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Biomedical subjects

S Tewari

Publications and source records attributed to S Tewari.

At least 19 recordsLinked to original sources
PubMed2005

TNFR2 gene polymorphism in coronary artery disease.

BACKGROUND: Recently atherosclerosis and coronary artery disease (CAD) are considered to be inflammatory diseases. The genetic polymorphism in inflammatory markers has been well studied and found to be associated with development of CAD. AIM: To study the association of biallelic polymorphism at position 196 in exon 6 of tumor necrosis factor 2 (TNFR2) gene and coronary artery disease. SETTINGS AND DESIGN: The study design was a prospective case control study conducted at a tertiary referral center mainly catering to the north Indian population. MATERIALS AND METHODS: One hundred and fifty angiographically proven patients with coronary artery disease and one hundred and fifty age matched controls were genotyped for TNFR2 gene by polymerase chain reaction followed by analysis of restriction fragment length polymorphism. STATISTICAL ANALYSIS: Genotype frequencies were compared in patients and controls by Chi-square test. Binary logistic regression analysis was used to examine the relationship between genotypes and disease, incorporating other variables into the model. RESULTS: The incidence of CAD in those with MM genotype was 65% and in those with RM genotype was 42%. Genotype frequency shows significant association of MM genotype with development of CAD (P < 0.001; odds ratio-2.585; 95% confidence interval 1.533-4.359). The association of TNFR2 genotype with CAD persisted on logistic regression analysis. CONCLUSION: MM genotype of TNFR2 gene is associated with development of CAD and RM genotype appears to be protective.

Adolescent↗
PubMed2004

T1 and M1 polymorphism in glutathione S-transferase gene and coronary artery disease in North Indian population.

BACKGROUND: DNA damage has been found to play an important role in atherosclerosis and coronary artery disease. Genetic polymorphisms of the genes coding for enzymes involved in the metabolism of genotoxins result in different phenotypes with respect to their ability to detoxify these agents. In the present study the contribution of the polymorphism in the glutathione S-transferase gene to the development of coronary artery disease has been investigated. METHODS: One hundred and ninety seven angiographically proven patients with coronary artery disease and one hundred and ninety eight age-matched controls were genotyped for glutathione S- transferase polymorphism by polymerase chain reaction. Genotype frequencies were compared in patients and controls by Chi-square test. Binary logistic regression was used to examine the relationship between genotype and disease, incorporating other variables into the model. RESULTS: GSTT1 null genotype was significantly decreased in patients with coronary artery disease. No significant association was found with GSTM1 genotypes. No such association was seen with smokers. CONCLUSION: Null genotype of GSTT1 is protective against coronary artery disease in our population.

Adult↗
PubMed2003

Cold chain monitoring of OPV at transit levels in India: correlation of VVM and potency status.

We have conducted a study to analyze monitoring of the cold chain of 674 OPV field samples collected at four different levels of vaccine distribution viz., immunization clinics, district stores, hospitals and Primary Health Centers (PHC) from states of Uttar Pradesh, Madhya Pradesh, and Delhi. The study design included: collection and scoring of vaccine vial monitor (VVM) status of the samples and testing for total oral polio virus concentration (TOPV) by standard WHO protocol. Ten samples each were exposed to 25 degrees C and 37 degrees C, and 10 samples as controls were kept at -20 degrees C. VVM were scored daily till they attained grade 4 and each sample was subsequently subjected to potency testing for individual polio serotypes 1, 2 and 3, and TOPV. Of the 674 samples tested it was observed that: samples from immunization clinics and district stores had an acceptable VVM score of grade 1 and 2; however the probable risk that a sub potent vaccine could have been administered was 2.15%. In 2.5% samples received from district stores vaccine had a VVM score of grade 3 (i.e., discard point), although vaccine when tested was found to be potent (i.e., leading to the vaccine wastage). With exposure to higher temperatures, VVM changed score to grade 2 and 3 when the vaccine was kept at 25 degrees C/37 degrees C, and the titres of individual serotypes 1, 2 and 3 and TOPV were beyond the acceptable limits. Important observations at the different levels of vaccine distribution network and correlation of VVM and potency status of OPV are discussed in the paper which will be of help to the EPI program managers at different transit levels.

