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Chandrasekaran S, Ruggiero S, Goodrick G. Outpatient medical management of later second trimester abortion (18-23.6 weeks) with procedural evacuation backup: A large case series. Contracept X 2024; 6:100104. [PMID: 38515629 PMCID: PMC10950721 DOI: 10.1016/j.conx.2024.100104] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 02/13/2024] [Accepted: 02/14/2024] [Indexed: 03/23/2024] Open
Abstract
Objective Document the clinical outcomes of an outpatient medical management with procedural evacuation backup procedure for abortions between 18 weeks zero days to 23 weeks six days gestation. Study design We conducted a retrospective medical records review of adult patients who received mifepristone and repeated misoprostol for second trimester abortion with procedural evacuation backup at an Arizona clinic between October 2017 and November 2021. We extracted patient demographics; pregnancy and medical history; and preoperative, intraoperative, and postoperative data. We assessed abortion outcomes, including procedure timing, mode of completion (medication alone or medications and procedural evacuation), and safety. Results All 359 patients had a complete abortion with 63.5% of patients completing with medication alone and 36.5% with procedural evacuation backup. The median time from first dose of misoprostol to fetal expulsion was six hours, among those who completed the abortion with medications alone. Of those who received procedural evacuation as backup, the median time for procedural evacuation was 10 minutes. The vast majority of patients (99.4%) did not have any adverse events. Two safety incidents (0.6%) occurred, a broad right ligament tear and a uterine rupture. Conclusion Patients in one outpatient setting safely and effectively received medical management of second trimester abortion with procedural evacuation backup, and two thirds completed with medications alone. Implications Outpatient settings may consider medical management of abortion between 18 and 24 weeks with procedural evacuation back-up as a safe, effective, and manageable second trimester abortion option. Additional research is needed on patient experience and satisfaction.
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Makleff S, Blaylock R, Ruggiero S, Key K, Chandrasekaran S, Gerdts C. Travel for later abortion in the USA: lived experiences, structural contributors and abortion fund support. Cult Health Sex 2023; 25:1741-1757. [PMID: 36866920 DOI: 10.1080/13691058.2023.2179666] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 07/18/2022] [Accepted: 02/08/2023] [Indexed: 12/02/2023]
Abstract
As abortion restrictions expand in the USA, pregnant people will continue to experience delays and be forced to travel for abortion. The study aims to describe later abortion travel experiences, understand structural factors influencing travel, and identify strategies to improve travel. This qualitative phenomenological study analyses data from 19 interviews with people who travelled at least 25 miles for abortion after the first trimester. Framework analysis used a structural violence lens. More than two-thirds of participants travelled interstate, and half received abortion fund support. Key considerations of travel include logistics, challenges during the journey, and physical and emotional recovery during and after travel. Restrictive laws, financial insecurity and anti-abortion infrastructure are forms of structural violence that created challenges and delays. Reliance on abortion funds facilitated access but also entailed uncertainty. Better resourced abortion funds could organise travel in advance, facilitate the travel of accompanying escorts, and tailor emotional support to reduce stress for those travelling. Clinical and practical support systems must be prepared to support people travelling for abortion, as later abortion and forced travel is increasing since the constitutional right to abortion in the USA was overturned. Findings can inform interventions to support the increasing number of people travelling for abortion.
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Affiliation(s)
- Shelly Makleff
- Ibis Reproductive Health, Cambridge, MA, USA
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Rebecca Blaylock
- Ibis Reproductive Health, Cambridge, MA, USA
- Centre for Reproductive Research & Communication, British Pregnancy Advisory Service, UK
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Chitra N, Chandrasekaran S, Venkata Srinivas C, Athmalingam S, Venkatraman B. Track detector based discriminative thoron measurement – An optimization study through experiments and modelling. Radiat Phys Chem Oxf Engl 1993 2023. [DOI: 10.1016/j.radphyschem.2022.110755] [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: 12/31/2022]
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Manikanda Bharath K, Natesan U, Chandrasekaran S, Srinivasalu S, Abdelrahman K, Abu-Alam T, Abioui M. Geochemometrics of primordial radionuclides and their potential radiological risk in coastal sediments of Southeast Coast of India. Journal of Radiation Research and Applied Sciences 2023. [DOI: 10.1016/j.jrras.2023.100525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Talebnia F, Pushparajah D, Chandrasekaran S, Hersch SJ, Nafissi N, Slavcev R. Application of an electro elution system for direct purification of linear covalently closed DNA fragments. J Chromatogr B Analyt Technol Biomed Life Sci 2023; 1218:123622. [PMID: 36842293 DOI: 10.1016/j.jchromb.2023.123622] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 01/23/2023] [Accepted: 01/25/2023] [Indexed: 02/10/2023]
Abstract
Gene therapy is a powerful treatment modality. Non-viral gene therapy vectors power one arm of this important approach, due to their enhanced safety profile compared to their viral counterparts. New non-viral approaches continue to be developed, but purification can bottleneck the scaleup and cost-effectiveness and quality of some of these advanced vectors. We require more advanced purification and separation techniques compared to conventional methods to maximize resolution in a scalable manner. The Prep Cell system is a continuous electro elution system that contains a circular gel casting tube where DNA mixtures can be run through and subsequently migrate into an elution chamber, to be eluted by a peristaltic pump. This DNA separation and purification process confers advantages over other conventional methods, including i) the elimination of multiple downstream purification process requirements; ii) its ability to be applied in mid-scale settings, and iii), its high-resolution power. In this study, we assessed the ability of this Prep Cell Model 491 system to purify a novel type of non-viral linear covalently closed (LCC) DNA minivector (ministring DNA) from its precursor parent plasmid DNA and process by-product DNA species by analyzing for effective separation via agarose gel electrophoresis, recovery yield, single enzyme digestion, and quality control assessments. Overall, effective separation and resolution of mini-DNA vectors was obtained using the Prep Cell system, conferring its potential to be applied towards mid-scale purification of DNA vectors for a variety of research, and eventually, clinical applications.
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Affiliation(s)
- F Talebnia
- Mediphage Bioceuticals, Inc. 661 University Avenue, Suite 1300, MaRS West Tower, Toronto, ON M5G0B7, Canada
| | - D Pushparajah
- University of Waterloo, 200 University Avenue West, Waterloo, ON N2L 3G1, Canada
| | - S Chandrasekaran
- Mediphage Bioceuticals, Inc. 661 University Avenue, Suite 1300, MaRS West Tower, Toronto, ON M5G0B7, Canada
| | - S J Hersch
- Mediphage Bioceuticals, Inc. 661 University Avenue, Suite 1300, MaRS West Tower, Toronto, ON M5G0B7, Canada
| | - N Nafissi
- Mediphage Bioceuticals, Inc. 661 University Avenue, Suite 1300, MaRS West Tower, Toronto, ON M5G0B7, Canada.
| | - R Slavcev
- Mediphage Bioceuticals, Inc. 661 University Avenue, Suite 1300, MaRS West Tower, Toronto, ON M5G0B7, Canada; University of Waterloo, 200 University Avenue West, Waterloo, ON N2L 3G1, Canada.
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D. L, Nagpal N, Chandrasekaran S, D. JH. A quantum-based approach for offensive security against cyber attacks in electrical infrastructure. Appl Soft Comput 2023. [DOI: 10.1016/j.asoc.2023.110071] [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: 02/05/2023]
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Chandrasekaran S, Key K, Ow A, Lindsey A, Chin J, Goode B, Dinh Q, Choi I, Choimorrow SY. The role of community and culture in abortion perceptions, decisions, and experiences among Asian Americans. Front Public Health 2023; 10:982215. [PMID: 36733282 PMCID: PMC9887147 DOI: 10.3389/fpubh.2022.982215] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 12/23/2022] [Indexed: 01/18/2023] Open
Abstract
Introduction Culture and community can play a role in views, stigma, and access related to abortion. No research to date has documented the influence of culture and community attitudes on Asian American (AA) experiences accessing abortion care in the United States (US). This paper aims to fill gaps in research and understand how cultural and community views influence medication abortion access and experiences among AAs. Methods We used a community-based participatory research approach, which included collaboration among experts in public health, advocates, practitioners, and community partners to understand abortion knowledge, attitudes, and experiences among AAs. Using a semi-structured interview guide, we interviewed twenty-nine eligible people of reproductive age over 18 that self-identified as Asian American or mixed race including Asian American, Native Hawaiian, and/or Pacific Islander (AANHPI), and had a medication abortion in the US between January 2016 and March 2021. Interviews were analyzed and coded in NVivo 12 using a modified grounded theory approach. Results Participants described various influences of religion negatively impacting acceptability of abortion among their family and community. Lack of openness around sexual and reproductive health (SRH) topics contributed to stigma and influenced most participants' decision not to disclose their abortion to family members, which resulted in participants feeling isolated throughout their abortion experience. When seeking abortion care, participants preferred to seek care with providers of color, especially if they were AANHPI due to past experiences involving stigma and judgment from White providers. Based on their experiences, respondents recommended ways to improve the abortion experience for AAs in the US including, (1) more culturally aware abortion providers from one's community who better understand their needs; (2) clinics providing abortion services located in or near AA communities with signage in local languages; and (3) tailored mental health resources with culturally aware therapists. Conclusion This study demonstrates ways in which culture and community opinions toward SRH can influence both the acceptability of abortion and experiences seeking abortion care among AAs. It is important to consider family and community dynamics among AAs to better tailor services and meet the needs of AAs seeking abortion care in the US.
