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Parmar V, Nair NS, Vanamali V, Hawaldar RW, Siddique S, Shet T, Desai SB, Rangarajan V, Patil A, Gupta S, Badwe RA. Abstract P3-03-03: Sentinel node biopsy (SNB) vs Low axillary sampling (LAS) in predicting nodal status of post-chemotherapy axilla in women with breast cancer. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p3-03-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction
There is no safe method of avoiding complete axillary lymph node dissection in women with breast cancer after neo-adjuvant chemotherapy. sentinel node biopsy (SNB) has had prohibitively high false negative rate. We tested low axillary sampling (LAS) and SNB performed in same patient to predict axillary lymph node status in clinically node negative women undergoing breast conservation or modified radical mastectomy after neo-adjuvant chemotherapy.
Methodology
Post neo-adjuvant chemotherapy 751 women who had no palpable axillary lymph node underwent LAS (all lymph nodes below intercosto-brachial nerve). Of these 751 women, 730 also underwent SNB by dual technique after injection of blue dye as well as radio-isotope. SN was identified within and outside axillary sampling specimen. SN as well as LAS specimens were distinctly examined for nodal metastasis. The rest of the axillary dissection was completed in all patients. Post NACT 292/751(38.9%) had residual positive lymph nodes on pathology. The identification rate, false negative rate (FNR), and negative predictive value (NPV) of SNB and LAS were compared for predicting negative axillary lymph node status.
Results
The median clinical tumor size was 5cm (1-15cm) and 533(71%) patients were N1 or N2 at presentation. The SNB identification rate was 87.1% (636 of 730), with a median of 5 nodes and node positive in 238 of 636 (37.4%). LAS identification rate was 98% (736 of 751), with a median of 7 nodes and node positive in 292 of 736 (39.6%). In all but one case, the SN was found within the LAS specimen. The FNR of SNB (blue, hot and adjacent palpable nodes) was 19.7% (47 of 238, one sided 95% upper CI 24.0) compared to LAS with FNR of 9.9% (29 of 292, one-sided 95% upper CI 12.8) (p<0.001). Comparative NPV for SNB and LAS were 89.4% and 93.9% respectively. If SNB was confined to blue/hot node excluding adjacent palpable nodes, FNR was 31.6% (74 of 234, 95% upper CI 36.6).
Conclusions
LAS is superior to SNB in identification rate, FNR and NPV in predicting node negative axilla post-neoadjuvant chemotherapy. LAS can be safely used to predict negative axilla with less than 10% chance of leaving residual disease.
Citation Format: Parmar V, Nair NS, Vanamali V, Hawaldar RW, Siddique S, Shet T, Desai SB, Rangarajan V, Patil A, Gupta S, Badwe RA. Sentinel node biopsy (SNB) vs Low axillary sampling (LAS) in predicting nodal status of post-chemotherapy axilla in women with breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P3-03-03.
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Affiliation(s)
- V Parmar
- Tata Memorial Centre, Mumbai, Maharashtra, India
| | - NS Nair
- Tata Memorial Centre, Mumbai, Maharashtra, India
| | - V Vanamali
- Tata Memorial Centre, Mumbai, Maharashtra, India
| | - RW Hawaldar
- Tata Memorial Centre, Mumbai, Maharashtra, India
| | - S Siddique
- Tata Memorial Centre, Mumbai, Maharashtra, India
| | - T Shet
- Tata Memorial Centre, Mumbai, Maharashtra, India
| | - SB Desai
- Tata Memorial Centre, Mumbai, Maharashtra, India
| | - V Rangarajan
- Tata Memorial Centre, Mumbai, Maharashtra, India
| | - A Patil
- Tata Memorial Centre, Mumbai, Maharashtra, India
| | - S Gupta
- Tata Memorial Centre, Mumbai, Maharashtra, India
| | - RA Badwe
- Tata Memorial Centre, Mumbai, Maharashtra, India
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Abstract
BACKGROUND Diabetic cystoid macular oedema (CMO) is a condition which involves fluid accumulation in the inner portion of the retina. It often follows changes in retinal blood vessels which enhance the fluid to come out of vessels. Although it may be asymptomatic, symptoms are primarily painless loss of central vision, often with the complaint of seeing black spots in front of the eye.It is reported that CMO may resolve spontaneously, or fluctuate for months, before causing loss of vision. If left untreated or undiagnosed, progression of CMO may lead to permanent visual loss.It has been noted that patients with diabetic retinopathy have elevated inflammatory markers, and therefore it is likely that inflammation aids in the progression of vascular disease in these patients. Several topical non-steroidal anti-inflammatory drugs (NSAIDs) such as ketorolac 0.5%, bromfenac 0.09%, and nepafenac 0.1%, have therefore also been used topically to treat chronic diabetic CMO. Hence this review was conducted to find out the effects of topical NSAIDs in diabetic CMO. OBJECTIVES To assess the effects of topical non-steroidal anti-inflammatory drugs (NSAIDs) for diabetic cystoid macular oedema (CMO). SEARCH METHODS We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (2014, Issue 12), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to January 2015), EMBASE (January 1980 to January 2015), Latin American and Caribbean Health Sciences Literature Database (LILACS) (January 1982 to January 2015), the ISRCTN registry (www.isrctn.com/editAdvancedSearch), ClinicalTrials.gov (www.clinicaltrials.gov) and the WHO International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 12 January 2015. SELECTION CRITERIA Randomised controlled trials (RCTs) and quasi-RCTs investigating the effects of topically applied NSAIDs in the treatment of people with diabetic CMO aged 18 years of age or over. DATA COLLECTION AND ANALYSIS Two review authors independently assessed trial eligibility and screened all available titles and abstracts for inclusion. There were no discrepancies and we did not have to contact trial investigators for missing data. MAIN RESULTS We did not identify any RCTs matching the inclusion criteria for this review. AUTHORS' CONCLUSIONS The review did not identify any RCTs investigating the effects of topical NSAIDs in the treatment of diabetic CMO. Most of the studies identified through the electronic searches had been conducted to analyse the effect of topical NSAIDs for pseudophakic CMO.In the absence of high quality evidence, clinicians need to use their clinical judgement and other low level evidence, such as observational non-randomised trials, to decide whether to use topical NSAIDs in cases of diabetic CMO.More research is needed to better understand the cause of this condition and its pathophysiology. This systematic review has identified the need for well designed, adequately powered RCTs to assess possible beneficial and adverse effects of topical NSAIDs in people with diabetic CMO. Future trials should aim to include a large sample size with an adequate follow-up period of up to one year.
