World Top 2% Scientist (Name included in the list of Stanford University USA, released in the month of October 2022 and October 2023 respectively ) since Year 2021
Descriptive statistics are an important part of biomedical research which is used to describe the... more Descriptive statistics are an important part of biomedical research which is used to describe the basic features of the data in the study. They provide simple summaries about the sample and the measures. Measures of the central tendency and dispersion are used to describe the quantitative data. For the continuous data, test of the normality is an important step for deciding the measures of central tendency and statistical methods for data analysis. When our data follow normal distribution, parametric tests otherwise nonparametric methods are used to compare the groups. There are different methods used to test the normality of data, including numerical and visual methods, and each method has its own advantages and disadvantages. In the present study, we have discussed the summary measures and methods used to test the normality of the data.
A study was performed among 4616 people aged 20 years and above in Yangon Division in 2003 to det... more A study was performed among 4616 people aged 20 years and above in Yangon Division in 2003 to determine the prevalence of hypertension and its associated factors. The prevalence of hypertension (systolic blood pressure ≥140 mm Hg, diastolic blood pressure ≥90 mm Hg, or use of antihypertensive drugs) was 33.8% (95% confidence interval [CI] = 32.1%-35.6%). The prevalence of prehypertension (systolic blood pressure = 120 to 139 mm Hg or diastolic blood pressure = 80 to 89 mm Hg) was 29% (95% CI = 27.2%-30.8%). The multiple logistic regression showed that age, low physical activity, high intake of alcohol, obesity, high level of total cholesterol, and diabetes mellitus were associated with hypertension. Among the hypertensive participants, 53% were aware of their hypertension, and 32% were currently taking antihypertensive medication, but only 11% had their hypertension controlled. The study highlights the low level of control despite the high level of hypertension prevalence in Yangon ...
Arquivo Brasileiro de Medicina Veterinária e Zootecnia, 2008
The intraocular pressure (IOP) and its correlations with arterial carbon dioxide partial pressure... more The intraocular pressure (IOP) and its correlations with arterial carbon dioxide partial pressure (PaCO2) and arterial pH were studied in five crested caracaras (Caracara plancus) anesthetized with isoflurane (ISO) and sevoflurane (SEV). Baseline IOP values were measured in both eyes (M0). Brachial artery was previously catheterized to obtain blood gas and cardiorespiratory analysis. Anesthesia was induced with 5% ISO and maintained with 2.5% for 40 minutes. IOP measurements and blood samples were evaluated in different moments until the end of the procedure. After recovering, a second anesthesia was induced with 6% SEV and maintained with 3.5%. Parameters were evaluated at the same time points of the previous procedure. IOP reduced significantly (P= 0.012) from M0 at all time points and no significative changes were observed between ISO and SEV anesthesias. Correlation between IOP and PaCO2 and between PIO and blood pH were found only for SEV. IOP and blood pH decreased in parallel...
Takayasu arteritis (TAK) could cause a stroke or transient ischemic attack (TIA) in young individ... more Takayasu arteritis (TAK) could cause a stroke or transient ischemic attack (TIA) in young individuals due to inflammatory vascular occlusion or intracerebral hemorrhage. We compared the clinical presentation, angiographic features, longitudinal patterns of disease activity, medical treatments, and survival in 34 TAK patients with stroke/TIA and 157 without stroke/TIA from a single-center retrospective cohort. TAK patients with stroke/TIA were older (p = 0.044) with a greater proportion of males (p = 0.022), more frequent vision loss (odds ratio (OR) for stroke/TIA vs. without stroke TIA 5.21, 95% CI 1.42–19.14), and less frequent pulse or blood pressure inequality (OR 0.43, 95% CI 0.19–0.96) than TAK patients without stroke/TIA. Hata’s angiographic type IIa was more common in TAK patients with stroke/TIA (OR 11.00, 95%CI 2.60–46.58) and type V in TAK patients without stroke/TIA (OR 0.27, 95% CI 0.12–0.58). Cyclophosphamide was used more often in TAK patients with stroke/TIA (p = 0.0...
