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Mehra R, Patra V, Dhillan R, Sharma A, Kashyap S, Rastogi G, Gupta L, Singh R, Chopra C, Sharma V. Replication study identified EFEMP1 association with varicose vein predisposition among Indians. Eur J Med Res 2024; 29:232. [PMID: 38609985 PMCID: PMC11015598 DOI: 10.1186/s40001-024-01786-8] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 03/11/2024] [Indexed: 04/14/2024] Open
Abstract
BACKGROUND Varicose vein is a chronic condition that affects the lower extremities of the human body. Several factors have been implicated in the development of this disease, viz age, gender, weight, height and prolonged standing. Recently, genome-wide studies have identified genetic biomarkers that are associated with varicose veins in different ethnic groups. Such genetic studies are lacking in South Asians specifically in Indians where the prevalence of varicose veins is high, and it is important to replicate these variants in the stated population. The study aimed to replicate the association of genetic variants associated with varicose veins in this target population, which were found to be associated with the other ethnic groups. METHODOLOGY The studied cohort is of the Indian population comprising unrelated 104 varicose veins cases and 448 non-varicose vein controls. The samples were genotyped using the Illumina Global Screening Array. Using the genomic data from UK BioBank and 23andMe studied cohorts; eight genetic variants were selected to replicate in our dataset. The allelic association was performed to identify the effective allele and risk was estimated using odds ratio and p-value as level of significance. Multifactor Dimensionality Reduction was used to estimate the cumulative effect of variants in Indians. RESULT Variant rs3791679 of EFEMP1 was found to be associated with varicose veins in Indians. After observing the association of the EFEMP1 with varicose veins, we further ensued to identify all genetic variants within EFEMP1 to uncover the additional variants associated with this trait. Interestingly, we identified six new variants of EFEMP1 gene that have shown association. Moreover, the cumulative effect of all associated variations was estimated and the risk was 2.7 times higher in cases than controls whereas independently their effect ranges from 0.37-1.58. CONCLUSION This study identifies EFEMP1 as a potential gene related to the risk of varicose veins in Indians. It also highlights that evaluating the maximum number of variants of a gene rather than focusing solely on replicating single variations offers a more comprehensive and nuanced understanding of the genetic factors contributing to a complex trait like varicose veins.
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Affiliation(s)
- Rohit Mehra
- Department of Vascular and Endovascular Surgery, Command Hospital (Southern Command), Pune, India.
| | - Vikram Patra
- Department of Vascular and Endovascular Surgery, Command Hospital (Northern Command), Udhampur, India
| | - Rishi Dhillan
- Department of Vascular and Endovascular Surgery, Army Hospital (Research and Referral), Delhi, India
| | - Anuka Sharma
- NMC Genetics India Pvt. Ltd. Gurugram, Haryana, 122001, India
| | - Sonal Kashyap
- School of Bioengineering and Biosciences, Lovely Professional University, Phagwara, Punjab, India
| | - Garima Rastogi
- NMC Genetics India Pvt. Ltd. Gurugram, Haryana, 122001, India
| | - Love Gupta
- NMC Genetics India Pvt. Ltd. Gurugram, Haryana, 122001, India
| | - Reena Singh
- School of Bioengineering and Biosciences, Lovely Professional University, Phagwara, Punjab, India
| | - Chirag Chopra
- School of Bioengineering and Biosciences, Lovely Professional University, Phagwara, Punjab, India
| | - Varun Sharma
- NMC Genetics India Pvt. Ltd. Gurugram, Haryana, 122001, India.
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Sivadas A, Sahana S, Jolly B, Bhoyar RC, Jain A, Sharma D, Imran M, Senthivel V, Divakar MK, Mishra A, Mukhopadhyay A, Gibson G, Narayan KV, Sivasubbu S, Scaria V, Kurpad AV. Landscape of pharmacogenetic variants associated with non-insulin antidiabetic drugs in the Indian population. BMJ Open Diabetes Res Care 2024; 12:e003769. [PMID: 38471670 PMCID: PMC10936492 DOI: 10.1136/bmjdrc-2023-003769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 02/28/2024] [Indexed: 03/14/2024] Open
Abstract
INTRODUCTION Genetic variants contribute to differential responses to non-insulin antidiabetic drugs (NIADs), and consequently to variable plasma glucose control. Optimal control of plasma glucose is paramount to minimizing type 2 diabetes-related long-term complications. India's distinct genetic architecture and its exploding burden of type 2 diabetes warrants a population-specific survey of NIAD-associated pharmacogenetic (PGx) variants. The recent availability of large-scale whole genomes from the Indian population provides a unique opportunity to generate a population-specific map of NIAD-associated PGx variants. RESEARCH DESIGN AND METHODS We mined 1029 Indian whole genomes for PGx variants, drug-drug interaction (DDI) and drug-drug-gene interactions (DDGI) associated with 44 NIADs. Population-wise allele frequencies were estimated and compared using Fisher's exact test. RESULTS Overall, we found 76 known and 52 predicted deleterious common PGx variants associated with response to type 2 diabetes therapy among Indians. We report remarkable interethnic differences in the relative cumulative counts of decreased and increased response-associated alleles across NIAD classes. Indians and South Asians showed a significant excess of decreased metformin response-associated alleles compared with other global populations. Network analysis of shared PGx genes predicts high DDI risk during coadministration of NIADs with other metabolic disease drugs. We also predict an increased CYP2C19-mediated DDGI risk for CYP3A4/3A5-metabolized NIADs, saxagliptin, linagliptin and glyburide when coadministered with proton-pump inhibitors (PPIs). CONCLUSIONS Indians and South Asians have a distinct PGx profile for antidiabetes drugs, marked by an excess of poor treatment response-associated alleles for various NIAD classes. This suggests the possibility of a population-specific reduced drug response in atleast some NIADs. In addition, our findings provide an actionable resource for accelerating future diabetes PGx studies in Indians and South Asians and reconsidering NIAD dosing guidelines to ensure maximum efficacy and safety in the population.
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Affiliation(s)
- Ambily Sivadas
- St John's Research Institute, Bangalore, Karnataka, India
| | - S Sahana
- CSIR Institute of Genomics and Integrative Biology, New Delhi, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, Uttar Pradesh, India
| | - Bani Jolly
- CSIR Institute of Genomics and Integrative Biology, New Delhi, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, Uttar Pradesh, India
| | - Rahul C Bhoyar
- CSIR Institute of Genomics and Integrative Biology, New Delhi, India
| | - Abhinav Jain
- CSIR Institute of Genomics and Integrative Biology, New Delhi, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, Uttar Pradesh, India
| | - Disha Sharma
- CSIR Institute of Genomics and Integrative Biology, New Delhi, India
| | - Mohamed Imran
- CSIR Institute of Genomics and Integrative Biology, New Delhi, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, Uttar Pradesh, India
| | - Vigneshwar Senthivel
- CSIR Institute of Genomics and Integrative Biology, New Delhi, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, Uttar Pradesh, India
| | - Mohit Kumar Divakar
- CSIR Institute of Genomics and Integrative Biology, New Delhi, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, Uttar Pradesh, India
| | - Anushree Mishra
- CSIR Institute of Genomics and Integrative Biology, New Delhi, India
| | | | - Greg Gibson
- Georgia Institute of Technology, Atlanta, Georgia, USA
| | | | - Sridhar Sivasubbu
- CSIR Institute of Genomics and Integrative Biology, New Delhi, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, Uttar Pradesh, India
| | - Vinod Scaria
- CSIR Institute of Genomics and Integrative Biology, New Delhi, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, Uttar Pradesh, India
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Welch AC, London SM, Wilshire CL, Gilbert CR, Buchwald D, Ferguson G, Allick C, Gorden JA. Access to Lung Cancer Screening Among American Indian and Alaska Native Adults: A Qualitative Study. Chest 2024; 165:716-724. [PMID: 37898186 DOI: 10.1016/j.chest.2023.10.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 10/20/2023] [Accepted: 10/21/2023] [Indexed: 10/30/2023] Open
Abstract
BACKGROUND Lung cancer is the leading cause of cancer mortality among American Indian and Alaska Native populations. American Indian and Alaska Native people use commercial tobacco products at higher rates compared with all other races and ethnicities. Moreover, they show lower adherence to cancer screening guidelines. RESEARCH QUESTION How do American Indian and Alaska Native adults perceive and use lung cancer screening? STUDY DESIGN AND METHODS We conducted a study in which we recorded and transcribed data from three focus groups consisting of American Indian and Alaska Native adults. Participants were recruited through convenience sampling at a national health conference. Transcripts were analyzed by inductive coding. RESULTS Participants (n = 58) of 28 tribes included tribal Elders, tribal leaders, and non-Native volunteers who worked with tribal communities. Limited community awareness of lung cancer screening, barriers to lung cancer screening at health care facilities, and health information-seeking behaviors emerged as key themes in discussions. Screening knowledge was limited except among people with direct experiences of lung cancer. Cancer risk factors such as multigenerational smoking were considered important priorities to address in communities. Limited educational and diagnostic resources are significant barriers to lung cancer screening uptake in addition to limited discussions with health care providers about cancer risk. INTERPRETATION Limited access to and awareness of lung cancer screening must be addressed. American Indian and Alaska Native adults use several health information sources unique to tribal communities, and these should be leveraged in designing screening programs. Equitable partnerships between clinicians and tribes are essential in improving knowledge and use of lung cancer screening.
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Affiliation(s)
- Allison C Welch
- Department of Thoracic Surgery and Interventional Pulmonology, Swedish Medical Center and Cancer Institute, Seattle, WA
| | - Sara M London
- Institute for Research and Education to Advance Community Health, Washington State University, Seattle, WA
| | - Candice L Wilshire
- Department of Thoracic Surgery and Interventional Pulmonology, Swedish Medical Center and Cancer Institute, Seattle, WA
| | | | - Dedra Buchwald
- Institute for Research and Education to Advance Community Health, Washington State University, Seattle, WA
| | - Gary Ferguson
- Institute for Research and Education to Advance Community Health, Washington State University, Seattle, WA
| | - Cole Allick
- Institute for Research and Education to Advance Community Health, Washington State University, Seattle, WA
| | - Jed A Gorden
- Department of Thoracic Surgery and Interventional Pulmonology, Swedish Medical Center and Cancer Institute, Seattle, WA.
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Pandya SP. Religiosity, Aging in the Homeland, and Growing Old in the Diaspora: A Longitudinal Study of Two Cohorts of Indian Older Adults. Int J Aging Hum Dev 2024:914150241235081. [PMID: 38389277 DOI: 10.1177/00914150241235081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2024]
Abstract
This article reports a longitudinal study comparing religiosity among two cohorts of Indian older adults-those who age in the homeland of India (AIH cohort) and immigrants (to the USA) or diaspora older adults (DOA). Results indicated that AIH and DOA cohorts' religiosity outcomes were comparable at baseline but there was a statistically significant increase in all outcomes of the DOA cohort at subsequent time points. Women and single older adults in both the cohorts had higher religiosity scores at baseline. Religiosity scores were higher among those in the DOA cohort who migrated following marital disruption (widowhood, divorce) or grandchild birth and lived with adult immigrant children and their families. The immigration process can have an impact on religious orientation of older adults and place is a significant variable impacting religiosity possibly for augmenting the sense of self, acquire social capital and preserve cultural identity in the foreign land.
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Affiliation(s)
- Samta P Pandya
- Tata Institute of Social Sciences, Mumbai, Maharashtra, India
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Sadhukhan D, Mitra P, Mishra S, Roy A, Podder G, Ray BK, Biswas A, Hui SP, Banerjee TK, Biswas A. Arg4810Lys mutation in RNF213 among Eastern Indian non-MMD ischemic stroke patients: a genotype-phenotype correlation. Neurol Sci 2024; 45:315-319. [PMID: 37698787 DOI: 10.1007/s10072-023-07051-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 08/31/2023] [Indexed: 09/13/2023]
Abstract
INTRODUCTION RNF213 mutations have been reported mostly in moyamoya disease (MMD) with varying frequencies across different ethnicities. However, its prevalence in non-MMD adult-onset ischemic stroke is still not well explored. AIMS AND OBJECTIVES This present study thus aims to screen the most common RNF213 variant (Arg4810Lys, among East Asians) in the Eastern Indian non-MMD ischemic stroke patients and correlate it with long-term progression and prognosis of the patients. The subjects were analyzed for this variant using PCR-RFLP and confirmed using Sanger sequencing method. RESULT AND CONCLUSION We have identified Arg4810Lys variant among eleven young-onset familial ischemic stroke patients in heterozygous manner. A positive correlation of the variant with positive family history (P = 0.001), earlier age at onset (P = 0.002), and history of recurrent stroke (P = 0.015) was observed. However, the carriers showed better cognitive performances in memory (P = 0.042) and executive function (P = 0.004). Therefore, we can conclude that Arg4810Lys/RNF213 - a pathogenic variant for young-onset familial ischemic stroke with higher incidence of recurrent events unlike in MMD cases, have no additional impact on cognition among Eastern Indians.
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Affiliation(s)
- Dipanwita Sadhukhan
- Molecular Biology & Clinical Neuroscience Division, National Neurosciences Centre, Calcutta, Kolkata, India
| | - Parama Mitra
- Molecular Biology & Clinical Neuroscience Division, National Neurosciences Centre, Calcutta, Kolkata, India
| | - Smriti Mishra
- Molecular Biology & Clinical Neuroscience Division, National Neurosciences Centre, Calcutta, Kolkata, India
| | - Arunima Roy
- Molecular Biology & Clinical Neuroscience Division, National Neurosciences Centre, Calcutta, Kolkata, India
| | - Gargi Podder
- Institute of Post Graduate Medical Education & Research and Bangur Institute of Neurosciences, Kolkata, India
| | - Biman Kanti Ray
- Institute of Post Graduate Medical Education & Research and Bangur Institute of Neurosciences, Kolkata, India
| | - Atanu Biswas
- Institute of Post Graduate Medical Education & Research and Bangur Institute of Neurosciences, Kolkata, India
| | - Subhra Prakash Hui
- S. N. Pradhan Centre for Neurosciences, University of Calcutta, Kolkata, India
| | - Tapas Kumar Banerjee
- Molecular Biology & Clinical Neuroscience Division, National Neurosciences Centre, Calcutta, Kolkata, India
| | - Arindam Biswas
- Molecular Biology & Clinical Neuroscience Division, National Neurosciences Centre, Calcutta, Kolkata, India.
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Osoro I, Kumar R, Sharma A. Ten-year risk assessment for cardiovascular diseases using ASCVD risk estimator plus: outcomes from hypertension and diabetes patients. Diabetol Metab Syndr 2023; 15:216. [PMID: 37891666 PMCID: PMC10604522 DOI: 10.1186/s13098-023-01170-2] [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: 06/21/2023] [Accepted: 09/23/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND Cardiovascular risk prediction models encompass numerous CVD risk factors. Available prediction models were developed from non-Asian cohorts hence we decided to evaluate the performance of the ASCVD risk estimator model and the associated 10-year CVD predisposing factors in Punjab. METHODS We carried out a cross-sectional study among patients having hypertension and diabetes mellitus in a tertiary hospital in Punjab, India. 201 participants without ASCVD who were ≥ 40 years old and had been admitted to the medical ward were assessed. a pre-validated questionnaire was used to collect data on the socio-demographics and behavioral patterns. Lipid profile and blood pressure measurements were collected as per standard protocols. The respondents' CVD risk was assessed using ASCVD Risk Estimator Plus. Data were analyzed using IBM SPSS version 26; bivariate analysis was done using Chi-square and binary logistic regression was used to identify the predictors of 10-year risk for CVD at a 5% level of significance. MEASUREMENTS We examined the stratification of the predicted outcomes and evaluated the associations between individual risk factors and the predicted cardiovascular events. Our study categorized the results of these outcomes into 4 categories: low category (1-5%), borderline category (6-9%) intermediate category (10-20%), and high category (21-95%). RESULTS Out of the 201 participants that enrolled in our study, the majority 76 (37.8%) were in the intermediate category, 56 (27.9%) were in the high category, 41 (20.4%) were in the borderline category, 28 (13.9%) were in the low category. The median ASCVD percentage was 14.20%. Respondents who were alcoholics, smokers, and drug abusers (OR = 5.8, 95% CI 0.397-83.584) were associated with the highest likelihood of developing CVDs. Furthermore, males had a significantly higher mean predicted CVD outcome % (M = 23.18%) compared to females (M = 14.91%). CONCLUSION According to our prediction study, it was discovered that 145 (72.1%) participants were not likely to have had an ASCVD in the next 10 years. However, middle-aged males should be more cautious with their lifestyle habits, particularly in dealing with risk factors that can expose them to CVDs.
