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Abstract
Workers in the fireworks industry are affected mentally because of hazards that occurred in and around the working environment which caused injuries/fire accidents due to carelessness of workers and poor maintenance of rules and regulations by management. Primary data were collected from 451 workers in 25 fireworks industries randomly. A structured questionnaire is developed to measure safety culture in the fireworks industry in terms of dimensions like work environment, worker awareness, process, governance and safety satisfaction. This instrument is tested for purification of items in terms of stability by various statistical tests like reliability and validity in statistical software like SPSS and AMOS. This field-based study examines safety culture among workers in the fireworks industry to find the real scenario in the workplace and give recommendations for management to control accidents and fire or explosions to save the lives of workers.
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Affiliation(s)
- S Rajaram
- Department of Mechanical Engineering, Sri Vidya College of Engineering & Technology, India
| | - G D Sivakumar
- Department of Mechanical Engineering, Sethu Institute of Technology, India
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Supriya P, Rajaram S. Literature Review on History and Pharmacotherapy of Parkinson`s Disease. JPRI 2021. [DOI: 10.9734/jpri/2021/v33i47a33082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Introduction: Parkinson’s disease (PD) is a slowly progressive neurodegenerative disease characterized by: Pill rolling tremors, Akathisia (inability to sit still), Rigidity, Kinesis (akinesia, dyskinesia), Instable (stooped) posture, no arm swinging in rhythm with legs, Sialorrhea Oculogyric crisiseyes are held fixed for a variable length of time), Nervous depression, Involuntary tremors, Seborrhoea and Masked facial expression.
Parkinson’s disease is a chronic, progressive, neurodegenerative disorder with an estimated prevalence of 31 to 328 per 100,000 people worldwide. It is estimated that more than 1 percent of the population over age 65 are afflicted with Parkinson’s disease; incidence and prevalence increase with age. There are numerous unanswered questions regarding the diagnosis and management of Parkinson’s disease. Surgical treatment for Parkinson’s disease is generally considered for patients who respond to medications but have intolerable side effects. Surgical options include ablative procedures, deep brain stimulation, and tissue transplantation. This review focused on History and management of Parkinson’s disease. The purpose of this literature review is to gain an understanding of the existing research relevant to history and pharmacotherapy of Parkinson’s disease.
Conclusion: Pharmacological treatment of PD should be tailored to the individual patient. Drug therapy is not obligatory in early PD; many patients can be managed for a time with exercise and lifestyle interventions. For patients with mild symptoms, MAO-B inhibitors, amantadine, or (in younger patients) anticholinergics are reasonable choices.
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Rajaram S, Van Boxmeer J, Leav B, Suphaphiphat P, Iheanacho I, Kistler K. 2556. Retrospective Evaluation of Mismatch From Egg-Based Isolation of Influenza Strains Compared With Cell-Based Isolation and the Possible Implications for Vaccine Effectiveness. Open Forum Infect Dis 2018. [PMCID: PMC6252794 DOI: 10.1093/ofid/ofy209.164] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Lower influenza vaccine effectiveness (VE) against circulating H3N2 strains compared with other influenza viruses is partly explained by antigenic mismatch between circulating strains and the vaccine strain (Belongia 2016). This mismatch has recently been linked to a new glycosylation site introduced in the egg-adaptation step (Zost 2017) and HA L194P substitution (Wu 2017) for H3N2. Vaccine manufactured using seed virus wholly grown in mammalian (e.g., Madin–Darby Canine Kidney—MDCK) cells, as with the NH17-18 version of Flucelvax®, avoids these mutations. Preliminary reports suggest that this cell-based vaccine showed greater VE than did similar egg-based vaccines [FDA Statement]. This study aimed to compile existing data on antigenic similarity to measure the degree of match with circulating wild-type isolates of egg- and MDCK-propagated versions of the vaccine H3N2 virus over multiple seasons.
Methods
Using publicly available reports from the Worldwide Influenza Centre, London (Crick), we compiled data on antigenic similarity, defined as H3N2 circulating wild-type virus isolates showing no more than a 4-fold reduction in titer to antisera raised against wholly MDCK- or egg-propagated versions of the vaccine H3N2 viruses. Titers were compared using hemagglutination inhibition (HI) assays and/or plaque reduction neutralization assays (PRNA).
Results
Data from Northern Hemisphere influenza seasons of 2011–2012 to 2017–2018 show a substantially higher proportion of tested circulating influenza H3N2 viruses matched the MDCK-propagated reference viruses than did corresponding egg-propagated reference vaccine viruses (Figures 1 and 2). In half of the seasons evaluated, there was little to no antigenic similarity between circulating viruses and the egg-based vaccine viral seed.
Conclusion
These data suggest higher levels of mismatch have occurred consistently with egg-propagated H3N2 reference viruses compared with MDCK-propagated reference viruses when measured against circulating wild-type isolates and may further explain the potential for lower VE observed against H3N2 historically. Furthermore, these data point to the importance of continuing to utilize cell-derived seeds in creating seasonal influenza vaccines for this strain.
Disclosures
S. Rajaram, Seqirus: Employee, Salary. J. Van Boxmeer, Seqirus: Employee, Salary. B. Leav, Seqirus: Employee and Shareholder, Salary. P. Suphaphiphat, Seqirus: Employee, Salary. I. Iheanacho, Seqirus: Consultant, Research support. K. Kistler, Seqirus: Consultant, Research support.