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Affiliation(s)
- Soumendra Sahoo
- Ophthalmology, Melaka Manipal Medical College, Bukit Baru, Melaka, Malaysia, 75150.
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Binu VS, Nair NS, Manjunatha PK, Kalesh MK. Impact of pixel intensity correlations on statistical inferences of expression levels in cDNA microarray experiments. Int J Bioinform Res Appl 2015; 11:257-267. [PMID: 26561021 DOI: 10.1504/ijbra.2015.069198] [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] [Indexed: 06/05/2023]
Abstract
In a cDNA microarray experiment, the final measurement is intensity ratio at a spot in the microarray chip. The objective of the present study is to estimate the uncertainty associated with the final intensity ratio at each spot in cDNA microarray chips and also to explore the role of pixel intensity correlations in statistical inferences of gene expression levels. We estimate uncertainty at each spot using the theory of error propagation under two different situations: (1) when there is no correlation between pixel intensities and (2) when the pixel intensities are positively correlated. The inverses of these estimated uncertainties are used as weights in downstream analysis to test the significance of each gene. The analysis was verified on a data downloaded from the GEO database. Our study shows that the uncertainty and statistical inference of gene expression levels depend on correlation between pixel intensities within a spot.
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Affiliation(s)
- V S Binu
- 1 Department of Statistics, Manipal University, Manipal, Karnataka, India
| | - N S Nair
- 2 Department of Statistics, Manipal University, Manipal, Karnataka, India
| | | | - M K Kalesh
- 4 Department of Statistics, Manipal University, Manipal, Karnataka, India
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Parmar V, Nair NS, Hawaldar R, Vanamali V, Gupta S, Shet T, Badwe RA. Abstract P4-16-08: Neoadjuvant depot hydroxy-progesterone and vitamin D3 in large operable and locally advanced breast cancer: Planned safety and response analysis of a phase III randomized controlled trial. Cancer Res 2013. [DOI: 10.1158/0008-5472.sabcs13-p4-16-08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background- The active metabolite of Vitamin D, 1,25-dihydroxycholecalciferol (Arachitol), and D3 analogs are known to be cytotoxic, anti-proliferative, pro-apoptotic[2] and potentiate responsiveness to cytotoxic agents such as doxorubicin.[3] Depot hydroxy-progesterone caproate (DHPC) has shown benefit in disease-free and overall survival when given as a single dose prior to definitive surgery in women with node positive operable breast cancer. [1] We undertook a factorial randomized controlled phase III study to evaluate the safety and efficacy of these interventions in the neoadjuvant setting in patients with operable and locally advanced breast cancer (NCT01608451).
Methods- The study was planned as a phase III, 2×2 factorial, randomized controlled trial with a sample size of 800. Women with high-risk (clinically T2N2, T3N1-3, all M0) operable or locally advanced breast cancer who were planned for neoadjuvant chemotherapy prior to surgery, were recruited in the study. Patients were randomized (2×2) to one of the following 4 arms: patients in Arm A received standard 4 cycles of anthracycline-based neoadjuvant chemotherapy followed by surgery, those in Arm B received 500 mg of DHPC 5-14 days prior to each cycle of chemotherapy and prior to surgery, those in Arm C received intramuscular injection of 300,000 IU Arachitol, and those in Arm D received a combination of both the experimental interventions at similar time points. The primary endpoint was disease-free survival and the secondary endpoints were overall survival, pathological complete response (pCR, defined as absence of invasive cancer in breast and axillary lymph nodes in the surgical specimen), and toxicity (defined by NCI Common Toxicity Criteria). We are reporting here a planned analysis of the secondary endpoints, after recruitment of 1/6th of total sample size, on toxicity and responses in the study arms.
Results- From September 2007 to December 2010, 120 patients were recruited in the study, 27 in Arm A, 33 in Arm B, 29 in Arm C and 31 in Arm D. The arms were balanced with respect to known prognostic variables including age, clinical tumor size, clinical nodal status and ER/PR and HER2 status. Of the 120 patients, 44(36.6%) were ER &/or PR positive with HER2 negative tumors, 27(22.3%) triple negative, 41(33.9%) ER &/or PR any with HER2 positive, and receptor status was unknown in 6.6%. The rates of all grades and grade III-IV febrile neutropenia, hepatic dysfunction, renal dysfunction and dyselectrolytemia were not different between the 4 arms. Surgery was performed in 114 of 120 patients(95.0%). The pCR rates in DHPC arm vs no DHPC was 5/51(9.8%) and 5/59(8.5%) respectively. The pCR rates in Arachitol versus no Arachitol arms were 5/55(9.0%) in both arms.
Conclusions- The addition of depot hydroxy-progesterone and vitamin D3 in neoadjuvant setting were found to be safe and well tolerated. Further details of toxicity, response and the ongoing study will be presented at the Symposium.
