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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.
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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
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Athe R, Dwivedi R, Singh K, Babusab Hulmani S, Karadi N, Boraiah C, Vasu S. Impact of COVID-19 on the Mental Health of Healthcare Workers and Job Loss From a Gender Perspective in India: A Systematic Review and Meta-Analysis. Cureus 2023; 15:e48219. [PMID: 38050506 PMCID: PMC10693901 DOI: 10.7759/cureus.48219] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/02/2023] [Indexed: 12/06/2023] Open
Abstract
The COVID-19 pandemic caused significant stress and anxiety among the general population and healthcare workers (HCWs) worldwide. India is one of the countries severely impacted by the pandemic. This review explores the gender perspective of mental health conditions among HCWs and job loss during the pandemic in India. Electronic databases (PubMed, Scopus, and Web of Science) were searched for articles published till March 2021. Studies that reported the prevalence of depression, anxiety, stress, and worry among HCWs in India during the pandemic and job loss in both males and females due to COVID-19 were included. We used a random-effects model to estimate pooled prevalence rates with 95% CIs. We assessed heterogeneity using the I2 statistic. The meta-analysis included 11 studies; the pooled prevalence of depression, anxiety, stress, and worry among HCWs was 34.9% (95%CI 27.33, 42.47), 35.4% (95%CI 24.46, 46.33), 32.9% (95%CI 25.43, 40.37), and 42.87% (95%CI 25.83, 59.91), respectively. The pooled prevalence of job loss due to COVID-19 was 16.6% (95%CI 8.34, 19.66). We employed meta-regression and Egger's regression for publication bias. The meta-analysis findings suggest that the prevalence of depression, anxiety, stress, and worry among HCWs in India during COVID-19 was high. Furthermore, job loss due to COVID-19 has also been prevalent in India. These findings emphasize the need for mental health support for HCWs and those who have lost their jobs during the pandemic. It is essential to prioritize mental health and job creation policies in India to support individuals affected by COVID-19.
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Affiliation(s)
- Ramesh Athe
- Data Science and Intelligent Systems, Indian Institute of Information Technology Dharwad, Dharwad, IND
| | - Rinshu Dwivedi
- Science and Humanities, Indian Institute of Information Technology Tiruchirappalli, Tiruchirappalli, IND
| | - Kasha Singh
- Computer Science and Engineering, Indian Institute of Information Technology Dharwad, Dharwad, IND
| | - Sabiha Babusab Hulmani
- Computer Science and Engineering, Indian Institute of Information Technology Dharwad, Dharwad, IND
| | - Nikhita Karadi
- Computer Science and Engineering, Indian Institute of Information Technology Dharwad, Dharwad, IND
| | - Chaithanya Boraiah
- Computer Science and Engineering, Indian Institute of Information Technology Dharwad, Dharwad, IND
| | - Sindhu Vasu
- Science and Humanities, Indian Institute of Information Technology Tiruchirappalli, Tiruchirappalli, IND
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Acharya A, Prabhu A, Negi S, Sharma K, Dwivedi R, Athe R. Spontaneous miscarriage/abortion in the first trimester and expectant management - a meta-analysis approach. Prz Menopauzalny 2023; 22:135-141. [PMID: 37829272 PMCID: PMC10566328 DOI: 10.5114/pm.2023.131307] [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] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 05/09/2023] [Indexed: 10/14/2023]
Abstract
Introduction To determine effectiveness and side effects of expectant care in first-trimester miscarriage. An increase in the spontaneous miscarriage rate and its associated complications exerts a burden on the overall health and quality of life of women. Expectant care in a first-trimester miscarriage has shown success ranging 75-80%. This study was designed to search the literature for information on the clinical safety and effectiveness of expectant management on spontaneous miscarriage during the first trimester. Material and methods The review included studies that included women in expectant care for spontaneous miscarriage in the first trimester. Trial studies were recognized through a methodical and organized database search from PubMed, COCHRANE, MEDLINE, Embase, and bibliography from January 2000 until December 2022. The methodological assessment and risk of bias was assessed using the Joanna Briggs Institute criteria. Results Eleven studies in systematic review and 7 studies in the meta-analysis were included. The included studies showed a low to moderate risk of bias. The odds of success in expectant intervention were low when compared with surgical intervention (odds ratio - OR: OR: 0.37 [0.28, 0.48]) and medical management (OR: 0.47 [0.36, 0.61]), and the need for surgical evacuation was high (OR: 2.59 [1.88, 3.59]). Conclusions Future trials should consider women's opinions and the effect on quality of life along with clinical consequences, to provide improved suggestions on the efficiency and adverse effects.
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Affiliation(s)
- Anwesa Acharya
- Department of Computer Science and Engineering, CMR University, Bangalore, India
| | - Ananya Prabhu
- Department of Public Health Dentistry, Manipal College of Dental Sciences, Manipal, India
| | - Shivali Negi
- Centre for Public Health, Punjab University, Chandigarh, India
| | - Kavya Sharma
- Centre for Public Health, Punjab University, Chandigarh, India
| | - Rinshu Dwivedi
- Department of Science and Humanities, Indian Institute of Information Technology, Tiruchirappalli, India
| | - Ramesh Athe
- Department of Data Science and Intelligent Systems, Indian Institute of Information Technology, Dharwad, India
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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.
