Lal Bahadur Nagar, India
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Purohit P.,Veer Surendra Sai Medical College | Mashon R.S.,Veer Surendra Sai Medical College | Mashon R.S.,Indian Council for Medical Research | Patel S.,Veer Surendra Sai Medical College | And 8 more authors.
International Journal of Laboratory Hematology | Year: 2014

Introduction: Hb Hofu (HBB:c. 380T>A) is a rare inherited hemoglobin abnormality with few case reports in the world literature. Methods: Screening for the sickle cell gene mutation and other hemoglobinopathies was carried out using the sickle slide test, Hb electrophoresis, and HPLC under an ongoing central government project. Results: We detected twelve Hb Hofu heterozygotes and three sickle Hb Hofu compound heterozygotes. The heterozygotes were asymptomatic except for one individual who had chronic kidney disease and moderate anemia. Only one HbS-Hofu case was symptomatic and presented with intermittent attacks of painful crisis. In the carrier state, the Hb Hofu eluted as a hump at the beginning of the HbA0 window. But in HbS-Hofu cases, Hb Hofu eluted as a single peak in the HbA0 window, with the HbA2 levels being >4% consistently. Conclusion: HbS-Hofu has a variable clinical presentation. The retention time of Hb Hofu on HPLC is very close to that of HbA0 and often elutes in the A0 window. Thus, there is every possibility of the HbS-Hofu chromatogram to be misinterpreted as that of a sickle cell trait/transfused sickle cell-beta-thalassemia case. This is the first time where Hb Hofu has been detected by HPLC, which is the widely accepted screening technique for hemoglobinopathies around the world. © 2013 John Wiley & Sons Ltd.


Jeemon P.,Center for Chronic Disease Control | Jeemon P.,University of Glasgow | Jeemon P.,Public Health Foundation of India | Mathur P.,Indian Council for Medical Research | And 4 more authors.
International Journal of Epidemiology | Year: 2012

Background The South-East Asia region (SEAR) accounts for one-quarter of the world's population, 40% of the global poor and ∼30% of the global disease burden, with a disproportionately large share of tuberculosis (35%), injuries (30%), maternal (33%) and <5-year-old mortality (30%). In this article, we describe the disease burden and status of epidemiological research and capacity in the SEAR to understand, analyse and develop capacity in response to the diverse burdens of diseases in the region. Methods Data on morbidity, mortality, risk factors, social determinants, research capacity, health education, workforce and systems in the SEAR were obtained using global data on burden of disease, peer-reviewed journals, World Health Organization (WHO) technical and advisory reports, and where available, validated country reports and key informants from the region. Results SEAR countries are afflicted with a triple burden of disease-infectious diseases, non-communicable diseases and injuries. Of the seven WHO regions, SEAR countries account for the highest proportion of global mortality (26%) and due to relatively younger ages at death, the second highest percentage of total years of life lost (30%). The SEAR exceeds the global average annual mortality rate for all three broad cause groupings-communicable, maternal, perinatal and nutritional conditions (334 vs 230 per 100 000); non-communicable diseases (676 vs 573 per 100 000); and injuries (101 vs 78 per 100 000). Poverty, education and other social determinants of health are strongly linked to inequities in health among SEAR countries and within socio-economic subgroups. India, Thailand and Bangladesh produce two-thirds of epidemiology publications in the region. Significant efforts to increase health workforce capacity, research and training have been undertaken in the region, yet considerable heterogeneity in resources and capacity remains. Conclusions Health systems, statistics and surveillance programmes must respond to the demographic, economic and epidemiological transitions that define the current disease burden and risk profile of SEAR populations. Inequities in health must be critically analysed, documented and addressed through multi-sectoral approaches. There is a critical need to improve public health intelligence by building epidemiological capacity in the region. Published by Oxford University Press on behalf of the International Epidemiological Association © The Author 2012.


