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Biomedical subjects

S Kohli

Publications and source records attributed to S Kohli.

13 recordsLinked to original sources
PubMed2000

Childhood leukaemia in areas with different radon levels: a spatial and temporal analysis using GIS.

OBJECTIVES: To evaluate the relation between exposure to ground radon levels and leukaemia among children using existing population and disease registers. DESIGN: Ecological correlation study. SETTING: The county of Ostergötland in Sweden. METHODS: Every child born in the county between 1979 and 1992 was mapped to the property centroid coordinates by linking addresses in the population and property registers. Population maps were overlaid with radon maps and exposure at birth and each subsequent year was quantified as high, normal, low or unknown. This was analysed with data from the tumour registry. Standardised mortality ratios (SMRs) were calculated using the age and sex specific rates for Sweden for the year 1995. RESULTS: 90 malignancies occurred among 53 146 children (498 887 person years) who formed the study population. SMRs for acute lymphatic leukaemia (ALL) among children born in high, normal and low risk areas were 1.43, 1.17 and 0.25 respectively. The relative risk for the normal risk group and high risk group as compared with the low risk group was 4.64 (95% CI 1.29, 28.26) and 5. 67 (95% CI 1.06, 42.27). The association between ALL and continued residence at normal or high risk areas showed a similar trend. No association between radon risk levels and any other malignancy was seen. CONCLUSION: Children born in and staying at areas where the risk from ground radon has been classified as low are less likely to develop ALL than those born in areas classified as normal and high risk.

Adolescent↗
PubMed1997

Individuals living in areas with high background radon: a GIS method to identify populations at risk.

OBJECTIVE: to identify and link populations and individuals that live within high risk areas. DESIGN: census registers and disease registers which contain data on individuals can only give aggregate statistics relating to postal code districts, town, county or state boundaries. However environmental risk factors rarely, if ever, respect these man-made boundaries. What is needed is a method to rapidly identify individuals who may live within a described area or region and to further identify the disease(s) occurring among these individuals and/or in these areas. METHOD: this paper describes a method for linking the standard registers available in Sweden, notably the residence-property addresses they contain and the geographical coordinate setting of these, to map the population as a point coverage. Using standard GIS methods this coverage could be linked, merged or intersected with any other map to create new subsets of population. Representation of populations down to the individual level by automatised spatialisation of available census data is in its simplicity a new informatics method which in the designated GIS medium adds a new power of resolution. RESULTS: We demonstrate this using the radon maps provided by the local communes. The Swedish annual population registration records of 1991 for the county of Ostergötland and the property register available at the Central Statistical Bureau of Sweden formed the main data sources. By coupling the address in the population register to the property register each individual was mapped to the centroid of a property. By intersecting the population coverage with the radon maps, the population living in high, normal or low risk areas was identified and then analysed and stratified by commune, sex and age. The resulting tables can be linked to other database registers, to visualise and analyse geographical and related patterns. The methodology can be adapted for use with any other environmental map or small area. It can also be expanded to the fourth dimension by linking likewise available migration information to generate immediately coordinate-set, accumulated exposition and similar data.

Databases, Factual↗
PubMed1997

Bhorugram (India): revisited. A 4 year follow-up of a computer-based information system for distributed MCH services.

Impact of a health informatics research project on the management and delivery of primary health care, focusing on maternal and child health care (MCH), was reported earlier in 1992, with encouraging results in terms of increased antenatal care coverage and decrease in Immunisation drop-outs. The software (MCHS) was based on essential data sets (EDS) to assist the care providers in information management for MCH care. The site was revisited after four years to evaluate the status of the project and to ascertain whether computers were still in use and was the dispensary staff using the MCHS package or not? The results are presented in this paper to demonstrate that 'information is a difference that makes a difference'. Information generated by the MCHS acted as a catalyst for behavioural change in the community from indifferent users to active users of the health care services. This is reflected by the increased acceptance of antenatal care, 80% fully immunised child (FIC) and participation in other primary health care activities.

Adolescent↗
PubMed1997

Primary care informatics: Bhorugram, India: revisited.

A Primary Health Care Informatics project was initiated in 1990 at Bhorugram, Rajasthan, India. It was reported in MIE91 with initial, encouraging results. The evaluation of the information system has been successful in all operational terms, and the Fully Immunised Child (FIC) could be used as a local cardinal index to monitor and evaluate the quality of care, cost-effectiveness and community participation. Health Systems and Health Economy Research alike have long searched for apt quality and performance markers that in themselves could embrace and express a number of aspects and factors. The FIC index is shown to well meet the criteria of such a cardinal measure in the MCHC services. We, also, demonstrate an implementation strategy for establishing Information Systems in Primary Health Care Centres in Developing countries.