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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.
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Sahoo KC, Athe R, Bhattacharya D, Dwivedi R, Sahoo RK, Aimol LW, Jain S, Rajsekhar K, Pati S. Use of Portable Automated Auditory Brainstem Responses in Universal Neonatal Hearing Screening: A Mixed-Method Study in Odisha, India. Indian J Pediatr 2023; 90:298-300. [PMID: 36598633 DOI: 10.1007/s12098-022-04435-2] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 10/13/2022] [Accepted: 11/03/2022] [Indexed: 01/05/2023]
Abstract
Hearing loss in children affects cognitive development, so early detection is crucial. It is because of the lack of portable technology that the majority of hearing problems go undetected. The authors conducted a mixed-method study in India to examine the concurrent validity and operational feasibility of portable automated brainstem response (P-AABR) and otoacoustic emissions (OAE) in universal neonatal hearing screening. They screened 198 children's ears using ABR and OAE devices. Additionally, 60 observations were recorded during the 'portable automated ABR' screening process. The hearing screening could be performed with P-AABR by any health care staff with basic skill-based training. However, the interpretation of the graphical wave required an audiologist. If the baby was quiet, the test could be performed in 20 min, including electrode implantation, impediment setting, earphone installation, and swipe counts. The P-AABR device can be used in the universal health coverage of hearing screening among infants in outreach areas due to its portability and minimal infrastructural requirements.
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Affiliation(s)
- Krushna Chandra Sahoo
- Health Technology Assessment in India (HTAIn), Regional Resource Hub, ICMR-Regional Medical Research Center, Bhubaneswar, Odisha, India.
| | - Ramesh Athe
- Health Technology Assessment in India (HTAIn), Regional Resource Hub, ICMR-Regional Medical Research Center, Bhubaneswar, Odisha, India
| | - Debdutta Bhattacharya
- Health Technology Assessment in India (HTAIn), Regional Resource Hub, ICMR-Regional Medical Research Center, Bhubaneswar, Odisha, India
| | - Rinshu Dwivedi
- Health Technology Assessment in India (HTAIn), Regional Resource Hub, ICMR-Regional Medical Research Center, Bhubaneswar, Odisha, India
| | - Rakesh Kumar Sahoo
- Health Technology Assessment in India (HTAIn), Regional Resource Hub, ICMR-Regional Medical Research Center, Bhubaneswar, Odisha, India
| | - Lanu Wanboy Aimol
- Ayjnishd (Divyangjan), Regional Center, Janla, Bhubaneswar, Odisha, India
| | - Shalu Jain
- Health Technology Assessment in India (HTAIn), Department of Health Research, Ministry of Health & Family Welfare, New Delhi, India
| | - Kavitha Rajsekhar
- Health Technology Assessment in India (HTAIn), Department of Health Research, Ministry of Health & Family Welfare, New Delhi, India
| | - Sanghamitra Pati
- Health Technology Assessment in India (HTAIn), Regional Resource Hub, ICMR-Regional Medical Research Center, Bhubaneswar, Odisha, India
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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.
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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
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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.
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Affiliation(s)
- L Lee-Johnson
- Department of Pharmacy, Queens Medical Centre , Nottingham
| | - R Dwivedi
- Department of Healthcare for older people, Queens Medical Centre , Nottingham
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Dwivedi R, Athe R, Mahesh K, Modem PK. The incubation period of coronavirus disease (COVID-19): A tremendous public health threat-Forecasting from publicly available case data in India. J Public Aff 2021; 21:e2619. [PMID: 33786017 PMCID: PMC7995164 DOI: 10.1002/pa.2619] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 08/13/2020] [Accepted: 01/01/2021] [Indexed: 05/16/2023]
Abstract
The World Health Organization (WHO) declared the Coronavirus Disease (COVID-19) a pandemic due to the huge upsurge in the number of reported cases worldwide. The COVID-19 pandemic in India has become a public health threat, and if we go by the number of confirmed cases then the situation seems to be a matter of grave concern. According to real-time data, the numbers of confirmed cases are growing exponentially. No doubt, substantial public health interventions both at the national and state levels are implemented immediately by the Government of India; there is a need for improved preparedness plans and mitigation strategies along with accurate forecasting. The present study aims to forecast the COVID-19 outbreak infected cases in India. The data have been obtained from https://www.covid19india.org, https://www.worldometers.info/coronavirus, and ICMR reported publicly available information about COVID-19 confirmation cases. We have used the double exponential smoothing method for forecasting the trends in terms of confirmed, active, recovered and death cases from COVID-19 for emergency preparedness and future predictions. Findings reveal that the estimated value of point forecast is just 8.22% of the total number of confirmed cases reported on a daily basis across the country. It was observed that the deaths were lower for the states and union territories with a higher detection rate. It is suggested that by keeping in view the limited healthcare resources in the country, accurate forecasting, early detection, and avoidance of acute care for the majority of infected cases is indispensable.
