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Biomedical subjects

S Nandy

Publications and source records attributed to S Nandy.

17 recordsLinked to original sources
PubMed2002

A patient with optic pathway glioma, scoliosis, Chiari type I malformation and syringomyelia: is it Neurofibromatosis type 1?

A 22 years old girl had features of optic pathway glioma, scoliosis, Chiari type 1 malformation and cervical syringomyelia. She had no cutaneous lesions. We considered this combination to be more than coincidental and argue in favour of considering the case as a variant form of Neurofibromatosis type 1. The relevent literature in favour of our contention has been reviewed.

Adult↗
PubMed2001

What is health? Where GPs' and patients' worlds collide.

Qualitative studies have highlighted the complexity of patient models of health. The present quantitative study aimed to compare general practitioners' (GPs) and patients' models of health. A questionnaire consisting of 27 'markers of health' was completed by 472 patients (response rate 78.8%) and 64 GPs (response rate 71%). The results showed that GPs and patients were comparable in their ratings of those markers relating to arousal, such as sleep, sex drive and energy and infections, such as neck glands and having lots of colds. However, in the main GPs and patients were consistently different. In particular, the patients showed a higher rating for those markers relating to digestion (e.g. appetite, bloatedness), bodily fluids (e.g. the colour and smell of urine, regularity of bowels), the condition of the tongue, hair and complexion and for more traditional medical markers (e.g. heart beat, body weight). In contrast, GPs reported higher ratings for mood and emotions. To conclude, patients appeared to hold much more diverse models of health than GPs and reported greater endorsement for markers consistent with both a humoral and medical approach to health. These results suggest that GPs and patients do not have a shared understanding of health, which has implications for the effectiveness of primary care consultations.

Adult↗
PubMed2001

Sertraline treatment of generalized social phobia: a 20-week, double-blind, placebo-controlled study.

OBJECTIVE: The authors evaluated the efficacy, safety, and tolerability of sertraline, a selective serotonin reuptake inhibitor, in the treatment of generalized social phobia. METHOD: Adult outpatients with generalized social phobia (N=204) from 10 Canadian centers were randomly assigned to receive sertraline or placebo in a 2:1 ratio for a 20-week double-blind study following a 1-week, single-blind, placebo run-in. The initial dose of sertraline was 50 mg/day with increases of 50 mg/day every 3 weeks permitted after the fourth week of treatment (dosing was flexible up to a maximum of 200 mg/day). Primary efficacy assessments were the percentage of patients rated much or very much improved on the Clinical Global Impression (CGI) improvement item and the mean changes from baseline to study endpoint in total score on the social phobia subscale of the Marks Fear Questionnaire and total score on the Brief Social Phobia Scale. RESULTS: In intent-to-treat endpoint analyses of 203 of the patients, significantly more of the 134 patients given sertraline (N=71 [53%]) than of the 69 patients receiving placebo (N=20 [29%]) were considered responders according to their CGI improvement scores at the end of treatment. The mean reductions in the social phobia subscale of the Marks Fear Questionnaire and in the total score on the Brief Social Phobia Scale were 32.6% and 34.3% in the sertraline group and 10.8% and 18.6% in the placebo group, respectively. Analysis of covariance showed superiority of sertraline over placebo on all primary and secondary efficacy measures. Sertraline was well tolerated: 103 (76%) of the 135 sertraline-treated patients and 54 (78%) of the 69 placebo-treated patients completed the study. CONCLUSIONS: Sertraline is an effective treatment for patients with generalized social phobia.

Adult↗
PubMed2001

Referral for minor mental illness: a qualitative study.

