Browsing by Author "A. Agrawal"

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An enlarged vision on various types of study design in human subjects
(2012) K. Ilango; T.M. Vijayakumar; G.P. Dubey; A. Agrawal
Clinical trials are utilized in many clinical specialties to test the efficacy of a specific treatment or intervention in a group of patients/subjects and inferences are then drawn about the use of the treatment in the general population. Just as in any other field of scientific and medical research, the choice of an appropriate design for a clinical trial is a vital element. In various study designs, the randomized clinical trial is the gold standard or reference, it is the design against which others are judged because it provides the greatest justification for concluding causality and is subject to the least number of problems or biases. Bias occurs when the way a study is designed or carried out causes an error in the results and conclusions. Both allocation concealment and masking add to the elimination of bias in randomized controlled trials. Clinical trials without controls are difficult to interpret and do not provide strong evidence. © IDOSI Publications, 2012.
Birthweight: its relationship with maternal and newborn skinfold thickness.
(1991) S. Swain; B.D. Bhatia; S. Pandey; L.K. Pandey; A. Agrawal
Two hundred and forty seven pregnant women at term and their offsprings were studied. Maternal skinfold thickness was measured from ten different sites and newborn skinfold thickness was measured from four different sites in each set of cases. Maternal skinfold thickness was positively correlated with the birthweight and skinfold thickness of the offspring. The birthweight was also positively correlated with the skinfold thickness of offspring. The maternal axillary sites and offspring's subscapular site had higher inter correlation as well as with the birthweight of offspring.
Changes in brain biogenic amines under influence of an indigenous drug, Geriforte, following immobilization stress
(1988) L. Upadhya; S.S. Shukla; A. Agrawal; G.P. Dubey
[No abstract available]
Clonazepam as add-on therapy in Parkinson's patients with sleep disorders: A prospective pilot study using video polysomnography
(2013) I. Jyothi; Tanu Priya; T.M. Vijayakumar; S. Ramesh Kannan; K. Ilango; A. Agrawal; G.P. Dubey
Use of Clonazepam was very common in Parkinson's patient with sleep problems such as rapid eye movement behavior Disorder. A pilot study was performed to evaluate the effects of Clonazepam on sleep pattern in Parkinson's patient using video polysomnography. Overnight polysomnography was performed prospectively in three healthy males (age 51.33±3.51 years) and with three male Parkinson's patient (age 60.00±8.00 years) with sleep disorders. The study was conducted in two phases using standard techniques in accordance with guidelines published by the American Academy of Sleep Medicine (AASM). For sleep stages evaluation, an electroencephalogram (4 channels with 2 central and 2 occipital) chin electromyogram (with 1 channel) and electro-oculogram (with 2 channels) were achieved. Polysomnography characteristics of healthy volunteers and Parkinson's patient with and with out Clonazepam effect was evaluated. Sleep latency was compared between healthy volunteers and Parkinson's patients in both the phases. The difference was highly significant [Phase I (p = 0.004, R2 = 0.896), Phase II (p<0.001, R2=0.999)], but there was no considerable effect of Clonazepam in PD Patients [Phase I, (p = 0.606, R2=0.072) Phase II (p = 0.726, R2 = 0.081)]. Clonazepam significantly increases the sleep efficiency [Phase I (p<0.001, R2 = 0.991) Phase II (p = 0.002, R2=0.998)] in Parkinson's patients but Clonazepam did not have any significant effect on wake after sleep onset, stage I sleep, sleep latency and wakefulness. Hence a larger population based longitudinal study should be performed to validate these findings.
Comparative evaluation of fosinopril and herbal drug Dioscorea bulbifera in patients of diabetic nephropathy.
(2013) R.G. Singh; M. Rajak; B. Ghosh; Usha; A. Agrawal; G.P. Dubey
Worldwide, diabetic nephropathy is one of the leading causes of end-stage renal failure. This hospital-based single-center prospective open-label randomized case-control interventional study was performed to evaluate and compare the native drug Dioscorea bulbifera with fosinopril in the management of diabetic nephropathy. Patients with diabetic nephropathy with proteinuria >500 mg/day or albuminuria >300 mg/ day, S Cr ≤2.5 mg/dL and hypertension controlled with a single drug were included into the study and were divided into three groups according to the interventional drugs that they were given; group A (n = 46) on fosinopril (5-40 mg/day), group B (n = 45) on Dioscorea bulbifera (500 mg BD) and group C (n = 46) on neither of these drugs. All necessary laboratory investigations needed to assess the effect of both the drugs were carried out. Patients were followed-up for six months. The study included 137 patients (M:F 2.61:1) with an age range of 19-76 years. At the sixth-month follow-up, a significant decrease in the systolic blood pressure was noted in all three groups whereas the diastolic blood pressure decreased significantly only in group B. There was significantly better control of both systolic and diastolic blood pressures in group B than in the other groups. Although fasting blood sugar was poorly controlled in the initial visit in all three groups, there was a significant decrease at the sixth-month follow-up in all three groups. Moreover, the decrease was significantly more pronounced in group B than in the other two groups. Low-density lipoprotein decreased significantly only in group B. Proteinuria, serum transforming growth factor-β, interleukin-6 (IL-6) and C-reactive protein decreased in both group A and group B, more so in the latter, but the differences between the groups were not statistically significant. Importantly, proteinuria and serum IL-6 showed an increasing trend in group C. It can be concluded that Dioscorea bulbifera was more effective than fosinopril in controlling blood pressure, glycemia, cholesterolemia and inflammatory state in diabetic nephropathy. Both agents decreased proteinuria. However, creatinine clearance significantly decreased with both the drugs, more so with Dioscera, and thus further evaluation with a larger trial is needed.
Congenital malformations at birth.
(1994) S. Swain; A. Agrawal; B.D. Bhatia
Three thousand nine hundred and thirty-two consecutive newborns were examined at birth for the presence of congenital malformations. The overall incidence of malformations was 1.2%. Congenital malformations accounted for 9.2% of perinatal and 12.8% of neonatal deaths. The central nervous system (39.5%) was most commonly involved followed by musculoskeletal system (14.5%). Involvement of more than one system was observed in 18.8% cases. Though there was higher incidence of malformations in babies born to mothers of more than 35 years the difference was not statistically significant. However, the babies born to mothers of gravidity 4 or more had significantly higher incidence of malformation when compared to mothers of lower gravidity (chi1(2) = 4.67, p < 0.05). The incidence of congenital malformations at birth was higher in stillborn and low birthweight babies.
