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2.
J Environ Manage ; 306: 114474, 2022 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-35026717

RESUMO

Solvent extraction separation of molybdenum (Mo) from the sulphate mediated leach solution bearing Aluminium (Al) and Nickel (Ni) was carried out using N-Methyl-N, N, N-tri-octyl-ammonium chloride. Extensive investigation for extraction study molybdenum in the function of time, Eq.pH, extractant concentration, diluents, temperature, strip solution concentration and phase ratio(A:O) for both extraction and stripping was examined to attain a suitable condition on its selective and enriched extraction. As per the equilibrium study and increasing trend of Eq. pH (pHe) at the correspondence initial pH, it was apparent about association of 1 mol of H+ ion during extraction which with was further supported on extraction of Mo as HMO4- at the pHe of 3.48. The association of 1 mol of exrractant during the extraction of Mo was also well evident from the slope analysis study. This indicates about anion exchange phenomenon due to Cl- ion of the N-Methyl-N, N, N-tri-octyl-ammonium chloride (extractant) with HMo4- from aqueous phase during complex formation reaction. The FTIR of the organic sample before and after extraction further confirms in support of the complex formation of the molybdenum with the extractant during extraction. The extraction isotherm was constructed at optmum extraction condition: pHe of 3.48 with 0.08M N-Methyl-N, N, N-tri-octyl-ammonium chloride predicts on need of 2-counter current stages for quantitative extraction of Mo at A:O = 3:1. To investigate the regeneration behaviour of adopted extractant along with enriched stripping of molybdenum, ammoniacal reagents were used in stripping study. The stripping of Mo showed promising and efficient using the mixture of the ammoniacal reagents (NH4OH + NH4Cl) over the either of the solo reagents. The stripping Mc-Cabe Thiele diagram was plotted using 2M NH4OH + NH4Cl ensures on quantitative stripping of Mo at SO: SS = 2:1 at 2 no. of stages. Both extraction and stripping isotherm results are validated at predicted isotherm conditions by 6-cycles counter current simulation (CCS) study leading to obtain 6-fold enrichment of Mo in stripped solution phase. The subsequent enriched content of Mo (∼60 g/L) in stripped solution phase was precipitated out followed by calcinations 400 °C to obtain a high pure MoO3. The recovered calcined product as MoO3 resulted through the proposed processing approach was as ascertained from XRD analysis.


Assuntos
Molibdênio , Níquel , Alumínio , Catálise , Sulfatos
3.
Geophys Res Lett ; 48(20): e2021GL093796, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34924636

RESUMO

Aerosols emitted in densely populated and industrialized Indo-Gangetic Plain, one of the most polluted regions in the world, modulate regional climate, monsoon, and Himalayan glacier retreat. Thus, this region is important for understanding aerosol perturbations and their resulting impacts on atmospheric changes during COVID-19 lockdown period, a natural experimental condition created by the pandemic. By analyzing 5 years (2016-2020) data of aerosols and performing a radiative transfer calculation, we found that columnar and near-surface aerosol loadings decreased, leading to reductions in radiative cooling at the surface and top of the atmosphere and atmospheric warming during lockdown period. Further, satellite data analyses showed increases in cloud optical thickness and cloud-particle effective radius and decrease in lower tropospheric air temperature during lockdown period. These results indicate critical influences of COVID-19 lockdown on regional climate and water cycle over Indo-Gangetic Plain, emphasizing need for further studies from modeling perspectives.

5.
J Postgrad Med ; 65(3): 134-140, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31169130

RESUMO

Introduction: Body adiposity measured by percentage of body fat (BF%) is found to be better predictor of cardiovascular morbidity and mortality than body mass index (BMI). Limited information exists showing relationship between BMI and BF% in North Indian population. Objectives: To study the relationship between BMI and BF% among North Indian adult females across various age strata and level of BMI. Materials and Methods: This was a cross-sectional study conducted at Ballabgarh Health and Demographic Surveillance Site (HDSS) among randomly selected females. BMI using standard techniques and BF% using bioelectrical impedance analysis was estimated. Linear regression was performed using general linear model with BF% as dependent variable and BMI as main independent variable. Results: Mean (±2 SD) age of participants was 41.3 ± 15.7 years. Mean BMI (±SD) was 23.3 (±4.6) kg/m2, whereas mean fat mass (±2 SD) and BF% (±95% CI) was 19.2 (±7.9) kg and 33.6 (±6.9) %. BMI and BF% were highly correlated among obese (r = 0.77), whereas least correlated (r = 0.32) in underweight females. Across age strata, correlation between BMI and BF% was maximum in 18-35 years age group (r = 0.95), whereas least in females ≥56 years (r = 0.67). Age and BMI together predicted 73% of variability in BF% in hierarchical linear regression model. Conclusions: In this population, we have found strong correlation between BMI and BF% particularly at higher level of BMI and in younger females. There is need to conduct more robust prospective longitudinal studies to assess BF%, which is a better predictor of cardiovascular morbidity and mortality.


