Subramaniam S.,International Health Sciences University |
Chakravarthi S.,International Health Sciences University |
Palanisamy U.D.,Monash University |
Radhakrishnan A.,International Health Sciences University |
Haleagrahara N.,James Cook University
Journal of Pharmacology and Toxicology | Year: 2012
Nephelium lappaceum is a tropical fruit native to Malaysia. The rind of N. lappaceum, is having extremely high antioxidant and free radical scavenging activities. The ethanol extract from the rind of Nephelium lappaceum was evaluated for acute and sub-chronic toxicity study in Sprague Dawley rats. In the acute study, a single oral administration of N. lappaceum rind extract (50, 200, 1000 and 2000 mg kg-1) was administered to rats for 14 days. In the sub chronic toxicity study, the extract was administered to rats (500, 2000 mg kg-1) for 28 days. There was no mortality, or adverse effects observed in rats. There was no significant difference observed in relative organ weights and the biochemical analysis (serum urea, creatinine, ALP, AST and total protein). Histological observation of liver and kidney also did not reveal any significant changes. In conclusion, present study showed that the lethal dose of ethanol extract of Nephelium lappaceum rind is more than 2000 mg kg-1 and there is a huge margin of safety for the therapeutic use. No-observed-adverse-effect-level (NOEL) of the extract is considered to be up to 2000 mg kg-1 day-1 for 28 days in rats. © 2012 Academic Journals Inc.
Purcell J.,Johns Hopkins University |
Sebastian R.,Johns Hopkins University |
Leigh R.,U.S. National Institutes of Health |
Jarso S.,International Health Sciences University |
And 4 more authors.
Cortex | Year: 2017
An intact orthographic processing system is critical for normal reading and spelling. Here we investigate the neural changes associated with impairment and subsequent recovery of the orthographic lexical processing system in an individual with an ischemic left posterior cerebral artery (PCA) stroke. This work describes a longitudinal case study of a patient, whose initials are MMY, with impairments in orthographic lexical processing for reading and spelling at stroke onset, and who recovered these skills within 1 year post stroke. We tested the hypothesis that this acute impairment to reading and spelling would be associated with a selective loss of neural activation in the left fusiform gyrus (FG), and that subsequent recovery would be associated with a gain of neural activation in this region. MMY's case provided a unique opportunity to assess the selectivity of neural changes because she demonstrated a behavioral recovery of naming as well; i.e., if there is neural recovery for reading and spelling, but not naming, then these neural changes are selective to the recovery of orthographic processing. To test our hypothesis, we examined longitudinal behavioral and functional magnetic resonance imaging (fMRI) data of reading, spelling, and visual object naming acquired acutely, 3 weeks, 5 months, and one year post stroke. In confirmation of our hypothesis, the loss and subsequent gain of orthographic lexical processing was associated with up-regulation of neural activation in areas previously associated with orthographic lexical processing: i.e., the left mid-FG and inferior frontal junction (IFJ). Furthermore, these neural changes were found to be selective to orthographic processing, as they were observed for reading and spelling, but not for visual object naming within the left mid-FG. This work shows that left PCA stroke can temporarily and selectively disrupt the orthographic lexical processing system, not only in the posterior region adjacent to the stroke, but also in relatively distant frontal orthographic processing regions. © 2017 Elsevier Ltd
Izudi J.,International Health Sciences University |
Akwang G.D.,Uganda Christian University |
Amongin D.,Busitema University
BMC Health Services Research | Year: 2017
Background: Globally, most maternal and newborn deaths are within the first week of delivery. Early postnatal-care (EPNC) visits between 2 and 7 days detects early morbidity and averts deaths. However, there is scarcity of information on use of EPNC in Mundri East County, South Sudan. This study investigated factors associated with EPNC use among postpartum mothers in Mundri East County, South Sudan. Methods: This was an analytical cross-sectional study of 385 postpartum mothers from 13 health facilities. Data was collected by structured questionnaires, entered in EpiData and analyzed with STATA at 5% significance level. Chi-squared, Fisher's exact and Student's t-tests were used for bivariate analysis and logistic regression for multivariable analysis. Results: The mean age of respondents was 27.9-years (standard deviation: 6.7), 276 (71.7%) were below 30-years, 163 (42.3%) were Muru ethnicity, 340 (88.3%) were single and 331 (86.1%) were unemployed. 44 (11.4%; 95% CI: 8.4-15.0) used EPNC. Poor health services access at government health facilities (Adjusted odds ratio (AOR) = 0.18; 95% CI: 0.05-0.61; P = 0.006), more than 1-h access to health facility (AOR = 0.27; 95% CI: 0.09-0.78; P = 0.015), at least secondary maternal education (AOR = 5.73; 95% CI: 1.14-28.74; P = 0.034) and receipt of PNC health education post-delivery (AOR = 3.47; 95% CI: 1.06-11.33; P = 0.004) were associated with EPNC use. Conclusions: Use of EPNC in Mundri East County, South Sudan was low. It was significantly reduced at government and inaccessible health facilities. However, it increased with receipt of PNC health education after delivery and at least secondary level of education. © 2017 The Author(s).
