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  • 1
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    CARDIOVASCULAR AUTONOMIC REGULATION IN SUBJECTS WITH NORMAL BLOOD PRESSURE, HIGH–NORMAL BLOOD PRESSURE and RECENT‐ONSET HYPERTENSION
    Wiley ; 2005
    In:  Clinical and Experimental Pharmacology and Physiology Vol. 32, No. 5-6 ( 2005-05), p. 488-494
    Details
    In: Clinical and Experimental Pharmacology and Physiology, Wiley, Vol. 32, No. 5-6 ( 2005-05), p. 488-494
    Abstract: 1. In the present study, we tested the hypothesis that heart rate variability (HRV) is reduced in recent‐onset hypertension and that pressor responses to standard autonomic reflex tests are not any different in hypertensives compared with normotensives. We also hypothesized that subjects with high–normal blood pressure (BP) would be distinguishable from normotensives on the basis of short‐term HRV indices. 2. Three groups of subjects, each consisting of 15 men and 10 women, were examined. The first group consisted of subjects with recent‐onset hypertension who were not taking antihypertensive medication (mean (±SD) age 50 ± 12 years; BP ≥ 140/90 mmHg), the second group consisted of subjects with high–normal BP (mean age 46 ± 13 years; BP 130–139/85–89 mmHg) and the third group consisted of subjects with normal BP (mean age 48 ± 12 years; BP 〈  120/80 mmHg). The aim was to characterize the autonomic state in each group. 3. Blood pressure, heart rate (HR), indices of short‐term HRV during supine rest and quiet standing, HR variation during timed deep breathing (HRVdb) and pressor responses to the cold pressor test and sustained isometric handgrip were compared between the groups. 4. Although the three groups were comparable ( P   〉  0.1) in terms of mean HR and low‐frequency (LF) power expressed in normalized units at rest and during quiet standing, the standard deviation of normal‐to‐normal RR intervals (SDNN) during supine rest, LF and high‐frequency spectral powers during supine rest and HRVdb were lowest in hypertensives ( P ≤  0.05 for each), indicating diminished baroreflex modulation of RR intervals in hypertensives. 5. In contrast, LF power was highest in subjects with high–normal BP ( P ≤  0.05) during supine rest and this is possibly because of higher BP variability. 6. The results suggest that HRVdb provides a simple measure of cardiac vagal effects in hypertensives, the rate–pressure product provides a simple measure of overall HRV in hypertensives and, in clinical hypertension, the arterial baroreflex mechanism is reset to maintain a higher BP through diminished vagal modulation of HR and possibly heightened sympathetic outflow to the heart and resistance vessels.
    Type of Medium: Online Resource
    ISSN: 0305-1870 , 1440-1681
    URL: Issue
    URL: Article
    DOI: 10.1111/cep.2005.32.issue-5-6
    DOI: 10.1111/j.1440-1681.2005.04218.x
    Language: English
    Publisher: Wiley
    Publication Date: 2005
    detail.hit.zdb_id: 2020033-X
    SSG: 15,3
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  • 2
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    Strategic Method to Identify Students Needing Additional Curricular Support: Empirical Evidence across Courses in Health Professions Education in a Private Health Sciences University
    Jaypee Brothers Medical Publishing ; 2019
    In:  SBV Journal of Basic, Clinical and Applied Health Science Vol. 2, No. 2 ( 2019-06), p. 69-72
    Details
    In: SBV Journal of Basic, Clinical and Applied Health Science, Jaypee Brothers Medical Publishing, Vol. 2, No. 2 ( 2019-06), p. 69-72
    Type of Medium: Online Resource
    ISSN: 2582-5593 , 2581-6039
    URL: Article
    DOI: 10.5005/jp-journals-10082-02205
    Language: English
    Publisher: Jaypee Brothers Medical Publishing
    Publication Date: 2019
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  • 3
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    Efficacy of micellized vs. fat-soluble vitamin D3 supplementation in healthy school children from Northern India
