1
|
Dwivedi R, Goel AD, Vyas V, Yadav SS, Sharma PP, Bhardwaj P, Singh P, Singh K. Gap identification for improvement in maternal and early infant health care practices among tribal pregnant women in an aspirational tribal district Sirohi, Rajasthan. J Family Med Prim Care 2023; 12:3291-3297. [PMID: 38361896 PMCID: PMC10866240 DOI: 10.4103/jfmpc.jfmpc_234_23] [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: 02/04/2023] [Revised: 06/22/2023] [Accepted: 07/27/2023] [Indexed: 02/17/2024] Open
Abstract
Background Sirohi is one of the aspirational districts of Rajasthan which is also tribal-dominated. The maternal and early infant health indicators are worrisome compared to regional or national statistics. First-trimester registration of pregnant women is 54% in district Sirohi, which is much less as compared to registration in the state of Rajasthan (63%) and India (59%). Four antenatal care (ANC) visits of pregnant women are 32% in district Sirohi, which is also much less as compared to ANC visits in the state of Rajasthan (39%) and India (51%). However, there was no tribal-specific data regarding maternal and early infant health. Objective The study aims to identify gaps for improvement in maternal and early infant health care practices among tribal pregnant women in an aspirational tribal district of Sirohi, Rajasthan. Materials and Methods It was a cross-sectional study conducted among 560 tribal pregnant women to assess the existing maternal, and early infant health care knowledge and practices through a pre-validated questionnaire in the tribal population of district Sirohi Rajasthan. Result Nineteen per cent (19.5%, n = 109) of tribal pregnant women got married between the age of 10 and 17 (less than the legal age of marriage of 18 years). There is a significant relationship between early age at marriage and low educational status P < 0.001, r = 0.241 among participants. Measurement of weight, blood pressure and urine examination was done in 32.5% (n = 181), 19.5% (n = 109) and 7.1% (n = 39), respectively, among tribal pregnant women. The majority (94.6%) of the pregnant tribal women (385/407) were anaemic. Approximately 60% (n = 337) of mothers were unaware of thermal protection (skin-to-skin care). Sixty per cent (n = 334) of tribal pregnant women preferred to seek consultation regarding antenatal and infant health care from doctors, while 40.1% (n = 224) were more comfortable seeking advice from traditional birth attendants (TBAs). Conclusion The study finds inadequate knowledge and practice towards maternal and early infant care among tribal pregnant women. As TBAs influence tribal pregnant women, systematic training and involvement of TBAs in maternal and child health are indispensable.
Collapse
Affiliation(s)
- Rakhi Dwivedi
- Scientist-C, Ministry of Tribal Affairs, Govt. of India Collaborative Project, Centre of Excellence for Tribal Health, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Akhil D. Goel
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Varuna Vyas
- Department of Paediatrics, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Suraj S. Yadav
- Scientist-C, Ministry of Tribal Affairs, Govt. of India Collaborative Project, Centre of Excellence for Tribal Health, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Prem P. Sharma
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Pankaj Bhardwaj
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Pratibha Singh
- Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Kuldeep Singh
- Scientist-C, Ministry of Tribal Affairs, Govt. of India Collaborative Project, Centre of Excellence for Tribal Health, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
- Department of Paediatrics, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| |
Collapse
|
2
|
Patel S, Ghebre R, Dwivedi R, Macheledt K, Watson S, Duffy B, Rogers E, Pusalavidyasagar S, Guo C, Misono S, Evans M, Lingras K, Kunin-Batson A, McCarty C, Sandoval-Garcia C, Nakib N, Johnson C, Barker S, Hutto S, Church A, Vezys V, Girard A, Spencer S, Berge J. Academic clinician frontline-worker wellbeing and resilience during the COVID-19 pandemic experience: Were there gender differences? Prev Med Rep 2023; 36:102517. [PMID: 38116283 PMCID: PMC10728464 DOI: 10.1016/j.pmedr.2023.102517] [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: 06/16/2023] [Revised: 11/16/2023] [Accepted: 11/18/2023] [Indexed: 12/21/2023] Open
Abstract
Prior research suggests COVID-19 has amplified stress on Academic Clinician Frontline-Workers (ACFW). The aim of this paper is: (1) to better understand the experiences of ACFW during the COVID-19 pandemic including their mental-emotional wellbeing, academic productivity, clinical experiences, and (2) to examine any gender differences. A cross-sectional survey was administered to University of Minnesota/M Health Fairview systems' faculty February-June 2021. Of the 291 respondents, 156 were clinicians, with 91 (58 %) identifying as Frontline-Workers (ACFW). Faculty wellbeing was assessed using validated measures in addition to measures of productivity and sociodemographics. For example, ACFW reported a higher Work-Family Conflict (WFC) scores compared to non-ACFW (26.5 vs. 24.1, p = 0.057) but did not report higher Family-Work Conflict (FWC) scores (17.7 vs. 16.3, p = 0.302). Gender sub-analyses, revealed that women ACFW compared to men ACFW reported higher WFC scores (27.7 vs. 24.1, p = 0.021) and FWC (19.3 vs. 14.3, p = 0.004). Academically, ACFW reported submitting fewer grants and anticipated delays in promotion and tenure due to the COVID-19 (p = 0.035). Results suggest COVID-19 has exacerbated ACFW stress and gender inequities. Reports of anticipated delay in promotion for ACFW may pose a challenge for the long-term academic success of ACFW, especially women ACFW. In addition, women may experience higher FWC and WFC as compared to men. Schools of academic medicine should consider re-evaluating promotion/tenure processes and creating resources to support women ACFW as well as ACFW caregivers.
Collapse
Affiliation(s)
- S.I. Patel
- Department of Neurology, lead of Salary, Resource, and Leadership Equity Action Group of the Center for Women in Medicine and Science, and member of the DEI Council at the University of Minnesota Medical School, Minneapolis, MN, USA
| | - R. Ghebre
- Department of Obstetrics and Gynecology, Associate Director for Diversity, Equity and Inclusion at Masonic Cancer Center and a member of the Retention and Recruitment Action Group in the Center for Women in Medicine and Science at the University of Minnesota Medical School, Minneapolis, MN, USA
| | - R. Dwivedi
- Department of Family Medicine and Community Health and member of the Center for Women in Medicine and Science Mentoring Action Group at the University of Minnesota Medical School, Minneapolis, MN, USA
| | - K. Macheledt
- Center for Women’s Health Research at the University of Minnesota Medical School, Minneapolis, MN, USA
| | - S. Watson
- Center for Women in Medicine and Science and Program Coordinator for the Center for Global Health and Social Responsibility at the University of Minnesota, Minneapolis, MN, USA
| | - B.L. Duffy
- Department of Medicine and a member of the Retention and Recruitment Action Group in the Center for Women in Medicine and Science at the University of Minnesota Medical School, Minneapolis, MN, USA
| | - E.A. Rogers
- Departments of Medicine and of Pediatrics, and member of the Salary, Resource, and Leadership Equity Action Group in the Center for Women in Medicine and Science at the University of Minnesota Medical School, Minneapolis, MN, USA
| | - S. Pusalavidyasagar
- Department of Medicine and member of the Center for Women in Medicine and Science Mentoring Action Group at the University of Minnesota Medical School, Minneapolis, MN USA
| | - C. Guo
- Department of Radiology and member of the Center for Women in Medicine and Science Strategic Communications and Collaborations Action Group at the University of Minnesota Medical School, Minneapolis, MN, USA
| | - S. Misono
- Department of Otolaryngology and member of the Center for Women in Medicine and Science Mentoring Action Group at the University of Minnesota Medical School, Minneapolis, MN, USA
| | - M.D. Evans
- Biostatistical Design and Analysis Center, Clinical and Translational Science Institute, University of Minnesota, Minneapolis, MN, USA
| | - K. Lingras
- Department of Psychiatry and Behavioral Sciences and a member of the Retention and Recruitment Action Group in the Center for Women in Medicine and Science at the University of Minnesota Medical School, Minneapolis, MN, USA
| | - A. Kunin-Batson
- Department of Pediatrics and member of the Center for Women in Medicine and Science Salary, Resource, and Leadership Equity Action Group at the University of Minnesota Medical School, Minneapolis, MN, USA
| | - C.A. McCarty
- Department of Family Medicine and Biobehavioral Health and Associate Dean for Research at the Duluth campus of the University of Minnesota, USA
| | - C. Sandoval-Garcia
- Departments of Neurosurgery and Pediatrics and member of the Center for Women in Medicine and Science Salary, Resource, and Leadership Equity Action Group at the University of Minnesota Medical School, Minneapolis, MN, USA
| | - N. Nakib
- Female Urology and Urodynamics in the Department of Urology, and the Strategic Communications and Collaborations Action Group Lead for the Center for Women in Medicine and Science at the University of Minnesota Medical School, Minneapolis, MN, USA
| | - C. Johnson
