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Search Results: 1 - 10 of 324989 matches for " Udaya S Tantry "
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Interaction between clopidogrel and proton-pump inhibitors and management strategies in patients with cardiovascular diseases
Paul A Gurbel, Udaya S Tantry, Dean J Kereiakes
Drug, Healthcare and Patient Safety , 2010, DOI: http://dx.doi.org/10.2147/DHPS.S7297
Abstract: teraction between clopidogrel and proton-pump inhibitors and management strategies in patients with cardiovascular diseases Review (3676) Total Article Views Authors: Paul A Gurbel, Udaya S Tantry, Dean J Kereiakes Published Date November 2010 Volume 2010:2 Pages 233 - 240 DOI: http://dx.doi.org/10.2147/DHPS.S7297 Paul A Gurbel1, Udaya S Tantry1, Dean J Kereiakes2 1Sinai Center for Thrombosis Research, Sinai Hospital of Baltimore, Baltimore, MD, USA; 2The Christ Hospital Heart and Vascular Center/The Lindner Research Center at The Christ Hospital, Cincinnati, OH, USA Abstract: Dual antiplatelet therapy (DAPT) with clopidogrel and aspirin has been successful in reducing ischemic events in a wide range of patients with cardiovascular diseases. However, the anti-ischemic effects of DAPT may also be associated with gastrointestinal (GI) complications including ulceration and bleeding particularly in ‘high risk’ and elderly patients. Current guidelines recommend the use of proton-pump inhibitors (PPIs) to reduce the risk of GI bleeding in patients treated with DAPT. However, pharmacodynamic studies suggest an effect of PPIs on clopidogrel metabolism with a resultant reduction in platelet inhibitory effects. Similarly, several observational studies have demonstrated reduced clopidogrel benefit in patients who coadministered PPIs. Although recent US Food and Drug Administration and European Medicines Agency statements discourage PPI (particularly omeprazole) and clopidogrel coadministration, the 2009 AHA/ACC/SCAI PCI guidelines do not support a change in current practice in the absence of adequately powered prospective randomized clinical trial data. The data regarding pharmacologic and clinical interactions between PPI and clopidogrel therapies are herein examined and treatment strategies are provided.
Interaction between clopidogrel and proton-pump inhibitors and management strategies in patients with cardiovascular diseases
Paul A Gurbel,Udaya S Tantry,Dean J Kereiakes
Drug, Healthcare and Patient Safety , 2010,
Abstract: Paul A Gurbel1, Udaya S Tantry1, Dean J Kereiakes21Sinai Center for Thrombosis Research, Sinai Hospital of Baltimore, Baltimore, MD, USA; 2The Christ Hospital Heart and Vascular Center/The Lindner Research Center at The Christ Hospital, Cincinnati, OH, USAAbstract: Dual antiplatelet therapy (DAPT) with clopidogrel and aspirin has been successful in reducing ischemic events in a wide range of patients with cardiovascular diseases. However, the anti-ischemic effects of DAPT may also be associated with gastrointestinal (GI) complications including ulceration and bleeding particularly in ‘high risk’ and elderly patients. Current guidelines recommend the use of proton-pump inhibitors (PPIs) to reduce the risk of GI bleeding in patients treated with DAPT. However, pharmacodynamic studies suggest an effect of PPIs on clopidogrel metabolism with a resultant reduction in platelet inhibitory effects. Similarly, several observational studies have demonstrated reduced clopidogrel benefit in patients who coadministered PPIs. Although recent US Food and Drug Administration and European Medicines Agency statements discourage PPI (particularly omeprazole) and clopidogrel coadministration, the 2009 AHA/ACC/SCAI PCI guidelines do not support a change in current practice in the absence of adequately powered prospective randomized clinical trial data. The data regarding pharmacologic and clinical interactions between PPI and clopidogrel therapies are herein examined and treatment strategies are provided.Keywords: cardiovascular disease, gastrointestinal, proton-pump inhibitor, antiplatelet therapy