Five insights from the Global Burden of Disease Study 2019
(Elsevier B.V., 2020) C. Abbafati; D.B. Machado; B. Cislaghi; O.M. Salman; M. Karanikolos; M. McKee; K.M. Abbas; O.J. Brady; H.J. Larson; S. Trias-Llimós; S. Cummins; S.M. Langan; B. Sartorius; A. Hafiz; E. Jenabi; N. Mohammad Gholi Mezerji; S. Borzouei; G. Azarian; S. Khazaei; M. Abbasi; B. Asghari; S. Masoumi; H. Komaki; A. Taherkhani; M. Adabi; M. Abbasifard; G. Bazmandegan; Z. Kamiab; A. Vakilian; M. Anjomshoa; A. Mokari; S. Sabour; M. Shahbaz; R. Saeedi; H. Ahmadieh; T. Yousefinezhadi; A. Haj-Mirzaian; R. Nikbakhsh; S. Safi; S. Asgari; S.N. Irvani; N. Jahanmehr; K. Ramezanzadeh; M. Abbasi-Kangevari; M. Khayamzadeh; H. Abbastabar; R. Shirkoohi; M. Fazlzadeh; H. Janjani; M. Hosseini; M. Mansournia; H. Tohidinik; A. Bakhtiari; A. Fazaeli; S. Mousavi; A. Hasanzadeh; B. Nabavizadeh; R. Malekzadeh; M. Hashemian; A. Pourshams; H. Salimzadeh; S.G. Sepanlou; M. Afarideh; A. Esteghamati; S. Esteghamati; A. Ghajar; B. Heidari; N. Rezaei; E. Mohamadi; A. Rahimi-Movaghar; F. Rahim; S. Eskandarieh; M. Sahraian; F. Mohebi; A. Aminorroaya; H. Ebrahimi; F. Farzadfar; B. Mohajer; F. Pishgar; S. Saeedi Moghaddam; M. Shabani; H. Zarafshan; H. Abolhassani; N. Hafezi-Nejad; R. Heidari-Soureshjani; M. Abdollahi; M. Farahmand; P. Salamati; E. Mehrabi Nasab; M. Tajdini; S. Aghamir; R. Mirzaei; Z. Dibaji Forooshani; M.M. Khater; F. Abd-Allah; A. Abdelalim; A. Abualhasan; S.I. El-Jaafary; A. Hassan; A. Elsharkawy; A.M. Khater; H.R. Elhabashy; M.R.R. Salem; H. Salem; M. Sadeghi; M. Jafarinia; M. Amini-Rarani; N. Mohammadifard; N. Sarrafzadegan; I. Abdollahpour; A. Sarveazad; A. Tehrani-Banihashemi; J. Yoosefi Lebni; N. Manafi; H. Pazoki Toroudi; F. Dorostkar; V. Alipour; A. Sheikhtaheri; J. Arabloo; S. Azari; A. Ghashghaee; A. Rezapour; M. Naserbakht; A. Kabir; F. Mehri; M. Yousefifard; M. Asadi-Aliabadi; E. Babaee; B. Eshrati; S. Goharinezhad; M. Moradi-Lakeh; P. Abedi; V. Rashedi; V. Kumar; I.Y. Elgendy; S. Basu; J. Park; A. Pereira; O.F. Norheim; A.W. Eagan; L.E. Cahill; A. Sheikh; A.I. Abushouk; M.U.G. Kraemer; B. Thakur; T.W. Bärnighausen; M.G. Shrime; A. Abedi; C.P. Doshi; K.H. Abegaz; B.S. Geberemariyam; Y.A. Aynalem; W.S. Shiferaw; A.E. Abosetugn; V. Aboyans; E.M. Abrams; M. Gitimoghaddam; N. Kissoon; J.L. Stubbs; M. Brauer; I.O. Iyamu; J.A. Kopec; F. Pourmalek; A.P. Ribeiro; D.C. Malta; R.S. Gomez; L.G. Abreu; M.R.M. Abrigo; A.M. Almulhim; S.M.A. Dahlawi; F.H. Pottoo; R.G. Menezes; T.M. Alanzi; A.K. Alumran; A.K. Abu Haimed; M. Madadin; F.M. Alanezi; E. Abu-Gharbieh; B. Saddik; L.J. Abu-Raddad; A.M. Samy; N. El Nahas; A.S. Shalash; A.F. Nabhan; A.M. Kamath; N.J. Kassebaum; A.Y. Aravkin; S. Kochhar; R.J.D. Sorensen; A. Afshin; K. Burkart; E.A. Cromwell; L. Dandona; S.D. Dharmaratne; E. Gakidou; S.I. Hay; H.H. Kyu; A.D. Lopez; R. Lozano; A.T. Misganaw; A.H. Mokdad; M. Naghavi; D.M. Pigott; R.C. Reiner; G.A. Roth; J.D. Stanaway; S. Vollset; T. Vos; H. Wang; S.S. Lim; C.J.L. Murray; R. Kalani; K.S. Ikuta; D.Y. Cho; C.J. Kneib; C.S. Crowe; B.B. Massenburg; S.D. Morrison; A. Acebedo; J.D. Adelson; K.M. Agesa; T. Alam; S.B. Albertson; J.A. Anderson; C.M. Antony; C. Ashbaugh; M. Assmus; G. Azhar; S. Balassyano; M.S. Bannick; C.M. Barthelemy; R.G. Bender; F.B. Bennitt; G.J. Bertolacci; M.H. Biehl; C. Bisignano; A.S. Boon-Dooley; P.S. Briant; D. Bryazka; B.R. Bumgarner; C.S. Callender; J. Cao; C.D. Castle; E. Castro; K. Causey; K.M. Cercy; J. Chalek; F.J. Charlson; A.J. Cohen; H. Comfort; K. Compton; A.J. Croneberger; J.A. Cruz; M. Cunningham; R. Dandona; W.J. Dangel; F.E. Dean; N.K. DeCleene; A. Deen; L. Degenhardt; Z.V. Dingels; I.N. Dippenaar; M.A. Dirac; A.J. Dolgert; S. Emmons-Bell; K. Estep; T. Farag; V.L. Feigin; R. Feldman; G. Ferrara; A.J. Ferrari; R. Fitzgerald; L.M. Force; J.T. Fox; T.D. Frank; W. Fu; K. Fukutaki; J.E. Fuller; N. Fullman; N.C. Galles; W.M. Gardner; A. Gershberg Hayoon; E. Goren; T.M. Gorman; H.C. Gottlich; G. Guo; B. Haddock; H. Hagins; L.M. Haile; E.B. Hamilton; C. Han; H. Han; J.D. Harvey; K. Henny; H.J. Henrikson; N.J. Henry; M.E. Herbert; T. Hsiao; C.K. Huynh; V.C. Iannucci; H. Ippolito; C.M.S. Irvine; H. Jafari; D. Jahagirdar; S.L. James; C.O. Johnson; S.C. Johnson; C. Keller; L. Kemmer; P.J. Kendrick; M. Knight; J.M. Kocarnik; K.J. Krohn; S.L. Larson; K.M. Lau; J.R. Ledesma; A.T. Leever; K.E. LeGrand; H. Lescinsky; C. Lin; H. Liu; Z. Liu; J. Lo; A. Lu; J. Ma; E.R. Maddison; H. Manguerra; A. Marks; I. Martopullo; C.I. Mastrogiacomo; E.A. May; M.D. Mooney; J.F. Mosser; E.C. Mullany; J. Mumford; S.B. Munro; V. Nandakumar; J. Nguyen; M. Nguyen; E. Nichols; M.R. Nixon; C.M. Odell; K.L. Ong; A.U. Orji; S.M. Ostroff; M. Pasovic; K.R. Paulson; S.A. Pease; A. Pennini; M. Pierce; T.M. Pilz; M. Pletcher; P.C. Rao; C. Razo; S.B. Redford; N. Reinig; M.B. Reitsma; P. Rhinehart; T. Robalik; S. Roberts; N.L.S. Roberts; S. Rolfe; A.N. Sbarra; L.E. Schaeffer; K.A. Shackelford; J. Shadid; F. Sharara; D.H. Shaw; B.S. Sheena; K.E. Simpson; A. Smith; C.N. Spencer; E.E. Spurlock; B.A. Stark; C. Steiner; K.M. Steuben; D.O. Sylte; M. Tang; H.J. Taylor; S. Terrason; A.M. Thomson; A.E. Torre; R. Travillian; C.E. Troeger; A. Vongpradith; M.K. Walters; J. Wang; A. Watson; S. Watson; J.L. Whisnant; H.A. Whiteford; K.E. Wiens; L.B. Wilner; S. Wilson; E.E. Wool; S.S. Wozniak; J. Wu; S. Wulf Hanson; H. Wunrow; R. Xu; S. Yadgir; J.A. Yearwood; H.W. York; C. Yuan; J.T. Zhao; P. Zheng; S.R.M. Zimsen; B.S. Zlavog; A.Y. Chang; E. Oren; R. Buchbinder; K.L. Chin; Y. Guo; K.R. Polkinghorne; A.G. Thrift; S.W.H. Lee; I.N. Ackerman; F.M. Cicuttini; S. Li; S. Zaman; H. Suleria; J. Zhang; B.C. Cowie; T. Wijeratne; G.C. Patton; S.M. Sawyer; T. Adair; A. Meretoja; O.O. Adetokunboh; A.A. Adamu; C.J. Iwu; C.D.H. Parry; S. Seedat; D.E. Ndwandwe; P.W. Mahasha; D.J. Stein; C.A. Nnaji; E.Z. Sambala; C.S. Wiysonge; O.M. Adebayo; O.S. Ilesanmi; M.O. Owolabi; A.M. Adeoye; I.A. Adedeji; V. Adekanmbi; S.E. Ibitoye; Y.O. John-Akinola; M.M. Oluwasanu; O.B. Oghenetega; R.O. Akinyemi; H. Zandian; D. Adham; T. Zahirian Moghadam; S.M. Advani; W.L. Teagle; D. Braithwaite; P. Agasthi; S. Saadatagah; M. Afshari; E.E. Agardh; P. Allebeck; A. Danielsson; K. Deuba; J.J. Carrero; D.K. Mohammad; S. Fereshtehnejad; J. Ärnlöv; C. Nowak; C.R. Cederroth; A. Ahmadi; A. Pathak; E.J. Mills; O.P. Kurmi; A.T. Olagunju; G. Agarwal; T. Sathish; M. Aghaali; A. Mohammadbeigi; A. Agrawal; T. Ahmad; K. Ahmadi; S. Maleki; M. Naderi; M.R. Salahshoor; R. Pourmirza Kalhori; A. Almasi; Y. Salimi; S. Siabani; A. Ziapour; A. Barzegar; H. Khazaie; N. Kianipour; F. Amiri; S. Salehi Zahabi; M. Mirzaei; M. Shamsi; F. Najafi; A. Jalali; K. Ghadiri; F. Heydarpour; N. Fattahi; B. Karami Matin; A. Kazemi Karyani; M. Pirsaheb; F. Rajati; E. Sadeghi; Y. Safari; K. Sharafi; S. Soltani; Y. Vasseghian; Z. Atafar; F. Jalilian; M. Mirzaei-Alavijeh; S. Saeidi; M. Soofi; A. Zangeneh; B. Mansouri; M. Ahmadi; M.A. Khafaie; S. Safiri; M. Moghadaszadeh; M. Asghari