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Affiliation(s)
| | - Katherine Key
- Ibis Reproductive Health, Cambridge, MA, United States,*Correspondence: Katherine Key ✉
| | - Abby Ow
- Ibis Reproductive Health, Cambridge, MA, United States
| | - Alyssa Lindsey
- National Asian Pacific American Women's Forum, Atlanta, GA, United States
| | - Jennifer Chin
- Division of Complex Family Planning, Department of Obstetrics and Gynecology, University of Washington, Seattle, WA, United States
| | - Bria Goode
- Ibis Reproductive Health, Oakland, CA, United States
| | - Quyen Dinh
- Southeast Asia Resource Action Center, Washington, DC, United States
| | - Inhe Choi
- HANA Center, Chicago, IL, United States
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Karmakar S, Srinivas CV, Rakesh PT, Gopalakrishnan V, Chandrasekaran S, Athmalingam S, Venkatraman B. Development of a numerical model for sector-average plume gamma dose and its validation with dose rate measurements at Kalpakkam NPP site, India. J Environ Radioact 2022; 255:107029. [PMID: 36265399 DOI: 10.1016/j.jenvrad.2022.107029] [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: 05/23/2022] [Revised: 09/15/2022] [Accepted: 09/19/2022] [Indexed: 06/16/2023]
Abstract
A Gaussian Plume based simple numerical model, named DIFFUSE is developed to simulate the long-term sector-average plume gamma dose due to radioactive plume released during normal operation of nuclear facilities. DIFFUSE calculates site specific joint frequency distributions of wind speed, wind direction and atmospheric stability using micrometeorological observations. It performs the finite sector-average dose integration for any stack height and gamma energy using Simpson's 1/3rd method with sufficient computational efficiency within the site boundary up to 2 km. Plume dose contribution to the main plume sector from nearest and next nearest side plume sectors is also calculated. DIFFUSE is validated with a 3-month long, starting from February 2021 to April 2021, dose rate observation data during operational releases from 100 m stack of Madras Atomic Power Station, Kalpakkam, India. Meteorological data from onsite 50 m tower and continuous dose rate observation from two sets of Autonomous Gamma Dose Logger (AGDL) detectors, namely n-AGDLs and r-AGDLs, placed in two different configurations along the geometric arcs of wind sectors around the stack are used. Simulated doses are compared with look-up table based dose estimates by Hukkoo et al. (1988). Linear spatial averaging of cumulative AGDL doses on a sector arc is used as measured sector-average dose for model validation. Simulations performed for both n-AGDL and r-AGDL configurations show DIFFUSE estimated doses are ∼37% lower and Hukkoo estimated doses are at least ∼50% lower than the measured doses. Statistical analysis of DIFFUSE simulated doses shows a statistical correlation of R2∼98.3%, slope of the fit ∼1.36 for n-AGDL setup and R2∼75.3%, slope of the fit ∼1.57 for r-AGDL setup. Overall, DIFFUSE produces conservative doses compared to look-up table based doses as required by regulatory bodies.
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Affiliation(s)
- Shanu Karmakar
- Environmental Assessment Division, Safety Quality & Resource Management Group, Indira Gandhi Centre for Atomic Research, Kalpakkam, 603102, India.
| | - C V Srinivas
- Environmental Assessment Division, Safety Quality & Resource Management Group, Indira Gandhi Centre for Atomic Research, Kalpakkam, 603102, India
| | - P T Rakesh
- Environmental Assessment Division, Safety Quality & Resource Management Group, Indira Gandhi Centre for Atomic Research, Kalpakkam, 603102, India
| | - V Gopalakrishnan
- Environmental Assessment Division, Safety Quality & Resource Management Group, Indira Gandhi Centre for Atomic Research, Kalpakkam, 603102, India
| | - S Chandrasekaran
- Environmental Assessment Division, Safety Quality & Resource Management Group, Indira Gandhi Centre for Atomic Research, Kalpakkam, 603102, India
| | - S Athmalingam
- Environmental Assessment Division, Safety Quality & Resource Management Group, Indira Gandhi Centre for Atomic Research, Kalpakkam, 603102, India
| | - B Venkatraman
- Environmental Assessment Division, Safety Quality & Resource Management Group, Indira Gandhi Centre for Atomic Research, Kalpakkam, 603102, India
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Meenakshi C, Venkatachalam P, Satish Srinivas K, Chandrasekaran S, Venkatraman B. Chromosome length ratio as a biomarker of DNA damage in cells exposed to high dose ionizing radiation. Mutat Res Genet Toxicol Environ Mutagen 2022; 879-880:503501. [PMID: 35914861 DOI: 10.1016/j.mrgentox.2022.503501] [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: 06/23/2021] [Revised: 04/28/2022] [Accepted: 05/13/2022] [Indexed: 06/15/2023]
Abstract
The premature chromosome condensation (PCC) assay is considered as complementary bio-dosimetry tool for chromosome aberration assay and the PCC assay can be used to estimate high dose exposure. Though the PCC ring is considered as prospective biomarker, chromosome length ratio (ratio of longest and shortest chromosome length in PCC spreads) of chemically induced PCC is shown to be very good indicator of ionizing radiation. In view of this, an in-vitro study has been performed using PCC assay to suggest chromosome length ratio (LR) as potential bio-dosimeter induced by high dose ionizing radiation. Blood samples were collected from healthy subjects (n = 3) after prior consent and irradiated to ten different doses ranging between 0 and 20 Gy using 6 MV LINAC X-rays with dose rate of 5.6 Gy/min. Irradiated lymphocytes were cultured and calyculin induced PCC spreads were prepared. PCC spreads were captured using image analysis system and chromosome lengths were measured using open-source ImageJ software. For each dose, LR for 50 chromosome spreads were computed and mean LR value was calculated. LR varies between 6.0 ± 0.08 and 23.6 ± 0.55 for the dose range between 2 and 20 Gy. The dose response curve for LR was observed to be linear with y = 1.02x + 3.36, R2 = 0.97. Linear dose response relationship obtained in the present study confirms the prospective use of LR measurement. This study is first of its kind to examine chromosome length ratio as a biomarker of DNA damage in cells exposed to high dose X-ray exposure.
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Affiliation(s)
- C Meenakshi
- Human Genetics Department, Sri Ramachandra Institute of Higher Education and Research, Chennai 600116, India.
| | - P Venkatachalam
- Human Genetics Department, Sri Ramachandra Institute of Higher Education and Research, Chennai 600116, India
| | - K Satish Srinivas
- Department of Radiation Oncology, Sri Ramachandra Institute of Higher Education and Research, Chennai 600116, India
| | - S Chandrasekaran
- Health, Safety and Environmental Group, Indira Gandhi Centre for Atomic Research, Kalpakkam 603102, India
| | - B Venkatraman
- Health, Safety and Environmental Group, Indira Gandhi Centre for Atomic Research, Kalpakkam 603102, India
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Dzuba IG, Chandrasekaran S, Fix L, Blanchard K, King E. Pain, Side Effects, and Abortion Experience Among People Seeking Abortion Care in the Second Trimester. Women's Health Reports 2022; 3:533-542. [PMID: 35651992 PMCID: PMC9148646 DOI: 10.1089/whr.2021.0103] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 02/22/2022] [Indexed: 12/04/2022]
Abstract
Background: There is limited documentation about pain and side effects associated with dilation and evacuation (D&E) abortion, yet, pain and side effects are important factors that can affect a client's abortion experience. In 2016, Hope Clinic for Women, an independent abortion clinic in Illinois, altered its cervical preparation protocols before D&E to reduce the total time of the abortion process and improve the client experience. This analysis addresses the gap in data on client experience of abortion in the later second trimester by evaluating pain, side effects, and acceptability by gestational age. Methods: Abortion clients obtaining services at the clinic between March 2017 and June 2018 were eligible to participate if they had viable singleton pregnancies of 16–23.6 weeks' gestation, spoke English, and were at least 18 years old. Eligible participants completed a two-part survey about their abortion experience. Results: We found that respondents seeking abortion care at later gestations in the second trimester were more likely to report pain during their abortions. We did not find any association between side effects and gestational age. Conclusion: Although most respondents were prepared for the pain they experienced, some reported experiencing more pain than they expected, and more effective pain relief was commonly reported as a way to improve the service. More research on patient experiences of later abortion is needed, particularly on experiences of pain and options for pain management.
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Affiliation(s)
| | | | - Laura Fix
- Ibis Reproductive Health, Cambridge, Massachusetts, USA
| | | | - Erin King
- Hope Clinic for Women, Granite City, Illinois, USA
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Chandrasekaran S, Choimorrow SY. Asian American and Pacific Islander Access to Abortion During COVID-19: A Complex Interplay of Factors. Health Equity 2022; 6:625-628. [PMID: 36081883 PMCID: PMC9448515 DOI: 10.1089/heq.2022.0036] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2022] [Indexed: 11/12/2022] Open
Abstract
Often stereotyped as the “model minority,” health care providers, lawmakers, and the general public regularly underestimate and ignore the health concerns of Asian American and Pacific Islanders (AAPIs). The COVID-19 pandemic has exposed the racism that AAPIs face—many communities report facing severe xenophobia during the pandemic, which has increased hesitancy to obtain needed medical treatment and heightened mental health issues at a time of isolation. The pandemic is also exacerbating the barriers that already exist in accessing abortion care—with travel restrictions, quarantine measures, lesser availability of appointments, and more burden on the health care staff and system. There has been no discussion on the impact of the pandemic on AAPIs' access to abortion care. We discuss challenges that are specific to AAPIs in accessing sexual and reproductive care, especially abortion, and how these are compounded by the lack of appropriate data and methods. We then discuss the added complexity that comes with accessing abortion care during a pandemic and provide recommendations for research methods to better reach these populations.
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Affiliation(s)
| | - Sung Yeon Choimorrow
- National Asian Pacific American Women's Forum, Washington, District of Columbia, USA
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Kundu D, Srinivas C, Chandrasekaran S, Venkatraman B. Radiological consequence assessment for hypothetical nuclear explosion scenario using HotSpot. Progress in Nuclear Energy 2022. [DOI: 10.1016/j.pnucene.2022.104192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Chitra N, Chandrasekaran S, Srinivas CV, Athmalingam S, Venkatraman B. Determination of soil porosity by a simple and novel technique of fusing thoron diffusion experiment and modeling. J Radioanal Nucl Chem 2022. [DOI: 10.1007/s10967-022-08312-2] [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: 11/29/2022]
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Jacob D, Vigasini N, Chandrasekaran S, Perumal A. Assessment of In Vitro Antioxidant, Antipsoriatic and Anticancer Activity of Methanolic Extract of Nigella sativa Seeds. Indian J Pharm Sci 2022. [DOI: 10.36468/pharmaceutical-sciences.983] [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: 11/22/2022] Open
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Panigrahi S, Mohanty AK, Samantara MK, Sahu G, Chandrasekaran S, Subramanian V, Srinivas CV. Distribution, annual committed effective dose, and health safety assessment of 210Po in marine biota from Kalpakkam coast, Bay of Bengal. Mar Pollut Bull 2021; 173:113147. [PMID: 34808544 DOI: 10.1016/j.marpolbul.2021.113147] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 06/02/2021] [Revised: 11/10/2021] [Accepted: 11/11/2021] [Indexed: 06/13/2023]
Abstract
Seafood, intertidal biota, beach sediment, and seawater from Kalpakkam coast, Bay of Bengal were analyzed for 210Po to evaluate the internal exposure and other radiological safety aspects. Kalpakkam houses various nuclear power generation facilities on its coast. The activity concentration of 210Po was more pronounced in the intertidal organisms. Pelagic planktivorous fishes have the highest activity of the non-technogenic radionuclide, followed by the detrital feeders, benthic planktivores, benthic carnivores, and pelagic carnivore fishes. The affinity of 210Po to organic detrital matter and planktonic organisms has led to a higher accumulation of radionuclide in planktivorous fishes. Activity concentration of 210Po in seafood ranged between 1.13 ± 0.3 and 96.71 ± 1.6 Bq kg-1 (Becquerel/kilogram). In seaweeds and gastropods, it ranged from 2.09 ± 0.2 to 8.21 ± 0.6 and from 9.31 ± 0.7 to 21.58 ± 1.2 Bq kg-1, respectively. The committed effective dose (CED) of 210Po in seafood varied from 31.18 to 456.68 μSv yr-1 (microSievert/year). Radiological hazard parameters, such as activity intake, CED in consumption, of the seafood from this coast are within the acceptable levels prescribed by the International Commission on Radiological Protection and US Environmental Protection Agency.