News Article | November 12, 2016
Site: www.prweb.com

The late Vasanthapuram Kumaraswami, MD, PhD (1950-2016), a pioneer in the fight against neglected tropical diseases, was awarded today the second annual Kyelem Prize at the annual meeting of the Coalition for Operational Research on Neglected Tropical Diseases, or COR-NTD. The award – received by Dr. Kumaraswami’s children Sameer and Manjusha Vasanthapuram – recognized a lifelong commitment to bringing innovative solutions to the fight against debilitating neglected tropical diseases. “It’s so fitting that Dr. Kumaraswami has been selected for this honor, which itself is given in memory of Dominique Kyelem,” said Julie Jacobson, MD, senior program officer with the Bill & Melinda Gates Foundation, who won the inaugural Kyelem Prize in 2015 and presented this year’s award. “Both men achieved amazing strides to prevent disease in the developing world, and both did so with a spirit of humility and optimism.” Dr. Kumaraswami worked for 40 years to eliminate lymphatic filariasis, which can cause a disfiguring condition called elephantiasis. He was the director-in-charge of the National Institute for Research in Tuberculosis (formerly the Tuberculosis Research Centre) and the National Institute of Epidemiology, both institutes of the Indian Council for Medical Research. In these roles, Kumaraswami pioneered research on the impact of a medicine called ivermectin on lymphatic filariasis. He also contributed to the founding of the Global Programme to Eliminate Filariasis, and propelled stakeholders to expand mass drug administration programs in India and the South-East Asia region to control the disease. After he retired, he joined the Atlanta-based Task Force for Global Health in Atlanta for two years as associate director of international programs. “Dr. Kumaraswami’s genius was not just his achievements – it was, rather, his ability to provide that spark, that environment, that opportunity for people to come together and work together to achieve great things, both at home in India and at home in the world,” said Eric Ottesen, MD, director of the Neglected Tropical Diseases Support Center, a program of The Task Force for Global Health that serves as the COR-NTD Secretariat. The 2016 Kyelem Prize was announced at the close of the COR-NTD meeting in Atlanta. Nearly 400 researchers, program implementers, donors, and representatives of the World Health Organization convened for the meeting to identify key questions facing programs aimed at eliminating neglected tropical diseases such as lymphatic filariasis. “Dr. Kumaraswami dedicated his life to ensuring that as many people as possible received treatment for lymphatic filariasis,” said Dr. Jacobson. “He leaves a large hole, but our coalition is determined to march forward and carry out both his and Dr. Kyelem’s legacy.” About the Coalition for Operational Research on Neglected Tropical Diseases: The Coalition for Operational Research on Neglected Tropical Diseases (COR-NTD) is a group of researchers, program implementers and their supporters with the shared goal of optimizing NTD control and elimination. Supported by grants from the Bill & Melinda Gates Foundation and the U.S. Agency for International Development to the Neglected Tropical Diseases Support Center at the Task Force for Global Health – which serves as the Coalition Secretariat – the aim of COR-NTD is to create new synergies within the operational research community for NTDs and align that research with the program needs. Learn more at http://www.ntdsupport.org/cor-ntd. About The Task Force for Global Health: The Task Force for Global Health works to reduce the global burden of disease and build public health systems that serve all people. Founded in 1984 by global health pioneer Dr. Willliam Foege, The Task Force consists of eight programs focused on neglected tropical diseases, vaccines, and health systems strengthening. It is affiliated with Emory University, headquartered in Decatur, GA, and has regional offices in Guatemala and Ethiopia. The Task Force received the 2016 Conrad N. Hilton Humanitarian Prize for its extraordinary contributions to alleviating human suffering. Learn more at http://www.taskforce.org.


Tolley E.E.,Health and Development science | Tsui S.,Health and Development science | Mehendale S.,Indian Council for Medical Research | Weaver M.A.,University of North Carolina at Chapel Hill | Kohli R.,National Dairy Research Institute
AIDS and Behavior | Year: 2012

The inconclusive results of past trials and recent findings of partial protection of Tenofovir 1% gel underscore the need to better understand product adherence in microbicide trials. This study aimed to identify factors predicting couples' ability to sustain topical gel and condom use during clinical trial participation. We enrolled 100 Indian participants of a randomized, controlled safety trial of Tenofovir 1% gel (CT cohort) and 100 similar women who were ineligible or declined trial participation (NCT cohort). Compared to the NCT cohort, CT women reported higher baseline condom use, more positive attitudes towards condoms and higher levels of protection efficacy. While NCT condom use remained low, CT condom use increased dramatically during the study. Reported gel consistency was higher than condom consistency. Individual and couple-related factors predicted condom consistency and interest in future gel use, but not gel consistency. Findings could inform trial recruitment strategies and product introduction. © Springer Science+Business Media, LLC 2011.