    Walter de Gruyter GmbH ; 2016
    In:  Journal of Pediatric Endocrinology and Metabolism Vol. 29, No. 12 ( 2016-01-1)
    Details
    In: Journal of Pediatric Endocrinology and Metabolism, Walter de Gruyter GmbH, Vol. 29, No. 12 ( 2016-01-1)
    Abstract: Vitamin D deficiency is a widely recognized public health problem. Efficacy of a recently developed micellized form of vitamin D3 has not been studied. Hence, we undertook this study to compare its efficacy with the conventionally used fat-soluble vitamin D3. Methods: In this open-labeled nonrandomized pilot study, we recruited 180 healthy children, aged 13–14 years in two groups and supplemented Group A (60 children) with 60,000 IU of fat-soluble vitamin D3/month with milk and Group B (120 children) with 60,000 IU/month of water miscible vitamin D3 under supervision for 6 months. Serum 25(OD)D, parathyroid hormone (PTH), calcium, phosphate, and alkaline phosphatase (ALP) levels were evaluated before and after supplementation in 156 children (54 in Group A and 102 in Group B) who completed the study. Results: We observed a significantly greater increase in the serum 25(OH)D levels in group B as compared to group A (31.8±9.1 ng/mL vs. 23.7±10.4 ng/mL; p 〈 0.001). All children in group B achieved adequate levels of serum 25(OH)D ( 〉 20 ng/mL) as against 83.3% children in group A. Serum PTH and ALP levels declined considerably in both the groups following supplementation. Conclusions: Vitamin D supplementation significantly increased the serum 25(OH)D levels in both groups. Miscible form of vitamin D3 appears to be better in achieving higher levels of serum 25(OH)D than that observed with a similar dose of fat-soluble vitamin D3. Further studies with different dose regimens are required to establish its efficacy over the conventionally used fat-soluble vitamin D3.
    Type of Medium: Online Resource
    ISSN: 2191-0251 , 0334-018X
    URL: Article
    DOI: 10.1515/jpem-2016-0191
    Language: Unknown
    Publisher: Walter de Gruyter GmbH
    Publication Date: 2016
    detail.hit.zdb_id: 2583847-7
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  • 4
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    Vitamin D: A New Promising Therapy for Congenital Ichthyosis
    American Academy of Pediatrics (AAP) ; 2016
    In:  Pediatrics Vol. 137, No. 1 ( 2016-01-01)
    Details
    In: Pediatrics, American Academy of Pediatrics (AAP), Vol. 137, No. 1 ( 2016-01-01)
    Abstract: Severe vitamin D deficiency and rickets are highly prevalent among children with congenital ichthyosis. We report an incidental observation of a dramatic and excellent clinical response with regard to skin scaling and stiffness in children with congenital ichthyosis after short-term high-dose vitamin D supplementation that has not been previously described. Seven children with congenital ichthyosis (5 with autosomal recessive congenital ichthyosis; 2 with epidermolytic ichthyosis) and severe vitamin D deficiency (and/or rickets) were given 60 000 IU of oral cholecalciferol daily for 10 days under supervision. All children were subsequently put on recommended daily allowance of 400 to 600 IU of cholecalciferol. The main outcome measures observed and studied were reduction in skin scaling and stiffness of the extremities. All cases had severe vitamin D deficiency (serum 25-hydroxyvitamin D & lt; 4 ng/mL) and secondary hyperparathyroidism. Six patients had clinical and radiologic evidence of rickets. Significant improvement in scaling was noticeable by day 5, showing further improvement by day 10, in 6 of the 7 cases. At 1 month, the skin had become near normal in all the cases of autosomal recessive congenital ichthyosis. Remarkable reduction in stiffness was also observed in all children. Supplementation with high-dose vitamin D followed by recommended daily allowance appears to be an effective form of therapy in the management of congenital ichthyosis with vitamin D deficiency.