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Affiliation(s)
- Rinshu Dwivedi
- Indian Institute of Information TechnologyTrichyTamil NaduIndia
| | - Ramesh Athe
- Indian Institute of Information TechnologyDharwadKarnatakaIndia
| | - Kavi Mahesh
- Indian Institute of Information TechnologyDharwadKarnatakaIndia
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Sahoo KC, Dwivedi R, Athe R, Bhattacharya D, Rajsekhar K, Pati S. Stakeholders' Perspective for Improved Universal Newborn Hearing Screening Uptake in Odisha, India. J Trop Pediatr 2021; 67:5905598. [PMID: 32929505 DOI: 10.1093/tropej/fmaa062] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Universal Newborn Hearing Screening (UNHS) is a significant public health initiative as early diagnosis and intervention are critical for children's cognitive development. In India, priority for UNHS has been provided since 2013; however, there are various operational challenges associated with it. There is a lack of multi-stakeholders perspective on UNHS, which is crucial for improving the service intake. Therefore, this study attempted to understand the perspective of various stakeholders to explore the practices, processes and technologies used in the existing UNHS landscape in Odisha, India. The qualitative in-depth interviews were conducted among various stakeholders including 15 mothers, 5 service providers (audiologists), 10 districts and state-level programme managers. Data were analysed using content analysis approaches. Two major themes emerged were 'social-shaping of technology for UNHS' and 'mothers' understanding and experience on UNHS'. Employee retention, equipment limitations, facilities maintenance and little knowledge among mothers about hearing screening have been described as major operational challenges. The study revealed that to increase universal coverage 'screening technology should be socially shaped'. There seems to be a need for 'portable technology with ease to use and better diagnostic accuracy' for first-stage screening at various levels of healthcare facilities along with community literacy on UNHS.
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Affiliation(s)
- Krushna Chandra Sahoo
- Health Technology Assessment in India (HTAIn), Regional Resource Hub, Department of Health Research, ICMR-Regional Medical Research Centre, Bhubaneswar 751023, Odisha, India
| | - Rinshu Dwivedi
- Department of Science and Humanities, Indian Institute of Information Technology, Tiruchirappalli 620015, Tamil Nadu, India
| | - Ramesh Athe
- Department of Humanities and Science, Indian Institute of Information Technology, Dharwad 580029, Karnataka, India
| | - Debdutta Bhattacharya
- Health Technology Assessment in India (HTAIn), Regional Resource Hub, Department of Health Research, ICMR-Regional Medical Research Centre, Bhubaneswar 751023, Odisha, India
| | - Kavitha Rajsekhar
- Department of Health Research, Ministry of Health and Family Welfare, Health Technology Assessment in India (HTAIn), New Delhi 110001, India
| | - Sanghamitra Pati
- Health Technology Assessment in India (HTAIn), Regional Resource Hub, Department of Health Research, ICMR-Regional Medical Research Centre, Bhubaneswar 751023, Odisha, India
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Dwivedi R, Pradhan J, Athe R. Measuring catastrophe in paying for healthcare: A comparative methodological approach by using National Sample Survey, India. Int J Health Plann Manage 2021; 36:1887-1915. [PMID: 34196030 DOI: 10.1002/hpm.3272] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 09/26/2020] [Revised: 06/19/2021] [Accepted: 06/20/2021] [Indexed: 11/07/2022] Open
Abstract
Healthcare expenditure significantly varies among various segments of the population. The appropriate measures of catastrophic health expenditure (CHE) will help to unravel the real burden of spending among households. Present study provides a link between the theoretical insights from Grossman's model and various methodological approaches for the estimation of CHE by using data from the three rounds of nationally representative Consumer Expenditure Surveys, India. Statistical analysis has been carried out by using multivariate logistic regression to identify the major determinants of CHE. Findings indicate that the occurrence of CHE has increased during 1993-2012. Rural residents and households with varying age composition such as with higher numbers of children and elderly were at higher risk. Economic status is significantly associated with CHE and increased demand for healthcare. The measurements differ as per the methodological approaches of CHE and definition of household's capacity to pay. Approach-based variations in the results can be of key importance in determining trends and magnitude in CHE. Despite these variations in measurements, study finds a limited incidence of CHE among the disadvantaged segment of the population though a greater share was devoted to health expenditure in recent years. Better risk pooling mechanism is required to address the healthcare needs of the disadvantaged segment such as elderly, children, poor and rural population in India.
