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Ng SHX, Chai GT, George PP, Kaur P, Yip WF, Chiam ZY, Neo HY, Tan WS, Hum A. Prognostic Factors of Mortality in Nonchronic Obstructive Pulmonary Disease Chronic Lung Disease: A Scoping Review. J Palliat Med 2024; 27:411-420. [PMID: 37702606 DOI: 10.1089/jpm.2023.0263] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/14/2023] Open
Abstract
Introduction: Patients with chronic lung disease (CLD) experience a heavy symptom burden at the end of life, but their uptake of palliative care is notably low. Having an understanding of a patient's prognosis would facilitate shared decision making on treatment options and care planning between patients, families, and their clinicians, and complement clinicians' assessments of patients' unmet palliative needs. While literature on prognostication in patients with chronic obstructive pulmonary disease (COPD) has been established and summarized, information for other CLDs remains less consolidated. Summarizing the mortality risk factors for non-COPD CLDs would be a novel contribution to literature. Hence, we aimed to identify and summarize the prognostic factors associated with non-COPD CLDs from the literature. Methods: We conducted a scoping review following published guidelines. We searched MEDLINE, Embase, PubMed, CINAHL, Cochrane Library, and Web of Science for studies published between 2000 and 2020 that described non-COPD CLD populations with an all-cause mortality risk period of up to three years. Only primary studies which reported associations with mortality adjusted through multivariable analysis were included. Results: Fifty-five studies were reviewed, with 53 based on interstitial lung disease (ILD) or connective tissue disease-associated ILD populations and two in bronchiectasis populations. Prognostic factors were classified into 10 domains, with pulmonary function and disease being the largest. Older age, lower forced vital capacity, and lower carbon monoxide diffusing capacity were most commonly investigated and associated with statistically significant increases in mortality risks. Conclusions: This comprehensive overview of prognostic factors for patients with non-COPD CLDs would facilitate the identification and prioritization of candidate factors to predict short-term mortality, supporting tool development for decision making and to identify high-risk patients for palliative needs assessments. Literature focused on patients with ILDs, and more studies should be conducted on other CLDs to bridge the knowledge gap.
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Affiliation(s)
- Sheryl Hui Xian Ng
- Health Services and Outcomes Research, National Healthcare Group, Singapore, Singapore
| | - Gin Tsen Chai
- Department of Respiratory and Critical Care Medicine, Tan Tock Seng Hospital, Singapore, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Pradeep Paul George
- Health Services and Outcomes Research, National Healthcare Group, Singapore, Singapore
| | - Palvinder Kaur
- Health Services and Outcomes Research, National Healthcare Group, Singapore, Singapore
| | - Wan Fen Yip
- Health Services and Outcomes Research, National Healthcare Group, Singapore, Singapore
| | - Zi Yan Chiam
- Department of Palliative Medicine, Tan Tock Seng Hospital, Singapore, Singapore
| | - Han Yee Neo
- Department of Palliative Medicine, Tan Tock Seng Hospital, Singapore, Singapore
| | - Woan Shin Tan
- Health Services and Outcomes Research, National Healthcare Group, Singapore, Singapore
| | - Allyn Hum
- Department of Palliative Medicine, Tan Tock Seng Hospital, Singapore, Singapore
- The Palliative Care Centre for Excellence in Research and Education, Dover Park Hospice, Singapore, Singapore
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Lister P, Sudharson NA, Kaur P. The impact of intermittent fasting on oral health. Br Dent J 2024; 236:425. [PMID: 38519653 DOI: 10.1038/s41415-024-7240-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Revised: 01/31/2024] [Accepted: 01/31/2024] [Indexed: 03/25/2024]
Affiliation(s)
- P Lister
- Dentist, Emmanuel Hospital Association, New Delhi, India.
| | - N A Sudharson
- Assistant Professor, Department of Prosthodontics, Christian Dental College, Ludhiana, India.
| | - P Kaur
- Alumna of Christian Dental College, Ludhiana, India.
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Yip W, Ng SHX, Kaur P, George PP, Guan JHC, Lee G, Koh TJK, Tan WS, Hum AYM. Risk factors for short-term all-cause mortality in patients with end stage renal disease: a scoping review. BMC Nephrol 2024; 25:71. [PMID: 38413903 PMCID: PMC10900550 DOI: 10.1186/s12882-024-03503-3] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 02/14/2024] [Indexed: 02/29/2024] Open
Abstract
OBJECTIVES There is a lack of prognostic information to guide the prediction of short-term all-cause mortality in patients with end-stage renal disease (ESRD). The aim was to review the risk factors that influenced the risk of short-term all-cause mortality in patients with ESRD. METHODS MEDLINE, Embase, PubMed, CINAHL, the Cochrane Library and Web of Science databases were searched for articles published between 2000 and 2020. Articles describing risk factors predicting short-term mortality (≤ 3 years) in patients with ESRD were included. Four reviewers independently performed title, abstract, full text screening and data extraction. Assessment of risk of bias was assessed using the Quality In Prognosis Studies (QUIPS) tool checklist. RESULTS 20,840 articles were identified and 113 papers were included for this review. Of the 113 papers, 6.2% included only peritoneal dialysis (PD) patients, 67.3% included only hemodialysis (HD) patients, 20.4% included both PD and HD patients, with the remaining papers featuring patients on conservative management or awaiting renal transplant. Risk factors were categorised into 13 domains: 1)demographics/ lifestyle, 2) comorbidities 3)intradialytic blood pressure, 4)biomarkers, 5)cardiovascular measurements, 6)frailty status, 7)medications, 8)treatment related indicators, 9)renal related parameters, 10)health status, 11)cause of ESRD, 12)access to healthcare care/ information and, 13)proxy measures for poor health. C-reactive protein(CRP), age, and functional status were observed to have higher percentage of instances of being significantly associated with all-cause mortality. CONCLUSION Commonly examined risk factors observed from this review may be used to build a general prognostic model for patients with ESRD, with specific treatment related risk factors added on to enhance the accuracy of the models.
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Affiliation(s)
- Wanfen Yip
- Health Services & Outcomes Research, National Healthcare Group, Singapore, Singapore.
| | - Sheryl Hui Xian Ng
- Health Services & Outcomes Research, National Healthcare Group, Singapore, Singapore
| | - Palvinder Kaur
- Health Services & Outcomes Research, National Healthcare Group, Singapore, Singapore
| | - Pradeep Paul George
- Health Services & Outcomes Research, National Healthcare Group, Singapore, Singapore
| | | | - Guozhang Lee
- Department of Internal Medicine, Singapore General Hospital, Singapore, Singapore
| | | | - Woan Shin Tan
- Health Services & Outcomes Research, National Healthcare Group, Singapore, Singapore
- Geriatric Education and Research Institute, Singapore, Singapore
| | - Allyn Yin Mei Hum
- Department of Palliative Medicine, Tan Tock Seng Hospital, Singapore, Singapore
- The Palliative Care Centre for Excellence in Research and Education, Dover Park Hospice, Singapore, Singapore
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Sharma GK, Patil A, Kaur P, Rajesh S, Drakonaki E, Botchu R. Comparison of efficacy of ultrasound-guided platelet rich plasma injection versus dry needling in lateral epicondylitis-a randomised controlled trial. J Ultrasound 2024:10.1007/s40477-023-00846-9. [PMID: 38393452 DOI: 10.1007/s40477-023-00846-9] [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: 09/19/2023] [Accepted: 11/08/2023] [Indexed: 02/25/2024] Open
Abstract
PURPOSE To assess whether Ultrasound guided dry needling is adequate for both common extensor tendon tears and tendinosis or whether ultrasound guided platelet rich plasma (PRP) has a superior outcome when compared to dry needling when there are tears of the common extensor tendon. MATERIALS AND METHODS This is a single-centre, single-blinded, randomised controlled trial conducted between November 2018 and April 2020. 40 patients diagnosed with lateral epicondylitis based on clinical and sonographic features and having comparable baseline characteristics were randomly assigned to the two study groups (dry needling and PRP). Inclusion criteria were patients aged 20 years or more who were symptomatic for at least 3 months with sonographic evidence of lateral epicondylitis. Exclusion criteria were complete tear of common extensor tendon confirmed on ultrasound and presence of other associated diseases like osteoarthritis of shoulder and elbow. RESULTS There was significant improvement in the visual analogue scale pain score in PRP group compared to the dry needling group at 9 months. However, this difference was not evident at 3 and 6 months follow-up. Mean improvement in common extensor tendon thickness in PRP group (5.1 mm at 3 months and 4.3 mm at 6 months) was slightly better than dry needling (4.4 mm at 3 months and 4.0 mm at 6 months). There was no difference in tear (if present) healing between both groups at 3 months. However at 6 months follow up, PRP demonstrated significant (mean-2.5) healing in tear compared to dry needling (mean-3.1). CONCLUSION Two injections of Ultrasound guided PRP are more beneficial non operative treatment compared to ultrasound guided dry needling, in lateral epicondylitis.
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Affiliation(s)
- G K Sharma
- JIPSI (Jaipur Institute of Pain & Sports Injuries), Jaipur, India
- Department of Interventional Radiology and clinical Imaging, The liver unit, Cochin gastroenterology Group, Cochin, India
| | - A Patil
- Department of Radiology, Alameen Medical College, Vijayapur, India
- Department of Interventional Radiology and clinical Imaging, The liver unit, Cochin gastroenterology Group, Cochin, India
| | - P Kaur
- JIPSI (Jaipur Institute of Pain & Sports Injuries), Jaipur, India
- Department of Interventional Radiology and clinical Imaging, The liver unit, Cochin gastroenterology Group, Cochin, India
| | - S Rajesh
- Department of Pain Management, JIPSI (Jaipur Institute of Pain & Sports Injuries), Jaipur, India
- Department of Interventional Radiology and clinical Imaging, The liver unit, Cochin gastroenterology Group, Cochin, India
| | | | - Rajesh Botchu
- Department of Radiology, Alameen Medical College, Vijayapur, India.
- Department of Interventional Radiology and clinical Imaging, The liver unit, Cochin gastroenterology Group, Cochin, India.
- Department of Musculoskeletal Radiology, Royal Orthopaedic Hospital, Bristol Road South, Northfield, Birmingham, UK.
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Sharma V, Kaur P, Aulakh RS, Sharma R, Verma R, Singh BB. Is Brucella excreted in cattle faeces? - Evidence from Punjab, India. Comp Immunol Microbiol Infect Dis 2024; 104:102099. [PMID: 38007989 DOI: 10.1016/j.cimid.2023.102099] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 11/13/2023] [Indexed: 11/28/2023]
Abstract
Brucellosis is a neglected zoonosis that affects animals and people in much of the underdeveloped world. The disease is endemic in cattle in Punjab, India and controlling it is a public health challenge. Dairy farmers and farm labour commonly handle cattle faeces with bare hands and personal protective equipments are not used. No studies have been conducted about the shedding of Brucella species in faeces of sero positive cattle in the state. This study aimed to isolate and identify the Brucella species from faeces of sero positive cattle in Punjab, India. Faecal samples were collected from 350 Brucella sero positive cattle in Ludhiana district of Punjab, India. Isolation was performed using a pre-enriched Brucella selective broth medium as well as Brucella selective medium agar plates containing horse serum and Brucella selective supplements. Isolates were identified using Gram staining technique and rapid slide agglutination test, and then confirmed by using bcsp31 and 16s rRNA genus specific PCR. Isolates were further identified up to species level by using Bruce-Ladder multiplex PCR. Fourteen Brucella species were isolated, all of which showed coccobacilli on gram staining, positive rapid slide agglutination test and amplification of bcsp31 and 16s rRNA genes. Of the 14 isolates, 11 were identified as Brucella abortus and 3 were identified as Brucella melitensis. The study demonstrates that animal faeces could pose a potential risk for animal and human health and faeces of seropositive cattle must be handled with care.
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Affiliation(s)
- V Sharma
- Centre for One Health, Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana, Punjab 141004, India
| | - P Kaur
- Department of Veterinary Microbiology, Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana, Punjab 141004, India
| | - R S Aulakh
- Centre for One Health, Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana, Punjab 141004, India
| | - R Sharma
- Centre for One Health, Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana, Punjab 141004, India
| | - R Verma
- Animal Disease Research Centre, Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana, Punjab 141004, India
| | - B B Singh
- Centre for One Health, Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana, Punjab 141004, India.
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Lister P, Sudharson NA, Joseph M, Kaur P. Cloud intelligence in diagnosis? Br Dent J 2023; 235:843. [PMID: 38066123 DOI: 10.1038/s41415-023-6617-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 11/08/2023] [Indexed: 12/18/2023]
Affiliation(s)
- P Lister
- Junior Lecturer, Department of Endodontics, Christian Dental College, Ludhiana, India.
| | - N A Sudharson
- Assistant Professor, Department of Prosthodontics, Christian Dental College, Ludhiana, India.
| | - M Joseph
- Lecturer, Department of Endodontics, Christian Dental College, Ludhiana, India.
| | - P Kaur
- Alumna of Christian Dental College, Ludhiana, India.