- University of Minnesota and an MPH student at the Harvard TH Chan School of Public Health, USA
| | - S. Barker
- Department of Radiology and a member of the Center for Women in Medicine and Science Salary, Resource, and Leadership Equity Action Group at the University of Minnesota Medical School, Minneapolis, MN, USA
| | - S. Hutto
- Department of Obstetrics, Gynecology and Women’s Health and a member of the Center for Women in Medicine and Science Salary, Resource, and Leadership Equity Action Group at the University of Minnesota Medical School, Minneapolis, MN, USA
| | - A.L. Church
- Department of Radiology and the Mentoring Action Group Lead for the Center for Women in Medicine and Science at the University of Minnesota Medical School, Minneapolis, MN, USA
| | - V. Vezys
- Department of Microbiology and Immunology, a member of the Center for Immunology and a member of the Center for Women in Medicine and Science Salary, Resource, and Leadership Equity Action Group at the University of Minnesota Medical School, Minneapolis, MN, USA
| | - A. Girard
- Department of Family Medicine and Community Health and member of the Center for Women in Medicine and Science Salary, Resource, and Leadership Equity Action Group at the University of Minnesota Medical School, Minneapolis, MN, USA
| | - S. Spencer
- Department of Pharmacology and the Retention and Recruitment Action Group Lead for the Center for Women in Medicine and Science at the University of Minnesota Medical School, Minneapolis, MN, USA
| | - J.M. Berge
- Department of Family Medicine and Community Health, Director of the Center for Women in Medicine and Science, and Director of the Women’s Health Research Program/Building Interdisciplinary Research Careers in Women’s Health (BIRCWH) Program at the University of Minnesota Medical School, Minneapolis, MN, USA
| |
Collapse
|
3
|
Dwivedi R, Goyal P, Yadav SS, Dwivedi P, Singh P, Singh K. Mapping of traditional healthcare providers and their healing approaches in a tribal community of district Sirohi, Rajasthan. J Family Med Prim Care 2023; 12:1150-1157. [PMID: 37636156 PMCID: PMC10451593 DOI: 10.4103/jfmpc.jfmpc_1610_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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Revised: 01/17/2023] [Accepted: 02/02/2023] [Indexed: 08/29/2023] Open
Abstract
Introduction Traditional applications of medicinal plants in healthcare practices provide indication to new therapeutic concepts; hence, their relevance is highly recognized. The objective of the study was to map the traditional healers from the aspirational district and scientific documentation of their healing practices to treat various diseases. Method This was community-based study in tribal subpopulation zone of district Sirohi. The data was collected through field survey and interviews of tribal healers by using semi-structured questionnaire. Result We identified 1015 tribal healers (68% male and 32% female), and all belong to Bhil, Meena, and Garasia communities of district Sirohi. The mean age was 60.45 ± 16.56 years, 82.6% healers were uneducated, and 12.6% had primary education, while 1.2% were graduates. Tribal healers act as primary point of care for tribal community and practiced various treatment modalities including herbal healing (32.7%), diviners (28.9%), child birth attendant (24.7%), and bone setters (13.7%). We recorded 88 herbal healing practices from tribal communities of district Sirohi and scientifically documented. The common diseases treated by tribal healers included wound healing, skin infection, fever, arthritis, pain, diarrhea, cough, and cold. The Fabaceae family was credited with highest number (17%) of plants used by herbal healers. It was also noted that some of the plants used for medicinal purpose are endangered and overexhausted. Conclusion Ethnopharmacological data is the foundation for further validation and value addition of herbal healthcare practices. The mapping of indigenous knowledge holders and scientific documentation of their knowledge might be a crucial step for providing clue regarding new therapeutic molecules.
Collapse
Affiliation(s)
- Rakhi Dwivedi
- Centre of Excellence for Tribal Health, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Prachi Goyal
- Centre of Excellence for Tribal Health, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Suraj S. Yadav
- Centre of Excellence for Tribal Health, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Pradeep Dwivedi
- Centre of Excellence for Tribal Health, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
- Department of Pharmacology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Pratibha Singh
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Kuldeep Singh
- Centre of Excellence for Tribal Health, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
- Department of Paediatrics, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| |
Collapse
|
4
|
Dwivedi R, Goel AD, Vyas V, Sharma PP, Bhardwaj P, Singh K. Is maternal anemia among tribal women being neglected? A study from Southern Rajasthan. Indian J Public Health 2023; 67:313-315. [PMID: 37459031 DOI: 10.4103/ijph.ijph_1552_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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2023] Open
Abstract
Poor birth outcomes have been linked to maternal anemia. Tribal women are at higher risk of malnutrition and disease due to sociocultural barriers and poor educational status. The data on the prevalence of maternal anemia and its associated factors among pregnant tribal women are limited. A community-based cross-sectional study was conducted among 429 pregnant tribal women for maternal anemia from August 2021 to June 2022. A structured questionnaire was employed to collect sociodemographic data. The prevalence of anemia was 85.7%, with a mean hemoglobin level of 9.21 ± 1.3 g/dL. On applying WHO 2011 anemia criteria for pregnant women, 25.0% had mild anemia, 73.4% had moderate anemia, and 1.6% had severe anemia. The significant factors associated with anemic condition were household condition, monthly income, and husband's occupation. The higher prevalence of anemia among pregnant tribal women is alarming that necessitates a rethinking of health infrastructure and outreach in tribal dominant areas.
Collapse
Affiliation(s)
- Rakhi Dwivedi
- Research Officer, Centre of Excellence for Tribal Health, Jodhpur, Rajasthan, India
| | - Akhil Dhanesh Goel
- Associate Professor, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Varuna Vyas
- Associate Professor, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Prem Prakash Sharma
- Associate Professor, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Pankaj Bhardwaj
- Additional Professor, Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Kuldeep Singh
- Professor, Department of Paediatrics, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| |
Collapse
|
5
|
Dwivedi R, Drumm BT, Griffin CS, Dudem S, Bradley E, Alkawadri T, Martin SL, Sergeant GP, Hollywood MA, Thornbury KD. Excitatory cholinergic responses in mouse primary bronchial smooth muscle require both Ca 2+ entry via l-type Ca 2+ channels and store operated Ca 2+ entry via Orai channels. Cell Calcium 2023; 112:102721. [PMID: 37023533 DOI: 10.1016/j.ceca.2023.102721] [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: 10/21/2022] [Revised: 03/10/2023] [Accepted: 03/23/2023] [Indexed: 04/08/2023]
Abstract
Malfunctions in airway smooth muscle Ca2+-signalling leads to airway hyperresponsiveness in asthma and chronic obstructive pulmonary disease. Ca2+-release from intracellular stores is important in mediating agonist-induced contractions, but the role of influx via l-type Ca2+ channels is controversial. We re-examined roles of the sarcoplasmic reticulum Ca2+ store, refilling of this store via store-operated Ca2+ entry (SOCE) and l-type Ca2+ channel pathways on carbachol (CCh, 0.1-10 µM)-induced contractions of mouse bronchial rings and intracellular Ca2+ signals of mouse bronchial myocytes. In tension experiments, the ryanodine receptor (RyR) blocker dantrolene (100 µM) reduced CCh-responses at all concentrations, with greater effects on sustained rather than initial components of contraction. 2-Aminoethoxydiphenyl borate (2-APB, 100 μM), in the presence of dantrolene, abolished CCh-responses, suggesting the sarcoplasmic reticulum Ca2+ store is essential for contraction. The SOCE blocker GSK-7975A (10 µM) reduced CCh-contractions, with greater effects at higher (e.g. 3 and 10 µM) CCh concentrations. Nifedipine (1 µM), abolished remaining contractions in GSK-7975A (10 µM). A similar pattern was observed on intracellular Ca2+-responses to 0.3 µM CCh, where GSK-7975A (10 µM) substantially reduced Ca2+ transients induced by CCh, and nifedipine (1 µM) abolished remaining responses. When nifedipine (1 µM) was applied alone it had less effect, reducing tension responses at all CCh concentrations by 25% - 50%, with greater effects at lower (e.g. 0.1 and 0.3 µM) CCh concentrations. When nifedipine (1 µM) was examined on the intracellular Ca2+-response to 0.3 µM CCh, it only modestly reduced Ca2+ signals, while GSK-7975A (10 µM) abolished remaining responses. In conclusion, Ca2+-influx from both SOCE and l-type Ca2+ channels contribute to excitatory cholinergic responses in mouse bronchi. The contribution of l-type Ca2+ channels was especially pronounced at lower doses of CCh, or when SOCE was blocked. This suggests l-type Ca2+ channels might be a potential target for bronchoconstriction under certain circumstances.