Jafarabadi; L. Doshmangir; F. Jadidi-Niaragh; M. Ghafourifard; A. Spotin; M. Khodayari; H. Samadi Kafil; L.R. Kalankesh; E. Ahmadpour; B. Yousefi; F. Ansari; H. Hassankhani; S. Karimi; H. Haririan; S. Mereta; M.B. Ahmed; G.T. Feyissa; L.G. Ciobanu; B. Aji; G.L. Aynalem; B. Gebresillassie; Y.G. Tefera; T.Y. Akalu; A.G. Baraki; G.A. Tesema; Z.T. Tessema; A.T. Tamiru; Z.N. Azene; H.B. Netsere; Y. Yano; T. Akinyemiju; C. Wu; S. Zadey; Z. Samad; J.S. Ji; P.P. Doshi; O. John; V. Jha; P.K. Maulik; K. Pesudovs; S. Resnikoff; P.B. Mitchell; P.S. Sachdev; B. Akombi; M.A. Godinho; R.Q. Ivers; A.E. Peden; R. Biswas; S. Boufous; C.J. Akunna; F. Alahdab; M.S. Hammer; A. van Donkelaar; Z. Al-Aly; R.P. Dellavalle; S. Alam; R.V. Martin; N. Alam; D. De Leo; S.K. Tadakamadla; K. Alam; J.E. Alcalde-Rabanal; L. Avila-Burgos; E. Serván-Mori; E. Denova-Gutiérrez; S. Rodríguez-Ramírez; L. Morales; A. Poznańska; B. Wojtyniak; J.A. Rivera; I.R. Campos-Nonato; J. Campuzano Rincon; T.G. Sánchez-Pimienta; M.B. Mengesha; F.T. Welay; N.M. Alema; D.G. Demsie; H. Teame; B.F. Teklehaimanot; B.W. Alemu; T. Gultie; A.B. Bante; Y.G. Yeshitila; Y.C.D. Geramo; M. Glagn; M.B. Sorrie; F.G. W/hawariat; A. Amare; A. Kasa; Y. Alemu; K.M. Mihretie; D.D. Atnafu; F.M. Demeke; A. Melese; S.A. Bante; G.A. Dessie; E.W. Mengesha; D. Nigatu; M.A.H. Almadi; K.F. Alhabib; Y. Mohammad; K.A. Altirkawi; M. Temsah; N. Kugbey; M.A. Ayanore; R.K. Alhassan; M. Ali; S. Ali; G. Alicandro; R. Kalhor; M. Alijanzadeh; C. Alinia; H. Yusefzadeh; A. Didarloo; H. Alizade; A. Nikpoor; S.M. Aljunid; F. Alla; L.F. Leal; A. Almasi-Hashiani; R. Moradzadeh; M. Zamanian; J. Nazari; S. Amini; F. Ghamari; N.A. Almasri; M. Khan; H.M. Al-Mekhlafi; N. Bedi; J. Alonso; E.S.P. Ciber; R.M. Al-Raddadi; J. Zakzuk; N. Alvis-Guzman; N.J. Alvis-Zakzuk; C.A. Castañeda-Orjuela; J.N. Malagón-Rojas; K. Gezae; H.A. Gesesew; S. Muthupandian; G.G. Gebremeskel; K. Berhe; B. Amare; M.A. Ayza; L.G. Gebremeskel; A.A.A. Gebreslassie; H. Bitew; K.A. Zewdie; F.G.G. Tela; T.K. Gill; J. Noubiap; Z.S. Lassi; D. Bhandari; A.L. Amit; C.T. Antonio; E.A. Faraon; J.F. Lopez; S.R. Atre; S.H. Ballew; K. Matsushita; A.T. Khoja; P. Daneshpajouhnejad; M. Ghadimi; O. Shafaat; J. Fanzo; D.A. Amugsi; G.H. Amul; D.S.Q. Koh; N. Venketasubramanian; E.W. Anbesu; J.A. Mohammed; T.G. Wondmeneh; C. Andrei; R.I. Negoi; D.V. Davitoiu; A. Manda; I. Negoi; L. Preotescu; M. Hostiuc; S. Hostiuc; R. Ancuceanu; M. Hasan; J. Leung; D. Anderlini; A.A. Mamun; J.C. Maravilla; J.J. McGrath; R. Lalloo; R. Uddin; H.E. Erskine; L.D. Knibbs; A.M. Mantilla Herrera; D.F. Santomauro; A. Mirica; M. Ausloos; C. Herteliu; A. Oţoiu; A. Pana; T. Andrei; S. Ştefan; S. Androudi; C. Angus; I. Ansari; H. Pourjafar; M. Shams-Beyranvand; A. Ansari-Moghaddam; M. Khammarnia; I. Antonazzo; P. Ferrara; S. Conti; P.A. Cortesi; C. Fornari; P.H. Lee; E. Antriyandarti; Z. Yousefi; A. Rafiei; J. Javidnia; R. Faridnia; D. Anvari; A. Goudarzian; M. Moosazadeh; M. Rezai; A. Daryani; M. Fareed; R. Anwer; S. Appiah; D. Paudel; M. Dichgans; S. Riahi; A. Rajabpour-Sanati; M. Arab-Zozani; A.A.K. Arba; O. Aremu; F. Ariani; T. Aripov; B. Armoon; M.M. Mahdavi; O.O. Arowosegbe; F. Tediosi; K.K. Aryal; A. Mosapour; M. Yaminfirooz; A. Arzani; A. Bijani; M.A. Jahani; S. Mouodi; M. Zamani; M. Asaad; M. Dianatinasab; M. Bahrami; K. Pakshir; A.A. Asadi-Pooya; M. Bayati; S. Shahabi; S. Athari; M.M.W. Atout; M.S. Atteraya; T. Brugha; F. Ausloos; E.F.G. Avokpaho; R. Room; M. Islam; D. Edvardsson; M. Rahman; B. Ayala Quintanilla; P.W. Gething; A.M. Briggs; G. Ayano; D. Hendrie; T.R. Miller; P.S. Azzopardi; P. Hoogar; D.B. B; V. Kulkarni; N. Kumar; P. Mithra; R.S. Shetty; R. Thapar; J. Padubidri; S.M. Bakkannavar; V.C. Nayak; P. Rastogi; B.K. Shetty; R. Bhageerathy; N. Gudi; A. Boloor; R. Holla; P. Rathi; B. Unnikrishnan; M.D. Janodia; J.J. Lang; A. Badawi; H.M. Orpana; Z.A. Bhutta; K.D. Shield; V. Chattu; A.D. Badiye; N. Kapoor; M. Bagherzadeh; N. Rabiee; E. Bagli; A.A. Baig; M. Bairwa; R. Lodha; R. Sagar; G.K. Rath; P. Bhardwaj; J. Charan; T. Kanchan; A. Joshi; A.P. Pakhare; M. Bakhshaei; B. Naghshtabrizi; A. Balachandran; H.W. Hoek; M.J. Postma; A. Geremew; A.M. Gebrehiwot; S. Balakrishnan; A. Desalew; H.A. Bojia; A.S. Mohammed; L.D. Regassa; P.G.K. Parmar; S. Balalla; S. Roberts; A. Baldasseroni; M.A. Stokes; K. Ball; S. Islam; R. Maddison; D. Balzi; M. Levi; M. Banach; S.K. Banerjee; P.C. Banik; L. Barua; M. Faruque; M.A. Barboza; S.L. Barker-Collo; J.B. Jonas; S. Panda-Jonas; J. De Neve; S. Kohler; B. Moazen; Shafiu Mohammed; L.H. Barrero; H. Basaleem; Q. Bassat; J.M. Haro; A. Koyanagi; J. Car; F. Greaves; A. Majeed; A.C. Davis; T.J. Steiner; D. Kusuma; R. Palladino; S. Rawaf; S. Saxena; D.L. Rawaf; B.T. Baune; A. Karch; B.A. Baye; J. Darega Gela; T. Kolola; J.S. Becker; M. DeLang; J. West; M.M. Gad; M.L. Serre; S. Gallus; A. Lugo; E. Beghi; E. Pupillo; C. Bosetti; G. Giussani; B. Bikbov; N. Perico; G. Remuzzi; M. Imani-Nasab; S. Nouraei Motlagh; Z. Sharafi; M. Behzadifar; Y. Béjot; T.T. Bekuma; M.T. Yilma; M.L. Bell; A.K. Bello; A. Rafiee; S.H. Keddie; T.C.D. Lucas; C. Dolecek; S.J. Dunachie; S.F. Rumisha; D.J. Weiss; S. Lewington; E.L. Collins; A.K. Nandi; Y. Zhao; D.A. Bennett; M.A. Karim; B. Lacey; R. Khundkar; S. Yaya; A.C. Goulart; I.S. Santos; I.M. Bensenor; P.A. Lotufo; M.R. Tovani-Palone; J. Castaldelli-Maia; Y. Wang; J.M. Furtado; C.P. Benziger; A.E. Berman; M. Mazidi; E. Bernabe; P.I. Dargan; M. Molokhia; K. Shibuya; A. Douiri; C.D.A. Wolfe; R.J. Hay; C. Flohr; P.S. Suchdev; P. Ram; R.S. Bernstein; Y. Liu; A.S. Bhagavathula; G. Khan; M. Grivna; N. Bhala; J.S. Chandan; A.M. Gaidhane; Z. Quazi Syed; D. Saxena; M. Khatib; A.G. Bhat; K. Bhattacharyya; S. Bhattarai; J.K. Das; S. Bibi; V. Bilano; M. Bin Sayeed; N. Cherbuin; E. D'Amico; G. Grosso; A.M. Borzì; A. Biondi; M. Vacante; A. Valli; B.M. Birihane; D. Bisanzio; S. Hassan; T. Bjørge; S. Øverland; M.J. Bockarie; G.A. Mensah; K. Sliwa; A. Gholamian; S. Bohlouli; S. Esmaeilnejad; M. Bohluli; S.R. Bolla; G. Borges; D. Bose; R. 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Effiong; C.D. Pond; J.R. Ehrlich; X. Liu; M.Y.W. Wei; I. El Sayed; M. El Tantawi; M. El Sayed Zaki; I. Elbarazi; A.C. Tsai; I.R. Elyazar; V. Yazdi-Feyzabadi; K. Eskandari; H. Sharifi; I. Halvaei; F. Ghaffarifar; L. Zaki; E. Hasanpoor; F. Esmaeilzadeh; A. Etemadi; Q. Lan; T.Y. Yeheyis; A.E. Etisso; O. Ezekannagha; C.S. e Farinha; A. Farioli; F.S. Violante; P.S. Faris; A. Faro; J.O. Lam; I. Filip; F. Fischer; L.S. Flor
