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Gurung J, Bera NK, Lama M, Singh B. Association of TLR-4 896A/G, TLR-4 1196C/T, and TLR-9 C/T polymorphism with schizophrenia in Indian Bengalee patient. Indian J Psychiatry 2022; 64:579-587. [PMID: 36714667 PMCID: PMC9881711 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_263_22] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Revised: 08/14/2022] [Accepted: 10/13/2022] [Indexed: 11/29/2022] Open
Abstract
Background Chronic low-grade inflammation triggered by viral agents is a suggested etiological factor for schizophrenia. However, the underlying mechanism of inflammation and genetic predisposition to schizophrenia is poorly understood. Toll-like receptor (TLR) is a potential candidate gene to understand the inflammatory process and genetic predisposition to schizophrenia as they are known to express widely in brain cells and can modulate cytokine synthesis through recognition of pathogen-associated molecular patterns. To date, no TLR mutations or single nucleotide polymorphisms have been established as accepted risk factors for schizophrenia. Aim Therefore, the present investigation was undertaken to study the role of single nucleotide polymorphisms (SNPs) within the TLR genes in the etiopathology of schizophrenia. Methods A total of 120 India-born Bengalee schizophrenia patients fulfilling diagnostic and statistical manual of mental disorders-V criteria, and 145 age, sex, and ethnicity-matched healthy controls were included in the study. Previous virally associated SNPs in TLR genes were genotyped by Polymerase chain reaction-restriction fragment length polymorphism assay. The allele frequency was compared using the odds ratio, and the association was studied under five inheritance models using the SNPStats program. Results The frequencies of G allele (OR = 2.68, P = 0.01) and A/G genotype of TLR-4 rs4986790 (P = 0.04), T allele (OR = 4.09, P = 0.01) and C/T genotype of TLR-4 rs4986791 (P = 0.05), and T allele of TLR-9 rs352140 (OR = 1.77; P = 0.00) were found to be significantly high in patients. The dominant model was the optimum genetic model for TLR-4 rs4986790 (OR = 3.24, P = 0.01) and TLR-9 rs352140 (OR = 2.88, P = 0.005). Conclusion The findings suggest that SNPs in TLR genes rs4986790, rs4986791, and rs352140 may confer susceptibility to schizophrenia among Indian Bengalee patients.
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Affiliation(s)
- Jiwan Gurung
- Department of Zoology, School of Life Sciences, Sikkim University, Gangtok, Sikkim, India
| | - Nirmal Kumar Bera
- Department of Psychiatry, North Bengal Medical College, and Hospital, Siliguri, West Bengal, India
| | - Manoj Lama
- Department of Zoology, GourBanga University, Malda, West Bengal, India
| | - Bisu Singh
- Department of Zoology, School of Life Sciences, Sikkim University, Gangtok, Sikkim, India
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Singh B, Chamlagai D, Gurung J. HLA Profile of Kami Population Refutes the Earlier Proposition of Exclusive Closer Genetic Affinity of All the Gorkhas to Mongoloids. Hum Hered 2021; 85:1-6. [PMID: 33592612 DOI: 10.1159/000514220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 12/23/2020] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Based on the HLA profile of Indian Gorkhas, Debnath and Chaudhuri (2006) proposed that Gorkhas are genetically closer to Mongoloids, and they may have originated from Mongolians or Tibetan stocks. However, the major limitation of the earlier study was that Gorkhas comprise 2 broad groups, i.e. Tibeto-Burmans and Indo-Aryans. Besides, Gorkhas have an assemblage of many sociocultural and linguistically distinct populations such as Rai, Magar, Limbu, Tamang, Newar, Bahun, Kami, and so on. Thus, the generalization of the findings on Gorkhas by considering them as a single homogenous population may not be free from biases. Therefore, the present study aims to understand the genetic affinity of a constituent population from the Gorkha community, i.e. Kami, based on HLA polymorphism. METHODS First field HLA typing was performed among 158 Kami individuals by PCR-SSP methods. RESULTS The most frequent genes observed were HLA-A*11, HLA-B*15, HLA-DRB1*15. The frequency of HLA-DRB1*15 reported here is the highest recorded among the North Indian population to date, which is a noteworthy finding of the study. The hierarchical cluster analysis and principal component analysis showed that the Kami population lies within the cluster of the Indian subcontinental population. CONCLUSION The study refutes the earlier proposition of exclusive belongingness of all the Gorkhas to Mongoloids.
