 0.01) as markers of NASH,showed higher mean NAFLD activity score(3.5 vs 3.0,P = 0.03) and higher mean fibrosis score(1.2 vs 0.52,P < 0.01) compared to patients with NAFLD without T2 DM.Furthermore,advanced fibrosis(32.5 vs 12.0,P < 0.01) and ballooning(27.3 vs 13.3,P < 0.01) was significantly higher among patients with NAFLD and T2 DM compared to patients with NAFLD without T2 DM.On multivariate analysis,T2 DM was independently associated with NASH(OR = 3.27,95%CI: 1.43-7.50,P < 0.01) and advanced fibrosis(OR = 3.45,95%CI: 1.53-7.77,P < 0.01) in all patients with NAFLD.There was a higher rate of T2DM(38.1 vs 19.4,P < 0.01) and cirrhosis(8.3 vs 0.0,P = 0.01) along with significantly higher mean Bilirubin(0.71 vs 0.56,P = 0.01) and AST(54.2 vs 38.3,P < 0.01) and ALT(78.7 vs 57.0,P = 0.01) level among patients with NASH when compared to patients with steatosis alone.The mean platelet count(247 vs 283,P < 0.01) and high-density lipoprotein cholesterol level(42.7 vs 48.1,P = 0.01) was lower among patients with NASH compared to patients with steatosis.CONCLUSION: Patients with NAFLD and T2 DM tend to have more advanced stages of NAFLD,particularly advanced fibrosis and higher rate of ballooning than patients with NAFLD without T2 DM. | Bharat K Puchakayala Siddharth Verma Pushpjeet Kanwar John Hart Raghavendra R Sanivarapu Smruti R Mohanty | 2015 | World Journal of Hepatology2015，7，25： | 10 |
| 2 | Acute inflammatory demyelinating polyneuropathy associated with pegylated interferon α 2a therapy for chronic hepatitis C virus infection显示文摘The combination of pegylated interferon (Peg-IFN) and ribavirin is the standard of care for chronic hepatitis C virus (HCV) infection treatment. In general, common side effects related to this combination therapy are mild and are very well tolerated. However, peripheral neuropathy including demyelinating polyneuropathy related to Peg-IFN is extremely rare. We present the first case of an acute inflammatory demyelinating polyneuropathy (AIDP) associated with Peg-IFN-α 2a (Pegasys) after 16 wk of a combination therapy with Pegasys and ribavirin in a 65-year-old woman with chronic HCV infection. She developed tingling, numbness, and weakness of her upper and lower extremities and was hospitalized for acute neurological deficits. Her clinical course, neurological findings, an electromyogram (EMG), nerve conductions studies (NCS), muscle biopsy, and a sural nerve biopsy were all consistent with AIDP likely related to Pegasys use. The patient recovered completely with the use of intravenous immunoglobulin (IVIG) including physical therapy and neurological rehabilitation. It is very important that gastroenterologists and/or hepatologists recognize this rare neurological complication related to Peg-IFN treatment very early, since it requires a prompt discontinuation of therapy including an immediate referral to a neurologist for the confirmation of diagnosis, management, and the prevention of long-term neurological deficits. | Vijay Khiani Thomas Kelly Adeel Shibli Donald Jensen Smruti R Mohanty | 2008 | World Journal of Gastroenterology2008，14，2： | 7 |
| 3 | Glycogenic hepatopathy:A narrative review显示文摘Glycogenic hepatopathy(GH) is a rare complication of the poorly controlled diabetes mellitus characterized by the transient liver dysfunction with elevated liver enzymes and associated hepatomegaly caused by the reversible accumulation of excess glycogen in the hepatocytes. It is predominantly seen in patients with longstanding type 1 diabetes mellitus and rarely reported in association with type 2 diabetes mellitus. Although it was first observed in the pediatric population, since then, it has been reported in adolescents and adults with or without ketoacidosis. The association of GH with hyperglycemia in diabetes has not been well established. One of the essential elements in the pathophysiology of development of GH is the wide fluctuation in both glucose and insulin levels. GH and non-alcoholic fatty liver disease(NAFLD) are clinically indistinguishable, and latter is more prevalent in diabetic patients and can progress to advanced liver disease and