Assuntos
Tecido Adiposo , Índice de Massa Corporal , Obesidade/epidemiologia , Vigilância da População , Magreza/epidemiologia , Adiposidade , Adolescente , Adulto , Estudos Transversais , Impedância Elétrica , Feminino , Humanos , Índia/epidemiologia , Modelos Lineares , Pessoa de Meia-Idade , População Rural/estatística & dados numéricos , Adulto Jovem
6.
Helminthologia ; 55(3): 230-239, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31662651

RESUMO

Snakehead fishes are widely consumed throughout South East Asia, China and India because of their good taste of meat and high nutrient values such as presence of prostaglandins, thromboxane and Omega-6 fatty acid. Parasitic infection constitutes significant economic loss in fish production. The aim of this work was to study the seasonal variation of helminths in snakeheads. In the presented study, a three-year survey has been performed. A total of 1013 individuals of Channa punctatus and 247 individuals of Channa striatus were examined. A total of 3783 helminths were collected, with an average of 3.02 helminths/fish. 43.50 % individuals of C. punctatus and 59.10 % of C. striatus were found to be infected with acanthocephalans, trematodes, nematodes and cestodes per year. The prevalence and mean abundance of Pallisentis sp. was at its peak in summer. However the prevalence of trematodes, nematodes and cestodes was at peak during autumn. Mean abundance of nematodes was at peak in summer. Interestingly, the males were found more infected as compared to the females and the infection rate in males peaked in summer. In comparison to other weight groups, medium size hosts (21 - 40 g) were found more consistently infected. Thus the results indicate that there are seasonal variations in parasitic helminths infecting C. punctatus and C. striatus which also depend upon sex and weight. These variations may be attributed to various environmental and biological factors including parasite life cycle and immune level of host.

7.
Clin Exp Immunol ; 191(3): 318-327, 2018 03.
Artigo em Inglês | MEDLINE | ID: mdl-29058314

RESUMO

Visceral leishmaniasis (VL) is a disseminated and lethal disease of reticulo-endothelial system caused by protozoan parasites Leishmania donovani and L. infantum, which are known to induce host T cell suppression. To understand the impact of parasite load on T cell function, the present was focused on parasite load with T cell function in bone marrow of 26 VL patients. We observed significant enrichment of forkhead box protein 3 (FoxP3)+ (P = 0·0003) and interleukin (IL)-10+ FoxP3+ regulatory T cells (Treg ) (P = 0·004) in the bone marrow (BM) of patients with high parasite load (HPL) compared with low parasite load (LPL). Concordantly, T effector cells producing interferon (IFN)-γ (P = 0·005) and IL-17A (P = 0·002) were reduced in the BM of HPL. Blocking of Treg -cell derived suppressive cytokines [(IL-10 and transforming growth factor (TGF)-ß] rescued the effector T cells and their functions. However, it was observed that TGF-ß levels were dominant, favouring Treg cell differentiation. Furthermore, the low ratio of IL-6/TGF-ß favours the suppressive milieu in HPL patients. Here we show the change in levels of various cytokines with the parasitic load during active VL, which could be helpful in devising newer immunotherapeutic strategies against this disease.