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Affiliation(s)
- Bisu Singh
- Department of Zoology, School of Life Sciences, Sikkim University, Gangtok, India,
| | - Dependra Chamlagai
- Department of Zoology, School of Life Sciences, Sikkim University, Gangtok, India
| | - Jiwan Gurung
- Department of Zoology, School of Life Sciences, Sikkim University, Gangtok, India
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Singh B, Chamlagai D, Gurung J. HLA-A -B and -DRB1 distribution in Kami: A caste population of Gorkha community from the sub-Himalayan region of West Bengal, India. Hum Immunol 2020; 81:395-396. [DOI: 10.1016/j.humimm.2020.06.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 06/14/2020] [Accepted: 06/14/2020] [Indexed: 11/25/2022]
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Abstract
BACKGROUND & OBJECTIVES Sikkim is a part of Eastern Himalayan biodiversity hotspot of India rich in bamboo flora harbouring over 30 different bamboo species. The present study was aimed to investigate the larval mosquito diversity in the bamboo stumps of Gangtok, Sikkim. Besides, efforts were also made to evaluate the propensity of particular species of mosquito towards specific bamboo species (if any). METHODS A total of 75 bamboo stumps of four genera were surveyed and screened at five different sampling sites of Gangtok from July to October 2017. Mosquito species similarity between the five sampling sites and the four varieties of bamboo species was calculated using the Bray-Curtis similarity index. RESULTS A total of 216 larvae were collected from 25 different bamboo stumps studied. The species identified were Aedes albopictus, Ae. atlanticus, Ae. aegypti, Orthopodomyia signifera, Oclerotatus japonicus, Oc. taeniorhynchus, Armigeres subalbatus, and Toxorhynchites splendens. The Oc. japonicus (34.5%) was found to be the most abundant species having distribution in Phyllostachys assamica, Dendrocalamus hamiltonii and Bambusa nutans. On the other hand, genus Armigeres subalbatus and Tx. splendens were found to breed only in the stumps of P. assamica. Based on Bray-Curtis similarity index highest species similarity was recorded between D. hamiltonii and P. assamica bamboo species. INTERPRETATION & CONCLUSION The study may help to understand the bioecology of the mosquito larvae which may help to devise suitable mosquito control programmes. Future studies including the survey of large number of bamboo stumps both in urban and rural areas of Sikkim may provide better insight into the mosquito diversity in the bamboo stumps of Sikkim.
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Affiliation(s)
- B Singh
- Department of Zoology, School of life Sciences, Sikkim University, Sikkim, India
| | - C Baruah
- Department of Zoology, School of life Sciences, Sikkim University, Sikkim, India
| | - D Saikia
- Department of Zoology, School of life Sciences, Sikkim University, Sikkim, India
| | - J Gurung
- Department of Zoology, School of life Sciences, Sikkim University, Sikkim, India
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Gurung J, Chamlagai D, Bera NK, Chaudhuri TK, Singh B. Elevated levels of C-reactive protein and IL-6 among the antipsychotic medicating schizophrenia patients of Siliguri, West Bengal, India. Nord J Psychiatry 2018; 72:311-317. [PMID: 29464976 DOI: 10.1080/08039488.2018.1441438] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
PURPOSE Chronic, low-grade inflammation is a proposed etiological factor associated with schizophrenia. Thus, various studies have been conducted to understand the role of inflammatory process in schizophrenia by using inflammatory maker C-reactive protein (CRP) with conflicting findings. Inadvertently, studies of CRP among the Indian schizophrenia patients are very few. Therefore, the present study was undertaken to investigate the role of inflammatory process among Indian Bengalee schizophrenia patients of Siliguri, using the marker CRP and its stimulating cytokine interleukin-6 (IL-6). In addition, the study also intended to investigate the immunomodulatory effect of antipsychotic medication on serum levels of CRP and IL-6. MATERIALS AND METHODS The serum levels of CRP and IL-6 were measured by Enzyme-Linked Immunosorbent Assay (ELISA) among 67 antipsychotic medicating, 28 psychotropic medication-free schizophrenia patients, and it was compared with 72 age, sex and ethnicity-matched controls. RESULTS A significantly higher level of CRP and IL-6 were recorded among the antipsychotic medicating patients. Although CRP was found to be higher among the psychotropic medication-free patients than the controls, it was not found to be significant. However, a significantly higher level of IL-6 was observed in this group. CONCLUSIONS The results provide the evidence for a possible immunomodulatory effect of antipsychotic drugs on CRP. Future investigations including the study of antipsychotics separately may help to understand the differential effects of individual antipsychotics on CRP level. Additional studies with a larger sample size of psychotropic medication-free patients may help to verify the role of inflammation in schizophrenia patients of this region.