Collapse
Affiliation(s)
- R Dwivedi
- Smooth Muscle Research Centre, Dundalk Institute of Technology, Dublin Road, Dundalk, Co. Louth, A91 K584, Ireland
| | - B T Drumm
- Smooth Muscle Research Centre, Dundalk Institute of Technology, Dublin Road, Dundalk, Co. Louth, A91 K584, Ireland
| | - C S Griffin
- Smooth Muscle Research Centre, Dundalk Institute of Technology, Dublin Road, Dundalk, Co. Louth, A91 K584, Ireland
| | - S Dudem
- Smooth Muscle Research Centre, Dundalk Institute of Technology, Dublin Road, Dundalk, Co. Louth, A91 K584, Ireland
| | - E Bradley
- Smooth Muscle Research Centre, Dundalk Institute of Technology, Dublin Road, Dundalk, Co. Louth, A91 K584, Ireland
| | - T Alkawadri
- Smooth Muscle Research Centre, Dundalk Institute of Technology, Dublin Road, Dundalk, Co. Louth, A91 K584, Ireland
| | - S L Martin
- School of Pharmacy, Queen's University Belfast, Belfast, United Kingdom
| | - G P Sergeant
- Smooth Muscle Research Centre, Dundalk Institute of Technology, Dublin Road, Dundalk, Co. Louth, A91 K584, Ireland
| | - M A Hollywood
- Smooth Muscle Research Centre, Dundalk Institute of Technology, Dublin Road, Dundalk, Co. Louth, A91 K584, Ireland
| | - K D Thornbury
- Smooth Muscle Research Centre, Dundalk Institute of Technology, Dublin Road, Dundalk, Co. Louth, A91 K584, Ireland.
| |
Collapse
|
6
|
Eastwood A, Deng J, Dwivedi R. 987 TACKLING OVERPRESCRIBING; WHAT ABOUT THE HABITUAL OFFENDER, PPI? Age Ageing 2022. [DOI: 10.1093/ageing/afac126.040] [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: 11/15/2022] Open
Abstract
Abstract
Introduction
Overprescribing is a serious problem in health systems internationally and can lead to preventable hospital assessments and admissions, even premature deaths1. Proton pump inhibitors (PPIs) are commonly prescribed in older people. They are associated with risk of C difficile infection, hypomagnesemia, osteoporosis, hypergastrinaemia, and are considered falls risk increasing drugs (FRID). Unfortunately, there isn’t a guideline which unifies the various indications of PPIs.
Method
303 discharges were screened from 2 acute geriatric wards between 01/10/2020 and 31/12/2020. After exclusions (34 deaths, 5 readmissions), 264 notes were reviewed. Those with a PPI mentioned on their discharge summaries were audited against both NICE dyspepsia guidelines and our hospital trust guidelines (PPI usage in those on co-medications), assessing whether long term use was advocated. Additional information was obtained from our hospital systems including digital health records.
Results
153/264(58%) patients had PPIs listed on their discharge summaries. Of those using PPIs, 146 (95%) had polypharmacy and 140(92%) had a CFS ≥5. More PPIs were commenced (18) than discontinued (16). Against NICE dyspepsia guidelines, 46/153(30%) patients did not require long term PPI treatment. 81/153 (53%) patients had a PPI prescribed due to anticoagulation, however, 37/81 (46%) did not fulfil our trust criteria for co-prescription.
Conclusion
PPI usage is prevalent in older people and often continued without a valid indication which could result in preventable harm in an already vulnerable cohort. There is a need to actively deprescribe PPIs within all healthcare settings. Our findings have been widely shared with our departmental colleagues and other relevant specialties and a guideline on long term use of PPIs in older people (>65) has been developed. Going forward, we plan to re-audit against this new guideline in 6 months to assess improvement.
References 1. Good for you, good for us, good for everybody. Published 22/9/21.
Collapse
Affiliation(s)
- A Eastwood
- Nottingham University Hospitals NHS Trust , Nottingham
| | - J Deng
- Nottingham University Hospitals NHS Trust , Nottingham
| | - R Dwivedi
- Nottingham University Hospitals NHS Trust , Nottingham
| |
Collapse
|
7
|
Lee-Johnson L, Dwivedi R. 1048 REDUCING RISK FROM WARFARIN- A COMPLETED AUDIT CYCLE ON NICE COMPLIANCE WITH WARFARIN FOR NVAF IN HOSPITALISED OLDER PEOPLE. Age Ageing 2022. [DOI: 10.1093/ageing/afac126.065] [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: 11/13/2022] Open
Abstract
Abstract
Introduction
Traditionally Warfarin has been mainly used for stroke thromboprophylaxis in patients with atrial fibrillation but direct oral anticoagulant (DOAC) are increasingly being used as they have improved safety profiles with comparable efficacy. Recent data from National Reporting and Learning System (NRLS) have discovered safety incidents related to anticoagulation, predominantly Warfarin, contributing in excess of 10% of all medication errors. National institute for clinical excellence (NICE) recommends reassessing anticoagulation choice for patients on Warfarin with poor anticoagulation control, indicated by any of the following: 1 > 2 INR values <1.5 or > 5 or 1 INR value >8, within the past 6 months 2 > Time in therapeutic range (TTR) <65% Intervention An initial retrospective audit on 50 patients on Warfarin for NVAF performed between June—September 18 showed poor compliance with NICE. We reviewed the previous 6 months INR values and recorded any significant deviations outside of the therapeutic range as per NICE. TTR over the last 6 months was calculated using the Rosendaal method. Following departmental audit presentation, a reaudit was carried out between Jan-Aug 2019 to assess improvement.
Results
Median age was 87.5 compared to 83 in the first audit. Warfarin was correctly continued in 7/38(18%) in the 1st audit which improved to 9/28 (32%) in the second. Number of patients discharged on warfarin with unstable INRs decreased significantly from 26/32 (81%) patients in the 1st audit to 10/24 (42%) in the 2nd.
Discussion
Our reaudit shows significant reduction in continuation of warfarin on discharge in patients with unstable INRs (p = 0.0043 Fisher exact test). Although, there is a trend towards improvement with NICE compliance; in general, the compliance with NICE remains poor. We suggest geriatricians to proactively review the appropriateness of warfarin prescription and to consider a DOAC in preference to Warfarin in all elderly patients.
Collapse
Affiliation(s)
- L Lee-Johnson
- Department of Pharmacy, Queens Medical Centre , Nottingham
| | - R Dwivedi
- Department of Healthcare for older people, Queens Medical Centre , Nottingham
| |
Collapse
|
8
|
Singh K, Dwivedi R, Goswami D, Singh P. Assessment of knowledge, attitude, practice (KAP) regarding directly observed therapy (DOT) in tuberculosis among ASHA workers from tribal subpopulation zone of Rajasthan. J Family Med Prim Care 2022; 11:6783-6788. [PMID: 36993051 PMCID: PMC10041269 DOI: 10.4103/jfmpc.jfmpc_2258_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 02/10/2022] [Accepted: 02/20/2022] [Indexed: 12/24/2022] Open
Abstract
Introduction A high level of community awareness and positive perception towards tuberculosis and its management is crucial for the successful outcome of any control measure. In India the Accredited Social Health Activist (ASHA) plays a key role in providing awareness and counselling on healthcare issues and management, particularly in remote areas. The tribal population is vulnerable to such infectious diseases due to resource limitations and remote locations. We assessed the knowledge, attitude, and practice (KAP) regarding directly observed therapy (DOT) among ASHA workers in the tribal belt of the Sirohi district of Rajasthan state. Material and Methods This cross-sectional study was conducted among ASHA workers of Sirohi district from January 2021 to June 2021. A predesigned and structured questionnaire was used to gather information on knowledge, attitude, and practices regarding the management of tuberculosis and DOT. Results A total of 95 ASHAs participated in the study with a mean age of 35.82 years. Good knowledge (Mean score = 6.2947 ± 1.08052) was observed regarding tuberculosis and DOT. 81% (n = 74) have good knowledge regarding DOT whereas most have a poor attitude and only 47% have adequate practice. A 55% of ASHAs did not adhere even a single TB patient in the last three years. Conclusion In our study, knowledge gaps were identified which may result in substandard patient care. The structured refresher training towards DOT and also training to work in tribal areas will further improve the KAP of ASHAs. It might be needed to provide a module or curriculum regarding awareness among ASHAs for strengthening follow-up system for tuberculosis patients among the tribal population.