BACKGROUND: Mild depression and anxiety are common problems in general practice. They can be managed by the general practitioner (GP) alone or referred. Previous quantitative studies have shown a large variation between GPs in terms of referral behaviour. The reasons for this variation are not fully understood. AIM: To describe and analyse GP's decision-making processes when considering who should be treating patients with minor mental illness, using a qualitative method. DESIGN OF STUDY: A qualitative interview study. SETTING: Twenty-three GPs in east London and Essex. METHOD: Subjects were chosen using a purposive sampling strategy and participated in one-to-one semi-structured interviews. A grounded theory approach was used for analysis. RESULTS: Two distinct referral strategies were identified--the 'containment' and the 'conduit' approaches. In addition, referrals were found to be of two types--proactive 'referrals to' and reactive 'referrals away'; for minor mental illness the 'referrals away' were found to predominate. Emotive as well as rational responses informed GP decision making on referral. CONCLUSIONS: Explanations of the variation in referral rates need to recognise the emotive responses of individual GPs to minor mental illness. The contribution of guidelines, which assume consistently rational responses to illness, may therefore be limited.

Adult↗
PubMed2000

Prevention of relapse in generalized social phobia: results of a 24-week study in responders to 20 weeks of sertraline treatment.

The aim of this study was to evaluate the efficacy, tolerability, and effects on quality of life of sertraline, a selective serotonin reuptake inhibitor, in the prevention of relapse of generalized social phobia. Fifty adult outpatients with generalized social phobia who were rated much or very much improved on the Clinical Global Impression Scale of Improvement (CGI-I) after 20 weeks of sertraline treatment (50-200 mg/day) were randomly assigned in a one-to-one ratio to either continue double-blind treatment with sertraline or immediately switch to placebo for another 24 weeks. The initial 20-week study was placebo-controlled, and 15 responders to placebo also continued to receive double-blind placebo treatment in the continuation study. Eighty-eight percent of patients in the sertraline-continuation group and only 40% of patients in the placebo-switch and placebo-responder groups completed the study. In intent-to-treat endpoint analyses, 1 (4%) of 25 patients in the sertraline-continuation group and 9 (36%) of 25 patients in the placebo-switch group had relapsed at study endpoint (chi2 = 8.0, Fisher exact test, p = 0.01). The relative risk (hazards ratio) for relapse associated with placebo-switch relative to sertraline-continuation treatment was 10.2 (95% confidence interval, 1.3-80.7). Mean CGI-Severity, Marks Fear Questionnaire (MFQ) Social Phobia subscale, and Duke Brief Social Phobia Scale (BSPS) total scores were reduced by 0.07, 0.34, and 1.86 in the Sertraline-Continuation group and increased by 0.88, 4.09, and 5.99 in the Placebo-Switch group (all F > 5.3, p < 0.03), respectively. CGI-Severity, MFQ Social Phobia subscale, and BSPS scores also increased in the Placebo-Responder group. Discontinuations because of lack of efficacy were 4% in the sertraline-continuation group, 28% in the placebo-switch group (chi2 = 5.36, Fisher exact test, p = 0.049), relative to sertraline, and 27% in the placebo-responder group. Sertraline was effective in preventing relapse of generalized social phobia. Future research should assess whether improvements may be maintained or further increased by longer periods of treatment or through the addition of cognitive-behavioral techniques.

Adult↗
PubMed1988

Measurement of wall shear stress distal to a tri-leaflet valve in a rigid model of the aortic arch with branch flows.

Flush mounted hot film anemometer probes were used to measure wall shear stress magnitudes on the inside and outside walls of a rigid model of the human aortic arch. The effects of the presence of an Ionescu-Shiley tri-leaflet bioprosthetic heart valve at the entrance of the aortic arch and the side flows through arteries located in the mid-arch region on wall shear stress magnitudes were determined. It was found that the presence of the tri-leaflet valve leads to an elevation of wall shear stress (relative to the same flow without a valve) over the entire aortic arch region by as much as 50 percent. The valve influence extended to about 180 deg from the entrance to the aorta on the inside wall and even further on the outside wall based on extrapolation of available data. Peak wall shear stress magnitudes measured on the outside wall were in the range of 1.5-4.0 N/m2 (15-40 dynes/cm2) over the length of the aortic arch and took on their highest values in the mid-arch region. Inside wall values were of comparable magnitude. It was observed that the presence of the aortic valve and side flow from the top of the aortic arch reduced wall shear stress reversal in the arch region.

