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Biomedical subjects

G K Singh

Publications and source records attributed to G K Singh.

At least 19 recordsLinked to original sources
PubMed1996

Preconceptional and prenatal multivitamin-mineral supplement use in the 1988 National Maternal and Infant Health Survey.

This paper examines the prevalence of multivitamin-mineral supplement use before and during pregnancy, as well as predictors of nonuse, in 9953 women who delivered live infants in the 1988 National Maternal and Infant Health Survey. Ninety-seven percent of the women were advised to take multivitamin-mineral supplements in prenatal care. Sixty-seven percent of Black mothers took supplements during pregnancy, as compared with 84% of White mothers. Multivariate analysis revealed that Black mothers; mothers who are less educated, younger, unmarried, and non-smokers; and mothers who participate in Women, Infants, and Children programs are at elevated risk for nonuse. These data help identify groups in need of supplementation guidance.

Adult↗
PubMed1996

US childhood mortality, 1950 through 1993: Trends and socioeconomic diffferentials.

OBJECTIVES: This study examined trends and differentials in US childhood mortality from 1950 through 1993 according to sex, race/ethnicity, education, family income, and cause of death. METHODS: Log-linear, multiple regression, and Cox proportional hazards regression models were applied to the data from the National Vital Statistics System, the National Longitudinal Mortality Study, and the Area Resource File. RESULTS: Substantial declines in US childhood mortality have occurred in the past 4 decades, primarily due to decreases in mortality from unintentional injuries, cancer, pneumonia and influenza, and congenital anomalies. The overall declining trend, however, has been dampened by a twofold to threefold increase in the suicide and homicide rates among children since 1968. Male, Black, American Indian, Hawaiian, and Puerto Rican children and those in the lower socioeconomic strata were at an increased risk of death. CONCLUSIONS: Increasing trends in mortality from violence, firearm injuries, and human immunodeficiency virus/acquired immunodeficiency syndrome pose a major obstacle to continued declines in US childhood mortality. Reducing socioeconomic disparities and improving access to and use of health care may bring about further declines in overall and injury-related childhood mortality.

Adolescent↗
PubMed1996

Trends and differentials in adolescent and young adult mortality in the United States, 1950 through 1993.

Using data from the National Vital Statistics System and the National Longitudinal Mortality Study, this study examined mortality trends and differentials from 1950 through 1993 among US adolescents and young adults according to sex, race/ethnicity, education, family income, marital status, and cause of dealth. No appreciable reduction in youth mortality has occurred, especially among men. Declines in youth mortality from accidents have been nearly ofset by increases in death rates from homicide, suicide, and firearm injuries. American Indians, Blacks, males, and those with least education and income were at increased risk of both overall and injury-specific youth mortality.

Adolescent↗
PubMed1996

Adverse pregnancy outcomes: differences between US- and foreign-born women in major US racial and ethnic groups.

OBJECTIVES: This study examined whether there were significant differentials between US-born and foreign-born women in risks of infant mortality, low birthweight, and preterm birth and whether these differentials, if they existed, varied across major US racial/ethnic groups. METHODS: Multivariate logistic regression was applied to national linked birth/infant death records for 1985 through 1987 to estimate overall and ethnic-specific maternal nativity effects on pregnancy outcomes. RESULTS: Substantial maternal nativity differences in risks of infant mortality and low birthweight were found, with the magnitude of the nativity effect varying significantly across racial/ethnic groups. Overall, foreign-born status was associated with 7% and 20% lower risks of low birthweight and infant mortality, respectively. However, the reduced risk of adverse pregnancy outcome associated with immigrant status tended to be substantially larger for Blacks, Cubans, Mexicans, and Chinese than for other ethnic groups. CONCLUSIONS: Maternal nativity status, along with ethnicity, may serve as an important axis of differentiation in birth outcome studies. Further research needs to be conducted to assess the effects of behavioral, cultural, and psychosocial factors in explaining the nativity differentials observed here.

Birth Certificates↗
PubMed1996

Perinatal mortality in urban slums in Lucknow.