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Govender M, Rajaram S. 951 A model for the delivery of integrated occupational health services within the south african public health system. Health Serv Res 2018. [DOI: 10.1136/oemed-2018-icohabstracts.471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Kazi AM, Ali N, Ibrahim A, Napar AA, Jamil M, Hussain S, Mahmood Z, Delgado R, Rosas V, Cortes A, Rajaram S. Tissue Culture Mediated Allelic Diversification and Genomic Enrichment of Wheat to Combat Production Constraints and Address Food Security. ACTA ACUST UNITED AC 2017. [DOI: 10.3329/ptcb.v27i1.35018] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
In view of the emerging population trends and that wheat crop is the major unequivocally recognized conduit towards addressing the food security challenges of 2050 this discourse embraces various research options that are viewed as possible solutions toward delivering those targets for providing nutritious food and meeting the aspirations that policy setters have debated on the subject for decades. The underlying strength for achieving these targets will require concerted efforts from plant researchers that are well integrated within effectively harnessing and utilizing prevalent genetic diversity of the wide array of alleles in a holistic pro‐active manner. We argue that the purists of basic and strategic research dimensions need to be thoughtfully defined, so that the vital target of delivering the “applied” gains are only realized from the outputs on farmer’s fields and measured by tons per hectare. In this quest, the pre‐breeding disciplines “classical mode” and its recently surfaced “modified sense” are pivotal, where within the former facet “tissue culture” (TC)/artificial culturing is embodied integrally. Taken for granted, TC has been the backbone of all wide hybridization studies and has made an enormous impact on the agricultural landscape spanning over the last six decades. With its intervention significant generic and specific incompatibilities have been overcome as well as allowing researchers to exploit the protocols for adding efficiency to breeding programs, facilitate operational technologies in running breeding programs and development of unique genetic stocks that preserve valuable allelic richness in user friendly forms for future free germplasmusage in global/private domains of plant improvement ventures.Plant Tissue Cult. & Biotech. 27(1): 89-140, 2017 (June)
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Brindha JT, Sreedevi KR, Manonmani C, Jesan T, Rajaram S, Ravi PM, Tripathi RM. A Comparison Between Measured Concentration of 3H in Kalpakkam Environment with Predicted Atmospheric Dispersion Model. Radiat Prot Dosimetry 2017; 174:583-587. [PMID: 27542814 DOI: 10.1093/rpd/ncw244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Accepted: 07/22/2016] [Indexed: 06/06/2023]
Abstract
The field measurements of 3H in the form of HTO present in air moisture carried out around Madras Atomic Power Station were compared with predicted values using atmospheric dispersion modeling. Air 3H samples were collected from different sectors at the site boundary of the operating reactors for the period of 2 y and compared with Gaussian Plume model. The predictions were comparable with the measured value. The slight variation observed between the two methods is attributed to the uncertainty involved in the measurement of air 3H concentration and in the measurement of site-specific meteorological parameters. The radiation dose imparted to members of public due to the levels observed is well within station technical specification limit for 3H.
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Affiliation(s)
- J Thulasi Brindha
- Health Physics Division, Bhabha Atomic Research Centre, Mumbai, India
| | - K R Sreedevi
- Health Physics Division, Bhabha Atomic Research Centre, Mumbai, India
| | - C Manonmani
- Health Physics Division, Bhabha Atomic Research Centre, Mumbai, India
| | - T Jesan
- Health Physics Division, Bhabha Atomic Research Centre, Mumbai, India
| | - S Rajaram
- Health Physics Division, Bhabha Atomic Research Centre, Mumbai, India
| | - P M Ravi
- Health Physics Division, Bhabha Atomic Research Centre, Mumbai, India
| | - R M Tripathi
- Health Physics Division, Bhabha Atomic Research Centre, Mumbai, India
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Rajaram S, Rajendran V, Sheik Abdullah A, Suganya R. Prediction of heart diseases using hybrid feature selection and modified Laplacian pyramid non-linear diffusion with soft computing methods. IJBET 2017. [DOI: 10.1504/ijbet.2017.10007482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Suganya R, Rajaram S, Abdullah AS, Rajendran V. Prediction of heart diseases using hybrid feature selection and modified Laplacian pyramid non-linear diffusion with soft computing methods. IJBET 2017. [DOI: 10.1504/ijbet.2017.086550] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Ramjug S, Hussain N, Hurdman J, Billings C, Elliot CA, Kiely DG, Sabroe I, Rajaram S, Swift AJ, Condliffe R. S111 Differences in characteristics and outcomes in systemic sclerosis-associated and idiopathic pulmonary arterial hypertension. Thorax 2016. [DOI: 10.1136/thoraxjnl-2016-209333.117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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10
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Kava S, Rajaram S, Arora VK, Goel N, Aggarwal S, Mehta S. Conventional cytology, visual tests and evaluation of P16(INK4A) as a biomarker in cervical intraepithelial neoplasia. Indian J Cancer 2016; 52:270-5. [PMID: 26905107 DOI: 10.4103/0019-509x.176729] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES (1) To detect cervical intraepithelial neoplasia (CIN) using Papanicolaou test (PAP test), visual tests (visual inspection after the application of acetic acid [VIA], visual inspection after the application of Lugol's iodine [VILI]), colposcopy, and biopsy. (2) To study the biomarker p16(INK4A) expression by immunostaining. MATERIALS AND METHODS Experimental study was conducted from November 2009 to April 2011. 1500 women were screened for cancer cervix using conventional PAP test, VIA, and VILI. Sensitivity, specificity, positive, and negative predictive values of these tests were calculated individually, sequentially, and in parallel. Women having positive results underwent colposcopy and biopsy if required. p16(INK4A) expression in biopsy samples was studied using immunohistochemistry. RESULTS All test positive cases (n = 235) underwent colposcopy. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of PAP with atypical squamous cells of undetermined significance (ASCUS) as cut-off was 40%, 99.25%, 35.25%, and 99.39%; VIA was 60%, 93.06%, 8.03%, and 99.56% and VILI was 80%, 86.06%, 5.4%, and 99.76%, respectively. When PAP, VIA, and VILI were used in parallel sensitivity, specificity, PPV, and NPV improved to 100%, 85.18%, 6.38%, and 100%, respectively. Colposcopic abnormalities were detected in 83 and biopsy proven CIN in 15. p(16INK4A) expression was seen in eight of 15 CIN cases. CONCLUSIONS (1) PAP test and visual techniques are complementary. (2) p(16INK4A) expression was seen in majority of CIN 2 lesions suggesting a higher grade lesion.
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Affiliation(s)
| | - S Rajaram
- Department of Obstetrics and Gynecology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
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Jones R, Lima E, Norseth C, Xu Y, Arechiga A, Rajaram S, Sabate J. A-05Psychosocial Predictors of Self-Perceived Memory and Its Implications on General Health and Neuropsychological Performance. Arch Clin Neuropsychol 2016. [DOI: 10.1093/arclin/acw043.05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Jesan T, Manonmani C, Brindha JT, Rajaram S, Ravi PM, Tripathi RM. Estimation of roughness length Z 0for Kalpakkam site. Radiat Prot Environ 2016. [DOI: 10.4103/0972-0464.185182] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Tadesse W, Ogbonnaya FC, Jighly A, Sanchez-Garcia M, Sohail Q, Rajaram S, Baum M. Genome-Wide Association Mapping of Yield and Grain Quality Traits in Winter Wheat Genotypes. PLoS One 2015; 10:e0141339. [PMID: 26496075 PMCID: PMC4619745 DOI: 10.1371/journal.pone.0141339] [Citation(s) in RCA: 76] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Accepted: 10/07/2015] [Indexed: 11/19/2022] Open
Abstract
The main goal of this study was to investigate the genetic basis of yield and grain quality traits in winter wheat genotypes using association mapping approach, and identify linked molecular markers for marker assisted selection. A total of 120 elite facultative/winter wheat genotypes were evaluated for yield, quality and other agronomic traits under rain-fed and irrigated conditions for two years (2011–2012) at the Tel Hadya station of ICARDA, Syria. The same genotypes were genotyped using 3,051 Diversity Array Technologies (DArT) markers, of which 1,586 were of known chromosome positions. The grain yield performance of the genotypes was highly significant both in rain-fed and irrigated sites. Average yield of the genotypes ranged from 2295 to 4038 kg/ha and 4268 to 7102 kg/ha under rain-fed and irrigated conditions, respectively. Protein content and alveograph strength (W) ranged from 13.6–16.1% and 217.6–375 Jx10-4, respectively. DArT markers wPt731910 (3B), wPt4680 (4A), wPt3509 (5A), wPt8183 (6B), and wPt0298 (2D) were significantly associated with yield under rain-fed conditions. Under irrigated condition, tPt4125 on chromosome 2B was significantly associated with yield explaining about 13% of the variation. Markers wPt2607 and wPt1482 on 5B were highly associated with protein content and alveograph strength explaining 16 and 14% of the variations, respectively. The elite genotypes have been distributed to many countries using ICARDA’s International system for potential direct release and/or use as parents after local adaptation trials by the NARSs of respective countries. The QTLs identified in this study are recommended to be used for marker assisted selection after through validation using bi-parental populations.