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Affiliation(s)
- Rinshu Dwivedi
- Department of Science and Humanities, Indian Institute of Information Technology, Trichy, Tamil Nadu, India
| | - Jalandhar Pradhan
- Department of Humanities and Social Sciences, National Institute of Technology, Rourkela, Odisha, India
| | - Ramesh Athe
- Department of Humanities and Sciences, Indian Institute of Information Technology, Dharwad, Karnataka, India
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Pati S, Mahapatra P, Dwivedi R, Athe R, Sahoo KC, Samal M, Das RC, Hussain MA. Multimorbidity and Its Outcomes Among Patients Attending Psychiatric Care Settings: An Observational Study From Odisha, India. Front Public Health 2021; 8:616480. [PMID: 33968863 PMCID: PMC8096979 DOI: 10.3389/fpubh.2020.616480] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [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: 11/03/2020] [Accepted: 12/30/2020] [Indexed: 12/17/2022] Open
Abstract
Background: Multimorbidity, the presence of two or more chronic health conditions is linked to premature mortality among psychiatric patients since the presence of one can further complicate the management of either. Little research has focused on the magnitude and effect of multimorbidity among psychiatric patients in low-and middle-income settings. Our study, provides the first ever data on multimorbidity and its outcomes among patients attending psychiatric clinics in Odisha, India. It further explored whether multimorbidity was associated with higher medical expenditure and the interaction effect of psychiatric illness on this association. Methods: This cross-sectional study included 500 adult patients presenting to the psychiatric clinic of a medical college hospital in Odisha over a period of 6 months (February 2019–July 2019). A validated structured questionnaire, “multimorbidity assessment questionnaire for psychiatric care” (MAQ-PsyC) was used for data collection. We used multinomial logistic model for the effect estimation. Odds ratios (OR) and 95% confidence intervals (CI) for high healthcare utilization and expenditure were calculated by number and pattern of multimorbidity. Data was analyzed by STATA 14. Results: Half (50%) of the psychiatric outpatients had multimorbidity. The relative probabilities of having one additional condition were 5.3 times (RRR = 5.3; 95% CI: 2.3, 11.9) and multiple morbidities were 6.6 times (RRR = 6.6; 95%CI: 3.3, 13.1) higher for patients in 60+ age group. Healthcare utilization i.e., medication use and physician consultation was significantly higher for psychiatric conditions such as mood disorders, schizophrenia, schizotypal and delusional disorders, and for hypertension, cancer, diabetes, among somatic conditions. Out of pocket expenditure (OOPE) was found to be highest for laboratory investigations, followed by medicines and transport expenditure. Within psychiatric conditions, mood disorders incurred highest OOPE ($93.43) while hypertension was the most leading for OOPE in physical morbidities ($93.43). Psychiatric illnesses had a significant interaction effect on the association between multimorbidity and high medical expenditure (P = 0.001). Conclusion: Multimorbidity is highly prevalent in psychiatric patients associated with significantly high healthcare utilization and medical expenditure. Such disproportionate effect of psychiatric multimorbidity on healthcare cost and use insinuates the need for stronger financial protection and tailor-made clinical decision making for these vulnerable patient subgroups.
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Affiliation(s)
- Sanghamitra Pati
- Indian Council of Medical Research (ICMR)-Regional Medical Research Centre, Bhubaneswar, India
| | - Pranab Mahapatra
- Department of Psychiatry, Kalinga Institute of Medical Sciences, Kalinga Institute of Industrial Technology (KIIT) University, Bhubaneswar, India
| | - Rinshu Dwivedi
- Department of Humanities and Science (Economics), Indian Institute of Information Technology, Tiruchirappalli, India
| | - Ramesh Athe
- Department of Humanities and Science (Mathematics), Indian Institute of Information Technology, Dharwad, India
| | - Krushna Chandra Sahoo
- Indian Council of Medical Research (ICMR)-Regional Medical Research Centre, Bhubaneswar, India
| | - Mousumi Samal
- Indian Council of Medical Research (ICMR)-Regional Medical Research Centre, Bhubaneswar, India
| | - Ram Chandra Das
- Department of Psychiatry, Kalinga Institute of Medical Sciences, Kalinga Institute of Industrial Technology (KIIT) University, Bhubaneswar, India
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Dwivedi R, Athe R, Pati S, Sahoo KC, Bhattacharya D. Mapping of Health Technology Assessment (HTA) teaching and training initiatives: Landscape for evidence-based policy decisions in India. J Family Med Prim Care 2020; 9:5458-5467. [PMID: 33532379 PMCID: PMC7842426 DOI: 10.4103/jfmpc.jfmpc_920_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 05/19/2020] [Revised: 06/19/2020] [Accepted: 08/26/2020] [Indexed: 11/16/2022] Open
Abstract
Demographic transitions accompanied with epidemiological shifts are affecting many countries around the globe. These apprehensions have raised the concern for constructing and sustaining healthcare systems especially among resource-constrained low- and middle-income-countries (LMICs) such as India. Introducing Health-Technology-Assessment (HTA) in the educational initiatives could support planners and policy-makers in formulating evidence-based-decision-making along with tackling inequalities/inefficiencies and promoting cost-effectiveness in resource allocation. A mapping exercise has been undertaken for examining the feasibility and implementation of HTA curriculum in the existing courses in India. To gain best possible insight on HTA curriculum, a situational analysis was conducted using systematic search strategy through search engines such as Google, Google Scholar, ProQuest and PubMed. Currently, seventy-one institutes in India are offering one or more courses through regular mode at undergraduate/postgraduate/diploma-certificate/doctorate-level pertaining to Medical-technology (MT), Biostatistics (BS), and Health-economics (HE). MT was offered in 37 institutes (52.12%), followed by BS in 23 (32.39%), and HE in nine (12.67%). Only two institutes (2.81%) are offering certificate-courses on HTA, mainly confined in virtual modules. This review reveals noticeable gaps in the existing curriculum in India and necessitates a novel academic initiative by introducing HTA in a full-fledged manner. Reforms in the research and educational initiatives need to be brought for promoting awareness regarding HTA. The application of domain needs to be widened from the field of health-policy formulators to research and teaching. This should be further strengthened with the strong academic collaborations to generate replicable findings, address challenges, and offer solutions for existing threats to HTA.