Assuntos
Medula Óssea/patologia , Leishmania donovani/fisiologia , Leishmaniose Visceral/imunologia , Subpopulações de Linfócitos T/imunologia , Linfócitos T Reguladores/imunologia , Adolescente , Adulto , Anticorpos Bloqueadores/farmacologia , Células Cultivadas , Criança , Citocinas/metabolismo , Feminino , Fatores de Transcrição Forkhead/metabolismo , Humanos , Terapia de Imunossupressão , Leishmaniose Visceral/parasitologia , Ativação Linfocitária , Masculino , Pessoa de Meia-Idade , Carga Parasitária , Adulto Jovem
8.
J Perinatol ; 37(8): 911-921, 2017 08.
Artigo em Inglês | MEDLINE | ID: mdl-28492525

RESUMO

OBJECTIVE: To examine the timing and microbiology of neonatal sepsis in a population-based surveillance in the Indian community setting. STUDY DESIGN: All live born infants in 223 villages of Odisha state were followed at home for 60 days. Suspect sepsis cases were referred to study hospitals for further evaluation including blood culture. RESULTS: Of 12 622 births, 842 were admitted with suspected sepsis of whom 95% were 4 to 60 days old. Culture-confirmed incidence of sepsis was 6.7/1000 births with 51% Gram negatives (Klebsiella predominating) and 26% Gram positives (mostly Staphylococcus aureus). A very high level of resistance to penicillin and ampicillin, moderate resistance to cephalosporins and extremely low resistance to Gentamicin and Amikacin was observed. CONCLUSION: The bacterial burden of sepsis in the Indian community is not high. Judicious choice of empiric antibiotics, antibiotic stewardship and alternate modalities should be considered for the management or prevention of neonatal sepsis in India.


Assuntos
Antibacterianos , Klebsiella , Sepse Neonatal , Staphylococcus aureus , Antibacterianos/classificação , Antibacterianos/uso terapêutico , Gerenciamento Clínico , Resistência Microbiana a Medicamentos , Feminino , Humanos , Incidência , Índia/epidemiologia , Recém-Nascido , Klebsiella/efeitos dos fármacos , Klebsiella/isolamento & purificação , Masculino , Sepse Neonatal/epidemiologia , Sepse Neonatal/microbiologia , Sepse Neonatal/prevenção & controle , Staphylococcus aureus/efeitos dos fármacos , Staphylococcus aureus/isolamento & purificação
9.
Bioorg Med Chem ; 25(6): 1725-1736, 2017 03 15.
Artigo em Inglês | MEDLINE | ID: mdl-28202315

RESUMO

Mycobacterium tuberculosis chorismate mutase (MtbCM) catalyzes the rearrangement of chorismate to prephenate in the shikimate biosynthetic pathway to form the essential amino acids, phenylalanine and tyrosine. Two genes encoding chorismate mutase have been identified in Mtb. The secretory form,∗MtbCM (encoded by Rv1885c) is assumed to play a key role in pathogenesis of tuberculosis. Also, the inhibition of MtbCM may hinder the supply of nutrients to the organism. Indeed, the existence of chorismate mutase (CM) in bacteria, fungi and higher plants but not in human and low sequence homology among known CM makes it an interesting target for the discovery of anti-tubercular agents. The present article mainly focuses on the recent developments in the structure, function and inhibition of MtbCM. The understanding of various aspects of MtbCM as presented in the current article may facilitate the design and subsequent chemical synthesis of new inhibitors against ∗MtbCM, that could lead to the discovery and development of novel and potent anti-tubercular agents in future.


Assuntos
Corismato Mutase/metabolismo , Mycobacterium tuberculosis/enzimologia , Sequência de Aminoácidos , Antituberculosos/farmacologia , Corismato Mutase/antagonistas & inibidores , Corismato Mutase/química , Inibidores Enzimáticos/farmacologia , Modelos Moleculares , Conformação Proteica , Homologia de Sequência de Aminoácidos
10.
Parasite Immunol ; 37(7): 368-75, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-25824598

RESUMO

Isolation of the soluble exogenous antigens (SEAgs), its immune response study and proteome profiling is an essential prerequisite for understanding the molecular pathogenesis of Leishmania donovani. The immunostimulatory potential of L. donovani SEAgs, purified from culture of L. donovani clinical isolate, was evaluated for their ability to induce cellular responses in treated/cured hamsters. SEAgs induced significant proliferative responses in lymphocytes (SI 5.6 ± 2.3; P < 0.01) isolated from cured hamster. In addition, significant NO production in response to SEAgs was also noticed in macrophages of hamsters, mouse and human cell lines (J774A-1 and THP1). Western blot analyses with antibodies against proteophosphoglycan (PPG; surface-expressed and secreted molecule) of L. donovani revealed that PPG molecules are also present in L. donovani SEAgs. Mass spectrometry (MS)-based proteome analysis of 12 protein bands of SEAgs through MALDI-TOF/TOF endorsed the identification of some Th1-stimulatory immunogenic proteins. These immunogenic proteins may offer increased hope for the discovery of new promising vaccine candidates against visceral leishmaniasis (VL). The overall results suggest that immunostimulatory molecules are present in the SEAgs, which may be further exploited, for developing a subunit vaccine against VL a fatal human disease.


