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Search Results: 1 - 10 of 436 matches for " Dodani Sunita "
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Community-Based Participatory Research Approaches for Hypertension Control and Prevention in Churches
Sunita Dodani
International Journal of Hypertension , 2011, DOI: 10.4061/2011/273120
Abstract: Hypertension (HTN) is a highly prevalent risk factor for cardiovascular (CV), cerebrovascular, and renal diseases and disproportionately affects African Americans (AAs). It has been shown that promoting the adoption of healthy lifestyles, ones that involve best practices of diet and exercise and abundant expert support, can, in a healthcare setting, reduce the incidence of hypertension in those who are at high risk. In this paper, we will examine whether similar programs are effective in the AA church-community-based participatory research settings, outside of the healthcare arena. If successful, these church-based approaches may be applied successfully to reduce the incidence and consequences of hypertension in large communities with potentially huge impact on public health.
Excess coronary artery disease risk in South Asian immigrants: Can dysfunctional high-density lipoprotein explain increased risk?
Sunita Dodani
Vascular Health and Risk Management , 2008,
Abstract: Sunita DodaniMedical College of Georgia, Augusta, GA, USABackground: Coronary artery disease (CAD) is the leading cause of mortality and morbidity in the United States (US), and South Asian immigrants (SAIs) have a higher risk of CAD compared to Caucasians. Traditional risk factors may not completely explain high risk, and some of the unknown risk factors need to be explored. This short review is mainly focused on the possible role of dysfunctional high-density lipoprotein (HDL) in causing CAD and presents an overview of available literature on dysfunctional HDL.Discussion: The conventional risk factors, insulin resistance parameters, and metabolic syndrome, although important in predicting CAD risk, may not sufficiently predict risk in SAIs. HDL has antioxidant, antiinflammatory, and antithrombotic properties that contribute to its function as an antiatherogenic agent. Recent Caucasian studies have shown HDL is not only ineffective as an antioxidant but, paradoxically, appears to be prooxidant, and has been found to be associated with CAD. Several causes have been hypothesized for HDL to become dysfunctional, including Apo lipoprotein A-I (Apo A-I) polymorphisms. New risk factors and markers like dysfunctional HDL and genetic polymorphisms may be associated with CAD.Conclusions: More research is required in SAIs to explore associations with CAD and to enhance early detection and prevention of CAD in this high risk group.Keywords: South Asian immigrants, coronary heart disease, cardiovascular risk, high-density lipoprotein
Community-Based Participatory Research Approaches for Hypertension Control and Prevention in Churches
Sunita Dodani
International Journal of Hypertension , 2011, DOI: 10.4061/2011/273120
Abstract: Hypertension (HTN) is a highly prevalent risk factor for cardiovascular (CV), cerebrovascular, and renal diseases and disproportionately affects African Americans (AAs). It has been shown that promoting the adoption of healthy lifestyles, ones that involve best practices of diet and exercise and abundant expert support, can, in a healthcare setting, reduce the incidence of hypertension in those who are at high risk. In this paper, we will examine whether similar programs are effective in the AA church-community-based participatory research settings, outside of the healthcare arena. If successful, these church-based approaches may be applied successfully to reduce the incidence and consequences of hypertension in large communities with potentially huge impact on public health. 1. Introduction Hypertension (HTN) is one of the most common diseases facing the American public today with elevated blood pressure (BP) representing the number 1 attributable risk for death worldwide [1–3]. The National Health and Nutrition Examination Survey (NHANES) data indicate that the age-standardized prevalence of HTN increased from 24.4% to 28.9% ( ) between surveys conducted in 1989–1991 and 1999–2004 [4]. An aging population, growing rates of obesity, high-sodium diets, and a sedentary lifestyle all are thought to contribute to this increase [5]. Nationally, HTN is the largest treatable contributor to stroke and the second largest contributor to coronary artery disease (CAD). It is also the second leading cause of end-stage renal disease and contributes significantly to congestive heart failure [6]. HTN increases the risk of stroke, heart attack, heart failure, and kidney disease [1, 3], and though it is a modifiable risk factor for all the aforementioned diseases, however, no significant change in HTN prevalence is seen from 1999 to 2006 [7, 8]. In 2005-2006, approximately 29% of the US population over the age of 18 was hypertensive (almost equal prevalence between male and female), with the definition of HTN being systolic BP (SBP) ≥140?mm?Hg and/or diastolic BP (DBP) ≥90?mm?Hg, or taking medications for HTN [3, 7, 8]. The prevalence of HTN increased with age from 7% among those aged 18–39 years to 67% among those aged 60 years and older [7]. Furthermore, during this time period, pre-HTN, defined as SBP between 120–139?mm?Hg and DBP between 80–89?mm?Hg emerged as is an independent risk factor for cardiovascular disease (CVD) [9] and is associated with an increase in all-cause and CV mortality [10–14]. Currently an estimated 37% of adult Americans have pre-HTN,
HEALS: A Faith-Based Hypertension Control Program for African-Americans: A Feasibility Study  [PDF]
Sunita Dodani, Sahel Arora, Dale Kraemer
Open Journal of Internal Medicine (OJIM) , 2014, DOI: 10.4236/ojim.2014.43015
Abstract: Objective: To determine the feasibility of a behavioral faith-based PREMIER study modified hypertension (HTN) control intervention in a semi urban African-American (AA) church. Methods: In a prospective longitudinal study design, a 12-week behavioral HEALS (Healthy Eating and Living Spiritually) intervention was tested for its feasibility and efficacy in a semi urban AA church. High-risk adult church members with HTN were recruited. Program sessions were weekly delivered by the trained church members. Data were analyzed using repeated measures ANOVA. Results: 22 of 34 subjects (65% retention) provided complete information on the outcome measures. Mean systolic blood pressure (SBP) reduction from baseline was 22 mmHg (p < 0.001) and 6.5 mmHg for diastolic BP (p = 0.0048). Mean weight reduction of 3.11 kg from the baseline (p < 0.0001) was also observed. 91% subjects attended 7 - 9 sessions. Conclusion: Promoting behavioral HTN control interventions in high risk AAs by empowering AA church communities is feasible and efficacious.