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Affiliation(s)
- Satyanarayan Panigrahi
- Environmental Assessment Section, EAD/RESG/SQRMG, Indira Gandhi Centre for Atomic Research, Kalpakkam, Tamil Nadu 603 102, India.
| | - A K Mohanty
- Aerosol Transport and Biodiversity Section, RESD/RESG/SQRMG, Indira Gandhi Centre for Atomic Research, Kalpakkam, India
| | - M K Samantara
- Aerosol Transport and Biodiversity Section, RESD/RESG/SQRMG, Indira Gandhi Centre for Atomic Research, Kalpakkam, India
| | - G Sahu
- Aerosol Transport and Biodiversity Section, RESD/RESG/SQRMG, Indira Gandhi Centre for Atomic Research, Kalpakkam, India
| | - S Chandrasekaran
- Environmental Assessment Section, EAD/RESG/SQRMG, Indira Gandhi Centre for Atomic Research, Kalpakkam, Tamil Nadu 603 102, India; Homi Bhaba National Institute, Anushakti Nagar, Mumbai, India
| | - V Subramanian
- Aerosol Transport and Biodiversity Section, RESD/RESG/SQRMG, Indira Gandhi Centre for Atomic Research, Kalpakkam, India
| | - C V Srinivas
- Environmental Assessment Section, EAD/RESG/SQRMG, Indira Gandhi Centre for Atomic Research, Kalpakkam, Tamil Nadu 603 102, India; Homi Bhaba National Institute, Anushakti Nagar, Mumbai, India
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Chandrasekaran S, Danis D, Jayanthi S, Vasanthi R. Vibrio parahaemolyticus in sea food in north Chennai coastal retail shops. Indian J Med Microbiol 2021. [DOI: 10.1016/j.ijmmb.2021.08.105] [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: 11/30/2022]
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Chandrasekaran S, Paul M, Ruggiero S, Monschauer E, Blanchard K, Robinson Y. Foley catheter and misoprostol for cervical preparation for second-trimester surgical abortion. Contraception 2021; 104:437-441. [PMID: 34174293 DOI: 10.1016/j.contraception.2021.06.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 06/17/2021] [Accepted: 06/17/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Document the effectiveness and safety of Foley balloon catheter and misoprostol use for cervical preparation before a same-day dilation and evacuation (D&E). STUDY DESIGN We conducted a retrospective medical records review of adult patients with viable pregnancies at 18 weeks 0 days to 21 weeks 6 days gestation who received a same-day D&E at an Alabama clinic using a 30-cc Foley balloon catheter and misoprostol for cervical preparation from January 2016 through December 2017. Patients received misoprostol 800 mcg buccally at the time of Foley placement and then every 4 hours until the physician deemed that dilation/effacement was adequate to proceed with a D&E. We extracted patient demographics, pregnancy and medical history, and preoperative, intraoperative, and postoperative data. We primarily evaluated effectiveness (D&E completion within one procedure day). Our secondary outcomes included safety, time between misoprostol and procedure start time, length of D&E, recovery time, and number of doses of misoprostol provided. RESULTS Two hundred and ninety patient charts met our review criteria - all of whom had a complete abortion in one day. Only one safety incident, a cervical laceration, occurred (0.3% of all procedures). The median time between Foley placement and first misoprostol dose and the procedure start was 7.2 hours (2.9-12.6 hours; interquartile range [IQR] 6.2-8.4 hours); median procedure length was 12 minutes (2-40 minutes; IQR 10-15 minutes); and median recovery time 14 minutes (4-89 minutes; IQR 14-16 minutes). Most patients needed two doses of misoprostol (n = 258, 89%), and 11 (4%) needed three doses; 21 (7%) patients needed one dose of misoprostol. CONCLUSION Patients in the mid-second trimester can effectively and safely undergo cervical preparation with a Foley balloon catheter and misoprostol to facilitate completion of same-day D&E. IMPLICATIONS Foley balloon catheter use with misoprostol for cervical preparation for second-trimester abortion (the Robinson Foley protocol) is effective and safe and can be completed in one day when used by an experienced physician.
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Affiliation(s)
| | - Maureen Paul
- Ibis Reproductive Health, Cambridge, MA 02140 USA
| | | | | | | | - Yashica Robinson
- Alabama Women's Center for Reproductive Alternatives, Huntsville, AL 35810 USA
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18
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Abstract
India has the world’s fastest growing outbreak of COVID-19. With limited mobility, increased reports of intimate partner violence, changes in living patterns of migrants, delays in accessing contraception and safe abortion care, and potential changes to decisions about parenting, there may be an increased need for abortion services in India due to the pandemic. The use of technology for providing abortion information and services has been well documented in global literature. The safety of abortion provision using telehealth has been established in several contexts including the United States and Australia. The importance of hotlines and other support systems that use technology to provide information and support to clients through their abortion is also highlighted in the literature. Several countries, such as the United Kingdom, France, New Zealand, and Pakistan are now allowing the use of technology for abortion/post-abortion care in light of the pandemic; however, India’s telemedicine guidelines do not include abortion. In a country where the majority of abortions take place outside the health system, allowing the use of telemedicine for abortion can help bring legality to users, and expand access to those facing additional barriers in accessing the care they deserve. We outline models for telemedicine provision of abortion in India and discuss the regulatory changes required to make telehealth for abortion a reality in India.
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Affiliation(s)
- Sruthi Chandrasekaran
- Senior Project Manager, Ibis Reproductive Health, Cambridge, MA, USA. Correspondence:
| | - V S Chandrashekar
- CEO, Foundation for Reproductive Health Services India, New Delhi, India (affiliate of MSI Reproductive Choices)
| | - Suchitra Dalvie
- Coordinator, Asia Safe Abortion Partnership, New Delhi, India
| | - Anand Sinha
- Country Advisor (India), The David and Lucile Packard Foundation, New Delhi, India
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Meenakshi C, Venkatachalam P, Chandrasekaran S, Venkatraman B. Construction of dose response curve for 6 MV LINAC X-rays using Premature Chromosome Condensation assay for radiation dosimetry. Appl Radiat Isot 2021; 173:109729. [PMID: 33906115 DOI: 10.1016/j.apradiso.2021.109729] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 03/28/2021] [Accepted: 04/09/2021] [Indexed: 10/21/2022]
Abstract
Quantification of chromosomal aberrations in the exposed personnel blood samples is considered as a 'gold standard' and sensitive biomarker in biological dosimetry. Despite technological developments, culture of cells for 48-52 h remains an unmet need in case of triage biodosimetry. Moreover, it is difficult to get sufficient number of metaphase spreads for scoring after high doses of exposures. The technique which causes condensation of chromatin before mitosis using biological or chemical agent is named as Premature Chromosome Condensation (PCC) assay. This assay is considered as an alternative to chromosome aberration assay, particularly at high acute doses of low and high LET radiation. To establish the PCC assay, blood samples were collected from healthy non-smoking individuals (n = 3) and exposed to various doses (0-20 Gy) of 6 MV X-rays at a dose rate of 5.6 Gy/min, using a high energy Linear accelerator (LINAC). Irradiated blood samples were subjected to Calyculin-A induced PCC. About 500 cells or more than 100 Ring Chromosomes (RC) were scored at each dose. Dicentric chromosomes (DC) and acentric fragments were also scored at each dose; the number of chromosomal aberrations in G1, M, G2/M and M/A phase of cell cycle were recorded and the frequency was used to construct the dose response curve. A dose dependent increase in RC and DC frequency were observed with a slope of 0.049 ± 0.002 and 0.30 ± 0.02 respectively. This study is first of its kind to construct a dose response curve for LINAC X-rays using a PCC assay.
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Affiliation(s)
- C Meenakshi
- Human Genetics Department, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamilnadu, India
| | - P Venkatachalam
- Human Genetics Department, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamilnadu, India.
| | - S Chandrasekaran
- Health, Safety and Environmental Group, Indira Gandhi Centre for Atomic Research, Kalpakkam, Tamilnadu, India
| | - B Venkatraman
- Health, Safety and Environmental Group, Indira Gandhi Centre for Atomic Research, Kalpakkam, Tamilnadu, India
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Balasundar S, Chandrasekaran S, Subramanian V, Venkatraman B. Investigations on neutron attenuation properties of poly-boron materials using Am-Be and 252Cf sources neutron spectra. ANN NUCL ENERGY 2021. [DOI: 10.1016/j.anucene.2020.108083] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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21
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Radhakrishnan D, Boopathy M, Gopalakrishnan V, Rakesh PT, Chandrasekaran S, Srinivas CV, Venkatesan R, Venkatraman B. Long-term trends in gamma radiation monitoring at the multi-facility nuclear site, Kalpakkam, South-India. Radiat Prot Environ 2021. [DOI: 10.4103/rpe.rpe_18_21] [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] Open
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22
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Kalra S, Das AK, Priya G, Ghosh S, Mehrotra RN, Das S, Shah P, Bajaj S, Deshmukh V, Sanyal D, Chandrasekaran S, Khandelwal D, Joshi A, Nair T, Eliana F, Permana H, Fariduddin MD, Shrestha PK, Shrestha D, Kahandawa S, Sumanathilaka M, Shaheed A, Rahim AA, Orabi A, Al-Ani A, Hussein W, Kumar D, Shaikh K. Fixed-dose combination in management of type 2 diabetes mellitus: Expert opinion from an international panel. J Family Med Prim Care 2020; 9:5450-5457. [PMID: 33532378 PMCID: PMC7842427 DOI: 10.4103/jfmpc.jfmpc_843_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 06/14/2020] [Accepted: 08/03/2020] [Indexed: 01/08/2023] Open
Abstract
Type 2 diabetes mellitus (T2DM) is a progressive disease with multifactorial etiology. The first-line therapy includes monotherapy (with metformin), which often fails to provide effective glycemic control, necessitating the addition of add-on therapy. In this regard, multiple single-dose agents formulated as a single-dose form called fixed-dose combinations (FDCs) have been evaluated for their safety, efficacy, and tolerability. The primary objective of this review is to develop practice-based expert group opinion on the current status and the causes of concern regarding the irrational use of FDCs, in Indian settings. After due discussions, the expert group analyzed the results from several clinical evidence in which various fixed combinations were used in T2DM management. The panel opined that FDCs (double or triple) improve patient adherence, reduce cost, and provide effective glycemic control and, thereby, play an important role in the management of T2DM. The expert group strongly recommended that the irrational metformin FDC's, banned by Indian government, should be stopped and could be achieved through active participation from the government, regulatory bodies, and health ministry, and through continuous education of primary care physicians and pharmacists. In T2DM management, FDCs play a crucial role in achieving glycemic targets effectively. However, understanding the difference between rational and irrational FDC combinations is necessary from the safety, efficacy, and tolerability perspective. In this regard, primary care physicians will have to use a multistep approach so that they can take informed decisions.