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Affiliation(s)
- W. Tadesse
- International Center for Agricultural Research in the Dry Areas (ICARDA), Beirut, Lebanon
- * E-mail:
| | - F. C. Ogbonnaya
- International Center for Agricultural Research in the Dry Areas (ICARDA), Beirut, Lebanon
| | - A. Jighly
- International Center for Agricultural Research in the Dry Areas (ICARDA), Beirut, Lebanon
| | - M. Sanchez-Garcia
- International Center for Agricultural Research in the Dry Areas (ICARDA), Beirut, Lebanon
| | - Q. Sohail
- International Center for Agricultural Research in the Dry Areas (ICARDA), Beirut, Lebanon
| | - S. Rajaram
- International Center for Agricultural Research in the Dry Areas (ICARDA), Beirut, Lebanon
| | - M. Baum
- International Center for Agricultural Research in the Dry Areas (ICARDA), Beirut, Lebanon
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Rajaram S, Bhaskaran S, Aggarwal P, Goel N. Spontaneous ovarian hyperstimulation mimicking ovarian neoplasm: A rare complication of hypothyroidism. J OBSTET GYNAECOL 2015; 35:532-3. [DOI: 10.3109/01443615.2014.968112] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Rajaram S, Swift AJ, Wild JM, Kiely DG. Response to: 'CT assessment for pulmonary hypertension requires systematic assessment of cardiac, vascular and parenchymal signs' by Marloes et al. Thorax 2015; 70:1087-8. [PMID: 26108572 DOI: 10.1136/thoraxjnl-2015-207394] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Accepted: 06/08/2015] [Indexed: 11/03/2022]
Affiliation(s)
- S Rajaram
- Academic Department of Radiology, University of Sheffield, Royal Hallamshire Hospital, Sheffield, UK
| | - A J Swift
- Academic Department of Radiology, University of Sheffield, Royal Hallamshire Hospital, Sheffield, UK
| | - J M Wild
- Academic Department of Radiology, University of Sheffield, Royal Hallamshire Hospital, Sheffield, UK
| | - D G Kiely
- Sheffield Pulmonary Vascular Disease Unit, Royal Hallamshire Hospital, Sheffield, UK
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Isac S, Ramesh BM, Rajaram S, Washington R, Bradley JE, Reza-Paul S, Beattie TS, Alary M, Blanchard JF, Moses S. Changes in HIV and syphilis prevalence among female sex workers from three serial cross-sectional surveys in Karnataka state, South India. BMJ Open 2015; 5:e007106. [PMID: 25818275 PMCID: PMC4386224 DOI: 10.1136/bmjopen-2014-007106] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVES This paper examined trends over time in condom use, and the prevalences of HIV and syphilis, among female sex workers (FSWs) in South India. DESIGN Data from three rounds of cross-sectional surveys were analysed, with HIV and high-titre syphilis prevalence as outcome variables. Multivariable analysis was applied to examine changes in prevalence over time. SETTING Five districts in Karnataka state, India. PARTICIPANTS 7015 FSWs were interviewed over three rounds of surveys (round 1=2277; round 2=2387 and round 3=2351). Women who reported selling sex in exchange for money or gifts in the past month, and aged between 18 and 49 years, were included. INTERVENTIONS The surveys were conducted to monitor a targeted HIV prevention programme during 2004-2012. The main interventions included peer-led community outreach, services for the treatment and prevention of sexually transmitted infections, and empowering FSWs through community mobilisation. RESULTS HIV prevalence declined significantly from rounds 1 to 3, from 19.6% to 10.8% (adjusted OR (AOR)=0.48, p<0.001); high-titre syphilis prevalence declined from 5.9% to 2.4% (AOR=0.50, p<0.001). Reductions were observed in most substrata of FSWs, although reductions among new sex workers, and those soliciting clients using mobile phones or from home, were not statistically significant. Condom use 'always' with occasional clients increased from 73% to 91% (AOR=1.9, p<0.001), with repeat clients from 52% to 86% (AOR=5.0, p<0.001) and with regular partners from 12% to 30% (AOR=4.2, p<0.001). Increased condom use was associated with exposure to the programme. However, condom use with regular partners remained low. CONCLUSIONS The prevalences of HIV infection and high-titre syphilis among FSWs have steadily declined with increased condom use. Further reductions in prevalence will require intensification of prevention efforts for new FSWs and those soliciting clients using mobile phones or from home, as well as increasing condom use in the context of regular partnerships.
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Affiliation(s)
- Shajy Isac
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
- Karnataka Health Promotion Trust, Bangalore, Karnataka, India
| | - B M Ramesh
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
- Karnataka Health Promotion Trust, Bangalore, Karnataka, India
| | - S Rajaram
- Karnataka Health Promotion Trust, Bangalore, Karnataka, India
| | - Reynold Washington
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
- Karnataka Health Promotion Trust, Bangalore, Karnataka, India
| | - Janet E Bradley
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Sushena Reza-Paul
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Tara S Beattie
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK
| | - Michel Alary
- Département de médecine sociale et préventive, Université Laval, Québec, Canada
| | - James F Blanchard
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Stephen Moses
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
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Ramesh B, Ghosh AK, Prakash V, Sharma M, Rajaram S, Kar A, Gaikwad A, Pradhan NK, Krishnamurthy J, Crockett M, Avery L, Moses S, Blanchard J. Facility mapping: A tool for effective planning for MNCH services. Ann Glob Health 2015. [DOI: 10.1016/j.aogh.2015.02.692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Rajaram S, Swift AJ, Condliffe R, Johns C, Elliot CA, Hill C, Davies C, Hurdman J, Sabroe I, Wild JM, Kiely DG. CT features of pulmonary arterial hypertension and its major subtypes: a systematic CT evaluation of 292 patients from the ASPIRE Registry. Thorax 2014; 70:382-7. [PMID: 25523307 PMCID: PMC4392204 DOI: 10.1136/thoraxjnl-2014-206088] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
We evaluated the prevalence and prognostic value of CT-pulmonary angiographic (CTPA) measures in 292 treatment naive patients with pulmonary arterial hypertension (PAH). Pulmonary artery calcification (13%) and thrombus (10%) were exclusively seen in PAH-congenital heart disease. Oesophageal dilation (46%) was most frequent in PAH-systemic sclerosis. Ground glass opacification (GGO) (41%), pericardial effusion (38%), lymphadenopathy (19%) and pleural effusion (11%) were common. On multivariate analysis, inferior vena caval area, the presence of pleural effusion and septal lines predicted outcome. In PAH, CTPA provides diagnostic and prognostic information. In addition, the presence of GGO on a CT performed for unexplained breathlessness should alert the physician to the possibility of PAH.