Nyamathi A.,University of California at Los Angeles | Sinha S.,All India Institute of Medical Sciences | Ganguly K.K.,Indian Council for Medical Research | Carpenter C.L.,University of California at Los Angeles
AIDS and Behavior | Year: 2013

Body composition in HIV-infected individuals is subject to many influences. We conducted a pilot 6-month randomized trial of 68 women living with AIDS (WLA) from rural India. High protein intervention combined with education and supportive care delivered by HIV-trained village women (activated social health activist [Asha] life [AL]) was compared to standard protein with usual care delivered by village community assistants (usual care [UC]). Measurements included CD4 counts, ART adherence, socio-demographics, disease characteristics (questionnaires); and anthropometry (bioimpedance analyzer). Repeated measures analysis of variance modeled associations. AL significantly gained in BMI, muscle mass, fat mass, ART adherence, and CD4 counts compared to UC, with higher weight and muscle mass gains among ART adherent (≥66 %) participants who had healthier immunity (CD4 ≥450). BMI of WLA improved through high protein supplementation combined with education and supportive care. Future research is needed to determine which intervention aspect was most responsible. © 2013 Springer Science+Business Media New York.


Nyamathi A.,University of California at Los Angeles | Salem B.E.,University of California at Los Angeles | Meyer V.,Cornell University | Ganguly K.K.,Indian Council for Medical Research | And 2 more authors.
AIDS Education and Prevention | Year: 2012

The purpose of this randomized pilot study is to conduct an intervention with 68 rural women living with AIDS to compare the effectiveness of two different programs on depressive symptoms. The trial was designed to assess the impact of the Asha-Life intervention engaging with an HIV-trained village woman, Asha (Accredited Social Health Activist), to participate in the care of women living with AIDS (WLA), along with other health care providers compared to a Usual Care group. Two high prevalence HIV/AIDS villages in rural Andhra Pradesh, which were demographically alike and served by distinct Public Health Centers, were selected randomly from a total of 16 villages. The findings of this study demonstrated that the Asha-Life participants significantly reduced their depressive symptom scores compared to the Usual Care participants. Moreover, women living with AIDS who demonstrated higher depressive symptom scores at baseline had greater reduction in their depressive symptoms than women with lower scores. © 2012 The Guilford Press.


Nirmal J.,All India Institute of Medical Sciences | Velpandian T.,All India Institute of Medical Sciences | Singh S.B.,All India Institute of Medical Sciences | Ranjan Biswas N.,All India Institute of Medical Sciences | And 5 more authors.
Current Eye Research | Year: 2012

Purpose: To evaluate the functional role of organic cation transporters (OCT) and ocular tissue distribution of intravitreally injected OCT substrate tetraethylammonium (TEA) in presence of OCT blocker (quinidine). Methods: New Zealand albino rabbits of either sex were used. Intravitreal quinidine pretreatment was made 30min before the administration of TEA. Modulation of vitreous and ocular tissue kinetics of OCT substrate was evaluated with or without blocker pretreatment. Gamma scintigraphy was also performed to visualize the vitreous residence of 99mTc-labelled TEA in the presence and absence of blocker. Results: Intravitreally injected quinidine did not significantly alter the ocular disposition of TEA. TEA showed less significant posterior elimination kinetics and slow anterior elimination which resulted in longer residence time of TEA in eye after intravitreal administration. Conclusions: Intravitreally injected OCT substrates may follow an anterior elimination pathway and prolonged residence time in vitreous humor. The present study shows that OCT may not be active from vitreous-to-blood route in the blood-retinal barrier. © 2012 Informa Healthcare USA, Inc.