Collapse
|
9
|
Sharma C, Dwivedi R, Bhardwaj P, Singh K, Joshi N, Sharma P. Effect of peer educator-PRAGATI (PeeR Action for Group Awareness through Intervention) on knowledge, attitude, and practice of menstrual hygiene in adolescent school girls. J Family Med Prim Care 2020; 9:3593-3599. [PMID: 33102335 PMCID: PMC7567287 DOI: 10.4103/jfmpc.jfmpc_309_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 03/19/2020] [Accepted: 04/09/2020] [Indexed: 11/13/2022] Open
Abstract
Context: Majority of the adolescent girls all over the world, suffer from anxiety, shame, discomfort, and isolation during menstruation. Awareness about menstrual hygiene and health can help them to overcome this situation. Aims: The study aims to elicit the existing knowledge, attitude, and practices regarding menstruation and to assess the effectiveness of a structured training program through peer educators-PRAGATI (PeeR Action for Group Awareness through Intervention) on menstrual hygiene among adolescent school girls. Subjects and Methods: This was a prospective interventional study. A structured training program through peer educators (PRAGATI) was used on adolescent females for evaluating menstrual hygiene awareness and practices through pre- and posttest. McNemar's test was used for paired nominal data and the difference between pretest and posttest was assessed by the paired t-test. Results: In the pretest, only 20.5% had adequate knowledge, 32.5% had poor knowledge, while 48.7% of girls had moderate knowledge about menstruation and menstrual hygiene. Post-intervention, 56.41% girls gained adequate knowledge (an increase of ~36%), 30.76% had moderate knowledge, and only 12.8% of them (a reduction of ~20%) still had poor knowledge. The mean increase of knowledge on menstrual hygiene in pretest and posttest analysis was statistically significant with P < 0.01. Conclusion: The training by the peer educators (PRAGATI) in creating awareness about menstrual hygiene and bringing about a significant change in attitude and practice is an effective method of spreading awareness among adolescents on menstrual hygiene related sensitive issues. However, repeated sessions are required to create momentum and enthusiasm for learning new things.
Collapse
|
10
|
Sahu PK, Chandra L, Pandey RK, Mehta NS, Dwivedi R, Mishra VN, Prakash R. Fast Development of Self‐Assembled, Highly Oriented Polymer Thin Film and Observation of Dual Sensing Behavior of Thin Film Transistor for Ammonia Vapor. MACROMOL CHEM PHYS 2019. [DOI: 10.1002/macp.201900010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Praveen Kumar Sahu
- Department of Electronics EngineeringIndian Institute of Technology (Banaras Hindu University) Varanasi 221005 India
| | - Lalit Chandra
- Department of Electronics EngineeringIndian Institute of Technology (Banaras Hindu University) Varanasi 221005 India
| | - Rajiv K. Pandey
- School of Materials Science and TechnologyIndian Institute of Technology (Banaras Hindu University) Varanasi 221005 India
| | - Niraj Singh Mehta
- Department of Ceramic EngineeringIndian Institute of Technology (Banaras Hindu University) Varanasi 221005 India
| | - R. Dwivedi
- Department of Electronics EngineeringIndian Institute of Technology (Banaras Hindu University) Varanasi 221005 India
| | - V. N. Mishra
- Department of Electronics EngineeringIndian Institute of Technology (Banaras Hindu University) Varanasi 221005 India
| | - Rajiv Prakash
- School of Materials Science and TechnologyIndian Institute of Technology (Banaras Hindu University) Varanasi 221005 India
| |
Collapse
|
11
|
Yadav S, Maurya SK, Anand G, Dwivedi R, Yadav D. Purification, characterization and retting of Crotolaria juncea fibres by an alkaline pectin lyase from Fusarium oxysporum MTCC 1755. 3 Biotech 2017; 7:136. [PMID: 28593518 DOI: 10.1007/s13205-017-0750-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [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: 11/22/2016] [Accepted: 01/30/2017] [Indexed: 11/30/2022] Open
Abstract
Using solid-state fermentation, production of an industrially important pectin lyase from a fungal strain Fusarium oxysporum MTCC 1755 was attempted, which was further subjected to purification and characterization. The enzyme was purified by three steps, namely ammonium sulfate fractionation, cation-exchange chromatography on CM cellulose followed by gel filtration chromatography using Sephadex G-100 column. A 16-fold purification with 31.2% yield and 3.2 U/mg specific activity was achieved. The optimum pH of the purified enzyme was 9.0 and stability ranged from pH 5.0-7.0 for 24 h. Optimum temperature of purified enzyme was found to be 40 °C while temperature stability ranged from 10 to 50 °C for 30 min. The K m and k cat of the enzyme was 1.75 mg/ml and 83.3 s-1, respectively. The purified enzyme was found to be highly stimulated by Ca2+ ions while sugars like mannitol and sorbitol, and salts like NaCl and CaCl2 enhanced the thermostability. The purified pectin lyase was found suitable for retting of Crotolaria juncea fiber.
Collapse
Affiliation(s)
- S Yadav
- Department of Biotechnology, DDU Gorakhpur University, Gorakhpur, 273009, India.
| | - S K Maurya
- Department of Biotechnology, DDU Gorakhpur University, Gorakhpur, 273009, India
| | - G Anand
- Department of Biotechnology, DDU Gorakhpur University, Gorakhpur, 273009, India
| | - R Dwivedi
- Department of Biotechnology, DDU Gorakhpur University, Gorakhpur, 273009, India
| | - D Yadav
- Department of Biotechnology, DDU Gorakhpur University, Gorakhpur, 273009, India
| |
Collapse
|
12
|
Agrawal A, Shrivastava J, Dwivedi R, Siddiqui M. Assessment of serum apolipoprotein B and apolipoprotein A-1 and their ratio in healthy full term small for gestational age newborns. J Neonatal Perinatal Med 2017; 10:49-53. [PMID: 28304324 DOI: 10.3233/npm-1672] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 02/05/2023]
Abstract
BACKGROUND Programmed changes in growth restricted fetuses can increase the risk of adulthood diseases due to elevated serum cholesterol and apolipoprotein-B (Apo-B) concentrations. Increasing evidence demonstrated the role of apoB/apoA-I ratio as a strong risk factor for cardiovascular diseases. OBJECTIVE To determine the concentration of cord blood lipoproteins and apolipoproteins as well as their correlation with birth weight. METHODS This cross-sectional study was conducted in a teaching institution in central India. Healthy full-term newborns, born out of normal vaginal deliveries, were recruited. Cases include term small for gestational age (SGA) babies while term appropriate for gestational age (AGA) babies were taken as controls. Their umbilical venous blood was collected and sent for biochemical analysis. RESULTS Out of 126 healthy newborns, 66 were cases and 60 were controls. Mean values of serum triglyceride (141.56±69.67 mg/dl vs. 113.67±33.38 mg/dl; p < 0.006; 95% CI = 8.31 to 47.46) and serum apo-B/apo-A-1 ratio (0.67±0.28 vs. 0.55±0.20; p < 0.007; 95% CI = 0.033 to 0.206) were significantly high and that of serum high density cholesterol (35.84±10.42 mg/dl vs. 40.73±11.70 mg/dl; p < 0.014; 95% CI = -8.79 to -0.98) and Apo-A1 [87.59±12.44 mg/dl vs. 101.87±35.07 mg/dl; p = 0.002; 95% CI = -23.39 to -5.16) were significantly low in SGA newborns. Serum cholesterol, very low-density cholesterol rlow-density cholesterol rand Apo-B did not show any significant difference. Among SGA newborns significant negative correlation was seen between birth weight and apo-B/apo-A1 and serum triglyceride, while birth weight and serum apo-A1 level showed significant positive correlation. There was no statistically significant correlation between birth weight and other parameters. CONCLUSION These findings further support the association of prenatal factors with lipid profile rand can serve as starting point for studying lipid transport system changes during early life in Indian population.