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Sudharson NA, Joseph M, Kaur P, Lister P, Jangde MK, Sudharson NG. NHS dentists and pension sustainability. Br Dent J 2023; 235:669. [PMID: 37945837 DOI: 10.1038/s41415-023-6509-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 10/06/2023] [Indexed: 11/12/2023]
Affiliation(s)
| | - M Joseph
- Christian Dental College, Ludhiana, India.
| | - P Kaur
- Christian Dental College, Ludhiana, India.
| | - P Lister
- Christian Dental College, Ludhiana, India.
| | - M K Jangde
- Department of Dentistry, Govt Medical College Kanker, Chhattisgarh, India.
| | - N G Sudharson
- Department of Community Medicine, KEM Medical College, Mumbai, India.
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Sharma V, Sharma R, Aulakh RS, Kaur P, Singh BB. Prevalence and risk factor investigation for exposure to Brucella species in surrogate stray cattle population reared in cow shelters in Punjab, India. Prev Vet Med 2023; 219:106023. [PMID: 37716180 DOI: 10.1016/j.prevetmed.2023.106023] [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: 11/06/2022] [Revised: 08/23/2023] [Accepted: 09/08/2023] [Indexed: 09/18/2023]
Abstract
Bovine brucellosis is endemic in cattle in India, however not much is known on the prevalence of this disease in stray cattle populations of the country. This study aimed to estimate the prevalence and identify risk factors associated with brucellosis in the stray cattle populations reared in cow shelters (gaushalas) of Punjab, India. Blood samples were collected from 587 cattle reared in 23 cow shelters in 23 districts (one per district) of the Punjab and were tested using Rose Bengal plate test (RBPT), standard tube agglutination test (STAT) and Indirect Enzyme Linked Immunosorbent Assay (i-ELISA). Information on the sex and breed of the animal, total cattle population and presence of a separate shed for parturition were collected. An animal was considered exposed to Brucella infection based on a positive RBPT or STAT test and a positive i-ELISA test. Explanatory variables for the animal level disease status outcome variable were sex and breed of the animal and at the shelter level were shelter cattle population size and presence of a separate shed for parturition. Univariable binomial exact logistic regression analysis was conducted to assess the association of each explanatory variable with the binary outcome variable. Sixty-two animals were seropositive on RBPT, with an apparent seroprevalence of 10.56% (95% confidence interval [CI]: 8.33%, 13.31%) and the estimated true seroprevalence of 11.48% (95% CI: 8.9%, 14.64%). Sixty three animals were seropositive using STAT [apparent seroprevalence of 10.73% (95% CI: 8.48%, 13.50%) and the estimated true seroprevalence of 10.69% (95% CI: 8.27%, 13.67%)], and 68 using i-ELISA [an apparent seroprevalence of 11.58% (95% CI: 9.24%, 14.43%) and the estimated true seroprevalence of 13.28% (95% CI: 10.50%, 16.66%)]. Cross bred cattle had a lower risk of being test positive (odds ratio 0.16, p = 0.04) as compared to indigenous cattle. Due to a ban on cow slaughter in the country, roaming stray cattle infected with brucellosis present a permanent risk of introduction of disease to the dairy farms and other vulnerable populations.
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Affiliation(s)
- V Sharma
- Centre for One Health, Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana, Punjab 141004, India
| | - R Sharma
- Centre for One Health, Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana, Punjab 141004, India
| | - R S Aulakh
- Centre for One Health, Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana, Punjab 141004, India
| | - P Kaur
- Department of Veterinary Microbiology, Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana, Punjab 141004, India
| | - B B Singh
- Centre for One Health, Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana, Punjab 141004, India.
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Kaur P, Kannapiran P, Ng SHX, Chu J, Low ZJ, Ding YY, Tan WS, Hum A. Predicting mortality in patients diagnosed with advanced dementia presenting at an acute care hospital: the PROgnostic Model for Advanced DEmentia (PRO-MADE). BMC Geriatr 2023; 23:255. [PMID: 37118683 PMCID: PMC10148534 DOI: 10.1186/s12877-023-03945-8] [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: 10/06/2022] [Accepted: 03/31/2023] [Indexed: 04/30/2023] Open
Abstract
BACKGROUND Challenges in prognosticating patients diagnosed with advanced dementia (AD) hinders timely referrals to palliative care. We aim to develop and validate a prognostic model to predict one-year all-cause mortality (ACM) in patients with AD presenting at an acute care hospital. METHODS This retrospective cohort study utilised administrative and clinical data from Tan Tock Seng Hospital (TTSH). Patients admitted to TTSH between 1st July 2016 and 31st October 2017 and identified to have AD were included. The primary outcome was ACM within one-year of AD diagnosis. Multivariable logistic regression was used. The PROgnostic Model for Advanced Dementia (PRO-MADE) was internally validated using a bootstrap resampling of 1000 replications and externally validated on a more recent cohort of AD patients. The model was evaluated for overall predictive accuracy (Nagelkerke's R2 and Brier score), discriminative [area-under-the-curve (AUC)], and calibration [calibration slope and calibration-in-the-large (CITL)] properties. RESULTS A total of 1,077 patients with a mean age of 85 (SD: 7.7) years old were included, and 318 (29.5%) patients died within one-year of AD diagnosis. Predictors of one-year ACM were age > 85 years (OR:1.87; 95%CI:1.36 to 2.56), male gender (OR:1.62; 95%CI:1.18 to 2.22), presence of pneumonia (OR:1.75; 95%CI:1.25 to 2.45), pressure ulcers (OR:2.60; 95%CI:1.57 to 4.31), dysphagia (OR:1.53; 95%CI:1.11 to 2.11), Charlson Comorbidity Index ≥ 8 (OR:1.39; 95%CI:1.01 to 1.90), functional dependency in ≥ 4 activities of daily living (OR: 1.82; 95%CI:1.32 to 2.53), abnormal urea (OR:2.16; 95%CI:1.58 to 2.95) and abnormal albumin (OR:3.68; 95%CI:2.07 to 6.54) values. Internal validation results for optimism-adjusted Nagelkerke's R2, Brier score, AUC, calibration slope and CITL were 0.25 (95%CI:0.25 to 0.26), 0.17 (95%CI:0.17 to 0.17), 0.76 (95%CI:0.76 to 0.76), 0.95 (95% CI:0.95 to 0.96) and 0 (95%CI:-0.0001 to 0.001) respectively. When externally validated, the model demonstrated an AUC of 0.70 (95%CI:0.69 to 0.71), calibration slope of 0.64 (95%CI:0.63 to 0.66) and CITL of -0.27 (95%CI:-0.28 to -0.26). CONCLUSION The PRO-MADE attained good discrimination and calibration properties. Used synergistically with a clinician's judgement, this model can identify AD patients who are at high-risk of one-year ACM to facilitate timely referrals to palliative care.
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Affiliation(s)
- Palvinder Kaur
- Health Services and Outcomes Research, National Healthcare Group, 3 Fusionopolis Link, #03-08, Singapore, 138543, Singapore
| | - Palvannan Kannapiran
- Health Services and Outcomes Research, National Healthcare Group, 3 Fusionopolis Link, #03-08, Singapore, 138543, Singapore
| | - Sheryl Hui Xian Ng
- Health Services and Outcomes Research, National Healthcare Group, 3 Fusionopolis Link, #03-08, Singapore, 138543, Singapore
| | - Jermain Chu
- Department of Palliative Medicine, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore
| | - Zhi Jun Low
- Department of Palliative Medicine, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore
| | - Yew Yoong Ding
- Geriatric Education and Research Institute, 2 Yishun Central 2, Singapore, 768024, Singapore
| | - Woan Shin Tan
- Health Services and Outcomes Research, National Healthcare Group, 3 Fusionopolis Link, #03-08, Singapore, 138543, Singapore
| | - Allyn Hum
- Palliative Care Centre for Excellence in Research and Education, Tan Tock Seng Hospital, 10 Jalan Tan Tock Seng, Singapore, 308436, Singapore.
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PRABHAHAR A, Kaur P, Kumar V, Kohli H, Ramachandran R. WCN23-0977 TO STUDY THE ASSOCIATION OF BONE MINERAL DENSITY WITH CLINICAL ACTIVITY IN ADULT-ONSET NEPHROTIC SYNDROME. Kidney Int Rep 2023. [DOI: 10.1016/j.ekir.2023.02.589] [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: 03/22/2023] Open
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Holt HR, Walker M, Beauvais W, Kaur P, Bedi JS, Mangtani P, Sharma NS, Gill JPS, Godfroid J, McGiven J, Guitian J. Modelling the control of bovine brucellosis in India. J R Soc Interface 2023; 20:20220756. [PMID: 36882115 PMCID: PMC9991488 DOI: 10.1098/rsif.2022.0756] [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] [Indexed: 03/09/2023] Open
Abstract
Brucellosis imposes substantial impacts on livestock production and public health worldwide. A stochastic, age-structured model incorporating herd demographics was developed describing within- and between-herd transmission of Brucella abortus in dairy cattle herds. The model was fitted to data from a cross-sectional study conducted in Punjab State of India and used to evaluate the effectiveness of control strategies under consideration. Based on model results, stakeholder acceptance and constraints regarding vaccine supply, vaccination of replacement calves in large farms should be prioritized. Test and removal applied at early stages of the control programme where seroprevalence is high would not constitute an effective or acceptable use of resources because significant numbers of animals would be 'removed' (culled or not used for breeding) based on false positive results. To achieve sustained reductions in brucellosis, policymakers must commit to maintaining vaccination in the long term, which may eventually reduce frequency of infection in the livestock reservoir to a low enough level for elimination to be a realistic objective. This work provides key strategic insights into the control of brucellosis in India, which has the largest cattle population globally, and a general modelling framework for evaluating control strategies in endemic settings.
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Affiliation(s)
- H R Holt
- Veterinary Epidemiology, Economics and Public Health Group, WOAH Collaborating Centre in Risk Analysis and Modelling, Department of Pathobiology and Population Sciences, Royal Veterinary College, University of London, Hatfield AL9 7TA, UK.,Communicable Diseases Policy Research Group, London School of Hygiene and Tropical Medicine, Keppel St, London WC1E 7HT, UK
| | - M Walker
- Veterinary Epidemiology, Economics and Public Health Group, WOAH Collaborating Centre in Risk Analysis and Modelling, Department of Pathobiology and Population Sciences, Royal Veterinary College, University of London, Hatfield AL9 7TA, UK.,London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, Imperial College London, London W2 1PG, UK
| | - W Beauvais
- Comparative Pathobiology Department, College of Veterinary Medicine, Purdue University, West Lafayette, IN 47906, USA
| | - P Kaur
- Department of Veterinary Microbiology, Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana, Punjab, India
| | - J S Bedi
- School of Public Health and Zoonosis, Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana, Punjab, India
| | - P Mangtani
- Faculty of Epidemiology and Population Health, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - N S Sharma
- Department of Veterinary Microbiology, Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana, Punjab, India
| | - J P S Gill
- School of Public Health and Zoonosis, Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana, Punjab, India
| | - J Godfroid
- Faculty of Biosciences, Fisheries and Economics, Department of Arctic and Marine Biology, UiT - The Arctic University of Norway, Hansine Hansens veg 18, 9019 Tromsø, Norway
| | - J McGiven
- WOAH Brucellosis Reference Laboratory, FAO Collaborating Centre for Brucellosis, Department of Bacteriology, Animal & Plant Health Agency, Surrey, UK
| | - J Guitian
- Veterinary Epidemiology, Economics and Public Health Group, WOAH Collaborating Centre in Risk Analysis and Modelling, Department of Pathobiology and Population Sciences, Royal Veterinary College, University of London, Hatfield AL9 7TA, UK
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Behera PK, Kaur P, Mishra SS, Mishra SK. Mapping and visualizing the research contribution of India on telemedicine: A scientometric study. J Postgrad Med 2023:370400. [PMID: 36861544 PMCID: PMC10394533 DOI: 10.4103/jpgm.jpgm_107_22] [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] [Indexed: 02/25/2023] Open
Abstract
Background The term "Telemedicine" is being used in the medical and health sector to treat patients and to provide medical guidance remotely. The intellectual output from India in terms of publications was harvested from Scopus® with the keyword "Telemedicine" and analyzed by using bibliometric techniques. Methods The source data was downloaded from the Scopus® database. All the publications on telemedicine and indexed in the database up to the year 2021 were considered for scientometric analysis. The software tools VOSviewer® version 1.6.18 to visualize bibliometric networks, statistical software R Studio® version 3.6.1 with the Bibliometrix package Biblioshiny® were used for analysis and data visualization, and EdrawMind® was used for mind mapping. Result India contributed 2,391 (4.32%) publications on telemedicine to a total of 55,304 publications worldwide until 2021. There were 886 (37.05%) papers that appeared in open access mode. The analysis revealed that the first paper was published in the year 1995 from India. Steep growth in the number of publications was observed in 2020 with 458 publications. The highest, 54 research publications, appeared in the "Journal of Medical Systems." The All India Institute of Medical Sciences (AIIMS), New Delhi, contributed the highest number of publications (n = 134). A considerable overseas collaboration was observed (USA: 11%; UK: 5.85%). Conclusions This is the first such attempt to address the intellectual output of India in the emerging medical discipline of telemedicine and has yielded useful information such as leading authors, institutions, their impact, and year-wise topic trends.