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Affiliation(s)
- S Rajaram
- Academic Unit of Radiology, University of Sheffield, Sheffield, UK
| | - A J Swift
- Academic Unit of Radiology, University of Sheffield, Sheffield, UK
| | - R Condliffe
- Sheffield Pulmonary Vascular Disease Unit and Academic Department of Respiratory Medicine, Royal Hallamshire Hospital, Sheffield, UK
| | - C Johns
- Academic Unit of Radiology, University of Sheffield, Sheffield, UK
| | - C A Elliot
- Sheffield Pulmonary Vascular Disease Unit and Academic Department of Respiratory Medicine, Royal Hallamshire Hospital, Sheffield, UK
| | - C Hill
- Department of Radiology, Sheffield Teaching Hospitals, UK
| | - C Davies
- Department of Radiology, Sheffield Teaching Hospitals, UK
| | - J Hurdman
- Sheffield Pulmonary Vascular Disease Unit and Academic Department of Respiratory Medicine, Royal Hallamshire Hospital, Sheffield, UK
| | - I Sabroe
- Sheffield Pulmonary Vascular Disease Unit and Academic Department of Respiratory Medicine, Royal Hallamshire Hospital, Sheffield, UK
| | - J M Wild
- Academic Unit of Radiology, University of Sheffield, Sheffield, UK
| | - D G Kiely
- Sheffield Pulmonary Vascular Disease Unit and Academic Department of Respiratory Medicine, Royal Hallamshire Hospital, Sheffield, UK
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Swift A, Rajaram S, Capener D, Elliot C, Condliffe R, Hurdman J, Kiely D, Wild J. S120 Right Ventricular Dysfunction In Pulmonary Hypertension With Combined Pulmonary Fibrosis And Emphysema Syndrome. Thorax 2014. [DOI: 10.1136/thoraxjnl-2014-206260.126] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Manu A, Santhanakrishnan V, Rajaram S, Ravi PM. Concentration of natural radionuclides in raw water and packaged drinking water and the effect of water treatment. J Environ Radioact 2014; 138:456-459. [PMID: 25223293 DOI: 10.1016/j.jenvrad.2014.08.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2013] [Revised: 08/14/2014] [Accepted: 08/22/2014] [Indexed: 06/03/2023]
Abstract
The raw water (RW) samples collected from natural sources are subjected to water treatment process, including reverse osmosis (RO), and are packed in bottles as packaged drinking water (PDW). Raw water (21 samples) taken from deep wells of Chennai and Secunderabad which are used in the production of PDW, were analysed for (234)U, (235)U, (238)U, (226)Ra, (228)Ra and (210)Pb activity concentrations. Activity Concentrations of (234)U, (235)U, (238)U, (226)Ra, (228)Ra, (210)Pb and (210)Po in PDW were also analysed. The mean activity concentrations of (234)U, (235)U, (238)U, (226)Ra, (228)Ra and (210)Pb in RW at Chennai were 12.1, ≤1.3, 7.1, 2.6, 27.5, and 16.3 mBq/L respectively. The mean activity concentrations of (234)U, (235)U, (238)U, (226)Ra, (228)Ra and (210)Pb in RW at Secunderabad were found to be 40.9, 1.7, 41.5 84.5, 100.1, and 17.0 mBq/L respectively. The mean concentrations of (234)U, (235)U, (238)U, (226)Ra, (228)Ra, (210)Pb and (210)Po in PDW at Chennai were found to be ≤1.3, ≤1.3, ≤1.3, ≤0.2, ≤1.7, 28.0 and 1.2 mBq/L at Secunderabad were found to be ≤1.3, ≤1.3, 1.7, 4.3, 5.0 and 28.1 mBq/L. The study indicated a considerable reduction in the concentration of natural radionuclides due to water treatment. The reduction ratios of RW to PDW for (234)U, (238)U, (226)Ra, (228)Ra were 97, 96, 94 and 95%. In case of (210)Pb, the PDW showed higher concentration of (210)Pb than RW. This was due to its in growth from (222)Rn which was not removed in the RO process.
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Affiliation(s)
- Anitha Manu
- Environmental Survey Laboratory, Environmental Studies Section, Health Physics Division, Bhabha Atomic Research Centre, Kalpakkam 603102, India.
| | - V Santhanakrishnan
- Environmental Survey Laboratory, Environmental Studies Section, Health Physics Division, Bhabha Atomic Research Centre, Kalpakkam 603102, India.