OBJECTIVES: To determine the perinatal mortality rate (PNMR) in the urban slums of Lucknow DESIGN: Cross-sectional survey. SETTING: Twenty five Anganwadi centres of urban Lucknow, with a population of 25,901. METHODS: Data was collected on birth and early neonatal deaths, gestational age of the neonate (determined at birth) and maternal variables like socio-economic status, maternal age, parity, and bad obstetrical history from January 1992 to March 1993. RESULTS: There were 966 births with a still-birth rate of 37.2 and PNMR of 59.0 per 1000. The relative risk of perinatal mortality with lower socio-economic status was 1.87, bad obstetrical history 2.18, and gestational age < 37 weeks 1.95. CONCLUSIONS: Further reduction in PNMR may be possible with focussed medical services to women of low socio-economic status having bad obstetrical history and those delivering before term.

Cross-Sectional Studies↗
PubMed1995

Validation of right ventricular volume measurements by magnetic resonance imaging in small hearts using a fetal lamb model.

RATIONALE AND OBJECTIVES: Cine-magnetic resonance (MR) imaging is established as an accurate method of determining cardiac ventricular volumes in adults but has not been validated for the smaller ventricular volumes found in infants. The purpose of the authors study was to evaluate the accuracy and reproducibility of MR imaging to measure small ventricle volumes. METHODS: The volume of silicone-rubber casts of the right ventricle of 11 fetal lamb hearts was measured by MR imaging using different imaging planes and slice section thicknesses and by water displacement. RESULTS: The ventricle volumes of the 11 hearts ranged from 0.45 to 3.00 mL. Accurate and reproducible values for the right ventricle volumes were obtained by MR imaging. Thin sections (3 mm) in the axial plane produced the best results. CONCLUSIONS: Based on studies in the nonmoving heart, MR imaging can accurately measure the small ventricular volumes expected in infants.

Animals↗
PubMed1995

Infant mortality in the United States: trends, differentials, and projections, 1950 through 2010.

OBJECTIVES: This study examined long-term trends and differences in infant mortality in the United States from 1950 through 1991 according to race and ethnicity, education, family income, and cause of death. Forecasts are made through the year 2010. METHODS: Log-linear regression models were applied to data from the National Vital Statistics System, National Linked Birth and Infant Death files, the National Maternal and Infant Health Survey, the National Natality Survey, and the National Infant Mortality Survey to model and forecast infant mortality. RESULTS: Dramatic declines in the US infant mortality rate have occurred in the past 4 decades, largely as a result of declines in mortality from pneumonia and influenza, respiratory distress syndrome, prematurity and low birthweight, congenital anomalies, and accidents. Despite the overall reductions, however, substantial racial/ethnic, educational, and income differences in infant mortality still exist. CONCLUSIONS: The long-term downward trend in US infant mortality has not benefited Blacks and Whites equally. The Black/White disparity in infant mortality has not only persisted but increased over time and is not expected to diminish in the near future. Educational inequalities have also widened, and racial disparities have generally increased across all educational levels.

Adult↗
PubMed1995

Annual summary of vital statistics-1994.

Recent trends in the vital statistics of the United States continued in 1994, including decreases in the number of births, the birth rate, the age-adjusted death rate, and the infant mortality rate. Life expectancy increased slightly to 75.7 years. Only marriages reversed the recent trend with a slight increase in 1994. An estimated 3,979,000 infants were born during 1994, a decline of < 1% from 1993. The birth rate was 15.3 live births per 1000 population, a 1% decline. These decreasing rates reflect a decline in the fertility rate to 67.1 live births per 1000 women aged 15 to 44 years. Final figures for 1993 indicate that fertility rates declined for all racial groups, by 1% for white women (to 65.4) and 3% for black women (to 80.5). The fertility rate for Hispanic women (106.9) was 84% higher than that for non-Hispanic white women and 31% higher than for non-Hispanic black women. Between 1991 and 1993, birth rates for teenage mothers remained virtually unchanged, and abortion rates have steadily declined, suggesting that teenage pregnancy rates are levelling off. The number and proportion of births to women over age 30, however, continued to rise. The rate of births to all unmarried women (45.3 per 1000 in 1993) has been stable for 3 years. Prenatal care utilization improved in 1993; 79% of women initiated care in the first trimester and < 5% had delayed care or no care. Improvements occurred among nearly all racial and ethnic groups. Reported smoking during pregnancy declined to 15.8% in 1993 from 16.9% in 1992. The proportion of babies delivered by cesarean section was 21.8% in 1993, a 2% decrease from 1992. Between 1992 and 1993, the rate of low birth weight (LBW) rose slightly to 7.2%, while very low birth weight (VLBW) remained stable at 1.3%. Most of the increase in LBW occurred among white infants and reflected, primarily, an increase in the proportion of multiple births. The black/white ratio in LBW continued to increase to more than two-fold with the largest difference recorded among term and postterm infants. Age-adjusted death rates in 1994 were lower for heart disease, malignant neoplasm, pulmonary diseases, other accidents, and homicides. The age-adjusted death rate for human immunodeficiency virus disease continued to rise to 15.1 in 1994. The infant mortality rate declined 4% in 1994, to 7.9 per 1000, the lowest rate ever recorded in the United States. The decline was primarily in neonatal mortality.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗
PubMed1994

