Imputation technique: replacing missing values in longitudinal data

2016-09-26T02-29-25Z
Source: International Journal of Community Medicine and Public Health
Gladius Jennifer. H.
In longitudinal studies, many cases are found missing in the follow-up data. These missing cases may arise due to item non response or unit non response. A data set with missing observations is often completed by using imputed values. The unit non response is usually carried out by some weighting adjustment. The item non response is made by the method called imputation. Imputation is a technique to replace a missing/incomplete or strange value with a more or less artificial value. There are plenty of methods available to impute the missing values in a longitudinal data. Imputation is useful because they make the data set easier to analyze, ensure consistency between the results from different analyses and reduce non response bias from item non response. But it is not necessary that the imputed value reduces the bias of the data, sometimes they may lead more bias also. It depends on the imputation procedure which we choose and also the form of estimate. The aim of this article is to sensitize doctors and post-graduate medical students about this useful analytical technique.


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Variations in prevalence of diabetes in various occupations: a quantitative and qualitative review

2016-09-26T02-29-25Z
Source: International Journal of Community Medicine and Public Health
T. Naveena.
Diabetes is one of the most dangerous diseases associated with many comorbidities and mortalities in world. This is associated with different risk factors and its occurrence cannot be predicted. The several risk factors include family history, overweight, unhealthy diet, sedentary lifestyle, increasing age, high blood pressure, stress. Prediction of occurrence and worsening of diabetes cannot be made but our duty is to reduce the risk factors to prevent ourselves landing up in such a long-lasting life burdening disease. Occupation determines many of the risk factors like lifestyle and stress factors as they are more or less similar to everyone belonging to a particular occupation. Study on occupational prevalence of diabetes helps us to identify our risk of diabetes and to prevent it. But presently unfortunately there are only 6 articles available on the occupational prevalence of diabetes. They report that there is increased prevalence of diabetes in police personnel and decreased prevalence of diabetes in farmers and construction workers. Though there is an article available on occupational prevalence of diabetes in teachers, conclusions cannot be drawn as the controls were not included in the study. So there is an immediate requirement to conduct research on prevalence of diabetes in various occupations by including controls.


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Presumed consent for organ donation: illusion of a choice

2016-09-26T02-29-25Z
Source: International Journal of Community Medicine and Public Health
Reeta Dar.
India has been following informed consent (opt- in) system of organ donation but soft pressures to shift to presumed consent (opt- out) system are simultaneously palpable. This paper describes presumed consent briefly and explains why the need to shift to this system is felt. The paper challenges the morality of presumed consent system and describes its use as absolutely unethical in view of socio cultural diversity, educational disparity and profound class stratification of our country. The paper throws some light on our own system which, unlike other countries, is not ready for this change. It focuses on thought-provoking issues that are deterrents to achieving increase in organ donation even if presumed consent system is adopted in India. It reflects the outcome of this coercive legal option in some countries. In some countries there was no change in organ donation rates. A few countries witnessed negative repercussions of presumed consent system. Some of these countries had no option except to revert back to opt- in system. The paper tries to give a message to the public and professionals by comparing Spain to India that has high donation rates in the world not because of presumed consent but because of other contributory factors. Spain initiated organ donation and transplant activities much ahead of India and their healthcare services are rated the best in the world. Socio-cultural, religious and political milieu unlike India is conducive to organ donation in Spain. Adequate investments in public health, adequate budget for organ donation and transplantation, excellent infrastructure, availability of public health assistance to 99% population, adequate availability of ICU beds, extending end of life care to all, positive approach to organ donation by majority of people, thorough professionalism and public trust is what makes Spain the best country in organ donation. The same is lacking in India. The paper warns us of this coercive option by drawing a parallel to the coercions that took place when India acted coercively to control population through compulsory sterilization and led to the wrath of masses in 1976. India as on date needs to focus on other issues to increase organ donation rates like development of infrastructure, developing well-functioning national, regional and state level organizations, building in trust of people, identifying potential donors, managing donors, caring for donor families, training manpower, increasing awareness on organ donation and transplantation, reimbursing fees to organ retrieval hospitals, merging efforts of various stakeholders, developing transparent and workable organ sharing policies and regular auditing of brain stem deaths.