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Affiliation(s)
- P K Behera
- PK Kelkar Library, Indian Institute of Technology, Kanpur, Uttar Pradesh, India
| | - P Kaur
- Central Library, Chandigarh University, Gharuan, Mohali, Punjab, India
| | - S S Mishra
- Centre for Development of Advanced Computing (CDAC), Mohali, Punjab, India
| | - S K Mishra
- Department of Biological Sciences and Bioengineering, Indian Institute of Technology, Kanpur, Uttar Pradesh, India
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Satpathy MM, Sharma NS, Kaur P, Arora AK. Detection of antimicrobial resistance genes in extended spectrum beta-lactamase-producing Escherichia coli from milk of indigenous Beetal goats of Punjab. Iran J Vet Res 2023; 24:37-41. [PMID: 37378388 PMCID: PMC10291518 DOI: 10.22099/ijvr.2023.43480.6365] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 01/02/2023] [Accepted: 01/07/2023] [Indexed: 06/29/2023]
Abstract
Background Antimicrobial resistance (AMR) is a burning issue in the present era. Mastitis in dairy animals is one of the most important causes of huge production loss to dairy farmers. Aims: The study aims to find the prevalence, antimicrobial resistance profile, and resistance genes in the extended-spectrum beta-lactamase-producing Escherichia coli in mastitic milk. Methods A total of 125 milk samples were collected from Beetal goats suffering from clinical mastitis from different districts of Punjab and processed for bacterial isolation and further identification. The drug resistance profile of ESBL-producing E. coli and its associations with molecular markers was analyzed using statistical analysis. Results The prevalence of ESBL-producing E. coli in dairy goats of Punjab was recorded as 6.4%. The isolates showed the highest resistance to the beta-lactam group of antibiotics. The resistance percentages of streptomycin, gentamicin, tetracycline, chloramphenicol, clotrimazole, and colistin were 50%, 37.5%, 50%, 25%, 25%, and 50%, respectively. The isolates showed intermediate resistance to imipenem (12.5%) and tetracycline (25%). The ESBL-producing E. coli isolates harbored the resistance genes blaCTXM (100%), blaTEM (62.5%), blaSHV (25%), blaOXA (37.5%), tetA (37.5%), tetB (25%), aadA (37.5%), sul1 (25%), MOXM (12.5%), DHAM (25%), and blaCMY-2 (50%). Tetracycline and sulphonamide resistances were statistically associated with their respective resistance genes (P<0.05). Streptomycin resistance was not statistically associated with the presence of the aadA gene (P>0.05). The genes blaIMP and blaNDM were not recorded in any of the isolates. In this study, 12.5% of the isolates showed co-resistance to colistin and carbapenem. Conclusion Antimicrobial resistance is a hot topic and requires immediate attention.
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Affiliation(s)
- M. M Satpathy
- MVSc Student in Veterinary Microbiology, Department of Veterinary Microbiology, Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana-141004, Punjab, India
| | - N. S Sharma
- Department of Veterinary Microbiology, Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana-141004, Punjab, India
| | - P Kaur
- Department of Veterinary Microbiology, Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana-141004, Punjab, India
| | - A. K Arora
- Department of Veterinary Microbiology, Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana-141004, Punjab, India
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Schwalb A, Cachay R, Wright A, Phillips PPJ, Kaur P, Diacon AH, Ugarte-Gil C, Mitnick CD, Sterling TR, Gotuzzo E, Horsburgh CR. Factors associated with screening failure and study withdrawal in multidrug-resistant TB. Int J Tuberc Lung Dis 2022; 26:820-825. [PMID: 35996282 DOI: 10.5588/ijtld.21.0729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
SETTING: Multidrug-resistant TB (MDR-TB) clinical trial in Lima, Peru and Cape Town, South Africa.OBJECTIVE: To identify baseline factors associated with screening failure and study withdrawal in an MDR-TB clinical trial.DESIGN: We screened patients for a randomized, blinded, Phase II trial which assessed culture conversion over the first 6 months of treatment with varying doses of levofloxacin plus an optimized background regimen (ClinicalTrials.gov: NCT01918397). We identified factors for screening failure and study withdrawal using Poisson regression to calculate prevalence ratios and Cox proportional hazard regression to calculate hazard ratios. We adjusted for factors with P < 0.2.RESULTS: Of the 255 patients screened, 144 (56.5%) failed screening. The most common reason for screening failure was an unsuitable resistance profile on sputum-based molecular susceptibility testing (n = 105, 72.9%). No significant baseline predictors of screening failure were identified in the multivariable model. Of the 111 who were enrolled, 33 (30%) failed to complete treatment, mostly for non-adherence and consent withdrawal. No baseline factors predicted study withdrawal in the multivariable model.CONCLUSION: No baseline factors were independently associated with either screening failure or study withdrawal in this secondary analysis of a MDR-TB clinical trial.
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Affiliation(s)
- A Schwalb
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - R Cachay
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - A Wright
- Vanderbilt University Medical Center, Vanderbilt Tuberculosis Center, Nashville, TN, USA
| | - P P J Phillips
- University of California San Francisco Center for Tuberculosis, San Francisco, CA, USA
| | - P Kaur
- Boston University, Departments of Epidemiology, Biostatistics, Global Health and Medicine, Boston, MA, USA
| | - A H Diacon
- TASK Applied Science and Stellenbosch University, Cape Town, South Africa
| | - C Ugarte-Gil
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - C D Mitnick
- School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - T R Sterling
- Vanderbilt University Medical Center, Vanderbilt Tuberculosis Center, Nashville, TN, USA
| | - E Gotuzzo
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - C R Horsburgh
- Boston University, Departments of Epidemiology, Biostatistics, Global Health and Medicine, Boston, MA, USA
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15
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Chong E, Zhu B, Ng SHX, Tan H, Goh EF, Molina JDC, Pereira MJ, Kaur P, Baldevarona-Llego J, Chia JQ, Chong A, Cheong S, Foo CL, Chan M, Lim WS. Emergency department interventions for frailty (EDIFY): improving functional outcomes in older persons at the emergency department through a multicomponent frailty intervention. Age Ageing 2022; 51:6520521. [PMID: 35134848 DOI: 10.1093/ageing/afab251] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 06/19/2021] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVES emergency department interventions for frailty (EDIFY) delivers frailty-centric interventions at the emergency department (ED). We evaluated the effectiveness of a multicomponent frailty intervention (MFI) in improving functional outcomes among older persons. DESIGN a quasi-experimental study. SETTING a 30-bed ED observation unit within a 1,700-bed acute tertiary hospital. PARTICIPANTS patients aged ≥65 years, categorised as Clinical Frailty Scale 4-6, and planned for discharge from the unit. METHODS we compared patients receiving the MFI versus usual-care. Data on demographics, function, frailty, sarcopenia, comorbidities and medications were gathered. Our primary outcome was functional status-Modified Barthel Index (MBI) and Lawton's iADL. Secondary outcomes include hospitalisation, ED re-attendance, mortality, frailty, sarcopenia, polypharmacy and falls. Follow-up assessments were at 3, 6 and 12 months. RESULTS we recruited 140 participants (mean age 79.7 ± 7.6 years; 47% frail and 73.6% completed the study). Baseline characteristics between groups were comparable (each n = 70). For the intervention group, MBI scores were significantly higher at 6 months (mean: 94.5 ± 11.2 versus 88.5 ± 19.5, P = 0.04), whereas Lawton's iADL scores experienced less decline (change-in-score: 0.0 ± 1.7 versus -1.1 ± 1.8, P = 0.001). Model-based analyses revealed greater odds of maintaining/improving MBI in the intervention group at 6 months [odds ratio (OR) 2.51, 95% confidence interval (CI) 1.04-6.03, P = 0.04] and 12 months (OR 2.98, 95% CI 1.18-7.54, P = 0.02). This was similar for Lawton's iADL at 12 months (OR 4.01, 95% CI 1.70-9.48, P = 0.002). ED re-attendances (rate ratio 0.35, 95% CI 0.13-0.90, P = 0.03) and progression to sarcopenia (OR 0.19, 95% CI 0.04-0.94, P = 0.04) were also lower at 6 months. CONCLUSIONS the MFI delivered to older persons at the ED can possibly improve functional outcomes and reduce ED re-attendances while attenuating sarcopenia progression.
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Affiliation(s)
- Edward Chong
- Department of Geriatric Medicine, Tan Tock Seng Hospital (TTSH), Singapore
- Institute of Geriatrics and Active Ageing (IGA), TTSH, Singapore
| | - Birong Zhu
- Department of Nursing Services, TTSH, Singapore
| | - Sheryl Hui Xian Ng
- Health Services and Outcomes Research (HSOR), National Healthcare Group, Singapore
| | - Hongyun Tan
- Department of Nursing Services, Woodlands Health, Singapore
| | - Eileen Fabia Goh
- Institute of Geriatrics and Active Ageing (IGA), TTSH, Singapore
| | | | | | - Palvinder Kaur
- Health Services and Outcomes Research (HSOR), National Healthcare Group, Singapore
| | | | - Jia Qian Chia
- Department of Geriatric Medicine, Tan Tock Seng Hospital (TTSH), Singapore
| | - Amanda Chong
- Department of Geriatric Medicine, Tan Tock Seng Hospital (TTSH), Singapore
| | | | | | - Mark Chan
- Department of Geriatric Medicine, Tan Tock Seng Hospital (TTSH), Singapore
- Institute of Geriatrics and Active Ageing (IGA), TTSH, Singapore
| | - Wee Shiong Lim
- Department of Geriatric Medicine, Tan Tock Seng Hospital (TTSH), Singapore
- Institute of Geriatrics and Active Ageing (IGA), TTSH, Singapore
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Kaur J, Kamboj K, Kaur P, Jose Kakkanattu T, Sethi J, Singh Kohli H, Kumar V, Kumar Yadav A. POS-171 MYO-INOSITOL OXYGENASE (MIOX) & YES-ASSOCIATED PROTEIN (YAP) IN COMMUNITY ACQUIRED ACUTE KIDNEY INJURY. Kidney Int Rep 2022. [DOI: 10.1016/j.ekir.2022.01.186] [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: 11/25/2022] Open
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SHARMA A, Kaur P, Kumar V, Kamboj K, Gondil V, Yadav A, Kohli H, Jha V. POS-426 CLINICAL TRIAL DATABASE (CTD): INTEGRATED DATABASE MANAGEMENT SYSTEM FOR CLINICAL TRIALS. Kidney Int Rep 2022. [DOI: 10.1016/j.ekir.2022.01.452] [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: 11/17/2022] Open
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18
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Kaur P, Wu HY, Hum A, Heng BH, Tan WS. Medical cost of advanced illnesses in the last-year of life-retrospective database study. Age Ageing 2022; 51:6406695. [PMID: 34673931 DOI: 10.1093/ageing/afab212] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [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: 05/27/2021] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE This study aims to quantify medical care utilisation, and to describe the cost trajectories of individuals with advanced illnesses in the last-year of life, differentiated by advanced cancer, end-stage organ failure and progressive neurological disorders. METHODS This retrospective database study included decedents who had previous inpatient or outpatient encounters at a public hospital in Singapore. Patients with advanced diseases were identified based on diagnostic codes and clinical criteria. Using a look-back approach, the amount of healthcare services utilised and the corresponding mean monthly and annual costs to the healthcare system in the last 12-months of life were quantified. RESULTS The last 12-months of life among 6,598 decedents was associated with £20,524 (95% confidence interval: £20,013-£21,036) in medical costs, of which 80% was accounted for by inpatient admissions. Costs increased sharply in the last 2-months of life, with a large proportion of monthly costs accounted for by inpatient admissions which rose rapidly from 61% at 12-months prior to death to 94% in the last-month of life. Compared to patients with cancer, individuals diagnosed with non-cancer advanced illnesses accumulated 1.6 times more healthcare costs in the last-year of life with significant differences across patients with end-stage organ failure and progressive neurological disorders. CONCLUSION Healthcare costs varied across disease conditions at the end-of-life. With advance care planning and close collaboration between the inpatient clinical team and the community providers, it may be possible to re-direct some of the hospitalisation costs to community-based palliative care services.