Nirmal J.,All India Institute of Medical Sciences | Sirohiwal A.,All India Institute of Medical Sciences | Singh S.B.,All India Institute of Medical Sciences | Biswas N.R.,All India Institute of Medical Sciences | And 3 more authors.
Experimental Eye Research | Year: 2013

The present study was conducted to test the hypothesis; OCT may be active from blood-to-vitreous for the uptake of its substrates. Ocular uptake of Tetraethylammonium (TEA) across blood ocular barriers and the tissue distribution was evaluated invivo in New Zealand albino rabbits after intravenous administration. Quinidine (blocker) pretreatment resulted in a significant (p<0.05) reduction in the Area Under the Curve (AUC) of TEA in vitreous (4.2 fold) and aqueous humor (1.8 fold) as compared to the control group which supports the role of OCT in uptake transport of its substrate across Blood ocular barrier. The blockade of OCT also affected the elimination of its substrate resulting in increased plasma levels. In most of the tissues, OCT are functionally present from apical to basolateral. The gene expression studies also showed the presence of OCT1, OCTN1 and OCTN2 in various ocular tissues studied. The present findings suggest that OCT are functionally active in blood ocular barriers and involved in the transport of its substrate from blood-to-vitreous humor. © 2013 Elsevier Ltd.


Nirmal J.,All India Institute of Medical Sciences | Velpandian T.,All India Institute of Medical Sciences | Singh S.B.,All India Institute of Medical Sciences | Biswas N.R.,All India Institute of Medical Sciences | And 3 more authors.
Journal of Chromatography B: Analytical Technologies in the Biomedical and Life Sciences | Year: 2011

Tetraethylammonium is widely used as a probe in organic cation transporters studies. A simple, highly sensitive, and specific method using direct protein precipitation was developed using Hydrophilic Interaction Liquid Chromatography coupled with positive electrospray ionization tandem mass spectrometry for the determination of tetraethylammonium (TEA) in rabbit plasma. Isocratic separation was achieved using a ZIC-HILIC column with acetonitrile and 5. mM ammonium acetate in the ratio of 8:2 containing 0.1% formic acid. Acquisition was performed in multiple reaction monitoring mode with the transitions: m/. z 130 → 100 and 130 → 86 for TEA and m/. z 276.1 → 142.2 for internal standard (homatropine). This method was validated to determine selectivity, linearity, sensitivity, precision, accuracy, recovery and stability. A good linearity was found within a range of 1.53-784.6. ng/mL. The above method has been demonstrated for its capability to estimate the plasma levels of TEA after its topical instillation in rabbit eyes. This method provides an accurate, precise and sensitive tool for determining TEA levels for transporter studies. © 2011 Elsevier B.V.


In rapidly developing countries such as India, the ubiquity of air pollution sources in urban and rural communities often results in ambient and household exposures significantly in excess of health-based air quality guidelines. Few efforts, however, have been directed at establishing quantitative exposure-response relationships in such settings. We describe study protocols for The Tamil Nadu Air Pollution and Health Effects (TAPHE) study, which aims to examine the association between fine particulate matter (PM2.5) exposures and select maternal, child and adult health outcomes in integrated rural-urban cohorts.The TAPHE study is organised into five component studies with participants drawn from a pregnant mother-child cohort and an adult cohort (n=1200 participants in each cohort). Exposures are assessed through serial measurements of 24-48 h PM2.5 area concentrations in household microenvironments together with ambient measurements and time-activity recalls, allowing exposure reconstructions. Generalised additive models will be developed to examine the association between PM2.5 exposures, maternal (birth weight), child (acute respiratory infections) and adult (chronic respiratory symptoms and lung function) health outcomes while adjusting for multiple covariates. In addition, exposure models are being developed to predict PM2.5 exposures in relation to household and community level variables as well as to explore inter-relationships between household concentrations of PM2.5 and air toxics. Finally, a bio-repository of peripheral and cord blood samples is being created to explore the role of gene-environment interactions in follow-up studies.The study protocols have been approved by the Institutional Ethics Committee of Sri Ramachandra University, the host institution for the investigators in this study. Study results will be widely disseminated through peer-reviewed publications and scientific presentations. In addition, policy-relevant recommendations are also being planned to inform ongoing national air quality action plans concerning ambient and household air pollution.

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