Displaying all 9 publications

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  1. Shaharudin S, Agrawal S
    J Sports Med Phys Fitness, 2016 Sep;56(9):980-9.
    PMID: 25732319
    BACKGROUND: The purpose of this study was to evaluate the muscle synergies during incremental rowing VO2 max Test of collegiate rowers and untrained subjects. As a power endurance sport, high aerobic capacity was one of the determinants of rowing performance. The modulation of muscle recruitment patterns following specific physiological demands was an indication of the robustness of muscle synergies composition which was overlooked in previous studies.

    METHODS: Ten male collegiate rowers and physically active untrained subjects were recruited. Muscle synergies were extracted from 16 rowing-specific muscles using Principal Component Analysis with varimax rotation. Incremental rowing VO2 max Test was performed on slides ergometer (SE). Rowing performance and physiological variables were analyzed.

    RESULTS: Rowers exerted greater power output, more energy expenditure and better rowing economy compared to untrained subjects. Rowers preferred to row slower with longer strokes compared to the untrained subjects. Three muscle synergies with high indices of similarity of waveform patterns were extracted in both groups. Significant association was found between muscle synergies and rowing economy.

    CONCLUSIONS: The findings of this study showed that muscle synergies were robust during aerobic-dominant activity for collegiate rowers and untrained subjects. Rowers and coaches could utilize the findings by emphasizing on muscle coordination training, which may enhance the rowing economy.

  2. Agrawal S, Chabra T, Pandey S, Bhardwaj P
    Malays Orthop J, 2019 Mar;13(1):20-24.
    PMID: 31001379 DOI: 10.5704/MOJ.1903.003
    Introduction: Carpal collapse of wrist occurs in disorders like rheumatoid arthritis and Kienbock's disease. Three techniques have been described to measure carpal collapse. First, the carpal height ratio (CHR), measured by dividing carpal height by 3rd metacarpal length. Second, the revised carpal height ratio (RCH ratio), measured by dividing carpal height by length of capitate. Third, capitate radius distance (CR index), measured by shortest distance between distal edge of radius and the proximal edge of capitate. The index publications describe good reliability of all these but which method out of the three is best in terms of intra- and inter-observer variability is not known. The purpose of this study was to find out which method had the least inter- and intra-observer variability for determining carpal collapse. Materials and Methods: Fifty normal wrist postero-anterior radiographs were studied by three assessors who measured CHR, RCH ratio and CR index separately. The measurements were repeated after one month by all the three observers. The results were then statistically analysed. Results: The p-value was <0.001 in all the three assessors in CR index meaning that the intra-observer variability was least in CR index. For the inter-observer variability intra class coefficient of 0.9 indicated that the CR index has the least variability. Conclusion: CR index is the most reproducible method to measure carpal collapse. The method which provides accurate measurement of carpal collapse will allow better staging of carpal disorders.

    Study site: Grande Hospital, Nepal
  3. Mail, M.S.Z., Mohd Azhar, N., Affandi, N.F., Shaharudin, S., Agrawal, S., Chee, L.M.
    JUMMEC, 2019;22(2):43-48.
    MyJurnal
    Background: Those with increased dynamic knee valgus are vulnerable to increased risk of non-contact knee
    injuries. However, studies on the top down kinetic chain of lower limb mechanics during dynamic motions
    such as single leg squat (SLS) among trained males were scarce.

    Objective: The objective of the study was to evaluate the relationship between isokinetic hip and knee strength
    and frontal plane projection angle (FPPA) of the knee joint during SLS.

    Methods: Thirty-two male junior athletes (twelve cyclists, ten runners and ten squash players) were screened
    for excessive dynamic knee valgus (DKV) prior to participation. Only those within the normal value of DKV were
    included. Their hip and knee isokinetic strength in sagittal plane were evaluated at 60º/s of angular velocity
    for both legs using dynamometer. Two dimensional knee FPPA was evaluated during SLS at 60º of knee flexion.
    Pearson correlation was evaluated between knee FPPA during SLS and isokinetic leg strength.