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Evaluation of wound healing activity of cow urine ark in diabetic Wistar albino rats

2016-09-25T15-23-50Z
Source: Journal of Intercultural Ethnopharmacology
Hiren N Hirapara, Vishal M Ghori, Ashish P Anovadiya, Chandrabhanu R Tripathi.
 In present study, effects of cow urine ark on diabetic wound healing was studied.  Wistar Albino rats were used for this study due to their susceptibility for diabetes with streptozotocin and they are established model for diabetic wound healing studies.  Excision, incision and dead space wound model were selected for evaluation of wound healing activities.  Streptozotocin (50 mg / kg) was given i.p. to produce diabetes. Random blood sugar was measured using glucometer from drop of blood from tail vein.  Cow urine ark (5.5 ml / kg) was given orally in the morning.  Excision wounds were traced on transparent sheet as well as photographed and analyzed for wound contraction and re-epithelization with help of UTHSCA image analyzer software. Incision wounds were analyzed for wound breaking strength with help of continuous water flow technique of Lee. Dead space wounds were analyzed for dry granuloma weight, hydroxyproline content and histopathological changes.  Cow urine ark significantly improved the collagen content and granulation tissue formation in diabetic wounds which can be useful in accelerating wound healing in diabetic patients. Clinical implementation would require clinical trials.


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Effects of herbal medicine on human uterine tumor-bearing nude mice

2016-09-25T14-53-40Z
Source: Journal of Intercultural Ethnopharmacology
Mi Hyang Ohh, Seong Jin Kim, Jong Kwon Han, Sok Cheon Pak, Kew-mahn Chee.
Aim: Uterine leiomyomas are the most common benign uterine neoplasms associated with significant morbidity. Herbal formulas capable of restoring yin-yang balance by dispersing blood stasis may be useful for managing fibroid symptoms. Materials and Methods: In this study, the antitumor properties of three herbs viz., Trogopterus xanthipes Milen-Edwards, Paeonia lactiflora Pallas, and Ulmus davidiana Planch, were evaluated in nude mice injected intravenously with human malignant myomas. Tumour fragments were xenografted subcutaneously through a flank incision in female mice. The mice entered the study for 8 weeks when their tumors reached the threshold volume (260 mm3). The mice were randomly allocated to receive subcutaneous injections of normal saline (group 1; negative control), P. lactiflora Pallas (group 2), U. davidiana Planch (group 3), T. xanthipes Milen-Edwards (group 4), and intravenous injections of paclitaxel (group 5; positive control). The weight and tumor volume were measured, followed by histopathology. Results: A few cases of abdominal distention and death were observed in the negative control group. Furthermore, a considerable enlargement of the liver and spleen was observed in the negative control group at autopsy with a gradual increase in body weight during the experiment. The mean tumor volume which increased in negative control mice reduced in mice treated with herbal remedies or paclitaxel from day 14 onwards (p

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Antidiabetic and antioxidant effects of Croton lobatus l. in alloxan-induced diabetic rats

2016-09-25T14-22-59Z
Source: Journal of Intercultural Ethnopharmacology
Taiye Remi Fasola, Blessing Ukwenya, Ademola Adetkunbo Oyagbemi, Temidayo Olutayo Omobowale, Temitayo Olabisi Ajibade.
Background: Croton lobatus contains high amount of antioxidant phytochemicals that probably account for its wide use as food and medicine in the traditional communities of West Africa. Methods: The study evaluated the modulatory role of methanol extract of Croton lobatus leaf on alloxan-induced diabetes and associated cardiovascular complications in male rats randomly selected and assigned to one of six groups (A to F) of eight animals each: A (distilled water); B (corn oil); C (Alloxan); D (Alloxan + 100 mg kg-1 Croton lobatus); E: (Alloxan + 200 mg kg-1 C. lobatus); and F (Alloxan + 100 mg kg-1 glibenclamide). The extract was administered orally for 14 days. Results: Acute toxicity studies revealed no mortality of rats at with the administration of different doses of extract up to the 5,000 mg kg-1 dose. Diabetic rats treated with 100 and 200 mg kg-1 C. lobatus leaf extract had significant (p

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Beneficial effects of yogasanas and pranayama in limiting the cognitive decline in Type 2 diabetes

2016-09-24T09-13-59Z
Source: National Journal of Physiology, Pharmacy and Pharmacology
Rajani Santhakumari Nagothu, Archana Rajagopalan, Yogananda Reddy Indla, Rajesh Paluru.
Background: Out of many complications that were observed in Type 2 diabetes, cognitive impairment is the most neglected. Aim and Objectives: The aim of the present study is to assess the cognitive decline in Type 2 diabetes and to observe the role of yogasanas and pranayama in ameliorating the cognitive decline. Materials and Methods: A total of 68 Type 2 diabetic patients were recruited in the study, 34 of them did specific yogasanas and pranayama (test group) for 6 months, and the remaining age- and sex-matched 34 patients were recruited as (control group) who were not on any specific exercise regimen. Glycemic index was estimated by measuring the glycosylated hemoglobin (HbA1c) concentration with Bio-Rad apparatus and cognition were assessed using Addenbrookes cognitive examination-revised (ACE-R), which is a neuropsychological battery. Data were analyzed with unpaired student t-test. P

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