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Affiliation(s)
- Ian Osoro
- Department of Pharmacy Practice, ISF College of Pharmacy, Moga, Punjab, 142001, India
| | - Ranjeet Kumar
- Department of Pharmacy Practice, ISF College of Pharmacy, Moga, Punjab, 142001, India
| | - Amit Sharma
- Department of Pharmacy Practice, ISF College of Pharmacy, Moga, Punjab, 142001, India.
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Firestone M, McConkey S, Beaudoin E, Bourgeois C, Smylie J. Mental health and cultural continuity among an urban Indigenous population in Toronto, Canada. Can J Public Health 2022:10.17269/s41997-022-00709-6. [PMID: 36525204 DOI: 10.17269/s41997-022-00709-6] [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] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 10/05/2022] [Indexed: 12/23/2022]
Abstract
OBJECTIVES Mental health and psychiatric disorders significantly affect individuals on personal and social levels. Indigenous populations in Canada have disproportionately high rates of mental health diagnoses. Our Health Counts (OHC) Toronto assessed mental health, racism, family disruption, and cultural continuity among urban Indigenous people. The objectives of this study were to understand (1) the demographics and characteristics of Indigenous adults with a diagnosed psychological/mental health disorder and (2) potential associations of psychological/mental health diagnoses with experiences of colonization and cultural continuity among Indigenous adults in Toronto. METHODS Using community-based participatory research methods, Indigenous adults in Toronto were recruited by respondent-driven sampling (RDS) to complete a comprehensive health assessment survey. RDS-II weights were applied to calculate population-based estimates, and adjusted odds ratios with 95% confidence intervals were produced using logistic regression, controlling for age and gender. RESULTS Among Indigenous adults, nearly half (45%) reported receiving a mental health diagnosis. Participants reported lifetime anxiety disorders (53%), major depression (51%), and high rates of suicide ideation (78%). Of Indigenous adults with a diagnosed mental health disorder, 72.7% reported participating in ceremony. Attending residential schools (OR: 7.82) and experiencing discrimination (OR: 2.69) were associated with having a mental health disorder. CONCLUSION OHC Toronto responded to the gaps in health assessment data for urban Indigenous people. Despite historic and ongoing trauma, Indigenous people have maintained cultural practices and a strong sense of identity. Efforts aimed at supporting Indigenous well-being must respond to the roots of trauma, racism, and existing Indigenous community knowledge and strengths.
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Affiliation(s)
- Michelle Firestone
- MAP Centre for Urban Health Solutions, Unity Health Toronto, Toronto, ON, Canada.
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
| | - Stephanie McConkey
- Well Living House, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
- Department of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Emily Beaudoin
- Well Living House, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
| | | | - Janet Smylie
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Well Living House, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
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Anderson E, Twiggs C, Goins RT, Astleford N, Winchester B. Nephrology and Palliative Care Providers' Beliefs in Engaging American Indian Patients in Palliative Care Conversations. J Palliat Med 2022; 25:1810-1817. [PMID: 35617692 DOI: 10.1089/jpm.2021.0612] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Background: American Indians with chronic kidney disease are twice as likely to develop end-stage renal disease. Palliative care is underused by American Indian patients, although studies show it is not due to an unwillingness to engage in conversations about end of life. Objectives: The aim of our study was to explore the experiences and beliefs of Nephrology and palliative care providers of one tribal community with respect to engaging patients and family members in palliative care. Design: Using an interview guide, individual, in-depth interviews were conducted between March and August 2019 with eligible participants. We used constant comparative analysis of interview transcripts. Setting and Subjects: Our study sample included eight participants, including four Nephrology providers and four palliative care providers. Results: We identified five themes, including (1) providers' stereotypes, (2) patients' mistrust of providers, (3) patients' end-of-life preferences, (4) available community resources, and (5) patients' family dynamics. Negative stereotypes were present in every theme, although most participants did not acknowledge the role stereotypes played in establishing trust and building therapeutic relationships conducive to end-of-life discussions. Conclusion: Providers serving American Indian patients with kidney disease should consider training in trauma informed care and cultural sensitivity. Negative stereotypes of American Indian patients may impact provider's ability to build trust, a key component of end-of-life conversations, and contribute to misperceptions related to family dynamics, end-of-life preferences, and available community resources.
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Affiliation(s)
- Elizabeth Anderson
- Department of Social Work, College of Health and Human Sciences, Western Carolina University, Cullowhee, North Carolina, USA
| | - Caroline Twiggs
- Mars Hill University, Community Engagement, Mars Hill, North Carolina, USA
| | - R Turner Goins
- Department of Social Work, College of Health and Human Sciences, Western Carolina University, Cullowhee, North Carolina, USA
| | - Nina Astleford
- Department of Social Work, College of Health and Human Sciences, Western Carolina University, Cullowhee, North Carolina, USA
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Hajar CGN, Md Akhir S, Zefarina Z, Riffin NSM, Tuan Mohammad TH, Hassan MN, Aziz MY, Pati S, Chambers GK, Kari ZA, Edinur HA, Che Mat NF. Distribution of 22 Single Nucleotide Polymorphisms in 13 Cytokine Genes in Malays, Chinese, and Indians in Peninsular Malaysia. Genet Test Mol Biomarkers 2022; 26:449-456. [PMID: 36166739 DOI: 10.1089/gtmb.2022.0107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Introduction: Cytokines are cell signaling glycoproteins that are particularly important in immunity and inflammatory responses. Therefore, variations, such as single nucleotide polymorphisms (SNPs), in genes encoding for cytokines may have important consequences for their roles in health. Materials and Methods: A total of 222 unrelated, healthy, and un-admixed Malays (n = 97), Chinese (n = 77), and Indians (n = 48) with a median age of 30 years old (range 21-50) were typed for 22 cytokine gene SNPs: IL-1α -889 T/C, IL-1β (-511 T/C, +3962 T/C), IL-1R pst1 1970 T/C, IL-1RA mspa1 11100 T/C, IL-4Rα +1902 G/A, IL-12 - 1188 C/A, IFN-γ +874 A/T, TGF-β (cdn 10 C/T, cdn 25 G/C), TNF-α (-308 A/G, -238 A/G) IL-2 (+166 G/T, -330 T/G), IL-4 (-1098 T/G, -590 T/C, -33 T/C), IL-6 (-174 C/G, nt565 G/A), and IL-10 (-1082 G/A, -819 C/T, -592 A/C). This involved using well-established polymerase chain reaction procedures with sequence-specific primers and restriction fragment length polymorphism methods. Results: The majority of the screened cytokine gene SNPs are polymorphic in all three ethnicities. Exceptions include TGF-β cdn 25 (G/C), IL-1β +3962 (T/C), and TNF-α -238 (A/G), which were all observed to be monomorphic in Malays, Chinese and Indians. Many of the analyzed cytokine gene SNP genotypes deviated from Hardy-Weinberg equilibrium and the three ethnic study groups were all well-separated from reference Asian, African and European populations in a principal component analysis plot. Conclusion: We successfully typed 22 SNPs in 13 cytokine genes from genetic material collected from unrelated and un-admixed Malay, Chinese and Indian individuals in Peninsular Malaysia. These new cytokine gene population datasets reveal interesting contrasts with other populations.
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Affiliation(s)
- Che Ghazali Norul Hajar
- Forensic Science Programme, School of Health Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
- Transfusion Medicine Unit, Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Suhaida Md Akhir
- Biomedicine Science Programme, School of Health Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Zulkafli Zefarina
- Transfusion Medicine Unit, Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Kelantan, Malaysia
- Department of Haematology, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
| | | | | | - Mohd Nazri Hassan
- Transfusion Medicine Unit, Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Kelantan, Malaysia
- Department of Haematology, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Mohd Yusmaidie Aziz
- Integrative Medicine Cluster, Advanced Medical and Dental Institute, Universiti Sains Malaysia, Pulau Pinang, Malaysia
| | | | | | - Zulhisyam Abdul Kari
- Faculty of Agro Based Industry, Universiti Malaysia Kelantan, Kelantan, Malaysia
| | - Hisham Atan Edinur
- Forensic Science Programme, School of Health Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
- Transfusion Medicine Unit, Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Nor Fazila Che Mat
- Transfusion Medicine Unit, Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Kelantan, Malaysia
- Biomedicine Science Programme, School of Health Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
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Gogri H, Parihar M, Kulkarni S, Madkaikar M, Sharma J, Gorakshakar A. Phenotyping and Genotyping of HNA: Prevalence, Risk of Alloimmunization, and HNA Incompatibilities in Indians. Transfus Med Hemother 2022; 50:30-38. [PMID: 36818775 PMCID: PMC9911994 DOI: 10.1159/000525654] [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: 03/14/2022] [Accepted: 06/20/2022] [Indexed: 11/19/2022] Open
Abstract
Background Antibodies to human neutrophil alloantigens (HNA) are involved in the pathophysiology of several clinical conditions including transfusion-related acute lung injury (TRALI), alloimmune and autoimmune neutropenia, and febrile nonhemolytic transfusion reactions leading to neutropenia. The cognate antigens are polymorphic structures expressed on several glycoproteins on the neutrophils, i.e., antigens HNA-1a, -1b, -1c, and -1d on Fc-γ-receptor IIIb; HNA-2 on CD177; HNA-3a and -3b on choline transporter-like protein 2; HNA-4a and -4b on CD11b/αM subunit of the αMβ2-integrin (CD11b/CD18, Mac-1, CR3); and HNA-5a and -5b on αL-subunit (CD11a) of the αLβ2 integrin (CD11a/CD18), leukocyte function associated molecule (LFA)-1. Currently, there is a lacuna of diagnostic methods for detection of HNA in India. This study aimed to determine the HNA frequencies in Indians, estimate the risk of alloimmunization, and prepare typed neutrophil panels, which can be used to detect HNA antibodies in neutropenia cases. Material and Methods EDTA blood samples were collected from random 1,054 blood donors. HNA-2 was phenotyped on fresh EDTA samples using FITC labelled monoclonal anti-CD177 by flowcytometry. HNA-1 (FCGR3B) genotyping was carried out by DNA sequencing and PCR-RFLP. Antigens of HNA-3 (SLC44A2) and HNA-5 (ITGAL) were genotyped by PCR-RFLP using TaqαI and Bsp1286I restriction enzymes, respectively, while HNA-4 (ITGAM) was genotyped by PCR-SSP. Results Allele frequencies of FCGR3B*01, FCGR3B*02, and FCGR3B*03 were found to be 0.433, 0.444, and 0.087, respectively. FCGR3B*01+*02+*03- was the most common genotype (33.78%). Ten individuals showed deficiency of FCGR3B individuals, while 23 showed hyperexpression, i.e., FCGR3B*01+*02+*03+. FCGR3B*04and *05 occurred with a frequency of 0.002 and 0.024. HNA-2 was found to be a high frequency antigen occurring in 98.8% population. Four percent individuals showed atypical expression of CD177 on their neutrophils. Allele frequencies of SLC44A2*01 and SLC44A2*02were 0.812 and 0.188, respectively, and that of ITGAM*01, ITGAM*02, ITGAL*01, and ITGAL*02 were 0.9546, 0.0454, 0.2372, and 0.7628, respectively. Conclusion This is the first study in India to report the frequencies of HNA among blood donors. Typed neutrophil panels identified in the present study will enable us to investigate suspected cases of immune neutropenia in future.
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Affiliation(s)
- Harita Gogri
- Department of Transfusion Medicine, ICMR-National Institute of Immunohematology, Mumbai, India,*Harita Gogri,
| | - Meghana Parihar
- Department of Transfusion Medicine, ICMR-National Institute of Immunohematology, Mumbai, India
| | - Swati Kulkarni
- Department of Transfusion Medicine, ICMR-National Institute of Immunohematology, Mumbai, India
| | | | - Jayashree Sharma
- Department of Transfusion Medicine, Blood Bank, K. E. M. Hospital, Mumbai, India
| | - Ajit Gorakshakar
- Department of Transfusion Medicine, ICMR-National Institute of Immunohematology, Mumbai, India,**Ajit Gorakshakar,
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Keisham C, Singh YL. The efficacy and tolerability of 40% Pyruvic acid on acne vulgaris, post acne scar and hyperpigmentation in Indians. J Cosmet Dermatol 2022; 21:4405-4409. [PMID: 35388603 DOI: 10.1111/jocd.14974] [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: 02/09/2022] [Accepted: 03/28/2022] [Indexed: 12/01/2022]
Abstract
INTRODUCTION Pyruvic acid in concentration between 40% and 70% is currently been used as a superficial to medium peeling agent for various dermatological indications including acne . However, there is a paucity of its efficacy studies on acne in Asians, particularly in Indian skin. AIM Our study was aimed at determining the efficacy and tolerability of 40% pyruvic acid on acne, post acne hyperpigmentation and scarring. MATERIALS AND METHODS A total of 30 patients with active acne, post acne scarring and hyperpigmentation were included. Patients already on oral antibiotic or topical antiacne medication for the last 4 weeks, a history of hypertrophic scarring, keloids, active or recurrent herpes were excluded. Chemical peeling was done at 2 weekly interval from 0 to 12 weeks. An objective assessment of active acne lesions, post-acne scarring, and hyperpigmentation were made at each visit that is at 0, 4,8,12 and 24 weeks. Patients were followed up 2 weeks after the last peel and again at 24 weeks. Permission from the ethical committee was also obtained. RESULTS There was significant decrease in the number of comedones at 12 weeks compared to 0 week ( P=0.001). Similarly the number of papules decreased from o weeks to 12 weeks (P value 0.004). Acne score improved from 0 weeks to 12 weeks ( P <0.0001); from 0 weeks to 24 weeks(P = 0.011) and hyperpigmentation improved from 0 weeks to 12 weeks (P=0.008); from 0 weeks to 24 weeks (P=0.021). CONCLUSION Our study showed a significant decrease in comedones, papules, acne score and hyperpigmentation, though acne scar did not improve significantly. However a study with larger sample is needed due to the limited number of patient population in our study.