The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 provides a rules-based synthesis of the available evidence on levels and trends in health outcomes, a diverse set of risk factors, and health system responses. GBD 2019 covered 204 countries and territories, as well as first administrative level disaggregations for 22 countries, from 1990 to 2019. Because GBD is highly standardised and comprehensive, spanning both fatal and non-fatal outcomes, and uses a mutually exclusive and collectively exhaustive list of hierarchical disease and injury causes, the study provides a powerful basis for detailed and broad insights on global health trends and emerging challenges. GBD 2019 incorporates data from 281 586 sources and provides more than 3·5 billion estimates of health outcome and health system measures of interest for global, national, and subnational policy dialogue. All GBD estimates are publicly available and adhere to the Guidelines on Accurate and Transparent Health Estimate Reporting. From this vast amount of information, five key insights that are important for health, social, and economic development strategies have been distilled. These insights are subject to the many limitations outlined in each of the component GBD capstone papers. © 2020 Elsevier Ltd
Global age-sex-specific fertility, mortality, healthy life expectancy (HALE), and population estimates in 204 countries and territories, 1950–2019: a comprehensive demographic analysis for the Global Burden of Disease Study 2019
(Elsevier B.V., 2020) C. Abbafati; D.B. Machado; B. Cislaghi; O.M. Salman; M. Karanikolos; M. McKee; K.M. Abbas; O.J. Brady; H.J. Larson; S. Trias-Llimós; S. Cummins; S.M. Langan; B. Sartorius; A. Hafiz; E. Jenabi; N. Mohammad Gholi Mezerji; S. Borzouei; G. Azarian; S. Khazaei; M. Abbasi; B. Asghari; S. Masoumi; H. Komaki; A. Taherkhani; M. Adabi; M. Abbasifard; G. Bazmandegan; Z. Kamiab; A. Vakilian; M. Anjomshoa; A. Mokari; S. Sabour; M. Shahbaz; R. Saeedi; H. Ahmadieh; T. Yousefinezhadi; A. Haj-Mirzaian; R. Nikbakhsh; S. Safi; S. Asgari; S.N. Irvani; N. Jahanmehr; K. Ramezanzadeh; M. Abbasi-Kangevari; M. Khayamzadeh; H. Abbastabar; R. Shirkoohi; M. Fazlzadeh; H. Janjani; M. Hosseini; M. Mansournia; H. Tohidinik; A. Bakhtiari; A. Fazaeli; S. Mousavi; A. Hasanzadeh; B. Nabavizadeh; R. Malekzadeh; M. Hashemian; A. Pourshams; H. Salimzadeh; S.G. Sepanlou; M. Afarideh; A. Esteghamati; S. Esteghamati; A. Ghajar; B. Heidari; N. Rezaei; E. Mohamadi; A. Rahimi-Movaghar; F. Rahim; S. Eskandarieh; M. Sahraian; F. Mohebi; A. Aminorroaya; H. Ebrahimi; F. Farzadfar; B. Mohajer; F. Pishgar; S. Saeedi Moghaddam; M. Shabani; H. Zarafshan; H. Abolhassani; N. Hafezi-Nejad; R. Heidari-Soureshjani; M. Abdollahi; M. Farahmand; P. Salamati; E. Mehrabi Nasab; M. Tajdini; S. Aghamir; R. Mirzaei; Z. Dibaji Forooshani; M.M. Khater; F. Abd-Allah; A. Abdelalim; A. Abualhasan; S.I. El-Jaafary; A. Hassan; A. Elsharkawy; A.M. Khater; H.R. Elhabashy; M.R.R. Salem; H. Salem; M. Sadeghi; M. Jafarinia; M. Amini-Rarani; N. Mohammadifard; N. Sarrafzadegan; I. Abdollahpour; A. Sarveazad; A. Tehrani-Banihashemi; J. Yoosefi Lebni; N. Manafi; H. Pazoki Toroudi; F. Dorostkar; V. Alipour; A. Sheikhtaheri; J. Arabloo; S. Azari; A. Ghashghaee; A. Rezapour; M. Naserbakht; A. Kabir; F. Mehri; M. Yousefifard; M. Asadi-Aliabadi; E. Babaee; B. Eshrati; S. Goharinezhad; M. Moradi-Lakeh; P. Abedi; V. Rashedi; V. Kumar; I.Y. Elgendy; S. Basu; J. Park; A. Pereira; O.F. Norheim; A.W. Eagan; L.E. Cahill; A. 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Background: Accurate and up-to-date assessment of demographic metrics is crucial for understanding a wide range of social, economic, and public health issues that affect populations worldwide. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 produced updated and comprehensive demographic assessments of the key indicators of fertility, mortality, migration, and population for 204 countries and territories and selected subnational locations from 1950 to 2019. Methods: 8078 country-years of vital registration and sample registration data, 938 surveys, 349 censuses, and 238 other sources were identified and used to estimate age-specific fertility. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate age-specific fertility rates for 5-year age groups between ages 15 and 49 years. With extensions to age groups 10–14 and 50–54 years, the total fertility rate (TFR) was then aggregated using the estimated age-specific fertility between ages 10 and 54 years. 7417 sources were used for under-5 mortality estimation and 7355 for adult mortality. ST-GPR was used to synthesise data sources after correction for known biases. Adult mortality was measured as the probability of death between ages 15 and 60 years based on vital registration, sample registration, and sibling histories, and was also estimated using ST-GPR. HIV-free life tables were then estimated using estimates of under-5 and adult mortality rates using a relational model life table system created for GBD, which closely tracks observed age-specific mortality rates from complete vital registration when available. Independent estimates of HIV-specific mortality generated by an epidemiological analysis of HIV prevalence surveys and antenatal clinic serosurveillance and other sources were incorporated into the estimates in countries with large epidemics. Annual and single-year age estimates of net migration and population for each country and territory were generated using a Bayesian hierarchical cohort component model that analysed estimated age-specific fertility and mortality rates along with 1250 censuses and 747 population registry years. We classified location-years into seven categories on the basis of the natural rate of increase in population (calculated by subtracting the crude death rate from the crude birth rate) and the net migration rate. We computed healthy life expectancy (HALE) using years lived with disability (YLDs) per capita, life tables, and standard demographic methods. Uncertainty was propagated throughout the demographic estimation process, including fertility, mortality, and population, with 1000 draw-level estimates produced for each metric. Findings: The global TFR decreased from 2·72 (95% uncertainty interval [UI] 2·66–2·79) in 2000 to 2·31 (2·17–2·46) in 2019. Global annual livebirths increased from 134·5 million (131·5–137·8) in 2000 to a peak of 139·6 million (133·0–146·9) in 2016. Global livebirths then declined to 135·3 million (127·2–144·1) in 2019. Of the 204 countries and territories included in this study, in 2019, 102 had a TFR lower than 2·1, which is considered a good approximation of replacement-level fertility. All countries in sub-Saharan Africa had TFRs above replacement level in 2019 and accounted for 27·1% (95% UI 26·4–27·8) of global livebirths. Global life expectancy at birth increased from 67·2 years (95% UI 66·8–67·6) in 2000 to 73·5 years (72·8–74·3) in 2019. The total number of deaths increased from 50·7 million (49·5–51·9) in 2000 to 56·5 million (53·7–59·2) in 2019. Under-5 deaths declined from 9·6 million (9·1–10·3) in 2000 to 5·0 million (4·3–6·0) in 2019. Global population increased by 25·7%, from 6·2 billion (6·0–6·3) in 2000 to 7·7 billion (7·5–8·0) in 2019. In 2019, 34 countries had negative natural rates of increase; in 17 of these, the population declined because immigration was not sufficient to counteract the negative rate of decline. Globally, HALE increased from 58·6 years (56·1–60·8) in 2000 to 63·5 years (60·8–66·1) in 2019. HALE increased in 202 of 204 countries and territories between 2000 and 2019. Interpretation: Over the past 20 years, fertility rates have been dropping steadily and life expectancy has been increasing, with few exceptions. Much of this change follows historical patterns linking social and economic determinants, such as those captured by the GBD Socio-demographic Index, with demographic outcomes. More recently, several countries have experienced a combination of low fertility and stagnating improvement in mortality rates, pushing more populations into the late stages of the demographic transition. Tracking demographic change and the emergence of new patterns will be essential for global health monitoring. Funding: Bill & Melinda Gates Foundation. © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980–2015: a systematic analysis for the Global Burden of Disease Study 2015