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Affiliation(s)
- Rinshu Dwivedi
- Department of Science and Humanities, Indian Institute of Information Technology, Tiruchirappalli, Tamil Nadu, India
| | - Ramesh Athe
- Department of Humanities and Science, Indian Institute of Information Technology, Dharwad, Karnataka, India
| | - Sanghamitra Pati
- Director and Scientist-G, ICMR-Regional Medical Research Centre, Chandrasekharpur-Bhubaneswar, Orissa, India
| | - Krushna C. Sahoo
- Consultant (Public Health), Health Technology Assessment in India, ICMR-Regional Medical Research Centre, Chandrasekharpur-Bhubaneswar, Odisha, India
| | - Debdutta Bhattacharya
- Scientist-D, ICMR-Regional Medical Research Centre, Chandrasekharpur-Bhubaneswar, Orissa, India
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Abstract
BACKGROUND Absence of better financing mechanism results in higher out of pocket expenditure and catastrophe, which leads to impoverishment and poverty especially among low- and middle-income countries like India. This paper examines the major characteristics associated with the higher out of pocket expenditure and provides an insight from Andersen's behavioural model that how predisposing, enabling and need factors influence the level and pattern of out of pocket expenditure in India. METHODS Data has been extracted from three rounds of nationally representative consumer expenditure surveys, i.e. 1993-1994, 2004-2005 and 2011-2012 conducted by the Government of India. States were categorized based on regional classification, and adult equivalent scale was used to adjust the household size. Multiple Generalized-Linear-Regression-Model was employed to explore the relative effect of various socio-economic covariates on the level of out of pocket expenditure. RESULTS The gap has widened between advantaged and disadvantaged segment of the population along with noticeable regional disparities among Indian states. Generalized-Linear-Regression-Model indicates that the most influential predisposing and enabling factor determining the level of out of pocket expenditure were age composition, religion, social-group, household type, residence, economic status, sources of cooking and lighting arrangements among the households. CONCLUSIONS Present study suggests the need for strengthening the affordability mechanism of the households to cope with the excessive burden of health care payments. Furthermore, special consideration is required to accommodate the needs of the elderly, rural, backward states and impoverishment segment of population to reduce the unjust burden of out of pocket expenditure in India.
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Affiliation(s)
- Rinshu Dwivedi
- Department of Humanities and Social Sciences, Indian Institute of Information Technology, Tiruchirappalli, Tamil Nadu, India
| | - Jalandhar Pradhan
- Department of Humanities and Social Sciences, National Institute of Technology Rourkela, Rourkela, India
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Athe R, Dwivedi R, Pati S, Mazumder A, Banset U. Meta-analysis approach on iron fortification and its effect on pregnancy and its outcome through randomized, controlled trials. J Family Med Prim Care 2020; 9:513-519. [PMID: 32318374 PMCID: PMC7114015 DOI: 10.4103/jfmpc.jfmpc_817_19] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 09/23/2019] [Revised: 01/24/2020] [Accepted: 02/03/2020] [Indexed: 12/17/2022] Open
Abstract
Micronutrients’ deficiency is a common phenomenon among a majority of the population residing in the low- and middle-income countries (LMICs) especially among women and children. Given the widespread prevalence of micronutrients’ deficiency in LMICs, iron-fortified foods could be of potential benefits for both the mother and the development of fetus. Present study aims to provide the evidence on the impact of iron fortification on hemoglobin (Hb) concentration during pregnancy and evaluates the specific maternal and pregnancy outcomes. We conducted systematic review by using search engines such as PubMed, Cochrane Library, Medline, EMbase, and secondary references. Meta-analyses were performed to calculate summary estimates on Hb during pregnancy, low birth weight (LBW), and preterm births. The weighted mean difference (WMD) and relative risk (RR) were calculated using random-effects models. Sources of heterogeneity were explored through meta-regression. Eight studies were included for the final analysis. The overall pooled estimate of Hb showed a significant increase in the fortification group compared with the control group [WMD = 4.45 g/L; 95% confidence interval (CI) = 2.73, 6.17 g/L; I2 = 83%, τ2 = 6.80, ρ <0.00001]. There has been a notable reduction in iron deficiency anemia (IDA) among pregnant women with substantial heterogeneity. Meta-regression suggests that the duration of feeding was positively associated with the effect size. Present review provides an evidence for the substantial benefits of iron fortification during pregnancy for reducing preterm births and risk of LBW. The safety, efficacy, and effective delivery of iron fortification need further research. Systematic review registration: PROSPERO International prospective register of systematic reviews – CRD42018116931.