Assuntos
Antígenos de Protozoários/imunologia , Leishmania donovani/imunologia , Leishmaniose Visceral/imunologia , Macrófagos/imunologia , Animais , Anticorpos/imunologia , Antígenos de Protozoários/isolamento & purificação , Linhagem Celular , Proliferação de Células , Cricetinae , Humanos , Imunização , Ativação Linfocitária/imunologia , Linfócitos/imunologia , Ativação de Macrófagos/imunologia , Masculino , Camundongos , Proteoma/imunologia
12.
J Postgrad Med ; 60(3): 276-81, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25121367

RESUMO

CONTEXT: Migrant workers constitute an important risk group for Human Immunodeficiency Virus/Acquired Immuno-Deficiency Syndrome transmission in India. Alcohol consumption before sexual intercourse has been postulated to influence condom use practices. This study aimed to assess this association with regard to non-spousal sexual encounters among male migrant workers in northern India. MATERIALS AND METHODS: A cross-sectional facility-based survey was conducted in 2011. Male migrant workers aged ≥18 years, who were born outside Haryana, who had moved to the current location after 15 years of age,had worked in the current factory for at least 1 year, who were willing to participate and were able to give written, informed consent were included in the study. A consecutive sampling was performed. Descriptive, bivariate and multiple logistic regression analyses were carried out. RESULTS: A total of 162 participants reported having experienced non-spousal sexual encounters in the last 1 year. The proportion of men who reported not having used a condom at their last non-spousal sexual encounter was 59.3%, and 78.4% of the men reported having consumed alcohol in the last 1 year. About 48.1% of men reported having consumed alcohol before their last non-spousal sexual encounter. Men who consumed alcohol were three times more likely to not use a condom at their last non-spousal sexual encounter (OR = 3.1, 95% CI: 1.5-6.4). This association persisted even after adjusting for relevant confounders. CONCLUSION: Alcohol consumption had a negative influence on condom use during non-spousal sexual encounter among male migrant workers. An integrated approach to promote condom use and reduce alcohol consumption among migrant men needs to be undertaken through targeted intervention strategies.


Assuntos
Preservativos/estatística & dados numéricos , Comportamento Sexual/estatística & dados numéricos , Migrantes/estatística & dados numéricos , Adulto , Consumo de Bebidas Alcoólicas/epidemiologia , Estudos Transversais , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Índia , Entrevistas como Assunto , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Comportamento Sexual/etnologia , População Urbana
13.
Br J Pharmacol ; 171(17): 4038-50, 2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-24837879

RESUMO

BACKGROUND AND PURPOSE: The aim of the present study was to evaluate the immunomodulatory and chemotherapeutic potential of alginate-(SA) coated nanocapsule (NCs) loaded with doxorubicin (SA-NCs-DOX) against visceral leishmaniasis in comparison with nano-emulsions containing doxorubicin (NE-DOX). EXPERIMENTAL APPROACH: NE-DOX was prepared using low-energy emulsification methods. Stepwise addition of protamine sulphate and SA in a layer-by-layer manner was used to form SA-NCs-DOX. SA-NCs-DOX, NE-DOX and Free DOX were compared for their cytotoxicity against Leishmania donovani-infected macrophages in vitro and generation of T-cell responses in infected hamsters in vivo. KEY RESULTS: Size and ζ potential of the NE-DOX and SA-NCs-DOX formulations were 310 ± 2.1 nm and (-)32.6 ± 2.1 mV, 342 ± 4.1 nm and (-)29.3 ± 1.2 mV respectively. SA-NCs-DOX was better (1.5 times) taken up by J774A.1 macrophages compared with NE-DOX. SA-NCs -DOX showed greater efficacy than NE-DOX against intramacrophagic amastigotes. SA-NCs-DOX treatment exhibited enhanced apoptotic efficiency than NE-DOX and free DOX as evident by cell cycle analysis, decrease in mitochondrial membrane potential, ROS and NO production. T-cell responses, when assessed through lymphoproliferative responses, NO production along with enhanced levels of iNOS, TNF-α, IFN-γ and IL-12 were found to be up-regulated after SA-NCs-DOX, compared with responses to NE-DOX in vivo. Parasitic burden was decreased in Leishmania-infected hamsters treated with SA-NCs-DOX, compared with NE-DOX. CONCLUSIONS AND IMPLICATIONS: Our results provide insights into the development of an alternative approach to improved management of leishmaniasis through a combination of chemotherapy with stimulation of the innate immune system.