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Affiliation(s)
- Sanjay Kalra
- Department of Endocrinology, Bharti Hospital and BRIDE, Karnal, Haryana, India
| | - A K Das
- Department of Endocrinology and Medicine, Pondicherry Institute of Medical Sciences, Puducherry, India
| | - G Priya
- Department of Endocrinology, Fortis Hospital, Mohali, India
| | - S Ghosh
- Department of Endocrinology and Metabolism, IPGMER, Kolkata, West Bengal, India
| | - R N Mehrotra
- Department of Endocrinology, Apollo Hospitals, Jubilee Hills, Hyderabad, Telangana, India
| | - S Das
- Department of Endocrinology, Apollo Hospitals, Bhubaneswar, Odisha, India
| | - P Shah
- Department of Endocrinology and Diabetes Gujarat Endocrine Centre, Ahmedabad, Gujarat, India
| | - S Bajaj
- Department of Endocrinology, MLN Medical College, Allahabad, Uttar Pradesh, India
| | - V Deshmukh
- Department of Endocrinology, Deshmukh Clinic and Research Centre, Pune, Maharashtra, India
| | - D Sanyal
- Department of Endocrinology, KPC Medical College, Kolkata, West Bengal, India
| | - S Chandrasekaran
- Department of Endocrinology and Diabetes, Dr. Rela Institute of Medical Science (RIMC), Chennai, Tamil Nadu, India
| | - D Khandelwal
- Department of Endocrinology and Diabetes, Maharaja Agrasen Hospital, New Delhi, India
| | - A Joshi
- Department of Endocrinology, Kathmandu Diabetes and Thyroid Centre, Nepal
| | - T Nair
- Department of Cardiology, PRS Hospital, Trivandrum, Kerala, India
| | - F Eliana
- Department of Internal Medicine, Faculty of Medicine, YARSI University, Jakarta, Indonesia
| | - H Permana
- Department of Internal Medicine, Faculty of Medicine, Padjadjaran University, Bandung, Indonesia
| | - M D Fariduddin
- Department of Endocrinology of Bangabandhu Sheikh, Mujib Medical University, Dhaka, Bangladesh
| | - P K Shrestha
- Department of Internal Medicine, Tribhuwan University Teaching Hospital, Kathmandu, Nepal
| | - D Shrestha
- Department of Endocrinologist, Norvic International Hospital, Kathmandu, Nepal
| | - S Kahandawa
- Department of Endocrinology, Teaching Hospital Karapitiya, Galle, Sri Lanka
| | - M Sumanathilaka
- Department of Endocrinology, National Hospital of Sri Lanka, Colombo, Sri Lanka
| | - A Shaheed
- Department of Internal Medicine, Indira Gandhi Memorial Hospital, Malé, Maldives
| | - A A Rahim
- Department of Diabetes and Metabolism, Alexandria University, Alexandria, Egypt
| | - A Orabi
- Department of Internal Medicine, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - A Al-Ani
- Department of Internal Medicine, Hamad Hospital, Doha, Qatar
| | - W Hussein
- Department of Endocrinology and Diabetes, Dr. Wiam Clinic, Royal Hospital, Awali Hospital, Bahrain
| | - D Kumar
- Department of Endocrinology, NMC Specialty Hospital, Abu Dhabi, UAE
| | - K Shaikh
- Department of Diabetes, Faculty of Internal Medicine, Royal Oman Police Hospital, Muscat, Oman
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Chandrasekaran S, Diamond-Smith N, Srinivasan K, Dalvie S. Preparing for an Increased Need for Abortion Access in India during and after COVID-19: Challenges and Strategies. Stud Fam Plann 2020; 51:377-383. [PMID: 33135170 DOI: 10.1111/sifp.12139] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Access to safe abortion is a reproductive rights and justice issue, and it is imperative that safe abortion access during and after the COVID-19 pandemic is a reality for all. India imposed a lockdown in March 2020 to contain the spread of the pandemic. Limited mobility, lack of clarity about abortion as an essential service and abortion as a service permitted through telemedicine, shut down of services providing long-acting and permanent methods of contraception, and changes to decision-making about birthing and parenting during a pandemic are factors that may impact the demand for abortion during and after the lockdown. Shortage of raw materials and limited inter- and intra- state transport of drugs may result in breakages in the supply of medication abortion. Given that 73 percent of abortions in India in 2015 occurred outside of health facilities, the pandemic may have several implications on the need for evidence-based information and quality abortion services, as well as if and how medication abortion is accessed in India, and what self-managed abortion looks like in the COVID-19 era. We discuss factors contributing to reduced access to abortion, changes in abortion need, and suggest strategies to respond to an increased demand for abortion in India.
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Affiliation(s)
- Sruthi Chandrasekaran
- Sruthi Chandrasekaran, Senior Project Manager, Ibis Reproductive Health, Suite 320, 2067 Massachusetts Avenue, Cambridge, MA, 02140, USA
| | - Nadia Diamond-Smith
- Nadia Diamond-Smith, Assistant Professor, Department of Epidemiology & Biostatistics, University of California, San Francisco, CA, 94158, USA
| | - Karthik Srinivasan
- Karthik Srinivasan, Chief Medical Advisor, International Planned Parenthood Federation, London, SE1 3UZ, UK
| | - Suchitra Dalvie
- Suchitra Dalvie, Coordinator, Asia Safe Abortion Partnership, Mumbai, India
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Ruggiero S, Chandrasekaran S, Key K, Ranker L, Gerdts C. P18 Improving the travel experiences of later abortion clients: Recommendations from clinics and abortion support organizations. Contraception 2020. [DOI: 10.1016/j.contraception.2020.07.037] [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: 11/25/2022]
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25
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Reiger ST, Dako-Gyeke P, Ngo TD, Eva G, Gobah L, Blanchard K, Chandrasekaran S, Grindlay K. Abortion knowledge and experiences among young women and men in Accra, Ghana. Gates Open Res 2020; 3:1478. [PMID: 32995709 PMCID: PMC7498762 DOI: 10.12688/gatesopenres.12961.2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/24/2020] [Indexed: 11/20/2022] Open
Abstract
Background : Despite the presence of legal abortion services in Ghana, unsafe abortion remains common, particularly among young women. Little is understood about what young people know about safe and legal abortion, and if and how they are utilizing it. Methods : To characterize abortion use and address gaps in safe access, from September-December 2013, we conducted a cross-sectional survey with 100 men and 250 women aged 18-24 in Accra, Ghana. Participants were asked about abortion experiences, including prior services, providers, methods, satisfaction, perceived support, and knowledge of laws. Descriptive statistics, Fisher's exact tests, and chi-square tests were performed. Results : Among surveyed youth, most (87% of women, 64% of men) thought abortion was illegal or did not know the law. In total, 30% of women and 14% of men ever had an abortion and partner who had an abortion, respectively. Among women's most recent abortions, medication abortion (61%), surgical methods (26%), and unsafe methods categorized "least safe" (14%) were the initial or only methods used. Most women who accessed medication abortion initially or as their only method saw a pharmacist (40%) or no one (33%). Nearly one-quarter of women (n=16, 24%) who initially took tablets used more than one method. Conclusions : Despite experiences with abortion, most young people in this study were unaware of its legality and unsafe abortions occurred. More needs to be done to ensure young people understand the law and have access to safe methods, and that pharmacists are trained to provide appropriate doses and formulations of medication abortion.
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Affiliation(s)
| | - Phyllis Dako-Gyeke
- Social and Behavioural Sciences, School of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Thoai D. Ngo
- Poverty, Gender and Youth Program, Population Council, New York, New York, 10017, USA
| | - Gillian Eva
- Marie Stopes International US, Washington, DC, 20033, USA
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Ruggiero S, Brandi K, Mark A, Paul M, Reeves MF, Schalit O, Blanchard K, Key K, Chandrasekaran S. Access to later abortion in the United States during COVID-19: challenges and recommendations from providers, advocates, and researchers. Sex Reprod Health Matters 2020; 28:1774185. [PMID: 32460663 PMCID: PMC7887955 DOI: 10.1080/26410397.2020.1774185] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Affiliation(s)
| | - Kristyn Brandi
- Assistant Professor, Department of Obstetrics, Gynecology, and Women's Health, Rutgers University, New Jersey Medical School, Newark, NJ, USA
| | - Alice Mark
- Medical Director, National Abortion Federation, Washington, DC, USA
| | - Maureen Paul
- Consultant, Ibis Reproductive Health, Cambridge, MA, USA
| | - Matthew F Reeves
- Executive Director, DuPont Clinic, Washington, DC, USA.,Adjunct Associate Professor of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Odile Schalit
- Executive Director, Brigid Alliance, New York, NY, USA
| | | | - Katherine Key
- Project Manager, Ibis Reproductive Health, Cambridge, MA, USA
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27
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Kalra S, Ghosh S, Das AK, Nair T, Bajaj S, Priya G, Mehrotra RN, Das S, Shah P, Deshmukh V, Chawla M, Sanyal D, Chandrasekaran S, Khandelwal D, Joshi A, Eliana F, Permana H, Fariduddin MD, Shrestha PK, Shrestha D, Kahandawa S, Sumanathilaka M, Shaheed A, Rahim AA, Orabi A, Al-Ani A, Hussein W, Kumar D, Shaikh K. Unravelling the utility of modern sulfonylureas from cardiovascular outcome trials and landmark trials: expert opinion from an international panel. Indian Heart J 2020; 72:7-13. [PMID: 32423565 PMCID: PMC7231843 DOI: 10.1016/j.ihj.2020.01.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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] [Received: 11/12/2019] [Revised: 12/25/2019] [Accepted: 01/05/2020] [Indexed: 12/13/2022] Open
Abstract
AIM The primary objective of this review is to develop practice-based expert group opinions on the cardiovascular (CV) safety and utility of modern sulfonylureas (SUs) in cardiovascular outcome trials (CVOTs). BACKGROUND The United States Food and Drug Administration issued new guidance to the pharmaceutical industry in 2008 regarding the development of new antihyperglycemic drugs. The guidance expanded the scope for the approval of novel antihyperglycemic drugs by mandating CVOTs for safety. A few long-term CVOTs on dipeptidyl peptidase 4 inhibitors, glucagon-like peptide 1 receptor agonists, and sodium-glucose cotransporter 2 inhibitors have been completed, while others are ongoing. SUs, which constitute one of the key antihyperglycemic agents used for the management of type 2 diabetes mellitus (T2DM), have been used as comparator agents in several CVOTs. However, the need for CVOTs on modern SUs remains debatable. In this context, a multinational group of endocrinologists convened for a meeting and discussed the need for CVOTs of modern SUs to evaluate their utility in the management of patients with T2DM. At the meeting, CVOTs of modern SUs conducted to date and the hypotheses derived from the results of these trials were discussed. REVIEW RESULTS The expert group analyzed the key trials emphasizing the CV safety of modern SUs and also reviewed the results of various CVOTs in which modern SUs were used as comparators. Based on literature evidence and individual clinical insights, the expert group opined that modern SUs are cardiosafe and that since they have been used as comparators in other CVOTs, CVOTs of SUs are not required. CONCLUSION Modern SUs can be considered a cardiosafe option for the management of patients with diabetes mellitus and CV disease; thus CVOTs among individuals with T2DM are not required.