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Affiliation(s)
- Chitralekha Keisham
- Jawaharlal Nehru Institute of Medical Sciences, Porompat, Imphal East, 795004, India
| | - Yumnam Lokendra Singh
- Jawaharlal Nehru Institute of Medical Sciences, Porompat, Imphal East, 795004, India
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Anjana RM, Siddiqui MK, Jebarani S, Vignesh MA, Kamal Raj N, Unnikrishnan R, Pradeepa R, Panikar VK, Kesavadev J, Saboo B, Gupta S, Sosale AR, Seshadri KG, Deshpande N, Chawla M, Chawla P, Das S, Behera M, Chawla R, Nigam A, Gupta A, Kovil R, Joshi SR, Agarwal S, Bajaj S, Pearson ER, Doney ASF, Palmer CNA, Mohan V. Prescribing Patterns and Response to Antihyperglycemic Agents Among Novel Clusters of Type 2 Diabetes in Asian Indians. Diabetes Technol Ther 2022; 24:190-200. [PMID: 34609928 DOI: 10.1089/dia.2021.0277] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Aim: To assess the prescribing patterns and response to different classes of antihyperglycemic agents in novel clusters of type 2 diabetes (T2D) described in India. Materials and Methods: We attempted to replicate the earlier described clusters of T2D, in 32,867 individuals with new-onset T2D (within 2 years of diagnosis) registered between October 2013 and December 2020 at 15 diabetes clinics located across India, by means of k-means clustering utilizing 6 clinically relevant variables. Individuals who had follow-up glycated hemoglobin (HbA1c) up to 2 years were included for the drug response analysis (n = 13,247). Results: Among the 32,867 participants included in the study, 20,779 (63.2%) were males. The average age at diagnosis was 45 years and mean HbA1c at baseline was 8.9%. The same four clusters described in India earlier were replicated. Forty percent of the study participants belonged to the mild age-related diabetes cluster, followed by insulin-resistant obese diabetes (27%), severe insulin-deficient diabetes (21%), and combined insulin-resistant and insulin-deficient diabetes (12%) clusters. The most frequently used antihyperglycemic agents were sulfonylureas, metformin, and dipeptidyl peptidase-4 inhibitors apart from insulin. While there were significant differences in HbA1c reduction between drugs across clusters, these were largely driven by differences in the baseline (pretreatment) HbA1c. Conclusions: In this new cohort, we were able to reliably replicate the four subtypes of T2D earlier described in Asian Indians. Prescribing patterns show limited usage of newer antihyperglycemic agents across all clusters. Randomized clinical trials are required to establish differential drug responses between clusters.
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Affiliation(s)
- Ranjit Mohan Anjana
- Department of Diabetology, Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, Chennai, India
| | - Moneeza Kalhan Siddiqui
- Division of Population Health & Genomics, School of Medicine, University of Dundee, Dundee, United Kingdom
| | - Saravanan Jebarani
- Department of Diabetology, Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, Chennai, India
| | - Mani Arun Vignesh
- Department of Diabetology, Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, Chennai, India
| | - Nithyanantham Kamal Raj
- Department of Diabetology, Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, Chennai, India
| | - Ranjit Unnikrishnan
- Department of Diabetology, Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, Chennai, India
| | - Rajendra Pradeepa
- Department of Diabetology, Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, Chennai, India
| | - Vijay K Panikar
- Department of Diabetology, Dr. Panikars Speciality Care Centre, Mumbai, Maharashtra, India
| | - Jothydev Kesavadev
- Department of Diabetology, Jothydev's Diabetes and Research Centre, Kerala, India
| | - Banshi Saboo
- Department of Diabetology, Diabetes Care & Hormone Clinic, Ahemedabad, Gujarat, India
| | - Sunil Gupta
- Department of Diabetology, Sunil's Diabetic Care & Research Center, Nagpur, Maharashtra, India
| | - Aravind R Sosale
- Department of Diabetology, Diacon Hospital, Bangalore, Karnataka, India
| | - Krishna G Seshadri
- Department of Endocrinology, Chennai Diabetes and Endocrine Clinic, Chennai, Tamilnadu, India
| | - Neeta Deshpande
- Department of Diabetology, Belgaum Diabetes Centre, Belgaum, Karnataka, India
| | - Manoj Chawla
- Department of Diabetology, Lina Diabetes Care, Mumbai, Maharashtra, India
| | - Purvi Chawla
- Department of Diabetology, Lina Diabetes Care, Mumbai, Maharashtra, India
| | - Sidhartha Das
- Department of Diabetology, Prof.S.Das Clinic, Cuttack, Odisha, India
| | - Manoranjan Behera
- Department of General Medicine, SCB Medical College, Cuttack, Odisha, India
| | - Rajeev Chawla
- Department of Diabetology, North Delhi Diabetes Centre, Delhi, India
| | - Anant Nigam
- Department of Diabetology, Nigam Diabetes Centre, Jaipur, Rajasthan, India
| | - Arvind Gupta
- Department of Diabetology, Rajasthan Hospital, Jaipur, Rajasthan, India
| | - Rajiv Kovil
- Department of Diabetology, Dr. Kovil's Diabetes Care Centre, Mumbai, Maharashtra, India
| | - Shashank R Joshi
- Department of Diabetology, Lilavati Hospital and Research Centre, Mumbai, Maharashtra, India
| | - Sanjay Agarwal
- Department of Medicine Aegle Clinic-Diabetes Care, Pune, Maharashtra, India
| | - Sarita Bajaj
- Department of Medicine, MLN Medical College, Allahabad, Uttar Pradesh, India
| | - Ewan R Pearson
- Division of Population Health & Genomics, School of Medicine, University of Dundee, Dundee, United Kingdom
| | - Alexander S F Doney
- Division of Population Health & Genomics, School of Medicine, University of Dundee, Dundee, United Kingdom
| | - Colin N A Palmer
- Division of Population Health & Genomics, School of Medicine, University of Dundee, Dundee, United Kingdom
| | - Viswanathan Mohan
- Department of Diabetology, Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, Chennai, India
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Rajan P, Leaver A, Refshauge K, Patil A, Kalkonde Y, Lincoln M, Hiller C. Cross-cultural adaptation, reliability and validity of the Marathi versions of the Back Beliefs Questionnaire and Pain Self-Efficacy Questionnaire in people living with chronic low back pain. Disabil Rehabil 2022; 44:646-652. [PMID: 35180035 DOI: 10.1080/09638288.2020.1773942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
PURPOSE To translate and cross-culturally adapt the Back Beliefs Questionnaire (BBQ) and Pain Self-Efficacy Questionnaire (PSEQ) into Marathi, and to evaluate their clinimetric properties in a native Marathi speaking population with chronic low back pain. MATERIAL AND METHODS The BBQ and PSEQ were translated into Marathi using international published guidelines. Fifty native Marathi speakers were recruited. Reliability (n = 43) was evaluated in terms of internal consistency (Cronbach α) and test-retest reliability [intra class correlation coefficient, ICC (2, 1)] and 95% confidence interval (CI). Convergent validity (n = 50) was assessed by correlating the Marathi versions of BBQ and PSEQ with the Marathi version of Roland Morris Disability Questionnaire (RMDQ). RESULTS Internal consistency of BBQ (Cronbach α = 0.67) was good and that for PSEQ (Cronbach α = 0.93) was high. Test-retest reliability for BBQ (ICC = 0.80; 95% CI: 0.66 to 0.89) was good and PSEQ (ICC = 0.85; 95% CI: 0.74 to 0.92) was excellent. A significant, low negative correlation was found between RMDQ and BBQ scores (r = -0.298; p = 0.036) and PSEQ (r = -0.28; p = 0.049). CONCLUSIONS The BBQ and PSEQ were successfully cross-culturally adapted into Marathi. Clinimetric evaluation of these questionnaires in a sample of native Marathi speaking populations with chronic low back pain demonstrated good acceptability, acceptable internal consistency, and high test-retest reliability.Implications for rehabilitationThe Back Beliefs Questionnaire (BBQ) and Pain Self Efficacy Questionnaire (PSEQ) were successfully cross-culturally adapted into Marathi.The Marathi versions of BBQ and PSEQ have good acceptability, acceptable internal consistency, and high test-retest reliability.They can be used by clinicians and researchers to evaluate beliefs about back pain and pain self-efficacy in Marathi speaking patients with chronic low back pain.
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Affiliation(s)
- Pavithra Rajan
- Faculty of Medicine and Health, Sydney School of Health Sciences, The University of Sydney, Sydney, Australia
| | - Andrew Leaver
- Faculty of Medicine and Health, Sydney School of Health Sciences, The University of Sydney, Sydney, Australia
| | - Kathryn Refshauge
- Faculty of Medicine and Health, Sydney School of Health Sciences, The University of Sydney, Sydney, Australia
| | | | - Yogeshwar Kalkonde
- Rural Chronic Non-communicable Diseases Research Programme, Society for Education and Research in Community Health (SEARCH), Gadchiroli, India
| | | | - Claire Hiller
- Faculty of Medicine and Health, Sydney School of Health Sciences, The University of Sydney, Sydney, Australia
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Singh KK, Kapoor A, Khanna R, Sahu A, Kapoor V, Kumar S, Garg N, Tewari S, Goel P. Serum Gamma Glutamyltransferase (GGT) in coronary artery disease: Exploring the Asian Indian Connection. Ann Card Anaesth 2022; 25:408-413. [PMID: 36254903 PMCID: PMC9732951 DOI: 10.4103/aca.aca_62_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND There is a need to identify novel markers for CAD, independent of traditional CV risk factors. One of these is gamma-glutamyl transferase (GGT), a marker of increased oxidative stress. Given the high prevalence of CAD in Asian Indians, the link of GGT and CAD in them needs to be studied. AIM To assess GGT in patients with angiographically documented CAD. METHODS AND RESULTS Two hundred patients aged 58.1 ± 9.95 years, 73% males, hypertension 56%, diabetes 40% were included. Mean GGT was 63.6 ± 44.33 (10-269 U/L). The levels of GGT progressively increased in those with single/double or triple-vessel CAD (36.5, 61.5, and 87 U/L, respectively, P < 0.001). Using objective criteria of CAD burden (SYNTAX and Gensini scores), we reaffirmed these findings. GGT in patients with SYNTAX tertiles 0-22, 23-32, and ≥ 33 was 33, 62, and 97 U/L, respectively and in Gensini tertiles 0-17.65, 17.66-56.65, ≥56.66 was 32, 52, and 88 U/L, respectively, all P < 0.001. SYNTAX score ≥ 23 was present in only 23% patients in GGT tertile 1 (<41 U/L), whereas60% and 94% in GGT tertiles 2 and 3 had SYNTAX ≥ 23. Significant positive correlation was seen between GGT and SYNTAX (r = 0.634) and Gensini score (r = 0.772). CONCLUSIONS In this study, GGT had an independent correlation with angiographic severity of CAD and SYNTAX and Gensini scores. Although the existing evidence seems biologically plausible, more studies are needed to explore the potential role of this inexpensive marker for predicting disease burden in patients with CAD.
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Affiliation(s)
- Kunal K. Singh
- Department of Cardiology, Sanjay Gandhi PGIMS, Lucknow, Uttar Pradesh, India
| | - Aditya Kapoor
- Department of Cardiology, Sanjay Gandhi PGIMS, Lucknow, Uttar Pradesh, India,Address for correspondence: Dr. Aditya Kapoor, Department of Cardiology, Sanjay Gandhi PGIMS, Lucknow - 226 014, Uttar Pradesh, India. E-mail:
| | - Roopali Khanna
- Department of Cardiology, Sanjay Gandhi PGIMS, Lucknow, Uttar Pradesh, India
| | - Ankit Sahu
- Department of Cardiology, Sanjay Gandhi PGIMS, Lucknow, Uttar Pradesh, India
| | - Vishwas Kapoor
- Department of Biostatistics and Health Informatics, Sanjay Gandhi PGIMS, Lucknow, Uttar Pradesh, India
| | - Sudeep Kumar
- Department of Cardiology, Sanjay Gandhi PGIMS, Lucknow, Uttar Pradesh, India
| | - Naveen Garg
- Department of Cardiology, Sanjay Gandhi PGIMS, Lucknow, Uttar Pradesh, India
| | - Satyendra Tewari
- Department of Cardiology, Sanjay Gandhi PGIMS, Lucknow, Uttar Pradesh, India
| | - Pravin Goel
- Department of Cardiology, Sanjay Gandhi PGIMS, Lucknow, Uttar Pradesh, India
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Frerichs L, Bell R, Lich KH, Reuland D, Warne DK. Health insurance coverage among American Indians and Alaska Natives in the context of the Affordable Care Act. Ethn Health 2022; 27:174-189. [PMID: 31181960 DOI: 10.1080/13557858.2019.1625873] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Accepted: 05/27/2019] [Indexed: 06/09/2023]
Abstract
Objectives: American Indians and Alaska Natives (AI/AN) have a unique healthcare system uniquely interwoven with the Affordable Care Act (ACA). The aim of this study is to document changes in health insurance among AI/AN adults before and after implementation of the ACA.Design: We used data from the American Community Survey from 2008 to 2016 to examine trends in health insurance. We compared to Non-Hispanic Whites and stratified AI/AN adults with and without Indian Health Service (IHS) coverage. We used multivariate regression to evaluate the probability of health insurance post-ACA and included time period and subgroup interaction terms.Results: Public and private health insurance coverage increased post-ACA by 3.17 and 1.24 percentage points, respectively, but the percent uninsured remained high (37.7% of those with IHS coverage and 19.2% of those without). AI/AN in Medicaid Expansion states had a significantly greater percentage point (pp) increase in public insurance (6.31 pp, 95% CI 5.04-7.59) than AI/AN in non-expansion states (p < 0.001). There was a greater increase in private coverage among AI/AN without IHS compared to AI/AN with IHS coverage (p = 0.002).Conclusions: Despite improvements in healthcare insurance coverage for AI/AN, substantial disparities remain. The improvements appeared to be largely driven by Medicaid Expansion. Without specific considerations for AI/AN, future healthcare reforms could intensify health injustices and inequities they face.
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Affiliation(s)
- Leah Frerichs
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Ronny Bell
- Department of Public Health, East Carolina University, Greenville, NC, USA
- North Carolina American Indian Health Board, Winston-Salem, NC, USA
| | - Kristen Hassmiller Lich
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Dan Reuland
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Donald K Warne
- School of Medicine and Health Sciences, University of North Dakota, Grand Forks, ND, USA
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Thenral M, Annamalai A. Challenges of Building, Deploying, and Using AI-Enabled Telepsychiatry Platforms for Clinical Practice Among Urban Indians: A Qualitative Study. Indian J Psychol Med 2021; 43:336-342. [PMID: 34385728 PMCID: PMC8327861 DOI: 10.1177/0253717620973414] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Published literature shows the overall challenges associated with artificial intelligence (AI)-enabled medicine and telepsychiatry more from the western perspective, with no specific mention from the perspective of individual stakeholders or Indians. This study was conceptualized to understand the perceived challenges of building, deploying, and using AI-enabled telepsychiatry for clinical practice from the perspectives of psychiatrist, patients, and the technology experts (who build such services) in urban India. METHODS Between February 2020 and April 2020, a semistructured topic guide was drafted for qualitative exploratory study among psychiatrists (n = 14), their patients (n = 14), technology experts (n = 13), and Chief Executive Officers (CEOs) (n = 5) of health technology incubation centers. Interviews were conducted over the phone, recorded, and analyzed using the grounded theory approach. RESULTS Almost all respondents cited ethical, legal, accountability, and regulatory implications as challenges. The major issues stated by patients were privacy/confidentiality, ethical violations, security/ hacking, and data ownership. Psychiatrists cited lack of clinical validation, lack of established studies or trials, iatrogenic risk, and healthcare infrastructure issues as the main challenges. Technology experts stated data-related issues as the major challenge. The CEOs quoted the lack of interdisciplinary experts as one of the main challenges in building deployable AI-enabled telepsychiatry in India. CONCLUSIONS There are challenges to deploy an AI-enabled telepsychiatry platform in India. There is a need to constitute an interdisciplinary team to systematically address these challenges. Deployment of AI-enabled telepsychiatry is not possible without clinical validation and addressing current challenges.