Collapse
|
13
|
Priyaja P, Dwivedi R, Sini S, Hatha M, Saravanane N, Sudhakar M. Remote sensing of bacterial response to degrading phytoplankton in the Arabian Sea. Environ Monit Assess 2016; 188:662. [PMID: 27837363 DOI: 10.1007/s10661-016-5666-8] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Accepted: 10/31/2016] [Indexed: 06/06/2023]
Abstract
A remote sensing technique has been developed to detect physiological condition of phytoplankton using in situ and moderate imaging spectroradiometer (MODIS)-Aqua data. The recurring massive mixed algal bloom of diatom and Noctiluca scintillans in the Northern Arabian Sea during winter-spring was used as test bed to study formation, growth and degradation of phytoplankton. The ratio of chlorophyll (chl) to particulate organic carbon (POC) was considered as an indicator of phytoplankton physiological condition and used for the approach development. Algal blooms represent the areas of new production, and therefore, knowledge of their degradation is important to the study microbial loop and export carbon flux. Relation of chl/POC ratio with bacterial abundance revealed Gaussian distribution. Bacteria were strongly correlated with POC, and hence, the latter which is available from satellite data could be used as a proxy for remote assessment of bacteria. Thresholds for active and degrading phytoplankton were determined using the ratio computed from the satellite data. The criteria were implemented on MODIS data to generate an image representing distribution of degrading algal bloom. Bacteria abundance data from two validation cruises during dinoflagellate and cyanobacteria bloom confirmed well match up of phytoplankton degradation information from the satellite. Comparison of environmental parameters during decay phase of dinoflagellate (N. scintillans bloom (winter) and Trichodesmium bloom (summer) revealed that degradation after active Trichodesmium bloom was more severe as compared to the N. scintillans. The present study also highlights the prediction capability of phytoplankton degradation using a time series of satellite retrieved chlorophyll/POC images.
Collapse
Affiliation(s)
- P Priyaja
- Centre for Marine Living Resources and Ecology (MoES), Kochi, 682 037, India
| | - R Dwivedi
- Indian National Centre for Ocean Information Services, Hyderabad, India.
| | - S Sini
- Cochin University of Science and Technology, Kochi, 682 022, India
| | - M Hatha
- Cochin University of Science and Technology, Kochi, 682 022, India
| | - N Saravanane
- Centre for Marine Living Resources and Ecology (MoES), Kochi, 682 037, India
| | - M Sudhakar
- Centre for Marine Living Resources and Ecology (MoES), Kochi, 682 037, India
| |
Collapse
|
14
|
Dwivedi R, Priyaja P, Rafeeq M, Sudhakar M. MODIS-Aqua detects Noctiluca scintillans and hotspots in the central Arabian Sea. Environ Monit Assess 2016; 188:50. [PMID: 26690080 DOI: 10.1007/s10661-015-5041-1] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Accepted: 12/08/2015] [Indexed: 06/05/2023]
Abstract
Northern Arabian Sea is considered as an ecologically sensitive area as it experiences a massive upwelling and long-lasting algal bloom, Noctiluca scintillans (green tide) during summer and spring-winter, respectively. Diatom bloom is also found to be co-located with N. scintillans and both have an impact on ecology of the basin. In-house technique of detecting species of these blooms from Moderate Resolution Imaging Spectroradiometer (MODIS)-Aqua data was used to generate a time-series of images revealing their spatial distribution. A study of spatial-temporal variability of these blooms using satellite data expressed a cyclic pattern of their spread over a period of 13 years. An average distribution of the blooms for January-March period revealed a peak in 2015 and minimum in 2013. Subsequently, a time-series of phytoplankton species images were generated for these 2 years to study their inter-annual variability and the associated factors. Species images during active phase of the bloom (February) in 2015 indicated development of N. scintillans and diatom in the central Arabian Sea also, up to 12° N. This observation was substantiated with relevant oceanic parameters measured from the ship as well as satellite data and the same is highlight of the paper. While oxygen depletion and release of ammonia associated with N. scintillans are detrimental for waters on the western side; it is relatively less extreme and supports the entire food chain on the eastern side. In view of these contrasting eco-sensitive events, it is a matter of concern to identify biologically active persistent areas, hot spots, in order to study their ecology in detail. An ecological index, persistence of the bloom, was derived from the time-series of species images and it is another highlight of our study.
Collapse
Affiliation(s)
- R Dwivedi
- Centre for Marine Living Resources and Ecology (MoES), Kochi, 682 037, India.
| | - P Priyaja
- Centre for Marine Living Resources and Ecology (MoES), Kochi, 682 037, India
| | - M Rafeeq
- Centre for Marine Living Resources and Ecology (MoES), Kochi, 682 037, India
| | - M Sudhakar
- Centre for Marine Living Resources and Ecology (MoES), Kochi, 682 037, India
| |
Collapse
|
15
|
Dwivedi R, Joshi R, Panthi S, Byanjankar S, Shrestha R. Outcome of Both Bone Forearm Fracture Fixation in Children by Rush Nails. JNMA J Nepal Med Assoc 2015; 53:244-249. [PMID: 27746464] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023] Open
Abstract
INTRODUCTION Forearm fractures are common upper limb injuries among children and usually treated non-operatively. Failure of non-operative treatment, open injuries and multiple fractures are the indications for surgery in paediatric both bone forearm fractures. Intramedullary nailing is considered as minimally invasive procedure with excellent to fair outcomes but it is not free of complications. We reviewed the results and evaluated the outcomes of IM fixation of forearm fractures in children by Rush nails to understand the risks and complications associated with these procedures. METHODS A retrospective crossectional study of all paediatric patients treated for diaphyseal forearm fractures for period of five years in a tertiary care setup. Complications were classified according to modified Clavien-Dindo complication classification system. Outcomes were graded depending upon complication grade along with range of motion of forearm. RESULTS A total of 25 patients were included in the study. Mean time for fracture union was 10.56 weeks. Outcomes were excellent in 16 (64%), good in 7 (28%), fair in 2 (8%) patients and no poor outcome was noted. Ten minor complications were seen. CONCLUSION Fixation of paediatric forearm fractures by intramedullary Rush nail is minimally invasive procedure and outcomes are excellent to fair with acceptable complication rates.
Collapse
Affiliation(s)
- R Dwivedi
- Department of Orthopaedics, Lumbini Medical College and Teaching Hospital, Tansen, Palpa, Nepal
| | - R Joshi
- Department of Orthopaedics, Lumbini Medical College and Teaching Hospital, Tansen, Palpa, Nepal
| | - S Panthi
- Department of Orthopaedics, Lumbini Medical College and Teaching Hospital, Tansen, Palpa, Nepal
| | - S Byanjankar
- Department of Orthopaedics, Lumbini Medical College and Teaching Hospital, Tansen, Palpa, Nepal
| | - R Shrestha
- Department of Orthopaedics, Lumbini Medical College and Teaching Hospital, Tansen, Palpa, Nepal
| |
Collapse
|
16
|
Shankar V, Almeyda R, Lamyman A, Dwivedi R. Acute calcific prevertebral tendinitis. Assoc Med J 2015. [DOI: 10.1136/bmj.h2898] [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]
|
17
|
Dwivedi R, Rafeeq M, Smitha BR, Padmakumar KB, Thomas LC, Sanjeevan VN, Prakash P, Raman M. Species identification of mixed algal bloom in the Northern Arabian Sea using remote sensing techniques. Environ Monit Assess 2015; 187:51. [PMID: 25638059 DOI: 10.1007/s10661-015-4291-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Accepted: 01/11/2015] [Indexed: 06/04/2023]
Abstract
Oceanic waters of the Northern Arabian Sea experience massive algal blooms during winter-spring (mid Feb-end Mar), which prevail for at least for 3 months covering the entire northern half of the basin from east to west. Ship cruises were conducted during winter-spring of 2001-2012 covering different stages of the bloom to study the biogeochemistry of the region. Phytoplankton analysis indicated the presence of green tides of dinoflagellate, Noctiluca scintillans (=N. miliaris), in the oceanic waters. Our observations indicated that diatoms are coupled and often co-exist with N. scintillans, making it a mixed-species ecosystem. In this paper, we describe an approach for detection of bloom-forming algae N. scintillans and its discrimination from diatoms using Moderate Resolution Imaging Spectroradiometer (MODIS)-Aqua data in a mixed-species environment. In situ remote sensing reflectance spectra were generated using Satlantic™ hyperspectral radiometer for the bloom and non-bloom waters. Spectral shapes of the reflectance spectra for different water types were distinct, and the same were used for species identification. Scatter of points representing different phytoplankton classes on a derivative plot revealed four diverse clusters, viz. N. scintillans, diatoms, non-bloom oceanic, and non-bloom coastal waters. The criteria developed for species discrimination were implemented on MODIS data and validated using inputs from a recent ship cruise conducted in March 2013.