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Affiliation(s)
- S Kalra
- Department of Endocrinology, Bharti Hospital and BRIDE, Karnal, Haryana, India.
| | - S Ghosh
- Department of Endocrinology and Metabolism, IPGMER, Kolkata, West Bengal, India
| | - A K Das
- Department of Endocrinology & Medicine, Pondicherry Institute of Medical Sciences, Puducherry, India
| | - T Nair
- Dept. of Cardiology, PRS Hospital, Trivandrum, Kerala, India
| | - S Bajaj
- Department of Endocrinology, MLN Medical College, Allahabad, Uttar Pradesh, India
| | - G Priya
- Department of Endocrinology, Fortis Hospital, Chandigarh, Punjab, India
| | - R N Mehrotra
- Department of Endocrinology, Apollo Hospitals, Jubilee Hills, Hyderabad, India
| | - S Das
- Department of Endocrinology, Apollo Hospitals in Bhubaneswar, India
| | - P Shah
- Department of Endocrinology and Diabetes Gujarat Endocrine Centre, Ahmedabad, India
| | - V Deshmukh
- Department of Endocrinology, Deshmukh Clinic and Research Centre, Pune, Maharashtra
| | - M Chawla
- Department of Diabetology, Lina Diabetes Care and Mumbai Diabetes Research Centre, Mumbai, India
| | - D Sanyal
- Department of Endocrinology, KPC Medical College, Kolkata, West Bengal
| | - S Chandrasekaran
- Department of Endocrinology & Diabetes, Dr. Rela Institute of Medical Science (RIMC), Chennai, Tamil Nadu, India
| | - D Khandelwal
- Department of Endocrinology & Diabetes, Maharaja Agrasen Hospital, New Delhi, India
| | - A Joshi
- Department of Endocrinology & Diabetes, Bhaktivedanta Hospital and Research Institute, Mumbai, India
| | - F Eliana
- Department of Internal Medicine, Faculty of Medicine, YARSI University, Jakarta, Indonesia
| | - H Permana
- Department of Internal Medicine, Faculty of Medicine, Padjadjaran University, Bandung, Indonesia
| | - M D Fariduddin
- Department of Endocrinology of Bangabandhu Sheikh, Mujib Medical University, Dhaka, Bangladesh
| | - P K Shrestha
- Department of Internal Medicine, Tribhuwan University Teaching Hospital, Kathmandu, Nepal
| | - D Shrestha
- Department of Endocrinologist, Norvic International Hospital Kathmandu, Nepal
| | - S Kahandawa
- Department of Endocrinology, Teaching Hospital Karapitiya, Sri Lanka
| | - M Sumanathilaka
- Department of Endocrinology, National Hospital of Sri Lanka, Colombo, Sri Lanka
| | - A Shaheed
- Department of Internal Medicine, Indira Gandhi Memorial Hospital, Malé, Maldives
| | - A A Rahim
- Department of Diabetes and Metabolism, Alexandria University, Alexandria, Egypt
| | - A Orabi
- Department of Internal Medicine, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - A Al-Ani
- Department of Internal Medicine, Hamad General Hospital, Doha, Qatar
| | - W Hussein
- Department of Endocrinology & Diabetes, Royal Hospital, Bahrain
| | - D Kumar
- Department of Endocrinology, NMC Specialty Hospital, Abu Dhabi
| | - K Shaikh
- Department of Diabetes, Faculty of Internal Medicine, Royal Oman Police Hospital, Muscat, Oman
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Chandrasekaran S, Gerdts C, Robinson Y, Hannum C, Blanchard K, Paul M. Safety and effectiveness of one-day later abortion procedures: A retrospective chart review. Contraception 2020. [DOI: 10.1016/j.contraception.2020.03.012] [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: 11/28/2022]
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Gailson T, Pandit S, Chandrasekaran S. Griscelli syndrome type 2. QJM 2020; 113:137. [PMID: 31199490 DOI: 10.1093/qjmed/hcz144] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- T Gailson
- Department of Pediatrics, Government Multi-Specialty Hospital, Sector 16, Chandigarh, India
| | - S Pandit
- Department of Pediatrics, Government Multi-Specialty Hospital, Sector 16, Chandigarh, India
| | - S Chandrasekaran
- Department of Pediatrics, Government Multi-Specialty Hospital, Sector 16, Chandigarh, India
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Vadivel T, Dhamodaran M, Kulathooran S, Kavitha S, Amirthaganesan K, Chandrasekaran S, Ilayaraja S, Senguttuvan S. Rhodium(III) complexes derived from complexation of metal with azomethine linkage of chitosan biopolymer Schiff base ligand: Spectral, thermal, morphological and electrochemical studies. Carbohydr Res 2020; 487:107878. [DOI: 10.1016/j.carres.2019.107878] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 11/03/2019] [Accepted: 11/14/2019] [Indexed: 10/25/2022]
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Chandrasekaran S, Sankaran Pillai G, Baskaran R, Venkatraman B. UNCERTAINTY EVALUATION IN DOSE ASSESSMENT DUE TO SPATIAL DISTRIBUTION OF NORM IN BEACH SANDS OF SOUTHEAST COAST OF INDIA: A PROBABILISTIC APPROACH. Radiat Prot Dosimetry 2019; 187:482-498. [PMID: 31711198 DOI: 10.1093/rpd/ncz189] [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: 06/12/2019] [Revised: 08/06/2019] [Accepted: 08/07/2019] [Indexed: 06/10/2023]
Abstract
A study on radionuclide distribution along coastal stretch in high background areas is constantly attracted to many researchers around the world. In the present study, the concentration of radionuclides in beach sands along the southeast coastal region of India has been studied in detail. Concentration of radionuclides is measured using gamma spectrometry at 148 pre-determined locations. It is found that 238U and 232Th concentrations are varying in the range from 3 (BDL) to 298.9 and 1150.2 Bq kg-1, respectively. Concentration of 40K in beach sand varied from 11 to 1743.4 Bq kg-1. The measured activity levels of radionuclides were compared with earlier studies carried out by various researchers in the same region under study. The related radiological parameters of interest were also determined and compared with the internationally recommended values. With an increase in emphasis on quality in dose assessment methods, dose to human population living in the vicinity requires uncertainty evaluation, which is carried out by taking into account variation in the activity values. This study would serve as a baseline radiological mapping for the southeast coast region of India for environmental impact assessment prior to plan of nuclear facility in the future.
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Affiliation(s)
- S Chandrasekaran
- Indira Gandhi Centre for Atomic Research, Homi Bhabha National Institute, Kalpakkam, Tamil Nadu, India
| | - G Sankaran Pillai
- Indira Gandhi Centre for Atomic Research, Homi Bhabha National Institute, Kalpakkam, Tamil Nadu, India
| | - R Baskaran
- Indira Gandhi Centre for Atomic Research, Homi Bhabha National Institute, Kalpakkam, Tamil Nadu, India
| | - B Venkatraman
- Indira Gandhi Centre for Atomic Research, Homi Bhabha National Institute, Kalpakkam, Tamil Nadu, India
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Pillai GS, Chandrasekaran S, Baskaran R, Venkatraman B, Deepu R. A REVIEW ON 210Po AND 210Pb IN INDIAN SEAFOOD AND DOSE TO CONSUMERS. Radiat Prot Dosimetry 2019; 187:139-153. [PMID: 31135907 DOI: 10.1093/rpd/ncz149] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 04/08/2019] [Accepted: 05/08/2019] [Indexed: 06/09/2023]
Abstract
India is the second largest seafood producer in the world marketing more than 7000 edible species. In this regard, commendable studies have been conducted since the 1970s by different research groups and more data are reported. In this work, all the studies on 210Po and 210Pb measurements in abiotic and biotic components of India have been combined and reviewed. The concentrations of 210Po and 210Pb are estimated by radiochemical separation followed by alpha counting. Grain size, season, Tsunami waves and place of sampling have a decisive bearing on 210Po and 210Pb concentration in abiotic components. Plankton shows a higher Kd factor (104) compared to seaweeds and sea grass (103). Pond ecosystems recorded the highest Kd factor (4·3 × 104) compared to other freshwater and marine ecosystems. Bioaccumulation of 210Po and 210Pb varies with respect to variety of seafood. The committed effective dose (CED) calculated for shellfish species maintained a higher range of 2.5 × 10-2 mSv/y to 9.8 × 10-1 mSv/y and for fish species fluctuated from 3.8 × 10-4 mSv/y to 2.0 × 10-1 mSv/y. The studies conducted so far are scattered, and need to be gathered for future reference and planning (i.e. There is not much information available for Kerala, Karnataka, Maharashtra, Gujarat, Andhra, West Bengal and Odessa coast). Therefore, it is strongly recommended that further and more complete research is undertaken to study the bioaccumulation of 210Po and 210Pb from seafood. Overall, the present review concludes that Indian seafood is radiologically safe.