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Khader; E.A. Khan; Y.H. Khang; S. Won; S. Khera; M. Tavakkoli; T.A.M. Khoja; D. Kim; Y.J. Kim; B.M. Kissela; Y. Kokubo; D. Kolte; S.T. McGarvey; S. Kosen; P.A. Koul; A. Koyanagi; B. Kuate Defo; B. Kucuk Bicer; E.J. Kuipers; V.S. Kulkarni; G.F. Kwan; S.R. Rao; H. Lam; J.O. Lam; J.B. Nachega; B.X. Tran; V.C. Lansingh; D.O. Laryea; A.A. Latif; A.E.B. Lawrynowicz; M. Levi; Y. Li; S.E. Lipshultz; J.D. Wilkinson; E.P. Simard; Y. Liu; M.R. Phillips; Q. Xiao; L. Lo; G. Logroscino; R. Lunevicius; S. Ma; V.M. Machado; M.T. Mackay; H. Magdy Abd El Razek; M. Magdy Abd El Razek; J. Mandisarisa; S. Mangalam; W. Marcenes; P.A. Meaney; D.J. Margolis; D.H. Silberberg; G.R. Martin; J. Martinez-Raga; M.B. Marzan; A.J. Mason-Jones; B.J. McMahon; M.M. Mehndiratta; S.M. Woldeyohannes; B.A. Tedla; B.M. Zeleke; P. Memiah; Z.A. Memish; W. Mendoza; T.J. Meretoja; T. Lallukka; F.A. Mhimbira; R. Micha; D. Mozaff; P. Shi; G.M. Singh; T.R. Miller; K.A. Mohammad; A. Mohammadi; V. Mohan; G.L.D. Mola; L. Monasta; M. Montico; L. Ronfani; L. Morawska; A. Werdecker; U.O. Mueller; R. Westerman; K.I. Musa; A.J. Paternina; S. Seedat; G. Nagel; D. Rothenbacher; K.S. Naidoo; B. Sartorius; L. Naldi; G. Remuzzi; V. Nangia; D. Nash; C. Nejjari; S. Neupane; C.R. Newton; F.N. Ngalesoni; J.D. Ngirabega; Q.L. Nguyen; P.M. Nkamedjie Pete; M. Nomura; L. Nyakarahuka; F.A. Ogbo; T. Ohkubo; P.R. Olivares; B.O. Olusanya; J.O. Olusanya; J.N. Opio; E. Oren; A. Ortiz; E. Ota; R. Ozdemir; P.A. Mahesh; J.D. Pandian; P.R. Pant; C. Papachristou; E. Park; J. Park; S.B. Patten; M. Tonelli; L. Stokic Pejin; D.M. Pereira; M. Cortinovis; G. Giussani; N. Perico; K. Pesudovs; J.D. Pillay; D. Plass; J.A. Platts-Mills; S. Polinder; C.A. Pope; M. Qorbani; A. Rafay; S.M. Rana; M. Rahman; S.U. Rahman; R.K. Rai; S. Rajsic; M. Raju; I. Rakovac; C.L. Ranabhat; T. Rangaswamy; A.L. Ribeiro; S. Ricci; A. Roca; D. Rojas-Rueda; N.K. Roy; G.M. Ruhago; B.F. Sunguya; S. Saha; R. Sahathevan; M.M. Saleh; J.R. Sanabria; M.D. Sanchez-Niño; L. Sanchez-Riera; R. Sarmiento-Suarez; M. Sawhney; M.P. Schaub; I.J.C. Schneider; D.A.S. Silva; A.E. Schutte; G. Shaddick; A. Shaheen; S. Shahraz; M.A. Shaikh; R. Sharma; B.P. Shetty; M. Shin; R. Shiri; I.D. Sigfusdottir; D.G.A. Silveira; J.I. Silverberg; Y. Yano; O.P. Singh; P.K. Singh; V. Singh; S. Soneji; K. Søreide; J.B. Soriano; L.A. Sposato; C.T. Sreeramareddy; V. Stathopoulou; M.B. Stein; S. Stranges; K. Stroumpoulis; S. Swaminathan; B.L. Sykes; R. Tabarés-Seisdedos; K.M. Tabb; J.S. Takala; R.T. Talongwa; B. Taye; M. Ten Have; E.M. Tuzcu; A.J. Thomson; A.G. Thrift; G.D. Thurston; R. Topor-Madry; F. Topouzis; J.A. Towbin; J. Traebert; T. Truelsen; U. Trujillo; U.S. Uchendu; K.N. Ukwaja; O.A. Uthman; R. Van Dingenen; A. van Donkelaar; T. Vasankari; A.M.N. Vasconcelos; N. Venketasubramanian; R. Vidavalur; F.S. Violante; V.V. Vlassov; M.T. Wallin; S. Weichenthal; R.A. White; H.C. Williams; J.Q. Wong; A.D. Woolf; D. Xavier; G. Xu; B. Yakob; L.L. Yan; P. Yip; N. Yonemoto; G. Yonga; M.Z. Younis; Z. Zaidi; M.E. Zaki; F. Zannad; D.E. Zavala; H. Zeeb; D. Zonies; L.J. Zuhlke
Background Improving survival and extending the longevity of life for all populations requires timely, robust evidence on local mortality levels and trends. The Global Burden of Disease 2015 Study (GBD 2015) provides a comprehensive assessment of all-cause and cause-specific mortality for 249 causes in 195 countries and territories from 1980 to 2015. These results informed an in-depth investigation of observed and expected mortality patterns based on sociodemographic measures. Methods We estimated all-cause mortality by age, sex, geography, and year using an improved analytical approach originally developed for GBD 2013 and GBD 2010. Improvements included refinements to the estimation of child and adult mortality and corresponding uncertainty, parameter selection for under-5 mortality synthesis by spatiotemporal Gaussian process regression, and sibling history data processing. We also expanded the database of vital registration, survey, and census data to 14 294 geography–year datapoints. For GBD 2015, eight causes, including Ebola virus disease, were added to the previous GBD cause list for mortality. We used six modelling approaches to assess cause-specific mortality, with the Cause of Death Ensemble Model (CODEm) generating estimates for most causes. We used a series of novel analyses to systematically quantify the drivers of trends in mortality across geographies. First, we assessed observed and expected levels and trends of cause-specific mortality as they relate to the Socio-demographic Index (SDI), a summary indicator derived from measures of income per capita, educational attainment, and fertility. Second, we examined factors affecting total mortality patterns through a series of counterfactual scenarios, testing the magnitude by which population growth, population age structures, and epidemiological changes contributed to shifts in mortality. Finally, we attributed changes in life expectancy to changes in cause of death. We documented each step of the GBD 2015 estimation processes, as well as data sources, in accordance with Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER). Findings Globally, life expectancy from birth increased from 61·7 years (95% uncertainty interval 61·4–61·9) in 1980 to 71·8 years (71·5–72·2) in 2015. Several countries in sub-Saharan Africa had very large gains in life expectancy from 2005 to 2015, rebounding from an era of exceedingly high loss of life due to HIV/AIDS. At the same time, many geographies saw life expectancy stagnate or decline, particularly for men and in countries with rising mortality from war or interpersonal violence. From 2005 to 2015, male life expectancy in Syria dropped by 11·3 years (3·7–17·4), to 62·6 years (56·5–70·2). Total deaths increased by 4·1% (2·6–5·6) from 2005 to 2015, rising to 55·8 million (54·9 million to 56·6 million) in 2015, but age-standardised death rates fell by 17·0% (15·8–18·1) during this time, underscoring