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Tuberculosis Treatment Completion for Tribal Patients in Kerala: Needs Constant Push!

Journal of Tuberculosis Research 2019年第4期7卷 185-201页

作者： Jyothilakshmi Chettipparan Rajan tanu anand Sharath Burugina Nagaraja Sabu Kochupurackal Ulahannan Karuna Sagili Manu Muraleedharan Sarojini Wayanad Social Service Society Wayanad Kerala India Department of Community Medicine North Delhi Municipal Corporation Medical College Hindu Rao Hospital Delhi India Department of Community Medicine ESIC Medical College and PGIMSR Bengaluru India Institute of Public Health Bengaluru India Department of TB and communicable diseases The Union New Delhi India State TB Demonstration and Training Centre Trivandrum India

Introduction: Tuberculosis (TB) incidence among tribal patients is high owing to their social and geographic vulnerability. Ensuring adherence to TB treatment among them remains a challenging task as it is dependent on socio-cultural and environmental factors. Objective: 1) To know the individuals’ perception of TB disease and anti-TB treatment;2) To explore the personal, social, family and cultural factors influencing on patient’s treatment adherence;3) To identify the challenges faced by health care providers in delivering services to the tribal population. Material and Methods: A descriptive qualitative study conducted among tribal patients (n = 16) and health providers (n = 6) of Manathavady TB unit, Wayanad District of Kerala. The data were collected through in-depth interviews (IDIs), audio-recorded in Malayalam, transcribed verbatim and translated into English. Transcripts were analysed using manual descriptive content analysis. Results: Most of the patients were oriented about the importance of completing TB treatment though lacked awareness about its causation. The supportive attitude of the community further encouraged them to continue TB treatment. However, substance abuse emerged as the biggest challenge to treatment adherence particularly among males. While accessibility to the health system, animal confrontation, and disaster risk emerged as barriers owing to the geographic landscape of the community, health services were found to be acceptable, available and affordable to all the patients. No stigma or discrimination was perceived by the patients at family, community and health system level. However, their beliefs in herbal medicines and conduct of certain rituals delayed them for seeking care. The personal commitment of the health care staff helped the TB patients to adhere better with the treatment thereby yielding best results. Conclusion: The TB treatment adherence among the tribal population was satisfactory due to personal, social and health sys

关键词： Treatment Adherence Kerala Qualitative Operational Research

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Threefold Increase in the Number of Drug Resistant TB Cases after Introduction of Universal Drug Susceptibility Testing: Experiences from Two South India Districts

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Journal of Tuberculosis Research 2020年第2期8卷 42-52页

作者： Sanath Kumar Gurram Krishnamurthy Sharath Burugina Nagaraja tanu anand Karuna D. Sagili Cheluve Gowda Shailaja Basavaraj Poojar Srinath Satyanarayana Department of Health and Family Tumkur District Karnataka India Department of Community Medicine ESIC Medical College and PGIMSR Bengaluru India Department of Community Medicine North Delhi Municipal Corporation Medical College Hindu Rao Hospital Delhi India Department of TB and Communicable Diseases the Union South East Asia Office New Delhi India Department of Community Medicine Sri Siddhartha Medical College Tumkur Karnataka India Department of Health and Family Belgaum District Karnataka India Department of Pharmacology Kasturba Medical College Mangalore Manipal Academy of Higher Education Manipal India The Union South East Asia Office New Delhi India

Background: In India, tuberculosis (TB) is a major public health problem, and the advent of drug resistance TB (DR-TB) has worsened the situation. The Revised National TB Control Programme (RNTCP) has introduced universal drug susceptibility testing (UDST) for all diagnosed TB cases in 2018. We conducted this study to know the advantage of implementing UDST when compared to selective testing existent in 2017 on key diagnostic cascade parameters and to identify the challenges in the implementation of UDST. Methods: The study was conducted in two districts of Karnataka, India during January 2017-December 2018. The quantitative part consisted of before-and-after design and the qualitative part consisted of descriptive design. Results: In 2017 (during selective testing/“before” period) out of the 2440 TB patients, 80 (3%) were diagnosed with Isoniazid and Rifampicin resistance patients;in contrast in 2018 (during UDST/“after” period) of the 5129 TB patients 258 (5%) were diagnosed with Isoniazid and Rifampicin resistance. However, the proportion of eligible patients tested for rifampicin resistance during the “after” period was 60% when compared to 100% during the “before” period and median turnaround time for testing was also longer during the “after” period when compared to the “before” period (32.5 days vs 27.5 days). Major reasons for these two gaps were found to be difficulties in collecting sputum specimens and transportation. Conclusion: The rollout of UDST has led to a three-fold increase in a number of DR-TB cases detected in the region. There is a need for the programme to increase the proportion tested for DST by increasing the laboratory capacity and address the challenges in sputum collection and transportation.