Assuntos
Alginatos/farmacologia , Antiprotozoários/farmacologia , Materiais Revestidos Biocompatíveis/farmacologia , Daunorrubicina/farmacologia , Leishmania donovani/efeitos dos fármacos , Nanocápsulas/química , Células Th1/efeitos dos fármacos , Alginatos/administração & dosagem , Alginatos/química , Animais , Antiprotozoários/administração & dosagem , Antiprotozoários/química , Linhagem Celular , Materiais Revestidos Biocompatíveis/administração & dosagem , Materiais Revestidos Biocompatíveis/química , Cricetinae , Daunorrubicina/administração & dosagem , Daunorrubicina/química , Ácido Glucurônico/administração & dosagem , Ácido Glucurônico/química , Ácido Glucurônico/farmacologia , Ácidos Hexurônicos/administração & dosagem , Ácidos Hexurônicos/química , Ácidos Hexurônicos/farmacologia , Leishmania donovani/imunologia , Macrófagos/efeitos dos fármacos , Macrófagos/imunologia , Macrófagos/parasitologia , Masculino , Camundongos , Células Th1/imunologia
14.
Indian J Clin Biochem ; 29(2): 213-20, 2014 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-24757305

RESUMO

Cancer cells generally exhibit increased glycolysis for ATP generation (the Warburg effect). Compounds that inhibit glycolysis have potential applications in cancer treatment. dl-glyceraldehyde (DLG) and 2-Deoxyglucose (2-DG) have been proven effective in the inhibition of glucose metabolism. Ehrlich ascites carcinoma (EAC) cells were injected intraperitoneally (i.p) in 10-12 weeks old Swiss albino mice, weighing between 20 and 30 g. The anticancer activity of DLG and 2-DG were determined by tumor volume, tumor weight, viable and nonviable tumor cell count, average survival time, percentage increase in life span and tumor inhibition ratio. The blood samples were obtained for biochemical analysis after 9 days of treatment to study the effect on liver, kidney and haematological parameters. Histopathological examination of liver and kidney was also performed. One-way ANOVA test and Dunnett's test were used for comparisons of parameters in study groups. Both DLG and 2-DG individually decreased the tumor weight, tumor volume, viable tumor cell count and significantly increased the life span of treated mice, however the combination was found to be better. The biochemical parameters of liver and kidney functions and haematological parameters were restored close to control group as compared with the EAC bearing mice. Histopathological examination of liver and kidney in EAC control group showed large areas of necrosis, congestion and mononuclear cell infiltration but such changes were not observed in liver and kidney sections observed after i.p injection of DLG and 2-DG for 9 days. Improvement was much better in the group where combination of these two drugs were used.

15.
Natl Med J India ; 27(3): 152-8, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25668088

RESUMO

BACKGROUND: The goal of medical education is to ensure that the medical graduate has acquired broad public health competencies needed to solve the health problems of the community. We present the current teaching of community medicine to medical students of the All India Institute of Medical Sciences (AIIMS), New Delhi during their 5-week posting at the rural centre at Ballabgarh, Haryana. METHODS: The teaching activities consist of field visits to different levels of health facilities and meeting with health workers, epidemiological exercises, a community-based exercise, posting in inpatient and outpatient departments of a secondary hospital, and domiciliary visits to families of patients. These are spread over 80 sessions of about 200 hours. There is very little didactic teaching and the assessment is broad-based. The evaluation of the posting was based on comparison of blinded pre- and post-posting assessments as well as anonymous feedback of the posting by the students. RESULTS: There was a significant increase in the mean scores of all components of the posting-epidemiology (5.1 to 8.4), health systems (6.8 to 9.3) and clinical (8.0 to 10.8). The posting did not result in a better understanding of a public health approach as compared to a clinical approach. The feedback provided by students was generally positive for all activities with 94% of them rating it as good or very good. CONCLUSION: The teaching of community medicine can be made more practical and interesting without compromising on learning. However, despite such a programme, getting medical students to develop a public health approach is a daunting task.