Collapse
Affiliation(s)
- R Dwivedi
- Centre for Marine Living Resources and Ecology, Ministry of Earth Sciences, Kochi-37, India,
| | | | | | | | | | | | | | | |
Collapse
|
18
|
Brar LS, Sharma RP, Dwivedi R. Effect of Vortex Finder Diameter on Flow Field and Collection Efficiency of Cyclone Separators. Particulate Science and Technology 2014. [DOI: 10.1080/02726351.2014.933144] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
19
|
Dwivedi R, Sah S, Dahal M, Acharya P, Gurung S. Close Versus Limited Open Method of Ender's Nail Fixation in Paediatric Femoral Shaft Fractures. JNMA J Nepal Med Assoc 2014; 52:806-810. [PMID: 26905709] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023] Open
Abstract
INTRODUCTION There are various surgical options for treating fracture of femoral shaft in children. Here we compare the results of close with limited open method of Ender's nails fixation of femoral shaft fractures in children. METHODS We studied 60 children with femoral shaft fractures in age group 5-15 years. Ender's nail fixation was done by close technique in 40 cases and in 20 cases by limited open technique. RESULTS The mean operative time was significantly high in limited open group being 64 minutes in comparison to 50 minutes in close group. There was no significant difference between close and limited open groups with respect to time for partial weight bearing and time for full weight bearing. Fracture united sooner in close group as compared to open group. Union was achieved in all patients within a mean of 11 weeks in close group in comparison to 12.4 weeks in open group. According to the Flynn criteria in close group 34 patients had excellent results, 6 had satisfactory and none poor. In limited open group outcome was excellent in 14 patients, satisfactory in 4 patients and 2 had poor result. There was no significant difference in outcome based on Flynn criteria between two groups. CONCLUSIONS Though operative time is more and healing is delayed in Ender's nail fixation by limited open technique, there is no statistical difference in final outcome as per Flynn criteria between close and limited open technique of Ender's nail fixation of femoral shaft fractures in children.
Collapse
Affiliation(s)
- R Dwivedi
- Department of Orthopaedics, Lumbini Medical College Teaching Hospital, Tansen Palpa, Nepal
| | - S Sah
- Department of Orthopaedics, Koshi Zonal Hospital, Biratnagar, Koshi, Nepal
| | - M Dahal
- Department of Orthopaedics, Koshi Zonal Hospital, Biratnagar, Koshi, Nepal
| | - P Acharya
- Department of Orthopaedics, Civil Service Hospital, Kathmandu, Nepal
| | - S Gurung
- Department of Orthopaedics, Nepalgunj Medical College, Kohalpur, Nepal
| |
Collapse
|
20
|
Hamadeh IS, Langaee TY, Dwivedi R, Garcia S, Burkley BM, Skaar TC, Chapman AB, Gums JG, Turner ST, Gong Y, Cooper-DeHoff RM, Johnson JA. Impact of CYP2D6 polymorphisms on clinical efficacy and tolerability of metoprolol tartrate. Clin Pharmacol Ther 2014; 96:175-81. [PMID: 24637943 PMCID: PMC4111800 DOI: 10.1038/clpt.2014.62] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.6] [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: 12/18/2013] [Accepted: 03/07/2014] [Indexed: 01/13/2023]
Abstract
Metoprolol is a selective β-1 adrenergic receptor blocker that undergoes extensive metabolism by the polymorphic enzyme, CYP2D6. Our objective was to investigate the influence of CYP2D6 polymorphisms on efficacy and tolerability of metoprolol tartrate. 281 study participants with uncomplicated hypertension received 50 mg of metoprolol twice daily followed by response guided titration to 100 mg twice daily. Phenotypes were assigned based on results of CYP2D6 genotyping and copy number variation assays. Clinical response to metoprolol and adverse effect rates were analyzed in relation to CYP2D6 phenotypes by using appropriate statistical tests. Heart rate response differed significantly by CYP2D6 phenotype (p-value <0.0001) with poor metabolizers & intermediate metabolizers showing greater HR reduction. However, blood pressure response and adverse effect rates were not significantly different by CYP2D6 phenotype. Other than a significant difference in heart rate response, CYP2D6 polymorphisms were not a determinant of the variability in response or tolerability to metoprolol.
Collapse
Affiliation(s)
- I S Hamadeh
- Department of Pharmacotherapy and Translational Research, Center for Pharmacogenomics, University of Florida College of Pharmacy, Gainesville, Florida, USA
| | - T Y Langaee
- Department of Pharmacotherapy and Translational Research, Center for Pharmacogenomics, University of Florida College of Pharmacy, Gainesville, Florida, USA
| | - R Dwivedi
- Department of Pharmacotherapy and Translational Research, Center for Pharmacogenomics, University of Florida College of Pharmacy, Gainesville, Florida, USA
| | - S Garcia
- Department of Pharmacotherapy and Translational Research, Center for Pharmacogenomics, University of Florida College of Pharmacy, Gainesville, Florida, USA
| | - B M Burkley
- Department of Pharmacotherapy and Translational Research, Center for Pharmacogenomics, University of Florida College of Pharmacy, Gainesville, Florida, USA
| | - T C Skaar
- Division of Clinical Pharmacology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - A B Chapman
- Renal Division, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
| | - J G Gums
- 1] Department of Pharmacotherapy and Translational Research, University of Florida College of Pharmacy, Gainesville, Florida, USA [2] Department of Community Health and Family Medicine, University of Florida College of Medicine, Gainesville, Florida, USA
| | - S T Turner
- Division of Nephrology and Hypertension, Department of Internal Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - Y Gong
- Department of Pharmacotherapy and Translational Research, Center for Pharmacogenomics, University of Florida College of Pharmacy, Gainesville, Florida, USA
| | - R M Cooper-DeHoff
- 1] Department of Pharmacotherapy and Translational Research, Center for Pharmacogenomics, University of Florida College of Pharmacy, Gainesville, Florida, USA [2] Division of Cardiology, Department of Medicine, University of Florida College of Medicine, Gainesville, Florida, USA
| | - J A Johnson
- 1] Department of Pharmacotherapy and Translational Research, Center for Pharmacogenomics, University of Florida College of Pharmacy, Gainesville, Florida, USA [2] Division of Cardiology, Department of Medicine, University of Florida College of Medicine, Gainesville, Florida, USA
| |
Collapse
|
21
|
|
22
|
Chaudhary AK, Chaudhary A, Tiwari SC, Dwivedi R. Can community-based, low-cost antenatal care in the third trimester of pregnancy reduce the incidence of low birth weight newborns? J Obstet Gynaecol India 2013; 62:286-90. [PMID: 23730031 DOI: 10.1007/s13224-012-0217-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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: 12/15/2009] [Accepted: 05/28/2012] [Indexed: 10/28/2022] Open
Abstract
OBJECTIVE To determine if community-based, low-cost interventions during third trimester of pregnancy can reduce the incidence of low birth weight babies. METHODS In a case control study, 290 pregnant women from a slum area were registered in the beginning of third trimester of pregnancy and provided full antenatal care comprising fortnightly check up, one IFA tablet daily, counseling for minimum one-and-a-half hour post-lunch rest in left lateral position, additional diet to ensure minimum 2,200 kcal per day, and management of clinical conditions, if any. An equal number of pregnant women belonging to the same slum area were registered as control who received routine antenatal services from the existing health care facilities. The birth weight of the babies in the two groups were recorded and compared. Test of significance and correlation coefficient were applied to the data. RESULTS Mean birth weight of the babies of the Subjects was 2.76 kg (SD 0.39) compared to mean birth weight of 2.57 kg (SD 0.36) of the babies in the Control group. Incidence of low birth weight babies among subjects who consumed minimum 2,400 kcal per day, had one-and-a-half hour post-lunch rest in left lateral position and who consumed one tablet of IFA (100 mg iron and 5 mg folic acid) per day during the last trimester of pregnancy was lower (17.6 %) as compared with women in the Control group (36.2 %). The difference in the mean birth weight of newborns of the two groups was statistically significant (t = 2.52, p < 0.01). CONCLUSIONS Incidence of low birth weight babies can be significantly reduced by providing simple, low-cost care to pregnant women during the last trimester of pregnancy in the community setting.