References:
1. Badwe RA et al. J Clin Oncol.2011 Jul 20;29(21):2845-51
2. James SY et al. J Steroid Biochem Mol Biol.1996 Jul;58(4):395-401
3. Chaudhary M et al. Cancer Chemother Pharmacol.2001;47(5):429-36.
Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P4-16-08.
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Affiliation(s)
- V Parmar
- Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - NS Nair
- Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - R Hawaldar
- Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - V Vanamali
- Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - S Gupta
- Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - T Shet
- Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - RA Badwe
- Tata Memorial Hospital, Mumbai, Maharashtra, India
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Abstract
BACKGROUND Haemoglobinopathies, inherited disorders of haemoglobin synthesis (thalassaemia) or structure (sickle cell disease), are responsible for significant morbidity and mortality throughout the world. The WHO estimates that, globally, 5% of adults are carriers of a haemoglobin condition, 2.9% are carriers of thalassaemia and 2.3% are carriers of sickle cell disease. Carriers are found worldwide as a result of migration of various ethnic groups to different regions of the world. Zinc is an easily available supplement and intervention programs have been carried out to prevent deficiency in people with thalassaemia or sickle cell anaemia. It is important to evaluate the role of zinc supplementation in the treatment of thalassaemia and sickle cell anaemia to reduce deaths due to complications. OBJECTIVES To assess the effect of zinc supplementation in the treatment of thalassaemia and sickle cell disease. SEARCH METHODS We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group's Haemoglobinopathies Trials Register comprising references identified from comprehensive electronic database searches and handsearches of relevant journals and abstract books of conference proceedings.Date of most recent search: 01 February 2013. SELECTION CRITERIA Randomised, placebo-controlled trials of zinc supplements for treating thalassaemia or sickle cell disease administered at least once a week for at least a month. DATA COLLECTION AND ANALYSIS Two review authors assessed the eligibility and risk of bias of the included trials, extracted and analysed data and wrote the review. We summarised results using risk ratios or rate ratios for dichotomous data and mean differences for continuous data. We combined trial results where appropriate. MAIN RESULTS We identified nine trials for inclusion with all nine contributing outcome data. Two trials reported on people with thalassaemia (n = 152) and seven on sickle cell anaemia (n = 307).In people with thalassaemia, in one trial, the serum zinc level value showed no difference between the zinc supplemented group and the control group, mean difference 47.40 (95% confidence interval -12.95 to 107.99). Regarding anthropometry, in one trial, height velocity was significantly increased in patients who received zinc supplementation for one to seven years duration, mean difference 3.37 (95% confidence interval 2.36 to 4.38) (total number of participants = 26). In one trial, however, there was no difference in body mass index between treatment groups.Zinc acetate supplementation for three months (in one trial) and one year (in two trials) (total number of participants = 71) was noted to increase the serum zinc level significantly in patients with sickle cell anaemia, mean difference 14.90 (95% confidence interval 6.94 to 22.86) and 20.25 (95% confidence interval 11.73 to 28.77) respectively. There was no significant difference in haemoglobin level between intervention and control groups, at either three months (one trial) or one year (one trial), mean difference 0.06 (95% confidence interval -0.84 to 0.96) and mean difference -0.07 (95% confidence interval -1.40 to 1.26) respectively. Regarding anthropometry, one trial showed no significant changes in body mass index or weight after one year of zinc acetate supplementation. In patients with sickle cell disease, the total number of sickle cell crises at one year were significantly decreased in the zinc sulphate supplemented group as compared to controls, mean difference -2.83 (95% confidence interval -3.51 to -2.15) (total participants 130), but not in zinc acetate group, mean difference 1.54 (95% confidence interval -2.01 to 5.09) (total participants 22). In one trial at three months and another at one year, the total number of clinical infections were significantly decreased in the zinc supplemented group as compared to controls, mean difference 0.05 (95% confidence interval 0.01 - 0.43) (total number of participants = 36), and mean difference -7.64 (95% confidence interval -10.89 to -4.39) (total number of participants = 21) respectively. AUTHORS' CONCLUSIONS According to the results, there is no evidence from randomised controlled trials to indicate any benefit of zinc supplementation with regards to serum zinc level in patients with thalassaemia. However, height velocity was noted to increase among those who received this intervention.There is mixed evidence on the benefit of using zinc supplementation in people with sickle cell disease. For instance, there is evidence that zinc supplementation for one year increased the serum zinc levels in patients with sickle cell disease. However, though serum zinc level was raised in patients receiving zinc supplementation, haemoglobin level and anthropometry measurements were not significantly different between groups. Evidence of benefit is seen with the reduction in the number of sickle cell crises among sickle cell patients who received one year of zinc sulphate supplementation and with the reduction in the total number of clinical infections among sickle cell patients who received zinc supplementation for both three months and for one year.The conclusion is based on the data from a small group of trials,which were generally of good quality, with a low risk of bias. The authors recommend that more trials on zinc supplementation in thalassaemia and sickle cell disease be conducted given that the literature has shown the benefits of zinc in these types of diseases.
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Affiliation(s)
- Kye Mon Min Swe
- Department of Community Medicine, Melaka-Manipal Medical College (MMMC), Melaka, Malaysia.