Background & objectives: The association between hyperglycaemia at admission, diabetes mellit... more Background & objectives: The association between hyperglycaemia at admission, diabetes mellitus (DM) status and mortality in hospitalized SARS-CoV-2 infected patients is not clear. The purpose of this study was to determine the relationship between DM, at-admission hyperglycaemia and 28 day mortality in patients admitted with moderate-severe SARS-CoV-2 infection requiring intensive care. Methods: All consecutive moderate-to-severe patients with SARS-CoV-2 infection admitted to the intensive care units (ICUs) over six months were enrolled in this single-centre, retrospective study. The predicators for 28 day mortality were analysed from the independent variables including DM status and hyperglycaemia at-admission. Results: Four hundred and fifty two patients with SARS-CoV-2 were admitted to the ICU, with a mean age of 58.5±13.4 yr, 78.5 per cent being male, HbA1c of 7.2 per cent (6.3-8.8) and 63.7 per cent having DM. Overall, 28 day mortality was 48.9 per cent. In univariate analysis, mortality in diabetes patients was comparable with non-diabetes (47.9 vs. 50.6%, P=0.58), while it was significantly higher in hyperglycaemic group (60.4 vs. 35.8%, P<0.001). In multivariate Cox regression analysis, after adjusting for age, sex and comorbidities, hyperglycaemia at-admission was an independent risk factor of mortality [hazard ratio (HR) 1.45, 95% confidence interval (CI) (1.06-1.99), P<0.05]. Interpretation & conclusions: This study showed that the presence of hyperglycaemia at-admission in critically ill SARS-CoV-2 patients was an independent predictor of 28 day mortality. However, the findings may be susceptible to unmeasured confounding, and more research from prospective studies is required.
Journal of Advances in Medicine and Medical Research
Introduction: Breast cancer commonly presents in locally advanced stage (LABC) in developing coun... more Introduction: Breast cancer commonly presents in locally advanced stage (LABC) in developing countries, for which NACT followed by surgery and radiotherapy is the standard of care. There is a need for a simple tool to risk categorise patients in the clinic, so that treatment intensification can be offered to women with high risk of recurrence. Materials and Methods: Data of prospectively maintained database of LABC (between January 2007 - December 2012), who received NACT followed by surgery, radiotherapy and endocrine therapy was retrospectively analysed for clinico-pathological factors associated with disease recurrences. A recurrence risk scoring model was developed on the basis of regression coefficient of identified independent risk factors. Results: In the data set of 206 patients, the median follow-up was 48 months (range: 6-156 months) and mean and median disease-free survival (DFS) were 87.41 and 85 months. The 1, 5, 10 years DFS was 95%, 54% and 41%. The independent risk f...
Background: Bio-medical waste is perilous and can be a health hazard. There is considerable role ... more Background: Bio-medical waste is perilous and can be a health hazard. There is considerable role of medical undergraduates, interns and post-graduates in preventing hazardous consequences from mishandling of bio-medical waste. Aims & Objectives: To assess the knowledge, attitude and practice about Bio-medical waste management among medical undergraduates, interns and post-graduate students. Methodology: A cross-sectional study was carried out among 75 participants including MBBS students, interns and post-graduate students (25 from each group) at King George’s Medical University, Lucknow through purposive sampling technique over a period of one month. A structured self-administered questionnaire was used for data collection. Data were analyzed using Chi-square, Fischer-exact, one-way ANOVA and Post Hoc (Tukey) Tests. Results: MBBS students had more knowledge and the better attitude towards BMW management guidelines as compared to interns and post-graduates(p<0.001), while post-gr...