    Results: Correlations between knee FPPA and hip and knee isokinetic strength were not statistically significant
    except between knee flexion peak torque/body weight (r = -0.35, p = 0.05) and hamstring to quadriceps ratio
    (r = -0.39, p = 0.03) of non-dominant leg.

    Conclusions: Isokinetic hip and knee strength and knee FPPA during SLS was correlated only for non-dominant
    leg during SLS among male junior athletes. DKV during SLS may be reduced through strengthening the muscles
    around hip and knee joints.
  4. Shaharudin S, Zanotto D, Agrawal S
    J Sports Sci Med, 2014 Dec;13(4):793-800.
    PMID: 25435771
    The slides ergometer (SE) was an improvisation from fixed ergometer (FE) to bridge the gap of mechanics between ergometer rowing and on-water rowing. The specific mechanical constraints of these two types of ergometers may affect the pattern of muscle recruitment, coordination and adaptation. The main purpose of this study was to evaluate the muscle synergy during 6 minutes maximal rowing on slides (SE) and fixed ergometers (FE). The laterality of muscle synergy was also examined. Surface electromyography activity, power output, heart rate, stroke length and stroke rate were analyzed from nine physically active subjects to assess the rowing performance. Physically active subjects, who were not specifically trained in rowing, were chosen to exclude the training effect on muscle synergy. Principal component analysis (PCA) with varimax rotation was applied to extract muscle synergy. Three muscle synergies were sufficient to explain the majority of variance in SE (94.4 ± 2.2 %) and FE (92.8 ± 1.7 %). Subjects covered more rowing distance, exerted greater power output and attained higher maximal heart rate during rowing on SE than on FE. The results proved the flexibility of muscle synergy to adapt to the mechanical constraints. Rowing on SE emphasized on bi-articular muscles contrary to rowing on FE which relied on cumulative effect of trunk and upper limb muscles during propulsive phase. Key pointsThree muscle synergies were extracted during maximal rowing on both fixed and slides ergometerUntrained subjects emphasized leg muscles while rowing on SEUntrained subjects focused on back muscles during FE rowing.
  5. Singhal D, Kanodia N, Singh R, Singh SK, Agrawal S
    Malays Orthop J, 2021 Nov;15(3):71-77.
    PMID: 34966498 DOI: 10.5704/MOJ.2111.011
    Introduction: Pre-operative identification of patients with inadequate hamstring graft for anterior cruciate ligament reconstruction is still a subject of interest. The purpose of this study is to correlate dimension of a harvested dimensions graft with patient physical anthropometric variables.

    Materials and methods: This cohort study included 280 patients (male = 226, female = 54) scheduled for primary anterior cruciate ligament (ACL) reconstruction. Interrelationships between quadruple semitendinosus (ST) graft and anthropometric parameters (age, sex, height, weight, and BMI) were assessed using Pearson Correlation test and regression analysis. Difference among gender was analysed using Mann Whitney and t test. The observed graft diameter was also compared with the literature using Bland - Altman plot.

    Results: Mean age of cohort was 29 years (range, 17-50 years), mean height was 1.69m (range, 1.6-1.9m), mean weight was 75 kg (range, 50-116kg) and mean BMI was 26kg/m2 (range 16.65-40.40kg/m2). Mean quadruple length of harvested ST graft was 7cm (7.1±0.6 cm, range, 5.6-8.8cm) and mean diameter was 8mm (8.2±0.8mm, range, 6.5-10mm). Only height and weight were significantly correlated with graft length and diameter in both sex (p value <0.05). Female, compared to male, had significantly smaller (p<0.0001) and thinner graft (p<0.0001). There was a strong agreement between the literature and our observed graft diameter, but with an overestimated graft diameter in 18.5% of the cases.

    Conclusion: Among anthropometric parameter, only height and weight had moderate positive correlation with graft diameter. Males had longer and wider ST graft in contrast to age-matched female group.