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Affiliation(s)
- Ramesh Athe
- Department of Humanities and Science (Mathematics), Indian Institute of Information Technology, Dharwad, Hubbali, Karnataka, India
| | - Rinshu Dwivedi
- Department of Humanities and Science (Economics), Indian Institute of Information Technology, Tiruchirapalli, Tamil Nadu, India
| | - Sanghamitra Pati
- ICMR-Regional Medical Research Centre (RMRC), Chandrasekharpur, Bhubaneswar, Orissa, India
| | - Anindita Mazumder
- PGDSM, Indian Statistical Institute, North East Centre, Tezpur, Assam, India
| | - Udit Banset
- PGDSM, Indian Statistical Institute, North East Centre, Tezpur, Assam, India
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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
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Pati S, Dwivedi R, Athe R, Dey PK, Swain S. Minimum data set (MDS) based trauma registry, is the data adequate? An evidence-based study from Odisha, India. J Family Med Prim Care 2019; 8:7-13. [PMID: 30911474 PMCID: PMC6396589 DOI: 10.4103/jfmpc.jfmpc_307_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND In majority of the low- and middle-income countries (LMICs), the societal cost of injuries are alarming. The severity and magnitude of the road traffic injuries (RTI) in India are not estimated accurately due to the lack of availability of data. The data are limited on the aspects such as demographics, cause, severity of injury, processes of care, and the final outcome of injuries. This study aimed to determine the feasibility of setting up a sustainable trauma registry in Odisha, India, and to determine the demographics, mechanism, severity, and outcomes of injury reported to the facilities/hospital. MATERIALS AND METHODS A prospective observational study was conducted at Srirama Chandra Bhanja Medical College and Hospital (SCB-MCH), Cuttack, India. Injured patients who reported/admitted to the emergency department were observed, and data were collected by using a minimum data set (MDS) developed by the World Health Organization (WHO). Data were collected for a period of one month in June 2015. Observations were collected on 20 variables. The completeness of data collection ranged from 60% (19 variables) to 70% (23 variables) out of total 33 variables. RESULTS This study uses 145 cases of injury reported in SCB-MCH. Out of the total reported population at the trauma registry, about 21% were females. Nearly 45% of the injury occurred on road/street. RTI accounted for 36.6% of injury. Out of the total admitted cases, 2.8% died in the emergency department, 11% were discharged to home, and 7.6% left against medical advice. Majority of the respondents have reported single injuries (77%). Head injuries were more common and severe among majority of the reported cases (44.1%), followed by neck injury (28.3%) and chest (15.9%). CONCLUSIONS This study indicates the challenges in obtaining complete data on injury. Data were missing in terms of admission, discharge, and Glasgow Comma Scale (GCS) among the studied population. This study suggests that individual GCS scoring should be done instead of total GCS scoring in each trauma patient. By collection and storage of adequate data, better policy decisions can be implemented, which will minimize and prevent trauma cases and maximize the utilization of the available resources.
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Affiliation(s)
- Sanghamitra Pati
- Health Technology Assessment (HTAIn), ICMR-Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Rinshu Dwivedi
- Health Technology Assessment (HTAIn), ICMR-Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Ramesh Athe
- Health Technology Assessment (HTAIn), ICMR-Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Pramod Kumar Dey
- Department of Health and Family Welfare, Government of Odisha, Bhubaneswar, Odisha, India
| | - Subhashisa Swain
- Indian Institute of Public Health (IIPH), Bhubaneswar, Odisha, India
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Pradhan J, Dwivedi R, Pati S, Rout SK. Does spending matters? Re-looking into various covariates associated with Out of Pocket Expenditure (OOPE) and catastrophic spending on accidental injury from NSSO 71st round data. Health Econ Rev 2017; 7:48. [PMID: 29264664 PMCID: PMC5738333 DOI: 10.1186/s13561-017-0177-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Accepted: 10/27/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Accidental Injury is a traumatic event which not only influences physical, psychological, and social wellbeing of the households but also exerts extensive financial burden on them. Despite the devastating economic burden of injuries, in India, there is limited data available on injury epidemiology. This paper aims to, first, examine the socio-economic differentials in Out of Pocket Expenditure (OOPE) on accidental injury; second, to look into the level of Catastrophic Health Expenditure (CHE) at different threshold levels; and last, to explore the adjusted effect of various socio-economic covariates on the level of CHE. METHODS Data was extracted from the key indicators of social consumption in India: Health, National Sample Survey Organisation (NSSO), conducted by the Government of India during January-June-2014. Logistic regression analysis was employed to analyse the various covariates of OOPE and CHE associated to accidental injury. FINDINGS Binary Logistic analysis has demonstrated a significant association between socioeconomic status of the households and the level of OOPE and CHE on accidental injury care. People who used private health services incurred 16 times higher odds of CHE than those who availed public facilities. The result shows that if the person is covered via any type of insurance, the odd of CHE was lower by about 28% than the uninsured. Longer duration of stay and death due to accidental injury was positively associated with higher level of OOPE. Economic status, nature of healthcare facility availed and regional affiliation significantly influence the level of OOPE and CHE. CONCLUSION Despite numerous efforts by the Central and State governments to reduce the financial burden of healthcare, large number of households are still paying a significant amount from their own pockets. There are huge differentials in cost for the treatment among public and private healthcare providers for accidental injury. It is expected that the findings would provide insights into the prevailing magnitude of accidental injuries in India, the profile of the population affected, and the level of OOPE among households.