| | - S Rajaram
- Environmental Survey Laboratory, Environmental Studies Section, Health Physics Division, Bhabha Atomic Research Centre, Kalpakkam 603102, India
| | - P M Ravi
- Environmental Studies Section, Health Physics Division, Bhabha Atomic Research Centre, Trombay, Mumbai 400085, India
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Mitchell KM, Prudden HJ, Ramesh BM, Washington R, Isac S, Rajaram S, Terris-Prestholt F, Vickerman P. Mathematical Modelling of the Impact of PrEP for Female Sex Workers and Men Who Have Sex with Men upon HIV Incidence and Survival in Southern India. AIDS Res Hum Retroviruses 2014. [DOI: 10.1089/aid.2014.5336.abstract] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Kate M. Mitchell
- London School of Hygiene and Tropical Medicine, Global Health and Development, London, United Kingdom
| | - Holly J. Prudden
- London School of Hygiene and Tropical Medicine, Global Health and Development, London, United Kingdom
| | - B M. Ramesh
- Karnataka Health Promotion Trust, Bangalore, India
- University of Manitoba, Winnipeg, MB, Canada
| | - Reynold Washington
- Karnataka Health Promotion Trust, Bangalore, India
- St. John's Research Institute, Bangalore, India
| | - Shajy Isac
- Karnataka Health Promotion Trust, Bangalore, India
| | - S Rajaram
- CHARME-India Project, Bangalore, India
| | - Fern Terris-Prestholt
- London School of Hygiene and Tropical Medicine, Global Health and Development, London, United Kingdom
| | - Peter Vickerman
- London School of Hygiene and Tropical Medicine, Global Health and Development, London, United Kingdom
- University of Bristol, Bristol, United Kingdom
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Mitchell KM, Foss AM, Prudden HJ, Mukandavire Z, Pickles M, Williams JR, Johnson HC, Ramesh BM, Washington R, Isac S, Rajaram S, Phillips AE, Bradley J, Alary M, Moses S, Lowndes CM, Watts CH, Boily MC, Vickerman P. Who mixes with whom among men who have sex with men? Implications for modelling the HIV epidemic in southern India. J Theor Biol 2014; 355:140-50. [PMID: 24727187 PMCID: PMC4064301 DOI: 10.1016/j.jtbi.2014.04.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2013] [Revised: 04/01/2014] [Accepted: 04/02/2014] [Indexed: 11/19/2022]
Abstract
In India, the identity of men who have sex with men (MSM) is closely related to the role taken in anal sex (insertive, receptive or both), but little is known about sexual mixing between identity groups. Both role segregation (taking only the insertive or receptive role) and the extent of assortative (within-group) mixing are known to affect HIV epidemic size in other settings and populations. This study explores how different possible mixing scenarios, consistent with behavioural data collected in Bangalore, south India, affect both the HIV epidemic, and the impact of a targeted intervention. Deterministic models describing HIV transmission between three MSM identity groups (mostly insertive Panthis/Bisexuals, mostly receptive Kothis/Hijras and versatile Double Deckers), were parameterised with behavioural data from Bangalore. We extended previous models of MSM role segregation to allow each of the identity groups to have both insertive and receptive acts, in differing ratios, in line with field data. The models were used to explore four different mixing scenarios ranging from assortative (maximising within-group mixing) to disassortative (minimising within-group mixing). A simple model was used to obtain insights into the relationship between the degree of within-group mixing, R0 and equilibrium HIV prevalence under different mixing scenarios. A more complex, extended version of the model was used to compare the predicted HIV prevalence trends and impact of an HIV intervention when fitted to data from Bangalore. With the simple model, mixing scenarios with increased amounts of assortative (within-group) mixing tended to give rise to a higher R0 and increased the likelihood that an epidemic would occur. When the complex model was fit to HIV prevalence data, large differences in the level of assortative mixing were seen between the fits identified using different mixing scenarios, but little difference was projected in future HIV prevalence trends. An oral pre-exposure prophylaxis (PrEP) intervention was modelled, targeted at the different identity groups. For intervention strategies targeting the receptive or receptive and versatile MSM together, the overall impact was very similar for different mixing patterns. However, for PrEP scenarios targeting insertive or versatile MSM alone, the overall impact varied considerably for different mixing scenarios; more impact was achieved with greater levels of disassortative mixing. Different mixing scenarios are explored for 3 groups of role-segregated MSM. Models show that the mixing scenario affects both R0 and endemic HIV prevalence. When models are fit to data, predicted HIV trends are unaffected by mixing. Impact of targeted (but not non-targeted) interventions can be affected by mixing.
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Affiliation(s)
- K M Mitchell
- London School of Hygiene and Tropical Medicine, London, UK.
| | - A M Foss
- London School of Hygiene and Tropical Medicine, London, UK.
| | - H J Prudden
- London School of Hygiene and Tropical Medicine, London, UK.
| | - Z Mukandavire
- London School of Hygiene and Tropical Medicine, London, UK.
| | - M Pickles
- London School of Hygiene and Tropical Medicine, London, UK; Imperial College London, London, UK.
| | | | - H C Johnson
- London School of Hygiene and Tropical Medicine, London, UK.
| | - B M Ramesh
- Karnataka Health Promotion Trust, Bangalore, India; University of Manitoba, Winnipeg, MB, Canada.
| | - R Washington
- Karnataka Health Promotion Trust, Bangalore, India; St. John's Research Institute, Bangalore, India.
| | - S Isac
- Karnataka Health Promotion Trust, Bangalore, India.
| | - S Rajaram
- CHARME-India Project, Bangalore, India.
| | | | - J Bradley
- CHARME-India Project, Bangalore, India; Centre de recherche du CHU de Québec, Québec, QC, Canada.
| | - M Alary
- Centre de recherche du CHU de Québec, Québec, QC, Canada; Département de medicine sociale et preventive, Université laval, Québec, QC, Canada; Institut national de santé publique du Québec, Québec, QC, Canada.
| | - S Moses
- University of Manitoba, Winnipeg, MB, Canada.
| | - C M Lowndes
- Centre de recherche du CHU de Québec, Québec, QC, Canada; Public Health England, London, UK.
| | - C H Watts
- London School of Hygiene and Tropical Medicine, London, UK.
| | - M-C Boily
- Imperial College London, London, UK.
| | - P Vickerman
- University of Bristol, Bristol, UK; London School of Hygiene and Tropical Medicine, London, UK.
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Suganya R, Kirubakaran R, Rajaram S. Registration of Ultrasound Liver Images Using Mutual Information Technique. Advances in Intelligent Systems and Computing 2014. [DOI: 10.1007/978-81-322-1680-3_17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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Agarwal S, Malhotra KP, Sinha S, Rajaram S. Profile of gynecologic malignancies reported at a tertiary care center in India over the past decade: comparative evaluation with international data. Indian J Cancer 2013; 49:298-302. [PMID: 23238148 DOI: 10.4103/0019-509x.104494] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE Comprehensive statistics on gynecologic malignancies reported from India are deficient. This study was performed to ascertain the profile of gynecologic cancers reported at our center regarding incidence, histologic subtypes, frequency of involvement at various sites and stage at presentation. We endeavored to compare our data with gynecologic cancers reported at other national and international centers. MATERIALS AND METHODS Retrospective review of records of gynecologic cancers obtained from Departments of Pathology and Gynecology, at a tertiary care center, Delhi from January 2000 to December 2009 was performed. Comparison with international data was performed using Fishcher's exact test and chi square tests. RESULTS A total of 1315 gynecologic cancers were reported. Cervical malignancies were the commonest at our center as compared to uterine malignancies in data from Surveillance, Epidemiology, and End Results (SEER) Program of United States and European Union. All malignancies except cervical cancers affected a younger age group at our center than in the US population. Cervical cancer presented at a relatively more advanced stage, ovarian cancers at more localized stages, whereas uterine cancers presented at similar stages as compared to Western data. CONCLUSIONS Our registry presents composite data from North India. Higher age and advanced stage at presentation of cervical cancers suggests lacunae in screening programs available. Ovarian malignancies were more localized at presentation than in the Western population for which environmental or genetic factors may be causative.