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Affiliation(s)
- Palvinder Kaur
- Health Services and Outcomes Research Department, National Healthcare Group, Singapore 138543
| | - Huei Yaw Wu
- Department of Palliative Medicine, Tan Tock Seng Hospital Singapore, Singapore 308433
- Palliative Care Centre for Excellence in Research and Education, Singapore 308436
| | - Allyn Hum
- Department of Palliative Medicine, Tan Tock Seng Hospital Singapore, Singapore 308433
- Palliative Care Centre for Excellence in Research and Education, Singapore 308436
| | - Bee Hoon Heng
- Health Services and Outcomes Research Department, National Healthcare Group, Singapore 138543
| | - Woan Shin Tan
- Health Services and Outcomes Research Department, National Healthcare Group, Singapore 138543
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19
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Jaiswal V, Brar APS, Sandhu BS, Singla LD, Narang D, Leishangthem GD, Kaur P. Comparative evaluation of various diagnostic techniques for detection of Cryptosporidium infection from the faecal samples of diarrhoeic bovine calves. Iran J Vet Res 2022; 23:247-254. [PMID: 36425600 PMCID: PMC9681974 DOI: 10.22099/ijvr.2022.42714.6204] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 03/23/2022] [Accepted: 04/19/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Cryptosporidium, an opportunistic, zoonotic, apicomplexan parasite, is one of the most common causes of diarrhea in neonatal bovine calves around the globe. Bovine calves act as a major source of infection by excreting huge numbers of highly resistant oocysts in faeces, which can survive for a long time in extreme environmental conditions. As low as ten oocysts can cause disease and mortality, leading to the requirement of an early and accurate diagnosis for proper and favorable prognosis, management, and control. AIMS The current study was conducted with the objective to evaluate various diagnostic techniques (acid fast staining, negative staining, fluorescent, ELISA, PCR, nested PCR, and qPCR) for the detection of Cryptosporidium in the faecal samples of diarrheic bovine calves. METHODS Two hundred diarrheic faecal samples from bovine calves were collected and subjected to these techniques for Cryptosporidium diagnosis. Results of these were evaluated for diagnostic comparison. RESULTS Out of 200 faecal samples evaluated, 24% (48/200) were detected positive for Cryptosporidium using a combination of two techniques as gold standard criteria. Cohen's kappa value indicated moderate to almost perfect agreement (0.616 to 0.986) among all the techniques used in the present study. Leishman staining showed the lowest sensitivity (54.17%), while nested PCR and qPCR showed the highest sensitivity (97.92%). Diagnostic specificity of all these tests ranged from 98.68 to 100%. CONCLUSION Auramine stain was used for the first time in the bovine calves in India for the detection and diagnostic comparison of Cryptosporidium. It showed strong agreement with the molecular as well as classical diagnostic techniques, and can be used for primary screening for better diagnosis.
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Affiliation(s)
- V. Jaiswal
- Department of Veterinary Pathology, Guru Angad Dev Veterinary and Animal Sciences University (GADVASU), Ludhiana, Punjab, India
| | - A. P. S. Brar
- Department of Veterinary Pathology, Guru Angad Dev Veterinary and Animal Sciences University (GADVASU), Ludhiana, Punjab, India
| | - B. S. Sandhu
- Department of Veterinary Pathology, Guru Angad Dev Veterinary and Animal Sciences University (GADVASU), Ludhiana, Punjab, India
| | - L. D. Singla
- Department of Veterinary Parasitology, Guru Angad Dev Veterinary and Animal Sciences University (GADVASU), Ludhiana, Punjab, India
| | - D. Narang
- Department of Veterinary Microbiology, Guru Angad Dev Veterinary and Animal Sciences University (GADVASU), Ludhiana, Punjab, India
| | - G. D. Leishangthem
- Department of Veterinary Pathology, Guru Angad Dev Veterinary and Animal Sciences University (GADVASU), Ludhiana, Punjab, India
| | - P. Kaur
- MSc in Biochemistry, Department of Veterinary Pathology, Guru Angad Dev Veterinary and Animal Sciences University (GADVASU), Ludhiana, Punjab, India
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20
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Javed R, Narang D, Kaur P, Chandra M, Filia G, Singh ST. A fluorescence polarization assay using recombinant protein ESAT-6 for the detection of antibodies against pathogenic Mycobacterium bovis in bovine. Iran J Vet Res 2022; 23:204-209. [PMID: 36425598 PMCID: PMC9681983 DOI: 10.22099/ijvr.2022.38558.5613] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 03/07/2022] [Accepted: 03/16/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Bovine tuberculosis (bTB) is a major bacterial disease that causes significant economic disruption across the globe. AIMS Our study was based on using a fluorescence polarization assay (FPA) that used fluorescein-labeled ESAT-6 protein to detect Mycobacterium bovis antibodies in bovine serum. METHODS The ESAT-6 protein was used in a FPA. Positive TB reactors were determined by the comparative intradermal test (CID) and interferon gamma test (IFN-γ). Antibodies against M. bovis were detected using a fluorescein isothiocyanate (FITC) labeled tracer and a whole culture FITC labeled tracer in the positive cattle. RESULTS Of the 192 animals tested for bTB, 37 were found to be positive by either the CID or IFN-γ assays. Using the mP values from five culture-positive serum samples, a cutoff value of more than >127 mp provided the best discrimination between positive reactors and negative bTB animals. The ESAT-6 results of FPA in comparison with CID results revealed sensitivity of 92.9% and specificity of 64.6%, and in comparison with results IFN-γ, showed sensitivity of 95.7% and specificity of 49%. FPA using FITC labelled ESAT-6 as a tracer has better sensitivity (95.7%) and specificity (49.1%) than IFN-γ test in humoral immune response in animals. CONCLUSION This work revealed that the ESAT-6 protein as an antigen can be used in diagnosing bTB using a practical and sensitive humoral test.
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Affiliation(s)
- R. Javed
- Ph.D. Student, Department of Veterinary Microbiology, College of Veterinary Science (COVS), Guru Angad Dev Veterinary and Animal Sciences University (GADVASU), Ludhiana, Punjab, India
| | - D. Narang
- Department of Veterinary Microbiology, College of Veterinary Science (COVS), Guru Angad Dev Veterinary and Animal Sciences University (GADVASU), Ludhiana, Punjab, India
| | - P. Kaur
- Department of Veterinary Microbiology, College of Veterinary Science (COVS), Guru Angad Dev Veterinary and Animal Sciences University (GADVASU), Ludhiana, Punjab, India
| | - M. Chandra
- Department of Veterinary Microbiology, College of Veterinary Science (COVS), Guru Angad Dev Veterinary and Animal Sciences University (GADVASU), Ludhiana, Punjab, India
| | - G. Filia
- Animal Disease Research Centre (ADRC), College of Veterinary Science (COVS), Guru Angad Dev Veterinary and Animal Sciences University (GADVASU), Ludhiana, Punjab, India
| | - S. T. Singh
- Directorate of Livestock Farms, Guru Angad Dev Veterinary and Animal Sciences University (GADVASU), Ludhiana, Punjab, India
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Ge L, Kaur P, Yap CW, Heng BH. Psychometric Properties of the Patient Activation Measure in Community-Dwelling Adults in Singapore. INQUIRY 2022; 59:469580221100781. [PMID: 35535478 PMCID: PMC9096181 DOI: 10.1177/00469580221100781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Introduction Measuring health activation in general population using valid instruments is needed to facilitate the evaluation of health education and behavioral programs in community. The 13-item Patient Activation Measure was well validated in patients with different chronic diseases but rarely validated in general population. The objective of this study was to assess the psychometric properties of the Patient Activation Measure among community-dwelling adults in Singapore. Methods Data of participants having valid responses to the English-version measure (N = 824) were analyzed. The psychometric properties were assessed by demonstrating evidence for uni-dimensionality using Rasch Principal Component Analysis of Residuals, known-group validity, convergent and divergent validity, and internal consistency reliability using Cronbach’s alpha. Results The uni-dimensionality of the Patient Activation Measure was supported by the Rasch Principal Component Analysis of Residuals results. Participants having multimorbidity or polypharmacy and being inactive in physical activity had significantly lower activation scores. The activation score was positively and moderately correlated with health confidence measured by the Health Confidence Measure (r = .38, P < .001), and negatively and weakly correlated with depressive symptoms measured by the Patient Health Questionnaire (r = − .13, P < .001). The internal reliability was good with a Cronbach’s alpha of .82. Conclusion The 13-item Patient Activation Measure has acceptable construct validity and good internal consistency among community-dwelling adults. It is a potential instrument to measure health activation in this population. Further research is required to investigate the expansion of response options, validate the cut-off scores for the activation levels and examine the test-retest reliability and responsiveness.
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Affiliation(s)
- Lixia Ge
- National Healthcare Group Pte. Ltd, Singapore, Singapore
| | - Palvinder Kaur
- National Healthcare Group Pte. Ltd, Singapore, Singapore
| | - Chun Wei Yap
- National Healthcare Group Pte. Ltd, Singapore, Singapore
| | - Bee Hoon Heng
- National Healthcare Group Pte. Ltd, Singapore, Singapore
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Ge L, Yap CW, Kaur P, Ong R, Heng BH. Psychometric evaluation of the 8-item Altarum Consumer Engagement (ACE) Measure™ in community-dwelling adults in Singapore. BMC Health Serv Res 2021; 21:1347. [PMID: 34915884 PMCID: PMC8680055 DOI: 10.1186/s12913-021-07369-1] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 12/02/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A valid and reliable measure is essential to assess patient engagement and its impact on health outcomes. This study aimed to examine the psychometric properties of the 8-item Altarum Consumer Engagement Measure™ (ACE Measure) among English-speaking community-dwelling adults in Singapore. METHODS This cross-sectional study involved 400 randomly selected community-dwelling adults (mean age: 49.7 years, 50.0% were female, 72.3% were Chinese) who completed the English version of the 8-item ACE Measure independently. The item-level statistics were described. The internal consistency of the measure was measured by Cronbach alpha and item-rest correlations. Validity of the tool was assessed by 1) factorial validity using confirmatory factor analysis (CFA), 2) hypothesis-testing validity by correlating ACE subscales (Commitment and Navigation) with health-related outcomes, and 3) criterion validity against the Patient Activation Measure and Health Confidence Measure. RESULTS There was no floor or ceiling effect for Commitment and Navigation subscales, and the Cronbach alpha for each subscale was 0.76 and 0.54, respectively. The two-factor structure was confirmed by CFA. In general, Commitment and Navigation subscales were positively correlated with frequency of activity participation (rho = 0.30 - 0.33) and EQ-5D visual analog scale (rho = 0.15 - 0.30). Individuals who perceived better health than peers had higher subscale scores (p < 0.01). Each subscale score had moderate and positive correlations with activation score (rho = 0.48 - 0.55) and health confidence score (rho = 0.35 - 0.47). CONCLUSIONS The two-subscale ACE Measure demonstrated good construct validity in English-speaking Singapore community-dwelling adults. Evidence in internal consistency was mixed, indicating further investigation.
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Affiliation(s)
- Lixia Ge
- Health Services and Outcomes Research, National Healthcare Group, 3 Fusionopolis Link #03-08, Nexus@one-north, Singapore, 138543, Singapore.
| | - Chun Wei Yap
- Health Services and Outcomes Research, National Healthcare Group, 3 Fusionopolis Link #03-08, Nexus@one-north, Singapore, 138543, Singapore
| | - Palvinder Kaur
- Health Services and Outcomes Research, National Healthcare Group, 3 Fusionopolis Link #03-08, Nexus@one-north, Singapore, 138543, Singapore
| | - Reuben Ong
- Health Services and Outcomes Research, National Healthcare Group, 3 Fusionopolis Link #03-08, Nexus@one-north, Singapore, 138543, Singapore
| | - Bee Hoon Heng
- Health Services and Outcomes Research, National Healthcare Group, 3 Fusionopolis Link #03-08, Nexus@one-north, Singapore, 138543, Singapore
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Quraishi A, Kaur P, Singh Sharma N, Arora AK. Antibiotic sensitivity patterns in Staphylococcus spp. isolated from goat milk in association with molecular detection of antibiotic resistance genes. Iran J Vet Res 2021; 22:239-243. [PMID: 34777526 DOI: 10.22099/ijvr.2021.38465.5599] [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] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 05/28/2021] [Accepted: 06/25/2021] [Indexed: 09/30/2022]
Abstract
Background Microbes become unresponsive to the drugs used to treat infections due to their ability to acquire antimicrobial resistance. Aims The present research aimed to study the patterns of phenotypic and genotypic antimicrobial resistance in Staphylococcus spp. isolated from goat milk. Methods A total of 200 milk samples were collected to isolate Staphylococcus spp. from mastitic and healthy goats from Punjab state, India. The isolates were then identified biochemically and molecularly (polymerase chain reaction (PCR)). An antibiotic sensitivity test was conducted using 15 different antibiotics. Molecular detection of antibiotic resistance genes was done using PCR. Chi-square test was done to study the association between genotypic and phenotypic resistance patterns among the isolates. Results A total of 47 Staphylococcus spp. were isolated of which 33 and 14 isolates were respectively coagulase positive and negative. The isolates phenotypically showed the highest resistance to Penicillin G (P) (91.4%). Methicillin resistant Staphylococcus aureus (MRSA) was found 56.25%. Amongst the antibiotic resistance genes, tetK (87.23%) was the most prevalent isolated gene followed by blaZ (85.10%), mecA (48.93%), and tetM (14.89%). Statistical analysis revealed that the genotypic and phenotypic resistance patterns were significantly associated with penicillin and methicillin (MET) resistances. Conclusion The high prevalence of antibiotic-resistant Staphylococcus spp., especially MRSA, in goat milk is of concern and needs to be addressed in this area.