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Affiliation(s)
- Thenral M
- Shri Sathya Sai Medical College and Research Institute, Ammapettai, Kanchipuram, Tamil Nadu, India
| | - Arunkumar Annamalai
- National Institute of Epidemiology, Indian Council of Medical Research, New Delhi, India
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Sedlmeier P, Rangaiah B, Weber D, Winkler I. How General Is the Semantic Structure of Time? A Comparison of Indians and Germans. Integr Psychol Behav Sci 2020; 54:494-513. [PMID: 32193791 DOI: 10.1007/s12124-020-09520-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
People in different cultures differ in their time-related behaviors and judgments. But do they also differ in how time is represented in their minds, that is, in their semantic structures of time, and if so, how and why? Two studies addressed these questions using participants’ time-related associative responses to compare the semantic structures of time across Indian and German university students. Study 1 compared time-related associations and found only low intercultural agreement, which increased somewhat if associations were grouped into categories. In Study 2, a comparison of the results of multidimensional scaling analyses on a cross-culturally representative selection of stimuli was consistent with the conclusion that differences across cultures are much more pronounced than commonalities. Two cultural aspects in particular might be responsible for the diversity in the semantic structures of time: the monochronic–polychronic distinction and the distinction between linear and cyclical time. Moreover, intercultural differences may be strongly intensified by language effects, especially if the languages in question greatly differ. It is concluded that behavioral and judgmental differences in dealing with time may be grounded in how people intuitively think about it and the language used to do so.
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Biswas A, Sadhukhan D, Biswas A, Das SK, Banerjee TK, Bal PS, Pal S, Ghosh A, Ray K, Ray J. Identification of GBA mutations among neurodegenerative disease patients from eastern India. Neurosci Lett 2021; 751:135816. [PMID: 33711404 DOI: 10.1016/j.neulet.2021.135816] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 09/25/2020] [Revised: 03/04/2021] [Accepted: 03/07/2021] [Indexed: 11/18/2022]
Abstract
INTRODUCTION GBA mutations have been reported in PD, PDD and DLB - but not associated with cognitive impairment for example in PSP, AD or MSA. However, frequencies of GBA mutations are ethnicity dependent. The present study aims to identify commonly reported GBA mutations (mostly from Asia), among eastern Indian patients with neurodegenerative disorders. METHODS The patient cohort consisting of 198 classical PD cases, 136 PD cases with cognitive impairment, 184 cases with Parkinson Plus syndrome, 46 AD and 241 unrelated controls, from eastern India. Subjects were analyzed for IVS2 + 1A > G, p.Arg120Trp, p.His255Gln, p.Arg257Gln, p.Glu326Lys, p.Asn370Ser, p.Asp409His, p.Leu444Pro, & RecNciI by PCR-RFLP techniques and confirmed by Sanger sequencing method. RESULTS We have identified only p.Leu444Pro variant among nine cases; three PDD, one DLB, two PD, two PSP and one AD patients in heterozygous condition. The highest frequency for p.Leu444Pro variant was found among PDD subgroup (3.95 %, P = 0.0134). An overall significant overrepresentation of positive family history (P = 0.000049), impaired recent memory (P = 0.0123) was observed among p.Leu444Pro carriers. Further, subgroup analysis for PD, PD-MCI and PDD, revealed statistically significant higher frequency of early age at onset (P = 0.0455), positive family history (P = 0.0025), higher UPDRS III score (off state) (P = 0.006), advanced H&Y stage (P = 0.045) and anxious behaviour (P = 0.0124) among p.Leu444Pro positive patients. CONCLUSION The p.Leu444Pro mutation of GBA was found in patients with PD, PDD, DLB, PSP and AD. An Overall higher frequency of positive family history and impaired recent memory are significantly associated with for p.Leu444Pro carriers from eastern India. Our study also ascertains contribution of p.Leu444Pro to an earlier onset of PD, PD-MCI and PDD, higher UPDRS III score (off state) against positive family history background. Furthermore, taking into consideration other Indian studies, we can conclude that p.Leu444Pro mutation plays a limited role in PD and other neurodegenerative disorders.
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Affiliation(s)
- Arindam Biswas
- Molecular Biology & Clinical Neuroscience Division, National Neurosciences Centre, Calcutta, India; S. N. Pradhan Centre for Neurosciences, University of Calcutta, Kolkata, India.
| | - Dipanwita Sadhukhan
- S. N. Pradhan Centre for Neurosciences, University of Calcutta, Kolkata, India
| | - Atanu Biswas
- Institute of Post graduate of Medical Education & Research and Bangur Institute of Neurosciences, Kolkata, India
| | - Shyamal K Das
- Institute of Post graduate of Medical Education & Research and Bangur Institute of Neurosciences, Kolkata, India
| | - Tapas K Banerjee
- Molecular Biology & Clinical Neuroscience Division, National Neurosciences Centre, Calcutta, India
| | - Partha Sarathi Bal
- Molecular Biology & Clinical Neuroscience Division, National Neurosciences Centre, Calcutta, India
| | - Sandip Pal
- Medical College & Hospitals, Kolkata, India
| | | | - Kunal Ray
- ATGC Diagnostics Private Limited, Kolkata, India
| | - Jharna Ray
- S. N. Pradhan Centre for Neurosciences, University of Calcutta, Kolkata, India.
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Alvarez-Silva C, Kashani A, Hansen TH, Pinna NK, Anjana RM, Dutta A, Saxena S, Støy J, Kampmann U, Nielsen T, Jørgensen T, Gnanaprakash V, Gnanavadivel R, Sukumaran A, Rani CSS, Færch K, Radha V, Balasubramanyam M, Nair GB, Das B, Vestergaard H, Hansen T, Mande SS, Mohan V, Arumugam M, Pedersen O. Trans-ethnic gut microbiota signatures of type 2 diabetes in Denmark and India. Genome Med 2021; 13:37. [PMID: 33658058 PMCID: PMC7931542 DOI: 10.1186/s13073-021-00856-4] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [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: 04/27/2020] [Accepted: 02/12/2021] [Indexed: 12/15/2022] Open
Abstract
Background Type 2 diabetes (T2D), a multifactorial disease influenced by host genetics and environmental factors, is the most common endocrine disease. Several studies have shown that the gut microbiota as a close-up environmental mediator influences host physiology including metabolism. The aim of the present study is to examine the compositional and functional potential of the gut microbiota across individuals from Denmark and South India with a focus on T2D. Many earlier studies have investigated the microbiome aspects of T2D, and it has also been anticipated that such microbial associations would be dependent on diet and ethnic origin. However, there has been no large scale trans-ethnic microbiome study earlier in this direction aimed at evaluating any “universal” microbiome signature of T2D. Methods 16S ribosomal RNA gene amplicon sequencing was performed on stool samples from 279 Danish and 294 Indian study participants. Any differences between the gut microbiota of both populations were explored using diversity measures and negative binomial Wald tests. Study samples were stratified to discover global and country-specific microbial signatures for T2D and treatment with the anti-hyperglycemic drug, metformin. To identify taxonomical and functional signatures of the gut microbiota for T2D and metformin treatment, we used alpha and beta diversity measures and differential abundances analysis, comparing metformin-naive T2D patients, metformin-treated T2D patients, and normoglycemic individuals. Results Overall, the gut microbial communities of Danes and Indians are compositionally very different. By analyzing the combined study materials, we identify microbial taxonomic and functional signatures for T2D and metformin treatment. T2D patients have an increased relative abundance of two operational taxonomic units (OTUs) from the Lachnospiraceae family, and a decreased abundance of Subdoligranulum and Butyricicoccus. Studying each population per se, we identified T2D-related microbial changes at the taxonomic level within the Danish population only. Alpha diversity indices show that there is no significant difference between normoglycemic individuals and metformin-naive T2D patients, whereas microbial richness is significantly decreased in metformin-treated T2D patients compared to metformin-naive T2D patients and normoglycemic individuals. Enrichment of two OTUs from Bacteroides and depletion of Faecalibacterium constitute a trans-ethnic signature of metformin treatment. Conclusions We demonstrate major compositional differences of the gut microbiota between Danish and South Indian individuals, some of which may relate to differences in ethnicity, lifestyle, and demography. By comparing metformin-naive T2D patients and normoglycemic individuals, we identify T2D-related microbiota changes in the Danish and Indian study samples. In the present trans-ethnic study, we confirm that metformin changes the taxonomic profile and functional potential of the gut microbiota. Supplementary Information The online version contains supplementary material available at 10.1186/s13073-021-00856-4.
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Affiliation(s)
- Camila Alvarez-Silva
- Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Blegdamsvej 3B, DK-2200, Copenhagen N, Denmark
| | - Alireza Kashani
- Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Blegdamsvej 3B, DK-2200, Copenhagen N, Denmark.,Danish Academy of Diabetes, Odense University Hospital, DK-5000 Odense C, Kløvervænget 6, Odense, Denmark
| | - Tue Haldor Hansen
- Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Blegdamsvej 3B, DK-2200, Copenhagen N, Denmark.,Department of Cardiology and Endocrinology, Slagelse Hospital, Slagelse, Denmark
| | - Nishal Kumar Pinna
- TCS Research, Tata Consultancy Services Limited, 54B Hadapsar Industrial Estate, Pune, 411013, India
| | - Ranjit Mohan Anjana
- Madras Diabetes Research Foundation, No. 4, Conran Smith Road, Gopalapuram, Chennai, 600 086, India
| | - Anirban Dutta
- TCS Research, Tata Consultancy Services Limited, 54B Hadapsar Industrial Estate, Pune, 411013, India
| | - Shruti Saxena
- Molecular Genetics Laboratory, Infections and Immunology, Translational Health Science and Technology Institute, NCR Biotech Science Cluster, Faridabad, 121001, India
| | - Julie Støy
- Steno Diabetes Center Aarhus, Aarhus Universitetshospital, Hedeager 3, 2. sal, Aarhus, 8200, Denmark
| | - Ulla Kampmann
- Steno Diabetes Center Aarhus, Aarhus Universitetshospital, Hedeager 3, 2. sal, Aarhus, 8200, Denmark
| | - Trine Nielsen
- Danish Academy of Diabetes, Odense University Hospital, DK-5000 Odense C, Kløvervænget 6, Odense, Denmark
| | - Torben Jørgensen
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospitals, University of Copenhagen, Copenhagen, Denmark
| | - Visvanathan Gnanaprakash
- Madras Diabetes Research Foundation, No. 4, Conran Smith Road, Gopalapuram, Chennai, 600 086, India
| | - Rameshkumar Gnanavadivel
- Madras Diabetes Research Foundation, No. 4, Conran Smith Road, Gopalapuram, Chennai, 600 086, India
| | - Aswath Sukumaran
- Madras Diabetes Research Foundation, No. 4, Conran Smith Road, Gopalapuram, Chennai, 600 086, India
| | | | - Kristine Færch
- Steno Diabetes Center Aarhus, Aarhus Universitetshospital, Hedeager 3, 2. sal, Aarhus, 8200, Denmark
| | - Venkatesan Radha
- Madras Diabetes Research Foundation, No. 4, Conran Smith Road, Gopalapuram, Chennai, 600 086, India
| | | | - Gopinath Balakrish Nair
- Molecular Genetics Laboratory, Infections and Immunology, Translational Health Science and Technology Institute, NCR Biotech Science Cluster, Faridabad, 121001, India
| | - Bhabatosh Das
- Molecular Genetics Laboratory, Infections and Immunology, Translational Health Science and Technology Institute, NCR Biotech Science Cluster, Faridabad, 121001, India
| | - Henrik Vestergaard
- Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Blegdamsvej 3B, DK-2200, Copenhagen N, Denmark
| | - Torben Hansen
- Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Blegdamsvej 3B, DK-2200, Copenhagen N, Denmark
| | - Sharmila Shekhar Mande
- TCS Research, Tata Consultancy Services Limited, 54B Hadapsar Industrial Estate, Pune, 411013, India.
| | - Viswanathan Mohan
- Madras Diabetes Research Foundation, No. 4, Conran Smith Road, Gopalapuram, Chennai, 600 086, India.
| | - Manimozhiyan Arumugam
- Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Blegdamsvej 3B, DK-2200, Copenhagen N, Denmark. .,Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.
| | - Oluf Pedersen
- Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Blegdamsvej 3B, DK-2200, Copenhagen N, Denmark.
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Garg R. Insulin resistance versus insulin deficiency: evidence of racial differences in the pathogenesis of type 2 diabetes. BMJ Open Diabetes Res Care 2021; 9:9/1/e002261. [PMID: 33771767 PMCID: PMC8006842 DOI: 10.1136/bmjdrc-2021-002261] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 03/11/2021] [Indexed: 11/04/2022] Open
Affiliation(s)
- Rajesh Garg
- Division of Endocrinology, Diabetes and Metabolism, University of Miami Miller School of Medicine, Miami, Florida, USA
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21
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Sahoo PR, Sahu M, Surapaneni PS, Maiti A, Vankamamidi R, Panda N, Biswal RN. Evolution of olfactory and gustatory dysfunctions in COVID-19 patients in India. Eur Arch Otorhinolaryngol 2021; 278:2875-2881. [PMID: 33392762 PMCID: PMC7779103 DOI: 10.1007/s00405-020-06563-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 12/10/2020] [Indexed: 01/05/2023]
Abstract
Purpose The ongoing coronavirus disease 19 (COVID-19) pandemic is spreading at an alarming rate across the globe. Sudden onset loss of smell and/or taste has been increasingly reported as a symptom of COVID-19. However, prevalence of these symptoms, and its severity varies widely between studies, with little data on its duration and recovery rate. Since this significantly impacts the quality of life of patients, there is a need for a study to provide insight into the loss of smell or taste in terms of its correlation with other upper respiratory tract symptoms, natural history and resolution rates. Methods This cross-sectional study included 718 mild to moderately symptomatic adult patients (≥ 18 years), admitted consecutively to Kalinga Institute of Medical Sciences (KIMS), Odisha, India between June 25 and July 24, 2020, who tested positive for SARS-CoV-2 by polymerase chain reaction on nasopharyngeal and throat swabs. Prevalence, severity, duration and factors associated with altered smell or taste sensation, and their follow-up were recorded. Results Of the 718 patients included in the study at baseline [563 (78%) men; median age 34 years], 101 (14%) patients experienced either altered smell or taste, with 52 (7%) experiencing both altered smell and taste. Seventy-seven (10.7%) patients had altered smell and 76 patients had altered taste (10.5%). Of these, 71 (92%) and 73 (96%) regained their sense of smell and taste, respectively, by 14 days after their swab tested positive. Presence of fever (OR = 5.4, 95% CI = 2.7–10.6, p < 0.001), cough (OR = 2.3, 95% CI = 1.2–4.2, p = 0.009) and nasal obstruction (OR = 3.1, 95% CI = 1.4–6.7, p = 0.006) were independently associated with increased likelihood of experiencing both altered taste and smell in multivariable models. Conclusion The prevalence of altered smell and taste in Indians was much lower compared to Europeans and similar to East Asians. Majority regained these senses by 2 weeks. Identification of these symptoms can help in early detection of the disease in suspected individuals. Supplementary Information The online version contains supplementary material available at 10.1007/s00405-020-06563-x.