Collapse
Affiliation(s)
- A K Chaudhary
- District Hospital, Bhopal, India ; Quarter No. 94/13-F, Tulsi Nagar, Bhopal, 462 003 India
| | | | | | | |
Collapse
|
23
|
Choudhary AK, Choudhary A, Tiwari SC, Dwivedi R. Factors associated with low birth weight among newborns in an urban slum community in Bhopal. Indian J Public Health 2013; 57:20-3. [DOI: 10.4103/0019-557x.111362] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
24
|
Abstract
Introduction: The surgical procedure by the anterior, posterior and combined antero-posterior approaches had applied for the treatment of cervical spondylotic myelopathy.
Methods: During the treatment process, all patients were pre-operatively as well post-operatively graded according to Japanese Orthopaedics Association. Several surgical methods such as anterior approach, posterior approach, and combined antero-posterior approach have been addressed for CSM patients, with the choice based on the pathogenesis of the myelopathy. The main indications for surgery were evidence of myelopathy on physical examinations, a JOA score below 13 points help with spinal cord compression observed on plain X-ray, CT scan, MRI studies.
Results: The pre-operative JOA scores were 7.60±1.23 in laminoplasty, 8.30±1.03 in diskectomy and corpectomy and 7.10±1.20 in combined antero-posterior approach patients. At the follow-up after three months the JOA scores were laminoplasty 13.30±1.30, diskectomy and corpectomy 13.55±1.15 and combined antero-posterior 13.50±1.08. The JOA recovery rate averaged, 61.08±11.25% in laminoplasty, 60.67±10.60% in diskectomy and corpectomy and 64.67±10.72% in combined anteroposterior approach. The high- signal intensity changed to normal in 18 out of 28 and no any kyphotic change and instability were found in cervical spine at the follow up.
Conclusions: Patients with OPLL (continuous, segmental and mixed type), stenosis of cervical spinal canal, multilevel cervical spondylosis, large and high ossification of IVDP with stenosis were improved with laminoplasty. Patients with PIVD, CSM with kyphosis, post laminectomy , OPLL herniated type, unstable vertebral alignment, stenosis by osteophytes, were improved with anterior approach . Ossified or deformed OPLL, unstable vertebral with stenosis ,OPLL or OYL with cervical meandearing (swan-neck) were improved with Combined anterior and posterior approach.
Keywords: cervical spondylotic mylopathy, anterior cervical diskectomy and fusion, corpectomy.
Collapse
|
25
|
Sah S, Wang L, Dahal M, Acharya P, Dwivedi R. Surgical management of cervical spondylotic myelopathy. JNMA J Nepal Med Assoc 2012; 52:172-177. [PMID: 23591248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023] Open
Abstract
INTRODUCTION The surgical procedure by the anterior, posterior and combined antero-posterior approaches had applied for the treatment of cervical spondylotic myelopathy. METHODS During the treatment process, all patients were pre-operatively as well post-operatively graded according to Japanese Orthopaedics Association. Several surgical methods such as anterior approach, posterior approach, and combined antero-posterior approach have been addressed for CSM patients, with the choice based on the pathogenesis of the myelopathy. The main indications for surgery were evidence of myelopathy on physical examinations, a JOA score below 13 points help with spinal cord compression observed on plain X-ray, CT scan, MRI studies. RESULTS The pre-operative JOA scores were 7.60±1.23 in laminoplasty, 8.30±1.03 in diskectomy and corpectomy and 7.10±1.20 in combined antero-posterior approach patients. At the follow-up after three months the JOA scores were laminoplasty 13.30±1.30, diskectomy and corpectomy 13.55±1.15 and combined antero-posterior 13.50±1.08. The JOA recovery rate averaged, 61.08±11.25% in laminoplasty, 60.67±10.60% in diskectomy and corpectomy and 64.67±10.72% in combined antero-posterior approach. The high-signal intensity changed to normal in 18 out of 28 and no any kyphotic change and instability were found in cervical spine at the follow up. CONCLUSIONS Patients with OPLL (continuous, segmental and mixed type), stenosis of cervical spinal canal, multilevel cervical spondylosis, large and high ossification of IVDP with stenosis were improved with laminoplasty. Patients with PIVD, CSM with kyphosis, post laminectomy, OPLL herniated type, unstable vertebral alignment, stenosis by osteophytes, were improved with anterior approach. Ossified or deformed OPLL, unstable vertebral with stenosis, OPLL or OYL with cervical meandearing (swan-neck) were improved with Combined anterior and posterior approach.
Collapse
Affiliation(s)
- S Sah
- Department of Orthopaedic, Koshi Zonal Hospital, Biratnagar, Koshi, Nepal
| | | | | | | | | |
Collapse
|
26
|
Dwivedi R, St. Rose S, Chisholm E, Clarke P, Kerawala C, Nutting C, Rhys-Evans P, Harrington K, Kazi R. 47. First speech-specific perceptual speech evaluation scale for head and neck cancer patients – Development and validation of the London speech evaluation scale. Eur J Surg Oncol 2012. [DOI: 10.1016/j.ejso.2012.06.047] [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: 11/16/2022] Open
|
27
|
Dwivedi R, Ham-Ying L, Snape J. Problem based review: the patient presenting with an acutely swollen arm. Acute Med 2012; 11:113-116. [PMID: 22685702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
A 69 year old female presented to the Emergency Department with swelling of her right arm and elbow, one week following a fall which resulted in a fracture of the middle third of her right clavicle (Figure 1). The forearm was hot and tender and the arm and hand function were somewhat impaired by swelling, but sensation was intact. Initial bloods were unremarkable, apart from a mild neutrophilia.
Collapse
Affiliation(s)
- R Dwivedi
- Kings Mill Hospital, Sutton in Ashfield, Notts, NG17 4JL, UK
| | | | | |
Collapse
|
28
|
Dwivedi R, St. Rose S, Roe J, Chisholm E, Bisase B, Nutting C. O7. A report on the reliability and validity of first speech-specific questionnaire “the English-version of Speech Handicap Index” in a cohort of English-speaking Head and Neck Cancer (HNC) patients. Oral Oncol 2011. [DOI: 10.1016/j.oraloncology.2011.06.118] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
29
|
Dwivedi R, St. Rose S, Roe J, Khan A, Bisase B, Nutting C. O6. Validation of a new swallow specific tool in a subset of head and neck cancer (HNC) patients. Oral Oncol 2011. [DOI: 10.1016/j.oraloncology.2011.06.117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
30
|
Dwivedi R, St. Rose S, Chisholm E, Heywood R, Kerawala C, Clarke P. O8. A report on the development and validation of a specific speech evaluation tool “The London Speech Evaluation ‘LSE’ scale” for Head and Neck Cancer (HNC) patients. Oral Oncol 2011. [DOI: 10.1016/j.oraloncology.2011.06.119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
31
|
Sharma P, Neupane S, Shrestha M, Dwivedi R, Paudel K. An ultrasonographic evaluation of solitary muscular and soft tissue cysticercosis. Kathmandu Univ Med J (KUMJ) 2011; 8:257-60. [PMID: 21209548 DOI: 10.3126/kumj.v8i2.3571] [Citation(s) in RCA: 10] [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: 11/18/2022]
Abstract
BACKGROUND Cysticercosis in humans is infection with the larval form (cysticercus cellulosae) of the pork tapeworm T. solium. Encystment of larvae can occur in almost any tissue. The location of cysts in order of frequency is the central nervous system, subcutaneous tissue and striated muscle, vitreous humour of the eye and, rarely, other tissues. High resolution ultrasound can be used in the diagnosis of muscular and soft tissue cysticercosis. OBJECTIVE The aim of this study is to evaluate the ultrasonographic findings in cases of muscular and soft tissue cysticercosis. MATERIALS AND METHODS It was a retrospective review of the cases of muscular and soft tissue cysticercosis which were diagnosed by ultrasound during June 2007 to May 2009 in the department of Radiology and Imaging, Nepalgunj Medical College Teaching Hospital. A total of six patients were evaluated. RESULT There were four males and two females. Age of the patient ranged from 18 to 50 years. All of the patients presented with a swelling with pain in fi ve of them. There was a wide variation in the location of the cysts. In all cases ultrasound revealed a cystic lesion with an echogenic eccentric pedunculated nodule attached to the wall. The mean diameter of the cyst was 6mm. Smooth wall was present in fi ve cases whereas one of the cysts revealed irregular wall. Pericystic inflammatory changes were seen in the adjacent muscles. CONCLUSION Ultrasound is a safe and non-invasive method that can be used in the diagnosis of muscular and soft tissue cysticercosis.
