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Kumar A, Mehrotra S, Singh G, Maurya VP, Narayanan K, Mahla AS, Chaudhari RK, Singh M, Soni YK, Kumawat BL, Dabas SK, Srivastava N. Supplementation of Slow-Release Melatonin Improves Recovery of Ovarian Cyclicity and Conception in Summer Anoestrous Buffaloes (Bubalus bubalis). Reprod Domest Anim 2015; 51:10-7. [PMID: 26566713 DOI: 10.1111/rda.12639] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Accepted: 10/10/2015] [Indexed: 11/30/2022]
Abstract
The role of melatonin as a protective neurohormone against restoring cyclicity in summer anoestrous animals in photoperiod species has gained wider acceptance. This study was designed to uncover the evidence the slow-release melatonin (MLT) has on initiation of ovarian cyclicity and conception rate (CR) in summer anoestrous buffaloes. Thus, buffaloes diagnosed as summer anoestrous (absence of overt signs of oestrus, concurrent rectal examination and radioimmunoassay for serum progesterone at 10 days interval) were grouped as untreated (Group I, sterilized corn oil, n = 8) and treated (Group II, single subcutaneous injection of MLT @18 mg/50 kg bwt in sterilized corn oil, n = 20). Animals treated and detected in oestrus were artificially inseminated (AI) followed by division into Group III (second dose of MLT on 5th day post-AI, n = 8) and Group IV (no melatonin administration, n = 10). Blood samples were collected at 4 days interval for estimation of serum MLT, progesterone and oestrogen using radioimmunoassay kit. Mean oestrous induction rate (OIR), oestrous induction interval (OII), interoestrous interval (IOI) and CR were estimated. Compared to control, concentration of melatonin was significantly (p < 0.05) higher in treated group ranging from 14.34 ± 1.72 to 412.31 ± 14.47 pg/ml whereas other two hormones did not show any concentration difference. Melatonin-administered buffaloes showed significantly (p < 0.05) higher (90%) OIR with OII of 18.06 ± 1.57 days. Results showed improvement in conception rate in buffaloes administered with post-insemination melatonin. It can be concluded from the study that slow-release melatonin supplementation restored cyclicity in summer anoestrous animals resulting in improvement in conception rate in buffaloes.
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Narayanan K, Gupta A, Manoj S, Seshadri K. HIV Infection Presenting with Dementia. THE JOURNAL OF THE ASSOCIATION OF PHYSICIANS OF INDIA 2015; 63:85-86. [PMID: 27604445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
We present a case of dementia in a young healthy individual. On evaluation he was detected to have HIV infection with low CD4 count and a high viral load. He had no opportunistic infections or any other AIDS defining illnesses. He recovered fully within 3 months of antiretroviral therapy.
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Purty S, Saranathan R, Prashanth K, Narayanan K, Asir J, Sheela Devi C, Kumar Amarnath S. Erratum: The expanding spectrum of human infections caused by Kocuria species: a case report and literature review. Emerg Microbes Infect 2015; 2:e91. [PMID: 26039557 PMCID: PMC3880876 DOI: 10.1038/emi.2013.93] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
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Kumar A, Mehrotra S, Singh G, Narayanan K, Das G, Soni Y, Singh M, Mahla A, Srivastava N, Verma M. Sustained delivery of exogenous melatonin influences biomarkers of oxidative stress and total antioxidant capacity in summer-stressed anestrous water buffalo (Bubalus bubalis). Theriogenology 2015; 83:1402-7. [DOI: 10.1016/j.theriogenology.2014.12.023] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Revised: 10/25/2014] [Accepted: 12/18/2014] [Indexed: 11/25/2022]
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Rajesh Y, Narayanan K, Reddy MS, Bhaskar VK, Shenoy GG, Subrahmanyam VM, Rao JV. Production of β -cyclodextrin from pH and thermo stable Cyclodextrin Glycosyl Transferase, obtained from Arthrobacter mysorens and its evaluation as a drug carrier for Irbesartan. Curr Drug Deliv 2015; 12:444-53. [PMID: 25901452 DOI: 10.2174/1567201812666150422163531] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2014] [Revised: 03/23/2015] [Accepted: 04/17/2015] [Indexed: 11/22/2022]
Abstract