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Affiliation(s)
- Pradipt Ranjan Sahoo
- Department of ENT, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India.
| | - Monalisa Sahu
- Department of Infectious Diseases, Yashoda Hospital, Secunderabad, Telangana, India
| | | | - Ayan Maiti
- Department of ENT, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Rachit Vankamamidi
- Department of ENT, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Nishant Panda
- Department of ENT, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Rudra Narayan Biswal
- Department of ENT, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India
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22
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Lee CL, Shyam S, Lee ZY, Tan JL. Food order and glucose excursion in Indian adults with normal and overweight/obese Body Mass Index: A randomised crossover pilot trial. Nutr Health 2020; 27:161-169. [PMID: 33349136 DOI: 10.1177/0260106020975573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Postprandial glycaemia has an impact on health but there is limited data about the effect of food order on postprandial glycaemia by body weight status. AIM To investigate the effects of food order on postprandial glucose (PPG) excursion, in Indian adults with normal (NL) and overweight/obese (OW) Body Mass Index. METHODS This randomised crossover study was conducted at a Malaysian university among Indian adults without diabetes. The participants consumed isocaloric test meals at three study visits based on randomised food orders: carbohydrate first/protein last (CF); protein first/carbohydrate last (CL); and a composite meal containing carbohydrate and protein (CM). Capillary blood glucose was measured at baseline, 30, 60, 90 and 120 minutes after starting the meal. RESULTS The CL food order had a blunting effect on PPG excursion at 30 and 60 minutes (p < 0.01). The CL food order resulted in lower glucose peak when compared with the CF and CM food order (p < 0.001). The CL food order resulted in lower incremental glucose peak (mmol/L) (NL: CF 3.9 ± 0.3, CM 3.0 ± 0.3, CL 2.0 ± 0.2; OW: CF 2.9 ± 0.3, CM 2.5 ± 0.3, CL 1.8 ± 0.2) and iAUC 0-120 min (mmol/Lxmin) (NL: CF 272.4 ± 26.7, CM 206.2 ± 30.3, CL 122.0 ± 14.8; OW: CF 193.2 ± 23.1, CM 160.1 ± 21.7, CL 113.6 ± 15.3) when compared with the CF food order (p < 0.001). The effect of food order on postprandial excursion did not differ between the NL (n = 14) and the OW (n = 17) groups. CONCLUSION In participants with normal and overweight/obese BMI, consuming food in the protein first/carbohydrate last order had the biggest effect in reducing PPG excursion.
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Affiliation(s)
- Ching Li Lee
- Nutrition and Dietetics Division, School of Health Sciences, 50103International Medical University, Kuala Lumpur, Malaysia
| | - Sangeetha Shyam
- Nutrition and Dietetics Division, School of Health Sciences, 50103International Medical University, Kuala Lumpur, Malaysia
| | - Zi Yi Lee
- Nutrition and Dietetics Division, School of Health Sciences, 50103International Medical University, Kuala Lumpur, Malaysia
| | - Jie Lene Tan
- Nutrition and Dietetics Division, School of Health Sciences, 50103International Medical University, Kuala Lumpur, Malaysia
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23
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Mehreen TS, Kamalesh R, Pandiyan D, Kumar DS, Anjana RM, Mohan V, Ranjani H. Incidence and Predictors of Dysglycemia and Regression to Normoglycemia in Indian Adolescents and Young Adults: 10-Year Follow-Up of the ORANGE Study. Diabetes Technol Ther 2020; 22:875-882. [PMID: 32349530 DOI: 10.1089/dia.2020.0109] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Background: The prevalence of diabetes in youth is increasing worldwide in parallel with the obesity epidemic. This study aimed to determine the incidence rates of dysglycemia (diabetes or prediabetes) and evaluate the predictors of its progression or regression to normal glucose tolerance (NGT) in a cohort of children and adolescents studied in Chennai, South India. Methods: A longitudinal follow-up of the Obesity Reduction and Awareness of Noncommunicable Diseases through Group Education (ORANGE) cohort was performed after a median of 7.1 years (n = 845; 5928 person-years of follow-up). To determine their diabetes status at follow-up, participants underwent an oral glucose tolerance test (n = 811 with NGT and 34 with prediabetes at baseline), excluding those with diabetes at baseline. Incidence rates for dysglycemia were reported per 1000 person-years of follow-up. Cox proportional hazards model was used to estimate the predictors of progression and regression. Results: Out of 811 individuals with NGT at baseline, 115 developed dysglycemia giving an incidence rate of 20.2 per 1000 person-years (95% confidence interval: 16.8-24.2). Among those with prediabetes at baseline, 70.6% of the individuals converted to NGT and the remaining 29.4% either got converted to diabetes or remained as prediabetes. Higher age, body mass index, fasting plasma glucose, 2-hour plasma glucose (2-h PG), positive family history of diabetes, and systolic blood pressure (BP) were independent predictors of incident dysglycemia, whereas lower age, waist circumference, 2-h PG, systolic BP, and triglycerides predicted regression to normoglycemia. Conclusions: This study highlights the growing burden of dysglycemia in Asian Indian youth and emphasizes the need for targeted preventive actions.
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Affiliation(s)
- T S Mehreen
- Department of Translational Research, Madras Diabetes Research Foundation, Chennai, India
| | - R Kamalesh
- Department of Research Operations, Madras Diabetes Research Foundation, Chennai, India
| | - D Pandiyan
- Department of Translational Research, Madras Diabetes Research Foundation, Chennai, India
| | - D Sathish Kumar
- Department of Translational Research, Madras Diabetes Research Foundation, Chennai, India
| | - R M Anjana
- Department of Diabetology, Madras Diabetes Research Foundation, Chennai, India
| | - V Mohan
- Department of Diabetology, Madras Diabetes Research Foundation, Chennai, India
| | - H Ranjani
- Department of Translational Research, Madras Diabetes Research Foundation, Chennai, India
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24
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Sivapandi K, Velumani A, Kallathiyan K, Iyer S, Sinkar P. Blood mercury and liver enzymes: A pan-India retrospective correlation study. Toxicol Ind Health 2020; 36:1019-1023. [PMID: 33200688 DOI: 10.1177/0748233720970437] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Mercury (Hg) is a toxic heavy metal, and the reported effects of exposure on liver function continue to be inconsistent. The objective of our study was to identify correlations between high blood Hg levels and liver enzymes in a pan-India population including adults ≥19 years of age. This retrospective study analyzed the data from 95,398 individuals tested for blood Hg levels and liver enzymes in our national laboratory. Testing for blood Hg was done by inductively coupled plasma-mass spectrometry, while testing for liver enzymes-aspartate aminotransferase (AST/SGOT), alanine aminotransferase (ALT/SGPT), and gamma-glutamyl transferase-was done by automated photometry systems. Data from all the individuals inclusive of 52,497 males and 42,901 females were studied. The frequency of high blood Hg levels (>5 µg/L) was found to be 0.6%, and the difference between males and females was not found to be significant. Further correlation by linear regression analysis found no relationship between high blood Hg levels and liver enzymes among females. However, among males, there was a significant correlation between high blood Hg levels, and increased AST as well as ALT. Our report suggested that for males but not females, Hg exposure may be one of the differentials for elevated liver enzymes.
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Affiliation(s)
- Krishnakumar Sivapandi
- Analytical Chemistry Division, Thyrocare Technologies Limited, Navi Mumbai, Maharashtra, India
| | - Amruta Velumani
- Analytical Chemistry Division, Thyrocare Technologies Limited, Navi Mumbai, Maharashtra, India
| | | | - Sandhya Iyer
- Analytical Chemistry Division, Thyrocare Technologies Limited, Navi Mumbai, Maharashtra, India
| | - Prachi Sinkar
- Analytical Chemistry Division, Thyrocare Technologies Limited, Navi Mumbai, Maharashtra, India
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Korn Malerbi F, Lelis Dal Fabbro A, Botelho Vieira Filho JP, Franco LJ. The feasibility of smartphone based retinal photography for diabetic retinopathy screening among Brazilian Xavante Indians. Diabetes Res Clin Pract 2020; 168:108380. [PMID: 32828834 DOI: 10.1016/j.diabres.2020.108380] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 08/09/2020] [Accepted: 08/17/2020] [Indexed: 11/29/2022]
Abstract
AIMS To evaluate the feasibility of smartphone based retinal photography for diabetic retinopathy (DR) screening among Brazilian Xavante Indians and the yield of retinal images. METHODS A non-probabilistic cluster sample of 170 individuals with and without diabetes was enrolled for ocular examination with a portable retinal camera during DR screening at two Xavante Reservations. Due to operational conditions and to optimize the field work, only the larger Xavante villages were included. Images were obtained after pupil dilation; image analysis included assessment of quality, presence of media opacities and diabetic retinopathy grading whenever possible for individuals with diabetes. RESULTS A total of 157 individuals underwent the complete ocular imaging protocol, 95 with diabetes (60.5%). Among those with diabetes, 23 (24.2%) could not have DR graded because of media opacities. For those with gradable images, the frequency of DR was 22.2%; sight-threatening DR was present in 9.7%. The main causes for ungradable images were cataracts and asteroid hyalosis. CONCLUSIONS The presence of DR was higher than in previous studies, calling attention for its prevention in this vulnerable population. The screening model with a smartphone-based portable retinal camera is feasible and could increase screening coverage if associated with telemedicine.
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Affiliation(s)
- Fernando Korn Malerbi
- Department of Ophthalmology, Escola Paulista de Medicina, Federal University of São Paulo, Rua Botucatu, 820, CEP 04023-062, São Paulo, SP, Brazil; Division of Endocrinology, Escola Paulista de Medicina, Federal University of Sao Paulo, Rua Estado de Israel, 639, CEP 04022-001, São Paulo, SP, Brazil.
| | - Amaury Lelis Dal Fabbro
- Department of Social Medicine, Ribeirao Preto Medical School, University of Sao Paulo, Rua Avenida Bandeirantes, 3900, CEP 14049-900, Ribeirão Preto, SP, Brazil.
| | - João Paulo Botelho Vieira Filho
- Division of Endocrinology, Escola Paulista de Medicina, Federal University of Sao Paulo, Rua Estado de Israel, 639, CEP 04022-001, São Paulo, SP, Brazil
| | - Laercio Joel Franco
- Division of Endocrinology, Escola Paulista de Medicina, Federal University of Sao Paulo, Rua Estado de Israel, 639, CEP 04022-001, São Paulo, SP, Brazil; Department of Social Medicine, Ribeirao Preto Medical School, University of Sao Paulo, Rua Avenida Bandeirantes, 3900, CEP 14049-900, Ribeirão Preto, SP, Brazil.
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Suhas S, Kumar V, Damodharan D, Sharma P, Rao NP, Varambally S, Venkatasubramanian G, Murthy P, Gangadhar BN. Do Indian patients with schizophrenia need half the recommended clozapine dose to achieve therapeutic serum level? An exploratory study. Schizophr Res 2020; 222:195-201. [PMID: 32518001 DOI: 10.1016/j.schres.2020.05.057] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 05/18/2020] [Accepted: 05/25/2020] [Indexed: 12/14/2022]
Abstract
Inter-racial differences in serum clozapine have received less scientific importance, as there are fewer studies on therapeutic drug monitoring (TDM) from Asia. We measured the serum clozapine levels in 142 patients with schizophrenia and related disorders at a tertiary care psychiatric institute in India. The clozapine concentration per milligram (mg) of oral clozapine dose (C/D ratio) was calculated, and the C/D ratio was used to estimate oral clozapine dose needed to achieve therapeutic serum clozapine level (350 ng/ml). This study examined Indian patients only and compared the results with weighted mean serum clozapine and its correlates in Caucasian population, based on published scientific literature. The median C/D ratio in our sample was 2.5 (n = 142), and the clozapine dose needed to achieve therapeutic serum clozapine level was 140 mg/d. The median C/D ratio of our subjects was nearly two and a half times higher than the weighted mean C/D ratio of Caucasians (2.5 v/s 1.07) reported elsewhere. After excluding the significant pharmacokinetic interactions and stratifying according to gender and smoking status, the estimated clozapine dose to achieve therapeutic serum level in male smokers (n = 9) and female non-smokers (n = 38) were 238 mg/d (C/D ratio; 1.47) and 120 mg/d (C/D ratio:2.93) respectively. On comparing, male smokers (600 mg/d versus 238 mg/d) and female non-smokers (300 mg/d versus 120 mg/d) in our study needed about 40% of the recommended clozapine dose for Caucasians to achieve therapeutic serum clozapine level. The pharmacogenetic correlates of lesser clozapine dose requirement in the Indian population require further research.
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Rhoades DA, Comiford AL, Dvorak JD, Ding K, Hopkins M, Spicer P, Wagener TL, Doescher MP. Perceptions of Smoking and Vaping on Weight Control Among Adult American Indians Who Smoke. J Community Health 2019; 44:1120-6. [PMID: 31273619 DOI: 10.1007/s10900-019-00694-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Interest in electronic cigarette (EC) use, or vaping, to help control weight is increasing. Many American Indian (AI) populations have a high prevalence of smoking, obesity, and EC use, but their perceptions of EC use for weight control are unknown. In Oklahoma in 2016, 375 AI adults who smoke completed a survey including perceptions about smoking and EC effects on weight control. Only 24% believed that smoking helps control weight, and 8% believed that vaping helps control weight. Perceptions differed by EC use, with ever users more often than never users perceiving that smoking (30% vs 12%, respectively; p < .01) and vaping (10% vs 5%; p = .04) help to control weight. Sex, age group (18-44 years vs 45 + years), education (high school graduate/equivalent vs less than high school), smoking cessation attempt in past year, and likelihood to quit in 6 months were not associated with weight control perceptions for either smoking or vaping. Uncertainty regarding EC effects on weight control was less common among EC ever users compared to never users (41% vs 53%, respectively; p = .04). Most people who did not believe or were uncertain that smoking controls weight also did not believe or were uncertain that vaping controls weight. However, only a minority (29%) of people who believed smoking controls weight also believed that vaping controls weight. Among adult AI who smoke, both smoking and vaping were infrequently perceived as helping to control weight, but such perceptions were reported more frequently among those who ever used ECs.
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Enas EA, Varkey B, Gupta R. Expanding statin use for prevention of ASCVD in Indians: Reasoned and simplified proposals. Indian Heart J 2020; 72:65-69. [PMID: 32534692 PMCID: PMC7296246 DOI: 10.1016/j.ihj.2020.03.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 03/28/2020] [Indexed: 01/21/2023] Open
Abstract
Atherosclerosis, a systemic disease, is the predominant cause of cardiovascular disease (CVD) that far exceeds other causes (egs: congenital, hypertension, arrhythmia). CVD is the leading cause of mortality globally (18 million lives, including 9 million from coronary artery disease (CAD) annually).1 The Global Burden of Disease study reported that in the year 2017, India had one of the highest mortality, most of them premature, from CVD (2.64 million, women 1.18, men 1.45) and CAD (1.54 million, women 0.62, men 0.92) in the world.2 A systemic disease of this magnitude and impact warrants a proactive preventive strategy and not a reactive, invasive and focal approach. In this editorial, we call for a wider use of statins in Indians, explain our rationale based on risk factors and risk-enhancing factors, and present a simplified and cost effective approach to combat CVD.
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Affiliation(s)
- Enas A Enas
- Coronary Artery Disease in Indians (CADI) Research Foundation, Lisle, IL, USA.
| | - Basil Varkey
- Medical College of Wisconsin, Milwaukee, WI, USA
| | - Rajeev Gupta
- Department of Preventive Cardiology & Internal Medicine, Eternal Heart Care Centre & Research Institute, Jaipur, India
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Florian MC, Rodrigues DA, de Mendonça SBM, Colombo AL, Tomimori J. Epidemiologic and Clinical Progression of Lobomycosis among Kaiabi Indians, Brazil, 1965-2019. Emerg Infect Dis 2020; 26:930-936. [PMID: 32310067 PMCID: PMC7181903 DOI: 10.3201/eid2605.190958] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Lobomycosis is a rare granulomatous skin disease with a high prevalence in the Amazon region. The Kaiabi Indians are an especially affected group. We studied the current epidemiologic and clinical progression of lobomycosis among the Kaiabi in Brazil, from initial case reports in 1965 through 2019. A total of 60 lobomycosis cases had been reported among the Kaiabi, and we identified 3 new cases in our review. Of 550 cases of lobomycosis ever reported worldwide, 11.5% were among the Kaiabi. We note a high incidence among female Kaiabi and a precocious onset of disease in this indigenous population. Male Kaiabi frequently are infected with the multicentric form and women more frequently exhibit the localized form. Ulcerated lesions are observed more often in the multicentric form. The prevalence among this indigenous group could be explained by genetic susceptibility and lifestyle, which exposes them to a particular agent in the habitats in which they live.