关键词： Operational Research Criteria C Line Probe Assay Universal Drug Susceptibility Testing Culture and Drug Susceptibility Testing

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A neural network-based electromyography motion classifier for upper limb activities

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Journal of Innovative Optical Health Sciences 2016年第6期9卷 77-84页

作者： Karan Veer tanu Sharma Ravinder Agarwal Electrical and Instrumentation Engineering Department Thapar University Computer Science Engineering Department GCET Ropar 174001India

The objective of the work is to investigate the classifcation of different movements based on the surface electromyogram(SEMG)pattern recognition *** testing was conducted for four arm movements using several experiments with artificial neural network class fication *** time domain features were extracted and consequently dlassification was implemented using back propagation neural dassifier(BPNC).Further,the realization of projected network was verified using cross validation(CV)process;hence ANOVA algorithm was carried *** of the network is analyzed by considering mean square error(MSE)value.A comparison was performed between the extracted feat ures and back propagation network results reported in the *** concurrent result indicates the significance of proposed network with classification accuracy(CA)of 100%recorded from two channels,while analysis of variance technique helps in investigating the effectiveness of classified sigmal for recognition tasks.

关键词： ANN SEMG arm recognition statistics classification RMS upper arm activities

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Development of prosthetic arm using body actioned SEMG signals

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Journal of Innovative Optical Health Sciences 2016年第6期9卷 58-65页

作者： Karan Veer tanu Sharma Amod Kumar EIED Department Thapar UniversityPatialaIndia CSED Department Global College of EngineeringKhanpur KuiIndia Chief Scientist CSIO-CSIRChandigarhIndia

People's working capability is badly affected when they sufer an amputated *** replacements with prosthetic devices to get a satisfactory level of performance for essential functions with the currently available prosthetic technology are very *** arm prostheses are becoming popular because they are operated by a natural contraction of intact ***,SEMG based artifdal arm was *** system cousists of diferent electronic and mechanical assemblies for operation of hand utilizing microcontroller in order to have minimum signal loss during its *** the hep of relay switching connected to low power DC motor,system is capable of opening and closing of grip according to individual wish.

关键词： SEMG electrodes variable gripping myoelectric controls electronic interface signals processing.

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Genetic and epigenetic alterations associated with gestational diabetes mellitus and adverse neonatal outcomes

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World Journal of Clinical Pediatrics 2025年第1期14卷 6-20页

作者： Amreen Shamsad tanu Gautam Renu Singh Monisha Banerjee Molecular and Human Genetics Laboratory Department of ZoologyUniversity of LucknowLucknow 226007Uttar PradeshIndia Department of Obstetrics and Gynecology King George’s Medical UniversityLucknow 226003Uttar PradeshIndia

Gestational diabetes mellitus(GDM)is a metabolic disorder,recognised during 24-28 weeks of *** is linked with adverse newborn outcomes such as macrosomia,premature delivery,metabolic disorder,cardiovascular,and neurological *** investigations have focused on the correlation of genetic factors such asβ-cell function and insulin secretary genes(transcription factor 7 like 2,potassium voltage-gated channel subfamily q member 1,adipo-nectin etc.)on maternal metabolism during gestation leading to *** alterations like DNA methylation,histone modification,and miRNA expression can influence gene expression and play a dominant role in feto-maternal meta-bolic *** between genes and environment,resulting in differ-ential gene expression patterns may lead to *** suggested that GDM women are more susceptible to insulin resistance,which alters intrauterine surroundings,resulting hyperglycemia and *** modi-fications in genes affecting neuroendocrine activities,and metabolism,increase the risk of obesity and type 2 diabetes in *** is currently no treatment or effective preventive method for GDM,since the molecular processes of insulin resistance are not well *** present review was undertaken to un-derstand the pathophysiology of GDM and its effects on adverse neonatal *** addition,the study of genetic and epigenetic alterations will provide lead to researchers in the search for predictive molecular biomarkers.