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Karanth L, Barua A, Kanagasabai S, Nair NS. Desmopressin acetate (DDAVP) for preventing and treating acute bleeds during pregnancy in women with congenital bleeding disorders. Cochrane Database Syst Rev 2013:CD009824. [PMID: 23633378 DOI: 10.1002/14651858.cd009824.pub2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Congenital bleeding disorders can cause obstetric haemorrhage during pregnancy, labour and following delivery. Desmopressin acetate is found to be an effective drug which can reduce the risk of haemorrhage and can also stop bleeding in certain congenital bleeding disorders. Its use in pregnancy has been controversial. Hence beneficial and adverse effects of desmopressin acetate in these groups of pregnant women should be evaluated. OBJECTIVES To determine the efficacy of desmopressin acetate in preventing and treating acute bleeds during pregnancy in women with congenital bleeding disorders. SEARCH METHODS We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group's Coaguopathies Trials Register comprising references identified from comprehensive electronic database searches and handsearches of relevant and abstract books of conferences proceedings. We also searched for any randomised controlled trials in a registry of ongoing trials and the reference lists of relevant articles and reviews.Date of most recent search: 28 February 2013. SELECTION CRITERIA Randomised and quasi-randomised controlled trials investigating the efficacy of desmopressin acetate versus tranexamic acid or factor VIII or rFactor VII or fresh frozen plasma in preventing and treating congenital bleeding disorders during pregnancy were eligible. DATA COLLECTION AND ANALYSIS No trials matching the selection criteria were eligible for inclusion. MAIN RESULTS No trials matching the selection criteria were eligible for inclusion. AUTHORS' CONCLUSIONS The review did not identify any randomised controlled trials investigating the relative effectiveness of desmopressin acetate for bleeding during pregnancy in women with congenital bleeding disorders. In the absence of high quality evidence, clinicians need to use their clinical judgement and lower level evidence (e.g. from observational trials) to decide whether or not to treat women with congenital bleeding disorders with desmopressin acetate.Given the ethical considerations, future randomised controlled trials are unlikely. However, other high quality controlled studies (such as risk allocation designs, sequential design, parallel cohort design) to investigate the risks and benefits of using desmopressin acetate in this population are needed.
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Affiliation(s)
- Laxminarayan Karanth
- Department of Obstetrics and Gynecology, Melaka Manipal Medical College, Melaka, Malaysia.
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Abstract
BACKGROUND During pregnancy, a Rhesus-negative (Rh-negative) woman may develop antibodies if her fetus is Rh-positive, which can cause fetal morbidity or mortality in following pregnancies, if untreated. OBJECTIVES To assess the effects of administering anti-D immunoglobulin (Ig) after spontaneous miscarriage in a Rh-negative woman, with no anti-D antibodies. SEARCH METHODS We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 December 2012). SELECTION CRITERIA Randomised controlled trials (RCT) in Rh-negative women without antibodies who were given anti-D Ig following spontaneous miscarriage compared with no treatment or placebo treatment following spontaneous miscarriage as control. DATA COLLECTION AND ANALYSIS Two review authors independently assessed trials for inclusion and trial quality. Two review authors extracted data and checked it for accuracy. MAIN RESULTS We included one RCT, involving 48 women who had a miscarriage between eight to 24 weeks of gestation. Of the 19 women in the treatment group, 14 had therapeutic dilatation & curettage (D&C) and five had spontaneous miscarriage; of the 29 women in the control group, 25 had therapeutic D&C and four had spontaneous miscarriage. The treatment group received 300 µg anti-D Ig intramuscular injection and were compared with a control group who received 1 cc homogenous gamma globulin placebo.This review's primary outcomes (development of a positive Kleihauer Betke test (a test that detects fetal cells in the maternal blood; and development of RhD alloimmunisation in a subsequent pregnancy) were not reported in the included study.Similarly, none of the review's secondary outcomes were reported in the included study: the need for increased surveillance for suspected fetal blood sampling and fetal transfusions in subsequent pregnancies, neonatal morbidity such as neonatal anaemia, jaundice, bilirubin encephalopathy, erythroblastosis, prematurity, hypoglycaemia (low blood sugar) in subsequent pregnancies, maternal adverse events of anti-D administration including anaphylactic reaction and blood-borne infections.The included study did report subsequent Rh-positive pregnancies in three women in the treatment group and six women in the control group. However, due to the small sample size, the study failed to show any difference in maternal sensitisation or development of Rh alloimmunisation in the subsequent pregnancies. AUTHORS' CONCLUSIONS There are insufficient data available to evaluate the practice of anti-D administration in an unsensitised Rh-negative mother after spontaneous miscarriage. Thus, until high-quality evidence becomes available, the practice of anti-D Immunoglobulin prophylaxis after spontaneous miscarriage for preventing Rh alloimmunisation cannot be generalised and should be based on the standard practice guidelines of each country.
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Affiliation(s)
- Laxminarayan Karanth
- Department of Obstetrics and Gynecology, Melaka Manipal Medical College, Melaka, Malaysia.
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Sahoo S, Barua A, Myint KT, Haq A, Abas ABL, Nair NS. Topical non-steroidal anti-inflammatory agents for diabetic cystoid macular oedema. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2012. [DOI: 10.1002/14651858.cd010009] [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: 11/07/2022]
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Parmar V, Nair NS, Badwe RA, Hawaldar R, Shet T, Desai S. Pathological complete response in locally advanced breast cancer: determinants and predictive significance. Natl Med J India 2012; 25:132-136. [PMID: 22963288] [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] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND Neoadjuvant chemotherapy is now the standard approach for most large breast cancers including locally advanced cancers of the breast. The majority of patients respond satisfactorily to chemotherapy with effective downsizing of tumours to consider breast conservation surgery. Pathological complete response (pathCR) is known to be a strong predictor of good outcome; however, many factors are known to influence the extent of response to chemotherapy. It has been observed that smaller the tumour, better is the response achieved in contrast to larger and locally advanced tumours where only one-third may respond well enough to merit breast conservation. Various other clinical, biological and molecular factors are also being evaluated as effective predictors of chemosensitivity. Most of these are either not easily available for all patients in developing countries or are overtly expensive and not applicable for all patients. METHODS We evaluated the clinical and pathological predictors of response to chemotherapy in 1402 women with locally advanced breast cancer. RESULTS There was a higher rate of pathCR in smaller tumours, younger women and ER-negative as well as triple negative tumours. The presence of ductal carcinoma in situ (DCIS) and lymphatic and vascular invasion (LVI) were associated with lower pathCR. CONCLUSION In the absence of ready availability of expensive molecular and genomic assays, clinical parameters and standard histopathological variables can also be useful indicators of response to neoadjuvant chemotherapy. Additionally, they can help identify those who could be eventually conserved or have a better outcome.