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Affiliation(s)
- S Agarwal
- Department of Pathology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Dilshad Garden, Delhi, India
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Rajaram S, Alary M, Banandur P, Thammattoor UK, Thomas T, Mainkar MK, Paranjape R, Adhikary R, Duchesne T, Isac S. P6.068 Effect of an HIV Prevention Program Among Female Sex Workers on the Decline in Syphilis Prevalence Among Their Clients in South India. Br J Vener Dis 2013. [DOI: 10.1136/sextrans-2013-051184.1221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Rajaram S, Chua HC, Fu X. PATIENTS WITH DYSPHASIA: ENCOUNTERS IN TAKING MEDICATION. BMJ Support Palliat Care 2013. [DOI: 10.1136/bmjspcare-2013-000491.158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Rajaram S, Chua HC, Lim ST. ISSUES ASSOCIATED WITH DELIRIUM SEVERITY AMONG OLDER PATIENTS. BMJ Support Palliat Care 2013. [DOI: 10.1136/bmjspcare-2013-000491.157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Rajaram S, Chua HC. LOW FOOD INTAKE IN OLDER PEOPLE WITH DEMENTIA. BMJ Support Palliat Care 2013. [DOI: 10.1136/bmjspcare-2013-000491.127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Bradley J, Ramesh BM, Rajaram S, Lobo A, Gurav K, Isac S, Chandra Shekhar Gowda G, Pushpalatha R, Moses S, Sunil KDR, Alary M. The feasibility of using mobile phone technology for sexual behaviour research in a population vulnerable to HIV: a prospective survey with female sex workers in South India. AIDS Care 2012; 24:695-703. [PMID: 22292915 DOI: 10.1080/09540121.2011.630371] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Sexual behaviour studies are often challenged by sampling, participation and measurement biases, and may be unacceptable to participants. We invited 293 randomly selected female sex workers (FSWs) in Bangalore, India, to participate in a telephone survey, with condom breakage as the main outcome. Free cell phones were supplied and trained interviewers telephoned FSWs daily to ask about all sex acts the previous day. Later, we undertook focus groups to discuss the methodology with the participants. We evaluated technical and operational feasibility; data reliability and measurement error; emotional and fatigue effects; interviewer bias; survey reactivity effects; and user acceptability. Response rates were high, with 84% of invited participants complying fully with the protocol. The study ran smoothly, with little evidence of biases. The methodology was highly acceptable; the respondents enjoyed using a new telephone and being interviewed at times convenient to them. Other reasons for the success of the method were that the study was sanctioned and supported by the sex worker collective, and the interviewers were well trained and developed a strong rapport with the participants. The success of this methodology, and the wealth of data produced, indicates that it can be an important tool for conducting sexual behaviour research in low literacy, high sex volume populations.
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Rajaram S, Brindha JT, Sreedevi KR, Hegde AG. Efficiency as a function of MEQ-CWT for large area germanium detectors using LLNL phantom. Radiat Prot Dosimetry 2012; 148:121-125. [PMID: 21325369 DOI: 10.1093/rpd/ncq594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
The lung counting system at Kalpakkam, India, used for the estimation of transuranics deposited in the lungs of occupational workers, consists of an array of three large area germanium detectors fixed in a single assembly. The efficiency calibration for low energy photons was carried out using ²⁴¹Am and ²³²Th lung sets of Lawrence Livermore National Laboratory phantom. The muscle equivalent chest wall thickness (MEQ-CWT) was derived for the three energies 59.5, 75.95 (average energy of ²³²Th) and 238.9 keV for the series of overlay plates made of different adipose mass ratios. Efficiency as a function of MEQ-CWT was calculated for individual detectors for the three energies. Variation of MEQ-CWT from 16 to 40 mm resulted in an efficiency variation of around 40 % for all the three energies. The array efficiency for different MEQ-CWT ranged from 1.4×10⁻³ to 3.2×10⁻³, 1.5×10⁻³ to 3.3×10⁻³ and 1.1×10⁻³ to 2.3×10⁻³ for 59.5, 75.95 and 238.9 keV, respectively. In the energy response, efficiency was observed to be maximum for 75.95 keV compared with 59.5 and 238.9 keV.
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Affiliation(s)
- S Rajaram
- Environmental Survey Laboratory, Health Physics Division, Bhabha Atomic Research Centre, Kalpakkam 603102, India.
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Deering KN, Boily MC, Lowndes CM, Shoveller J, Tyndall MW, Vickerman P, Bradley J, Gurav K, Pickles M, Moses S, Ramesh BM, Washington R, Rajaram S, Alary M. A dose-response relationship between exposure to a large-scale HIV preventive intervention and consistent condom use with different sexual partners of female sex workers in southern India. BMC Public Health 2011; 11 Suppl 6:S8. [PMID: 22375863 PMCID: PMC3287561 DOI: 10.1186/1471-2458-11-s6-s8] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background The Avahan Initiative, a large-scale HIV preventive intervention targeted to high-risk populations including female sex workers (FSWs), was initiated in 2003 in six high-prevalence states in India, including Karnataka. This study assessed if intervention exposure was associated with condom use with FSWs’ sexual partners, including a dose-response relationship. Methods Data were from a cross-sectional study (2006-07) of 775 FSWs in three districts in Karnataka. Survey methods accounted for the complex cluster sampling design. Bivariate and multivariable logistic regression was used to separately model the relationships between each of five intervention exposure variables and five outcomes for consistent condom use (CCU= always versus frequently/sometimes/never) with different sex partners, including with: all clients; occasional clients; most recent repeat client; most recent non-paying partner; and the husband or cohabiting partner. Linear tests for trends were conducted for three continuous intervention exposure variables. Results FSWs reported highest CCU with all clients (81.7%); CCU was lowest with FSWs’ husband or cohabiting partner (9.6%). In multivariable analysis, the odds of CCU with all clients and with occasional clients were 6.3-fold [95% confidence intervals, CIs: 2.8-14.5] and 2.3-fold [95% CIs: 1.4-4.1] higher among FSWs contacted by intervention staff and 4.9-fold [95% CIs: 2.6-9.3] and 2.3-fold [95% CIs: 1.3-4.1] higher among those who ever observed a condom demonstration by staff, respectively, compared to those who had not. A significant dose-response relationship existed between each of these CCU outcomes and increased duration since first contacted by staff (P=0.001; P=0.006) and numbers of condom demonstrations witnessed (P=0.004; P=0.026); a dose-response relationship was also observed between condom use with all clients and number of times contacted by staff (P=0.047). Intervention exposure was not associated with higher odds of CCU with the most recent repeat client, most recent non-paying partner or with the husband or cohabiting partner. Conclusion Study findings suggest that exposure to a large-scale HIV intervention for FSWs was associated with increased CCU with commercial clients. Moreover, there were dose-response relationships between CCU with clients and increased duration since first contacted by staff, times contacted by staff and number of condom demonstrations. Additional program effort is required to increase condom use with non-commercial partners.