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Affiliation(s)
- Jalandhar Pradhan
- Department of Humanities and Social Sciences, National Institute of Technology, Rourkela, Orissa 769 008 India
| | - Rinshu Dwivedi
- Department of Humanities and Social Sciences, National Institute of Technology, Rourkela, Orissa 769 008 India
| | - Sanghamitra Pati
- Regional Medical Research Centre, Bhubaneswar, Odisha 751023 India
| | - Sarit Kumar Rout
- Indian Institute of Public Health-PHFI, Bhubaneswar, Odisha 751024 India
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Abstract
The present article focuses on the perception of elderly regarding younger generation in rural Odisha. Data for this study were collected from the rural areas of Bargarh district using semi-structured interview schedule. For this study, 310 males and females were interviewed by using systematic sampling technique. Various issues like condition of the aged in context of respect and care have been taken into consideration. Other factors like their level of satisfaction from the care provided by their children and how they perceive today’s youth has been analysed. ANOVA was conducted to see which socio-demographic variables have the most significant effect on the perception of elderly later, factor analysis is used and the results show that the elderly have a negative perception regarding the younger generation. Results show that the elderly feels that today’s youth is selfish and least bothered about their needs and demands.
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Affiliation(s)
- Pallavi Banjare
- Senior Research Fellow, National Institute of Technology, Rourkela, Odisha, India
| | - Jalandhar Pradhan
- Assistant Professor, National Institute of Technology, Rourkela, Odisha, India
| | - Rinshu Dwivedi
- Senior Research Fellow, National Institute of Technology, Rourkela, Odisha, India
| | - S.S. Mahapatra
- Professor, National Institute of Technology, Rourkela, Odisha, India
| | - Bikash Ranjan Debata
- Senior Research Fellow, National Institute of Technology, Rourkela, Odisha, India
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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.
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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
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Pradhan J, Dwivedi R, Banjare P. Relying on Whom? Correlates of Out of Pocket Health Expenditure among the Rural Elderly in Odisha, India. Ageing Int 2017. [DOI: 10.1007/s12126-017-9293-7] [Citation(s) in RCA: 3] [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: 12/17/2022]
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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.
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Dwivedi R, Pradhan J. Does equity in healthcare spending exist among Indian states? Explaining regional variations from national sample survey data. Int J Equity Health 2017; 16:15. [PMID: 28088198 PMCID: PMC5237520 DOI: 10.1186/s12939-017-0517-y] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Accepted: 01/03/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Equity and justice in healthcare payment form an integral part of health policy and planning. In the majority of low and middle-income countries (LMICs), healthcare inequalities are further aggravated by Out of Pocket Expenditure (OOPE). This paper examines the pattern of health equity and regional disparities in healthcare spending among Indian states by applying Andersen's behavioural model of healthcare utilization. METHODS The present study uses data from the 66th quinquennial round of Consumer Expenditure Survey, of the National Sample Survey Organization (NSSO), conducted in 2009-10 by Ministry of Statistics and Programme Implementation (MoSPI), Government of India (GoI). To measure equity and regional disparities in healthcare expenditure, states have been categorized under three heads on the basis of monthly OOPE i.e., Category A (OOPE > =INR 100); Category B (OOPE between INR 50 to 99) and Category C (OOPE < INR 50). Multiple Generalised Linear Regression Model (GLRM) has been employed to explore the effect of various socio-economic covariates on the level of OOPE. RESULTS The gap in the ratio of average healthcare spending between the poorest and richest households was maximum in Category A states (richest/poorest = 14.60), followed by Category B (richest/poorest 11.70) and Category C (richest/poorest 11.40). Results also indicate geographical concentration of lower level healthcare spending among Indian states (e.g., Odisha, Chhattisgarh and all the north-eastern states). Results from the multivariate analysis suggest that people residing in urban areas, having higher economic status, belonging to non-Muslim communities, non-Scheduled Tribes (STs), and non-poor households spend more on healthcare than their counterparts. CONCLUSIONS In spite of various efforts by the government to reduce the burden of healthcare spending, widespread inequalities in healthcare expenditure are prevalent. Households with high healthcare needs (SCs/STs, and the poor) are in a more disadvantaged position in terms of spending on health care. It has also been observed that spending on healthcare was comparatively lower among backward or isolated states. No doubt, the overall social security measures should be enhanced, but at the same time, looking at the regional differences, more priority should be assigned to the disadvantaged states to reduce the burden of OOPE. It is proposed that there is need to increase government spending, especially for the disadvantaged states and population, to minimise the burden of OOPE.
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Affiliation(s)
- Rinshu Dwivedi
- Research Scholar Department of Humanities and Social Sciences, National Institute of Technology, Rourkela, Odisha 769 008 India
| | - Jalandhar Pradhan
- Department of Humanities and Social Sciences, National Institute of Technology, Rourkela, Odisha 769 008 India
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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.