关键词： Gene expression Gestational diabetes mellitus Feto-maternal outcome Epigenetic alteration Molecular biomarkers

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Modelling rapid non-destructive test using light weight deflectometer on granular soils across different degrees of saturation

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Journal of Rock Mechanics and Geotechnical Engineering 2024年第7期16卷 2732-2748页

作者： Javad Ghorbani Arooran Sounthararajah Troyee tanu Dutta Jayantha Kodikara ARC Smart Pavements Hub Dept.of Civil EngineeringMonash UniversityVIC3800Australia

This study introduces an advanced finite element model for the light weight deflectometer(LWD),which integrates contact mechanics with fully coupled *** simulating LWD tests on granular soils at various saturation levels,the model accurately reflects the dependence of the LWD modulus on dry density,water content,and effective *** model addresses and overcomes the limitations of previous finite element models for this specific ***,this research presents the first experimentally validated fully coupled contact impact ***,the research provides a comparative assessment of elastoplastic and nonlinear elastic models and contrasts an enriched node-tosegment method(developed in this study)with the more precise mortar technique for contact *** comparisons reveal unique advantages and challenges for each ***,the study underscores the importance of careful application of the LWD modulus,emphasising the need for sophisticated tools to interpret soil behaviour accurately.

关键词： Granular soils Plasticity Finite element analysis Contact mechanics Modulus Degree of saturation

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Propagation delay and power dissipation for different aspect ratio of single-walled carbon nanotube bundled TSV

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Journal of Semiconductors 2015年第6期36卷 99-104页

作者： tanu Goyal Manoj Kumar Majumder Brajesh Kumar Kaushik Department of ECE IEC College of Engineering and Technology Department of E&CE Indian Institute of Technology Roorkee

Through-silicon vias （TSVs） have provided an attractive solution for three-dimensional （3D） integrated devices and circuit technologies with reduced parasitic losses and power dissipation, higher input-output （I/O） den- sity and improved system performance. This paper investigates the propagation delay and average power dissipation of single-walled carbon nanotube bundled TSVs having different via radius and height. Depending on the physical configuration, a comprehensive and accurate analytical model of CNT bundled TSV is employed to represent the via （vertical interconnect access） line of a driver-TSV-load （DTL） system. The via radius and height are used to estimate the bundle aspect ratio （AR） and the cross-sectional area. For a fixed via height, the delay and the power dissipation are reduced up to 96.2% using a SWCNT bundled TSV with AR = 300 ： 1 in comparison to AR = 6：1.

关键词： carbon nanotube through-silicon vias equivalent RLC circuit model propagation delay power-delay product area-delay product

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Frequency of alcohol and smoking cessation counseling in hepatitis C patients among internists and gastroenterologists

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World Journal of Gastroenterology 2009年第47期15卷 6010-6011页

作者： tanu Chandra Mary Reyes Huy Nguyen Marie Borum Division of Gastroenterology and Liver Disease George Washington University Hospital1320 N.Veitch Street Apt 1308 ArlingtonVA 22201United States

Given the overwhelming evidence that both alcoho consumption and smoking accelerate the progression of hepatitis C virus(HCV)-induced liver disease we evaluated the frequency of alcohol and smoking counseling of patients with HCV-induced liver disease by their primary care internists and *** hundred and twenty-three medical records of consecutive patients with HCV-induced liver disease referred by an internist to a gastroenterologist for its management were *** gender,race,history of and counseling against alcohol and tobacco use by a physician and a gastroenterologist were obtained A database was created using Microsoft *** were 105 African-Americans,12 Caucasians and six patients of other races/***-six(37%)pa- tients were daily tobacco users and 34(28%)patients were daily alcohol *** was a statistically significant difference in the frequencies of alcohol(P= 0.0002)and smoking cessation(P=0.0022)between gastroenterologists and *** study reveals that internists and gastroenterologists,alike,inadequately counsel patients with hepatitis C about tobacco and alcohol use.