Impact of clopidogrel treatment on platelet function and thrombogenecity in diabetic patients undergoing elective coronary stenting  [PDF]
Anand Singla, Kevin P. Bliden, Young-Hoon Jeong, Joseph DiChiara, Mark J. Antonino, Denny P. Mathew, William C. Muse, Katrina Abadilla, Tania Gesheff, Udaya S. Tantry, Paul A. Gurbel
Journal of Diabetes Mellitus (JDM) , 2012, DOI: 10.4236/jdm.2012.22025
Abstract: High platelet reactivity (HPR) and suboptimal response to dual antiplatelet therapy (DAPT) may explain high recurrent rates of ischemic events in Type II diabetes mellitus (DM) patients undergoing percutaneous coronary intervention (PCI). The aim of this study was to examine the effect of clopidogrel on platelet reactivity, and thrombogenecity between DM and non-DM PCI-treated patients (n = 138). Patients were categorized according to clopidogrel treatment and DM status. Patients received a maintenance-dose clopidogrel of 75 mg/d (C75 group, n = 72) or a 600 mg clopidogrel loading-dose in clopidogrel na?ve patients (C600 group, n = 66). Platelet function was assessed by thrombelastography, flow cytometry, VerifyNowTM aspirin assay and light transmittance aggregometry (LTA). Aspirin response was similar between treatments and DM status. In the C75 group, DM patients had higher 5 and 20 μM ADP-, 2 μg/ml collagen-induced LTA; and p-selectin expression compared to non-DM patients (p ≤ 0.05 for all). DM patients in the C600 group had higher 5 and 20 μM ADP-induced LTA post dosing (p < 0.04) and higher maximum induced platelet-fibrin clot strength at baseline and post dosing timepoints (p < 0.05 for all). The present study provides further evidence that DM patients on DAPT are characterized by persistently higher platelet reactivity and thrombogenecity, making them potential candidates for more potent P2Y12 receptor antagonists.
A Comparative Study of DOTS and Non-DOTS Interventions in Tuberculosis Cure
S Murali,N Udaya
Indian Journal of Community Medicine , 2004,
Abstract:
Augmenting Numerical Stability of the Galerkin Finite Element Formulation for Electromagnetic Flowmeter Analysis
Sethupathy S,Udaya Kumar
Mathematics , 2015,
Abstract: The magnetic flow meter is one of the best possible choice for the measurement of flow rate of liquid metals in fast breeder reactors. Due to the associated complexities in the measuring environment, theoretical evaluation of their sensitivity is always preferred. In order to consider the 3D nature of the problem and the general flow patterns, numerical field computational approach is inevitable. When classical Galerkin's finite element formulation is employed for the solution, it is known to introduce numerical oscillations at high flow rates. The magnetic field produced by the flow induced currents circulate within the fluid and forms the source of this numerical problem. To overcome this, modified methods like stream-line upwind Petrov-Galerkin schemes are generally suggested in the allied areas like fluid dynamics, in which a similar dominance of advective (curl or circulation) component occurs over diffusion (divergence) component. After a careful analysis of the numerical instability through a reduced one dimensional problem, an elegant stable approach is devised. In this scheme, a pole-zero cancellation approach is adopted. The proposed scheme is shown to be absolutely stable. However, at lower flow rates numerical results exhibits small oscillation, which can be controlled by reducing the element size. The source of stability at higher flow rates, as well as, oscillations at lower flow rates are analysed using analytical solution of the associated difference equation. Finally the proposed approach is applied to the original flow meter problem and the solution is shown to be stable.