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Affiliation(s)
- G Sankaran Pillai
- Radiological, Environment and Safety Division (RESD), Health Safety and Environment Group (HSEG), Indira Gandhi Centre for Atomic Research, Homi Bhabha National Institute (HBNI), Kalpakkam 603 102, Tamil Nadu, India
| | - S Chandrasekaran
- Radiological, Environment and Safety Division (RESD), Health Safety and Environment Group (HSEG), Indira Gandhi Centre for Atomic Research, Homi Bhabha National Institute (HBNI), Kalpakkam 603 102, Tamil Nadu, India
| | - R Baskaran
- Radiological, Environment and Safety Division (RESD), Health Safety and Environment Group (HSEG), Indira Gandhi Centre for Atomic Research, Homi Bhabha National Institute (HBNI), Kalpakkam 603 102, Tamil Nadu, India
| | - B Venkatraman
- Radiological, Environment and Safety Division (RESD), Health Safety and Environment Group (HSEG), Indira Gandhi Centre for Atomic Research, Homi Bhabha National Institute (HBNI), Kalpakkam 603 102, Tamil Nadu, India
| | - R Deepu
- Radiological, Environment and Safety Division (RESD), Health Safety and Environment Group (HSEG), Indira Gandhi Centre for Atomic Research, Homi Bhabha National Institute (HBNI), Kalpakkam 603 102, Tamil Nadu, India
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Moseson H, Shaw J, Chandrasekaran S, Kimani E, Maina J, Malisau P, Musa Y, Nmezi S, Philipo K, Borjas EB, Young YY. Contextualizing medication abortion in seven African nations: A literature review. Health Care Women Int 2019; 40:950-980. [DOI: 10.1080/07399332.2019.1608207] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
| | | | | | - Esther Kimani
- Trust for Indigenous Culture and Health, Nairobi, Kenya
| | - Jedidah Maina
- Trust for Indigenous Culture and Health, Nairobi, Kenya
| | | | - Yiga Musa
- Community Health Rights Network (COHERINET), Kampala, Uganda
| | - Sybil Nmezi
- Generation Initiative for Women and Youth Network, Lagos, Nigeria
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Reiger ST, Dako-Gyeke P, Ngo TD, Eva G, Gobah L, Blanchard K, Chandrasekaran S, Grindlay K. Abortion knowledge and experiences among young women and men in Accra, Ghana. Gates Open Res 2019; 3:1478. [PMID: 32995709 PMCID: PMC7498762 DOI: 10.12688/gatesopenres.12961.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/17/2019] [Indexed: 11/05/2023] Open
Abstract
Background : Despite the presence of legal abortion services in Ghana, unsafe abortion remains common, particularly among young women. Little is understood about what young people know about safe and legal abortion, and if and how they are utilizing it. Methods : To characterize abortion use and address gaps in safe access, from September-December 2013, we conducted a cross-sectional survey with 100 men and 250 women aged 18-24 in Accra, Ghana. Participants were asked about abortion experiences, including prior services, providers, methods, satisfaction, perceived support, and knowledge of laws. Descriptive statistics, Fisher's exact tests, and chi-square tests were performed. Results : Among surveyed youth, most (87% of women, 64% of men) thought abortion was illegal or did not know the law. In total, 30% of women and 14% of men ever had an abortion and partner who had an abortion, respectively. Among women's most recent abortions, medication abortion (61%), surgical methods (26%), and unsafe methods categorized "least safe" (14%) were the initial or only methods used. Most women who accessed medication abortion initially or as their only method saw a pharmacist (40%) or no one (33%). Nearly one-quarter of women (n=16, 24%) who initially took tablets used more than one method. Conclusions : Despite experiences with abortion, most young people in this study were unaware of its legality and unsafe abortions occurred. More needs to be done to ensure young people understand the law and have access to safe methods, and that pharmacists are trained to provide appropriate doses and formulations of medication abortion.
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Affiliation(s)
| | - Phyllis Dako-Gyeke
- Social and Behavioural Sciences, School of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Thoai D. Ngo
- Poverty, Gender and Youth Program, Population Council, New York, New York, 10017, USA
| | - Gillian Eva
- Marie Stopes International US, Washington, DC, 20033, USA
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Baalamurugan J, Ganesh Kumar V, Chandrasekaran S, Balasundar S, Venkatraman B, Padmapriya R, Bupesh Raja VK. Utilization of induction furnace steel slag in concrete as coarse aggregate for gamma radiation shielding. J Hazard Mater 2019; 369:561-568. [PMID: 30818120 DOI: 10.1016/j.jhazmat.2019.02.064] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Revised: 02/18/2019] [Accepted: 02/19/2019] [Indexed: 06/09/2023]
Abstract
The present investigation highlights the utilization of Induction Furnace (IF) steel slag as a partial replacement for coarse aggregate in concrete. The concrete blocks of size 150 × 150 × 50 mm were casted and the effect of density, compressive strength, linear attenuation coefficient, Gamma Attenuation Factor (GAF) and Half Value Layer (HVL) has been explored. Gamma attenuation measurements were carried out using NaI (Tl) based gamma detector. Gamma ray source 60Co emitting two gamma energies 1.17 and 1.33 MeV was used for radiation measurements. The results of this present study shows that 50% of IF steel slag replacement increases the density (2.81 g/cm3) and compressive strength (29.11 N/mm2). The Linear attenuation coefficient (0.1953 cm-1-0.2236 cm-1) and GAF (0.6343-0.6710) is higher at 50% replacement of IF steel slag than conventional concrete. HVL values were also having positive impact in 50% replacement of IF steel slag (3.10 cm) in concrete than conventional concrete (3.55 cm). The partial replacement of IF steel slag as coarse aggregate in concrete is effective in gamma shielding.
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Affiliation(s)
- J Baalamurugan
- Nanoscience and Materials Chemistry Division - Centre for Ocean Research, Sathyabama Institute of Science and Technology, Chennai - 600119, India
| | - V Ganesh Kumar
- Nanoscience and Materials Chemistry Division - Centre for Ocean Research, Sathyabama Institute of Science and Technology, Chennai - 600119, India.
| | - S Chandrasekaran
- HBNI, Health Safety and Environment Group, Indira Gandhi Centre for Atomic Research, Kalpakkam, 603102, India
| | - S Balasundar
- HBNI, Health Safety and Environment Group, Indira Gandhi Centre for Atomic Research, Kalpakkam, 603102, India
| | - B Venkatraman
- HBNI, Health Safety and Environment Group, Indira Gandhi Centre for Atomic Research, Kalpakkam, 603102, India
| | - R Padmapriya
- Department of Civil Engineering Sathyabama Institute of Science and Technology, Chennai - 600119,India
| | - V K Bupesh Raja
- Department of Automobile Engineering, Sathyabama Institute of Science and Technology, Chennai, 600119, India
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Laitman BM, Chandrasekaran S, Rifkin R, Barnum K, Thomas DC, Meah YS. Benefits of a Physician-Scientist-Tailored Curriculum at a Medical Student-Run Free Clinic. Med Sci Educ 2019; 29:9-10. [PMID: 34457440 PMCID: PMC8368602 DOI: 10.1007/s40670-018-00668-z] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
We designed a curriculum to help sustain pre-clinical knowledge for MD/PhD trainees in their graduate training phase while securing regular providers for our student-run free clinic. MD/PhD involvement increased from 1.91 to 2.45 students-per-clinic-day following implementation, and participants affirmed increased preparedness and comfort entering medical school clinical clerkships.
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Affiliation(s)
- B. M. Laitman
- Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029 USA
| | - S. Chandrasekaran
- Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029 USA
| | - R. Rifkin
- Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029 USA
| | - K. Barnum
- Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029 USA
| | - D. C. Thomas
- Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029 USA
| | - Y. S. Meah
- Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029 USA
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Ng SM, Ayoola OO, McGuigan MP, Chandrasekaran S. A multicentre study evaluating the risk and prevalence of diabetic retinopathy in children and young people with type 1 diabetes mellitus. Diabetes Metab Syndr 2019; 13:744-746. [PMID: 30641800 DOI: 10.1016/j.dsx.2018.11.063] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [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] [Received: 11/10/2018] [Accepted: 11/30/2018] [Indexed: 11/20/2022]
Abstract
INTRODUCTION There is currently limited data published on the prognostic factors and prevalence of diabetic eye disease in children and young people (CYP) with Type 1 diabetes mellitus (T1DM), yet diabetic retinopathy remains one of the commonest causes of blindness in young adults. The aim of this study was to determine the risk and prevalence of diabetic retinopathy (DR) and to evaluate the risk factors associated with diabetic retinopathy in CYP with T1DM. METHODS All CYP with Type 1 diabetes between 12 and 18 years of age, registered with the regional diabetic retinopathy screening programme were evaluated from 2012 to 2013 in four diabetes units within the north west region of the United Kingdom. Patients who had evidence of diabetic retinopathy were reviewed to identify risk factors for presence or absence of diabetic retinopathy. RESULTS 237 patients between the ages 12-18 years were included in the. The prevalence of diabetic retinopathy was 11%. Out of 27 patients with evidence of diabetic retinopathy, 44% were reported as background changes and 56% had pre-proliferative DR. Significant risk factors for diabetic retinopathy disease in the population using univariate analyses were duration of diabetes, puberty, age at diagnosis and mean HbA1c in the preceding 12 months. Multivariate logistic regression analysis found age of diagnosis (p = 0.04) and mean HbA1c as significant independent risk factors for presence of diabetic retinopathy (p = 0.02). CONCLUSIONS The prevalence of diabetic retinopathy in this paediatric population was 11%. Early age at diagnosis and poor metabolic control are independent risk factors for diabetic retinopathy.