Samuel A.J.S.J.,International Health Sciences University |
Mohan S.,University of Malaya |
Chellappan D.K.,Health Science University |
Kalusalingam A.,Health Science University |
Ariamuthu S.,Captain Srinivasa Murti Drug Research Institute for Ayurveda
Journal of Ethnopharmacology | Year: 2012
Ethnopharmacological relevance: The roots of Hibiscus vitifolius Linn. (Malvaceae) is used for the treatment of jaundice in the folklore system of medicine in India. This study is an attempt to evaluate the hepatoprotective activity of the roots of Hibiscus vitifolius against anti-tubercular drug induced hepatotoxicity. Materials and methods: Hepatotoxicity was induced in albino rats of either sex by oral administration of a combination of three anti-tubercular drugs. Petroleum ether, chloroform, methanol and aqueous extracts of roots of Hibiscus vitifolius (400 mg/kg/day) were evaluated for their possible hepatoprotective potential. Results: All the extracts were found to be safe up to a dose of 2000 mg/kg. Among the four extracts studied, oral administration of methanol extract of Hibiscus vitifolius at 400 mg/kg showed significant difference in all the parameters when compared to control. There was a significant (P < 0.001) reduction in the levels of serum aspartate amino transaminase, alanine amino transferase, alkaline phosphatase, lactate dehydrogenase, total and direct bilirubin, where as an increase was found in the levels of total cholesterol, total protein and albumin. Liver homogenate studies showed a significant increase in the levels of total protein, phospholipids and glycogen, and a reduction in the levels of total lipids, triglycerides, and cholesterol against control animals. In the tissue anti-oxidant studies, we found a significant increase in the levels of catalase and superoxide dismutase, whereas there was marked reduction in the levels of thiobarbituric acid reactive substances, as compared to control. Histology of liver sections of the animals treated with the extracts showed significant reduction of necrosis and fatty formation when compared with control specimens. Conclusion: These findings suggest that the root extracts of Hibiscus vitifolius have potent hepatoprotective activity, thereby justifying its ethnopharmacological claim. © 2012 Elsevier Ireland Ltd. All rights reserved.
Duffy K.,International Medical Group |
Wooding N.,International Health Sciences University |
Dea M.,Centers for Disease Control |
Coutinho A.,Makerere University
PLoS ONE | Year: 2013
Introduction:Modelling, supported by the USAID Health Policy Initiative and UNAIDS, performed in 2011, indicated that Uganda would need to perform 4.2 million medical male circumcisions (MMCs) to reach 80% prevalence. Since 2010 Uganda has completed 380,000 circumcisions, and has set a national target of 1 million for 2013.Objective:To evaluate the relative reach and cost-effectiveness of PrePex compared to the current surgical SMC method and to determine the effect that this might have in helping to achieve the Uganda national SMC targets.Methods:A cross-sectional descriptive cost-analysis study conducted at International Hospital Kampala over ten weeks from August to October 2012. Data collected during the performance of 625 circumcisions using PrePex was compared to data previously collected from 10,000 circumcisions using a surgical circumcision method at the same site. Ethical approval was obtained.Results:The moderate adverse events (AE) ratio when using the PrePex device was 2% and no severe adverse events were encountered, which is comparable to the surgical method, thus the AE rate has no effect on the reach or cost-effectiveness of PrePex. The unit cost to perform one circumcision using PrePex is $30.55, 35% ($7.90) higher than the current surgical method, but the PrePex method improves operator efficiency by 60%, meaning that a team can perform 24 completed circumcisions compared to 15 by the surgical method. The cost-effectiveness of PrePex, comparing the cost of performing circumcisions to the future cost savings of potentially averted HIV infections, is just 2% less than the current surgical method, at a device cost price of $20.Conclusion:PrePex is a viable SMC tool for scale-up with unrivalled potential for superior reach, however national targets can only be met with effective demand creation and availability of trained human resource. © 2013 Galukande et al.