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Subramaniam K, Babu T. Does Bone Mineral Apparent Density Facilitate Accurate Identification of Osteoporosis in the Short Postmenopausal Women? Indian J Endocrinol Metab 2020; 24:275-279. [PMID: 33083269 PMCID: PMC7539034 DOI: 10.4103/ijem.ijem_101_20] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 04/08/2020] [Accepted: 05/25/2020] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE Height is one of the most important aspects affecting the areal bone mineral density (BMD). There are several height adjustments in children but none in widespread use for adults. This is specifically a problem in ethnic groups where mean height is substantially lower. We hypothesized that height adjustment of areal BMD would reduce the misclassification in short individuals. MATERIALS AND METHODS This is a retrospective study involving 373 postmenopausal women. Their records were reviewed and bone mineral apparent density (BMAD) were calculated. Areal BMD T-scores and BMAD T-scores were then compared. RESULTS The mean height of the cohort was 154.4 cm. There were 47 women who were defined as short (≤147 cm). In short women, BMAD neither showed improvement nor decrement in T-scores, and BMAD T-scores predicted more number of osteoporosis than BMD T-scores. When divided into height ranges, taller women (>160 cm) showed worsening of BMAD T-scores as compared to BMD T-scores (Chi-square test for trend P < 0.001). Hence, BMAD might actually "correct" for larger bone and not shorter bones. CONCLUSION BMAD was not found to be a suitable alternative in short postmenopausal women to accurately determine whether the low bone density in them is because of dual-energy X-ray absorptiometry artifact or whether they truly have a low density.
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Affiliation(s)
| | - Tom Babu
- Department of Endocrinology, Silverline Hospital, Kochi, Kerala, India
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Suchy-Dicey A, Shibata D, Cholerton B, Nelson L, Calhoun D, Ali T, Montine TJ, Longstreth WT, Buchwald D, Verney SP. Cognitive Correlates of MRI-defined Cerebral Vascular Injury and Atrophy in Elderly American Indians: The Strong Heart Study. J Int Neuropsychol Soc 2020; 26:263-75. [PMID: 31791442 DOI: 10.1017/S1355617719001073] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE American Indians experience substantial health disparities relative to the US population, including vascular brain aging. Poorer cognitive test performance has been associated with cranial magnetic resonance imaging findings in aging community populations, but no study has investigated these associations in elderly American Indians. METHODS We examined 786 American Indians aged 64 years and older from the Cerebrovascular Disease and its Consequences in American Indians study (2010-2013). Cranial magnetic resonance images were scored for cortical and subcortical infarcts, hemorrhages, severity of white matter disease, sulcal widening, ventricle enlargement, and volumetric estimates for white matter hyperintensities (WMHs), hippocampus, and brain. Participants completed demographic, medical history, and neuropsychological assessments including testing for general cognitive functioning, verbal learning and memory, processing speed, phonemic fluency, and executive function. RESULTS Processing speed was independently associated with the presence of any infarcts, white matter disease, and hippocampal and brain volumes, independent of socioeconomic, language, education, and clinical factors. Other significant associations included general cognitive functioning with hippocampal volume. Nonsignificant, marginal associations included general cognition with WMH and brain volume; verbal memory with hippocampal volume; verbal fluency and executive function with brain volume; and processing speed with ventricle enlargement. CONCLUSIONS Brain-cognition associations found in this study of elderly American Indians are similar to those found in other racial/ethnic populations, with processing speed comprising an especially strong correlate of cerebrovascular disease. These findings may assist future efforts to define opportunities for disease prevention, to conduct research on diagnostic and normative standards, and to guide clinical evaluation of this underserved and overburdened population.
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Pawar VB, Surude RG, Sonthalia N, Zanwar V, Jain S, Contractor Q, Rathi PM. Minimal Hepatic Encephalopathy in Indians: Psychometric Hepatic Encephalopathy Score and Inhibitory Control Test for Diagnosis and Rifaximin or Lactulose for Its Reversal. J Clin Transl Hepatol 2019; 7:304-312. [PMID: 31915599 PMCID: PMC6943207 DOI: 10.14218/jcth.2017.00037] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2017] [Revised: 05/28/2018] [Accepted: 02/14/2019] [Indexed: 12/15/2022] Open
Abstract
Background and Aims: Psychometric hepatic encephalopathy score (PHES) is used widely for diagnosis of minimal hepatic encephalopathy (MHE). This prospective study aimed to determine the utility of the inhibitory control test (ICT) for the diagnosis of MHE. Additionally, the efficacy of rifaximin and lactulose for reversal of MHE was evaluated. Methods: A total of 180 eligible cirrhotic patients underwent testing for MHE. When PHES was ≤ -5 and ICT lures were ≥ 14, MHE was diagnosed. The 108 patients with MHE were randomized to three groups for treatment with either lactulose, rifaximin, or placebo. Treatment outcomes were measured at the end of 3 months. Results: The 108 patients with MHE diagnosed by PHES and/or ICT accounted for 60%. The diagnosis of MHE was made by both ICT and PHES positivity in 56 patients, by abnormal ICT and normal PHES in 37 patients, and by abnormal PHES and normal ICT in 15 patients. For diagnosis of MHE, ICT had sensitivity of 78.87%, specificity of 66.06% with 60.22% positive predictive value and 82.76% negative predictive value. An area under the curve value of 0.724 (95% CI: 0.653-0.788) was obtained for diagnosis of MHE. Reversal of MHE was seen in 71.42%, 70.27% and 11.11% of patients in the rifaximin, lactulose and placebo arms (p < 0.001). Rifaximin showed better tolerability compared to lactulose. Conclusions: For the diagnosis of MHE, ICT is a simple tool but has lower sensitivity and better specificity than PHES. Rifaximin is as efficacious as lactulose in the treatment of MHE and better tolerated.
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Affiliation(s)
- Vinay B. Pawar
- Correspondence to: Vinay B. Pawar, Department of Gastroenterology, Topiwala National Medical College and BYL Ch Hospital, Dr. A.L Nair Road, Mumbai, Maharashtra 400008, India. Tel: +22-23021639, E-mail:
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Montanha-Andrade K, Maia W, Pimentel ACP, Arsati YBDOL, Santos JND, Cury PR. Dental health status and its indicators in adult Brazilian Indians without exposition to drinking water fluoridation: a cross-sectional study. Environ Sci Pollut Res Int 2019; 26:34440-34447. [PMID: 31637613 DOI: 10.1007/s11356-019-06571-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 11/05/2018] [Accepted: 09/23/2019] [Indexed: 06/10/2023]
Abstract
Water fluoridation is considered a cost-effective and practical method for controlling and preventing dental caries in the general population. The objective of this study was to evaluate the dental health status and risk indicators for dental caries in adult Brazilian Indians without exposition to dental caries-preventive effects of water fluoridation. Decayed (DT), missing (MT), and filled (FT) permanent teeth (DMFT), as well as plaque index, unstimulated salivary flow rate, salivary buffering capacity, and fasting blood glucose were examined in 225 adult Indians. Smoking habits and sociodemographic data were evaluated using a structured questionnaire. Drinking water samples from 10 Indian villages were analyzed for the natural fluoride concentration. The mean DMFT was 10.33 ± 6.91 (DT, 4.19 ± 3.99; MT, 4.99 ± 5.64; FT, 1.14 ± 1.75). DMFT index ≥ 9 was associated with age ≥ 35 years (p = 0.000), lower education (p = 0.03), and plaque index > 40% (p = 0.003). DT was associated only with plaque index (p = 0.03). MT was associated with age (p < 0.001) and plaque index (p = 0.01). FT was negatively associated with age (p = 0.02) and income (p = 0.02). Fluoride concentration varied from 0.01 to 0.07 mg/L and was not associated with dental health status (p ≥ 0.29). In conclusion, poorer dental health status was associated with older age, higher plaque index, and lower education and income levels. The fluoride level in the drinking water of Kiriri villages was lower than the level recommended for preventing dental caries. Water fluoridation may be recommended for this population.
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Affiliation(s)
- Katia Montanha-Andrade
- Post-graduate Program in Dentistry and Health, School of Dentistry, Federal University of Bahia, Av. Araújo Pinho, 62, Canela, Salvador, Bahia, 40110-150, Brazil
| | - Wolf Maia
- Post-graduate Program in Dentistry and Health, School of Dentistry, Federal University of Bahia, Av. Araújo Pinho, 62, Canela, Salvador, Bahia, 40110-150, Brazil
| | | | - Ynara Bosco De Oliveira Lima Arsati
- Department of Biological Sciences, State University of Feira de Santana, Pc Purificação, 48, Santo Amaro, Feira de Santana, Bahia, 44200-000, Brazil
| | - Jean Nunes Dos Santos
- Department of Oral Pathology, School of Dentistry, Federal University of Bahia, Av. Araújo Pinho, 62, Canela, Salvador, Bahia, 40110-150, Brazil
| | - Patricia Ramos Cury
- Department of Periodontics, School of Dentistry, Federal University of Bahia, Av. Araújo Pinho, 62, Canela, Salvador, Bahia, 40110-150, Brazil.
- Faculdade de Odontologia, Av. Araújo Pinho, 62, Canela, Salvador, Bahia, 40110-150, Brazil.
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Paradkar MU, Padate B, Shah SAV, Vora H, Ashavaid TF. Association of Genetic Variants with Hyperhomocysteinemia in Indian Patients with Thrombosis. Indian J Clin Biochem 2019; 35:465-473. [PMID: 33013017 DOI: 10.1007/s12291-019-00846-9] [Citation(s) in RCA: 4] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Accepted: 08/20/2019] [Indexed: 11/24/2022]
Abstract
Hyperhomocysteinemia known to be associated with increased thrombotic tendency has been considered as a risk factor for coronary artery disease, atherosclerosis, venous thrombosis, and stroke. There are three main genes MTHFR, cystathionine beta-synthase (CBS) and methionine synthase (MS) and it's genetic variant that are known to influence the homocysteine metabolism leading to hyperhomocysteinemia. There is scarcity of Indian data on hyperhomocysteinemia and genetics variants in patients with thrombosis. Hence the objective of present study was to determine MTHFR, CBS, and MS genetic variants in thrombosis patients from Indian population. Genetic variant analysis was performed on thrombosis patients to detect MTHFR C677T (rs1801133), MTHFR A1298C (rs1801131), MS A2756G (rs1805087) and CBS T833C (rs5742905) mutations. The mutant allele frequencies of MTHFR 677T, MTHFR 1298C, MS2756G and CBS 833C were observed to be 16.1%, 37.5%, 34.1% and 5.8% respectively. MTHFR 677TT genotype was observed to be significantly associated with elevated homocysteine (Hcy) levels (64.65 μmol/L) alleles as compared to CC alleles (32.43 μmol/L) and CT alleles (30.54 μmol/L). MTHFR A1298C, MS A2756G and CBS T833C genotypes did not showed significant association with higher Hcy levels. Thus, in Indian patients with thrombosis only MTHFR T677T genotype was observed to be significantly associated with hyperhomocysteinemia.
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Affiliation(s)
- Minal Umesh Paradkar
- Research Laboratories, P. D. Hinduja Hospital & Medical Research Centre, Lalita Girdhar Bldg (S1), Veer Savarkar Marg, Mahim, Mumbai 400016, India
| | - Balkrishna Padate
- Department of Hemato-Oncology and Bone Marrow Transplant, P. D. Hinduja Hospital & Medical Research Centre, Veer Savrkar Marg, Mumbai 400016, India
| | - Swarup A V Shah
- Research Laboratories, P. D. Hinduja Hospital & Medical Research Centre, Lalita Girdhar Bldg (S1), Veer Savarkar Marg, Mahim, Mumbai 400016, India
| | - Hiral Vora
- Research Laboratories, P. D. Hinduja Hospital & Medical Research Centre, Lalita Girdhar Bldg (S1), Veer Savarkar Marg, Mahim, Mumbai 400016, India
| | - Tester F Ashavaid
- Department of Laboratory Medicine, Biochemistry Laboratory, P. D. Hinduja Hospital & Medical Research Center, Lalita Girdhar Bldg (S1), Veer Savarkar Marg, Mahim, Mumbai, 400 016 India
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Nash SH, Day G, Zimpelman G, Hiratsuka VY, Koller KR. Cancer incidence and associations with known risk and protective factors: the Alaska EARTH study. Cancer Causes Control 2019; 30:1067-1074. [PMID: 31428891 DOI: 10.1007/s10552-019-01216-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Accepted: 08/09/2019] [Indexed: 11/29/2022]
Abstract
PURPOSE Cancer is the leading cause of mortality among Alaska Native (AN) people. The Alaska Education and Research Towards Health (EARTH) cohort was established to examine risk and protective factors for chronic diseases, including cancer, among AN people. Here, we describe the cancer experience of the Alaska EARTH cohort in relation to statewide- and region-specific tumor registry data, and assess associations with key cancer risk factors. METHODS AN participants were recruited into the Alaska EARTH cohort during 2004-2006. Data collected included patient demographic, anthropometric, medical and family history, and lifestyle information. This study linked the Alaska EARTH data with cancer diagnoses recorded by the Alaska Native Tumor Registry (ANTR) through 12/31/15. We compared EARTH incidence to ANTR statewide incidence. We examined independent associations of smoking status, diet, BMI, and physical activity with incident all-site cancers using multivariable-adjusted Cox proportional hazards models. RESULTS Between study enrollment and 2015, 171 of 3,712 (4.7%) Alaska EARTH study participants were diagnosed with cancer. The leading cancers among Alaska EARTH participants were female breast, lung, and colorectal cancer, which reflected those observed among AN people statewide. Incidence (95% CI) of cancer (all sites) among Alaska EARTH participants was 629.7 (510.9-748.6) per 100,000 person-years; this was comparable to statewide rates [680.5 (660.0-701.5) per 100,000 population]. We observed lower risk of all-sites cancer incidence among never smokers. CONCLUSIONS Cancer incidence in the Alaska EARTH cohort was similar to incidence observed statewide. Risk and protective factors for leading cancers among AN people mirror those observed among other populations.
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Affiliation(s)
- Sarah H Nash
- Alaska Native Epidemiology Center, Alaska Native Tumor Registry, Community Health Services, Alaska Native Tribal Health Consortium, Anchorage, AK, USA.
| | - Gretchen Day
- Clinical and Research Services, Community Health Services, Alaska Native Tribal Health Consortium, Anchorage, AK, USA
| | - Garrett Zimpelman
- Alaska Native Epidemiology Center, Alaska Native Tumor Registry, Community Health Services, Alaska Native Tribal Health Consortium, Anchorage, AK, USA
| | | | - Kathryn R Koller
- Clinical and Research Services, Community Health Services, Alaska Native Tribal Health Consortium, Anchorage, AK, USA
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Manoharan A, Shewade DG, Ravindranath PA, Rajkumar RP, Ramprasad VL, Adithan S, Damodaran SE. Resequencing CYP2D6 gene in Indian population: CYP2D6*41 identified as the major reduced function allele. Pharmacogenomics 2019; 20:719-729. [PMID: 31368850 DOI: 10.2217/pgs-2019-0049] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Aim: The CYP2D6 gene is highly polymorphic and harbors population specific alleles that define its predominant metabolizer phenotype. This study aimed to identify polymorphisms in Indian population owing to scarcity of CYP2D6 data in this population. Materials & methods: The CYP2D6 gene was resequenced in 105 south Indians using next generation sequencing technology and haplotypes were reconstructed. Results & conclusion: Four novel missense variants have been designated as CYP2D6*110, *111, *112 and *113. The most common alleles were CYP2D6*1 (42%), *2 (32%), and *41 (12.3%) and diplotypes were CYP2D6*1/*2 (26%), *1/*1 (11%), *2/*41 (10%) and *1/*41 (7%) accounting for high incidence of extensive metabolizers in Indians.