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Affiliation(s)
- V Parmar
- Breast Services, Surgical Oncology, Tata Memorial Hospital, Parel, Mumbai, Maharashtra, India.
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Karanth L, Barua A, Kanagasabai S, Nair NS. Desmopressin acetate (DDAVP) for preventing and treating acute bleeds during pregnancy in women with congenital bleeding disorders. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2012. [DOI: 10.1002/14651858.cd009824] [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] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Gentilcore D, Nair NS, Vanis L, Rayner CK, Meyer JH, Hausken T, Horowitz M, Jones KL. Comparative effects of oral and intraduodenal glucose on blood pressure, heart rate, and splanchnic blood flow in healthy older subjects. Am J Physiol Regul Integr Comp Physiol 2009; 297:R716-22. [PMID: 19553500 DOI: 10.1152/ajpregu.00215.2009] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Postprandial hypotension occurs frequently, particularly in the elderly. The magnitude of the fall in blood pressure (BP) and rise in heart rate (HR) in response to enteral glucose are greater when gastric emptying (GE) or small intestinal infusion are more rapid. Meal ingestion is associated with an increase in splanchnic blood flow. In contrast, gastric distension may attenuate the postprandial fall in BP. The aims of this study were to evaluate, in older subjects, the comparative effects of intraduodenal glucose infusion, at a rate similar to GE of oral glucose, on BP, HR, superior mesenteric artery (SMA) flow, and blood glucose. Eight healthy subjects (5 men, 3 women, age 66-75 yr) were studied on two occasions. On day 1, each subject ingested 300 ml of water containing 75 g glucose. GE was quantified by three-dimensional ultrasonography between time t = 0-120 min, and the rate of emptying (kcal/min) was calculated. On day 2, glucose was infused intraduodenally at the same rate as that on day 1. On both days, BP, HR, SMA flow, and blood glucose were measured. The mean GE of oral glucose was 1.3 +/- 0.1 kcal/min. Systolic BP (P < 0.01), SMA flow (P < 0.05), and blood glucose (P < 0.01) were greater and HR less (P < 0.01) after oral, compared with intraduodenal, glucose. There were comparable falls in diastolic BP during the study days (P < 0.01 for both). We conclude that the magnitude of the fall in systolic BP and rise in HR are less after oral, compared with intraduodenal, glucose, presumably reflecting the "protective" effect of gastric distension.
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Affiliation(s)
- Diana Gentilcore
- Univ. of Adelaide, Discipline of Medicine, Royal Adelaide Hospital, North Terrace, Adelaide, SA 5000, Australia
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Brennan IM, Feltrin KL, Nair NS, Hausken T, Little TJ, Gentilcore D, Wishart JM, Jones KL, Horowitz M, Feinle-Bisset C. Effects of the phases of the menstrual cycle on gastric emptying, glycemia, plasma GLP-1 and insulin, and energy intake in healthy lean women. Am J Physiol Gastrointest Liver Physiol 2009; 297:G602-10. [PMID: 19556358 DOI: 10.1152/ajpgi.00051.2009] [Citation(s) in RCA: 147] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
There is evidence that the menstrual cycle affects appetite, such that energy intake is lower during the follicular compared with the luteal phase. Gastric emptying influences energy intake, glycemia, and plasma glucagon-like peptide-1 (GLP-1), insulin, and cholecystokinin (CCK) release. We hypothesized that 1) gastric emptying of a glucose drink is slower, and glycemia, plasma hormones, hunger, and energy intake are less, during the follicular compared with the luteal phase; 2) the reduction in the latter parameters during the follicular phase are related to slower gastric emptying; and 3) these parameters are reproducible when assessed twice within a particular phase of the menstrual cycle. Nine healthy, lean women were studied on three separate occasions: twice during the follicular phase (days 6-12) and once during the luteal phase (days 18-24). Following consumption of a 300-ml glucose drink (0.17 g/ml), gastric emptying, blood glucose, plasma hormone concentrations, and hunger were measured for 90 min, after which energy intake at a buffet meal was quantified. During the follicular phase, gastric emptying was slower (P < 0.05), and blood glucose (P < 0.01), plasma GLP-1 and insulin (P < 0.05), hunger (P < 0.01), and energy intake (P < 0.05) were lower compared with the luteal phase, with no differences for CCK or between the two follicular phase visits. There were inverse relationships between energy intake, blood glucose, and plasma GLP-1 and insulin concentrations with the amount of glucose drink remaining in the stomach at t = 90 min (r < -0.6, P < 0.05). In conclusion, in healthy women 1) gastric emptying of glucose is slower, and glycemia, plasma GLP-1 and insulin, hunger, and energy intake are less during the follicular compared with the luteal phase; 2) energy intake, glycemia, and plasma GLP-1 and insulin are related to gastric emptying; and 3) these parameters are reproducible when assessed twice during the follicular phase.