Study of low dosage prostaglandin--usages and complications.

Low dosage intravenous (< 0.01 micrograms.kg-1.min-1) and oral prostaglandin E have been reported to produce fewer complications than higher intravenous doses in the ductal manipulation of congenital heart disease. Over a 3-year period 34 patients were treated with low dosage intravenous or oral prostaglandin. Eighteen (53%) had complications associated with this treatment with 14 having more than one complication. Major complications occurred in nine neonates: necrotising enterocolitis (7), apnoea/bradycardia (5), convulsions (1), haemorrhage (1), and resulted in a change of management. This study therefore concludes that the high incidence of complications is similar with both low and high dosages of intravenous and oral prostaglandin. The use of prostaglandin in any form deserves caution.

Administration, Oral↗
PubMed1994

Magnetic resonance measurement of volumes using a phantom. Application to the cardiac ventricles of infants and small children.

RATIONALE AND OBJECTIVES: Cine magnetic resonance (MR) is an established method for determining cardiac ventricular volumes in adults. The reported section slice thickness may be too thick for accurate measurement of ventricular volumes in infants and young children. In this article, acceptable slice thickness is established for cine MR in children. METHODS: Balloons filled with a dilute gadolinium solution were immersed in a water bath. The balloons were scanned using a fast scan technique to simulate cine MR. Scanning was performed using different slice thicknesses. Volumes were calculated using previously reported techniques. These calculated volumes were compared to direct measurement of the balloon volumes using graduated syringes. RESULTS: The balloons varied in volume from 0.9 mL to 27.3 mL. Measurements using 3- and 5-mm slice thickness sections were found to be significantly more accurate than 10-mm slice thickness sections. CONCLUSION: Section thickness should be less than 1-cm when performing cine MR in infants and small children for measurement of ventricular volumes.

Child↗
PubMed1994

Clinical predictors of Japanese encephalitis.

Over a 5-year period, virological investigations for Japanese encephalitis (JE) were conducted in children presenting with acute encephalopathic illness. Clinical features of JE-positive patients (n = 116) were compared with patients in whom the diagnosis could be excluded (n = 57). Multivariate analysis by logistic regression revealed that two clinical signs--central hyperpneic breathing pattern and extrapyramidal signs--were significant predictors of the diagnosis. Application of the model yielded a sensitivity of 41.3% and a specificity of 80.7% with positive and negative predictive values of 81.3 and 40.3%, respectively. This indicates that the model may be helpful in making the diagnosis but not in excluding it. The model should be further validated in different areas where the disease is prevalent.

Child↗
PubMed1994

Birthweight differentials among Asian Americans.

