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Biomedical subjects

R N Sinha

Publications and source records attributed to R N Sinha.

27 records · Page 2Linked to original sources

Mycotoxin production in amber durum wheat stored at 15 and 19% moisture content.

Ochratoxin A and citrinin developed in 11 kg parcels of amber durum wheat at 15% and 19% initial moisture content (MC) exposed to simulated bulk storage in a Manitoba granary for 60 weeks between July 1984 and September 1985. Other biotic and abiotic variables were monitored throughout the storage period. Ochratoxin A reached maximum levels of 11.8 and 0.11 ppm at 19 and 15% initial MC, respectively, during weeks 44-48; citrinin reached levels of 80.0 and 0.65 ppm at these respective moistures during the same period. The effect of 19% initial MC was significantly greater for the following variables: ochratoxin A, citrinin, Aspergillus flavus, Aspergillus glaucus group species, Alternaria species, Aspergillus versicolor, bacteria, fungal propagule count, seed germination, O2, CO2, moisture content, and fat acidity. Principal component analysis indicated that the first two components, describing greater than 60% of the variability in the data, partially defined the ecological relationships leading to mycotoxin production in the stored durum wheat system.

Alternaria↗

Efficacy of insulin pump therapy: mealtime delivery is the key factor.

OBJECTIVE: To investigate, in a clinical setting, the effect of implementation of continuous subcutaneous insulin infusion (CSII) on control of plasma glucose and to identify factors associated with improved glycemic control in patients with type 1 diabetes mellitus. METHODS: Nineteen patients (16 women and 3 men) with type 1 diabetes were studied retrospectively. Their mean age was 42.6 years (range, 30 to 58), and the mean duration of diabetes was 21 years. The subjects underwent follow-up for a mean of 14 months after conversion to CSII therapy. With use of paired t tests, pre-CSII and follow-up data were evaluated relative to changes in weight, insulin dosing, and glycosylated hemoglobin (HbA(1c)). RESULTS: At follow-up, the total daily dose of insulin had decreased by 18%, from a baseline mean value of 45.2 IU to 37.1 IU (P = 0.02). HbA(1c) was reduced from 8.4% to 7.7% (P<0.01). The total daily insulin-to-weight ratio also significantly decreased from 0.66 IU/kg to 0.53 IU/kg (P<0.05). Before insulin pump use, the regular/NPH insulin ratio was 0.5 IU; at follow-up, the pump bolus/basal insulin ratio was 1.0 IU (P = 0.02). No weight gain was observed; the mean weight of the study patients decreased 0.2 kg, from 69.4 kg at baseline to 69.2 kg at follow-up (not significantly different). CONCLUSION: In a clinical setting, CSII therapy in patients with type 1 diabetes improves glycemic control and lowers the total daily basal insulin dose without affecting weight. Improved glycemic control was associated with a shift in insulin therapy from a high percentage of intermediate-acting insulin to a greater percentage of insulin administered in a meal-associated bolus form. This study emphasizes the importance of mealtime insulin adjustment for tight glycemic control in patients using CSII therapy. Future studies evaluating the benefits of decreased total insulin and an increased bolus/basal insulin ratio may be important in helping to understand how to avoid long-term complications of diabetes.

Adult↗

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↗

Declining trend in routine UIP coverage.

Routine UIP coverage status in the state of West Bengal and three selected Municipal Corporation areas (Calcutta, Howrah and Siliguri) were studied during 1997-98 and 1998-99. Also, UIP coverage status in the 'high risk' areas of the State (areas which reported Polio cases during 1998) was studied during 1998-99. UIP coverage in the state of West Bengal was only 54.3% in 1997-98, which further declined to 48.1% in 1998-99. In the three urban areas, UIP coverage ranged between 57.3%-70.9% in 1997-98, which further declined to 29.6%-47.1% in 1998-99. Antigenwise coverage revealed very poor performance with DPT3, OPV3, and Measles in 1997-98 and further decline in 1998-99. Dropout rate was also very high. In 1998-99 drop-out rate ranged between 30.1% to 54.2% in different studied areas. Some other studies suggested that PPI activities, which are very visible and targetted programme, may adversely affect routine UIP services. There is urgent need for further probing to identify the reasons for such poor state of affairs, keeping PPI angle in mind and to initiate remedial measure urgently.

Antigens, Viral↗

Coverage of Maternal Care Services in the state of West Bengal.

Evaluation of the Coverage of Maternal Care Services was conducted during the year 1999 in the entire State of West Bengal, Urban poor localities of randomly selected three Municipal Corporation areas and 'high-risk' urban wards or villages of West Bengal that had reported AFP cases in 1998. It was observed that mothers who had three or more antenatal check-ups varied between 54% to 82% in different study areas. Tetanus Toxoid coverage varied between 83.5% to 93.4% being lowest in high-risk areas. Only a very small section of mothers (12.7% to 23.7%) consumed 100 or more Iron and Folic acid tablets during pregnancy. 'Danger Signs' of pregnancy were informed to only 21.1% to 38.2% of the pregnant mothers. Proportion of home deliveries varied between 16.7% (Calcutta) to as high as 72.7% (high-risk areas). Deliveries conducted by untrained personnel were 60.8% in high risk areas, 38.1% in State clusters and between 14.2% to 29.4% in the three urban areas. Vast majority of mothers (78.8% to 88.4%) received no post-natal check-up.

Blood Pressure↗

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↗

A study on the delivery practices in riverine & non-riverine blocks of the district of South 24-Parganas, West Bengal.

A cross sectional study was undertaken in three riverine and two non-riverine blocks of South 24 Parganas district, West Bengal to study the delivery practices and compare between two locality. During the reference period of one year, of 3073 total deliveries, 89.36% were home deliveries. Home deliveries were higher in the riverine blocks (95.07%) compared to non-riverine blocks (81.64%). 'Dai' conducted 58.36% and 90.62% of home deliveries in riverine and non-riverine blocks respectively. Only 18.4% of the 'Dai' were trained.

Cross-Sectional Studies↗