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Affiliation(s)
- Ixchel M Brennan
- University of Adelaide Discipline of Medicine, Royal Adelaide Hospital, Adelaide, South Australia, Australia
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Nair NS, Brennan IM, Little TJ, Gentilcore D, Hausken T, Jones KL, Wishart JM, Horowitz M, Feinle-Bisset C. Reproducibility of energy intake, gastric emptying, blood glucose, plasma insulin and cholecystokinin responses in healthy young males. Br J Nutr 2009; 101:1094-102. [PMID: 18680633 DOI: 10.1017/s0007114508042372] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Gastric emptying, as well as intragastric meal distribution, and gastrointestinal hormones, including cholecystokinin (CCK), play an important role in appetite regulation. The evaluation of gastrointestinal factors regulating food intake is commonly performed in healthy, lean, young male participants. It has, however, been suggested that there is a marked interindividual variability in the effects of nutrient 'preloads' on energy intake in this group. Whether there is significant intraindividual variation in acute energy intake after a nutrient preload, and, if so, how this relates to day-to-day differences in gastric emptying and gastrointestinal hormone release, is unclear. The purpose of the present paper is to evaluate the hypothesis that energy intake after a nutrient preload would be reproducible and associated with reproducible patterns of gastric emptying, intragastric distribution and gastrointestinal hormone release. Fifteen healthy men (age 25 (sem 5) years) consumed a glucose preload (50 g glucose in 300 ml water; 815 kJ) on three occasions. Gastric emptying and intragastric meal distribution (using three-dimensional ultrasound), blood glucose, plasma insulin and CCK concentrations and appetite perceptions were evaluated over 90 min, and energy intake from a cold buffet-style meal was then quantified. Energy intake was highly reproducible within individuals between visits (intraclass correlation coefficient, ri = 0.9). Gastric emptying, intragastric meal distribution, blood glucose, plasma insulin and CCK concentrations and appetite perceptions did not differ between visits (ri>0.7 for all). In healthy males, energy intake is highly reproducible, at least in the short term, and is associated with reproducible patterns of gastric emptying, glycaemia, insulinaemia and CCK release.
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Affiliation(s)
- Nivasinee S Nair
- Discipline of Medicine, Royal Adelaide Hospital, University of Adelaide, North Terrace, Adelaide, SA 5000, Australia
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Rao RSP, Lena A, Nair NS, Kamath V, Kamath A. Effectiveness of reproductive health education among rural adolescent girls: a school based intervention study in Udupi Taluk, Karnataka. Indian J Med Sci 2008; 62:439-443. [PMID: 19265233] [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] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
BACKGROUND Adolescence is the most important and sensitive period of one's life [1] . According to the World Health Organization (WHO) Expert Committee, adolescence is defined as the period between 10 and 19 years, the second decade of life. OBJECTIVE To determine the effectiveness of an educational intervention program on knowledge of reproductive health among adolescent girls. SETTINGS AND DESIGN This educational intervention study was carried out over a period of one year. A total of 791 rural girls in the age group 16-19 years were randomly selected from coastal villages in Udupi District, Karnataka. MATERIALS AND METHODS Adolescent girls were educated regarding reproductive health and their awareness levels were evaluated immediately following intervention. STATISTICAL ANALYSIS Data was tabulated and analyzed using SPSS version 11.0 for Windows. Findings were described in terms of proportions and percentages. Chi square test was used to test the effect of the intervention. RESULTS A significant increase in overall knowledge after the intervention (from 14.4 to 68%, P < 0.01) was observed regarding contraception. Knowledge regarding ovulation, first sign of pregnancy and fertilization improved by 37.2% (95% CI = (35.2, 39.2), P < 0.001). Knowledge regarding the importance of diet during pregnancy improved from 66 to 95% following the intervention. CONCLUSION This study clearly showed that an educational intervention program can bring about a desirable change in knowledge among adolescent girls regarding reproductive health.
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Affiliation(s)
- R S P Rao
- Department of Community Medicine, Kasturba Medical College, Manipal, India
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Prabhu RA, Goyal NK, Nair NS, Pai G, Wadhwa T. Interventions for dialysis patients with hepatitis C virus (HCV) infection. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2008. [DOI: 10.1002/14651858.cd007003] [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: 11/05/2022]
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Lena A, Nair NS, Kamath V, Kamath A, Rao R. Effectiveness of reproductive health education among rural adolescent girls: A school based intervention study in Udupi Taluk, Karnataka. ACTA ACUST UNITED AC 2008. [DOI: 10.4103/0019-5359.48455] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [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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Abstract
BACKGROUND Breast cancer being one of the leading cancers among women in developing countries, prevention or identification of the disease at an early stage is of paramount importance in saving as well as improving the quality of life. Breast health awareness appears to be a pragmatic method for this. OBJECTIVE To determine the acceptability and effectiveness of an educational intervention programme on breast health awareness for rural women by trained female health workers. SETTINGS AND DESIGN Community based non-randomised educational intervention study carried out over a period of 1 year. Three hundred and sixty rural women in the age group 30--59 years were randomly selected (and age-wise stratified), from a coastal village in Southern India. METHODS Women were educated on breast health and breast self-examination by specifically trained health workers and their awareness and proficiency levels were evaluated at the end of 1 and 3 months post-intervention. STATISTICAL ANALYSIS This was done using the Statistical Package for Social Sciences Version 10. RESULTS Following the educational intervention, a significant increase in overall awareness regarding breast cancer (z=-15.807; P< 0.001) as well as in the performance of self-examination of the breast 321/342 (93%) was observed. Forgetfulness or being too busy appeared to be the two most frequently perceived barriers. CONCLUSION This study clearly shows that a community oriented educational intervention programme emphasizing on proper technique can bring about the desirable behavioural change among women.