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Affiliation(s)
- Jiwan Gurung
- a Department of Zoology, School of Life Sciences , Sikkim University , Sikkim , India
| | - Dependra Chamlagai
- a Department of Zoology, School of Life Sciences , Sikkim University , Sikkim , India
| | - Nirmal Kumar Bera
- b Department of Psychiatry , North Bengal Medical College, and Hospital , Siliguri , India
| | - Tapas Kumar Chaudhuri
- c Department of Zoology, Cellular Immunology Laboratory , University of North Bengal , Siliguri , India
| | - Bisu Singh
- a Department of Zoology, School of Life Sciences , Sikkim University , Sikkim , India
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Abstract
OBJECTIVE The present study had been undertaken to investigate the sociodemographic profile of individuals who had committed suicide in Sikkim which may throw light on the vulnerable groups. MATERIALS AND METHODS Ten-year suicide data (2006-2015) obtained from Police Headquarters, Crime Branch, Gangtok, have been statistically evaluated to study the sociodemographic profile. RESULTS The results showed that out of 1604 suicide cases recorded for the past 10 years, 1051 were males (65.5%) and 553 (34.5%) were females. Suicide was found to be common among the age group of 21-30 years (24.4%), Rai community (15.8%), population of rural areas (82.6%), and among the population of eastern districts (50.6%). Hanging (94.8%) was found to be the most common method adopted for suicide. CONCLUSION The study provides preliminary information about the vulnerable groups for suicide in the state which may be vital for taking necessary steps for its prevention shortly.
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Affiliation(s)
- Reshma Chettri
- Department of Zoology, School of Life Sciences, Sikkim University, Gangtok, Sikkim, India
| | - Jiwan Gurung
- Department of Zoology, School of Life Sciences, Sikkim University, Gangtok, Sikkim, India
| | - Bisu Singh
- Department of Zoology, School of Life Sciences, Sikkim University, Gangtok, Sikkim, India
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Vogl TJ, Lindemayr S, Gurung J, Zangos S, Naguib N, Mbalisike E. Palliative Behandlung bei malignem Pleuramesotheliom: Repetitive Transarterielle Chemoperfusion (TACP). ROFO-FORTSCHR RONTG 2011. [DOI: 10.1055/s-0031-1279119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Mbalisike E, Gurung J, Azizi A, Farshid P, Ghasemi M, Darvishi A, Volkmar J, Vogl TJ. Interventionelle C-Arm CT versus MRT: Ausmaß der Vaskularisation mit Einfluss auf das Ansprechen kolorektaler Lebermetastasen mit TACE. ROFO-FORTSCHR RONTG 2011. [DOI: 10.1055/s-0031-1279201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Mbalisike E, Gurung J, Hedayati-Emami A, Rück S, Lehnert T, Vogl T. Volumetrische Analysen von Lebermetastasen des Mammakarzinoms unter repetitiver intraarterieller Chemoembolisation (third line therapy). ROFO-FORTSCHR RONTG 2010. [DOI: 10.1055/s-0030-1252664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Maataoui A, Reusch E, Khan MF, Gurung J, Thalhammer A, Ackermann H, Mulert-Ernst R, Vogl TJ, Jacobi V. [Comparison of analog and digital fluoroscopy devices regarding patient radiation exposure in enteroclysis]. ROFO-FORTSCHR RONTG 2008; 180:246-51. [PMID: 18278732 DOI: 10.1055/s-2008-1027186] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
PURPOSE With the development and refinement of digital imaging, conventional fluoroscopic units are increasingly being replaced by state-of-the-art digital units for the practice of gastrointestinal imaging. The purpose of this study was to compare digital and conventional methods of gastrointestinal imaging by enteroclysis based on radiation exposure to the patient and fluoroscopy time. MATERIALS AND METHODS The medical records of 241 patients who underwent enteroclysis by the conventional technique in 1990 and 309 patients who underwent enteroclysis by digital technique between 2000 and 2004 were reviewed. The radiation exposure of the patient and the fluoroscopy time were evaluated. RESULTS The mean radiation exposure was significantly lower (p < or = 0.05) for patients examined by the digital technique (4945.07 cGy x cm (2)) than for patients examined by the conventional technique (7513.6 cGy x cm (2)). The fluoroscopy time was significantly lower with the conventional technique (mean fluoroscopy time 9 min 43 sec) than with the digital technique (17 min 10 sec). CONCLUSION We conclude that radiation exposure does not correlate directly with fluoroscopy time. Technical refinements of the digital technique such as Last Image Hold frames, which allow images to be stored with no increase in radiation dose and help to reduce digital fluorography exposures and pulsed fluoroscopy, result in significant dose reduction.