BackgroundCOVID‐19‐associated pulmonary aspergillosis (CAPA) has been widely reported but homogen... more BackgroundCOVID‐19‐associated pulmonary aspergillosis (CAPA) has been widely reported but homogenous large cohort studies are needed to gain real‐world insights about the disease.MethodsWe collected clinical and laboratory data of 1161 patients hospitalised at our Institute from March 2020 to August 2021, defined their CAPA pathology, and analysed the data of CAPA/non‐CAPA and deceased/survived CAPA patients using univariable and multivariable models.ResultsThe overall prevalence and mortality of CAPA in our homogenous cohort of 1161 patients were 6.4% and 47.3%, respectively. The mortality of CAPA was higher than that of non‐CAPA patients (hazard ratio: 1.8 [95% confidence interval: 1.1–2.8]). Diabetes (odds ratio [OR] 1.92 [1.15–3.21]); persistent fever (2.54 [1.17–5.53]); hemoptysis (7.91 [4.45–14.06]); and lung lesions of cavitation (8.78 [2.27–34.03]), consolidation (9.06 [2.03–40.39]), and nodules (8.26 [2.39–28.58]) were associated with development of CAPA by multivariable an...
Background Posterior fossa malformations are less common than supratentorial malformations, but h... more Background Posterior fossa malformations are less common than supratentorial malformations, but hemorrhages in posterior fossa are more serious due to presence of vital structures within this region. Most common cause of bleed in posterior fossa apart from hypertension is aneurysms but other vascular malformations are also there which cause hemorrhage. Here we discuss other causes of posterior fossa bleed beyond aneurysms. Results A total of 80 patients were evaluated: 47 (58.8%) had aneurysms, 29 (36.3%) had arteriovenous malformations, one each had developmental venous anomaly and brainstem cavernoma. Thirty vascular malformations were detected, of which 18 (62.1%) were pial arteriovenous malformations (AVMs), 11 (37.9%) were dural arteriovenous fistulas (dAVF), and one had developmental venous anomaly (DVA). Six patients of AVM underwent both DSA and CTA, and CTA could correctly diagnose only 2 of 4 pial AVMs detected by DSA. Among two dAVFs detected by DSA, CTA could demonstrate...
Descriptive statistics are an important part of biomedical research which is used to describe the... more Descriptive statistics are an important part of biomedical research which is used to describe the basic features of the data in the study. They provide simple summaries about the sample and the measures. Measures of the central tendency and dispersion are used to describe the quantitative data. For the continuous data, test of the normality is an important step for deciding the measures of central tendency and statistical methods for data analysis. When our data follow normal distribution, parametric tests otherwise nonparametric methods are used to compare the groups. There are different methods used to test the normality of data, including numerical and visual methods, and each method has its own advantages and disadvantages. In the present study, we have discussed the summary measures and methods used to test the normality of the data.
A study was performed among 4616 people aged 20 years and above in Yangon Division in 2003 to det... more A study was performed among 4616 people aged 20 years and above in Yangon Division in 2003 to determine the prevalence of hypertension and its associated factors. The prevalence of hypertension (systolic blood pressure ≥140 mm Hg, diastolic blood pressure ≥90 mm Hg, or use of antihypertensive drugs) was 33.8% (95% confidence interval [CI] = 32.1%-35.6%). The prevalence of prehypertension (systolic blood pressure = 120 to 139 mm Hg or diastolic blood pressure = 80 to 89 mm Hg) was 29% (95% CI = 27.2%-30.8%). The multiple logistic regression showed that age, low physical activity, high intake of alcohol, obesity, high level of total cholesterol, and diabetes mellitus were associated with hypertension. Among the hypertensive participants, 53% were aware of their hypertension, and 32% were currently taking antihypertensive medication, but only 11% had their hypertension controlled. The study highlights the low level of control despite the high level of hypertension prevalence in Yangon ...