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Affiliation(s)
- Kathleen N Deering
- Division of AIDS, Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, Canada.
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Deering KN, Bhattacharjee P, Bradley J, Moses SS, Shannon K, Shaw SY, Washington R, Lowndes CM, Boily MC, Ramesh BM, Rajaram S, Gurav K, Alary M. Condom use within non-commercial partnerships of female sex workers in southern India. BMC Public Health 2011; 11 Suppl 6:S11. [PMID: 22376171 PMCID: PMC3287549 DOI: 10.1186/1471-2458-11-s6-s11] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Background Although female sex workers (FSWs) report high levels of condom use with commercial sex clients, particularly after targeted HIV preventive interventions have been implemented, condom use is often low with non-commercial partners. There is limited understanding regarding the factors that influence condom use with FSWs’ non-commercial partners, and of how programs can be designed to increase condom use with these partners. The main objectives of this study were therefore to describe FSWs’ self-reported non-commercial partners, along with interpersonal factors characterizing their non-commercial partnerships, and to examine the factors associated with consistent condom use (CCU) within non-commercial partnerships. Methods This study used data collected from cross-sectional questionnaires administered to 988 FSWs in four districts in Karnataka state in 2006-07. We used bivariate and multivariable logistic regression analysis to examine the relationship between CCU (i.e., ‘always’ compared to ‘never’, ‘sometimes’ or ‘frequently’) with non-commercial partners of FSWs (including the respondents’ husband or main cohabiting partner [if not married] and their most recent non-paying partner [who is neither a husband nor the main cohabiting partner, and with whom the FSW had sex within the previous year]) and interpersonal factors describing these partnerships, as well as social and environmental factors. Weighting and survey methods were used to account for the cluster sampling design. Results Overall, 511 (51.8%) FSWs reported having a husband or cohabiting partner and 247 (23.7%) reported having a non-paying partner. CCU with these partners was low (22.6% and 40.3% respectively). In multivariable analysis, the odds of CCU with FSWs’ husband or cohabiting partner were 1.8-fold higher for FSWs whose partner knew she was a sex worker (adjusted odds ratio [AOR]: 1.84, 95% confidence intervals[CI]: 1.02-3.32) and almost 6-fold higher if the FSW was unmarried (AOR: 5.73, 95%CI: 2.79-11.76]. CCU with FSWs’ non-paying partner decreased by 18% for each one-year increase in the duration of the relationship (AOR: 0.82, 95%CI: 0.68-0.97). Conclusions This study revealed important patterns and interpersonal determinants of condom use within non-commercial partnerships of FSWs. Integrated structural and community-driven HIV/STI prevention programs that focus on gender and reduce sex work stigma should be investigated to increase condom use in non-commercial partnerships.
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Affiliation(s)
- Kathleen N Deering
- Division of AIDS, Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, Canada.
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Bradley J, Rajaram S, Moses S, Bhattacharjee P, Lobo AM, Ramesh BM, Washington R, Alary M. Changes in HIV knowledge, and socio-cultural and sexual attitudes in South India from 2003-2009. BMC Public Health 2011; 11 Suppl 6:S12. [PMID: 22376184 PMCID: PMC3287550 DOI: 10.1186/1471-2458-11-s6-s12] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Background As communities face serious pressures on traditional values, such as those posed by HIV infection, cultural inertia may result, whereby existing trends towards more liberalized views of sexuality are stalled. We examined changes in attitudes around HIV in Bagalkot district, south India, between 2003 and 2009. Methods General population surveys were conducted in 2003 and 2009, among approximately 6,600 randomly sampled men and women in 10 villages and 20 urban blocks of Bagalkot. Questions about HIV knowledge, sexuality, gender and condoms were included. We compared responses in the two surveys using a multivariate logistic regression model. Results Awareness of HIV increased significantly from 76.9% in 2003 to 87.8% in 2009, and condom awareness increased significantly (37.4% to 65.4%) in all groups studied. However, in 2009, only 23% of people mentioned condoms as a means of prevention, an improvement from 8% in 2003 (adjusted odds ratio (AOR) 3.3; 95%CI 2.6-4.1, p <0.001). There was a significant increase in the number of women believing sex workers should be compulsorily tested for HIV (76.3%-86.4%%, AOR 1.8; 95%CI 1.4-2.4, p<0.001). An increasing number agreed that “it is wrong to talk about sex” (p=0.05), especially women (21.9% vs. 32.4%, p<0.01). There was an increase in women who thought it “wrong to talk about AIDS in a respectable family”, and more respondents in 2009 thought it improper to discuss condoms (15.6% vs. 27.4%, AOR 1.9, 95%CI 1.4-2.8, p=0.001). In 2003, 31.4% agreed that “access to condoms promotes promiscuity”, increasing to 45.2% in 2009 (AOR 1.7; 95%CI 1.3-2.3, p<0.001). Educated and young urban women were the most likely to believe this. In 2003, 19.3% and in 2009 30.2% (AOR 1.8, 95%CI 1.4-2.3, p<0.001) thought that sex education promotes sexual activity and promiscuity. Conclusions Despite increases over time in HIV-related knowledge and reductions in stigmatizing attitudes, resistance to changing cultural mores was apparent, with less willingness to embrace openness and discuss sexuality. Young and female respondents appeared to be the most resistant to change, reflecting a cultural inertia that mirrors studies of other pressures on traditional societal values. More effort is required to advocate among women and young people for healthy sexuality, openness and safe sex practices.
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Affiliation(s)
- Janet Bradley
- CHARME-India Project, Bangalore, India KHPT office, IT Park 5th floor, #1-4 Rajajinagar Industrial Area, Behind KSSIDC Admin Office, Rajajinagar, Bangalore 560 044, India.