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Affiliation(s)
- Aarthi Manoharan
- Department of Pharmacology, Jawaharlal Institute of Postgraduate Medical Education & Research, Puducherry 605006, India
| | - Deepak Gopal Shewade
- Department of Pharmacology, Jawaharlal Institute of Postgraduate Medical Education & Research, Puducherry 605006, India
| | | | - Ravi Philip Rajkumar
- Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education & Research, Puducherry 605006, India
| | | | - Surendiran Adithan
- Department of Pharmacology, Jawaharlal Institute of Postgraduate Medical Education & Research, Puducherry 605006, India
| | - Solai Elango Damodaran
- Department of Pharmacology, Jawaharlal Institute of Postgraduate Medical Education & Research, Puducherry 605006, India
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Cullen T, Flowers J, Sequist TD, Hays H, Biondich P, Laing MZ. Envisioning health equity for American Indian/Alaska Natives: a unique HIT opportunity. J Am Med Inform Assoc 2019; 26:891-894. [PMID: 31329880 PMCID: PMC6696492 DOI: 10.1093/jamia/ocz052] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 03/07/2019] [Accepted: 04/05/2019] [Indexed: 11/12/2022] Open
Abstract
The Indian Health Service provides care to remote and under-resourced communities in the United States. American Indian/Alaska Native patients have some of the highest morbidity and mortality among any ethnic group in the United States. Starting in the 1980s, the IHS implemented the Resource and Patient Management System health information technology (HIT) platform to improve efficiency and quality to address these disparities. The IHS is currently assessing the Resource and Patient Management System to ensure that changing health information needs are met. HIT assessments have traditionally focused on cost, reimbursement opportunities, infrastructure, required or desired functionality, and the ability to meet provider needs. Little information exists on frameworks that assess HIT legacy systems to determine solutions for an integrated rural healthcare system whose end goal is health equity. This search for a next-generation HIT solution for a historically underserved population presents a unique opportunity to envision and redefine HIT that supports health equity as its core mission.
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Affiliation(s)
- Theresa Cullen
- Center for Biomedical Informatics, Regenstrief Institute, Inc, Indianapolis, Indiana, USA
| | - Jan Flowers
- Biobehavioral Nursing and Health Informatics, School of Nursing, University of Washington, Seattle, Washington, USA
| | - Thomas D Sequist
- Division of General Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, USA
| | - Howard Hays
- Center for Biomedical Informatics, Regenstrief Institute, Inc, Indianapolis, Indiana, USA
| | - Paul Biondich
- Global Health Informatics, Center for Biomedical Informatics, Regenstrief Institute, Inc, Indianapolis, Indiana, USA
| | - Maia Z Laing
- Office of the Chief Technology Officer, U.S. Department of Health and Human Services, Washington, DC, USA
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Kumar A, Shariff M. Atherosclerostic cardiovascular disease risk score: Are Indians underestimating the risk of cardiovascular disease? Indian Heart J 2019; 71:364-365. [PMID: 31779868 PMCID: PMC6890962 DOI: 10.1016/j.ihj.2019.08.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 04/20/2019] [Accepted: 08/13/2019] [Indexed: 12/21/2022] Open
Affiliation(s)
- Ashish Kumar
- Resident, Department of Critical Care Medicine, St John's Medical College Hospital, Bangalore, India.
| | - Mariam Shariff
- Resident, Department of Critical Care Medicine, St John's Medical College Hospital, Bangalore, India
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Abstract
Nutrient requirements and recommended dietary allowances (RDAs) are set and revised periodically by the Indian Council of Medical Research. These are meant to guide the population and provide policy directions regarding nutrient requirements corresponding to a healthy population. This review article provides an overview of the current recommendations (RDA, 2010) and the challenges faced by the committee to contextualize RDA to the Indian scenario which has a background of double burden of malnutrition, diverse dietary habits but predominantly home-based cereal-pulse vegetarian diet with low bioavailability of several nutrients and lower consumption of packaged fortified foods. The need for country-specific requirements and harmonization of methodologies related to nutrient requirements and RDA are also discussed. The recommendations fixed for iron have been provided in detail as an example. The measures to carry forward RDA revisions to ensure its sustainability have been emphasized.
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Affiliation(s)
| | - Little Flower Augustine
- Tata-NIN Centre for Excellence in Community Nutrition, ICMR-National Institute of Nutrition, Hyderabad, India
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Enas EA, Varkey B, Dharmarajan TS, Pare G, Bahl VK. Lipoprotein(a): An underrecognized genetic risk factor for malignant coronary artery disease in young Indians. Indian Heart J 2019; 71:184-198. [PMID: 31543191 PMCID: PMC6796644 DOI: 10.1016/j.ihj.2019.04.007] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [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: 01/12/2019] [Revised: 03/14/2019] [Accepted: 04/26/2019] [Indexed: 02/06/2023] Open
Abstract
Malignant coronary artery disease (CAD) refers to a severe and extensive atherosclerotic process involving multiple coronary arteries in young individuals (aged <45 years in men and <50 years in women) with a low or no burden of established risk factors. Indians, in general, develop acute myocardial infarction (AMI) about 10 years earlier; AMI rates are threefold to fivefold higher in young Indians than in other populations. Although established CAD risk factors have a predictive value, they do not fully account for the excessive burden of CAD in young Indians. Lipoprotein(a) (Lp(a)) is increasingly recognized as the strongest known genetic risk factor for premature CAD, with high levels observed in Indians with malignant CAD. High Lp(a) levels confer a twofold to threefold risk of CAD-a risk similar to that of established risk factors, including diabetes. South Asians have the second highest Lp(a) levels and the highest risk of AMI from the elevated levels, more than double the risk observed in people of European descent. Approximately 25% of Indians and other South Asians have elevated Lp(a) levels (≥50 mg/dl), rendering Lp(a) a risk factor of great importance, similar to or surpassing diabetes. Lp(a) measurement is ready for clinical use and should be an essential part of all CAD research in Indians.
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Affiliation(s)
- Enas A Enas
- Coronary Artery Disease in Indians (CADI) Research Foundation, Lisle, IL, USA.
| | - Basil Varkey
- Medical College of Wisconsin, Milwaukee, WI, USA
| | | | | | - Vinay K Bahl
- Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India
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Beans JA, Saunkeah B, Brian Woodbury R, Ketchum TS, Spicer PG, Hiratsuka VY. Community Protections in American Indian and Alaska Native Participatory Research-A Scoping Review. Soc Sci (Basel) 2019; 8:127. [PMID: 31463160 DOI: 10.3390/socsci8040127] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Experiences with unethical research practices have caused some American
Indian and Alaska Native (AIAN) individuals, organizations, and tribes to
mistrust health research. To build trust and repair relationships, current
research with AIAN peoples often involves participatory research (PR)
approaches. This article assesses community-level protections described in the
scientific literature on PR involving AIAN communities. A scoping review search
in PubMed and PsychInfo for articles published between January 2000 and June
2017 yielded an AIAN PR article dataset. Of 178 articles, a subset of 23
articles that described aspects of community protections were analyzed for
descriptions of community-level protection practices. We identified the presence
or absence of a description of four community protection measures in each
article: a tribal research department, the development of community-level
mechanisms for research regulation if not present, community collaboration
throughout the research process, and project employment of a community member.
The development of community-level mechanisms for research regulation was
described in 39% of the articles. Ninety-one percent of these articles described
community collaboration during the research process. Seventeen percent included
descriptions of all four community-level protection measures. The extent and
consistency to which community-level protections are described is variable; the
current literature lacks reporting on community-level protection practices
specific to tribal communities.
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Abstract
PURPOSE Puberty onset exhibits remarkable inter-individual and ethnic differences. 5% of Chileans are indigenous but puberty ethnic disparities have not been studied. We aim for evaluating precocious puberty prevalence in children with Mapuche ancestry vs non-indigenous Chilean children (according to their surnames). METHODS Longitudinal cohort study: 1003 children (50.2% girls) participating in the Growth and Obesity Chilean Cohort Study (GOCS) were studied. Annual anthropometry was measured since 4-7 years. Subsequently, Tanner staging and anthropometry were measured every 6 months. In girls, Tanner stage was assessed by breast palpation and in boys by testicular volume measurements. The cohort was stratified in three groups depending on Mapuche surname numbers as follows: (A) no indigenous surnames (n = 811), (B) one to two indigenous surnames (n = 147), and (C) three or more indigenous surnames (n = 45). We evaluated the prevalence of precocious thelarche, pubarche, menarche and gonadarche (testicular volume ≥ 4 ml-G2), using a cutoff age of 8 years in girls and 9 years in boys while controlling for socioeconomic status, body mass index, waist circumference, IGF-1 and DHEAS at 7 years. RESULTS In girls, no significant differences were observed. On the contrary, in boys, precocious gonadarche prevalence was higher in group C (29.2%) vs group A (6.0%) and vs group B (10.5%) (p =0.001, p = 0.004, respectively). Increased precocious gonadarche and pubarche risks in group C were observed even after adjustment [OR 7.31; 95% IC (2.32-23.51); p = 0.001] and [OR 6.17, 95% CI (1.62-23.49); p = 0.008], respectively. CONCLUSION Indigenous origin in Chile is an independent risk factor for precocious gonadarche and pubarche in boys but not in girls.
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Affiliation(s)
- M Fernández
- Institute of Maternal and Child Research (IDIMI), Faculty of Medicine, University of Chile, Santa Rosa 1234, 2a Piso, PO Box 226-3, Santiago, Chile
| | - A Pereira
- Institute of Nutrition and Food Technology (INTA), Faculty of Medicine, University of Chile, Santiago, Chile
| | - C Corvalán
- Institute of Nutrition and Food Technology (INTA), Faculty of Medicine, University of Chile, Santiago, Chile
| | - V Mericq
- Institute of Maternal and Child Research (IDIMI), Faculty of Medicine, University of Chile, Santa Rosa 1234, 2a Piso, PO Box 226-3, Santiago, Chile.
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McCotter O, Kennedy J, McCollum J, Bartholomew M, Iralu J, Jackson BR, Haberling D, Benedict K. Coccidioidomycosis Among American Indians and Alaska Natives, 2001-2014. Open Forum Infect Dis 2019; 6:ofz052. [PMID: 30882015 DOI: 10.1093/ofid/ofz052] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 01/25/2019] [Accepted: 02/01/2019] [Indexed: 11/15/2022] Open
Abstract
Background American Indians and Alaska Natives (AI/ANs) may be uniquely vulnerable to coccidioidomycosis given the large population residing in the Southwestern United States. We describe coccidioidomycosis-associated hospitalizations and outpatient visits during 2001-2014 in the Indian Health Service (IHS) system and compare hospitalizations with data from the Agency for Healthcare Research and Quality's National (Nationwide) Inpatient Sample (NIS). Methods We identified hospitalizations in the IHS and the NIS and outpatient visits in the IHS using International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) codes 114.0-114.9. We calculated average annual hospitalization and outpatient visit rates per 1 000 000 population and used Poisson regression to calculate rate ratios (RRs) and 95% confidence intervals (CIs). We used multivariable logistic regression to assess factors associated with IHS hospitalization. Results AI/ANs had the highest average annual hospitalization rate (58.0; 95% CI, 49.5-66.6) of any racial/ethnic group in the NIS, compared with 13.4 (95% CI, 12.7-14.2) for non-Hispanic whites. IHS data showed a hospitalization rate of 37.0; the median length of stay (interquartile range) was 6 (3-10) days. The average annual outpatient visit rate in IHS was 764.2, and it increased from 529.9 in 2001 to 845.9 in 2014. Male sex, age ≥65 years, diabetes, and extrapulmonary or progressive coccidioidomycosis were independently associated with increased risk for hospitalization. Twenty-four percent of patients had ICD-9-CM codes for community-acquired pneumonia in the 3 months before coccidioidomycosis diagnosis. Conclusions AI/ANs experience high coccidioidomycosis-associated hospitalization rates, high morbidity, and possible missed opportunities for earlier diagnosis. Yearly trends in IHS data were similar to the general increase in hospitalizations and reported cases nationwide in the same period.
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Affiliation(s)
- Orion McCotter
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jordan Kennedy
- Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | | | | | - Brendan R Jackson
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Dana Haberling
- Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Kaitlin Benedict
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia
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Craig LB, Peck JD, Janitz AE. The prevalence of infertility in American Indian/Alaska Natives and other racial/ethnic groups: National Survey of Family Growth. Paediatr Perinat Epidemiol 2019; 33:119-125. [PMID: 30706501 PMCID: PMC6438739 DOI: 10.1111/ppe.12538] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 12/20/2018] [Accepted: 01/02/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND The prevalence of infertility in American Indian/Alaska Native (AI/AN) populations is unknown. The objective of our study was to estimate the prevalence of infertility and impaired fecundity in the AI/AN population and other racial and ethnic groups. METHODS We analyzed female respondent data from the pooled National Survey of Family Growth (NSFG) cycles 2002, 2006-2010, and 2011-2013. We used modified Poisson regression with robust error variance accounting for survey weighting to estimate prevalence proportion ratios (PPR) and 95% confidence intervals (CI) for NSFG definitions of infertility and impaired fecundity by race and Hispanic ethnicity. RESULTS The prevalence of infertility and impaired fecundity in the pooled NSFG was 6.4% (95% CI 5.7, 7.0) and 11.0% (95% CI 11.0, 12.2), respectively. Compared to whites, blacks had a 1.45 times greater adjusted prevalence of infertility (95% CI 1.15, 1.83) and AI/ANs had a 1.37 times greater prevalence of infertility (95% CI 0.91, 2.06) compared to whites. We observed a 1.30 times greater prevalence of impaired fecundity among AI/AN (95% CI 1.04, 1.62) compared to whites. We observed no differences in impaired fecundity for black or Asian/Pacific Islander women compared to whites or for Hispanic compared to non-Hispanic women. CONCLUSIONS Inequalities in the burden of reproductive impairments among blacks and AI/AN women warrant further evaluation to identify opportunities for prevention and disparity reduction.
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Affiliation(s)
- LaTasha B Craig
- Section of Reproductive Endocrinology & Infertility, Department of Obstetrics and Gynecology, College of Medicine, University of Oklahoma Health Science Center, Oklahoma City, Oklahoma
| | - Jennifer D Peck
- Department of Biostatistics and Epidemiology, College of Public Health, University of Oklahoma Health Science Center, Oklahoma City, Oklahoma
| | - Amanda E Janitz
- Department of Biostatistics and Epidemiology, College of Public Health, University of Oklahoma Health Science Center, Oklahoma City, Oklahoma
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45
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Enas EA, Varkey B, Dharmarajan TS, Pare G, Bahl VK. Lipoprotein(a): An independent, genetic, and causal factor for cardiovascular disease and acute myocardial infarction. Indian Heart J 2019; 71:99-112. [PMID: 31280836 PMCID: PMC6620428 DOI: 10.1016/j.ihj.2019.03.004] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [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: 01/01/2019] [Revised: 02/10/2019] [Accepted: 03/13/2019] [Indexed: 12/24/2022] Open
Abstract
Lipoprotein(a) [Lp(a)] is a circulating lipoprotein, and its level is largely determined by variation in the Lp(a) gene (LPA) locus encoding apo(a). Genetic variation in the LPA gene that increases Lp(a) level also increases coronary artery disease (CAD) risk, suggesting that Lp(a) is a causal factor for CAD risk. Lp(a) is the preferential lipoprotein carrier for oxidized phospholipids (OxPL), a proatherogenic and proinflammatory biomarker. Lp(a) adversely affects endothelial function, inflammation, oxidative stress, fibrinolysis, and plaque stability, leading to accelerated atherothrombosis and premature CAD. The INTER-HEART Study has established the usefulness of Lp(a) in assessing the risk of acute myocardial infarction in ethnically diverse populations with South Asians having the highest risk and population attributable risk. The 2018 Cholesterol Clinical Practice Guideline have recognized elevated Lp(a) as an atherosclerotic cardiovascular disease risk enhancer for initiating or intensifying statin therapy.
