Browsing by Author "Neeraj Agarwal"

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Community engagement for healthcare delivery without incentive: sustainable or not for Universal Health Coverage?
(Indian Association of Preventive and Social Medicine, 2025) Archana Pandey; Alok Kumar; Neeraj Agarwal; Anju Bharti; Neeta Kumar; Sangeeta Kansal
Apart from healthcare service delivery, the growing digitalization of health records raises a need to connect every citizen with a digital health ecosystem under the Ayushman Bharat Digital Mission. Considering this fact, an ICMR-funded project, the human resource in the form of Home Health Guides (HHGs) is envisaged to bridge the gap between the community and the health system as complementary to the existing health workforce. These are active volunteers in the community who are educated till matriculation and are willing to work in the field for at least two or three hours without any incentives/remunerations. Their assigned roles are to record and update the health-related information of the assigned families. They are also supposed to assess health emergencies, guide the community regarding their healthcare needs, and link them with the existing healthcare system. As part of the project, we have provided hand-holding support, training, and a few other non-monetary incentives in the form of first aid and medical tool kit, stationary, etc. It was observed that along with the health system, the community also needs the assistance of such a cadre for updating their health records. Also, despite so much effort, these volunteers are not motivated therefore, such initiatives need to be revised and should include monetary incentives to keep them motivated. ©The Author(s). 2025 Open Access.
Preface
(Springer Singapore, 2020) Ashish Dwivedi; Neeraj Agarwal; Lipika Ray; Amit Kumar Tripathi
[No abstract available]
Role of urinary transforming growth factor beta-b1 and monocyte chemotactic protein-1 as prognostic biomarkers in posterior urethral valve
(Wolters Kluwer Medknow Publications, 2020) Pranay Panigrahi; Sarita Chowdhary; Shyamendra Pratap Sharma; Rakesh Kumar; Neeraj Agarwal; Shiv Prasad Sharma
Background: Posterior Urethral Valves (PUV) are the most common cause of congenital LUT obstruction in males. Biomarkers of glomerular or tubular injury may be of particular value in predicting the need for surgical intervention or in tracing progression of chronic kidney disease. Measurement of biomarker in urine is relatively easy. Aim: To evaluate the changes in values of urinary Transforming Growth Factor Beta 1(TGF-B1) and Monocyte Chemotactic Protein (MCP-1) before and after valve ablation and its prognostic value in Posterior urethral valve. Material and Method: This prospective study was conducted from September 2016 to August 2018. The study group included 20 consecutive male babies with the diagnosis of PUV treated and followed up versus equal numbers of age matched control without any renal or urinary tract disease. Pre-operative urine samples were collected in Operative room. Cystoscopy and valve ablation was done. Follow up was done clinically by urinary stream and radiologically with VCUG. Follow-up was planned at 1 month, 3 months and 6 months following cystoscopic valve ablation. All collected urine samples were centrifuged at 10,000 rpm for 20 minutes. Supernatant was collected and two divided aliquots were stored at -200c to be thawed on the day of assay. Optical density of each well was recorded at 450 nm and 540 nm A p-value of <0.05 was considered to be statistically significant. Result and Discussion: Out of 20 cases of PUV, 14 (70%) cases were 1st born males of their family. The median age at the time of valve ablation in PUV cases was 2.5 (1.20-3.87) years.. Most common symptoms are fever and UTI. The preoperative median serum creatinine level was 1.65 mg/dl(1.22-2.42) pre-ablation, and fall significantly after ablation. Median eGFR level (calculated) was 25.635 (16.38-35.40) and after 6 months was 71.490 (45.44-96.93). Preoperative median MCP1 in PUV cases was 147.2 (82.8-512.5) and significant difference was also found in 1st, 3rd and 6th months after surgery (p<0.001, p=0.004 and p=0.002).Preoperative median TGF-B1 level was 197.8 pg/ml (79.9-386.4). There was no statistically significant change in TGF-B1 level at preoperative to 1 month and preop to 3 months after surgery but at 6 months after surgery the median TGF-B1 level significantly decreased as compared with preoperative TGF-B1 level. Conclusion: TGF β1 and MCP1 can be considered as prognostic urinary biomarkers in patients of PUV and can be used to specify and counsel patient's attendant regarding possibility of ESRD and need for further intervention. © 2020 Journal of Indian Association of Pediatric Surgeons.
Skin aging & cancer: Ambient UV-R exposure
(Springer Singapore, 2020) Ashish Dwivedi; Neeraj Agarwal; Lipika Ray; Amit Kumar Tripathi
This book summarizes the potent effect of ultraviolet radiation (UVR) on the photoaging and cancer formation. Skin is the largest human organ which continually reconstructs itself to ensure its viability, integrity, and ability to provide protection for the body. This protection can be compromised by the aging of the skin which ultimately promotes skin inflammation, impaired wound repair, and increased risk of skin cancer. The book entails mechanistic insights into the UVR-induced immunomodulation and DNA damage in the skin to delineate the pathogenesis, and develop novel ways for prevention of photoaging of the skin cells. It also elucidates the potential of nanotechnology in the treatment of skin cancer. Further, it discusses the bioinformatics approaches to understand the molecular mechanism of photoaging and cancer formation. © Springer Nature Singapore Pte Ltd. 2019.