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Affiliation(s)
- S M Ng
- Department of Paediatrics, Southport and Ormskirk NHS Trust, United Kingdom.
| | - O O Ayoola
- Department of Paediatrics, Lancashire Teaching Hospitals NHS Foundation Trust, United Kingdom
| | - M P McGuigan
- Department of Paediatrics, Mid Cheshire Hospitals NHS Foundation Trust, United Kingdom
| | - S Chandrasekaran
- Department of Paediatrics, East Cheshire NHS Trust, United Kingdom
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Grindlay K, Dako-Gyeke P, Ngo TD, Eva G, Gobah L, Reiger ST, Chandrasekaran S, Blanchard K. Contraceptive use and unintended pregnancy among young women and men in Accra, Ghana. PLoS One 2018; 13:e0201663. [PMID: 30118485 PMCID: PMC6097688 DOI: 10.1371/journal.pone.0201663] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Accepted: 07/19/2018] [Indexed: 11/18/2022] Open
Abstract
The objective of this study was to determine factors associated with modern contraceptive use and unintended pregnancy among young women and men in Accra, Ghana. From September-December 2013, we conducted a cross-sectional survey with 250 women and 100 men aged 18–24. We explored determinants of modern contraceptive use among males and females and unintended pregnancy among females. Descriptive statistics, chi-square tests, Fisher’s exact tests, and multivariable logistic regression were used. Participants had an average of three lifetime sexual partners, and 91% had one current partner. Overall, 44% reported current modern contraceptive use. In multivariate modeling, modern contraceptive use was associated with higher education compared to primary (AORs 2.1–4.3); ever talking with someone about contraception (AOR 4.7); feeling unsupported by a healthcare provider for contraception (AOR 2.2); and not feeling at risk of unintended pregnancy (AOR 2.7). While ≥70% of participants recognized most contraceptive methods, awareness of some methods was lacking. Nearly all respondents (91%) felt at least one modern method was unsafe. Nearly half of all females (45%) reported their last pregnancy was unintended, and 63% of females and 58% of males felt at risk for future unintended pregnancy. Women were more likely to experience unintended pregnancy if they had ever given birth (AOR 6.7), their sexual debut was 8–14 years versus 20–24 years (AOR 3.4), or they had 3–4 lifetime sexual partners versus 1–2 (AOR 2.4). Targeted interventions are needed to improve understanding of the safety of modern contraceptive methods, increase awareness of long-acting methods, and consequently increase modern contraceptive access and use.
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Affiliation(s)
- Kate Grindlay
- Ibis Reproductive Health, Cambridge, Massachusetts, United States of America
- * E-mail:
| | - Phyllis Dako-Gyeke
- Department of Social and Behavioral Sciences, School of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Thoai D. Ngo
- Poverty, Gender and Youth Program, Population Council, New York, New York, United States of America
| | - Gillian Eva
- Marie Stopes International US, Washington, DC, United States of America
| | | | - Sarah T. Reiger
- Ibis Reproductive Health, Cambridge, Massachusetts, United States of America
| | | | - Kelly Blanchard
- Ibis Reproductive Health, Cambridge, Massachusetts, United States of America
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Chandrasekaran S, Basu P, Krishnan H, Sivasubramanian K, Baskaran R, Venkatraman B. Development of Gadolinium (neutron poison) monitoring system for fuel reprocessing facilities: Computational model and validation with experiments. Progress in Nuclear Energy 2018. [DOI: 10.1016/j.pnucene.2018.04.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Chandrasekaran S, Sasaki M, Sapkota B, Pollack B. 178 PI3-kinase signaling modulates the induction of MHC molecules by IFN-gamma. J Invest Dermatol 2018. [DOI: 10.1016/j.jid.2018.03.183] [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: 11/30/2022]
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Sankaran Pillai G, Chandrasekaran S, Sivasubramanian K, Baskaran R, Venkatraman B. A REVIEW ON VARIATION OF NATURAL RADIOACTIVITY ALONG THE SOUTHEAST COAST OF TAMIL NADU FOR THE PAST 4 DECADES (1974-2016). Radiat Prot Dosimetry 2018; 179:125-135. [PMID: 29069491 DOI: 10.1093/rpd/ncx233] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Accepted: 09/30/2017] [Indexed: 06/07/2023]
Abstract
This review deals with natural radioactivity variation along the southeast coast of Tamil Nadu for the past four decades (1974-2016). About 40 research works have been conducted along the coast since 1974 in various environmental matrices using a variety of experimental methods. For these measurements researchers are adopted different experimental methods. The measured gamma dose rate ranged from 30 to 8700 nGy/h. The mean specific activity of 238U, 232Th and 40K was found to be 58.8 ± 28.7, 465.2 ± 147.3 and 311.2 ± 27.8 Bq/kg, respectively. The calculated annual exposure rate ranged from 0.29 to 12.8 mSv/y with the mean value of 3.7 mSv/y which is above the global average of 2.4 mSv/y as reported by United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR) (Report to General Assembly, Annex B Exposures of the public and workers from various sources of radiation. United Nations, New York (2008)). Plant food items recorded low 210Po activities as compared to seafood organisms. Grain size, season and place of sampling have a decisive bearing on coastal radioactivity. Therefore, it is concluded from the review data that there is an appreciable elevation in background radiation level in the coastal region. This review suggests that new radiological surveys using improved methodology that cover the entire coastal stretch are needed.
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Affiliation(s)
- G Sankaran Pillai
- Radiological Safety Division (RSD), Health Safety and Environment Group (HSEG), Indira Gandhi Centre for Atomic Research, Homi Bhabha National Institute (HBNI), Kalpakkam 603102, Tamil Nadu, India
| | - S Chandrasekaran
- Radiological Safety Division (RSD), Health Safety and Environment Group (HSEG), Indira Gandhi Centre for Atomic Research, Homi Bhabha National Institute (HBNI), Kalpakkam 603102, Tamil Nadu, India
| | - K Sivasubramanian
- Radiological Safety Division (RSD), Health Safety and Environment Group (HSEG), Indira Gandhi Centre for Atomic Research, Homi Bhabha National Institute (HBNI), Kalpakkam 603102, Tamil Nadu, India
| | - R Baskaran
- Radiological Safety Division (RSD), Health Safety and Environment Group (HSEG), Indira Gandhi Centre for Atomic Research, Homi Bhabha National Institute (HBNI), Kalpakkam 603102, Tamil Nadu, India
| | - B Venkatraman
- Radiological Safety Division (RSD), Health Safety and Environment Group (HSEG), Indira Gandhi Centre for Atomic Research, Homi Bhabha National Institute (HBNI), Kalpakkam 603102, Tamil Nadu, India
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Huse HK, Miller SA, Chandrasekaran S, Hindler JA, Lawhon SD, Bemis DA, Westblade LF, Humphries RM. Evaluation of Oxacillin and Cefoxitin Disk Diffusion and MIC Breakpoints Established by the Clinical and Laboratory Standards Institute for Detection of mecA-Mediated Oxacillin Resistance in Staphylococcus schleiferi. J Clin Microbiol 2018; 56:e01653-17. [PMID: 29187565 PMCID: PMC5786728 DOI: 10.1128/jcm.01653-17] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Accepted: 11/24/2017] [Indexed: 01/30/2023] Open
Abstract
Staphylococcus schleiferi is a beta-hemolytic, coagulase-variable colonizer of small animals that can cause opportunistic infections in humans. In veterinary isolates, the rate of mecA-mediated oxacillin resistance is significant, with reported resistance rates of >39%. The goal of this study was to evaluate oxacillin and cefoxitin disk diffusion (DD) and MIC breakpoints for detection of mecA-mediated oxacillin resistance in 52 human and 38 veterinary isolates of S. schleiferi Isolates were tested on multiple brands of commercial media and according to Clinical and Laboratory Standards Institute (CLSI) methods. Zone diameters and MIC values were interpreted using CLSI breakpoints (CLSI, Performance Standards for Antimicrobial Susceptibility Testing. M100-S27, 2017) for Staphylococcus aureus/Staphylococcus lugdunensis, coagulase-negative staphylococci (CoNS), and Staphylococcus pseudintermedius Results were compared to those of mecA PCR. Twenty-nine of 90 (32%) isolates were mecA positive. Oxacillin inhibition zone sizes and MICs interpreted by S. pseudintermedius breakpoints reliably differentiated mecA-positive and mecA-negative isolates, with a categorical agreement (CA) of 100% and no very major errors (VMEs) or major errors (MEs) for all media. For cefoxitin DD results interpreted using S. aureus/S. lugdunensis and CoNS breakpoints, CA values were 85% and 75%, respectively, and there were 72% and 64% VMEs, respectively, and 0 MEs. For cefoxitin MICs interpreted using S. aureus/S. lugdunensis breakpoints, CA was 81%, and there were 60% VMEs and no MEs. Our data demonstrate that oxacillin DD or MIC testing methods using the current S. pseudintermedius breakpoints reliably identify mecA-mediated oxacillin resistance in S. schleiferi, while cefoxitin DD and MIC testing methods perform poorly.
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Affiliation(s)
- H K Huse
- UCLA David Geffen School of Medicine, Los Angeles, California, USA
| | - S A Miller
- UCLA David Geffen School of Medicine, Los Angeles, California, USA
| | - S Chandrasekaran
- UCLA David Geffen School of Medicine, Los Angeles, California, USA
| | - J A Hindler
- UCLA David Geffen School of Medicine, Los Angeles, California, USA
| | - S D Lawhon
- Texas A&M University College of Veterinary Medicine, College Station, Texas, USA
| | - D A Bemis
- University of Tennessee College of Veterinary Medicine, Knoxville, Tennessee, USA
| | | | - R M Humphries
- UCLA David Geffen School of Medicine, Los Angeles, California, USA
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Gul MZ, Chandrasekaran S, Manjulatha K, Bhat MY, Maurya R, Qureshi IA, Ghazi IA. Antiproliferative and Apoptosis-inducing Effects of Abrus precatorius Against Human Monocytic Leukaemia (THP-1) Cell Line. Indian J Pharm Sci 2018. [DOI: 10.4172/pharmaceutical-sciences.1000359] [Citation(s) in RCA: 1] [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: 11/09/2022] Open
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Kulkarni NM, Malampati S, Mahat MYA, Chandrasekaran S, Raghul J, Khan AA, Krishnan UM, Narayanan S. Altered pharmacokinetics of rosiglitazone in a mouse model of non-alcoholic fatty liver disease. Drug Metab Pers Ther 2017; 31:165-71. [PMID: 27522101 DOI: 10.1515/dmpt-2016-0008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Accepted: 06/24/2016] [Indexed: 01/11/2023]
Abstract
BACKGROUND Severe forms of non-alcoholic fatty liver disease (NAFLD) adversely affect the liver physiology and hence the pharmacokinetics of drugs. Here, we investigated the effect of NAFLD on the pharmacokinetics of rosiglitazone, an insulin sensitizer used in the treatment of type 2 diabetes. METHODS Male C57BL/6 mice were divided into two groups. The first group (n=14) was fed with normal chow feed and the second group (n=14) was fed with 60% high-fat diet (HFD) and 40% high fructose liquid (HFL) for 60 days to induce NAFLD. The development of NAFLD was confirmed by histopathology, liver triglyceride levels and biochemical estimations, and used for pharmacokinetic investigations. Rosiglitazone was administered orally at 30 mg/kg dose. At predetermined time points, blood was collected and rosiglitazone concentrations were determined using LC/MS/MS. Plasma concentrations were subjected to non-compartmental analysis using Phoenix WinNonlin (6.3), and the area under the plasma concentration-time curve (AUC) was calculated by the linear-up log-down method. RESULTS HFD and HFL diet successfully induced NAFLD in mice. Rosiglitazone pharmacokinetics in NAFLD animals were altered significantly as compared to healthy mice. Rosiglitazone exposure increased significantly in NAFLD mice (2.5-fold higher AUC than healthy mice). The rosiglitazone oral clearance was significantly lower and the mean plasma half-life was significantly longer in NAFLD mice as compared to healthy mice. CONCLUSIONS The NAFLD mouse model showed profound effects on rosiglitazone pharmacokinetics. The magnitude of change in rosiglitazone pharmacokinetics is similar to that observed in humans with moderate to severe liver disease. The present animal model can be utilized to study the NAFLD-induced changes in the pharmacokinetics of different drugs.