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Affiliation(s)
- A Quraishi
- MVSc Student in Veterinary Microbiology, Department of Veterinary Microbiology, College of Veterinary Sciences, Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana-141004, Punjab, India
| | - P Kaur
- Department of Veterinary Microbiology, College of Veterinary Sciences, Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana-141004, Punjab, India
| | - N Singh Sharma
- Department of Veterinary Microbiology, College of Veterinary Sciences, Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana-141004, Punjab, India
| | - A K Arora
- Department of Veterinary Microbiology, College of Veterinary Sciences, Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana-141004, Punjab, India
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Saini A, Gupta P, Bansal P, Sharma RP, Krishan B, Kaur P, Ferretti V. SYNTHESES, CHARACTERIZATION, X-RAY STRUCTURAL DETERMINATION, AND PACKING ANALYSES OF TERNARY COPPER(II) COMPLEXES: [Cu(2-PHENOXYACETATE/4-CHLOROBENZOATE)2(TEMED)]. J STRUCT CHEM+ 2021. [DOI: 10.1134/s0022476621090080] [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: 11/23/2022]
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25
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Yadav A, Kamboj K, Kaur P, Kumar V, Jha V. POS-400 EFFECT OF ORAL CHOLECALCIFEROL SUPPLEMENTATION ON SERUM LEVEL OF ANGIOGENIC MARKERS IN CHRONIC KIDNEY DISEASE. Kidney Int Rep 2021. [DOI: 10.1016/j.ekir.2021.03.418] [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] Open
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26
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Chong E, Zhu B, Tan H, Molina JDC, Goh EF, Baldevarona-Llego J, Chia JQ, Chong A, Cheong S, Kaur P, Pereira MJ, Ng SHX, Foo CL, Chan M, Lim WS. Emergency Department Interventions for Frailty (EDIFY): Front-Door Geriatric Care Can Reduce Acute Admissions. J Am Med Dir Assoc 2021; 22:923-928.e5. [PMID: 33675695 DOI: 10.1016/j.jamda.2021.01.083] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [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: 12/01/2020] [Revised: 01/19/2021] [Accepted: 01/28/2021] [Indexed: 12/13/2022]
Abstract
OBJECTIVES The EDIFY program was developed to deliver early geriatric specialist interventions at the emergency department (ED) to reduce the number of acute admissions by identifying patients for safe discharge or transfer to low-acuity care settings. We evaluated the effectiveness of EDIFY in reducing potentially avoidable acute admissions. DESIGN A quasi-experimental study. SETTING ED of a 1700-bed tertiary hospital. PARTICIPANTS ED patients aged ≥85 years. MEASUREMENTS We compared EDIFY interventions versus standard care. Patients with plans for acute admission were screened and recruited. Data on demographics, premorbid function, frailty status, comorbidities, and acute illness severity were gathered. We examined the primary outcome of "successful acute admission avoidance" among the intervention group, which was defined as no ED attendance within 72 hours of discharge from ED, no transfer to an acute ward from subacute-care units (SCU) within 72-hours, or no transfer to an acute ward from the short-stay unit (SSU). Secondary outcomes were rehospitalization, ED re-attendance, institutionalization, functional decline, mortality, and frailty transitions at 1, 3, and 6 months. RESULTS We recruited 100 participants (mean age 90.0 ± 4.1 years, 66.0% women). There were no differences in baseline characteristics between intervention (n = 43) and nonintervention (n = 57) groups. Thirty-five (81.4%) participants in the intervention group successfully avoided an acute admission (20.9% home, 23.3% SCU, and 44.2% SSU). All participants in the nonintervention group were hospitalized. There were no differences in rehospitalization, ED re-attendance, institutionalization and mortality over the study period. Additionally, we observed a higher rate of progression to a poorer frailty category at all time points among the nonintervention group (1, 3, and 6 months: all P < .05). CONCLUSIONS AND IMPLICATIONS Results from our single-center study suggest that early geriatric specialist interventions at the ED can reduce potentially avoidable acute admissions without escalating the risk of rehospitalization, ED re-attendance, or mortality, and with possible benefit in attenuating frailty progression.
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Affiliation(s)
- Edward Chong
- Department of Geriatric Medicine, Tan Tock Seng Hospital (TTSH), Singapore; Institute of Geriatrics and Active Ageing (IGA), TTSH, Singapore.
| | - Birong Zhu
- Department of Nursing Services, TTSH, Singapore
| | - Hongyun Tan
- Department of Nursing Services, Woodlands Health Campus, Singapore
| | | | - Eileen Fabia Goh
- Institute of Geriatrics and Active Ageing (IGA), TTSH, Singapore
| | | | - Jia Qian Chia
- Department of Geriatric Medicine, Tan Tock Seng Hospital (TTSH), Singapore
| | - Amanda Chong
- Department of Geriatric Medicine, Tan Tock Seng Hospital (TTSH), Singapore
| | | | - Palvinder Kaur
- Health Services and Outcomes Research (HSOR), National Healthcare Group, Singapore
| | | | - Sheryl Hui Xian Ng
- Health Services and Outcomes Research (HSOR), National Healthcare Group, Singapore
| | | | - Mark Chan
- Department of Geriatric Medicine, Tan Tock Seng Hospital (TTSH), Singapore; Institute of Geriatrics and Active Ageing (IGA), TTSH, Singapore
| | - Wee Shiong Lim
- Department of Geriatric Medicine, Tan Tock Seng Hospital (TTSH), Singapore; Institute of Geriatrics and Active Ageing (IGA), TTSH, Singapore
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Chanda A, Chauhan A, Kaur P, Soni A, Sehgal S, Khurana A, Parkash O, Verma Y. P37.11 Assessment of Plasma D-Dimer as a Predictive Biomarker for Treatment Response in Lung Cancer Treated with Radiation Therapy. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.758] [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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Chauhan A, Chanda A, Kaur P, Soni A, Sehgal S, Khurana A, Verma Y, Parkash O. P30.06 Outcome Differences Amongst Histopathological Variants of Non Small Cell Lung Cancer Treated With Palliative Radiotherapy. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.651] [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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Ng SHX, Kaur P, Kremer C, Tan WS, Tan AL, Hens N, Toh MP, Teow KL, Kannapiran P. Estimating Transmission Parameters for COVID-19 Clusters by Using Symptom Onset Data, Singapore, January-April 2020. Emerg Infect Dis 2021; 27:582-585. [PMID: 33496243 PMCID: PMC7853533 DOI: 10.3201/eid2702.203018] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
We estimated the generation interval distribution for coronavirus disease on the basis of serial intervals of observed infector–infectee pairs from established clusters in Singapore. The short mean generation interval and consequent high prevalence of presymptomatic transmission requires public health control measures to be responsive to these characteristics of the epidemic.
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Kaur P, Chong SL, Kannapiran P, Teo WSK, Ling CNW, Weichen CW, Ruling G, Yin LS, Leng TY, Pei SY, Kang TT, Han LZ, Peizhen L, Yee LLH, George PP. Cost-utility analysis of hearing aid device for older adults in the community: a delayed start study. BMC Health Serv Res 2020; 20:1112. [PMID: 33261603 PMCID: PMC7709244 DOI: 10.1186/s12913-020-05977-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 11/25/2020] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Hearing aids (HA) is the primary medical intervention aimed to reduce hearing handicap. This study assessed the cost-effectiveness of HA for older adults who were volunteered to be screened for hearing loss in a community-based mobile hearing clinic (MHC). METHODS Participants with (1) at least moderate hearing loss (≥40 dB HL) in at least one ear, (2) no prior usage of HA, (3) no ear related medical complications, and (4) had a Mini-Mental State Examination score ≥ 18 were eligible for this study. Using a delayed-start study design, participants were randomized into the immediate-start (Fitted) group where HA was fitted immediately or the delayed-start (Not Fitted) group where HA fitting was delayed for three months. Cost utility analysis was used to compare the cost-effectiveness of being fitted with HA combined with short-term, aural rehabilitation with the routine care group who were not fitted with HA. Incremental cost effectiveness ration (ICER) was computed. Health Utility Index (HUI-3) was used to measure utility gain, a component required to derive the quality adjusted life years (QALY). Total costs included direct healthcare costs, direct non-healthcare costs and indirect costs (productivity loss of participant and caregiver). Demographic data was collected during the index visit to MHC. Cost and utility data were collected three months after index visit and projected to five years. RESULTS There were 264 participants in the Fitted group and 163 participants in the Not Fitted group. No between-group differences in age, gender, ethnicity, housing type and degree of hearing loss were observed at baseline. At 3 months, HA fitting led to a mean utility increase of 0.12 and an ICER gain of S$42,790/QALY (95% CI: S$32, 793/QALY to S$62,221/QALY). At five years, the ICER was estimated to be at S$11,964/QALY (95% CI: S$8996/QALY to S$17,080/QALY) assuming 70% of the participants continued using the HA. As fewer individuals continued using their fitted HA, the ICER increased. CONCLUSIONS HA fitting can be cost-effective and could improve the quality of life of hearing-impaired older individuals within a brief period of device fitting. Long term cost-effectiveness of HA fitting is dependent on its continued usage.
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Affiliation(s)
- Palvinder Kaur
- Health Services and Outcomes Research, National Healthcare Group, 3 Fusionopolis Link #03-08 Nexus@One-north, Singapore, 138543, Singapore
| | - Sheue Lih Chong
- Ear, Nose and Throat Head & Neck Department, National University Hospital, 5 Lower Kent Ridge Road, Singapore, 119074, Singapore
| | - Palvannan Kannapiran
- Health Services and Outcomes Research, National Healthcare Group, 3 Fusionopolis Link #03-08 Nexus@One-north, Singapore, 138543, Singapore
| | - W-S Kelvin Teo
- Health Services and Outcomes Research, National Healthcare Group, 3 Fusionopolis Link #03-08 Nexus@One-north, Singapore, 138543, Singapore
| | - Charis Ng Wei Ling
- Health Services and Outcomes Research, National Healthcare Group, 3 Fusionopolis Link #03-08 Nexus@One-north, Singapore, 138543, Singapore
| | - Chiang Win Weichen
- Ear, Nose and Throat Head & Neck Department, National University Hospital, 5 Lower Kent Ridge Road, Singapore, 119074, Singapore
| | - Gan Ruling
- Ear, Nose and Throat Head & Neck Department, National University Hospital, 5 Lower Kent Ridge Road, Singapore, 119074, Singapore
| | - Lee Sing Yin
- Ear, Nose and Throat Head & Neck Department, National University Hospital, 5 Lower Kent Ridge Road, Singapore, 119074, Singapore
| | - Tang Ying Leng
- Ear, Nose and Throat Head & Neck Department, National University Hospital, 5 Lower Kent Ridge Road, Singapore, 119074, Singapore
| | - Soo Ying Pei
- Ear, Nose and Throat Head & Neck Department, National University Hospital, 5 Lower Kent Ridge Road, Singapore, 119074, Singapore
| | - Then Tze Kang
- Ear, Nose and Throat Head & Neck Department, National University Hospital, 5 Lower Kent Ridge Road, Singapore, 119074, Singapore
| | - Lim Zhen Han
- Ear, Nose and Throat Head & Neck Department, National University Hospital, 5 Lower Kent Ridge Road, Singapore, 119074, Singapore
| | - Lin Peizhen
- Ear, Nose and Throat Head & Neck Department, National University Hospital, 5 Lower Kent Ridge Road, Singapore, 119074, Singapore
| | - Lynne Lim Hsueh Yee
- Ear Nose Throat & Hearing Centre, 3 Mount Elizabeth, Singapore, 228510, Singapore
| | - Pradeep Paul George
- Health Services and Outcomes Research, National Healthcare Group, 3 Fusionopolis Link #03-08 Nexus@One-north, Singapore, 138543, Singapore.
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Kaur P, Tan WS, Gunapal PPG, Ding YY, Ong R, Wu HY, Hum A. Deaths in dementia: a scoping review of prognostic variables. BMJ Support Palliat Care 2020; 11:242-252. [PMID: 32561548 DOI: 10.1136/bmjspcare-2020-002217] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 01/21/2020] [Revised: 04/17/2020] [Accepted: 05/12/2020] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To identify the types of factors included in research examining mortality in patients with dementia, and to stratify the identified factors by care settings. DESIGN We systematically searched PubMed, Embase, PsycINFO and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases, and identified grey literature from the Networked Digital Library of Theses and Dissertations, Open Grey and Grey Literature Report. Two authors independently screened for eligibility of studies. Independent reviewers extracted relevant study information. We conducted a narrative synthesis of the data. RESULTS We identified 8254 articles, of which 94 met the inclusion criteria. More than half (n=53) were published between 2009 and 2018 with half from Europe. Studies were conducted across hospices/nursing homes (n=25), hospital (n=23), outpatient clinics (n=21), mixed settings (n=15) and in the community (n=10). Nearly 60% adopted a prospective cohort study design with 87% performing multivariable analysis. Overall, 239 variables were identified and classified into six themes-individual factors, health status, functional ability, cognition and mental health, treatments and health system factors. Although a general set of factors were common across all studies, when stratified by care settings, variations were seen in the specific variables included. CONCLUSION Identifying prognostic variables relevant to the dementia population in each setting is key to facilitate appropriate care plans and to ensure timely access to palliative care options. Future research should also focus on ensuring the replicability of prognostic models and to generate a better understanding of the direct and interacting influence of the identified factors on mortality.
