285 research outputs found
Assessment and management of perioperative pain in neurosurgical patients
This PhD thesis investigated the assessment and management of pain in a neurosurgical population. A national survey of anesthesiologists in India was conducted to understand practices for pain assessment and management in patients undergoing neurosurgeries. The practices varied, with 50% using structured format for pain assessment/management, and 15% using opioids for postoperative pain relief. To understand the burden of pain after brain surgery in India, a prospective observational study was performed. Two out of three patients reported significant pain during the first three days of surgery. Reporting of pain is not possible under anesthesia. Hence, objective methods are explored. During tracheal intubation, changes in analgesia nociception index, a monitor for intraoperative pain/nociception, were found to correlate with changes in heart rate and blood pressure. Another parameter, the surgical pleth index, also predicted pain and response to analgesics during brain surgery. Non-opioid pain medicines were found to be equivalent to opioids in brain surgery, and superior in spine surgery, in clinical trials and the meta-analysis performed as part of this thesis
An evaluation of DNA-damage response and cell-cycle pathways for breast cancer classification
Accurate subtyping or classification of breast cancer is important for
ensuring proper treatment of patients and also for understanding the molecular
mechanisms driving this disease. While there have been several gene signatures
proposed in the literature to classify breast tumours, these signatures show
very low overlaps, different classification performance, and not much relevance
to the underlying biology of these tumours. Here we evaluate DNA-damage
response (DDR) and cell cycle pathways, which are critical pathways implicated
in a considerable proportion of breast tumours, for their usefulness and
ability in breast tumour subtyping. We think that subtyping breast tumours
based on these two pathways could lead to vital insights into molecular
mechanisms driving these tumours. Here, we performed a systematic evaluation of
DDR and cell-cycle pathways for subtyping of breast tumours into the five known
intrinsic subtypes. Homologous Recombination (HR) pathway showed the best
performance in subtyping breast tumours, indicating that HR genes are strongly
involved in all breast tumours. Comparisons of pathway based signatures and two
standard gene signatures supported the use of known pathways for breast tumour
subtyping. Further, the evaluation of these standard gene signatures showed
that breast tumour subtyping, prognosis and survival estimation are all closely
related. Finally, we constructed an all-inclusive super-signature by combining
(union of) all genes and performing a stringent feature selection, and found it
to be reasonably accurate and robust in classification as well as prognostic
value. Adopting DDR and cell cycle pathways for breast tumour subtyping
achieved robust and accurate breast tumour subtyping, and constructing a
super-signature which contains feature selected mix of genes from these
molecular pathways as well as clinical aspects is valuable in clinical
practice.Comment: 28 pages, 7 figures, 6 table
Methods for protein complex prediction and their contributions towards understanding the organization, function and dynamics of complexes
Complexes of physically interacting proteins constitute fundamental
functional units responsible for driving biological processes within cells. A
faithful reconstruction of the entire set of complexes is therefore essential
to understand the functional organization of cells. In this review, we discuss
the key contributions of computational methods developed till date
(approximately between 2003 and 2015) for identifying complexes from the
network of interacting proteins (PPI network). We evaluate in depth the
performance of these methods on PPI datasets from yeast, and highlight
challenges faced by these methods, in particular detection of sparse and small
or sub- complexes and discerning of overlapping complexes. We describe methods
for integrating diverse information including expression profiles and 3D
structures of proteins with PPI networks to understand the dynamics of complex
formation, for instance, of time-based assembly of complex subunits and
formation of fuzzy complexes from intrinsically disordered proteins. Finally,
we discuss methods for identifying dysfunctional complexes in human diseases,
an application that is proving invaluable to understand disease mechanisms and
to discover novel therapeutic targets. We hope this review aptly commemorates a
decade of research on computational prediction of complexes and constitutes a
valuable reference for further advancements in this exciting area.Comment: 1 Tabl
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