Cold Temperature↗
PubMed2003

Absence of factor V Leiden (G1691A) mutation, FII G20210A allele in coronary artery disease in North India.

BACKGROUND: Interaction between various genetic and environmental factors is associated with coronary artery diseases (CADs). Factor V Leiden mutation (FVL) and FII G20210A polymorphism are two recently described genetic factors with a propensity towards venous thrombosis, however, with a doubtful role in coronary artery disease and myocardial infarction. AIM: Present study was conducted to assess the relationship of both these factors in coronary artery disease in population from North India. SETTING AND DESIGN: Case control study. MATERIAL AND METHODS: Two hundred angiographically proven coronary artery disease patients were studied to examine the association of Factor V Leiden mutation and FII G20210A mutation with coronary artery disease and myocardial infarction. Out of 200 patients, 51 had myocardial infarction. Two hundred controls were selected who were from north India and were also age and sex matched. RESULTS AND CONCLUSIONS: Our results indicate that both these polymorphisms were totally absent in our population, therefore, these variants cannot be considered as independent risk factors or as a predictor for CAD. However, there is a need to confirm the above findings on patients from different populations from different parts of the country as there are reports which show that the incidence of Factor V Leiden varies from 1.3 % to 10%.

Adult↗
PubMed2001

A study of consecutive autopsies in a medical ICU : a comparison of clinical cause of death and autopsy diagnosis.

OBJECTIVE: To determine the degree of concordance between clinical cause of death and autopsy diagnosis in a medical ICU (MICU) setting. DESIGN: Retrospective medical chart and autopsy report review. SETTING: MICU in a tertiary referral hospital. PATIENTS: Consecutive admissions to an MICU over a 2-year period from January 1, 1994, to December 31, 1995. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: One thousand eight hundred patients were admitted to the MICU during the study period. There were 401 in-ICU deaths (22.3%). The autopsy rate was 22.7% (91 of 401). The mean +/- SD age of the autopsied patients (55.1 +/- 13.5 years) was lower than those without autopsy (62.4 +/- 15.2 years; p < 0.001). The two groups were otherwise similar with regard to sex, race, APACHE (acute physiology and chronic health evaluation) III scores, and lengths of stay in the MICU and hospital. The discordance between clinical and postmortem diagnoses was 19.8% (95% confidence interval, 12 to 29%). There were no differences in age, sex, APACHE III scores, predicted mortality, and lengths of stay in MICU hospital between patients with concordant and discordant diagnoses. In 44.4% (8 of 18) of the discordant cases, management would have been modified had the autopsied diagnosis been made premortem. Seven of the autopsied patients had organ transplantation. Three of the patients who had organ transplantation had discordant diagnoses, including two patients with disseminated fungal infection that was not diagnosed clinically. Although the observed discordance in transplant patients (43%) was higher than in those without transplant (19%), the difference was not statistically significant (p = 0.15). CONCLUSION: Younger patients tended to have a higher autopsy rate than older patients. The discordance between the clinical cause of death and postmortem diagnosis was 19.8%. In 44.4% of the discordant cases, knowledge of the correct diagnosis would have altered therapy.

APACHE↗
PubMed2001

Beneficial effects of nicorandil versus enalapril in chronic rheumatic severe mitral regurgitation: six months follow up echocardiographic study.