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Affiliation(s)
- Palvinder Kaur
- Health Services and Outcomes Research, National Healthcare Group, Singapore
| | - Woan Shin Tan
- Health Services and Outcomes Research, National Healthcare Group, Singapore.,Palliative Care Centre for Excellence in Research and Education, Singapore
| | | | - Yew Yoong Ding
- Geriatric Education and Research Institute, Singapore.,Department of Geriatric Medicine, Tan Tock Seng Hospital, Singapore
| | - Reuben Ong
- Health Services and Outcomes Research, National Healthcare Group, Singapore
| | - Huei Yaw Wu
- Palliative Care Centre for Excellence in Research and Education, Singapore.,Department of Palliative Medicine, Tan Tock Seng Hospital, Singapore
| | - Allyn Hum
- Palliative Care Centre for Excellence in Research and Education, Singapore .,Department of Palliative Medicine, Tan Tock Seng Hospital, Singapore
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Narang A, Singh Randhawa S, Kumar Sood N, Chhabra S, Singla LD, Kaur P. Atypical theileriosis with cutaneous involvement in a cow in India: a case report. REV SCI TECH OIE 2020; 38:703-709. [PMID: 32286574 DOI: 10.20506/rst.38.3.3019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Bovine tropical theileriosis caused by Theileria annulata is an overwhelming haemoprotozoan tick-borne disease in taurine and cross-bred cattle in Punjab, India. However, there seems to be no report from India of cutaneous nodules associated with the disease. This report describes a five-year-old cross-bred cow presented to a university clinic with a history of fever, inappetence and malaise for the past six to seven days. Clinical examination revealed normal vital parameters, pale mucous membranes, mild enlargement of the prescapular lymph nodes and multiple subcutaneous nodular masses (2-4 cm) on the neck and abdomen. Haematology revealed mild anaemia and leucopenia with 48% neutrophils, 48% lymphocytes and 4% eosinophils. Romanowsky-stained smears of fineneedle aspiration biopsy samples from swollen lymph nodes and subcutaneous masses showed an increased number of lymphoid cells, suggesting cutaneous lymphomatosis. However, a critical examination of the smears from subcutaneous nodules showed a large number of Koch's blue bodies in macrophages and lymphoblasts, and several piroplasms were also noticed within the red blood cells in lymph node smears. A peripheral blood smear revealed mild to moderate parasitaemia. Extracted DNA from the parasitologically positive blood sample was subjected to nested polymerase chain reaction (nPCR) using T. annulata speciesspecific primers encoding the 30-kiloDalton major sporozoite surface antigen. The desired 572-base pair amplified product of the nPCR was comparable to the positive control. This seems to be a rare case of T. annulata in an adult cross-bred cow, showing cutaneous nodular involvement.
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Kamboj K, Yadav A, Kumar V, Kaur P, Kohli H, Jha V. SUN-103 MAJOR ADVERSE KIDNEY EVENT RATES IN INDIAN SUBJECTS WITH CKD: FINDINGS FROM ICKD COHORT. Kidney Int Rep 2020. [DOI: 10.1016/j.ekir.2020.02.630] [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: 10/24/2022] Open
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Madarkar BS, Kaur P. Treatment of Neonatal Seizures: Levetiracetam vs Phenobarbitone. Indian Pediatr 2019; 56:1065-1066. [PMID: 31884447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- B S Madarkar
- Department of Neonatology, Prashanthi Hospital, Warangal, Telangana, India.
| | - P Kaur
- Department of Pediatrics, Lady Hardinge Medical College, New Delhi, India
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35
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Gupta A, Singh PK, Sharma P, Kaur P, Sharma S, Singh TP. Structural and biochemical studies of phosphopantetheine adenylyltransferase from Acinetobacter baumannii with dephospho-coenzyme A and coenzyme A. Int J Biol Macromol 2019; 142:181-190. [PMID: 31525415 DOI: 10.1016/j.ijbiomac.2019.09.090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Revised: 09/11/2019] [Accepted: 09/11/2019] [Indexed: 11/29/2022]
Abstract
Phosphopantetheine adenylyl transferase catalyzes a rate limiting penultimate step of the multistep reaction which produces coenzyme A (CoA) as a final product. CoA is required as an essential cofactor in a number of metabolic reactions. Therefore inhibiting the function of this enzyme will lead to cell death in bacteria. Acinetobacter baumannii is multi drug resistant pathogen and causes infections in immunocompromised patients. AbPPAT has been cloned, expressed, purified and crystallized and structures of two complexes of AbPPAT with dephospho coenzyme A (dPCoA) and coenzyme A (CoA) have been determined. Both dPCoA and CoA molecules are observed in the substrate binding site of AbPPAT. A comparison with the structures of the complexes of PPAT from other species shows that the orientations of dPCoA are identical in all the structures. On the other hand, as observed from the structures of the complexes of CoA with PPAT, the orientations of CoA are found to differ considerably. This shows that the substrates occupy identical positions in the substrate binding sites of enzymes whereas the positions of inhibitors may differ. The binding studies carried out using fluorescence method and surface plasmon resonance techniques showed that binding affinity of CoA towards AbPPAT is nearly three times higher than that of dPCoA.
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Affiliation(s)
- A Gupta
- Department of Biophysics, All India Institute of Medical Sciences, New Delhi, India
| | - P K Singh
- Department of Biophysics, All India Institute of Medical Sciences, New Delhi, India
| | - P Sharma
- Department of Biophysics, All India Institute of Medical Sciences, New Delhi, India
| | - P Kaur
- Department of Biophysics, All India Institute of Medical Sciences, New Delhi, India
| | - S Sharma
- Department of Biophysics, All India Institute of Medical Sciences, New Delhi, India
| | - T P Singh
- Department of Biophysics, All India Institute of Medical Sciences, New Delhi, India.
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Kaur P, Kamboj K, Yadav A, Jha V, CKD Investigators I. SAT-248 SEX-DIFFERENCE IN INDIAN PATIENTS WITH CKD – FINDINGS FROM THE INDIAN CHRONIC KIDNEY DISEASE STUDY. Kidney Int Rep 2019. [DOI: 10.1016/j.ekir.2019.05.284] [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: 10/26/2022] Open
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Evans R, Bundred JR, Kaur P, Hodson J, Griffiths EA. Meta-analysis of the influence of a positive circumferential resection margin in oesophageal cancer. BJS Open 2019; 3:595-605. [PMID: 31592511 PMCID: PMC6773635 DOI: 10.1002/bjs5.50183] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Accepted: 04/23/2019] [Indexed: 01/05/2023] Open
Abstract
Background The evidence regarding the prognostic impact of a positive circumferential resection margin (CRM) in oesophageal cancer is conflicting, and there is global variability in the definition of a positive CRM. The aim of this study was to determine the impact of a positive CRM on survival in patients undergoing oesophagectomy for oesophageal cancer. Methods A systematic review and meta‐analysis was performed. PubMed and Embase databases were searched for articles to May 2018 examining the effect of a positive CRM on survival. Cohort studies written in English were included. Meta‐analyses of univariable and multivariable hazard ratios (HRs) were performed using both Royal College of Pathologists (RCP) and College of American Pathologists (CAP) criteria. Risk of bias was assessed using the Newcastle–Ottawa Scale. Egger regression, and Duval and Tweedie trim‐and‐fill statistics were used to assess publication bias. Results Of 133 studies screened, 29 incorporating 6142 patients were finally included for analysis. Pooled univariable HRs for overall survival in patients with a positive CRM were 1·68 (95 per cent c.i. 1·48 to 1·91; P < 0·001) and 2·18 (1·84 to 2·60; P < 0·001) using RCP and CAP criteria respectively. Subgroup analyses demonstrated similar results for patients by T category, neoadjuvant therapy and tumour type. Pooled HRs from multivariable analyses suggested that a positive CRM was independently predictive of a worse overall survival (RCP: 1·41, 1·21 to 1·64, P < 0·001; CAP: 2·37, 1·60 to 3·51, P < 0·001). Conclusion A positive CRM is associated with a worse prognosis regardless of classification system, T category, tumour type or neoadjuvant therapy.
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Affiliation(s)
- R Evans
- Department of Upper Gastrointestinal Surgery University Hospitals Birmingham NHS Foundation Trust Birmingham UK
| | - J R Bundred
- Department of Upper Gastrointestinal Surgery University Hospitals Birmingham NHS Foundation Trust Birmingham UK.,College of Medical and Dental Sciences University of Birmingham Birmingham UK
| | - P Kaur
- Department of Upper Gastrointestinal Surgery University Hospitals Birmingham NHS Foundation Trust Birmingham UK
| | - J Hodson
- Institute of Translational Medicine University Hospitals Birmingham NHS Foundation Trust Birmingham UK
| | - E A Griffiths
- Department of Upper Gastrointestinal Surgery University Hospitals Birmingham NHS Foundation Trust Birmingham UK.,Institute of Cancer and Genomic Sciences, College of Medical and Dental Sciences University of Birmingham Birmingham UK
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Kuehnle E, Kaur P, Siggelkow W, Luebbe K, Schrader I, Uleer C, Noeding S, Noeding KH, Noesselt T, Arfsten M, Busch C, Krentel N, Hillemanns P, Dörk T, Park-Simon TW. Abstract P1-15-10: A prospective multicenter real-world study on neoadjuvant treatment and clinical outcome in TNBC patients. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p1-15-10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction
Controversy exists with regards to the optimal regimen for neoadjuvant chemotherapy (NAC) of TNBC. Platinum-based regimens seem to be more active in TNBC improving pCR rates significantly. But adding platinum to an anthracycline/taxane chemotherapy regime comes at the expense of greater toxicity. Its impact on survival and long-term-outcomes remains undetermined. Practical guidelines vary across leading international professional societies. In this real-world multicenter study neoadjuvant regimens, pCR rates and survival were evaluated.
Material and methods
This study was conducted from 2012-2017 in six certified breast cancer centers in the region of Hanover, Germany, including rural and urban populations by using a personal questionnaire and data from the medical records. All patients with primary TNBC (ER<1%, PR<1%, Her2/neu 0, 1+ or 2+ FISH/CISH negative) and no evidence of distant disease were eligible.
Results
143/217 patients (66%) received NAC and 74/217patients (34%) adjuvant chemotherapy. 63/143 (44%) patients achieved pCR. 23/63 (35%) received platinum-based NAC and 40/63 (65%) received chemotherapy without platinum. In 80 patients pCR was not achieved. 12/80 patients received platinum and 68/80 non platinum-based NAC. pCR was significantly higher among patients with platinum-based chemotherapy (chi-square, p < 0.003). 20/23 patients who achieved pCR received NAC containing anthracycline/taxane/carboplatin, 3/23 patients received a taxane/carboplatin-based regime. Treatment discontinuation was seen in 12/35 (34%) patients receiving platinum-based NAC vs 15/108 (14%) in non-platinum-based NAC. Mean follow up was 17 months (1-70months). A significant difference in OS (p=0.007) and DFS (p=0.001) was seen for patients with a pCR.
Conclusion
Our trial confirms that platinum based NAC achieves significantly higher rates of pCR in patients with TNBC. pCR was associated with significantly longer DFS and OS. The CALBG protocol (CALBG 40603) was the preferred choice of treatment regimen followed by the GeparSixto protocol. In our study the pCR rate was comparable to that of both trials in which pCR rates of 60% (CALBG 40603) and 53% (GeparSixto) were achieved. However, in our trial 34% of the patients discontinued treatment due to toxicity. Therefore these protocols should be used in carefully selected patients. In a real world setting less toxic chemotherapy regimens achieved a pCR rate of 37%. In terms of toxicity and adherence to chemotherapy, these regimens are reasonable alternative options. In daily care close monitoring of treatment response is essential during NAC. In patients who have a rapid clinical response to platinum-free NAC the benefit of adding platinum is questionable. In contrast, the addition of platinum seems to be appropriate in those patients who show only limited response under NAC.
Citation Format: Kuehnle E, Kaur P, Siggelkow W, Luebbe K, Schrader I, Uleer C, Noeding S, Noeding K-H, Noesselt T, Arfsten M, Busch C, Krentel N, Hillemanns P, Dörk T, Park-Simon T-W. A prospective multicenter real-world study on neoadjuvant treatment and clinical outcome in TNBC patients [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P1-15-10.