Arquivo Brasileiro de Medicina Veterinária e Zootecnia, 2008
The intraocular pressure (IOP) and its correlations with arterial carbon dioxide partial pressure... more The intraocular pressure (IOP) and its correlations with arterial carbon dioxide partial pressure (PaCO2) and arterial pH were studied in five crested caracaras (Caracara plancus) anesthetized with isoflurane (ISO) and sevoflurane (SEV). Baseline IOP values were measured in both eyes (M0). Brachial artery was previously catheterized to obtain blood gas and cardiorespiratory analysis. Anesthesia was induced with 5% ISO and maintained with 2.5% for 40 minutes. IOP measurements and blood samples were evaluated in different moments until the end of the procedure. After recovering, a second anesthesia was induced with 6% SEV and maintained with 3.5%. Parameters were evaluated at the same time points of the previous procedure. IOP reduced significantly (P= 0.012) from M0 at all time points and no significative changes were observed between ISO and SEV anesthesias. Correlation between IOP and PaCO2 and between PIO and blood pH were found only for SEV. IOP and blood pH decreased in parallel...
Takayasu arteritis (TAK) could cause a stroke or transient ischemic attack (TIA) in young individ... more Takayasu arteritis (TAK) could cause a stroke or transient ischemic attack (TIA) in young individuals due to inflammatory vascular occlusion or intracerebral hemorrhage. We compared the clinical presentation, angiographic features, longitudinal patterns of disease activity, medical treatments, and survival in 34 TAK patients with stroke/TIA and 157 without stroke/TIA from a single-center retrospective cohort. TAK patients with stroke/TIA were older (p = 0.044) with a greater proportion of males (p = 0.022), more frequent vision loss (odds ratio (OR) for stroke/TIA vs. without stroke TIA 5.21, 95% CI 1.42–19.14), and less frequent pulse or blood pressure inequality (OR 0.43, 95% CI 0.19–0.96) than TAK patients without stroke/TIA. Hata’s angiographic type IIa was more common in TAK patients with stroke/TIA (OR 11.00, 95%CI 2.60–46.58) and type V in TAK patients without stroke/TIA (OR 0.27, 95% CI 0.12–0.58). Cyclophosphamide was used more often in TAK patients with stroke/TIA (p = 0.0...
Background & objectives: The association between hyperglycaemia at admission, diabetes mellit... more Background & objectives: The association between hyperglycaemia at admission, diabetes mellitus (DM) status and mortality in hospitalized SARS-CoV-2 infected patients is not clear. The purpose of this study was to determine the relationship between DM, at-admission hyperglycaemia and 28 day mortality in patients admitted with moderate-severe SARS-CoV-2 infection requiring intensive care. Methods: All consecutive moderate-to-severe patients with SARS-CoV-2 infection admitted to the intensive care units (ICUs) over six months were enrolled in this single-centre, retrospective study. The predicators for 28 day mortality were analysed from the independent variables including DM status and hyperglycaemia at-admission. Results: Four hundred and fifty two patients with SARS-CoV-2 were admitted to the ICU, with a mean age of 58.5±13.4 yr, 78.5 per cent being male, HbA1c of 7.2 per cent (6.3-8.8) and 63.7 per cent having DM. Overall, 28 day mortality was 48.9 per cent. In univariate analysis, mortality in diabetes patients was comparable with non-diabetes (47.9 vs. 50.6%, P=0.58), while it was significantly higher in hyperglycaemic group (60.4 vs. 35.8%, P<0.001). In multivariate Cox regression analysis, after adjusting for age, sex and comorbidities, hyperglycaemia at-admission was an independent risk factor of mortality [hazard ratio (HR) 1.45, 95% confidence interval (CI) (1.06-1.99), P<0.05]. Interpretation & conclusions: This study showed that the presence of hyperglycaemia at-admission in critically ill SARS-CoV-2 patients was an independent predictor of 28 day mortality. However, the findings may be susceptible to unmeasured confounding, and more research from prospective studies is required.