BACKGROUND AND AIM OF THE STUDY: It is possible that vasodilator therapy may retard left ventricular (LV) dilatation and functional deterioration in chronic mitral regurgitation (MR). The study objectives were to evaluate comparatively the efficacy of nicorandil (a new, balanced vasodilator) and enalapril therapy on LV volume, mass and function in mildly symptomatic, chronic rheumatic severe MR. METHODS: Eighty-seven mildly symptomatic rheumatic patients with severe MR were enrolled in this prospective, randomized study. All patients underwent serial echocardiography study at entry, and again at six months. Eighty patients completed the study. RESULTS: At six months, the nicorandil and enalapril patient groups each had a significant reduction in LV end-systolic volume index (57.4 +/- 24.8 versus 43.2 +/- 20.7 ml/m2, p = 0.003; 50.0 +/- 19.0 versus 40.4 +/- 14.2 ml/m2, p = 0.006, respectively) and LV mass index (218.0 +/- 88.0 versus 188.0 +/- 76.0 g/m2, p = 0.05; 217.2 +/- 48.0 versus 186.2 +/- 45.0 g/m2, p = 0.002 respectively). Both nicorandil and enalapril caused significant improvement in ejection fraction (63.8 +/- 7.0 versus 71.0 +/- 6.7%, p <0.0001; 63.2 +/- 6.9 versus 67.5 +/- 6.4%, p = 0.002, respectively) and a reduction in LV end-systolic stress (152.9 +/- 29.0 versus 126.0 +/- 25.0 dyne/cm2, p = 0.001; 150.0 +/- 30.2 versus 138.0 +/- 29.0 dyne/cm2, p = 0.002, respectively). However, nicorandil caused a greater reduction in absolute LV end-systolic volume index (13.3 +/- 10.1 versus 9.6 +/- 5.9 ml/m2, p = 0.02), and a greater improvement in absolute ejection fraction (7.2 +/- 4.7 versus 4.2 +/- 2.6%, p = 0.0005) than enalapril. CONCLUSION: It is concluded that nicorandil is equivalent to enalapril in improving LV volume, mass, end-systolic stress and ejection fraction in mildly symptomatic chronic rheumatic severe mitral regurgitation over a period of six months.

Adolescent↗
PubMed2001

Caries experience in 3-7 year-old children in Haryana (India).

A study was carried out to know the prevalence of dental caries in 509 primary school children in the age group of 3-7 years. The mean prevalence of caries in all the age group from 3 to 6 year was 33.8% while the prevalence 6 years was 38.2%. It was seen that prevalence was significantly higher (P < 0.05) at the age of 6 years (dmft = 0.91 SD = 1.40) as compared to 3 years (dmft = 0.41 SD = 1.16). Deciduous molars were most affected by caries and prevalence of restored teeth was 1.2%. The difference between males and females was statistically significant and the mean dmft per child was found to be 0.73 and mean dmft per affected child was 2.37. Assessment regarding oral hygiene habits depicted that only 3% of children cleaned their teeth once a day with tooth brush and tooth paste.

Chi-Square Distribution↗
PubMed2000

Primary congenital anomalies of the coronary arteries: a coronary: arteriographic study.

Geographic variations in the incidence of different congenital coronary anomalies are well known, but infrequently studied in the Indian population. Among 4,100 adult patients who underwent diagnostic coronary arteriography, 39 (0.95%) patients (34 males, 5 females) had one or more anomalous coronary arteries. Their mean age was 46.4 +/- 8.2 years (range, 26-68 years). Thirty-five (89.74%) had anomalies of origin and distribution, while the remaining four (10.25%) had coronary artery fistulae. Right coronary artery was the commonest anomalous vessel, involved in 19 (48.74%) patients. It was originating from the left sinus of Valsalva in 15 and from the non-facing aortic sinus in four patients. Anomalous left circumflex artery was the second commonest anomaly, seen in 14 (35.89%) patients. Anomalous left anterior descending artery and anomalous left coronary artery from pulmonary artery were seen in one patient each. Among patients with coronary fistulae, two had fistulae between the left anterior descending artery and the main pulmonary artery, one between the conal artery and the right atrium, while the fourth patient had fistulae from the right coronary as well as from the left anterior descending artery to the left atrium. Atherosclerotic plaques in the anomalous arteries were seen in only 13 (33.33%) patients, much less than the overall incidence of coronary artery disease in patients with congenital coronary anomalies in this series (66.66%). In four (10.25%) patients, only the anomalous vessels were involved in coronary artery disease. Thus, in a small subgroup there does not appear to be an increased risk for development of atherosclerotic coronary artery disease in anomalous coronary arteries. Recognition of coronary anomalies is important in patients undergoing coronary arteriography, coronary interventions and cardiac surgery. Variations in the frequency of primary congenital coronary anomalies may possibly have a genetic background.

Adult↗
PubMed2000

Comparative study of antioxidant potential of tea with and without additives.