Butorphanol for Post-Operative Analgesia - A Comparative Clinical Study with Ketorolac
Thrivikrama Padur Tantry,Nandish S Vastrad,Prashanth Mohan,Rajani Kadri
Online Journal of Health & Allied Sciences , 2010,
Abstract: Introduction: Butorphanol, an opioid derivative has been shown to have, in addition to its analgesic properties, several other advantageous effects like antistressor, sedative and anti-shivering action. The efficacy and safety profile of ketorolac, yet another widely used post-operative analgesic is well documented. This study aims to compare the two analgesics. Aims and objectives: This study was conducted to compare the analgesic efficacy and other effects of butorphanol and ketorolac, administered intramuscularly, in post-operative patients who have undergone lower abdominal and pelvic surgeries. Materials and methods: 50 patients undergoing lower abdominal and pelvic surgeries under general or spinal anaesthesia were randomly divided into two Groups (25 each). At a particular level of post-operative pain, the patients Groups I and II were administered intramuscular ketorolac 30mg and butorphanol 2mg respectively. The analgesic effect was studied using Visual Analogue Scale (VAS) and the verbal category scale. Patients were monitored for the sedative action, respiratory status and other vital parameters for 300 minutes and for other adverse reactions over the next twelve hours. Observations: Butorphanol provided better analgesia within the first two hours of administration, while ketorolac was more effective at 4-5 hours. Better sedative action without any significant respiratory depressant effect was demonstrated with butorphanol. There were no clinically significant hemodynamic fluctuations or adverse reactions with butorphanol or ketorolac. Conclusions: Butorphanol provides better early analgesia as compared to ketorolac with a desirable and safe sedative effect in post-operative patients who have undergone lower abdominal and pelvic surgeries.
Congenital cystic biliary disease (a case report).
Tantry B,Yadav S,Kumar V,Padhee A
Journal of Postgraduate Medicine , 1989,
Abstract:
Formation of Composite Surface during Friction Surfacing of Steel with Aluminium
S. Janakiraman,K. Udaya Bhat
Advances in Tribology , 2012, DOI: 10.1155/2012/614278
Abstract: Commercial pure aluminium was deposited on medium carbon steel using friction surfacing route. An aluminium rod was used as the consumable tool. Normal load and tool rotation speed were the variables. Under certain combinations of load and speed the deposition was continuous and uniform. The deposit consisted of Al embedded with fine particles of iron. The interface between substrate material and deposited material was smooth and relatively small. A mechanism is discussed for formation of a composite surface on the steel substrate. 1. Introduction Steel remains one of the important structural material because of its relatively low cost, high processability, manipulation of the properties using principles of alloy design, heat treatment, and so forth [1]. Unfortunately, it’s service properties like corrosion resistance, oxidation resistance, are not very good. This limitation arises because the oxide layer forming on the surface of the steel is a noncompact one [1]. This limitation can be overcome by modifying the surface of the steel appropriately, either by changing the surface chemistry (alloying at the surface) or by deposition of another metal at the surface [2]. The deposited metal may on its own give beneficial properties or after appropriate conversion. On this count, deposition of a thin layer of aluminium on steel is very relevant. Aluminium layer, when it is oxidized, forms a compact oxide layer, protecting the substrate steel from oxidation, corrosion, and abrasion [3, 4]. A thin layer of Al on steel can be obtained by various means, that is, liquid route and solid route. Hot dip aluminising is a predominant method using liquid route, but this route is handicapped by the formation of brittle intermetallics [5]. Chemical routes like pack aluminising do not involve use of liquid state, but they also involve processing at elevated temperatures for long duration, again giving rise to intermetallics and grain growth in the substrate. In this context friction surfacing is a promising route. It can produce an aluminium layer on the steel substrate [6], and if a compact oxide layer is required top layer can be made to undergo oxidation. In friction surfacing the surface of a component is modified using mechanical energy generated using a friction tool [7]. An alloying element can be added during friction surfacing which will be mixed with the substrate to generate an alloyed surface. In friction surfacing, the tool is a consumable one and depending on the relative strengths of substrate and tool materials, as well as temperature attained, both