Cyclodextrins (CDs) are carrier molecules produced by cyclization of α-1,4-glucans by Cyclodextrin Glycosyl Transferase (CGTase). These torus shaped molecules have hydrophobic cavity and hydrophilic shell making them useful in pharmaceutical, food, textile, pesticide and cosmetic industries. In this study, culture conditions for the production of CGTase by organism belonging to Arthrobacter genus obtained from a paddy field soil were optimized by single parameter mode. Soluble starch, yeast extract and magnesium sulphate played an important role in CGTase production. Percentage increase in CGTase yield under optimized conditions was 396.77%. The enzyme precipitated by 60% ammonium sulphate was purified using DEAE-sepharose. The molecular weight of the purified protein as determined by SDS-PAGE was 75 kDa. Purified CGTase was thermostable and stable over a wide pH range. Dissolution studies on β -cyclodextrin-Irbesartan complex revealed that β -CDs formed were useful in preparing immediate release oral dosage forms.
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Kumar KVS, Aravinda K, Narayanan K. Monostotic fibrous dysplasia with Raynaud′s phenomenon. J Nat Sci Biol Med 2015; 6:462-4. [PMID: 26283854 PMCID: PMC4518434 DOI: 10.4103/0976-9668.160042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Fibrous dysplasia (FD) is a benign bone disorder characterized by alteration in bone morphology. Monostotic FD is the commonest variant and affects the craniofacial bones. Raynaud's phenomenon is recurrent vasospasm of the fingers and toes due to cold exposure. The disease is usually idiopathic or secondary to connective tissue disorders. Raynaud's phenomenon is not described previously with FD. We recently encountered two interesting patients of craniofacial monostotic FD with Raynaud's phenomenon and report the same in this report.
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Dar S, Chaudhary G, Mehrotra S, Qureshi S, Sankar M, Jan M, Kumar H, Chaudhary R, Palanivelu M, Narayanan K. Association ofEscherichia coliandFusobacterium necrophorumwith subclinical endometritis in postpartum Murrah buffalo. ACTA ACUST UNITED AC 2015. [DOI: 10.5958/0973-970x.2015.00076.0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Mahla A, Vyas S, Kumar H, Singh G, Das G, Kumar A, Narayanan K. Studies on sexual behaviour in female dromedary camel (Camelus dromedarius). J CAMEL PRACT RES 2015. [DOI: 10.5958/2277-8934.2015.00023.5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Ahmed S, Narayanan K, Gadakh A, Dodheri S, Surendranath S, Nathan S, Mukherjee S, Marappan S, Sushmita R, Dhadunia S, Obilisetti K, Anil J, Reddy J, Reddy K, Basavaraju A, Naik C, Pandit C, Ramachandra M. 321 Potent and selective inhibition of EZH2 by AU-2121 leads to significant tumor growth inhibition in mutant EZH2 dependent non-Hodgkin lymphoma. Eur J Cancer 2014. [DOI: 10.1016/s0959-8049(14)70447-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Narayanan K, Sahu SK. Energy Consumption Response to Climate Change: Policy Options for India. IIM KOZHIKODE SOCIETY & MANAGEMENT REVIEW 2014. [DOI: 10.1177/2277975214544014] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In this article, the contributions of energy use to the climate variation debates are explored. Analyses based on secondary data depict that global fossil fuel use has increased and dominated world energy consumption and supply which is quite similar to the Indian case. This increase in the global energy use has resulted in higher emissions. To account for the changes in carbon dioxide (CO2) emission, this article follows an index decomposition analysis using data from PROWESS database of the Center for Monitoring Indian Economy (CMIE). Two factors are considered to account for the changes in emission intensity of Indian economy: (i) shift in output among three sectors of the India economy (Agriculture, Service and Manufacturing) and (ii) structural change due to change in aggregate output with respect to emissions change. Based on the estimates, we conclude that structural changes in the Indian economy from 1991 to 2007 played important major driving factor in reducing emissions compared to output shifts across sectors. Based on the findings and international experiences, few policy options for Indian economy, such as, energy pricing reforms, promoting investment in renewable energy technologies and creating public environmental awareness, are further suggested.
