Browsing by Author "Narendra K. Tiwary"

Now showing 1 - 6 of 6

Acne cosmetica revisited: A case-control study shows a dose-dependent inverse association between overall cosmetic use and post-adolescent acne
(S. Karger AG, 2013) Sanjay Singh; Baldeep Kaur Mann; Narendra K. Tiwary
Background: Case-control studies to support the concept of acne cosmetica are lacking. Objective: To examine the association of post-adolescent acne with the use of cosmetics and cosmetic procedures. Methods: 910 post-adolescent patients with acne and an equal number of matched controls were studied for exposure to cosmetics and cosmetic procedures. A cumulative cosmetic exposure index was stratified into four quarters of increasing exposure. Results: Comparison of different cumulative exposure categories with the lowest exposure category (multivariate analysis, logistic regression) showed that the odds ratios, which were always <1, progressively declined as cosmetic exposure increased [odds ratios (95% confidence intervals): 0.679 (0.501-0.922), 0.355 (0.258-0.487), 0.307 (0.217-0.433)]. However, some individual cosmetics had odds ratios >1. Conclusion: Overall cosmetic use was negatively associated with post-adolescent acne. The term 'acne cosmetica' is appropriate in the sense that some cosmetics may cause acne. © 2013 S. Karger AG, Basel.
Antioxidant status of children with idiopathic nephrotic syndrome
(2011) Om P. Mishra; Aditya K. Gupta; Rajniti Prasad; Ziledar Ali; Ram S. Upadhyay; Surendra P. Mishra; Narendra K. Tiwary; Franz S. Schaefer
The production of free radicals can cause renal injury and play an important role in the pathogenesis of idiopathic nephrotic syndrome. Markers of reactive oxygen species (ROS) were evaluated in 48 patients with active nephrotic syndrome (ANS) and 30 age- and gender-matched healthy children. Plasma malondialdehyde (MDA), protein carbonyl, nitrite, copper, zinc, selenium, ascorbic acid, and superoxide dismutase (SOD) levels were estimated in patients with ANS and controls. Measurements were repeated in 39 cases after achievement of remission, and in 10 other children who were in remission of >6 months' duration. Plasma MDA and nitrite levels were significantly higher and selenium was lower in ANS patients compared with controls. Plasma protein carbonyl, copper ascorbic acid, zinc, and superoxide dismutase levels were comparable in ANS patients and controls. Plasma copper level was significantly higher in active cases than in the remission and long-term remission groups. Selenium value showed a rise and then normalized in long-term remission. Among different sub-groups of ANS, no significant differences were found in the levels of various parameters, except plasma selenium, which was significantly lower in first-attack nephrotic syndrome (FANS) in comparison to infrequently relapsing nephrotic syndrome (IRNS) and frequently relapsing nephrotic syndrome (FRNS) patients. Thus, we observed evidence of oxidative stress and impaired antioxidant defense during acute nephrotic syndrome. Antioxidant status recovered completely only during long-term remission. © 2010 IPNA.
Clinical profile and response to first-line ARV in HIV patients from eastern UP and Bihar: A retrospective study
(2013) Rohit Goel; M. Rai; J. Chakravarty; L.P. Meena; Narendra K. Tiwary; Shyam Sundar; Anju Bharti
Background and objectives: Spectrum of infections in Human Immunodeficiency Virus (HIV) infected patient from Eastern UP and Bihar has not been systemically evaluated. This study was conducted with the following objectives; a) explore the spectrum of clinical conditions associated with HIV disease, b)the difference between clinical and investigatory parameters in those patients who presented with infection from those who present without infection and c) to evaluate the effect of anti-retroviral (ARV) therapy. Methods: 1248 subjects who fulfilled the inclusion criteria were enrolled for the study from May 2007 to November 2008. Patients were evaluated for their baseline characteristics along with CD4 count and followed up for at least for 6 months after initiation of ARV (6-24 months). Result and interpretation: In this retrospective study, tuberculosis (58.96%) was the commonest infection followed by chronic diarrhoea (26.56%) and various skin infections. Males had significantly higher incidence (p value<.001) of infection as compared to females. There was a significant difference between the patients who presented with infection from those who presented without infection for their baseline weight (42.3 vs 45.42), haemoglobin (9.06 vs 9.91), mean CD4 count at baseline (107.38 vs 128.38/μL) and CD4 count after 6 month of therapy (298.09 vs 322.98 /μL). Mortality was also significantly high (p value<0.05) in those who presented with infection (19.95% vs 15.1%), although there was no difference between these two groups on their improvement in CD4 count from baseline after 6 months of therapy. Conclusion: Among the spectrum of infection in HIV patient from North East part of India, tuberculosis was commonest, followed by skin infections and chronic diarrhoea. Patients who presented with infection at the time of initial presentation had a low haemoglobin, body weight and CD4 count and had high initial mortality but if they survived they show similar response to ARV therapy as patients who presented without infection. © JAPI.