Aorta, Thoracic↗
PubMed1987

Flush mounted hot film anemometer measurement of wall shear stress distal to a tri-leaflet valve for Newtonian and non-Newtonian blood analog fluids.

Wall shear stress has been measured by flush-mounted hot film anemometry distal to an Ionescu-Shiley tri-leaflet valve under pulsatile flow conditions. Both Newtonian (aqueous glycerol) and non-Newtonian (aqueous polyacrylamide) blood analog fluids were investigated. Significant differences in the axial distribution of wall shear stress between the two fluids are apparent in flows having nearly identical Reynolds numbers. The Newtonian fluid exhibits a (peak) wall shear rate which is maximized near the valve seat (30 mm) and then decays to a fully developed flow value (by 106 mm). In contrast, the shear rate of the non-Newtonian fluid at 30 mm is less than half that of the Newtonian fluid and at 106 mm is more than twice that of the Newtonian fluid. It is suggested that non-Newtonian rheology influences valve flow patterns either through alterations in valve opening associated with low shear separation zones behind valve leaflets, or because of variations in the rate of jet spreading. More detailed studies are required to clarify the mechanisms. The Newtonian wall shear stresses for this valve are low. The highest value observed anywhere in the aortic chamber was 2.85 N/m2 at a peak Reynolds number of 3694.

Aortic Valve↗
PubMed1986

Flush-mounted hot film anemometer accuracy in pulsatile flow.

The accuracy of a flush-mounted hot film anemometer probe for wall shear stress measurements in physiological pulsatile flows was evaluated in fully developed pulsatile flow in a rigid straight tube. Measured wall shear stress waveform based on steady flow anemometer probe calibrations were compared to theoretical wall shear stress waveforms based on well-established theory and measured flow rate waveforms. The measured and theoretical waveforms were in close agreement during systole (average deviation of 14 percent at peak systole). As expected, agreement was poor during diastole because of flow reversal and diminished frequency response at low shear rate.

Blood Circulation↗
PubMed1986

Department of the Environment (DOE) household projections.

"This article briefly describes the basis of the method of household projections developed by the Department of the Environment and touches on some of the problems and shortcomings." The projections concern England and Wales only.

Developed Countries↗
PubMed1983

Effects of centrophenoxine on lipofuscin in the retinal pigment epithelium of old mice.

The effects of centrophenoxine on the retinal pigment epithelium (RPE) of 17 month old female mice have been studied. Animals were injected subcutaneously for 3 months (60 injections) with the drug (0.1 mg/g of body wt) daily in 0.1 M phosphate buffered saline at pH 7.0. The morphological changes in the pigment layers of the retina of both eyes were studied by light and electron microscopy and the lipofuscin pigment was demonstrated by its autofluorescence and ultrastructural characteristics. There was a significant reduction of the lipofuscin pigment in the treated animals, but the melanin pigment remained unchanged. The lipofuscin granules also appeared less osmiophilic and showed a greater preponderance of membranes and vacuoles. Although the precise mechanism of action of the drug is not clear, an increased protective function of the pigment epithelium by the drug has been suggested.

Aging↗
PubMed1981

A profile of the child psychiatric population of Newfoundland.

At all referrals during the year 1977 to the only child psychiatric facility in the Province of Newfoundland and Labrador were investigated on a number of variables. Two hundred and two children were referred. This was considered a very low rate of referrals. Distance of the child's residence beyond the range of 50 kilometres from the unit was negatively associated to referrals. Lack of parental employment was not associated with increased rate of referrals. Children from the outlying regions of the Province were unlikely to come from broken families. Academic failure was common among those referred. Few differences were observed in the clinical diagnoses between those referred from the Avalon Peninsula and the regions lying further away. As compared to another Canadian province, Ontario, (Ottawa-Carleton region) (2), fewer aggressive children were referred in Newfoundland. Some implications of these findings for the practice of child psychiatry in the Province were discussed.

Adolescent↗
PubMedDate not supplied

Analytical studies on the impact of land reclamation on ground water flow.