changes in population growth and shifts in global age structures. The result was similar for non-communicable diseases (NCDs), with total deaths from these causes increasing by 14·1% (12·6–16·0) to 39·8 million (39·2 million to 40·5 million) in 2015, whereas age-standardised rates decreased by 13·1% (11·9–14·3). Globally, this mortality pattern emerged for several NCDs, including several types of cancer, ischaemic heart disease, cirrhosis, and Alzheimer's disease and other dementias. By contrast, both total deaths and age-standardised death rates due to communicable, maternal, neonatal, and nutritional conditions significantly declined from 2005 to 2015, gains largely attributable to decreases in mortality rates due to HIV/AIDS (42·1%, 39·1–44·6), malaria (43·1%, 34·7–51·8), neonatal preterm birth complications (29·8%, 24·8–34·9), and maternal disorders (29·1%, 19·3–37·1). Progress was slower for several causes, such as lower respiratory infections and nutritional deficiencies, whereas deaths increased for others, including dengue and drug use disorders. Age-standardised death rates due to injuries significantly declined from 2005 to 2015, yet interpersonal violence and war claimed increasingly more lives in some regions, particularly in the Middle East. In 2015, rotaviral enteritis (rotavirus) was the leading cause of under-5 deaths due to diarrhoea (146 000 deaths, 118 000–183 000) and pneumococcal pneumonia was the leading cause of under-5 deaths due to lower respiratory infections (393 000 deaths, 228 000–532 000), although pathogen-specific mortality varied by region. Globally, the effects of population growth, ageing, and changes in age-standardised death rates substantially differed by cause. Our analyses on the expected associations between cause-specific mortality and SDI show the regular shifts in cause of death composition and population age structure with rising SDI. Country patterns of premature mortality (measured as years of life lost [YLLs]) and how they differ from the level expected on the basis of SDI alone revealed distinct but highly heterogeneous patterns by region and country or territory. Ischaemic heart disease, stroke, and diabetes were among the leading causes of YLLs in most regions, but in many cases, intraregional results sharply diverged for ratios of observed and expected YLLs based on SDI. Communicable, maternal, neonatal, and nutritional diseases caused the most YLLs throughout sub-Saharan Africa, with observed YLLs far exceeding expected YLLs for countries in which malaria or HIV/AIDS remained the leading causes of early death. Interpretation At the global scale, age-specific mortality has steadily improved over the past 35 years; this pattern of general progress continued in the past decade. Progress has been faster in most countries than expected on the basis of development measured by the SDI. Against this background of progress, some countries have seen falls in life expectancy, and age-standardised death rates for some causes are increasing. Despite progress in reducing age-standardised death rates, population growth and ageing mean that the number of deaths from most non-communicable causes are increasing in most countries, putting increased demands on health systems. Funding Bill & Melinda Gates Foundation. © 2016 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY license
In vivo antioxidant and neuroprotective effect of Hippophae rhamnoides. L
(2013) Shivapriya Shivakumar; K. Ilango; A. Agrawal; A. Trigunyat; G.P. Dubey
Background: Oxidative stress leads to many disorders and this can be overcome using plants sources, rich in antioxidants that can reduce the damage caused by these stress markers. Prolonged oxidative stress to neurons in the brain leads to increased formation of lipofuscin. Lipofuscin is a yellow-brown product which accumulates in various cells like nerve cells, ganglia cells, heart and muscle cells and it is the end product of oxidation of lipids, protein and other biomolecules present in the cell and it is found to be a principal marker of brain vulnerability, stress, aging and related pathology. Materials and Method: Hippophae rhamnoides is a rich source of anti-oxidants. Present study was conducted to evaluate the neuroprotective and antioxidant activities of H. rhamnoides. Sprague dawley rats of different age groups were used for the study. The neuroprotective activity of the plant was assessed by its ability to maintain the level of neurotransmitters. The antioxidant activity was measured from the level of stress markers and lipofuscin pigmentation. Lipofuscin pigment formation was estimated by a quantitative method based on fluorescence spectroscopy. Results: It was observed that there was an increase in the level of the neurotransmitters in treated animals it is also seen the lipofuscin concentration was (6-8 times) less in H. rhamnoides treated animals when compared with normal aged animals. Conclusion: The results conclude that H. rhamnoides has a therapeutic potential to act as a neuroprotective and antioxidant agent by reducing oxidative stress markers and lipofuscin pigments.
Markers of genital tuberculosis in infertility
(2011) A. Khanna; A. Agrawal
Introduction: Although genital tuberculosis is a condition that is prevalent worldwide, it is still a diagnostic dilemma. This study aimed to find an effective diagnostic modality for the condition. Methods: A total of 100 infertile women were clinically evaluated with haemoglobin estimation, total and differential count, Mantoux test, tubercle bacilli enzyme-linked immunosorbent assay (TB ELISA), hysterosalpingography, pelvic ultrasonography, laparohysteroscopy, premenstrual endometrial biopsy for histopathology, culture and tubercle bacilli polymerase chain reaction (TBPCR). The womens' Day 2 hormonal profile (luteinising, follicle-stimulating, prolactin and thyroid-stimulating hormones) and their husbands' semen analysis were also conducted. Results: A total of 58 women had primary infertility and 42 had secondary infertility. Female factor infertility was present in 63 percent of the cases (mostly tubal; 45.97 percent). 26 women tested positive for endometrial TBPCR. Erythrocyte sedimentation rate, Mantoux test, TB ELISA and hysterosalpingography were found to have high negative predictive value (greater than 80 percent), while the positive predictive value was 35-45 percent. Laparoscopy findings were suggestive of tuberculosis in 13 percent of the women, out of which 83.3 percent were positive for endometrial TBPCR. Hysteroscopy revealed intrauterine adhesions in 34.8 percent of the women, with 68.8 percent being positive for tubercular bacilli. Conclusion: Our study established that in cases of genital tuberculosis, the use of expensive endometrial TBPCR tests may be avoided with a detailed workup, which would also help in the institution of anti-tubercular treatment in early disease, thus enhancing the chance of pregnancy.