Uhlig C.,TU Dresden |
Uhlig C.,International Health Sciences University |
Bluth T.,TU Dresden |
Schwarz K.,TU Dresden |
And 8 more authors.
Anesthesiology | Year: 2016
Background: It is not known whether modern volatile anesthetics are associated with less mortality and postoperative pulmonary or other complications in patients undergoing general anesthesia for surgery. Methods: A systematic literature review was conducted for randomized controlled trials fulfilling following criteria: (1) population: adult patients undergoing general anesthesia for surgery; (2) intervention: patients receiving sevoflurane, desflurane, or isoflurane; (3) comparison: volatile anesthetics versus total IV anesthesia or volatile anesthetics; (4) reporting on: (a) mortality (primary outcome) and (b) postoperative pulmonary or other complications; (5) study design: randomized controlled trials. The authors pooled treatment effects following Peto odds ratio (OR) meta-analysis and network meta-analysis methods. Results: Sixty-eight randomized controlled trials with 7,104 patients were retained for analysis. In cardiac surgery, volatile anesthetics were associated with reduced mortality (OR = 0.55; 95% CI, 0.35 to 0.85; P = 0.007), less pulmonary (OR = 0.71; 95% CI, 0.52 to 0.98; P = 0.038), and other complications (OR = 0.74; 95% CI, 0.58 to 0.95; P = 0.020). In noncardiac surgery, volatile anesthetics were not associated with reduced mortality (OR = 1.31; 95% CI, 0.83 to 2.05, P = 0.242) or lower incidences of pulmonary (OR = 0.67; 95% CI, 0.42 to 1.05; P = 0.081) and other complications (OR = 0.70; 95% CI, 0.46 to 1.05; P = 0.092). Conclusions: In cardiac, but not in noncardiac, surgery, when compared to total IV anesthesia, general anesthesia with volatile anesthetics was associated with major benefits in outcome, including reduced mortality, as well as lower incidence of pulmonary and other complications. Further studies are warranted to address the impact of volatile anesthetics on outcome in noncardiac surgery. © 2016, the American Society of Anesthesiologists, Inc. Wolters Kluwer Health, Inc.