Child↗
PubMed1996

Cardiovascular and metabolic effects of insulin-like growth factor I at rest and during exercise in humans.

To determine whether insulin-like growth factor I (IGF-I) has systemic cardiovascular effects in humans, 60 micrograms/kg IGF-I or saline were injected sc in a cross-over, randomized, double blind fashion into eight healthy male volunteers. Cardiac function and performance were evaluated by echocardiography and exercise test. In parallel, the metabolic effects of IGF-I during exercise were investigated. IGF-I improved cardiac performance with a significant increase in stroke volume and cardiac output by 14% and 18% (P < 0.03 and P < 0.04), respectively. Ejection fraction increased by 9% after IGF-I treatment (P < 0.05). Heart rate was not significantly increased at rest or during exercise. Systolic blood pressure was slightly increased by IGF-I, whereas diastolic blood pressure was slightly decreased, resulting in a continuous increase in the blood pressure amplitude at rest and during exercise, but without reaching statistical significance. Maximal exercise duration and peak oxygen consumption were not changed. Exercise was uneventful, without pathological changes on electrocardiogram records. Glucose levels were unchanged, whereas insulin and C peptide levels were decreased by IGF-I at rest. During exercise, insulin levels were further decreased, and the insulin-sparing effect of exercise resulted in a further enhancement of tissue sensitivity to insulin. GH levels were suppressed by IGF-I treatment at rest, but were still stimulated by exercise. In conclusion, IGF-I has positive inotropic effects in man. Further investigation of the potential role of IGF-I in cardiac conditions such as heart failure appears to be warranted.

Adult↗
PubMed1995

Distance from the Primary Health Center: a GIS method to study geographical access to health care.

Aerial distance from the dependent Primary Health Center is a crude but objective measure of geographical accessibility to Primary Health care facilities. This report describes a method for calculation of distances between the PHC and the population it serves using the data available from the local health authorities and the Swedish Central Statistical Bureau. The Swedish annual population registration records of 1991 and the property register available with the Central Statistical Bureau of Sweden formed the main data sources. By coupling the address in the population register to the property register each individual was mapped to the centroid of a property. The location of the PHCs as well as the areas covered by each were obtained from the local health authorities and mapped. By intersecting the population coverage with the PHC coverage the population for each PHC area was identified. Subsequently the distance to the PHC was calculated for each individual (property centroid). The population maps so generated can be linked to other databases to visualize and analyze the spatial dimension of health and disease. The methodology can be adapted for use with postal code districts, census enumeration tracts, or any other small area.

Adolescent↗
PubMed1994

Primary health care computing analysis of Swedish maternal health records.

In our attempt to develop an "Essential Data Set" for a computer based information system to support Maternal & Child Health Care services an analysis of Swedish maternal care services was undertaken. The present study analyses the information system in the domain of maternal and child health care at the primary health center level with a view to identify areas where a computer-based medical record could effect improvements. The study showed that even in a well organized maternal care service as in Sweden lacunae exist in the information system. The paper forms, called MHV1, MHV2, MHV3 and FV1, though well designed, were incomplete in a large number of the cases. The MHV1 forms were completed in less than 45%, the MHV 2 form in 87.5% and the FV1 form in 70% of the cases. Certain elements of the data set were less likely to be completed than others. Another weak spot was the inaccessibility of the paper records during off-hours. These deficiencies could be eliminated by the use of a computerized medical record based on an essential data set.

Ambulatory Care Information Systems↗
PubMed1990

The effect of three different surface treatments on the tensile strength of the resin bond to nickel-chromium-beryllium alloy.

The effect of three different metal surface treatments on the tensile strength of the resin bond to non-noble nickel-chromium-beryllium alloy was studied by bonding metal to metal. Chemical etching of the metal for 1 hour obtained the highest strength, followed by air-abraded bond specimens. Lowest strength was obtained with the gel-etch method. All resulted in clinically acceptable values.

Acid Etching, Dental↗
PubMed1988

Coronary artery dissection secondary to blunt chest trauma.

A 38-yr-old woman presented with an anterolateral myocardial infarction following blunt chest trauma sustained in a motor vehicle accident. Subsequent cardiac catheterization revealed a large left ventricular aneurysm and angiographic evidence of dissection of the proximal left anterior descending artery. Review of the literature and management are discussed.

Adult↗