Measuring the health-related Sustainable Development Goals in 188 countries: a baseline analysis from the Global Burden of Disease Study 2015
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Andersen; C.A.T. Antonio; P. Anwari; J. Ärnlöv; A. Larsson; A. Artaman; H. Asayesh; R.J. Asghar; S. Atique; E.F.G.A. Avokpaho; A. Awasthi; B.P. Ayala Quintanilla; U. Bacha; K. Balakrishnan; A. Barac; S.L. Barker-Collo; S. Mohammed; L.H. Barrero; S. Basu; L.C. Del; S. Bazargan-Hejazi; J. Beardsley; N. Bedi; E. Beghi; Y. Béjot; K.N. Sheth; M.L. Bell; A.K. Bello; I.S. Santos; I.M. Bensenor; P.A. Lotufo; A. Berhane; C.D. Wolfe; E. Bernabé; I. Wolfe; O.A. Bernal; H.S. Roba; A.S. Beyene; Y.M. Mesfin; N. Bhala; S. Bhatt; S. Biadgilign; B. Bikbov; S. Soneji; E. Bjertness; A.S. Htet; R.R.A. Bourne; M. Brainin; H. Krueger; C.C. Gotay; N. Kissoon; S. Murthy; F. Pourmalek; A. Brazinova; M. Majdan; J. Shen; N.J.K. Breitborde; D.M. Broday; T.S. Brugha; R. Buchbinder; B. Gabbe; A.G. Thrift; Z.A. Butt; A. van Donkelaar; R.V. Martin; H. Carabin; R. Cárdenas; V. Caso; C.A. Castañeda-Orjuela; J. Castillo Rivas; F. Catalá-López; F. Cavalleri; P. Cecílio; J. das Neves; J. Massano; J.M. Pedro; H. Chang; J. Chang; X. Che; P.P. Chiang; M. Chibalabala; V.H. Chisumpa; C.C. Mapoma; J.J. Choi; R. Chowdhury; H. Christensen; M. Cirillo; F.B. Piel; A. Rodriguez; G.S. Cooke; A. Majeed; L.T. Cooper; J.A. Crump; S. Derrett; R.G. Poulton; S.A. Damtew; S.B. Workie; K. Deribe; W. Tefera; A.Z. Giref; D. Haile; G. Temam Shifa; P.I. Dargan; A.C. Davis; J.N. Newton; N. Steel; K. Davletov; E.F. de Castro; D. De Leo; L. Degenhardt; S. Resnikoff; P.B. Mitchell; D.C. Des Jarlais; S. Dey; P.K. Dhillon; D.K. Lal; S. Zodpey; S.D. Dharmaratne; E.R. Dorsey; K.E. Doyle; A.H. Kemp; M. Dubey; M.H.U. Rahman; U. Ram; A. Singh; R.K. Verma; A.K. Yadav; B.B. Duncan; C. Kieling; M.I. Schmidt; H. Ebrahimi; A. Esteghamati; F. Farzadfar; N. Hafezi-Nejad; A. Kasaeian; M. Parsaeian; F. Pishgar; S. Sheikhbahaei; S. Fahimi; R. Malekzadeh; G. Roshandel; S.G. Sepanlou; M.S. Hassanvand; A. Khosravi; V. Rahimi-Movaghar; A.Y. Endries; S.P. Ermakov; S. Soshnikov; B. Eshrati; T.A. Farid; A.R. Khan; C.S.E.S. Farinha; A. Faro; V.L. Feigin; M.M. Felicio; J.G. Fernandes; F. Fischer; N. Foigt; I. Shiue; F.G.R. Fowkes; E.B. Franca; R.C. Franklin; A.L. Garcia-Basteiro; T. Gebre; B.D. Gessner; R.F. Gillum; A. Mehari; I.A. Ginawi; M. Giroud; M.D. Gishu; A.K. Tura; P. Gona; A. Goodridge; S.V. Gopalani; A. Goto; M. Inoue; K.F. Greenwell; R. Gupta; R. Gupta; V. Gupta; R.A. Gutiérrez; B. Gyawali; K.M. Iburg; Y.A. Halasa; E.A. Undurraga; R.R. Hamadeh; S. Hamidi; M. Hammami; G.J. Hankey; J.M. Haro; H.W. Hoek; V. Skirbekk; M. Horino; N. Horita; H.D. Hosgood; D.G. Hoy; G. Hu; H. Huang; B.T. Idrisov; G.F. Kwan; N. Kawakami; K. Shibuya; F. Islami; T.A. Jacobs; K.H. Jacobsen; M.B. Jakovljevic; H.A.F. Jansen; M. Javanbakht; A.U. Jayatilleke; S.H. Jee; Y. Jiang; T. Jibat; J.B. Jonas; Z. Kabir; Y. Kalkonde; R. Kamal; C.N. Kesavachandran; J. She; H. Kan; A. Kandel; A. Karch; C. Karimkhani; P. Karunapema; A. Kaul; J.F. Kayibanda; P.N. Keiyoro; R. Matzopoulos; C.D. Parry; A.P. Kengne; C.S. Wiysonge; D.J. Stein; B.M. Mayosi; M. Shey; A. Keren; Y.S. Khader; E.A. Khan; G. Khan; Y.H. Khang; S. Won; T.A.M. Khoja; J. Khubchandani; C. Kim; D. Kim; S. Kim; Y.J. Kim; R.W. Kimokoti; Y. Kokubo; D. Kolte; S. Kosen; P.A. Koul; A. Koyanagi; M. Kravchenko; Y.Y. Varakin; B. Kuate Defo; R.S. Kuchenbecker; E.J. Kuipers; V.S. Kulkarni; A. Lal; R.M. Lucas; H. Lam; Q. Lan; D.O. Laryea; A.A. Latif; J.L. Leasher; M. Leinsalu; R. Leung; M. Levi; S. Linn; S.E. Lipshultz; J.D. Wilkinson; E.P. Simard; Y. Liu; M.R. Phillips; B.K. Lloyd; L. Lo; G. Logroscino; R. Lunevicius; M. Magdy; C. Magis-Rodriguez; M. Mahdavi; D.C. Malta; P.A. Meaney; D.J. Margolis; J. Martinez-Raga; A.J. Mason-Jones; B.A. Tedla; P. Memiah; Z.A. Memish; W. Mendoza; G.B.M. Mensink; T.J. Meretoja; F.A. Mhimbira; T.R. Miller; E.J. Mills; A. Mohammadi; L. Monasta; M. Montico; L. Ronfani; J.D. Monis; L. Morawska; J. Sun; R. Mori; A. Werdecker; U.O. Mueller; R. Westerman; M.E. Murdoch; B. Murimira; J. Murray; K.I. Musa; J.B. Nachega; S. Seedat; B.X. Tran; G. Nagel; D. Rothenbacher; K.S. Naidoo; O. Oladimeji; B. Sartorius; E.A. Zegeye; L. Naldi; G. Remuzzi; V. Nangia; C. Nejjari; C.R. Newton; F.N. Ngalesoni; P. Nguhiu; Q.L. Nguyen; P.M. Nkamedjie; S. Nolte; R.H. Osborne; M. Nomura; O.F. Norheim; C.M. Obermeyer; F.A. Ogbo; I. Oh; P.R. Olivares; B.O. Olusanya; J.O. Olusanya; J.N. Opio; E. Oren; A. Ortiz; E. Ota; P.A. Mahesh; E. Park; H. Park; T. Patel; S.T. Patil; S.B. Patten; M. Tonelli; D. Paudel; D.M. Pereira; N. Perico; K. Pesudovs; M. Petzold; J.D. Pillay; S. Polinder; M. Qorbani; A. Radfar; M. Rahman; S.U. Rahman; R.K. Rai; S. Rajsic; M. Raju; S.M. Rana; C.L. Ranabhat; K. Ranganathan; A.H. Refaat; A.L. Ribeiro; D. Rojas-Rueda; A. Roy; R. Sagar; M. Satpathy; B.B. Sackey; M.M. Saleh; J.R. Sanabria; R. Sarmiento-Suarez; M. Savic; M. Sawhney; J. Schmidhuber; I.J.C. Schneider; D.A.S. Silva; A.E. Schutte; A. Shaheen; M.A. Shaikh; R. Sharma; M. Shigematsu; M. Shin; S. Yoon; R. Shiri; K. Shishani; I.D. Sigfusdottir; J.I. Silverberg; Y. Yano; O.P. Singh; P.K. Singh; K. Søreide; J.B. Soriano; L.A. Sposato; C.T. Sreeramareddy; H. Stahl; V. Stathopoulou; N. Steckling; S. Stranges; M. Strong; B.F. Sunguya; S. Swaminathan; B.L. Sykes; R. Tabarés-Seisdedos; K.M. Tabb; R.T. Talongwa; M.R. Tarawneh; M. Tavakkoli; B. Taye; E.M. Tuzcu; J. Thakur; A.J. Thomson; G.D. Thurston; R. Tobe-Gai; R. Topor-Madry; F. Topouzis; Z. Tsala Dimbuene; S. Tyrovolas; K.N. Ukwaja; C.J. Uneke; O.A. Uthman; T. Vasankari; A.M.N. Vasconcelos; N. Venketasubramanian; F.S. Violante; V.V. Vlassov; P. Volkow; M.T. Wallin; S. Weichenthal; A.D. Woolf; M. Wubshet; G. Xu; B. Yakob; L.L. Yan; P. Yip; N. Yonemoto; M.Z. Younis; C. Yu; Z. Zaidi; M.E. Zaki; C. Zambrana-Torrelio; T. Zapata; D. Zonies
Background In September, 2015, the UN General Assembly established the Sustainable Development Goals (SDGs). The SDGs specify 17 universal goals, 169 targets, and 230 indicators leading up to 2030. We provide an analysis of 33 health-related SDG indicators based on the Global Burden of Diseases, Injuries, and Risk Factors Study 2015 (GBD 2015). Methods We applied statistical methods to systematically compiled data to estimate the performance of 33 health-related SDG indicators for 188 countries from 1990 to 2015. We rescaled each indicator on a scale from 0 (worst observed value between 1990 and 2015) to 100 (best observed). Indices representing all 33 health-related SDG indicators (health-related SDG index), health-related SDG indicators included in the Millennium Development Goals (MDG index), and health-related indicators not included in the MDGs (non-MDG index) were computed as the geometric mean of the rescaled indicators by SDG target. We used spline regressions to examine the relations between the Socio-demographic Index (SDI, a summary measure based on average income per person, educational attainment, and total fertility rate) and each of the health-related SDG indicators and indices. Findings In 2015, the median health-related SDG index was 59·3 (95% uncertainty interval 56·8–61·8) and varied widely by country, ranging from 85·5 (84·2–86·5) in Iceland to 20·4 (15·4–24·9) in Central African Republic. SDI was a good predictor of the health-related SDG index (r2=0·88) and the MDG index (r2=0·92), whereas the non-MDG index had a weaker relation with SDI (r2=0·79). Between 2000 and 2015, the health-related SDG index improved by a median of 7·9 (IQR 5·0–10·4), and gains on the MDG index (a median change of 10·0 [6·7–13·1]) exceeded that of the