cirrhosis. Gradient dual-echo MRI can distinguish GH from NAFLD; however, GH can reliably be diagnosed only by liver biopsy. Adequate glycemic control can result in complete remission of clinical, laboratory and histological abnormalities. There has been a recent report of varying degree of liver fibrosis identified in patients with GH. Future studies are required to understand the biochemical defects underlying GH, noninvasive, rapid diagnostic tests for GH, and to assess the consequence of the fibrosis identified as severe fibrosis may progress to cirrhosis. Awareness of this entity in the medical community including specialists is low. Here we briefly reviewed the English literature on pathogenesis involved, recent progress in the evaluation, differential diagnosis, and management. | Jagannath M Sherigar Joline De Castro Yong Mei Yin Debra Guss Smruti R Mohanty | 2018 | World Journal of Hepatology2018，10，2： | 7 |
| 4 | Predictive value of ALT levels for non‐alcoholic steatohepatitis ( NASH ) and advanced fibrosis in non‐alcoholic fatty liver disease ( NAFLD )显示文摘 | Siddharth Verma Donald Jensen John Hart Smruti R. Mohanty | 2013 | Liver Int2013，，9： | 5 |
| 5 | Reactivation of hepatitis B after liver transplantation: Current knowledge, molecular mechanisms and implications in management显示文摘Chronic hepatitis B(CHB) is a major global health problem affecting an estimated 350 million people with more than 786000 individuals dying annually due to complications, such as cirrhosis, liver failure and hepatocellular carcinoma(HCC). Liver transplantation(LT) is considered gold standard for treatment of hepatitis B virus(HBV)-related liver failure and HCC. However, post-transplant viral reactivation can be detrimental to allograft function, leading to poor survival. Prophylaxis with high-dose hepatitis B immunoglobulin(HBIG) and anti-viral drugs have achieved remarkable progress in LT by suppressingviral replication and improving long-term survival. The combination of lamivudine(LAM) plus HBIG has been for many years the most widely used. However, life-long HBIG use is both cumbersome and costly, whereas long-term use of LAM results in resistant virus. Recently, in an effort to develop HBIG-free protocols, high potency nucleos(t)ide analogues, such as Entecavir or Tenofovir, have been tried either as monotherapy or in combination with low-dose HBIG with excellent results. Current focus is on novel antiviral targets, especially for covalently closed circular DNA(ccc DNA), in an effort to eradicate HBV infection instead of viral suppression. However, there are several other molecular mechanisms through which HBV may reactivate and need equal attention. The purpose of this review is to address post-LT HBV reactivation, its risk factors, underlying molecular mechanisms, and recent advancements and future of anti-viral therapy. | Ranjit Chauhan Shilpa Lingala Chiranjeevi Gadiparthi Nivedita Lahiri Smruti R Mohanty Jian Wu Tomasz I Michalak Sanjaya K Satapathy | 2018 | World Journal of Hepatology2018，10，3： | 5 |
| 6 | Nonalcoholic Fatty Liver Disease: A Review and Update显示文摘 | Jeffrey R. Lewis Smruti R. Mohanty | 2010 | Digestive Diseases and Sciences2010，，3： | 4 |
| 7 | Oral microbiota and host innate immune response in bisphosphonate-related osteonecrosis of the jaw显示文摘Bacterial biofilms have emerged as potential critical triggers in the pathogenesis of bisphosphonate(BP)-related osteonecrosis of the jaw(ONJ) or BRONJ. BRONJ lesions have shown to be heavily colonized by oral bacteria, most of these difficult to cultivate and presents many clinical challenges. The purpose of this study was to characterize the bacterial diversity in BRONJ lesions and to determine host immune response. We examined tissue specimens from three cohorts(n530); patients with periodontal disease without a history of BP therapy(Control, n510), patients with periodontal disease having history of BP therapy but without ONJ(BP, n55) and patients with BRONJ(BRONJ, n515). Denaturing gradient gel electrophoresis of polymerase chain reaction(PCR)-amplified 16 S r RNA gene fragments revealed less bacterial diversity in BRONJ than BP and