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Affiliation(s)
- Enas A Enas
- Coronary Artery Disease in Indians (CADI) Research Foundation, Lisle, IL USA.
| | - Basil Varkey
- Emeritus of Medicine, Medical College of Wisconsin, USA
| | - T S Dharmarajan
- Medicine, Albert Einstein College of Medicine, Bronx, NY, USA; Department of Medicine, Montefiore Medical Center (Wakefield Campus), Bronx, NY, USA
| | | | - Vinay K Bahl
- Department of Cardiology, All India Institute of Medical Sciences New Delhi, India
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Abstract
The purpose of this study was to understand what factors influenced work-family balance and related health behaviors among a sample of rural North American Indian women. We interviewed 89 women through both in-depth interviews and focus groups across four tribal communities in the American Southwest and Upper Midwest between July 2010 and August 2011. Interviews were transcribed, coded, and analyzed for emerging themes related to work- family demands placed on women and resources available to cope with those demands. Three prominent themes emerged: structural characteristics (the context of rural reservation life), role stressors (women's multiple and conflicting roles) and the influence of social support (communal nature of care in the family and institutional support in the workplace). We found that women in participating rural reservation communities often acted as primary caregivers for both immediate and extended family, and often placed the needs of others before themselves. The context of rural reservations, with high rates of unemployment, poverty, and chronic illnesses associated with the collective trauma of colonization, placed high demands on female caregivers. Social support from within the workplace, family, and cultural traditions helped some female caregivers balance the demands of home and work. Tribal worksites could be a resource for promoting health and work-life balance by being responsive to the particular demands placed on women that often interfere with engaging in positive health behaviors in general and tribal wellness programs in particular.
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Affiliation(s)
- Karina Christiansen
- a Department of Health Policy and Management , Johns Hopkins Bloomberg School of Public Health , Baltimore , USA
| | - Preety Gadhoke
- b Department of Pharmacy Administration and Public Health , College of Pharmacy and Health Sciences of St. John's University , Queens , USA
| | - Marla Pardilla
- c Center for Human Nutrition within the Department of International Health , Johns Hopkins Bloomberg School of Public Health , Baltimore , USA
| | - Joel Gittelsohn
- c Center for Human Nutrition within the Department of International Health , Johns Hopkins Bloomberg School of Public Health , Baltimore , USA
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Saxena A, Sharma G, Tyagi S, Mourya M, Coshic P, Tiwari PK, Mehra NK, Kanga U. HLA-A*02 repertoires in three defined population groups from North and Central India: Punjabi Khatries, Kashmiri Brahmins and Sahariya Tribe. HLA 2018; 93:16-23. [PMID: 30516033 DOI: 10.1111/tan.13447] [Citation(s) in RCA: 4] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 11/26/2018] [Accepted: 11/29/2018] [Indexed: 01/30/2023]
Abstract
The allelic family of HLA-A*02 with a repertoire of approximately 1022 alleles represents the predominant and most heterogeneous group at the HLA-A locus. This remarkable diversity signifies its evolutionary relevance. Its population-specific diversity is attributed to environmental factors and pathogen pressure and can be harnessed in biology and medicine, particularly in disease association and for HLA-based vaccination approaches. We therefore investigated the HLA-A*02 repertoire in two North Indian caste populations, viz Punjabi Khatries (PK, N = 250), Kashmiri Brahmins (KB, N = 160) and a Central Indian tribe Sahariya (ST, N = 100) using Luminex-based high-resolution rSSO method. When required, results were confirmed with high-resolution PCR-SSP and/or next-generation sequencing (NGS). In the three populations evaluated, HLA-A*02 was observed with an overall high phenotypic/allelic frequency, however, A*02 repertoire differed among them. A total of six alleles were observed (A*02:01, *02:03, *02:05, *02:06, *02:07 and *02:11) in the caste groups, compared with four (except *02:05 and *02:07) in the tribals. Our striking observation was the high occurrence of A*02:11 at the repertoire level (80.6% in ST, 39% in PK, 31.8% in KB). Globally, this allele is rare, observed with low frequencies in limited ethnic groups. The primordial A*02:01 allele, representative A*02 allele in most ethnicities was observed as the second predominant allele (PK = 27.3%, KB = 31.8% and ST = 11.9%). Extremely high occurrence of A*02:11 in ST may be representation of ancient Austro-Asiatic genetic pool. In caste populations, the observed A*02 repertoire may be a consequence of natural selection and/or admixture from different populations.
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Affiliation(s)
- Abhishweta Saxena
- Department of Transplant Immunology and Immunogenetics, All India Institute of Medical Sciences, New Delhi, India
| | - Gaurav Sharma
- Department of Transplant Immunology and Immunogenetics, All India Institute of Medical Sciences, New Delhi, India
| | - Shweta Tyagi
- Department of Transplant Immunology and Immunogenetics, All India Institute of Medical Sciences, New Delhi, India
| | - Manish Mourya
- Department of Transplant Immunology and Immunogenetics, All India Institute of Medical Sciences, New Delhi, India
| | - Poonam Coshic
- Department of Transfusion Medicine (Blood Bank), All India Institute of Medical Sciences, New Delhi, India
| | - Pramod K Tiwari
- Centre for Genomics Molecular and Human Genetics, School of studies in Zoology, Jiwaji University, Gwalior, India
| | - Narinder K Mehra
- Dr C.G Pandit National Chair and Former Dean (Research), All India Institute of Medical Sciences, New Delhi, India
| | - Uma Kanga
- Department of Transplant Immunology and Immunogenetics, All India Institute of Medical Sciences, New Delhi, India
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Paradkar MU, Shah SAV, Dherai AJ, Shetty D, Ashavaid TF. Distribution of CYP2D6 genotypes in the Indian population - preliminary report. Drug Metab Pers Ther 2018; 33:141-151. [PMID: 30098281 DOI: 10.1515/dmpt-2018-0011] [Citation(s) in RCA: 4] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2018] [Accepted: 05/16/2018] [Indexed: 11/15/2022]
Abstract
Abstract
Background
Cytochrome P450 2D6 (CYP2D6) allelic distribution exhibits differences amongst worldwide populations. There is lack of data from Mumbai, Western India, on the major CYP2D6 alleles *2, *3, *4, *5, *10 and *41, and gene multiplication alleles. Hence, the present study was undertaken to determine the distribution of these clinically relevant CYP2D6 alleles.
Methods
Fifty-two healthy individuals were screened using TaqMan SNP genotyping and copy number variation (CNV) assays by real-time polymerase chain reaction.
Results
The allele frequencies of CYP2D6*2, *3, *4, *5, *10 and *41 alleles were observed to be 30.8%, 0%, 11.5%, 3.9%, 19.2% and 17.3%, respectively. The frequency of CYP2D6 gene one copy, two copies, three copies and four copies were observed to be 7.7%, 76.9%, 13.5% and 1.9%, respectively. The predicted phenotype frequency was observed to be 78.9%, 3.9% and 9.6% for extensive, intermediate, and ultrarapid metabolizers, respectively, whereas poor metabolizers were not detected.
Conclusions
CYP2D6 allele frequencies showed heterogeneous distribution in the present study as compared to worldwide populations. High frequency of CYP2D6*41 allele, gene duplication alleles and UMs was observed. The scarcity and/or lack of data from the Indian population on these alleles further substantiates the need for screening of CYP2D6 genotyping.
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Affiliation(s)
- Minal U Paradkar
- Research Laboratories, P. D. Hinduja National Hospital and Medical Research Centre, Mahim, Mumbai, India
| | - Swarup A V Shah
- Research Laboratories, P. D. Hinduja National Hospital and Medical Research Centre, Mahim, Mumbai, India
| | - Alpa J Dherai
- Department of Biochemistry, P. D. Hinduja National Hospital and Medical Research Centre, Mahim, Mumbai, India
| | - Dhanashri Shetty
- Department of Biochemistry, P. D. Hinduja National Hospital and Medical Research Centre, Mahim, Mumbai, India
| | - Tester F Ashavaid
- Head - Department of Laboratory Medicine, Director - Lab Research, Department of Biochemistry, P. D. Hinduja National Hospital and Medical Research Centre, Veer Savarkar Marg, Mahim, Mumbai 400 016, India
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Bhanushali AA, Pradhan G, Contractor A, Das BR. Frequency and association of disabled homolog 2-interacting protein (DAB2IP) variant rs7025486 G>A with coronary artery disease risk in Indian population. Indian Heart J 2018; 70 Suppl 3:S480-S482. [PMID: 30595311 PMCID: PMC6309282 DOI: 10.1016/j.ihj.2018.06.016] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Accepted: 06/17/2018] [Indexed: 11/29/2022] Open
Abstract
Genome wide association study has identified rs7025486 G>A polymorphism within DAB2IP (Disabled homolog 2-interacting protein) gene with increased risk of coronary heart disease (CAD). In this study we have determined the frequency and association of rs7025486 with CAD in Indians. The study was performed on 214 patients with CAD and 125 controls. The 'AA' genotype was associated with an increased risk in the CAD age group <50 yrs as compared to CAD age group>50 yrs (OR 3.149; P 0.034) and controls >50 yrs (OR 3.430; P 0.080). The risk allele (A) was significantly associated with premature CAD.
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Affiliation(s)
- Aparna A Bhanushali
- Research and Development, SRL Ltd Prime Square Building, Plot No 1, S. V. Road, Goregaon (W), Mumbai, 400 062, India.
| | - Gayatri Pradhan
- Research and Development, SRL Ltd Prime Square Building, Plot No 1, S. V. Road, Goregaon (W), Mumbai, 400 062, India.
| | - A Contractor
- Sir H. N Reliance Foundation Hospital & Research Centre Raja Rammohan Roy Road, Prarthana Samaj, Khetwadi, Girgaon, Maharashtra, Mumbai, 400004, India.
| | - Bibhu R Das
- Research and Development, SRL Ltd Prime Square Building, Plot No 1, S. V. Road, Goregaon (W), Mumbai, 400 062, India.
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50
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Alexander S, John GT, Korula A, Vijayakumar TS, David VG, Mohapatra A, Valson AT, Jacob S, Koshy PM, Rajan G, John EE, Matthai SM, Jeyaseelan L, Ponnusamy B, Cook T, Pusey C, Daha MR, Feehally J, Barratt J, Varughese S. Protocol and rationale for the first South Asian 5-year prospective longitudinal observational cohort study and biomarker evaluation investigating the clinical course and risk profile of IgA nephropathy: GRACE IgANI cohort. Wellcome Open Res 2018; 3:91. [PMID: 30345379 PMCID: PMC6148466 DOI: 10.12688/wellcomeopenres.14644.1] [Citation(s) in RCA: 4] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/18/2018] [Indexed: 12/18/2022] Open
Abstract
Background: IgA nephropathy (IgAN) is the most common primary glomerulonephritis and an important cause of end-stage kidney disease. Unlike the slowly progressive course seen among Caucasian and East Asian subjects (actuarial survival 80-85% over 10 years), in India about 30-40% of patients have nephrotic syndrome and renal dysfunction at presentation and a 10-year renal survival of 35%, as reported from a retrospective registry. These observations cannot be entirely attributed to a lack of uniform screening protocols or late referral and attest to the probability that IgAN may not be the same disease in different parts of the world. Methods: We will prospectively recruit 200 patients with IgAN (the GRACE IgANI- Glomerular Research And Clinical Experiments- Ig A Nephropathy in Indians-cohort) and stratify them into low and high risk of progression based on published absolute renal risk scores. We will test the validity of this risk score in an unselected Indian IgAN population over a 5-year follow-up period. In parallel, we will undertake extensive exploratory serum, urine, renal and microbiome biomarker studies, firstly, to determine if the underlying pathogenic pathways are the same in Indian IgAN compared to those reported in Caucasian and East Asian IgAN. Secondly, we will systematically assess the value of measuring selected biomarkers and adding this data to traditional measures of risk in IgAN to predict kidney failure. We ultimately hope to generate a composite IgAN risk score specific for the Indian population. Ethics and data dissemination: Approval was obtained from the Institutional Review Board (Silver, Research and Ethics Committee) of the Christian Medical College, Vellore, India (Ref. No. IRB Min. No. 8962 [Other] dated 23.07.2014 and IRB Min. No. 9481 [Other] dated 24.06.2015). It is anticipated that results of this study will be presented at national and international meetings, with reports being published from late 2018.
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Affiliation(s)
- Suceena Alexander
- Department of Nephrology, Christian Medical College, Vellore, Tamil Nadu, 632004, India
| | - George T John
- Department of Renal Medicine, Royal Brisbane and Women's Hospital, Queensland, 4029, Australia
| | - Anila Korula
- Department of General Pathology, Christian Medical College, Vellore, Tamil Nadu, 632004, India
| | - T S Vijayakumar
- Department of Nephrology, Christian Medical College, Vellore, Tamil Nadu, 632004, India
| | - Vinoi George David
- Department of Nephrology, Christian Medical College, Vellore, Tamil Nadu, 632004, India
| | - Anjali Mohapatra
- Department of Nephrology, Christian Medical College, Vellore, Tamil Nadu, 632004, India
| | - Anna T Valson
- Department of Nephrology, Christian Medical College, Vellore, Tamil Nadu, 632004, India
| | - Shibu Jacob
- Department of Nephrology, Christian Medical College, Vellore, Tamil Nadu, 632004, India
| | - Pradeep Mathew Koshy
- Department of Nephrology, Christian Medical College, Vellore, Tamil Nadu, 632004, India
| | - Gautam Rajan
- Department of Nephrology, Christian Medical College, Vellore, Tamil Nadu, 632004, India
| | - Elenjickal Elias John
- Department of Nephrology, Christian Medical College, Vellore, Tamil Nadu, 632004, India
| | - Smita Mary Matthai
- Central Electron Microscope Unit, Christian Medical College, Vellore, Tamil Nadu, 632004, India
| | - L Jeyaseelan
- Department of Biostatistics, Christian Medical College, Vellore, Tamil Nadu, 632004, India
| | - Babu Ponnusamy
- Centre for Cellular and Molecular Platforms, Bengaluru, Karnataka, 560065, India
| | - Terence Cook
- Centre for Complement and Inflammation Research, Imperial College, London, UK
| | - Charles Pusey
- Department of Medicine, Imperial College Healthcare NHS Trust, London, UK
| | - Mohamed R Daha
- Rijksuniversiteit Groningen Faculteit Biologie, Groningen, Netherlands
| | - John Feehally
- University of Leicester, College of Medicine Biological Sciences and Psychology, Leicester, UK
| | - Jonathan Barratt
- University of Leicester, College of Medicine Biological Sciences and Psychology, Leicester, UK
| | - Santosh Varughese
- Department of Nephrology, Christian Medical College, Vellore, Tamil Nadu, 632004, India
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