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Bradley J, Rajaram S, Alary M, Isac S, Washington R, Moses S, Ramesh BM. Determinants of condom breakage among female sex workers in Karnataka, India. BMC Public Health 2011; 11 Suppl 6:S14. [PMID: 22376237 PMCID: PMC3287552 DOI: 10.1186/1471-2458-11-s6-s14] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Background Condoms are effective in preventing the transmission of HIV and other sexually transmitted infections, when properly used. However, recent data from surveys of female sex workers (FSWs) in Karnataka in south India, suggest that condom breakage rates may be quite high. It is important therefore to quantify condom breakage rates, and examine what factors might precipitate condom breakage, so that programmers can identify those at risk, and develop appropriate interventions. Methods We explored determinants of reported condom breakage in the previous month among 1,928 female sex workers in four districts of Karnataka using data from cross-sectional surveys undertaken from July 2008 to February 2009. Using stepwise multivariate logistic regression, we examined the possible determinants of condom breakage, controlling for several independent variables including the district and client load. Results Overall, 11.4% of FSWs reported at least one condom break in the previous month. FSWs were much more likely to report breakage if under 20 years of age (AOR 3.43, p = 0.005); if divorced/ separated/widowed (AOR 1.52, p = 0.012); if they were regular alcohol users (AOR 1.63, p = 0.005); if they mostly entertained clients in lodges/rented rooms (AOR 2.99, p = 0.029) or brothels (AOR 4.77, p = 0.003), compared to street based sex workers; if they had ever had anal sex (AOR 2.03, p = 0.006); if the sex worker herself (as opposed to the client) applied the condom at last use (AOR 1.90, p < 0.001); if they were inconsistent condom users (AOR 2.77, p < 0.001); and if they had never seen a condom demonstration (AOR 2.37, p < 0.001). Conclusions The reported incidence of condom breakage was high in this study, and this is a major concern for HIV/STI prevention programs, for which condom use is a key prevention tool. Younger and more marginalized female sex workers were most vulnerable to condom breakage. Special effort is therefore required to seek out such women and to provide information and skills on correct condom use. More research is also needed on what specific situational parameters might be important in predisposing women to condom breakage.
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Affiliation(s)
- Janet Bradley
- CHARME-India Project, Bangalore; India KHPT office, IT Park 5th floor, #1-4 Rajajinagar Industrial Area, Behind KSSIDC Admin Office, Rajajinagar, Bangalore 560 044, India.
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Abstract
OBJECTIVE The aim of this study was to assess the effect on neonatal thyroid function of iodinated contrast media administered for CT pulmonary angiography (CTPA) in babies whose mothers were investigated for suspected pulmonary embolism during pregnancy. METHODS Retrospective review of 115 pregnant patients investigated for suspected pulmonary embolism. The patient cohort consisted of two groups: Group A consisted of 73 pregnant females who received iodinated contrast agent for CTPA, and Group B (control group) consisted of 42 pregnant females who were investigated by perfusion imaging only. The results of the neonatal thyroid function tests for the babies of the mothers in Groups A and B were compared. RESULTS All of the neonatal thyroid function tests for both groups were normal with no statistical difference between the two groups. CONCLUSION No adverse effect on thyroid function was demonstrated in neonates exposed to in utero iodinated contrast media. However, as our study involves a small patient group, the results should be interpreted with caution.
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Affiliation(s)
- S Rajaram
- Department of Radiology, Sheffield Teaching Hospital Trust, Sheffield, UK.
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Swift ER, Rajaram S, Byass OR, Chiu K, Swift AJ. S20 Time-resolved CT pulmonary angiography contrast transit time in patients with pulmonary embolism: a novel functional CT metric of right heart strain? Thorax 2011. [DOI: 10.1136/thoraxjnl-2011-201054b.20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Rajaram S, Swift AJ, Capener D, Hill C, Davies C, Elliot R, Hurdman J, Condliffe R, Wild JM, Kiely DG. S23 Accuracy of contrast enhanced MR lung perfusion compared to perfusion scintigraphy in diagnosing chronic thromboembolic pulmonary hypertension. Thorax 2011. [DOI: 10.1136/thoraxjnl-2011-201054b.23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Swift AJ, Rajaram S, Condliffe R, Capener D, Hill C, Davies C, Hurdman J, Elliot C, Wild JM, Kiely DG. S70 Diagnostic utility and prognostic value of quantitative cardiac MR indices in patients with suspected pulmonary hypertension. Thorax 2011. [DOI: 10.1136/thoraxjnl-2011-201054b.70] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Bradley J, Rajaram S, Alary M, Isac S, Moses S, Ramesh BM. P1-S2.03 Determinants of condom breakage among female sex workers in Karnataka, India. Br J Vener Dis 2011. [DOI: 10.1136/sextrans-2011-050108.60] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Deering K, Bhattacharjee P, Washington R, Bradley J, Boily MC, Shaw S, Shannon K, Ramesh BM, Rajaram S, Moses S, Alary M. P2-S2.12 Condom use within intimate partnerships of female sex workers in Southern India. Br J Vener Dis 2011. [DOI: 10.1136/sextrans-2011-050108.308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Bradley J, Rajaram S, Ramesh B, Bhattacharjee P, Isac S, Lobo A, Moses S, Blanchard J, Washington R, Alary M. O2-S1.06 Community responses to an HIV epidemic in South India: knowledge, moral panic and cultural inertia. Br J Vener Dis 2011. [DOI: 10.1136/sextrans-2011-050109.72] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Mahajan U, Banandur P, Rajaram S, Duchesne T, Abdous B, Ramesh BM, Moses S, Alary M. O1-S11.02 Determinants of time trends in HIV prevalence in the young antenatal population of Karnataka districts. Br J Vener Dis 2011. [DOI: 10.1136/sextrans-2011-050109.62] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Pickles M, Ramesh BM, Adhikary R, Rajaram S, Isac S, Washington R, Boily MC, Bradley J, Moses S, Alary M. P1-S4.05 Quantifying social desirability biases in reported condom use among female sex workers in Southern India. Br J Vener Dis 2011. [DOI: 10.1136/sextrans-2011-050108.149] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Cheah E, Rajaram S, Chua HC, Ng HL, Tim HM, Fadillah F, Zheng D. Managing functional decline among the elderly patients in ward 3 Geriatric ward using the Katz Index of Independence in Activities of Daily Living (ADL). BMJ Support Palliat Care 2011. [DOI: 10.1136/bmjspcare-2011-000053.98] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Cheah E, Rajaram S, Chua HC, Ng HL, Tim HM, Cinnappan S, Lim ST. Managing the cognitive impairment of elderly patients using the Mini Mental State Examination (MMSE). BMJ Support Palliat Care 2011. [DOI: 10.1136/bmjspcare-2011-000053.99] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Cheah E, Rajaram S, Chua HC, Ng HL, Tim HM, Fadillah F, Zheng D. Management of depression among the elderly patients in ward 3 Geriatric ward using the Geriatric Depression Scale (GDS). BMJ Support Palliat Care 2011. [DOI: 10.1136/bmjspcare-2011-000053.97] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Cheah E, Rajaram S, Cheah E, Sidek N, Tan MH, Fadillah F, Zheng D, Hamid H. Managing the quality of sleep among elderly patients using the Pittsburgh Sleep Quality Index. BMJ Support Palliat Care 2011. [DOI: 10.1136/bmjspcare-2011-000053.89] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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