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Bhubaneshwar, India

Patel S.,Veer Surendra Sai Medical College | Purohit P.,Veer Surendra Sai Medical College | Mashon R.S.,Veer Surendra Sai Medical College | Dehury S.,Veer Surendra Sai Medical College | And 6 more authors.
Pediatric Blood and Cancer | Year: 2014

Background: Although hydroxyurea is the only effective agent for the treatment of sickle cell disease, published experience with this drug is limited to treatment of homozygous sickle cell anemia and HbS/β thalassemia. The role of hydroxyurea in the treatment of patients with HbSD-Punjab, a rare hemoglobinopathy with phenotypic expression similar to that of sickle cell anemia is unknown. Procedure: Over a period of 10 years, we followed 42 patients with HbSD-Punjab, of which 20 presented with severe clinical manifestations (≥3 episodes of VOC and/or ≥2 units of blood transfusion in the previous 12 months). These 20 patients were enrolled for treatment with hydroxyurea at a dose of 10mg/kg/day and followed prospectively for a period of 24 months. Results: The frequency of VOC decreased significantly and none of them required blood transfusion while receiving hydroxyurea. The HbF, total hemoglobin, MCV, MCH, and MCHC levels increased significantly, whereas HbS, WBC, platelet count, total serum bilirubin, and LDH levels decreased significantly in all the patients. No short-term drug toxicity was observed. Conclusion: This study describes the use of hydroxyurea therapy in patients with HbSD-Punjab. Low dose hydroxyurea (10mg/kg/day) was found to be effective in reducing the clinical severity in patients with HbSD-Punjab without any short-term toxicity. In view of easy affordability amongst poor patients, widespread acceptability by patients and doctors, the need of infrequent monitoring and its potential effectiveness, low dose hydroxyurea is suitable for treatment of patients with HbSD-Punjab. © 2014 Wiley Periodicals, Inc. Source

Chaudhury N.,Asian Institute of Public Health | Phatak A.,Central Research Services | Paliwal R.,PS Medical College | Raichaudhari C.,PS Medical College
Lung India | Year: 2010

Background: There is a high prevalence of silicosis and other morbid conditions leading to early death among agate workers at Khambhat of Gujarat. Aims: The present study describes the prevalence of X-ray positive silicosis in a sample of a high-risk group visiting a clinic at Shakarpur of Khambhat. Settings and Design: A cross-sectional study among 123 clinically suspected cases was conducted over 6 months. Materials and Methods: A chest physician and a radiologist independently evaluated the Chest X-rays of 123 clinically suspected patients of silicosis. Silicosis was confirmed if either of them rated the X-ray as positive. Statistical Analysis: Descriptive statistics and logistic regression were done using SPSS software version 14. Results: Out of 123 cases, 85 (69.1%) were confirmed as silicosis. There was no significant difference in the prevalence between males (70.3%) and females (69.4%). Workers with more than 10 years of exposure to silica had an odd ratio of 4.8, 95% CI (1.76, 13.60) compared to those with less than 10 years of exposure. A logistic regression analysis showed that for every extra year of exposure, the odds of getting silicosis increased by about 12%. Conclusions: This study highlights the catastrophic effects of exposures to silica in agate worker, which calls for urgent protective measures for this population. Source

Padhi B.K.,Asian Institute of Public Health
Journal of Exposure Science and Environmental Epidemiology | Year: 2016

Recent studies have highlighted the presence of endotoxin in indoor air and its role in respiratory morbidities. Burning of household fuels including unprocessed wood and dried animal dung could be a major source of endotoxin in homes. We measured endotoxin levels in different size fractions of airborne particles (PM10, PM2.5, and PM1), and estimated the deposition of particle-bound endotoxin in the respiratory tract. The study was carried out in homes burning solid biomass fuel (n=35) and LPG (n=35). Sample filters were analyzed for endotoxin and organic carbon (OC) content. Household characteristics including temperature, relative humidity, and carbon dioxide levels were also recorded. Multivariate regression models were used to estimate the contributing factors for airborne endotoxin. Respiratory deposition doses were calculated using a computer-based model. We found a higher endotoxin concentration in PM2.5 fractions of the particle in both LPG (median: 110, interquartile range (IQR) 100–120 EU/m3) and biomass (median: 350, IQR: 315–430 EU/m3) burning homes. In the multivariate-adjusted model, burning of solid biomass fuel (β: 67; 95% CI: 10.5–124) emerged as the most significant predictor followed by OC (β: 4.7; 95% CI: 2.7–6.8), RH (β: 1.6; 95% CI: 0.76–2.4), and PM2.5 (β: 0.45; 95% CI: 0.11–0.78) for airborne endotoxin (P<0.05). We also observed an interaction between PM organic carbon content and household fuel in predicting the endotoxin levels. The model calculations showed that in biomass burning homes, total endotoxin deposition was higher among infants (59%) than in adult males (47%), of which at least 10% of inhaled endotoxin is deposited in the alveolar region of the lung. These results indicate that fine particles are significant contributors to the deposition of endotoxin in the alveolar region of the lung. Considering the paramount role of endotoxin exposure, and the source and timing of exposure on respiratory health, additional studies are warranted to guide evidence-based public health interventions.Journal of Exposure Science and Environmental Epidemiology advance online publication, 9 March 2016; doi:10.1038/jes.2016.5. © 2016 Nature America, Inc. Source