Land reclamation has been a common practice to produce valuable land in coastal areas. The impact of land reclamation on coastal environment and marine ecology is well recognized and widely studied. It has not been recognized yet that reclamation may change the regional ground water regime, which may in turn modify the coastal environment, flooding pattern, and stability of slopes and foundations. This paper represents the first attempt to examine quantitatively the effect of reclamation on ground water levels. Analytical solutions are developed to study the ground water change in response to reclamation based on two hypothetical models. In the first model, the ground water flow regime changes only in the hillside around the reclamation areas. In the second model, the ground water regime changes in the entire hill. Both models assume that the ground water flow is in a steady state and satisfies the Dupuit assumptions. Hypothetical examples are used to demonstrate how the ground water level, ground water divide and ground water submarine discharge will change with the scale and hydraulic conductivity of the reclamation materials. The results show that the change of ground water regime depends mainly on the length of the reclaimed area and the values of hydraulic conductivity of the reclaimed materials. It is also seen that the reclamation may impact not only the ground water regime near the coast areas around the reclamation site, but also that in the coast areas opposite the reclamation area. A reclamation site near Tseung Kwan O in the New Territories in Hong Kong, China, is used as a case study to discuss the possible modification of the ground water system caused by reclamation.

Conservation of Natural Resources↗
PubMedDate not supplied

Missed opportunities for immunisation in children.

All opportunities for immunisation in children should be utilised properly, as sustaining high levels of full immunisation coverage is essential to meet the goal of eradication of poliomyelitis as well as control the other vaccine-preventable diseases; yet many opportunities for immunisation are missed in all types of health facilities, even in teaching hospitals. Reducing such missed opportunities is the cheapest way to increase immunisation coverage. The present study discusses the problem of missed opportunities for immunisation in children in Paediatric Outpatient Department and Immunisation Clinic of R.G. Kar Medical and Hospital, Calcutta and the underlying factors of the problem. Prevalence of missed opportunities in Paediatric OPD and Immunisation clinic was 37.8% and 1.4% respectively. Most of the missed opportunities were attributed to health care providers and delivery system of health care of the studied hospital.

Child, Preschool↗
PubMedDate not supplied

Status of maternal and new born care at first referral units in the state of West Bengal.

A study was conducted in 12 First Referral Units (FRUs), selected through multistage sampling, from 6 districts of West Bengal. Infrastructure facilities, record keeping, referral system and MCH indicators related to newborn care were documented. Data was collected by review of records, interview and observation using a pre-designed proforma. Inadequate infrastructure facilities (e.g. no sanctioned posts of specialists, no blood bank at rural hospitals declared as First Referral Units etc.); poor utilization of equipment like neonatal resuscitation sets, radiant warmer etc, lack of training of the service providers were evident. Records/registers were available but incomplete. Referral system was found to be almost nonexistent. Most of the deliveries (86.1%) were normal delivery. Deliveries (87.71%) and immediate neonatal resuscitation (94.9%) were done mostly by nursing personnel. Institution based maternal, perinatal and early neonatal mortality rates were found to be 5.6, 62.4 and 25.2 per 1000 live births respectively. Eclampsia (48.9%), hemorrhage (17.7%), puerperal sepsis (7.1%) were reported to be major causes of maternal mortality. Common causes of early neonatal mortality were birth asphyxia (54.3%), sepsis (14.6%) and prematurity/LBW (12.4%).

Documentation↗
PubMedDate not supplied

Utilisation pattern of blood in a teaching hospital of Kolkata.

An annual utilisation of blood transfusion services at several depts. of R.G. Kar Medical College and Hospital, Kolkata were assessed among a sample of 3122 patients selected by Systematic Random Sampling Technique from the register made available in the blood bank there. Record analysis revealed that overall 79.4% of supplied blood units were actually transfused, wastage of 21.6%. Wastage was maximum in the Department of Gynae & Obstetrics (33.11%) and Surgery (32.87%). Only single unit of blood was requisitioned and transfused for 5.44% & 30.90% of the patients respectively. Most common indications of blood transfusion were for surgical cases (37.92%), followed by anaemia (34.80%) and haemorrhage (26.92%). The use of blood and blood products merit attention, appraisal and instructional guiding accordingly.

Anemia↗