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Affiliation(s)
- E Kuehnle
- Hannover Medical School, Hanover, Germany; DIAKOVERE Henriettenstift, Breast Center, Hanover, Germany; Klinikum Hannover Nordstadt, Cooperative Breast Center Klinikum Region Hanover, Hanover, Germany; HELIOS Klinikum Hildesheim, Breast Center, Hildesheim, Germany; Sana Klinikum Hameln-Pyrmont, Breast Center, Hameln, Germany; Kreiskrankenhaus Stadthagen, Breast Center Schaumburg, Stadthagen, Germany; PVA Mammographiescreening Niedersachsen Süd, Hildesheim, Germany
| | - P Kaur
- Hannover Medical School, Hanover, Germany; DIAKOVERE Henriettenstift, Breast Center, Hanover, Germany; Klinikum Hannover Nordstadt, Cooperative Breast Center Klinikum Region Hanover, Hanover, Germany; HELIOS Klinikum Hildesheim, Breast Center, Hildesheim, Germany; Sana Klinikum Hameln-Pyrmont, Breast Center, Hameln, Germany; Kreiskrankenhaus Stadthagen, Breast Center Schaumburg, Stadthagen, Germany; PVA Mammographiescreening Niedersachsen Süd, Hildesheim, Germany
| | - W Siggelkow
- Hannover Medical School, Hanover, Germany; DIAKOVERE Henriettenstift, Breast Center, Hanover, Germany; Klinikum Hannover Nordstadt, Cooperative Breast Center Klinikum Region Hanover, Hanover, Germany; HELIOS Klinikum Hildesheim, Breast Center, Hildesheim, Germany; Sana Klinikum Hameln-Pyrmont, Breast Center, Hameln, Germany; Kreiskrankenhaus Stadthagen, Breast Center Schaumburg, Stadthagen, Germany; PVA Mammographiescreening Niedersachsen Süd, Hildesheim, Germany
| | - K Luebbe
- Hannover Medical School, Hanover, Germany; DIAKOVERE Henriettenstift, Breast Center, Hanover, Germany; Klinikum Hannover Nordstadt, Cooperative Breast Center Klinikum Region Hanover, Hanover, Germany; HELIOS Klinikum Hildesheim, Breast Center, Hildesheim, Germany; Sana Klinikum Hameln-Pyrmont, Breast Center, Hameln, Germany; Kreiskrankenhaus Stadthagen, Breast Center Schaumburg, Stadthagen, Germany; PVA Mammographiescreening Niedersachsen Süd, Hildesheim, Germany
| | - I Schrader
- Hannover Medical School, Hanover, Germany; DIAKOVERE Henriettenstift, Breast Center, Hanover, Germany; Klinikum Hannover Nordstadt, Cooperative Breast Center Klinikum Region Hanover, Hanover, Germany; HELIOS Klinikum Hildesheim, Breast Center, Hildesheim, Germany; Sana Klinikum Hameln-Pyrmont, Breast Center, Hameln, Germany; Kreiskrankenhaus Stadthagen, Breast Center Schaumburg, Stadthagen, Germany; PVA Mammographiescreening Niedersachsen Süd, Hildesheim, Germany
| | - C Uleer
- Hannover Medical School, Hanover, Germany; DIAKOVERE Henriettenstift, Breast Center, Hanover, Germany; Klinikum Hannover Nordstadt, Cooperative Breast Center Klinikum Region Hanover, Hanover, Germany; HELIOS Klinikum Hildesheim, Breast Center, Hildesheim, Germany; Sana Klinikum Hameln-Pyrmont, Breast Center, Hameln, Germany; Kreiskrankenhaus Stadthagen, Breast Center Schaumburg, Stadthagen, Germany; PVA Mammographiescreening Niedersachsen Süd, Hildesheim, Germany
| | - S Noeding
- Hannover Medical School, Hanover, Germany; DIAKOVERE Henriettenstift, Breast Center, Hanover, Germany; Klinikum Hannover Nordstadt, Cooperative Breast Center Klinikum Region Hanover, Hanover, Germany; HELIOS Klinikum Hildesheim, Breast Center, Hildesheim, Germany; Sana Klinikum Hameln-Pyrmont, Breast Center, Hameln, Germany; Kreiskrankenhaus Stadthagen, Breast Center Schaumburg, Stadthagen, Germany; PVA Mammographiescreening Niedersachsen Süd, Hildesheim, Germany
| | - K-H Noeding
- Hannover Medical School, Hanover, Germany; DIAKOVERE Henriettenstift, Breast Center, Hanover, Germany; Klinikum Hannover Nordstadt, Cooperative Breast Center Klinikum Region Hanover, Hanover, Germany; HELIOS Klinikum Hildesheim, Breast Center, Hildesheim, Germany; Sana Klinikum Hameln-Pyrmont, Breast Center, Hameln, Germany; Kreiskrankenhaus Stadthagen, Breast Center Schaumburg, Stadthagen, Germany; PVA Mammographiescreening Niedersachsen Süd, Hildesheim, Germany
| | - T Noesselt
- Hannover Medical School, Hanover, Germany; DIAKOVERE Henriettenstift, Breast Center, Hanover, Germany; Klinikum Hannover Nordstadt, Cooperative Breast Center Klinikum Region Hanover, Hanover, Germany; HELIOS Klinikum Hildesheim, Breast Center, Hildesheim, Germany; Sana Klinikum Hameln-Pyrmont, Breast Center, Hameln, Germany; Kreiskrankenhaus Stadthagen, Breast Center Schaumburg, Stadthagen, Germany; PVA Mammographiescreening Niedersachsen Süd, Hildesheim, Germany
| | - M Arfsten
- Hannover Medical School, Hanover, Germany; DIAKOVERE Henriettenstift, Breast Center, Hanover, Germany; Klinikum Hannover Nordstadt, Cooperative Breast Center Klinikum Region Hanover, Hanover, Germany; HELIOS Klinikum Hildesheim, Breast Center, Hildesheim, Germany; Sana Klinikum Hameln-Pyrmont, Breast Center, Hameln, Germany; Kreiskrankenhaus Stadthagen, Breast Center Schaumburg, Stadthagen, Germany; PVA Mammographiescreening Niedersachsen Süd, Hildesheim, Germany
| | - C Busch
- Hannover Medical School, Hanover, Germany; DIAKOVERE Henriettenstift, Breast Center, Hanover, Germany; Klinikum Hannover Nordstadt, Cooperative Breast Center Klinikum Region Hanover, Hanover, Germany; HELIOS Klinikum Hildesheim, Breast Center, Hildesheim, Germany; Sana Klinikum Hameln-Pyrmont, Breast Center, Hameln, Germany; Kreiskrankenhaus Stadthagen, Breast Center Schaumburg, Stadthagen, Germany; PVA Mammographiescreening Niedersachsen Süd, Hildesheim, Germany
| | - N Krentel
- Hannover Medical School, Hanover, Germany; DIAKOVERE Henriettenstift, Breast Center, Hanover, Germany; Klinikum Hannover Nordstadt, Cooperative Breast Center Klinikum Region Hanover, Hanover, Germany; HELIOS Klinikum Hildesheim, Breast Center, Hildesheim, Germany; Sana Klinikum Hameln-Pyrmont, Breast Center, Hameln, Germany; Kreiskrankenhaus Stadthagen, Breast Center Schaumburg, Stadthagen, Germany; PVA Mammographiescreening Niedersachsen Süd, Hildesheim, Germany
| | - P Hillemanns
- Hannover Medical School, Hanover, Germany; DIAKOVERE Henriettenstift, Breast Center, Hanover, Germany; Klinikum Hannover Nordstadt, Cooperative Breast Center Klinikum Region Hanover, Hanover, Germany; HELIOS Klinikum Hildesheim, Breast Center, Hildesheim, Germany; Sana Klinikum Hameln-Pyrmont, Breast Center, Hameln, Germany; Kreiskrankenhaus Stadthagen, Breast Center Schaumburg, Stadthagen, Germany; PVA Mammographiescreening Niedersachsen Süd, Hildesheim, Germany
| | - T Dörk
- Hannover Medical School, Hanover, Germany; DIAKOVERE Henriettenstift, Breast Center, Hanover, Germany; Klinikum Hannover Nordstadt, Cooperative Breast Center Klinikum Region Hanover, Hanover, Germany; HELIOS Klinikum Hildesheim, Breast Center, Hildesheim, Germany; Sana Klinikum Hameln-Pyrmont, Breast Center, Hameln, Germany; Kreiskrankenhaus Stadthagen, Breast Center Schaumburg, Stadthagen, Germany; PVA Mammographiescreening Niedersachsen Süd, Hildesheim, Germany
| | - T-W Park-Simon
- Hannover Medical School, Hanover, Germany; DIAKOVERE Henriettenstift, Breast Center, Hanover, Germany; Klinikum Hannover Nordstadt, Cooperative Breast Center Klinikum Region Hanover, Hanover, Germany; HELIOS Klinikum Hildesheim, Breast Center, Hildesheim, Germany; Sana Klinikum Hameln-Pyrmont, Breast Center, Hameln, Germany; Kreiskrankenhaus Stadthagen, Breast Center Schaumburg, Stadthagen, Germany; PVA Mammographiescreening Niedersachsen Süd, Hildesheim, Germany
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Abstract
Objectives: High body mass index (BMI) has been associated with increased mortality, healthcare utilization and costs. This study investigates the one-year chronic disease progression and risk of developing diabetes with varying cardiovascular disease (CVD) risks based on the Asian BMI categories. Methods: Patients with BMI information from 2008 to 2014 were included in the analysis ( N=23,508). Patients were stratified into low, moderate, high and very high CVD risk categories. To study disease progression for patients with varying CVD risks, patients were further segmented into seven mutually exclusive disease states based on prevalence of chronic diseases and their complications. The categories were no known chronic disease, at-risk of developing chronic disease, one chronic condition, more than two chronic conditions, chronic conditions with complications, patients with cancer and death. Logistic regression was used to determine the association of CVD risk categories and risk of having diabetes. Results: High CVD risk patients had more chronic diseases in the following year as compared with low CVD risk patients. With reference to low CVD risk patients, patients in the moderate, high and very high risk categories had an odds ratio of 1.78 (95% confidence interval (CI): 1.60 to 1.98), 2.84 (95% CI: 2.51 to 3.21) and 3.99 (95% CI: 3.30 to 4.82) for having diabetes after adjusting for age, gender and ethnicity. Conclusions: Higher BMI is associated with greater chronic disease progression in the following year. Diet control and lifestyle modifications should be encouraged to prevent people from shifting to higher BMI strata as this can be detrimental in the long run.
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Affiliation(s)
- Palvinder Kaur
- Department of Health Services and Outcomes Research, National Healthcare Group, Singapore
| | - Nakul Saxena
- Department of Health Services and Outcomes Research, National Healthcare Group, Singapore
| | - Zhecheng Zhu
- Department of Health Services and Outcomes Research, National Healthcare Group, Singapore
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Goel A, Liu C, Kaur P, Wong M, Scala L. Genitourinary (GU) Toxicity in Patients with Intermediate and High-Risk Prostate Cancer Managed with Hypofractionated External Radiation and High Dose Rate (HDR) Brachytherapy Boost. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.308] [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: 10/28/2022]
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Sharma J, Sango C, Kaur P, Bhardwaj N. Crude cellulase treatment for reactivity enhancement of pre-hydrolysed kraft dissolving pulp for viscose. N Biotechnol 2018. [DOI: 10.1016/j.nbt.2018.05.1089] [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: 11/15/2022]
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Worsley MP, Forrest PN, Roesch S, Thatcher C, Sermon PA, Kaur P. Nanoengineering ABO 3 active sites from low-energy routes (TX100-stabilised water-in-oil microemulsions, surface segregation and surface complexation on colloidal AlOOH/sol-gel Al 2O 3 surfaces) for pollution control catalysis. Faraday Discuss 2018; 208:537-553. [PMID: 29946606 DOI: 10.1039/c8fd00006a] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
It is shown that water-in-oil microemulsions (m/e or μE) can produce BaCeO3 (BCO) and LaCoO3 (LCO) precursors. The nanoparticles (NPs) adsorb on AlOOH sols, in much the same way as Turkevich previously immobilised platinum group metal sols. BCO is active in CO and propane oxidation and NO removal under stoichiometric exhaust conditions, but LCO is a better oxidation catalyst. Activity was also seen when Ba,Ce and La,Co are inserted into/segregate at the surface of AlOOH/Al2O3. However, there is only formation of low levels of BCO, CAIO3 (CAO), LCO and LaAIO3 (LAO) perovskites, along with aluminates and separate oxides. The complexing of cations by AlOOH surface-held oxalate ions, albeit with different efficiencies, has also been explored. All three routes yield active catalysts with micro-domains of crystallinity; microemulsions produce the best defined perovskite NPs, but even those from surface segregation have higher turnover numbers than traditional Pt catalysts. Perovskite NPs may open up green chemistry for air pollution control that is consistent with a circular economy.
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Affiliation(s)
- M P Worsley
- Nanomaterials Laboratory, Wolfson Centre, Brunel University, Uxbridge, Middx. UB8 3PH, UK.