Collapse
Affiliation(s)
- P Sharma
- Department of Radiology and Imaging, Nepalgunj Medical College, Banke, Nepal.
| | | | | | | | | |
Collapse
|
32
|
Srivastava J, Pandey P, Mishra V, Dwivedi R. Structural and micro structural studies of PbO-doped SnO2 sensor for detection of methanol, propanol and acetone. ACTA ACUST UNITED AC 2011. [DOI: 10.1016/s1003-9953(10)60168-5] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
33
|
Tripathi RP, Pandey J, Kukshal V, Ajay A, Mishra M, Dube D, Chopra D, Dwivedi R, Chaturvedi V, Ramachandran R. Synthesis, in silico screening and bioevaluation of dispiro-cycloalkanones as antitubercular and mycobacterial NAD+-dependent DNA ligase inhibitors. Med Chem Commun 2011. [DOI: 10.1039/c0md00246a] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
|
34
|
Singh RV, Joshi SC, Dwivedi R. SYNTHETIC, STEREOCHEMICAL, AND BIOLOGICAL ASPECTS OF MANGANESE (II) COMPLEXES WITH UNSYMMETRICAL SULFUR CONTAINING BIDENTATE SCHIFF BASES. PHOSPHORUS SULFUR 2010. [DOI: 10.1080/10426500490274664] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
35
|
Radheshyam A, Reddy VS, Dwivedi R, Prasad R. Kinetic studies and Mechanism Evolution of the Ammoxidation of 3-picoline Over V2O5/ZrO2 Catalyst. CAN J CHEM ENG 2008. [DOI: 10.1002/cjce.5450830213] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
36
|
Kumar A, Sharma M, Dwivedi R, Visavadia B. Paediatric maxillofacial services: The impact of regionalisation. Br J Oral Maxillofac Surg 2007. [DOI: 10.1016/j.bjoms.2007.07.161] [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: 11/16/2022]
|
37
|
Bhat ML, Rasool Z, Kadri SM, Wani N, Hassan G, Mumtaz D, Qureshi W, Shiekh B, Dwivedi R. Cystic dysplasia of testis: a case report. J Clin Pathol 2006; 59:1002-3. [PMID: 16935982 PMCID: PMC1860477 DOI: 10.1136/jcp.2005.032888] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
38
|
Dwivedi R, Saha S, Chowienczyk PJ, Ritter JM. Block of Inward Rectifying K
+
Channels (K
IR
) Inhibits Bradykinin-Induced Vasodilatation in Human Forearm Resistance Vasculature. Arterioscler Thromb Vasc Biol 2005; 25:e7-9. [PMID: 15591222 DOI: 10.1161/01.atv.0000152610.40086.31] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective—
To investigate the possible involvement of inward rectifying K
+
channels (K
IR
) in the response of human resistance vessels to bradykinin in vivo.
Methods and Results—
Drugs were administered via the brachial artery in healthy male volunteers and forearm blood flow was measured by venous occlusion plethysmography. Inhibition of K
IR
by barium chloride (4 μmol min
−1
) alone or with additional inhibition of Na
+
/K
+
ATPase (ouabain 2.7 μmol min
−1
) reduced responses to bradykinin (30 pmol min
−1
), by 26±8.3% and 36±7.2%, respectively (each
P
<0 0.05). Barium with ouabain plus inhibitors of prostaglandin (PG) and nitric oxide synthesis inhibited but did not abolish responses to bradykinin (51±2.8% inhibition;
P
<0.01); norepinephrine (240 pmol min
−1
) caused similar reduction of baseline blood flow, as did this combination of inhibitors, but did not significantly inhibit the response to bradykinin. Barium plus ouabain did not significantly reduce responses to acetylcholine or albuterol.
Conclusion—
A component of the vasodilator response to bradykinin in human forearm vasculature is mediated by K
IR
.
Collapse
Affiliation(s)
- R Dwivedi
- Department of Clinical Pharmacology, GKT Division of Cardiovascular Medicine, St Thomas' Hospital, London, United Kingdom
| | | | | | | |
Collapse
|
39
|
Khanna R, Ip K, Allums KK, Baik K, Abernathy CR, Pearton SJ, Heo YW, Norton DP, Ren F, Dwivedi R, Fogarty TN, Wilkins R. Effects of high dose proton irradiation on the electrical performance of ZnO Schottky diodes. ACTA ACUST UNITED AC 2004. [DOI: 10.1002/pssa.200409059] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
40
|
Singh RV, Dwivedi R, Joshi SC. Synthetic, magnetic, spectral, antimicrobial and antifertility studies of dioxomolybdenum(VI) unsymmetrical imine complexes having a N∩N donor system. TRANSIT METAL CHEM 2004. [DOI: 10.1023/b:tmch.0000014487.86754.93] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
|
41
|
Walenga RW, Kester M, Coroneos E, Butcher S, Dwivedi R, Statt C. Constitutive expression of prostaglandin endoperoxide G/H synthetase (PGHS)-2 but not PGHS-1 in hum an tracheal epithelial cells in vitro. Prostaglandins 1996; 52:341-59. [PMID: 8948503 DOI: 10.1016/s0090-6980(96)00101-3] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Primary cultures of human tracheal epithelial (HTE) cells cultured in vitro, in defined serum-free media, express prostaglandin endoperoxide G/H synthase (PGHS) activity and produce prostaglandin E2 (PGE2). In contrast to every other cell type studied to date, HTE cells appear to constitutively express PGHS-2, the 'inducible' form of the enzyme, while expressing little or no PGHS-1, the 'housekeeping' isoenzyme in vitro. Prostaglandin synthesis in HTE cells was reduced by a selective PGHS-2 inhibitor, N-[2-cyclohexyloyl-4-nitrophenyl] methane-sulfonamide (NS398), with an IC50 of approximately 1 microM. Immunoblotting and immunoprecipitation of enzymatic activity with isozyme-specific antisera revealed only the PGHS-2 isoform. Full length human cDNA probes detected only PGHS-2 message in Northern blots. Neither PGHS-2 activity nor mRNA levels were dependent on, nor stimulated by peptide growth factors present in the defined serum-free growth medium, or by serum. Prolonged maintenance in the absence of retinoic acid, however, lead to a decline in PGHS activity. Phorbol-myristate acetate (PMA) induced PGHS-2 activity and mRNA and neither PMA-induced, nor constitutive PGHS-2 expression was suppressed by corticosteroids. Actinomycin D-treatment for six hours reduced the PGHS-2 activity and mRNA to only 50% that of untreated cells, suggesting that PGHS-2 mRNA is extremely stable in these cells. HTE cells, at least in vitro, appear unique among prostaglandin-producing cells in that they express PGHS-2, constitutively, independent of regulation by growth factors, serum, or corticosteroids and fail to express PGHS-1 under any culture condition studied.
Collapse
Affiliation(s)
- R W Walenga
- Department of Pediatrics, Case Western Reserve University, Cleveland, OH 44106, USA.
| | | | | | | | | | | |
Collapse
|
42
|
Vishnoi A, Gopal R, Dwivedi R, Srivastava S. Distributed parameter analysis of dark I–V characteristics of the solar cell: estimation of equivalent lumped series resistance and diode quality factor. ACTA ACUST UNITED AC 1993. [DOI: 10.1049/ip-g-2.1993.0025] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
43
|
|
44
|
Dwivedi R. The effect of fungal metabolites and of coriander seeds on the growth of pathogenic bacteria. Ann Inst Pasteur (Paris) 1972; 123:311-4. [PMID: 4632293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
|
45
|
Dwivedi R, Dwivedi RS. Rhizosphere microflora of Coriander with emphasis on fungistasis. Ann Inst Pasteur (Paris) 1972; 122:455-61. [PMID: 5051232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
|
46
|
Dwivedi R. A Case of Craniocleido-Dysostosis. Ind Med Gaz 1947; 82:274. [PMID: 29015269 PMCID: PMC5196400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
|