    Type of Medium: Online Resource
    ISSN: 0031-4005 , 1098-4275
    URL: Article
    DOI: 10.1542/peds.2015-1313
    Language: English
    Publisher: American Academy of Pediatrics (AAP)
    Publication Date: 2016
    detail.hit.zdb_id: 1477004-0
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  • 5
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    A randomised controlled trial comparing the efficacy of micellised and fat-soluble vitamin D 3 supplementation in healthy adults
    Cambridge University Press (CUP) ; 2019
    In:  British Journal of Nutrition Vol. 121, No. 8 ( 2019-04-28), p. 859-865
    Details
    In: British Journal of Nutrition, Cambridge University Press (CUP), Vol. 121, No. 8 ( 2019-04-28), p. 859-865
    Abstract: Nanoemulsion formulation of vitamin D 3 have been shown to have better bioavailability than the coarse emulsion preparation in vitro and in vivo animal studies. In the absence of randomised trial in humans, comparing the efficacy of nanotechnology-based miscellised vitamin D 3 over conventional vitamin D 3 , we undertook this study. A total of 180 healthy adults were randomised to receive either micellised (DePura, group A) or conventional vitamin D 3 (Calcirol, group B) at a monthly dose of 60 000 IU (1500μg) for 6 months. The outcome parameters were serum 25 - hydroxyvitamin D (25(OH)D), parathyroid hormone (PTH), Ca, phosphate, alkaline phosphatase and urinary Ca:creatinine ratio. A total of eighty-nine subjects in group A and seventy-seven in group B completed the trial. Subjects in both the groups had a significant increase in their serum 25(OH)D levels following supplementation (group A: 21·5 ( sd 10·9) to 76·7 ( sd 18·8) nmol/l ( P 〈 0·001); group B: 22·8 ( sd 10·4) to 57·8 ( sd 16·0) nmol/l ( P 〈 0·001)). Participants in micellised group had an additional increase of 20·2 (95 % CI 14·0, 26·4) nmol/l in serum 25(OH)D levels ( P 〈 0·001). The difference between the groups was 17·5 (95 % CI 11·8, 23·1) nmol/l, which remained statistically significant ( P 〈 0·001) even after adjustment for age and sex. Significant decline in mean serum PTH was observed in both the groups. No hypercalcaemia or hypercalciuria was noted. Although supplementation with both the preparations resulted in a significant rise in serum 25(OH)D levels, micellised vitamin D 3 appeared to be more efficacious in achieving higher levels of serum 25(OH)D.
    Type of Medium: Online Resource
    ISSN: 0007-1145 , 1475-2662
    URL: Article
    DOI: 10.1017/S0007114518003215
    Language: English
    Publisher: Cambridge University Press (CUP)
    Publication Date: 2019
    detail.hit.zdb_id: 2016047-1
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    SSG: 21
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  • 6
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    Impact of three different daily doses of vitamin D 3 supplementation in healthy schoolchildren and adolescents from North India: a single-blind prospective randomised clinical trial
    Cambridge University Press (CUP) ; 2019
    In:  British Journal of Nutrition Vol. 121, No. 5 ( 2019-03-14), p. 538-548
    Details
    In: British Journal of Nutrition, Cambridge University Press (CUP), Vol. 121, No. 5 ( 2019-03-14), p. 538-548
    Abstract: In India, there is a lack of information about the adequate daily dose of vitamin D 3 supplementation in school children. Hence, we undertook this study to evaluate the adequacy and efficacy of different doses of vitamin D 3 in schoolchildren. A total of 1008 vitamin D-deficient (VDD) children, aged 6–16 years with serum 25-hydroxyvitamin D (25(OH)D) levels 〈 50nmol/l, were cluster randomised into three groups (A-344, B-341 and C-232) for supplementation (600, 1000 and 2000 IU daily) of vitamin D 3 under supervision for 6 months. Of the 1008 subjects who completed the study, 938 (93 %) were compliant. Baseline and post-supplementation fasting blood and urine samples were evaluated for Ca, phosphates, alkaline phosphatase, 25(OH)D and parathormone and urine Ca:creatinine ratio. The mean age of the subjects was 11·7 ( sd 2·4) years, and the overall mean baseline serum 25(OH)D level was 24·3 ( SD 9·5)nmol/l. Post-supplementation rise in serum 25(OH)D in compliant group was maximum with 2000 IU (70·0 ( SD 30·0)nmol/l), followed by 1000 IU (46·8 ( SD 22·5)nmol/l) and 600 IU (36·5 ( SD 18·5)nmol/l), and serum 25(OH)D levels of ≥50nmol/l were achieved in 71·5, 81·8 and 92·9 % by groups A, B and C, respectively. Secondary hyperparathyroidism decreased from 31·7 to 8·4 % post-supplementation. Two participants developed hypercalciuria, but none developed hypercalcaemia. Children with VDD benefit maximum with the daily supplementation of 2000 IU of vitamin D 3 . Whether recommendations of 400 IU/d by Indian Council of Medical Research or 600 IU by Indian Academy of Pediatrics or Institute of Medicine would suffice to achieve vitamin D sufficiency in children with VDD remains debatable.