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Affiliation(s)
- A Maataoui
- Institut für Diagnostische und Interventionelle Radiologie, J.-W.-Goethe-Universität, Theodor-Stern-Kai 7, Frankfurt am Main.
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Gurung J, Lehnert T, Korkusuz H, Jacobi V, Vogl T. Experimentelle Optimierung der Kontrastmitteldichte für die MDCT und Evaluation des Einflusses der Kontrastmitteldichte auf die Strahlendosis. ROFO-FORTSCHR RONTG 2008. [DOI: 10.1055/s-2008-1073984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Harth M, Sebesteny T, Hoffmann F, Gurung J, Khan F, Proschek P, Weisser P, Vogl T. Frei verfügbare neue interaktive webbasierte Anatomie-Atlanten für den Radiologen am Arbeitsplatz. ROFO-FORTSCHR RONTG 2008. [DOI: 10.1055/s-2008-1073872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Korkusuz H, Ester P, Hübner F, El Kader A, Gurung J, Kahn V, Lehnert T, Vogl T. Experimentelle Autoimmun Myokarditis im Rattenmodell: Late Enhancement. ROFO-FORTSCHR RONTG 2008. [DOI: 10.1055/s-2008-1073650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Chiappetta S, Korkusuz H, Gurung J, Kerl JM, Mayer F, Burkhard T, Lehnert T, Vogl T. Tumorvolumenadaptierte Chemotherapie (TVACT) mit Mitomycin im Rattenmodell. ROFO-FORTSCHR RONTG 2008. [DOI: 10.1055/s-2008-1073687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Harth M, Gurung J, Khan F, Reichel P, Müller C, Gürvit Ö, Müller C, Maataoui A, Vogl TJ. Webbasierte interaktive Lernmodule zum Erfassen und Verstehen komplexer und vielschichtiger radiologischer Diagnostik radiologischer Untersuchungsverfahren. ROFO-FORTSCHR RONTG 2007. [DOI: 10.1055/s-2007-977227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Bisdas S, Gurung J, Konstantinou G, Lehnert T, Herzog C, Balzer JO, Mack MG, Koh TS, Vogl TJ. Akuter Schlaganfall: Effekt der Arteriellen Input Funktion auf Perfusionwerte und Ischämievolumetrie in der Perfusions-CT. ROFO-FORTSCHR RONTG 2007. [DOI: 10.1055/s-2007-977212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Gurung J, Maataoui A, Khan M, Wetter A, Harth M, Jacobi V, Vogl TJ. Automated Detection of Lung Nodules in Multidetector CT: Influence of Different Reconstruction Protocols on Performance of a Software Prototype. ROFO-FORTSCHR RONTG 2006; 178:71-7. [PMID: 16392060 DOI: 10.1055/s-2005-858831] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE To evaluate the accuracy of software for computer-aided detection (CAD) of lung nodules using different reconstruction slice thickness protocols in multidetector CT. MATERIALS AND METHODS Raw image data sets for 15 patients who had undergone 16-row multidetector CT (MDCT) for known pulmonary nodules were reconstructed at a reconstruction thickness of 5.0, 2.0 and 1.0 mm with a reconstruction increment of 1.5, 1.0 and 0.5 mm, respectively. The "Nodule Enhanced Viewing" (NEV) tool of LungCare for computer-aided detection of lung nodules was applied to the reconstructed images. The reconstructed images were also blinded and then evaluated by 2 radiologists (A and B). Data from the evaluating radiologists and CAD was then compared to an independent reference standard established using the consensus of 2 independent experienced chest radiologists. The eligible nodules were grouped according to their size (diameter > 10, 5 - 10, < 5 mm) for assessment. Statistical analysis was performed using the receiver operating characteristic (ROC) curve analysis, t-test and two-rater Cohen's Kappa co-efficient. RESULTS A total of 103 nodules were included in the reference standard by the consensus panel. The performance of CAD was marginally lower than that of readers at a 5.0-mm reconstruction thickness (AUC = 0.522, 0.517 and 0.497 for A, B and CAD, respectively). In the case of 2.0-mm reconstruction slices, the performance of CAD was better than that of the readers (AUC = 0.524, 0.524 and 0.614 for A, B and CAD, respectively). CAD