  6. Rani PS, Doddam SN, Agrawal S, Hasnain SE, Sechi LA, Kumar A, et al.
    Int J Med Microbiol, 2014 Jul;304(5-6):620-5.
    PMID: 24863528 DOI: 10.1016/j.ijmm.2014.04.010
    Mycobacterium avium ssp. paratuberculosis (MAP) is an obligate intracellular pathogen. It causes chronic intestinal inflammation in ruminants known as Johne's disease and is associated with human Crohn's disease. Furthermore, association of MAP with other autoimmune diseases, such as type-1 diabetes, has been established in patients from Sardinia (Italy) which is a MAP endemic and genetically isolated region. Due to largest livestock population and consequently high MAP prevalence amidst a very high diabetes incidence in India, we sought to test this association on a limited number of patient samples from Hyderabad. Our results of ELISA with MAP lysate and MAP-specific protein MAP3738c as well as PCR/real-time PCR of MAP-specific sequences IS900 and/or f57 indicated that, in contrast to Sardinian diabetic patients, MAP infection in blood is not discerned in diabetic patients in Hyderabad. The association of a mycobacterial trigger with diabetes therefore could well be a population-specific phenomenon, highly dependent on genetic repertoire and the environment of susceptible populations. However, a larger study is needed in order to confirm this.
  7. Lee YM, Bahrami B, Baranage D, Sivagurunathan PD, Wong W, Bausili MM, et al.
    Clin Exp Ophthalmol, 2024 Aug 15.
    PMID: 39145570 DOI: 10.1111/ceo.14432
    BACKGROUND: To assess topical dorzolamide as medical therapy for idiopathic full-thickness macular holes (FTMHs).

    METHODS: Randomised, double-blinded, placebo-controlled, single-centre clinical trial involving 32 patients with idiopathic small FTMHs (<400 μm $$ \upmu \mathrm{m} $$ ). Participants in both arms used topical dorzolamide 2% or saline thrice daily for 8 weeks with monthly OCT. Those with persisting FTMH underwent vitrectomy with ILM peel and gas tamponade. The primary outcome was the rate of FTMH closure at the end of treatment.

    RESULTS: Between 6 March 2020 and 16 June 2023, 32 eligible patients were enrolled: 16 participants in each arm. All participants in both groups were included in the final analysis. At the final visit, 3 of 16 (18.8%) patients in both the topical dorzolamide and placebo group demonstrated closure. There was no statistically significant difference in the proportion of FTMH closure between the control and treatment group (p = 1.00), nor statistically significant difference in the mean change in best corrected visual acuity (BCVA; p = 0.909). There was no difference in the change in FTMH diameter between groups (p = 0.225). No serious adverse events were reported in either group.

    CONCLUSION: Topical dorzolamide was safe but not superior to placebo in the functional and anatomical outcomes of FTMH.

  8. Trujillo-Santamaría H, Robles-Torres JI, Teoh JY, Tanidir Y, Campos-Salcedo JG, Bravo-Castro EI, et al.
    Curr Urol, 2024 Mar;18(1):55-60.
    PMID: 38505163 DOI: 10.1097/CU9.0000000000000163
    BACKGROUND: Emphysematous pyelonephritis (EPN) is a necrotizing infection of the kidney and the surrounding tissues associated with considerable mortality. We aimed to formulate a score that classifies the risk of mortality in patients with EPN at hospital admission.

    MATERIALS AND METHODS: Patients diagnosed with EPN between 2013 and 2020 were retrospectively included. Data from 15 centers (70%) were used to develop the scoring system, and data from 7 centers (30%) were used to validate it. Univariable and multivariable logistic regression analyses were performed to identify independent factors related to mortality. Receiver operating characteristic curve analysis was performed to construct the scoring system and calculate the risk of mortality. A standardized regression coefficient was used to quantify the discriminating power of each factor to convert the individual coefficients into points. The area under the curve was used to quantify the scoring system performance. An 8-point scoring system for the mortality risk was created (range, 0-7).