Iowa medicaid 2: lapse of glycemic control on abrupt transition from insulin glargine to insulin detemir in type 2 diabetes mellitus  [PDF]
Udaya Kabadi
Journal of Diabetes Mellitus (JDM) , 2011, DOI: 10.4236/jdm.2011.14017
Abstract: Background: Iowa Care (Iowa Medicaid in State of Iowa, USA), switched insulin glargine to detemir in subjects with Diabetes Mellitus (DM) without the knowledge or approval of healthcare providers beginning 8/2006.Impact of this transition in subjects with Type 1 DM is recently reported. Objective: To examine the impact of this transition on various parameters of diabetes management in Type 2 DM. Subjects and Methods: A retrospective review of the records of subjects with Type 2 DM was conducted until 8/2007 in whom the transition had occurred. Only those subjects with adequate glycemic control while receiving insulin glargine [GI] and completing at least 3 months of therapy with insulin detemir [DI] are included in this report. Ten subjects with Type 2 DM, duration 7 ± 2 years with age, 55 ± 3 years who were switched from GI to DI (Group 1) fulfilled the criteria for inclusion. Subjects were switched from GI in Q AM to DI Q HS in the same daily dose. Glycemic control (HbA1c), body weight, daily insulin dose (Units) and severe hypoglycemic events during the last 2 weeks of the period, pre switch and again at the end of 3 months post switch were assessed. Records of 8 subjects matched for age, duration of DM, glycemic control while receiving GI for additional 3 months (Group 2) during the same period were examined for comparison. All subjects were followed in the outpatient clinic at intervals of 3 months. Results Glycemic control remained stable on continuing GI AM; HbA1c; 7.1 ± 0.3 to 7.1 ± 0.3%, while it worsened on switching to DI Q HS; HbA1c, 7.1 ± 0.3 to 8.1 ± 0.5 [P < 0.01]. A mild weight loss was noted in subjects on transition. No severe hypoglycemic events were reported in any subject in either group. Conclusion Abrupt transition from insulin glargine to insulin detemir in subjects with Type 2 DM is likely to result in lapse of glycemic control which may cause decreased quality of life. Furthermore, use of insulin detemir may result in increased costs due to need of the higher daily dose as well as additional equipment required for probable twice daily administration to achieve adequate glycemic control. Therefore, insulin glargine and detemir appear to be far from being bioequivalent.
Preliminary Studies on Plants with Anthelmintic Properties in Kashmir—The North-West Temperate Himalayan Region of India  [PDF]
Khurshid A. Tariq, Mudasir A. Tantry
Chinese Medicine (CM) , 2012, DOI: 10.4236/cm.2012.32017
Abstract: There is a growing interest in traditional uses of plants for health care among different communities especially in the developing countries. Kashmir valley is a temperate agro-climatic zone of north-west temperate Himalayan region of India and is blessed with a diverse variety of medicinal flora. The traditional uses of plants against parasitic infections in human beings and their live-stock is a common practice in the valley as most of the populations are rural and conventional veterinary drugs are very expensive and therefore unaffordable. This study is an ethno-botanical survey of those plant species traditionally used as anthelmintic that may warrant scientific validation for efficacy. The survey utilized well structured questionnaire and detailed discussions and recorded 44 plant species belonging to 37 genera and 26 families claimed as traditional anthelmintics in different preparations and forms. Out of these some plant species like Artemisia absinthium (tethwen) and Achillea millifolium (pahel-ghassa) were scientifically validated for their claimed anthelmintic action against gastrointestinal nematode infections in sheep. A few of other plants like Allium sativum (rohun), Myrsine africana have been scientifically validated for their claim by other people in various parts of the world. These plants together with other species reported in this study could be further scientifically evaluated for in vitro and in vivo anthelmintic activity against a diverse variety of parasitic groups in host and non host animals. That will lay a foundation and set a targeted platform for pharmacological studies and development of novel anthelmintic products to fill a gap in the anthelmintic drug industry, which is facing the crisis of anthelmintic resistance to conventional anthelmintic drugs.
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