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Affiliation(s)
- R S P Rao
- Department of Community Medicine, Kasturba Medical College, Manipal, Karnataka, India
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Pandey GK, Dutt D, Nair NS, Subramanyam M, Nagaraj K. Interventions to modify sexual risk behaviors for preventing HIV infection in street children and youth people in developing countries. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2005. [DOI: 10.1002/14651858.cd005480] [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: 11/08/2022]
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Rao RSP, Nair S, Nair NS, Kamath VG. Acceptability and effectiveness of a breast health awareness programme for rural women in India. Indian J Med Sci 2005; 59:398-402. [PMID: 16199925] [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] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
BACKGROUND Breast cancer being one of the leading cancers among women in developing countries, prevention or identification of the disease at an early stage is of paramount importance in saving as well as improving the quality of life. Breast health awareness appears to be a pragmatic method for this. OBJECTIVE To determine the acceptability and effectiveness of an educational intervention programme on breast health awareness for rural women by trained female health workers. SETTINGS AND DESIGN Community based non-randomised educational intervention study carried out over a period of 1 year. Three hundred and sixty rural women in the age group 30--59 years were randomly selected (and age-wise stratified), from a coastal village in Southern India. METHODS Women were educated on breast health and breast self-examination by specifically trained health workers and their awareness and proficiency levels were evaluated at the end of 1 and 3 months post-intervention. STATISTICAL ANALYSIS This was done using the Statistical Package for Social Sciences Version 10. RESULTS Following the educational intervention, a significant increase in overall awareness regarding breast cancer (z=-15.807; P< 0.001) as well as in the performance of self-examination of the breast 321/342 (93%) was observed. Forgetfulness or being too busy appeared to be the two most frequently perceived barriers. CONCLUSION This study clearly shows that a community oriented educational intervention programme emphasizing on proper technique can bring about the desirable behavioural change among women.
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Affiliation(s)
- R S P Rao
- Department of Community Medicine, Kasturba Medical College, Manipal, Karnataka, India
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21
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Abstract
OBJECTIVE A cross sectional study was conducted in the rural field practice area of Department of Community Medicine, KMC, Manipal to find out the prevalence of goitre among school children in the age group of 8-10 years. METHODS A total of 722 children were selected from the study population by the method of probability proportion to size (PPS) stratified sampling giving due representation to both Government and private schools. Children were clinically examined for the presence of goitre and graded according to WHO guidelines. Urine and salt samples were collected from subsample to estimate the urinary iodine excretion level and iodine content in the salt respectively. RESULTS Over all prevalence of goitre was 30 percent. Prevalence among males was 28.8 percent and among females it was 31.2 percent. In the both sexes goitre rate increased with the advancement of age. Prevalence of grade I and grade II goitre was 29.4 and 0.6 percent respectively. Prevalence of goitre was significantly higher among children who had urinary iodine excretion level less than optimum (<10 mcg/dl). Estimation of iodine content in the salt sample revealed that 48.3 percent of samples had adequate iodine content (>=15 ppm). There was significant increase in the goitre rate as the iodine content in the salt decreased (p=0.01). CONCLUSION Prevalence of goitre among school children was high and therefore constituted a public health problem in this region.
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Affiliation(s)
- R S P Rao
- Department of Community Medicine, Kasturba Medical College, Manipal, Karnataka, India.
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Abstract
Talo-calcaneal angles were measured on anteroposterior, stress dorsiflexion, and plantarflexion lateral radiographs of 75 normal feet and 145 clubfeet. The talus and calcaneum from 15 normal fetal limbs were dissected without disturbing the subtalar capsule. Anteroposterior and lateral radiographs of these specimens were also obtained. The long axes of the ossific nuclei and the long axes of the cartilaginous anlagen of the bones were marked, and the talo-calcaneal angles were measured. The talo-calcaneal angles were lower in clubfeet than in normal feet, but there was considerable overlap in the ranges of normal and clubfeet for all the angles measured. The lateral talo-calcaneal angles in normal feet were higher in dorsiflexion than in plantarflexion, whereas the converse was true in clubfeet. The talo-calcaneal angles measured from the axes of the ossific nuclei of the fetal specimens were higher than those measured from the axes of the cartilaginous anlagen. Using logistic regression analysis, a mathematical model was made to predict the probability of correction of clubfeet. A lateral talo-calcaneal angle difference (between the stress dorsiflexion and plantarflexion angles) of 20 degrees suggests that there is a 93% probability that the hindfoot deformity of clubfoot has been adequately corrected. A talo-calcaneal angle of 30 degrees or a talo-calcaneal index of 40 degrees does not ensure correction of clubfoot. A decrease of the talo-calcaneal angle by up to 10 degrees occurs as the child grows because of the alteration of the shape of the ossific nucleus of the talus that occurs normally with growth.
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Affiliation(s)
- B Joseph
- Department of Orthopaedics, Kasturba Medical College, Manipal, India.
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Kumar V, Rao NN, Nair NS. Micronuclei in oral squamous cell carcinoma. A marker of genotoxic damage. Indian J Dent Res 2000; 11:101-6. [PMID: 11310090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023] Open
Affiliation(s)
- V Kumar
- Depts. of Oral Pathology and Microbiology and Community Medicine, College of Dental Surgery, Kasturba Medical College, Manipal, India
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Abstract
A community based study was conducted in the rural areas of Udupi taluk, Karnataka state of South India to identify the socio-demographic, maternal and obstetric determinants of low birth weight. All singleton live births that occurred in the study area during a one year period (October 1991 to September 1992) were included. A total of 2919 singleton child-mother pairs formed the basis of the analysis. Information about social, demographic and economic conditions of the families; maternal factors such as age, parity, quality of antenatal care and previous obstetric history were collected by interviewing the mothers and family members and verifying the available medical records through the field investigators especially recruited and trained for this purpose. Data was analyzed using multiple logistic regression model. Primis, elderly mothers and mothers who had not received good quality antenatal care were found to be more at risk of having low birth weight babies. Other significant determinants were family custom, socio-economic status and environmental sanitation.