Oxidative damage is one of the many mechanism leading to chronic diseases. Therefore interest is growing in the protection afforded by antioxidant nutrients against free radical reactions. More recently, the attention has shifted to polyphenols. Polyphenols are secondary plant metabolites occurring widely in plant food. They possess outstanding antioxidant properties, suggesting a possible protective role in man. Tea (Camellia sinensis) is a widely consumed beverage throughout the world containing polyphenols more than 35% of its dry weight. In the present work we have investigated the effect of tea without milk, tea with milk and lemon tea on the serum lipid peroxidation level (as a parameter of free radical generation). The results show that there were significant decrease in serum lipid peroxidation (Malonaldehyde) level half hour after ingestion of lemon tea and tea without milk which tends to normalize with increase in time. This decrease is much significant in case of lemon tea than tea without milk after half hour or one hour. Hence the interpretation is, tea without milk is a good source of antioxidant and addition of lemon to tea increases its antioxidant potential.

Adult↗
PubMed1999

Statistics of shear-induced rearrangements in a two-dimensional model foam.

Under steady shear, a foam relaxes stress through intermittent rearrangements of bubbles accompanied by sudden drops in the stored elastic energy. We use a simple model of foam that incorporates both elasticity and dissipation to study the statistics of bubble rearrangements in terms of energy drops, the number of nearest neighbor changes, and the rate of neighbor-switching (T1) events. We do this for a two-dimensional system as a function of system size, shear rate, dissipation mechanism, and gas area fraction. We find that for dry foams, there is a well-defined quasistatic limit at low shear rates where localized rearrangements occur at a constant rate per unit strain, independent of both system size and dissipation mechanism. These results are in good qualitative agreement with experiments on two-dimensional and three-dimensional foams. In contrast, we find for progessively wetter foams that the event size distribution broadens into a power law that is cut off only by system size. This is consistent with criticality at the melting transition.

Journal Article↗
PubMed1997

Nonpulmonary medical complications in the intermediate and long-term survivor.

This article deals with the nonpulmonary, non-infectious complications in intermediate and long-term survivors of lung transplantation. Although they are an infrequent cause of mortality, these disorders can cause significant morbidity in this population. Diseases associated with the gamut of medications used post-transplant are specifically discussed, as are diseases caused by the direct immunosuppressive action of some of these drugs. General care of transplant patients also entails attention to their underlying diseases, and to routine medical considerations common to all patients.

Bone Diseases↗
PubMed1997

Study of pulmonary functions in swimmers of Lucknow city.

In this study, the pulmonary functions of young swimmers of K.D. Singh Babu Stadium, Lucknow were studied, 20 swimmers of the age group of 15-20 years were chosen along with 15 students as controls. The parameters taken into account were Forced Vital Capacity (FVC), Forced Expiratory Volume (FEV1) and Peak Expiratory Flow Rate (PEFR). Two sets of readings were recorded. One before the start and the other at the end of the practice season. These readings were compared to each other and also with the values of the controls. The results indicate that swimming has considerable effect on enhancing lung functions of an individual as FVC, FEV1, PEFR were significantly raised in swimmers after swimming session. Such results suggest that swimming may be induced in the exercise programme for rehabilitation of respiratory patients who have compromised lung functions.

Adolescent↗
PubMed1997

Role of low dose aspirin in prevention of pregnancy induced hypertension.

In a prospective randomised clinical study 50 primi or multigravidae with history of essential hypertension or pregnancy induced hypertension (PIH) in previous pregnancy were selected from antenatal clinics, on the basis of positive roll over test (ROT) carried out between 28 to 30 weeks of pregnancy. The study group comprised 25 women who received 50 mg aspirin daily from day of positive ROT till 37 weeks of pregnancy. Other 25 women served as control. The incidence of PIH in study and control group was 4% versus 28% and that of pre-term birth was 4% versus 24%. The mean birth weight of newborns in the two groups was 3.04 +/- 0.38 kg and 2.71 +/- 0.48 kg respectively. All these differences were statistically significant. No adverse maternal or neonatal complication due to aspirin was observed.

Adult↗