Journal of Advances in Medicine and Medical Research
Introduction: Breast cancer commonly presents in locally advanced stage (LABC) in developing coun... more Introduction: Breast cancer commonly presents in locally advanced stage (LABC) in developing countries, for which NACT followed by surgery and radiotherapy is the standard of care. There is a need for a simple tool to risk categorise patients in the clinic, so that treatment intensification can be offered to women with high risk of recurrence. Materials and Methods: Data of prospectively maintained database of LABC (between January 2007 - December 2012), who received NACT followed by surgery, radiotherapy and endocrine therapy was retrospectively analysed for clinico-pathological factors associated with disease recurrences. A recurrence risk scoring model was developed on the basis of regression coefficient of identified independent risk factors. Results: In the data set of 206 patients, the median follow-up was 48 months (range: 6-156 months) and mean and median disease-free survival (DFS) were 87.41 and 85 months. The 1, 5, 10 years DFS was 95%, 54% and 41%. The independent risk f...
Background: Bio-medical waste is perilous and can be a health hazard. There is considerable role ... more Background: Bio-medical waste is perilous and can be a health hazard. There is considerable role of medical undergraduates, interns and post-graduates in preventing hazardous consequences from mishandling of bio-medical waste. Aims & Objectives: To assess the knowledge, attitude and practice about Bio-medical waste management among medical undergraduates, interns and post-graduate students. Methodology: A cross-sectional study was carried out among 75 participants including MBBS students, interns and post-graduate students (25 from each group) at King George’s Medical University, Lucknow through purposive sampling technique over a period of one month. A structured self-administered questionnaire was used for data collection. Data were analyzed using Chi-square, Fischer-exact, one-way ANOVA and Post Hoc (Tukey) Tests. Results: MBBS students had more knowledge and the better attitude towards BMW management guidelines as compared to interns and post-graduates(p<0.001), while post-gr...
BackgroundCOVID‐19‐associated pulmonary aspergillosis (CAPA) has been widely reported but homogen... more BackgroundCOVID‐19‐associated pulmonary aspergillosis (CAPA) has been widely reported but homogenous large cohort studies are needed to gain real‐world insights about the disease.MethodsWe collected clinical and laboratory data of 1161 patients hospitalised at our Institute from March 2020 to August 2021, defined their CAPA pathology, and analysed the data of CAPA/non‐CAPA and deceased/survived CAPA patients using univariable and multivariable models.ResultsThe overall prevalence and mortality of CAPA in our homogenous cohort of 1161 patients were 6.4% and 47.3%, respectively. The mortality of CAPA was higher than that of non‐CAPA patients (hazard ratio: 1.8 [95% confidence interval: 1.1–2.8]). Diabetes (odds ratio [OR] 1.92 [1.15–3.21]); persistent fever (2.54 [1.17–5.53]); hemoptysis (7.91 [4.45–14.06]); and lung lesions of cavitation (8.78 [2.27–34.03]), consolidation (9.06 [2.03–40.39]), and nodules (8.26 [2.39–28.58]) were associated with development of CAPA by multivariable an...
Background Posterior fossa malformations are less common than supratentorial malformations, but h... more Background Posterior fossa malformations are less common than supratentorial malformations, but hemorrhages in posterior fossa are more serious due to presence of vital structures within this region. Most common cause of bleed in posterior fossa apart from hypertension is aneurysms but other vascular malformations are also there which cause hemorrhage. Here we discuss other causes of posterior fossa bleed beyond aneurysms. Results A total of 80 patients were evaluated: 47 (58.8%) had aneurysms, 29 (36.3%) had arteriovenous malformations, one each had developmental venous anomaly and brainstem cavernoma. Thirty vascular malformations were detected, of which 18 (62.1%) were pial arteriovenous malformations (AVMs), 11 (37.9%) were dural arteriovenous fistulas (dAVF), and one had developmental venous anomaly (DVA). Six patients of AVM underwent both DSA and CTA, and CTA could correctly diagnose only 2 of 4 pial AVMs detected by DSA. Among two dAVFs detected by DSA, CTA could demonstrate...
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Papers by Prabhaker Mishra