    Type of Medium: Online Resource
    ISSN: 0007-1145 , 1475-2662
    URL: Article
    DOI: 10.1017/S0007114518003690
    Language: English
    Publisher: Cambridge University Press (CUP)
    Publication Date: 2019
    detail.hit.zdb_id: 2016047-1
    SSG: 12
    SSG: 21
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  • 7
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    Medical Education in India
    Yong Loo Lin School of Medicine ; 2018
    In:  The Asia Pacific Scholar Vol. 3, No. 2 ( 2018-5-2), p. 55-57
    Details
    In: The Asia Pacific Scholar, Yong Loo Lin School of Medicine, Vol. 3, No. 2 ( 2018-5-2), p. 55-57
    Type of Medium: Online Resource
    ISSN: 2424-9335 , 2424-9270
    URL: Issue
    URL: Journal
    URL: Article
    DOI: 10.29060/TAPS.2018-3-2
    DOI: 10.29060/TAPS
    DOI: 10.29060/TAPS.2018-3-2/PV1060
    Language: Unknown
    Publisher: Yong Loo Lin School of Medicine
    Publication Date: 2018
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  • 8
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    Alternatives to MMRM for preclinical Alzheimer’s clinical trials : Clinical trial design and implementation
    Wiley ; 2020
    In:  Alzheimer's & Dementia Vol. 16, No. S9 ( 2020-12)
    Details
    In: Alzheimer's & Dementia, Wiley, Vol. 16, No. S9 ( 2020-12)
    Abstract: The Mixed Model for Repeated Measures (MMRM; Mallinckrodt, et al. 2001) is the most commonly used approach for assessing treatment effects in Alzheimer’s clinical trials. An alternative nonlinear Disease Progression Model (DPM) which assumes the ratio of group means is fixed over time has been proposed for DIAN‐TU (e.g. Wang, et al. 2018). We assess nonlinear models and alternative linear models for Preclinical Alzheimer’s clinical trials like the A4 Study (Sperling, et al. 2014). Method Tables 1 and 2 describe the mean and correlation structures that we considered. Models were fit to data from cognitively normal ADNI participants (amyloid positive vs negative). We compared mean PACC trajectories over time and Akaike Information Criterion (AIC; Sakamoto, et al 1986). All models were fit by maximum likelihood using the R package nlme. Simulations were used to assess power and Type I error for clinical trials in Preclinical Alzheimer’s (Figure 1). Results Figure 2 demonstrates the various mean structures fit to ADNI. Models with stronger shape assumptions are smoother than the unstructured mean of MMRM (dashed lines). The DPM‐like nonlinear model with fixed group mean ratio (“NL0”) provides a relative underestimate of the amyloid group difference at final visit. Comparing values of AIC (Figure 3), we find little evidence to support using alternatives to the unstructured mean and variance of the typical MMRM. Simulation studies (Table 3) suggest that power can be improved with simpler mean structures (Hybrid or Quadratic), while maintaining good Type I error control with an unstructured variance. It was difficult to fit the nonlinear models with the full suite of correlation structures. The NL0 could be reliably fit with random intercept and heterogeneous variance but showed no advantage over the simpler Hybrid or Quadratic mean structures. Conclusion ADNI data support the use of the MMRM with unstructured mean and variance, but simulations suggest simpler mean structures might provide a modest improvement in the power from 85%, with an unstructured mean, to 90%, with Hybrid or Quadratic mean. Nonlinear DPM‐like models demonstrated no advantage over linear model alternatives in ADNI and in simulations of Preclinical Alzheimer’s clinical trials.
    Type of Medium: Online Resource
    ISSN: 1552-5260 , 1552-5279
    URL: Issue
    URL: Article
    DOI: 10.1002/alz.v16.S9
    DOI: 10.1002/alz.044915
    Language: English
    Publisher: Wiley
    Publication Date: 2020
    detail.hit.zdb_id: 2201940-6
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