关键词： Alcohol Hepatitis C virus Counseling Smoking Hepatocellular carcinoma

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Compatible package-based agriculture systems:an urgent need for agro-ecological balance and climate change adaptation

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Soil Ecology Letters 2022年第3期4卷 187-212页

作者： Rishikesh Singh tanu Kumari Pramit Verma Bhupinder Pal Singh Akhilesh Singh Raghubanshi Integrative Ecology Laboratory(IEL) Institute of Environment&Sustainable Development(IESD)Banaras Hindu UniversityVaranasi 221005India NSW Department of Primary Industries Elizabeth Macarthur Agricultural InstituteMenangleNSW 2568Australia

Besides contributing majorly in the growth of a country,agriculture is one of the severely affected sectors at *** modifications and adaptations are being made in agricultural practices to cope-up with the declining soil fertility and changing climate scenarios across the ***,the development and adoption of a single agricultural practice may not help in the holistic mitigation of the impacts of climate change and may result in economic vulnerability to ***,it is high time to develop and recommend a group of agricultural practices i.e.,package-based agriculture system having some compatibility for one another in the long *** this article,a viewpoint has been given on some emergent agronomic practices adopted in the tropical agroecosystems which have potential to be developed as compatible agricultural package in ***,we also emphasized on exploring some key indicators/environmental factors to assess the compatibility of different agronomic *** identifying the research transition from single to combined agricultural practices,a bibliometric analysis was performed by using conservation agriculture(CA),the system of rice intensification(SRI),organic agriculture and soil(biochar)amendment as the major agronomic practices being used for improving agroecological services such as improving nutrient cycling,soil fertility and crop productivity as well as climate change *** results revealed that scientific communities are now paying attention to exploring the role of combined agricultural practices for agro-ecological balance and climate change ***,the limitations of the adoption of agronomic packages under different agro-climatic zones have also been *** recommendations of the study would further help the environmental decision-makers to develop potential measures for climate change mitigation without compromising the agro-ecological balance.

关键词： Agricultural policies Bibliometric analysis Biochar Conservation agriculture GHG emission Organic farming SRI Sustainable agriculture

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Cut-off of body mass index and waist circumference to predict hypertension in Indian adults

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World Journal of Clinical Cases 2014年第7期2卷 272-278页

作者： tanu Midha Vinay Krishna Bhola Nath Ranjeeta Kumari Yashwant Kumar Rao Umeshwar Pandey Samarjeet Kaur Department of Community Medicine Government Medical CollegeKannaujUttar Pradesh 209732India Department of Cardiovascular and Thoracic Surgery LPS Institute of CardiologyKanpurUttar Pradesh 208002India Department of Community Medicine VCSGGMS and RISrinagarGarhwalUttarakhand 246174India Department of Community and Family Medicine AIIMSRishikesh 249201India Department of Pediatrics GSVM Medical CollegeKanpurUttar Pradesh 208002India Department of Cardiology LPS Institute of CardiologyKanpurUttar Pradesh 208002India Department of Community Medicine GSVM Medical CollegeKanpurUttar Pradesh 208002India

AIM: To determine the cut-off values of body mass index(BMI) and waist circumference to predict hypertension in adults in north ***: A community based cross-sectional study was conducted in 801 subjects in Kanpur, aged 20 years and above, using multistage stratified random sampling technique. A pre-tested structured question-naire was used to elicit the required information from the study participants and the diagnostic criteria for hypertension were taken according to the Seventh Joint National Committee Report on Hypertension(JNC-7). Receiver operating characteristic(ROC) analysis was used to estimate the cut-off values of BMI and waist circumference to predict ***: The ROC analysis revealed that BMI is a good predictor of hypertension for both men(area under the ROC curve 0.714) and women(area under the ROC curve 0.821). The cut-off values of BMI for predicting hypertension were identified as ≥ 24.5 kg/m2 in men and ≥ 24.9 kg/m2 in women. Similarly, the ROC analysis for waist circumference showed that it is a good predictor of hypertension both for men(area under the ROC curve 0.784) and women(area under the ROC curve 0.815). The cut-offs for waist circumference for predicting hypertension were estimated as ≥ 83 cm for men and ≥ 78 cm for women. Adults with high BMI or high waist circumference had a higher prevalence of hypertension, ***: Simple anthropometric measurements such as BMI and waist circumference can be used for screening people at increased risk of hypertension in order to refer them for more careful and early diagnostic evaluation. Policies and programs are required for primary and secondary prevention of hypertension.

关键词： Anthropometric indices Body mass index Waist circumference Obesity,Hypertension Adults

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