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Gautam A, Jain A, Kaur P, Sikka A. Morphology and variations in the extrarenal part of renal artery – A cadaveric study. J ANAT SOC INDIA 2018. [DOI: 10.1016/j.jasi.2018.06.100] [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: 10/28/2022]
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Shchekotikhin A, Tikhomirov A, Kaur P, Shtil A. PO-458 The role of functional groups in the antitumor properties of antrafuran. ESMO Open 2018. [DOI: 10.1136/esmoopen-2018-eacr25.479] [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: 11/03/2022] Open
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Abstract
OBJECTIVE Multimorbidity in patients with heart failure (HF) results in poor prognosis and is an increasing public health concern. We aim to examine the effect of multimorbidity focusing on type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD) on all-cause and cardiovascular disease (CVD)-specific mortality among patients diagnosed with HF in Singapore. DESIGN Retrospective cohort study. SETTING Primary and tertiary care in three (out of six) Regional Health Systems in Singapore. PARTICIPANTS Patients diagnosed with HF between 2003 and 2016 from three restructured hospitals and nine primary care polyclinics were included in this retrospective cohort study. PRIMARY OUTCOMES All-cause mortality and CVD-specific mortality. RESULTS A total of 34 460 patients diagnosed with HF from 2003 to 2016 were included in this study and were followed up until 31 December 2016. The median follow-up time was 2.1 years. Comorbidities prior to HF diagnosis were considered. Patients were categorised as (1) HF only, (2) T2DM+HF, (3) CKD+HF and (4) T2DM+CKD+HF. Cox regression model was used to determine the effect of multimorbidity on (1) all-cause mortality and (2) CVD-specific mortality. Adjusting for demographics, other comorbidities, baseline treatment and duration of T2DM prior to HF diagnosis, 'T2DM+CKD+HF' patients had a 56% higher risk of all-cause mortality (HR: 1.56, 95% CI 1.48 to 1.63) and a 44% higher risk of CVD-specific mortality (HR: 1.44, 95% CI 1.32 to 1.56) compared with patients diagnosed with HF only. CONCLUSION All-cause and CVD-specific mortality risks increased with increasing multimorbidity. This study highlights the need for a new model of care that focuses on holistic patient management rather than disease management alone to improve survival among patients with HF with multimorbidity.
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Affiliation(s)
- Palvinder Kaur
- Health Services and Outcomes Research, National Healthcare Group, Singapore
| | - Nakul Saxena
- Health Services and Outcomes Research, National Healthcare Group, Singapore
| | - Alex Xiaobin You
- Health Services and Outcomes Research, National Healthcare Group, Singapore
| | - Raymond C C Wong
- Department of Cardiology, National University Heart Centre, Singapore, Singapore
| | - Choon Pin Lim
- Department of Cardiology, National Heart Centre Singapore, Singapore
| | - Seet Yoong Loh
- Department of Cardiology, Tan Tock Seng Hospital, Singapore
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Yadav R, Saini A, Kaur P, Behera D, Sethi S. Diagnostic accuracy of GenoType® MTBDRsl VER 2.0 in detecting second-line drug resistance to M. tuberculosis. Int J Tuberc Lung Dis 2018; 22:419-424. [DOI: 10.5588/ijtld.17.0663] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- R. Yadav
- Department of
Medical Microbiology and
| | - A. Saini
- Department of
Medical Microbiology and
| | - P. Kaur
- Department of
Medical Microbiology and
| | - D. Behera
- Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - S. Sethi
- Department of
Medical Microbiology and
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Yamauchi P, Crowley J, Kaur P, Spelman L, Warren R. Biosimilars: what the dermatologist should know. J Eur Acad Dermatol Venereol 2018; 32:1066-1074. [PMID: 29360210 DOI: 10.1111/jdv.14812] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Accepted: 11/17/2017] [Indexed: 11/27/2022]
Abstract
Biosimilars are highly similar versions of approved branded biologics. In contrast to generics, which are identical copies of the originator medicines, biosimilars are considered unique but related molecules that differ from the originator reference product as well as from each other. Owing to the complexity of biologic medicines, such as therapeutic monoclonal antibodies, minor differences between biosimilars and the reference products are acceptable provided these differences do not result in any clinically meaningful differences in safety or efficacy. In addition, minor changes in structure and function may occur over time in originator biologic products as a result of alterations in production materials (e.g. cell lines), processes or conditions. The developmental process for biosimilars focuses on a 'totality of evidence' approach that emphasizes a stepwise investigational process, including comprehensive structural, functional, pharmacologic and clinical assessment for similarity. The goal of the phase 3 clinical development programme for a biosimilar is not to establish efficacy, per se, but to demonstrate that there are no clinically meaningful differences between the proposed biosimilar and the reference product. The requirement to show clinical similarity informs biosimilar study design, including the selection of the patient population, disease state (indication), study endpoints and statistical methods. Based on the clinical trial results in a representative patient population, results may be extrapolated to other indications provided scientific justification is demonstrated based on, among other things, similar mechanism of action in the extrapolated indications. This review presents the current state of knowledge with respect to biosimilars. We aim to provide the practising clinician with a working knowledge of biosimilars as well as provide some practical guidance on their use and potential benefits in treating dermatologic diseases.
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Affiliation(s)
- P Yamauchi
- UCLA School of Medicine, Santa Monica, CA, USA
| | - J Crowley
- Bakersfield Dermatology, Bakersfield, CA, USA
| | - P Kaur
- Amgen Inc., Thousand Oaks, CA, USA
| | - L Spelman
- Veracity Clinical Research and Probity, Brisbane, Qld, Australia
| | - R Warren
- The Dermatology Centre, University of Manchester, Salford Royal Foundation Hospital, Salford, Manchester, UK
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Ring A, Porras T, Campo D, Kaur P, Forte VA, Tripathy D, Lu J, Zada G, Wagle N, Wecsler JS, Lang JE. Abstract P2-01-04: The whole transcriptional landscape of circulating tumor cells compared to metastases in stage IV breast cancer. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p2-01-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Metastatic breast cancer (MBC) and the circulating cells (CTCs) leading to macrometastasis are inherently different than primary breast cancer, evolving under the selection pressure of systemic therapy. A better understanding of the tumor biology of CTCs compared to metastasis may shed light on treatment opportunities.
Methods: We performed whole transcriptome sequencing (RNA Seq) on fresh metastatic tumor biopsies (mets), CTCs, and peripheral blood (PB) from 21 newly diagnosed MBC patients. CTCs were harvested using the ANGLE Parsortix to isolate cells based on size and deformability. Data were analyzed for differential expression, pathways, single nucleotide variants (SNV), fusions, intrinsic subtype, and a CTC-mets shared gene signature was validated using data from The Cancer Genome Atlas (TCGA). Detailed clinical-pathological and treatment data was evaluated.
Results: CTCs as a group showed much stronger gene expression of oncogenes, stem cell genes, keratins and mesenchymal markers than did mets from the same patients. Matched patient comparisons for 66 potentially clinically actionable genes for 8/9 pathways showed no significant difference in gene expression targets between CTCs and mets on ANOVA, although fold-change did vary. Eight SNVs in the ESR1 gene (n=5 patients) and 5 SNVs in the HER2 gene (n=2 patients) were shared between CTCs and distant metastases.
Differential gene expression analysis identified a signature of 8870 genes that were statistically significantly correlated between CTCs and mets (FDR adjusted p<0.05). Ingenuity pathway analysis was applied to the list of genes shared between CTCs and mets, with analysis of canonical pathways and upstream regulators revealing numerous oncogenes and breast cancer related genes. The top upstream regulators of CTCs-mets were beta-estradiol, progesterone, FOXA1, HNRPA2B1 and HNF1A. The top 50 genes of this CTC-mets shared signature were prognostic of worse overall survival in the TCGA breast cancer dataset (p<0.001), which included 817 patients with a median follow-up of 59.5 months. Second time-point data for n=5 patients with subsequent PB draws 6 months after baseline is currently pending. Intrinsic subtyping of mets by either NanoString assays or RNA Seq were not concordant with intrinsic subtyping of CTCs by RNA Seq.
Four of 21 CTC samples showed strong whole transcriptome RPKM correlation with PB (R2)>0.9, however, 3/21 CTC samples showed strong whole transcriptome RPKM correlation with mets (R2)>0.8. The remainder showed low correlation with both. Coverage was 91.4X for CTCs, 140.2X for mets and 138.5X for PB.
Conclusions: We present the transcriptomic landscape of CTCs with comparison to metastases and peripheral blood all acquired prior to treatment of newly diagnosed Stage IV breast cancer. Multiple genes, including oncogenes and stem cell genes, were found with higher expression in CTCs versus metastases. When focusing on 66 known potentially clinically actionable genes in breast cancer, CTCs did not show significantly different patterns of expression than mets in terms of up-regulation versus down-regulation compared to PB. RNA Seq of CTCs may be utilized to identify molecular alterations that are potentially clinically actionable.
Citation Format: Ring A, Porras T, Campo D, Kaur P, Forte VA, Tripathy D, Lu J, Zada G, Wagle N, Wecsler JS, Lang JE. The whole transcriptional landscape of circulating tumor cells compared to metastases in stage IV breast cancer [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P2-01-04.
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Affiliation(s)
- A Ring
- University of Southern California (USC) Norris Cancer Center; USC University Park Campus Genomics Core; Maimonades Medical Center; MD Anderson Cancer Center
| | - T Porras
- University of Southern California (USC) Norris Cancer Center; USC University Park Campus Genomics Core; Maimonades Medical Center; MD Anderson Cancer Center
| | - D Campo
- University of Southern California (USC) Norris Cancer Center; USC University Park Campus Genomics Core; Maimonades Medical Center; MD Anderson Cancer Center
| | - P Kaur
- University of Southern California (USC) Norris Cancer Center; USC University Park Campus Genomics Core; Maimonades Medical Center; MD Anderson Cancer Center
| | - VA Forte
- University of Southern California (USC) Norris Cancer Center; USC University Park Campus Genomics Core; Maimonades Medical Center; MD Anderson Cancer Center
| | - D Tripathy
- University of Southern California (USC) Norris Cancer Center; USC University Park Campus Genomics Core; Maimonades Medical Center; MD Anderson Cancer Center
| | - J Lu
- University of Southern California (USC) Norris Cancer Center; USC University Park Campus Genomics Core; Maimonades Medical Center; MD Anderson Cancer Center
| | - G Zada
- University of Southern California (USC) Norris Cancer Center; USC University Park Campus Genomics Core; Maimonades Medical Center; MD Anderson Cancer Center
| | - N Wagle
- University of Southern California (USC) Norris Cancer Center; USC University Park Campus Genomics Core; Maimonades Medical Center; MD Anderson Cancer Center
| | - JS Wecsler
- University of Southern California (USC) Norris Cancer Center; USC University Park Campus Genomics Core; Maimonades Medical Center; MD Anderson Cancer Center
| | - JE Lang
- University of Southern California (USC) Norris Cancer Center; USC University Park Campus Genomics Core; Maimonades Medical Center; MD Anderson Cancer Center
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Bedi J, Gill J, Kaur P, Aulakh R. Pesticide residues in milk and their relationship with pesticide contamination of feedstuffs supplied to dairy cattle in Punjab (India). J Anim Feed Sci 2018. [DOI: 10.22358/jafs/82623/2018] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Sobti R, Shekari M, Tamandani DK, Kaur P, Suri V, Huria A. Effect of NBS1 Gene Polymorphism on the Risk of Cervix Carcinoma in a Northern Indian Population. Int J Biol Markers 2018; 23:133-9. [DOI: 10.1177/172460080802300301] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Cervical cancer is one of the most common neoplastic diseases affecting women, with a worldwide incidence of almost half a million cases. A history of smoking and use of oral contraceptives have been confirmed to be risk factors for cervical cancer. Genetic susceptibility and immune response, especially impaired cellular immune response, may well be related to the development of cervical cancer. NBS1 is one of the key proteins participating in the recognition and repair of double-strand breaks that may lead to genomic instability and cancer if unrepaired. The objective of the present study was therefore to investigate NBS1 Glu185Gln gene polymorphisms and the risk of cervix cancer in a northern Indian population. We found that passive smokers having particular NBS1 genotypes (Glu/Gln, Gln/Gln or Glu/Gln + Gln/Gln) have an increased risk of developing cervix cancer (OR 5.21, p=0.000001; OR 4.60, p=0.001; OR 5.10, p=0.0000009, respectively). The risk was increased 2.4-fold in oral contraceptive users with a Glu/Gln genotype. We conclude that the risk of cervical cancer is increased in passive smokers and in users of oral contraceptives with certain NBS1 genotypes.
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Affiliation(s)
- R.C. Sobti
- Department of Biotechnology, Panjab University, Chandigarh
| | - M. Shekari
- Department of Biotechnology, Panjab University, Chandigarh
| | | | - P. Kaur
- Department of Biotechnology, Panjab University, Chandigarh
| | - V. Suri
- Department of Obstetrics and Gynecology, Postgraduate Institute of Medical Education and Research, Chandigarh
| | - A. Huria
- Department of Obstetrics and Gynecology, Government Medical College and Hospital, Chandigarh - India
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