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Gowane GR, Sharma AK, Sankar M, Narayanan K, Bisht P, Subramaniam S, Pattnaik B. The expression of IL6 and 21 in crossbred calves upregulated by inactivated trivalent FMD vaccine. Anim Biotechnol 2014; 25:108-18. [PMID: 24555796 DOI: 10.1080/10495398.2013.834826] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Foot and mouth disease (FMD) is an economically important disease and a whole-virus inactivated trivalent virus vaccine is the mainstay for controlling the disease in India. The protective humoral immune response to FMD vaccination is a complex, but, tightly regulated process mediated by the interplay of interleukins (IL). Based on the specific role of IL6 and 21 in adaptive immune response, we hypothesized that inactivated trivalent FMD vaccine would stimulate IL6 and 21 expression in the circulating lymphocytes. The expressions of IL6 and 21 were assayed on 0, 28, 60, 90, and 120 d post-vaccination (DPV) by quantitative PCR (qPCR) with simultaneous assessment of FMDV antibody titer by liquid phase blocking ELISA. The results revealed that the peak expression of IL6 and 21 was on DPV 28 which correlated well with the FMDV antibody titer and plummeted to the prevaccination titer level by 60 DPV. As IL21 is the final effector of antibody production as compared to IL6, we investigated the expression of IL21 in calves that had protective titer (>1.8) with the unprotected group (<1.8). Expression of IL21 on 28 DPV was numerically higher in the protected than that of the unprotected group of calves.
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Boveda S, Providencia R, Albenque JP, Combes N, Combes S, Hireche H, Casteigt B, Bouzeman A, Jourda F, Narayanan K, Marijon E. Real-time assessment of pulmonary vein disconnection during cryoablation of atrial fibrillation: can it be 'achieved' in almost all cases? Europace 2013; 16:826-33. [DOI: 10.1093/europace/eut366] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Shanmugam M, Narayanan K, Mahalakshmi M, Kabilan S, Chidambaranathan V. Synthesis, characterization and biological studies of some novel 3-fluorosalicylaldehyde based amine derivatives. SPECTROCHIMICA ACTA. PART A, MOLECULAR AND BIOMOLECULAR SPECTROSCOPY 2013; 116:394-400. [PMID: 23973585 DOI: 10.1016/j.saa.2013.07.084] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2013] [Accepted: 07/22/2013] [Indexed: 06/02/2023]
Abstract
A series of biologically important substituted 3-fluorosalicylaldehyde derivatives (1a-h) with various primary amines were synthesized by using ionic liquid (1-Butyl-3-methylimidazolium bis(trifluoromethylsulfonyl)imide) as an efficient catalyst. A new series of Schiff base derivatives (1a-h) were synthesized and characterized by IR, NMR ((1)H, (13)C, (1)H-(1)H COSY and HSQC), mass spectra and elemental analysis. Further crystal structure of compound 1a was evaluated by single crystal X-ray diffraction techniques. All the synthesized compounds were screened for in vitro antimicrobial activity against a panel of selected bacterial and fungal strains using Streptomycin and Amphotericin B as standards. Most of the synthesized compounds demonstrated moderate effects on both antibacterial and antifungal activities at minimum inhibitory concentrations (MIC's).