Assuntos
Estágio Clínico , Medicina Comunitária/educação , Educação de Graduação em Medicina , Serviços de Saúde Rural , Humanos , Índia , Faculdades de Medicina
17.
J Bone Joint Surg Br ; 94(4): 523-8, 2012 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-22434470

RESUMO

We describe 261 peripheral nerve injuries sustained in war by 100 consecutive service men and women injured in Iraq and Afghanistan. Their mean age was 26.5 years (18.1 to 42.6), the median interval between injury and first review was 4.2 months (mean 8.4 months (0.36 to 48.49)) and median follow-up was 28.4 months (mean 20.5 months (1.3 to 64.2)). The nerve lesions were predominantly focal prolonged conduction block/neurapraxia in 116 (45%), axonotmesis in 92 (35%) and neurotmesis in 53 (20%) and were evenly distributed between the upper and the lower limbs. Explosions accounted for 164 (63%): 213 (82%) nerve injuries were associated with open wounds. Two or more main nerves were injured in 70 patients. The ulnar, common peroneal and tibial nerves were most commonly injured. In 69 patients there was a vascular injury, fracture, or both at the level of the nerve lesion. Major tissue loss was present in 50 patients: amputation of at least one limb was needed in 18. A total of 36 patients continued in severe neuropathic pain. This paper outlines the methods used in the assessment of these injuries and provides information about the depth and distribution of the nerve lesions, their associated injuries and neuropathic pain syndromes.


Assuntos
Militares/estatística & dados numéricos , Traumatismos dos Nervos Periféricos/epidemiologia , Guerra , Adolescente , Adulto , Campanha Afegã de 2001- , Inglaterra/epidemiologia , Explosões/estatística & dados numéricos , Feminino , Fraturas Ósseas/epidemiologia , Fraturas Ósseas/etiologia , Humanos , Guerra do Iraque 2003-2011 , Masculino , Traumatismo Múltiplo/epidemiologia , Traumatismo Múltiplo/etiologia , Traumatismo Múltiplo/cirurgia , Neuralgia/epidemiologia , Neuralgia/etiologia , Traumatismos dos Nervos Periféricos/etiologia , Traumatismos dos Nervos Periféricos/cirurgia , Lesões dos Tecidos Moles/epidemiologia , Lesões dos Tecidos Moles/etiologia , Índices de Gravidade do Trauma , Adulto Jovem
18.
J Bone Joint Surg Br ; 94(4): 529-35, 2012 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-22434471

RESUMO

The outcomes of 261 nerve injuries in 100 patients were graded good in 173 cases (66%), fair in 70 (26.8%) and poor in 18 (6.9%) at the final review (median 28.4 months (1.3 to 64.2)). The initial grades for the 42 sutures and graft were 11 good, 14 fair and 17 poor. After subsequent revision repairs in seven, neurolyses in 11 and free vascularised fasciocutaneous flaps in 11, the final grades were 15 good, 18 fair and nine poor. Pain was relieved in 30 of 36 patients by nerve repair, revision of repair or neurolysis, and flaps when indicated. The difference in outcome between penetrating missile wounds and those caused by explosions was not statistically significant; in the latter group the onset of recovery from focal conduction block was delayed (mean 4.7 months (2.5 to 10.2) vs 3.8 months (0.6 to 6); p = 0.0001). A total of 42 patients (47 lower limbs) presented with an insensate foot. By final review (mean 27.4 months (20 to 36)) plantar sensation was good in 26 limbs (55%), fair in 16 (34%) and poor in five (11%). Nine patients returned to full military duties, 18 to restricted duties, 30 to sedentary work, and 43 were discharged from military service. Effective rehabilitation must be early, integrated and vigorous. The responsible surgeons must be firmly embedded in the process, at times exerting leadership.