Control cohorts. Sequence analysis detected six phyla with predominant affiliation to Firmicutes in BRONJ(71.6%), BP(70.3%) and Control(59.1%). Significant differences(P,0.05) in genera were observed, between Control/BP, Control/BRONJ and BP/BRONJ cohorts. Enzyme-linked immunosorbent assay(ELISA)results indicated that the levels of myeloperoxidase were significantly lower, whereas interleukin-6 and tumor necrosis factor-alpha levels were moderately elevated in BRONJ patients as compared to Controls. PCR array showed significant changes in BRONJ patients with downregulation of host genes, such as nucleotide-binding oligomerization domain containing protein 2, and cathepsin G, the key modulators for antibacterial response and upregulation of secretory leukocyte protease inhibitor, proteinase 3 and conserved helix–loop–helix ubiquitous kinase. The results suggest that colonization of unique bacterial communities coupled with deficient innate immune response is likely to impact the pathogenesis of ONJ. | Smruti Pushalkar Xin Li Zoya Kurago Lalitha V Ramanathapuram Satoko Matsumura Kenneth E Fleisher Robert Glickman Wenbo Yan Yihong Li Deepak Saxena | 2014 | International Journal of Oral Science2014，6，4： | 4 |
| 8 | Nonalcoholic Fatty Liver Disease: A Review and Update显示文摘 | Jeffrey R. Lewis Smruti R. Mohanty | 2010 | Digestive Diseases and Sciences2010，，3： | 2 |
| 9 | Nonalcoholic Fatty Liver Disease: A Review and Update显示文摘 | Jeffrey R. Lewis Smruti R. Mohanty | 2010 | Digestive Diseases and Sciences2010，，3： | 1 |
| 10 | Primary prophylaxis of gastric variceal bleeding comparing cyanoacrylate injection and beta-blockers: A randomized controlled trial显示文摘 | Smruti Ranjan Mishra Barjesh Chander Sharma Ashish Kumar Shiv Kumar Sarin | 2010 | Journal of Hepatology2010，，6： | 1 |
| 11 | Primary central nervous sys- tem lymphoma: A profile of 26 cases from western India显示文摘 | Agarwal Pankaj Menon Suresh Smruti B | 2009 | Neurology India2009，57，6： | 1 |
| 12 | An empirical comparison study on kernel based support vector machine for classification of gene expression data set 显示文摘 | Smruti Rekha Das Kaberi Das Debahuti Mishra | 2012 | Procedia Engineering2012，38，： | 1 |
| 13 | Prevalence of Helicobacter pylori infection in bariatric patients: a histologic assessment显示文摘 | Siddharth Verma Desh Sharma Pushpjeet Kanwar Won Sohn Smruti R. Mohanty Anthony J. Tortolani Piotr Gorecki | 2012 | Surgery for Obesity and Related Diseases2012，，： | 1 |
| 14 | Sjogren's syndrome in the NOD mouse model is an interleukin-4 time-dependent,antibody isotype-specific autoimmune disease显示文摘 | Juehua G Smruti K Janet G C | 2006 | Journal of Autoimmunity2006，26，8： | 1 |
| 15 | Nonalcoholic Fatty Liver Disease: A Review and Update显示文摘 | Jeffrey R. Lewis Smruti R. Mohanty | 2010 | Digestive Diseases and Sciences2010，，3： | 1 |
| 16 | Primary prophylaxis of gastric variceal bleeding comparing cyanoacrylate injection and beta-blockers: A randomized controlled trial显示文摘 | Smruti Ranjan Mishra Barjesh Chander Sharma Ashish Kumar Shiv Kumar Sarin | 2010 | Journal of Hepatology2010，，6： | 1 |
| 17 | Primary prophylaxis of gastric variceal bleeding comparing cyanoacrylate injection and beta-blockers: A randomized controlled trial显示文摘 | Smruti Ranjan Mishra Barjesh Chander Sharma Ashish Kumar Shiv Kumar Sarin | 2010 | Journal of Hepatology2010，，6： | 1 |
| 18 | Early primary prophylaxis with beta-blockers does not prevent the growth of small esophageal varices in cirrhosis: a randomized controlled trial显示文摘 | Shiv Kumar Sarin Smruti Ranjan Mishra Praveen Sharma Barjesh Chander Sharma Ashish Kumar | 2013 | Hepatology International2013，，1： | 1 |
| 19 | Univentricular repair: is routine fenestration justified?显示文摘 | Balram Airan Rajesh Sharma Shiv Kumar Choudhary Smruti R Mohanty Anil Bhan Ujjwal Kumar Chowdhari Rajnish Juneja Shyam Sunder Kothari Anita Saxena Panangipalli Venugopal | 2000 | The Annals of Thoracic Surgery2000，，6： | 1 |
| 20 | Impacts of FDI on R&D strategies of firms in the post-1991 era显示文摘 | Vinish Kathuria Das Smruti | 2005 | IIMB Management Review2005，6，： | 1 |
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