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Paramasivam M, Deepa M, Selvi C, Chandrasekaran S. Dissipation kinetics of beta-cyfluthrin and imidacloprid in tea and their transfer from processed tea to infusion. Ecotoxicol Environ Saf 2017; 144:531-536. [PMID: 28683415 DOI: 10.1016/j.ecoenv.2017.06.065] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [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: 04/04/2017] [Revised: 06/23/2017] [Accepted: 06/26/2017] [Indexed: 06/07/2023]
Abstract
Dissipation kinetics of mixed formulation consisting beta-cyfluthrin and imidacloprid in tea crop under an open field ecosystem was investigated. The mixed formulation was applied on tea plant at recommended (27 + 63) and double the recommended (54 + 126g a.i./ha) dose and residues were determined using gas chromatography-electron capture detector and high performance liquid chromatography-photodiode array detector for beta-cyfluthrin and imidacloprid, respectively. The limit of quantification of analytical method was 0.05µg/g and the average recoveries were ranged from 88.36% to 103.49% with relative standard deviations of less than 6% at three spiked levels. The experimental results showed that in the green tea leaves imidacloprid dissipated faster than beta-cyfluthrin with the half-life ranging between 1.20-1.39 and 2.89-3.15days, respectively. The beta-cyfluthrin residues present in the processed tea not transferred into the tea infusion during the infusion process and imidacloprid transferred in the range 43.12-49.7%. On the basis of the transfer of residues from processed tea to infusion, a waiting period of 17 days for tea plucking after pesticide application at recommended dose may be suggested.
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Affiliation(s)
- M Paramasivam
- Pesticide Toxicology Laboratory, Department of Agricultural Entomology, Tamil Nadu Agricultural University, Coimbatore 641003, Tamil Nadu, India.
| | - M Deepa
- Pesticide Toxicology Laboratory, Department of Agricultural Entomology, Tamil Nadu Agricultural University, Coimbatore 641003, Tamil Nadu, India
| | - C Selvi
- Pesticide Toxicology Laboratory, Department of Agricultural Entomology, Tamil Nadu Agricultural University, Coimbatore 641003, Tamil Nadu, India
| | - S Chandrasekaran
- Pesticide Toxicology Laboratory, Department of Agricultural Entomology, Tamil Nadu Agricultural University, Coimbatore 641003, Tamil Nadu, India
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Chandrasekaran S, Kyaw NTT, Harries AD, Yee IA, Ellan P, Kurusamy T, Yusoff N, Mburu G, Mohammad WMZW, Suleiman A. Enrolment and retention of people who inject drugs in the Needle & Syringe Exchange Programme in Malaysia. Public Health Action 2017; 7:155-160. [PMID: 28695090 DOI: 10.5588/pha.17.0003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2017] [Accepted: 03/21/2017] [Indexed: 11/10/2022] Open
Abstract
Setting: Needle and Syringe Exchange Programme (NSEP) implemented by non-governmental organisations in Malaysia. Objectives: To determine enrolment, characteristics and retention in the NSEP of people who inject drugs (PWID) between 2013 and 2015. Design: Retrospective cohort study. Results: There were 20 946 PWID, with a mean age of 38 years. The majority were male (98%) and of Malay ethnicity (92%). Follow-up data were available for 20 761 PWID. Annual retention of newly enrolled PWID for each year was respectively 85%, 87% and 78% for 2013, 2014 and 2015, although annual enrolment over these years declined from 10 724 to 6288 to 3749. Total person-years (py) of follow-up were 27 806, with loss to follow-up of 40 per 100 py. Cumulative probability of retention in NSEP was 66% at 12 months, 45% at 24 months and 26% at 36 months. Significantly higher loss to follow-up rates were observed in those aged 15-24 years or ⩾50 years, females, transgender people and non-Malay ethnic groups. Conclusion: Annual retention of new PWID on NSEP was impressive, although enrolment declined over the 3 years of the study and cumulative loss to follow-up was high. A better understanding of these programmatic outcomes is required.
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Affiliation(s)
| | - N T T Kyaw
- International Union Against Tuberculosis and Lung Disease, Myanmar Country Office, Mandalay, Myanmar
| | - A D Harries
- International Union Against Tuberculosis and Lung Disease, Paris, France.,London School of Hygiene & Tropical Medicine, London, UK
| | - I A Yee
- Malaysian AIDS Council, Kuala Lumpur, Malaysia
| | - P Ellan
- Malaysian AIDS Council, Kuala Lumpur, Malaysia
| | - T Kurusamy
- Malaysian AIDS Council, Kuala Lumpur, Malaysia
| | - N Yusoff
- Malaysian AIDS Council, Kuala Lumpur, Malaysia
| | - G Mburu
- Department of Health Research, Lancaster University, Lancaster, UK
| | - W M Z W Mohammad
- School of Medical Sciences, Universiti Sains Malaysia, Penang, Malaysia
| | - A Suleiman
- Ministry of Health Malaysia, Putrajaya, Malaysia
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Shpigler HY, Saul MC, Murdoch EE, Cash-Ahmed AC, Seward CH, Sloofman L, Chandrasekaran S, Sinha S, Stubbs LJ, Robinson GE. Behavioral, transcriptomic and epigenetic responses to social challenge in honey bees. Genes, Brain and Behavior 2017; 16:579-591. [DOI: 10.1111/gbb.12379] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Revised: 03/03/2017] [Accepted: 03/14/2017] [Indexed: 01/06/2023]
Affiliation(s)
- H. Y. Shpigler
- Carl R. Woese Institute for Genomic Biology; University of Illinois at Urbana-Champaign (UIUC); Urbana IL USA
| | - M. C. Saul
- Carl R. Woese Institute for Genomic Biology; University of Illinois at Urbana-Champaign (UIUC); Urbana IL USA
| | - E. E. Murdoch
- Carl R. Woese Institute for Genomic Biology; University of Illinois at Urbana-Champaign (UIUC); Urbana IL USA
| | - A. C. Cash-Ahmed
- Carl R. Woese Institute for Genomic Biology; University of Illinois at Urbana-Champaign (UIUC); Urbana IL USA
| | - C. H. Seward
- Carl R. Woese Institute for Genomic Biology; University of Illinois at Urbana-Champaign (UIUC); Urbana IL USA
- Department of Cell and Developmental Biology; University of Illinois at Urbana-Champaign (UIUC); Urbana IL USA
| | - L. Sloofman
- Carl R. Woese Institute for Genomic Biology; University of Illinois at Urbana-Champaign (UIUC); Urbana IL USA
- Center for Biophysics and Quantitative Biology; University of Illinois at Urbana-Champaign (UIUC); Urbana IL USA
| | - S. Chandrasekaran
- Harvard Society of Fellows; Harvard University; Cambridge MA USA
- Faculty of Arts and Sciences; Harvard University; Cambridge MA USA
- Broad Institute of MIT and Harvard; Cambridge MA USA
- Department of Biomedical Engineering; University of Michigan; Ann Arbor MI USA
| | - S. Sinha
- Carl R. Woese Institute for Genomic Biology; University of Illinois at Urbana-Champaign (UIUC); Urbana IL USA
- Center for Biophysics and Quantitative Biology; University of Illinois at Urbana-Champaign (UIUC); Urbana IL USA
- Department of Computer Science; University of Illinois at Urbana-Champaign (UIUC); Urbana IL USA
- Department of Entomology; University of Illinois at Urbana-Champaign (UIUC); Urbana IL USA
| | - L. J. Stubbs
- Carl R. Woese Institute for Genomic Biology; University of Illinois at Urbana-Champaign (UIUC); Urbana IL USA
- Department of Cell and Developmental Biology; University of Illinois at Urbana-Champaign (UIUC); Urbana IL USA
- Neuroscience Program; University of Illinois at Urbana-Champaign (UIUC); Urbana IL USA
| | - G. E. Robinson
- Carl R. Woese Institute for Genomic Biology; University of Illinois at Urbana-Champaign (UIUC); Urbana IL USA
- Department of Entomology; University of Illinois at Urbana-Champaign (UIUC); Urbana IL USA
- Neuroscience Program; University of Illinois at Urbana-Champaign (UIUC); Urbana IL USA
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Chandrasekaran S. Meet Our Editorial Board Member. CURR ORG CHEM 2017. [DOI: 10.2174/138527282110170330230532] [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: 11/22/2022]
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49
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Balasundaram K, Raja R, Zhu Q, Chandrasekaran S, Zhou H. New global asymptotic stability of discrete-time recurrent neural networks with multiple time-varying delays in the leakage term and impulsive effects. Neurocomputing 2016. [DOI: 10.1016/j.neucom.2016.06.040] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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50
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James R, Avudaiappan S, Assistant Professor A, Natarajan K, Chandrasekaran S. Multifocal Tuberculosis. J Assoc Physicians India 2016; 64:83-84. [PMID: 27762524] [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: 06/06/2023]
Abstract
Multifocal Tuberculosis represents the many faces of an age old disease. It is characterized by the presence of large multifocal tuberculous areas in same or different organs. A 50 year old male patient, presented with features suggestive of renal failure, low grade fever and cough with mucoid expectoration. He was found to have pulmonary TB, genitourinary TB and tuberculous lymphadenitis. He was started on antituberculous treatment to which he showed good response.
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Affiliation(s)
| | | | | | - Kumar Natarajan
- Professor, Department of General Medicine, Coimbatore Medical College Hospital, Coimbatore, Tamil Nadu
| | - S Chandrasekaran
- Professor, Department of General Medicine, Coimbatore Medical College Hospital, Coimbatore, Tamil Nadu
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