non-MDG index (a median change of 5·5 [2·1–8·9]). Since 2000, pronounced progress occurred for indicators such as met need with modern contraception, under-5 mortality, and neonatal mortality, as well as the indicator for universal health coverage tracer interventions. Moderate improvements were found for indicators such as HIV and tuberculosis incidence, minimal changes for hepatitis B incidence took place, and childhood overweight considerably worsened. Interpretation GBD provides an independent, comparable avenue for monitoring progress towards the health-related SDGs. Our analysis not only highlights the importance of income, education, and fertility as drivers of health improvement but also emphasises that investments in these areas alone will not be sufficient. Although considerable progress on the health-related MDG indicators has been made, these gains will need to be sustained and, in many cases, accelerated to achieve the ambitious SDG targets. The minimal improvement in or worsening of health-related indicators beyond the MDGs highlight the need for additional resources to effectively address the expanded scope of the health-related SDGs. Funding Bill & Melinda Gates Foundation. © 2016 The Authors(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY license
Morphosynthesis of calcium carbonate in poly(vinylalcohol)
(2002) A. Sinha; A. Agrawal; S. Nayar; S.K. Das; P. Ramachandrarao
In situ synthesis of calcium carbonate particles has been carried out in poly(vinylalcohol) solution and physical gels under free drift conditions. A multitude of morphologies, ranging from spherulites to helical structures of calcite, are produced by systematically varying the polymer concentration both in solution as well as in gels.
Mucopolysaccharidosis type IV (Morquio syndrome)
(2007) M.N. Singh; A. Agrawal; V. Tilak; N.K. Singh
[No abstract available]
Pharmacogenetic comprised prospect on cytochrome P450 facilitated drug interactions
(2013) K. Ilango; T.M. Vijayakumar; A. Agrawal; G.P. Dubey
Drug-drug interactions are important concerns in healthcare around the world; especially multiple drugs are used to treat one or more disease. It is now recognized that many drug-drug interactions can be described by alterations in the metabolic enzymes that are present in the liver and other extra-hepatic tissues. Many of the major pharmacokinetic interactions between drugs are due to hepatic cytochrome P450 (P450 or CYP) enzymes being affected by previous administration of other drugs. After co-administration, some drugs act as potent enzyme inducers, whereas others are inhibitors. Inter-Individual variability in CYP450 induction or inhibition comprises an important component contributing to the difficulties in assessing and predicting metabolism-based drug-drug interactions in humans. Pharmacogenomic techniques allow efficient analysis of these risk factors, and genotyping tests have the potential to optimize drug therapy in the future. This review updates the CYP450s mediated metabolic drug interactions and its Pharmacogenetic relevance. It is concluded that apart from the study of inhibitors or inducers of CYP enzymes the Pharmacogenetic knowledge regarding CYP polymorphism also now developed to a stage where it can be implemented in drug development and in clinical routine for specific drug treatments, thereby improving the drug response and reducing costs for drug treatment. Copyright © 2013 American Scientific Publishers. All rights reserved.
Prevalence and pattern of antiphospholipid antibody syndrome in a hospital based longitudinal study of 193 patients of systemic lupus erythematosus
(2013) N.K. Singh; A. Agrawal; M.N. Singh; V. Kumar; M. Godhra; A. Gupta; D.P. Yadav; Usha; R.G. Singh; T.B. Singh
Background: Antiphospholipid antibody syndrome (APS) is a systemic autoimmune disease characterised by thrombophilic state and obstetrical complications. Prevalence of APS varies in different parts of the world. So this study was conducted to find out the prevalence and pattern of APS in systemic lupus erythematosus (SLE) in this region. Material and Methods: In this hospital based longitudinal study from 2004 to 2011, we studied 193 patients of systemic lupus erythematosus (SLE) for prevalence of APS and its different characteristics. The diagnosis of SLE was made according to American College of Rheumatology (ACR) criteria and diagnosis of APS was made according to Sapporo criteria. Results: Prevalence of APS in SLE was 25.38%. Mean age at study entry was 25.5 ±6.9 years and majority of APS patients were in the age group 21-30 yrs (44.89%). The most common clinical manifestation in both SLE with APS and SLE without APS was musuloskeletal involvement (79.59% and 84.72% respectively). Among 49 patients of SLE having APS, multisystem involvement was present in 16 patients and life threatening complications were present in 12 patients. Late foetal loss was the most common obstetrical manifestation of APS (26.53%) and deep vein thrombosis was most common thrombotic manifestation (16.32%). Anticardiolipin antibodies(IgG aCL) were the most common antibody (85.71%) detected. Lupus anticoagulant was present in 71.42% cases of SLE having APS. ANA and anti-dsDNA antibodies were present in 97.95% and 77.55% cases of SLE having APS. Conclusion: APS is a major cause of morbidity and mortality in patients of SLE. The incidence of secondary APS in SLE varies in different geographical regions and it was 25.38% in our study. Pregnancy morbidity and deep vein thrombosis were the most common complications of APS. IgG aCL was the most common antibody in APS patients. Screening for the presence of aPL antibodies in SLE patients and timely initiation of prophylactic treatment can prevent many of the complications. © JAPI.
Radio-isotopic determination of platelet monoamine oxidases and regulation of its activity by an indigenous drug
(1988) G.P. Dubey; V.K. Srivastava; A. Agrawal; K.N. Udupa
[No abstract available]
Revival of interest in low-dose diuretic therapy in hypertension
(2005) N.K. Singh; A. Agrawal; A. Gogia
[No abstract available]
Role of an indigenous drug Geriforte on blood levels of biogenic amines and its significance in the treatment of anxiety neurosis
(1990) L. Upadhyaya; A.K. Tiwari; A. Agrawal; G.P. Dubey
[No abstract available]
Role of Seabuckthorn (Hippophae rhamnoides) in the maintenance of cardiovascular homeostasis following cold stress
(Natural Remedies Private Limited, 2003) G.P. Dubey; A. Agrawal; S.P. Dixit
Objective: To study the beneficial role of Seabuckthorn (Hippophae rhamnoides) in the maintenance of cardiovascular homeostasis following cold stress. Materials and Methods: The effect of the alcoholic extract of Seabuckthorn in the daily oral dose of 500 mg was studied on various electrophysiological and neurochemical parameters following cold stress among the positive cold stress responders (human subjects) continuously for 3 months. Results: The average differences in cardiovascular responses like systolic and diastolic blood pressure, and pulse rate that were found to be raised following cold pressor test, minimized following three months oral administration of Seabuckthorn. Further, the psychophysiological parameters like occipito frontalis EMG and galvanic skin resistance also regulated under drug treatment. The serotonin and plasma cortisol levels were also modified following oral administration of Seabuckthorn. Conclusion: Seabuckthorn exhibited beneficial effects to reduce the cardiovascular reactivity following cold stress and thus it enhances the stress tolerance capacity as well as better adaptation towards stress.