Assuntos
Militares/estatística & dados numéricos , Traumatismos dos Nervos Periféricos/cirurgia , Guerra , Adolescente , Adulto , Explosões/estatística & dados numéricos , Feminino , Humanos , Masculino , Traumatismo Múltiplo/etiologia , Traumatismo Múltiplo/reabilitação , Traumatismo Múltiplo/cirurgia , Condução Nervosa , Neuralgia/etiologia , Neuralgia/cirurgia , Traumatismos dos Nervos Periféricos/etiologia , Traumatismos dos Nervos Periféricos/reabilitação , Nervo Fibular/lesões , Nervo Fibular/fisiopatologia , Nervo Fibular/cirurgia , Prognóstico , Recuperação de Função Fisiológica , Reoperação/métodos , Limiar Sensorial , Lesões dos Tecidos Moles/etiologia , Lesões dos Tecidos Moles/reabilitação , Lesões dos Tecidos Moles/cirurgia , Retalhos Cirúrgicos , Nervo Tibial/lesões , Nervo Tibial/fisiopatologia , Nervo Tibial/cirurgia , Índices de Gravidade do Trauma , Resultado do Tratamento , Ferimentos Penetrantes/cirurgia , Adulto Jovem
19.
Indian Pediatr ; 49(4): 291-4, 2012 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-21992859

RESUMO

OBJECTIVE: To identify the determinants of neonatal mortality. STUDY DESIGN: Nested case-control study. STUDY SETTING: 28 villages under the intensive field practice area of Comprehensive Rural Health Services Project, Ballabgarh, Haryana serving a population of 87,016, as on 31st December 2009. The study period was from 2005 to 2009. METHODS: The data were obtained from Health Management Information System and analyzed using multivariate logistic regression analysis. A hierarchical approach was used to analyze the factors associated with neonatal deaths, using community level factors, socio-economic status and biological determinants. The population attributable fractions were estimated for significant variables. RESULTS: The total live births during the study period were 10392 and neonatal deaths were 248. The infant and neonatal mortality rates during the study period were 45.6 and 23.8 per 1000 live births, respectively. Socio-economic determinants (Low educational status of parents [OR 2.1, 95% CI; 1.4, 3.3]; fathers occupation [OR 1.8, 95% CI; 1.0, 3.0]; Rajput caste [OR 2.0, 95% CI; 1.2, 3.4] appeared to explain a major fraction (45.7%) of neonatal deaths. Community level factors (villages with no health facility [OR 1.5, 95% CI; 1.0, 2.1]; villages with population >6000 [OR 1.7, 95% CI; 1.2, 2.5]) were associated with 27.3% of all neonatal deaths. Proximate determinants (early childbearing age of mother (<20 years) [OR 2.0, 95% CI; 1.2, 3.2]) were least important. All the three level of variables seemed to act independently with little mediation among them. CONCLUSION: Neonatal mortality is affected by socioeconomic, community level and proximate biological determinants.


Assuntos
Mortalidade Infantil , População Rural/estatística & dados numéricos , Adulto , Feminino , Humanos , Índia/epidemiologia , Recém-Nascido , Modelos Logísticos , Masculino , Razão de Chances , Curva ROC , Estudos Retrospectivos , Fatores de Risco , Fatores Socioeconômicos
20.
Indian J Nephrol ; 22(6): 438-43, 2012 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-23440952

RESUMO

The burden of noncommunicable diseases is rising in India. A high prevalence of lifestyle-related diseases in perimenopausal women in the community makes them vulnerable to chronic kidney diseases (CKD). A cross-sectional community-based study was carried out among women >35 years of age in the village of Ballabgarh, Haryana (north India). Eligible women were selected by the probability proportionate to size sampling method. Estimation of glomerular filtration rate (GFR) was carried out by using the age- and body surface area (BSA)-adjusted Cockcroft-Gault (CG) and modification of diet in renal disease (MDRD) equations. Association of risk factors such as obesity, hyperlipidemia, hypertension, and diabetes mellitus with CKD was also assessed using multivariate logistic regression analysis. A total of 455 women were studied. The prevalence of low GFR (<60 mL/min/1.73 m(2)) by the CG/BSA equations and MDRD equation was found to be 18.2% (95% confidence interval 14.6, 21.8) and 5.9% (95% confidence interval 3.7, 8.1), respectively. Obesity (odds ratio 15.5) (P = 0.002), hyperlipidemia (odds ratio: 2.5) (P = 0.017), and age (P < 0.001) were significantly associated with reduced GFR on multivariate logistic regression analysis. This study observed a high prevalence of CKD and its risk factors among perimenopausal women in a rural community in north India. The study highlights the need of a multipronged, community-based intervention strategy that includes a high-risk screening approach and awareness generation about CKD and its risk factors in the community.

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