Brazinova A.,International Health Sciences University |
Majdan M.,International Health Sciences University
Traffic Injury Prevention | Year: 2016
Objective: Road traffic mortality takes an enormous toll in every society. Transport safety interventions play a crucial role in improving the situation. In the period 1996–2014 several road safety measures, including a complex new road traffic law in 2009, were implemented in the Slovak Republic, introducing stricter conditions for road users. The aim of this study is to describe and analyze the trends in road user mortality in the Slovak Republic in individual age groups by sex during the study period 1996–2014. Methods: Data on overall mortality in the Slovak Republic for the period 1996–2014 were obtained from the Statistical Office of the Slovak Republic. Mortality rates were age-adjusted to the European standard population. Joinpoint regression was used to assess the statistical significance of change in time trends of calculated standardized mortality rates. Results: Mortality rates of all types of road users as well as all age groups and both sexes in the Slovak Republic in the period 1996–2014 are decreasing. The male : female ratio decreased from 4:1 in 1996 to 2:1 in 2014. Motor vehicle users (other than motorcyclists) and pedestrians have the highest mortality rates among road user groups. Both of these groups show a significant decline in mortality rates over the study period. Within the age groups, people age 65 years and over have the highest mortality rates, followed by the age groups 25–64 and 15–24 years old. Joinpoint regression confirmed a steady, significant decline in all mortality rates over the study period. A statistically significant decrease in mortality rates in the last years of the study period was observed in the age group 25–64 and in male motorcycle users. Assessing the impact of the 2009 road traffic law, a drop was observed in the average standardized mortality rate of all road traffic users from 14.56 per 100,000 person years in the period 1996–2008 to 7.69 per 100,000 person years in the period 2009–2014. A similar drop in the average standardized mortality rate was observed in all individual road user groups. Conclusions: The implementation of the new traffic regulations may have contributed significantly to the observed decrease in mortality rates of road users in the Slovak Republic. A significant decrease in mortality was observed in all population groups and in all groups of road users. The introduction of a new comprehensive road traffic law may have expedited the decrease of road fatalities, especially in the age group 25–64 years old. This type of evidence-based epidemiology data can be used for improved targeting of future public health measures for road traffic injury prevention. 2016 © Taylor & Francis Group, LLC
Clausen L.N.,Copenhagen University |
Clausen L.N.,International Health Sciences University |
Astvad K.,Copenhagen University |
Ladelund S.,Copenhagen University |
And 3 more authors.
AIDS | Year: 2012
Objective: We hypothesized that hepatitis C virus (HCV) load and genotype may influence all-cause mortality in HIV-HCV-coinfected individuals. DESIGN AND Methods: Observational prospective cohort study. Mortality rates were compared in a time-updated multivariate Poisson regression analysis. Results: We included 264 consecutive HIV-HCV-coinfected individuals. During 1143 person years at risk (PYR) 118 individuals died [overall mortality rate 10 (95% confidence interval; 8, 12)/100 PYR]. In multivariate analysis, a 1 log increase in HCV viral load was associated with a 30% higher mortality risk [adjusted mortality rate ratio (aMRR): 1.30 (1.10,1.54)] when adjusted for sex, age, HIV exposure group, CD4+ cell count, HIV RNA, HCV genotype and interleukin (IL)-28B genotype. Further, HCV genotype 3 vs. 1 [aMRR: 1.83 (1.12, 2.98)] and HIV RNA [aMRR: 3.14 (1.37,7.17) for undetectable vs. just detectable HIV RNA] were independent predictors of mortality, whereas a higher CD4+ cell count was associated with a 41% reduction in mortality rate per 50 cell increase between 0 and 200cells/μl [aMRR: 0.59 (0.48, 0.72)] and a 10% reduction for increases above 200cells/μl [aMRR: 0.90 (0.82-0.98)]. IL28B) CC genotype was associated with 54% higher mortality risk [aMRR: 1.54 (0.89, 3.82] compared to TT genotype. Conclusion: High-HCV viral load, HCV genotype 3 and IL28B genotype CC had a significant influence on the risk of all-cause mortality among individuals coinfected with HIV-1. This may have consequences for the management of HIV-HCV-coinfected individuals. © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins.
Panthi S.,Travel and Mountain Medicine Center |
Basnyat B.,International Health Sciences University
Journal of Association of Physicians of India | Year: 2013
Increasing number of Hindu pilgrims visit the Himalayas where some of them suffer from high altitude illness including the life threatening forms, high altitude pulmonary oedema (HAPE) and high altitude cerebral oedema. Compared to tourists and trekkers, pilgrims are usually ignorant about altitude illness. This is a case of a pilgrim who suffered from HAPE on his trip to Kailash-Mansarovar and is brought to a tertiary level hospital in Kathmandu. This report emphasises on how to treat a patient with HAPE, a disease which is increasingly being seen in the high altitude pilgrim population. © JAPI.
PubMed | Catalan Institution for Research and Advanced Studies, International Health Sciences University, Germans Trias i Pujol Health Science Research Institute IGTP Badalona, University of Barcelona and University Of Barcelonabarcelona
Type: | Journal: Frontiers in cell and developmental biology | Year: 2017
[This corrects the article on p. 131 in vol. 4, PMID: 27900319.].