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Gowane GR, Sharma AK, Sankar M, Narayanan K, Das B, Subramaniam S, Pattnaik B. Association of BoLA DRB3 alleles with variability in immune response among the crossbred cattle vaccinated for foot-and-mouth disease (FMD). Res Vet Sci 2013; 95:156-63. [PMID: 23541924 DOI: 10.1016/j.rvsc.2013.03.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2012] [Revised: 02/23/2013] [Accepted: 03/03/2013] [Indexed: 12/20/2022]
Abstract
Polymorphism of bovine leukocyte antigen (BoLA) DRB3 gene is being intensively investigated for potential association with economically important diseases of cattle. Accordingly, we investigated the association of DRB3 Exon 2 polymorphism as evidenced by the variation in the binding pockets with variability in immune response to inactivated trivalent (O, A and Asia1) foot and mouth disease virus (FMDV) vaccine in a closed population of crossbred cattle. Antibody titer of ≥ 1.8 was set as the cut off value to distinguish the protected (≥ 1.8) and unprotected (<1.8) animals. Eleven different alleles of over 3% frequency were detected in the population. We found that DRB3 alleles 0201, 0801 and 1501 always ranked high for protective immune response whereas alleles 0701, 1103 and 1101 consistently ranked low for unprotected immune response for all the three serotypes. Rank correlation of DRB3 alleles among the three serotypes was positive, high in magnitude and statistically significant (P<0.05). Logistic regression analysis revealed that odds of protection from the vaccine were highest for all the three serotypes if allele (∗)1501 was present and strengthened the results of allele ranking. Predicted amino acid substitution in the peptide binding pockets revealed that all the important sites had high Wu-Kabat index. Similarly, specific residues in pockets were crucial for immune response to FMD vaccine. There were specific substitutions in un-protected alleles such as absence of acidic amino acids substituted by basic amino acid at β71, presence of non-polar cysteine or basic histidine at β30 and presence of polar tyrosine at β37. From the observations, we hypothesize that the substitutions lead to unique conformational changes in the protein products of the studied alleles that would associate with the protective or unprotective antibody response to FMDV vaccine. The knowledge has potential implications in future selection programs if integrated with the complete BoLA haplotype details and production traits of the herd.
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Shanmugam M, Narayanan K, Chidambaranathan V, Kabilan S. Synthesis, spectral characterization and antimicrobial studies of novel s-triazine derivatives. SPECTROCHIMICA ACTA. PART A, MOLECULAR AND BIOMOLECULAR SPECTROSCOPY 2013; 105:383-390. [PMID: 23333692 DOI: 10.1016/j.saa.2012.12.046] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2012] [Revised: 12/10/2012] [Accepted: 12/14/2012] [Indexed: 06/01/2023]
Abstract
A series of fifteen novel triazinyl derivatives, with various natural nucleobases by mono, di and tri substitution in cyanuric chloride at the 2,4- and/or 6-positions was synthesized. Target molecules were synthesized by stoichiometric addition of various nucleophiles to cyanuric chloride in the presence of suitable base. The structural characterizations of all the compounds were made by spectral and analytical techniques, IR, (1)H NMR, (13)C NMR, and 2D NMR (HSQC, HMBC), mass spectral and elemental analysis. All the synthesized compounds were screened for in vitro antimicrobial activity against a panel of selected bacterial and fungal strains using Streptomycin and Amphotericin B as standards. The minimum inhibition concentration (MIC) results revealed that most of the purine (1a-2a, 1b-2b, and 1c-2c) compounds exhibit excellent activity against selected bacterial and fungal strains.