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Affiliation(s)
- N S Nair
- Department of Community Medicine, Kasturba Medical College, Manipal, Karnataka
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Abstract
A large scale community-based study in South Kanara district of Karnataka state, India has revealed that, despite a low infant mortality rate (IMR), there is a clear association between IMR and lack of antenatal care (ANC) as well as IMR and poor quality ANC. We analyse the factors which determine the utilization of ANC and show the association between quality of ANC and maternal literacy, occupation, age and parity. Factors which are also significantly associated are socio-economic status, religion and matriarchal system. Characteristically, those who do not receive any ANC are poor, illiterate, multiparous unskilled mothers over 30 years of age and who live far away from a medical facility. This study conclusively demonstrates that even in regions where IMR is low there is enough scope to reduce it further by concentrating our efforts on the high risk population.
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Affiliation(s)
- S Chandrashekar
- Department of Community Medicine, Kasturba Medical College, Manipal, Karnataka State, India
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Abstract
Perinatal mortality is one of the most sensitive indices of maternal and child health. The perinatal mortality rate is an indicator of the extent of pregnancy wastage as well as of the quality and quantity of health care available to the mother and the newborn. A community based prospective study carried out on 13,214 births in South Kanara district between Oct. 1991-Sept. 1992 revealed a perinatal mortality rate (PNMR) of 44.65/1000 births. Among the various factors influencing perinatal mortality, breech deliveries and babies of multiple pregnancies had a very high perinatal mortality rate of 180.81/1000 births (adjusted odd's ratio: 4.90) and 128/1000 births (adjusted odd's ratio: 2.64). The previous bad obstetric history of the mother, parity and sex of the newborn were among the other important factors influencing the PNMR.
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Affiliation(s)
- S Chandrashekar
- Department of Community Medicine, Kasturba Medical College, Manipal
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Rao RS, Chakladar BK, Nair NS, Kutty PR, Acharya D, Bhat V, Chandrasekhar S, Rodrigues VC, Kumar P, Nagaraj K, Prasad KN, Krishnan L. Influence of parental literacy and socio-economic status on infant mortality. Indian J Pediatr 1996; 63:795-800. [PMID: 10830063 DOI: 10.1007/bf02730932] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The influence of parental literacy and socio-economic status (SES) on infant mortality rate (IMR) was studied. This report is only a part of much larger community-based prospective study conducted to determine the factors influencing infant mortality in Dakshina Kannada district of Karnataka, by the Department of Community Medicine, Kasturba Medical College, Manipal, with the financial assistance form IDRC, Canada. A total of 12,857 livebirths during the period of October 1, 1991, to September 30, 1992, where registered and followed up for one year. There were 391 infant deaths which gives an IMR of 30.4 per 1,000 livebirths. Univariate analysis and subsequent stepwise multiple logistic regression analysis revealed that, literacy and SES have a very significant role in reducing IMR.
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Affiliation(s)
- R S Rao
- Department of Community Medicine, Kasturba Medical College, Manipal, Karnataka
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Kar HK, Sharma AK, Misra RS, Beena KR, Zaheer SA, Mukherjee R, Mukherjee A, Parida SK, Walia R, Nair NS. Reversal reaction in multibacillary leprosy patients following MDT with and without immunotherapy with a candidate for an antileprosy vaccine, Mycobacterium w. LEPROSY REV 1993; 64:219-26. [PMID: 8231601 DOI: 10.5935/0305-7518.19930024] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Immunotherapy with a candidate for an antileprosy vaccine, Mycobacterium w, was given in addition to standard multidrug therapy (MDT) to 53 multibacillary lepromin negative patients belonging to BB, BL and LL types of leprosy (vaccine group). An equal control group received MDT and injections of micronized starch as placebo. Both the vaccine and placebo were administered intradermally every 3 months. The patients were evaluated at determined intervals by clinical, bacteriological and histopathological parameters and lepromin testing. Reactional episodes were analysed with reference to incidence, onset, frequency and severity during and after release from treatment (RFT). Incidence of reversal reaction (RR) was marginally higher in the vaccine group (22.6% vaccine group vs 15% control group). All cases with a history of downgrading type 1 reaction developed RR during therapy. Most episodes occurred within the 1st year of the commencement of therapy--50% developing within 3 months. Late reversal reaction (after RFT) were observed in 3.8% of cases in both groups, and 50% of the reactors in the control group and 33% in the vaccine group had repeated reactional episodes. Incidence of neuritis associated with RR as well as isolated neuritis was similar in both groups.
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Affiliation(s)
- H K Kar
- Department of Skin, STD and Leprosy, Dr. RML Hospital, New Delhi
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Kharat I, Nair NS, Dhall K, Sawhney H, Krishna U, Shahani SM, Banerjee A, Roy S, Kumar S, Hingorani V. Analysis of menstrual records of women immunized with anti-hCG vaccines inducing antibodies partially cross-reactive with hLH. Contraception 1990; 41:293-9. [PMID: 2182289 DOI: 10.1016/0010-7824(90)90070-c] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Menstrual data of 13 control subjects and 88 subjects immunized with three beta-hCG-based vaccine formulations were analysed. Immunization did not change the menstrual regularity; bleeding days were normal (3-7 days) and 89% of the menstrual cycles were within the normal range of 22-35 days. Irregular (short or long) cycles were observed in both immunized and control groups. These were, however, unrelated to prevailing anti-hCG antibody titres or to cross-reactivity of antibodies with hLH.
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Affiliation(s)
- I Kharat
- National Institute of Immunology, New Delhi
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Sahadevan MG, Nair NS, Balakrishnan P. Meningitis due to Mima polymorpha. Report of three cases. J Assoc Physicians India 1965; 13:719-21. [PMID: 5840520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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Nair NS, Kannankutti NK. Turner's syndrome: report of a case. Indian Pediatr 1965; 2:307-9. [PMID: 5847439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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Nair NS. A study of parental consanguinity. Indian Pract 1965; 18:629-31. [PMID: 5832336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Nair NS, Mathai NM. Congenital sucrase deficiency. Indian Pediatr 1965; 2:99-101. [PMID: 5827231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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