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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
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Pradhan J, Dwivedi R. Do we provide affordable, accessible and administrable health care? An assessment of SES differential in out of pocket expenditure on delivery care in India. Sex Reprod Healthc 2016; 11:69-78. [PMID: 28159131 DOI: 10.1016/j.srhc.2016.10.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Revised: 10/25/2016] [Accepted: 10/27/2016] [Indexed: 11/26/2022]
Abstract
BACKGROUND Reproductive and Child Health (RCH) financing is a key area of focus which can lead towards an overall empowerment of women through financial inclusion. The major objectives of this paper are: first; to examine the socio-economic differentials in Out of Pocket Expenditure (OOPE) on delivery care, second; to look into the role of insurance coverage, third; to analyse various sources of financing, and fourth; to measure the adjusted effect of various covariates on the level of OOPE. METHODS Data were extracted from the National Sample Survey Organisations (NSSO), 71st round "Key indicators of social consumption in India, Health" conducted by the GoI during January to June 2014. Multivariate Generalised Linear Regression Model (GLRM) has been used to analyse the various covariates of OOPE on maternity care. FINDINGS Multivariate analysis has demonstrated a significant association between socioeconomic status of women and the level of OOPE on delivery care. Level of education, urban residence, higher caste and social group affiliation, strong economic conditions, and use of private facilities for the child birth among the mothers were a significant predictor of the expenditure on maternity care. CONCLUSION Despite various efforts by the central and state governments to reduce financial burden, still a large number of households are paying a significant amount from their own pockets. There is an immediate need to re-look in the aspects of insurance coverage and high level of OOPE in delivery care.
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Affiliation(s)
- Jalandhar Pradhan
- Department of Humanities and Social Sciences, National Institute of Technology, Rourkela 769 008, Orissa, India.
| | - Rinshu Dwivedi
- Department of Humanities and Social Sciences, National Institute of Technology, Rourkela 769 008, Orissa, India
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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.
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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
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Banjare P, Dwivedi R, Pradhan J. Factors associated with the life satisfaction amongst the rural elderly in Odisha, India. Health Qual Life Outcomes 2015; 13:201. [PMID: 26691176 PMCID: PMC4687085 DOI: 10.1186/s12955-015-0398-y] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [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: 05/26/2015] [Accepted: 12/15/2015] [Indexed: 12/13/2022] Open
Abstract
Background Life Satisfaction (LS) is an indicator of subjective well-being (SWB) among the elderly, and is directly associated with health and mortality. Present study deals with the factors associated with the LS among the rural elderly in Odisha, India. Methods A cross-sectional survey using multi-stage random sampling procedure was conducted among elderly (60+ years) in Bargarh district of Odisha. The survey was conducted among 310 respondents. Hierarchical regression analysis was used to assess the adjusted effect of various socio-economic, demographic, health conditions (physical and mental), social support and effects of multi-morbidity on LS. Results Cognitive health was the most influential factor in determining LS among both men (β = 0.327) and women (β = 0.329). Individual’s social support also plays an influential role in LS among rural elderly. Elderly who are living alone and have any sort of disability and had low score of activities of daily living (ADL) have also reported significantly lower perceived LS for both the genders. Conclusion It is necessary to analyze and identify the major factors which can improve upon the level of LS among the elderly population. Better understanding of these factors can help in removing the superfluous anxiety of old age in the mindset of people which is pervading in the society.
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Affiliation(s)
- Pallavi Banjare
- Department of Humanities and Social Sciences, National Institute of Technology, Rourkela, 769 008, Orissa, India.
| | - Rinshu Dwivedi
- Department of Humanities and Social Sciences, National Institute of Technology, Rourkela, 769 008, Orissa, India.
| | - Jalandhar Pradhan
- Department of Humanities and Social Sciences, National Institute of Technology, Rourkela, 769 008, Orissa, India.
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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.
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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
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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]
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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.
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Affiliation(s)
- R Dwivedi
- Centre for Marine Living Resources and Ecology, Ministry of Earth Sciences, Kochi-37, India,
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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]
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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.
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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
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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.
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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
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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.
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Affiliation(s)
- A K Chaudhary
- District Hospital, Bhopal, India ; Quarter No. 94/13-F, Tulsi Nagar, Bhopal, 462 003 India
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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
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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.
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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.
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Affiliation(s)
- S Sah
- Department of Orthopaedic, Koshi Zonal Hospital, Biratnagar, Koshi, Nepal
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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
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39
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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.
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Affiliation(s)
- R Dwivedi
- Kings Mill Hospital, Sutton in Ashfield, Notts, NG17 4JL, UK
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40
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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]
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41
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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]
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42
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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]
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43
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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.
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Affiliation(s)
- P Sharma
- Department of Radiology and Imaging, Nepalgunj Medical College, Banke, Nepal.
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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]
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45
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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]
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46
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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]
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47
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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]
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48
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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]
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49
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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
.
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Affiliation(s)
- R Dwivedi
- Department of Clinical Pharmacology, GKT Division of Cardiovascular Medicine, St Thomas' Hospital, London, United Kingdom
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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]
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