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Thomas RM, Narayanan K, Ramanathan A. A Comparative Study of Technology and Industry Clusters of SMEs in India. SCIENCE TECHNOLOGY AND SOCIETY 2012. [DOI: 10.1177/097172181201700304] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This article attempts to compare the Small and Medium Enterprises (SMEs) belonging to industry and technology clusters in India. They are compared in terms of the technological efforts, nature of competition, competitive strategy, outward orientation, research and development intensity and export intensity. First part of the article gives the economics of clustering and the second part analyses the inter-cluster differences, if any, between the firms belonging to 13 clusters drawn from Mumbai and Thiruvananthapuram. The analysis reveals that the firms in the technology cluster are more outward oriented and R and D intensive compared to their counterparts in the industry cluster. They also differ in terms of the type of competitors and the competitive strategies. While the firms in the technology cluster face competition from established foreign firms, those in the industry cluster from established local firms. Process innovations are used by firms in the technology cluster whereas productivity improvements are used by firms in the industry cluster for sustaining competitive advantage. In the regression analysis, the nature of cluster, use of technology/business collaboration (Networking) and market share emerge as significant variables in explaining the R and D intensity of firms. Export intensity is explained by the R and D intensity and scale of operation.
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Jain A, Narayanan K, Siddharthan N. Agglomeration, Technology Clusters and Networks: Introduction to the Special Issue. SCIENCE TECHNOLOGY AND SOCIETY 2012. [DOI: 10.1177/097172181201700301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Dutta N, Narayanan K. Impact of Environmental Regulation on Technical Efficiency. SCIENCE TECHNOLOGY AND SOCIETY 2011. [DOI: 10.1177/097172181101600305] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
There is a large concentration of chemical firms around Mumbai, and the Maharashtra Pollution Control Board has been actively monitoring them. Such monitoring is likely to have an impact on the productive efficiency of these firms. The firms argue that additional costs to minimise environmental damage have reduced their efficiency. We try to find out whether these water-polluting firms in the chemical industry around Mumbai are actually unable to cope with the additional cost of pollution abatement, or whether by using cleaner practices, are able to improve their efficiency, and support the ‘win-win’ opportunities as claimed by the Porter Hypothesis. The study is carried out by estimating an Output Distance Function using a stochastic production function. The panel data of fifty water-polluting small-to medium-scale firms for three-year period of 2004–06 was collected in a primary survey of chemical industries around Mumbai. We find that the polluting firms are technically more efficient than those firms which adhere to pollution norms. Thus, the Porter Hypothesis does not hold for the sample.
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Narayanan K, Marwaha V, Shanmuganandan K, Shankar S. Correlation between Systemic Lupus Erythematosus Disease Activity Index, C3, C4 and Anti-dsDNA Antibodies. Med J Armed Forces India 2011; 66:102-7. [PMID: 27365721 DOI: 10.1016/s0377-1237(10)80118-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2009] [Accepted: 01/10/2010] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Therapeutic decisions in systemic lupus erythematosus (SLE) are based on the disease activity and nature of organ involvement. There are various clinical and laboratory methods to assess the lupus flares. METHODS Fifty one SLE patients with active disease (lupus flare) were studied. Systemic lupus erythematosus disease activity index (SLEDAI), C3, C4 and anti-double stranded DNA levels were estimated and repeated monthly till remission. After remission these tests were done three monthly. Values of serological parameters were then correlated with SLEDAI score. RESULT Thirteen (25.4%) patients had predominantly renal involvement while 38 (74.6%) patients had non-renal affliction. Musculoskeletal and mucocutaneous symptoms were the commonest features of lupus flare (90%). It was observed that 12 out of 13 (92.3%) patients with active renal involvement had low C3 levels and 11 (84.6%) had low C4 levels. The anti-dsDNA levels were elevated in all patients with predominant renal flare. In non-renal flare anti-dsDNA titre was raised only in 35% cases. Low C3 and C4 levels were noticed in 43% and 53% of non-renal flares respectively. Significant positive correlation was noticed between SLEDAI score and anti-dsDNA levels (0.01 level two-tailed prediction) and a significant negative correlation was observed with SLEDAI and C3, C4 levels (0.01 and 0.05 levels, two-tailed prediction) in our patients. On subgroup analysis it was noticed that this correlation is stronger for renal lupus. Negative correlation of SLEDAI and complement levels was not observed in non-renal flares. CONCLUSION Calculation of SLEDAI is a vital clinical tool for assessment of SLE patients. Serial estimation of anti-dsDNA titre, C3 and C4 levels help us diagnose lupus flare and make appropriate therapeutic decisions in patients with high SLEDAI score.