Comparative evaluation of blood and serum samples in rapid Immunochromatographic tests for visceral Leishmaniasis
(2013) Dinesh Kumar; Basudha Khanal; Puja Tiwary; Shyam Lal Mudavath; Narendra K. Tiwary; Rupa Singh; Kanika Koirala; Marleen Boelaert; Suman Rijal; Shyam Sundar
Rapid diagnostic tests (RDTs) based on the detection of specific antibodies in serum are commonly used for the diagnosis of visceral leishmaniasis (VL). Several commercial kits are available, and some of them allow the use of whole-blood samples instead of serum. An RDT is much more user-friendly for blood samples than for serum samples. In this study, we examined the sensitivities and specificities of six different commercially available immunochromatographic tests for their accuracy in detecting Leishmania infection in whole blood and serum of parasitologically confirmed VL cases. This study was performed in areas of India and Nepal where VL is endemic. A total of 177 confirmed VL cases, 208 healthy controls from areas of endemicity (EHCs), 26 malaria patients (MP), and 37 tuberculosis (TB) patients were enrolled. The reproducibilities of the blood and serum results and between-reader and between-laboratory results were tested. In India, the sensitivities of all the RDTs ranged between 94.7 and 100.0%, with no significant differences between whole blood and serum. The specificities ranged between 92.4 and 100.0%, except for the specificity of the Onsite Leishmania Ab RevB kit, which was lower (33.6 to 42.0%). No differences in specificities were observed for blood and serum. In Nepal, the sensitivities of all the test kits, for whole-blood as well as serum samples, ranged between 96.3 and 100.0%, and the specificities ranged between 90.1 and 96.1%, again with the exception of that of the Onsite Leishmania Ab RevB test, which was markedly lower (48.7 to 49.3%). The diagnostic accuracies of all the tests, except for one brand, were excellent for the whole-blood and serum samples. We conclude that whole blood is an adequate alternative for serum in RDTs for VL, with sensitivities and specificities comparable to those obtained in serum samples, provided that the test kit is of overall good quality.Copyright © 2013, American Society for Microbiology. All Rights Reserved.
Determinants of survival in adult HIV patients on antiretroviral therapy in eastern Uttar Pradesh: A prospective study
(Indian Council of Medical Research, 2014) Jaya Chakravarty; Narendra K. Tiwary; Shashi Ranjan Prasad; Saurabh Shukla; Anurag Tiwari; Rabindra Nath Mishra; Shyam Sundar
Background & objectives: The National AIDS Control Organization (NACO) of India has been providing free ARV (antiretroviral) drugs since 2004. By 2012, 486,173 patients had received treatment through the antiretroviral therapy (ART) centres. The objective of this observational study was to assess the factors determining survival of patients on ART under routine programme conditions in an ART centre in north India five years after its inception.; Methods: Treatment naive HIV positive patients who were enrolled in the ART centre between May 2009 and May 2010 and started on ART as per the Revised NACO guidelines 2009, were included in the study and outcome was assessed after two years of follow up.; Results: A total of 1689 patients were included in the analysis, of whom 272 (16.10%) expired, 205 (12.13%) were lost to follow up (LFU), 526 (31.14%) were transferred out to other facilities and 686 (40.63%) were alive at the end of two years. Majority (92%) of the deaths occurred in the first six months of therapy. Age >30 yr, male gender, poor functional status, haemoglobin level <11 g/dl, body weight <45 kg and CD4 count <100/ul at baseline had significantly higher relative hazard of death. Most LFU also occurred in the first six months and these patients had significantly low CD4 count, weight, haemoglobin level and higher number of patients in Stages III and IV as compared to those who survived.; Interpretation & conclusions: The study findings revealed poor survival in the first six months of therapy especially in those with severe immunosuppression. This emphasizes the need for early enrolment into the programme. The high LFU occurring early after initiation of therapy suggests the urgent need to build an efficient patient retrieval system in the programme. © 2014, Indian Council of Medical Research. All rights reserved.
Peritoneal dialysis in children with acute kidney injury: A developing country experience
(2012) Om P. Mishra; Aditya K. Gupta; Vishal Pooniya; Rajniti Prasad; Narendra K. Tiwary; Franz Schaefer
Background: Peritoneal dialysis (PD) is the preferred and convenient treatment modality for acute kidney injury (AKI) in children and hemodynamically unstable patients. Methods: The outcome of acute PD was studied in 57 children (39 boys) with AKI, aged 1 month to 12 years, at a tertiary care center of a teaching hospital in India. Results: Hemolytic uremic syndrome (36.8%) was the most common cause of AKI, followed by septicemia (24.6%) and acute tubular necrosis (19.3%). Treatment with PD was highly effective in lowering retention markers (p < 0.001). Overall mortality was 36.8%. The risk of mortality by multi-variate analysis was higher when patients were anuric [odds ratio (OR): 8.2; 95% confidence interval (CI): 1.3 to 49; p < 0.05], had septicemia (OR: 3.79; 95% CI: 1.55 to 25.8; p < 0.05), or severe infectious complications (OR: 8.2; 95% CI: 1.5 to 42.9; p < 001). Conclusions: Because of its simplicity and feasibility, acute PD is still an appropriate treatment choice for children with AKI in resource-poor settings. Septicemia and severity of AKI are contributory factors to high mortality in pediatric acute kidney injury.