OBJECTIVES: This study examines differentials in mean birthweight and the risk for low birthweight among various Asian-American groups in New York State (n = 499,377). METHODS: Using resident singleton live-birth records from New York State for 1985 and 1986, Asian-American births were compared with Black, American Indian, and White births. Multivariate ordinary least squares and logistic regression models were used to analyze ethnic differences. RESULTS: Compared with White births, the expected mean difference in birthweight was -115 g for Chinese, -235 g for Japanese, -164 g for Filipinos, -120 g for Blacks, and 74 g for American Indians. The risk for low birthweight was 45% higher for Filipinos and 49% higher for Blacks as compared with Whites. CONCLUSIONS: Results of this study suggest substantial heterogeneity in mean birthweight and risk for low birthweight among ethnic groups in general and the major Asian-American groups in particular. Interestingly, after controlling for ethnic differences in sociodemographic risk factors, Filipinos appear to resemble Blacks much more closely than they do their Japanese and Chinese counterparts with respect to risk for low birthweight.

Adolescent↗
PubMed1994

Handigodu disease: a radiological study. A new variety of spondyloepi(meta)physeal dysplasia of the autosomal dominant type.

Handigodu disease is a new syndrome of familial spondyloepi(meta)physeal dysplasia. It is inherited as an autosomal dominant trait. The disease is prevalent in a localised area of South India. On the basis of detailed clinical, anthropometric and radiological investigations of 234 affected individuals, it has been observed that different clinical presentations reflect variation in the severity of the disease. All of them could be explained as being caused by defective development of bones as a result of monogenic disorder.

Adolescent↗
PubMed1992

Analgesia for the reduction of Colles fracture. A comparison of hematoma block and intravenous sedation.

OBJECTIVE: An alternative to general anesthesia was tested against conventional sedation by a double-blind, randomized clinical trial in reduction of Colles fracture. SETTINGS: A large teaching hospital where cases of Colles fracture are not different from those seen in district hospitals. PATIENTS: Sixty-six out of 80 consecutive cases with this fracture were selected from March to August 1990 on the basis of: 1) informed consent; 2) no contraindication to any method of analgesia; 3) no analgesic during the past 8 hours; 4) injury duration less than 96 hours; 5) no mental, auditory, or visual impairment; and 6) no associated injury. INTERVENTIONS: Patients were randomized into 2 equal groups. After tests for Xylocaine (Astra brand of lidocaine hydrochloride) sensitivity in both groups, the A group received 30 mg of pentazocine with 5 mg of diazepam intravenously on the dorsum of the affected wrist (sedation group), whereas the B group received 20 cc of 1.5% Xylocaine into the fracture hematoma. Five minutes later the fracture was reduced and immobilized by Lakhtakia or A. Singh. MAIN OUTCOME MEASURES: Thirteen to 15 hours later Manglik, blinded to the analgesia status of the patient, recorded pain before, during, and after reduction using Visual Analogue Scale (VAS). MAIN RESULTS: Statistically, randomization and blinding were found to be effective. The pain scores during reduction in the local anesthetic group (median = 1.8) were significantly less than those in the sedation group (median = 8.7), P < 0.001 using the Wilcoxon rank sum test. The difference persisted in regression analysis. The 2 methods proved comparable in safety and other measures of effectiveness. CONCLUSIONS: Hematoma block by local anesthetic is a safe and effective alternative to sedation in reduction of Colles fracture.

Adult↗
PubMed1989

Documentation of the first web space angle.

We describe a new method of measuring adduction contractures of the thumb by using stent mould casts of the first web, which are sectioned sagittally to give an accurate clinical angle at their cut section. This can be recorded from ink impressions. This method has been used successfully in 65 cases and appears more accurate than other methods.

Casts, Surgical↗
PubMed1987

Studies on pathogenesis of fowl pox: virological study.

One-month-old WLH chickens were inoculated with a field isolate of fowl pox virus (FPV) by intradermal (i.d.) and intratracheal (i.t.) routes. In intradermally infected chickens, the virus in titrable amounts was first detected in the skin at the inoculation site on day 2 and in lungs on day 4 followed by viraemia on the day 5 post-infection (p.i.). Subsequently the virus was recovered from liver, spleen, kidney and brain, but not from the heart. The chickens infected by i.t. route showed an almost similar outcome with minor differences as the virus was first demonstrated in the lungs on day 2 p.i., viraemia occurred on day 4 p.i. Initiation of pocks at the inoculation site in i.d. infected birds was observed on days 3 to 4 p.i., generalized cutaneous pock lesions appeared from 7 to 8 days p.i.

Animals↗