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Anoop U, Verma K, Narayanan K. Primary cilia in the pathogenesis of dentigerous cyst: a new hypothesis based on role of primary cilia in autosomal dominant polycystic kidney disease. ACTA ACUST UNITED AC 2011; 111:608-17. [DOI: 10.1016/j.tripleo.2010.12.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2010] [Revised: 12/02/2010] [Accepted: 12/20/2010] [Indexed: 01/19/2023]
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Narayanan K, Bhakuni DS, Jain R, Vasdev V, Mullick G. O20 Efficacy and safety of guide free sacroiliac (SI) joint steroid injection in axial spondyloarthropathy (SPA). INDIAN JOURNAL OF RHEUMATOLOGY 2010. [DOI: 10.1016/s0973-3698(10)60595-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Narayanan K, Jain R, Bhakuni DS, Garg, Vasdev V. P15 Pattern of DMARD use and associated comorbidities in chronic RA who have received more than 10 years of DMARD therapy. INDIAN JOURNAL OF RHEUMATOLOGY 2009. [DOI: 10.1016/s0973-3698(09)60033-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Narayanan K, Bhakuni DS, Garg OP, Vasdev V, Jain R. P14 Use of infliximab in ankylosing spondylitis—a practical approach. INDIAN JOURNAL OF RHEUMATOLOGY 2009. [DOI: 10.1016/s0973-3698(09)60032-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Narayanan K, Bhakuni DS, Garg OP. Experience with rituximab in rheumatoid arthritis. INDIAN JOURNAL OF RHEUMATOLOGY 2009. [DOI: 10.1016/s0973-3698(10)60197-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Khatami Z, Handley G, Narayanan K, Weaver JU. Applicability of estimated glomerular filtration rate in stratifying chronic kidney disease. Scandinavian Journal of Clinical and Laboratory Investigation 2009; 67:297-305. [PMID: 17454844 DOI: 10.1080/00365510601045070] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE The aim of this audit was to evaluate the degree of glomerular filtration rate (GFR) among inpatients and outpatients in a District General Hospital, with special attention given to laboratory testing and impact on health delivery. BACKGROUND UK Chronic Kidney Disease guidelines recommend that investigation of renal function should be accompanied by an estimation of GFR (eGFR) in order to identify and manage patients with chronic kidney disease (CKD). The estimated GFR forms the basis for classification of CKD and appropriate action plans for patient management and follow-up. METHOD A retrospective audit of 8160 results from a predominantly British Caucasian population was carried out; extracting creatinine results from two isolated months in years 2001 and 2004. The estimated GFR (eGFR) was calculated using the MDRD formula. The data were classified according to demography, serum creatinine and eGFR. Patients from the 2001 database were classified according to eGFR and those with a value of <60 mL/min/1.73 m(2) were followed up in 2004. RESULTS The difference in eGFR between the men and women was significantly different with medians (confidence intervals) of 80.1 (41-109) and 64.4 (30-84.6) (p<0.0001), respectively. There was an inverse association between age and eGFR in both genders (p<0.0001), with a decrease in eGFR of around 7 % for each decade increase in age. 1926 patients (24 %) of results studied had eGFR <60 mL/min, of whom 64 % were females and 36 % males. Follow-up of patients with eGFR<60 mL/min from 2001 showed that 4 % progressed to stages 4 and 5 CKD. CONCLUSION eGFR is inversely associated with increasing age and female gender. MDRD derived eGFR fails to completely compensate for age and gender variations and thus different action limits may be required. Small but significant numbers of patients progressed to stages 4 and 5 CKD. Additional clarity in describing "progressive fall in eGFR" in the guidelines would improve identification of the population most at risk.
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