was found to be significantly superior to radiologists in the case of 1.0-mm reconstruction slices (AUC = 0.537, 0.531 and 0.675 for A, B and CAD, respectively). The sensitivity at a reconstruction thickness of 1.0 mm was determined to be 66.99 %, 68.93 % and 80.58 % for A, B and CAD, respectively. The time required for detection was shortest for CAD at reconstruction slices of 1.0 mm (mean t = 4 min). The performance of radiologists was greatly enhanced when using CAD: sensitivity 91.26 % and 94.17 % for CAD+A and CAD+B, respectively (AUC = 0.889 and 0.917). CAD was most advantageous in the detection of nodules < 10 mm. CONCLUSION At a 1.0-mm reconstruction thickness, CAD's ability to detect nodules < 10 mm is superior to that of radiologists and its relatively short evaluation time makes it a viable second reader.
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Affiliation(s)
- J Gurung
- Institut für Diagnostische und Interventionelle Radiologie, Klinikum der Johann-Wolfgang-Goethe-Universität, Frankfurt am Main.
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Harth M, Hoffmann F, Gurung J, Oezlem G, Schwarz W, Reichel P, Khan F, Vogl TJ. Aufbau einer radiologischen Online-Teaching-Suite mit konsequentem Einsatz von Open Source-Tools (ZOPE/ZMS) und professionellem Support (ZMS-Publishing). ROFO-FORTSCHR RONTG 2005. [DOI: 10.1055/s-2005-868258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Adel AM, Graichen H, Abolmaali D, Khan F, Gurung J, Straub R, Hinterwimmer S, Vogl TJ. Knorpelvolumenmessung mittels MRT. ROFO-FORTSCHR RONTG 2005. [DOI: 10.1055/s-2005-868180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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van Brakel WH, Anderson AM, Wörpel FC, Saiju R, Bk HB, Sherpa S, Sunwar SK, Gurung J, De Boer M, Scholten E. A scale to assess activities of daily living in persons affected by leprosy. LEPROSY REV 1999; 70:314-23. [PMID: 10603721 DOI: 10.5935/0305-7518.19990035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The aim of this study was to develop a scale for identifying disability among people in the rural areas of developing countries. The studies were carried out in the Green Pastures Hospital and the leprosy field programme of the Western Region of Nepal. With the help of staff experienced in working with people with disability, a 68-question questionnaire was made, based on the International Classification of Impairments, Activities and Participation (ICIDH-2). A survey was carried out of 269 people affected by leprosy who had impairments, as well as a sample of those who were unimpaired. The survey results were used to develop the questionnaire into a scale, using standard scale development methods. This included checking of criterion validity, discrimination and reliability and stability using weighted kappa statistics. Of the 68 questions, 38 were included in the second draft of the instrument. Eight questions were added to identify difficulty in relationships, about the use of aids and about occupation and employment. The sum score of the scale against the expert score gave a Spearman correlation coefficient of 0.72. Intra- and inter-interviewer reliability coefficients were 0.77 (95% CI 0.73-0.81) and 0.61 (95% CI 0.56-0.67), respectively. The stability test gave an overall kappa of 0.76 (95% CI 0.70-0.82). Four questions with particularly poor results were omitted from the final draft of the instrument. An interview-based instrument was developed for identifying limitations in activities of daily living (disability) in people living in a rural setting in a developing country--the Green Pastures Activity Scale (GPAS). The scale performed well during validity and reliability testing. It consists of 34 activity questions, five relationship questions, and three questions on the use of aids, occupation and employment.
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