    RESULTS: In total, 570 patients were included (400 in the test group and 170 in the validation group). Independent predictors of mortality in the multivariable logistic regression were included in the scoring system: quick Sepsis-related Organ Failure Assessment score ≥2 (2 points), anemia, paranephric gas extension, leukocyte count >22,000/μL, thrombocytopenia, and hyperglycemia (1 point each). The mortality rate was <5% for scores ≤3, 83.3% for scores 6, and 100% for scores 7. The area under the curve was 0.90 (95% confidence interval, 0.84-0.95) for test and 0.91 (95% confidence interval, 0.84-0.97) for the validation group.

    CONCLUSIONS: Our score predicts the risk of mortality in patients with EPN at presentation and may help clinicians identify patients at a higher risk of death.

  9. Global Burden of Disease Cancer Collaboration, Fitzmaurice C, Abate D, Abbasi N, Abbastabar H, Abd-Allah F, et al.
    JAMA Oncol, 2019 Dec 01;5(12):1749-1768.
    PMID: 31560378 DOI: 10.1001/jamaoncol.2019.2996
    IMPORTANCE: Cancer and other noncommunicable diseases (NCDs) are now widely recognized as a threat to global development. The latest United Nations high-level meeting on NCDs reaffirmed this observation and also highlighted the slow progress in meeting the 2011 Political Declaration on the Prevention and Control of Noncommunicable Diseases and the third Sustainable Development Goal. Lack of situational analyses, priority setting, and budgeting have been identified as major obstacles in achieving these goals. All of these have in common that they require information on the local cancer epidemiology. The Global Burden of Disease (GBD) study is uniquely poised to provide these crucial data.

    OBJECTIVE: To describe cancer burden for 29 cancer groups in 195 countries from 1990 through 2017 to provide data needed for cancer control planning.

    EVIDENCE REVIEW: We used the GBD study estimation methods to describe cancer incidence, mortality, years lived with disability, years of life lost, and disability-adjusted life-years (DALYs). Results are presented at the national level as well as by Socio-demographic Index (SDI), a composite indicator of income, educational attainment, and total fertility rate. We also analyzed the influence of the epidemiological vs the demographic transition on cancer incidence.

    FINDINGS: In 2017, there were 24.5 million incident cancer cases worldwide (16.8 million without nonmelanoma skin cancer [NMSC]) and 9.6 million cancer deaths. The majority of cancer DALYs came from years of life lost (97%), and only 3% came from years lived with disability. The odds of developing cancer were the lowest in the low SDI quintile (1 in 7) and the highest in the high SDI quintile (1 in 2) for both sexes. In 2017, the most common incident cancers in men were NMSC (4.3 million incident cases); tracheal, bronchus, and lung (TBL) cancer (1.5 million incident cases); and prostate cancer (1.3 million incident cases). The most common causes of cancer deaths and DALYs for men were TBL cancer (1.3 million deaths and 28.4 million DALYs), liver cancer (572 000 deaths and 15.2 million DALYs), and stomach cancer (542 000 deaths and 12.2 million DALYs). For women in 2017, the most common incident cancers were NMSC (3.3 million incident cases), breast cancer (1.9 million incident cases), and colorectal cancer (819 000 incident cases). The leading causes of cancer deaths and DALYs for women were breast cancer (601 000 deaths and 17.4 million DALYs), TBL cancer (596 000 deaths and 12.6 million DALYs), and colorectal cancer (414 000 deaths and 8.3 million DALYs).

    CONCLUSIONS AND RELEVANCE: The national epidemiological profiles of cancer burden in the GBD study show large heterogeneities, which are a reflection of different exposures to risk factors, economic settings, lifestyles, and access to care and screening. The GBD study can be used by policy makers and other stakeholders to develop and improve national and local cancer control in order to achieve the global targets and improve equity in cancer care.

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