Chandhiok N.,Indian Council of Medical Research | Chaudhury N.,Asian Institute of Public Health | Singha S.,Indian Council of Medical Research
International Health | Year: 2015

Background: Shortage of skilled birth attendants (SBA) is one of the determinants of maternal mortality in India. To combat this shortage, innovative task-shifting strategies to engage providers of the Indian system of medicine (Ayurveda and Homeopathy), called AYUSH practitioners (AP), to provide SBA services is being implemented. Methods: Engagement of APs for SBA service provision was assessed in 3 states of India (Maharashtra, Rajasthan and Odisha) through 73 in-depth interviews (37 with APs and 36 with programme managers). The interviews explored the providers' SBA training experience, barriers for SBA service provision, workplace and community acceptance, and the perspective of programmemanagers on the competence and quality of SBA services provided. Results: SBA training led to skill enhancement with adoption of appropriate maternal and newborn care practices. A dedicated trainer, more hands-on practice, and strengthening training on newborn care practices and management of complications emerged as the training needs. Conditional involvement in SBA-related work, a discriminatory attitude at the workplace and lack of legal/regulatory authorisation were identified as barriers to the inclusion of APs in SBA service provision. Conclusions: Quality skill enhancement measures, an enabling work environment, a systematic task-shifting process, role definition, supportive supervision and credentialing could be key for the integration of APs and their acceptance in the health system. © The Author 2014. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. Source

Panigrahi A.,Asian Institute of Public Health | Sohani S.,College of Public Administration | Amadi C.,College of Public Administration | Joshi A.,College of Public Administration
Technology and Health Care | Year: 2014

INTRODUCTION: Chronic obstructive pulmonary disease (COPD) is a pulmonary disease characterized by airflow limitation that is not fully reversible. It is projected to be the third leading cause of death worldwide by 2020. The objective of the study was to examine the impact of music on psychological and physiological outcomes among individuals with COPD. METHODS: The scientific databases PubMed, google scholar and EBSCO were used to search for relevant articles published during a period of 01/01/2005 to 12/31/2012. The search terms Music and COPD, Music and Emphysema, Singing and COPD, Singing and Emphysema , music improves COPD and singing therapy on COPD, were used either in single or in combination. The inclusion criteria included studies having an experimental study design, were written in English and were conducted among individuals age 18 years and above. Studies that focused on the healthy population or had a disease other than COPD were excluded. Studies where music therapy was not the primary intervention and were systematic reviews were also excluded from the final analysis. Variables analyzed included year of publication, study location, study setting, target audience, study design, sample size, study duration, intervention and its components and the outcomes including physiological and psychological were assessed. RESULTS: A total of 7 papers that met the inclusion criteria were included in the final analysis. Studies included various music interventions such as singing, listening and playing music. Forty percent of the studies were performed in US. More than half of the studies (70%, n=5) had a randomized control study design and were performed in a hospital setting. The duration of the studies varied from 6 weeks to 21 months. The sample size in these studies varied from 7 to 72. Music showed improvement in the psychological outcomes such as quality of life, dyspnea and anxiety and mixed results in the improvement of physiological outcomes such as FEV, FVC, and breathing control among individuals living with COPD. DISCUSSION: More research of a longer duration and with a larger sample size is needed to examine the impact of music interventions on clinical, functional, psychological and physiological outcomes among COPD individuals. © 2014 - IOS Press and the authors. Source

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