HEALS: A Faith-Based Hypertension Control and Prevention Program for African American Churches: Training of Church Leaders as Program Interventionists
Sunita Dodani,Debra Sullivan,Sydney Pankey,Catherine Champagne
International Journal of Hypertension , 2011, DOI: 10.4061/2011/820101
Abstract: Background. A 12-session church-based HEALS program (healthy eating and living spiritually) was developed for hypertension control and prevention program in African Americans (AAs). This study presents specifics of training lay health educators to effectively deliver HEALS to high-risk AAs. Methods. A one-day workshop was conducted by the research experts in an AA church. Five church members were recruited to be program interventionists called church health counselors (CHCs). Results. Using principles of adult education, a training protocol was developed with the intention of recognizing and supporting CHCs skills. CHCs received training on delivering HEALS program. The process of training emphasized action methods including role playing and hands-on experience with diet portion measurements. Conclusion. With adequate training, the community lay health educator can be an essential partner in a community-based hypertension control programs. This may motivate program participants more and encourages the individual to make the behavior modifications on a permanent basis.
Can novel Apo A-I polymorphisms be responsible for low HDL in South Asian immigrants?
Dodani Sunita,Dong Yanbin,Zhu Haidong,George Varghese
Indian Journal of Human Genetics , 2008,
Abstract: Coronary artery disease (CAD) is the leading cause of death in the world. Even though its rates have decreased worldwide over the past 30 years, event rates are still high in South Asians. South Asians are known to have low high-density lipoprotein (HDL) levels. The objective of this study was to identify Apolipoprotein A-I (Apo A-I) polymorphisms, the main protein component of HDL and explore its association with low HDL levels in South Asians. A pilot study on 30 South Asians was conducted and 12-h fasting samples for C-reactive protein, total cholesterol, HDL, low-density lipoprotein (LDL), triglycerides, Lipoprotein (a), Insulin, glucose levels, DNA extraction, and sequencing of Apo A-I gene were done. DNA sequencing revealed six novel Apo A-I single nucleotide polymorphisms (SNPs) in South Asians, one of which (rs 35293760, C938T) was significantly associated with low (< 40 mg/dl) HDL levels (P = 0.004). The association was also seen with total cholesterol (P = 0.026) and LDL levels (P = 0.032). This pilot work has highlighted some of the gene-environment associations that could be responsible for low HDL and may be excess CAD in South Asians. Further larger studies are required to explore and uncover these associations that could be responsible for excess CAD risk in South Asians.
HEALS: A Faith-Based Hypertension Control and Prevention Program for African American Churches: Training of Church Leaders as Program Interventionists
Sunita Dodani,Debra Sullivan,Sydney Pankey,Catherine Champagne
International Journal of Hypertension , 2011, DOI: 10.4061/2011/820101
Abstract: Background. A 12-session church-based HEALS program (healthy eating and living spiritually) was developed for hypertension control and prevention program in African Americans (AAs). This study presents specifics of training lay health educators to effectively deliver HEALS to high-risk AAs. Methods. A one-day workshop was conducted by the research experts in an AA church. Five church members were recruited to be program interventionists called church health counselors (CHCs). Results. Using principles of adult education, a training protocol was developed with the intention of recognizing and supporting CHCs skills. CHCs received training on delivering HEALS program. The process of training emphasized action methods including role playing and hands-on experience with diet portion measurements. Conclusion. With adequate training, the community lay health educator can be an essential partner in a community-based hypertension control programs. This may motivate program participants more and encourages the individual to make the behavior modifications on a permanent basis. 1. Introduction Hypertension (known as the “silent killer”) prevalence is highly variable among populations worldwide. In the US, there is a disproportionate burden of hypertension and its complications in African Americans (AAs) [1]. Not only are AAs more likely to suffer from hypertension than are whites, but they also experience a higher complication rate, greater severity, and earlier disease onset. From 1988–1994 to 1999–2002, the prevalence of hypertension in adults increased from 35.8% to 41.4% among AAs, and it was particularly high among AA women, at 44.0% compared to 28.1% in whites [2]. Hypertension is more common in middle-aged or older, less-educated, overweight or obese, and physically inactive AAs [3]. As a result, compared with whites, AAs have a 1.3-times greater rate of nonfatal stroke, a 1.8-times greater rate of fatal stroke, a 1.5-times greater rate of heart disease death, and a 4.2-times greater rate of end-stage kidney disease [4, 5]. Many AAs, however, remain unaware of their blood pressure status [5]. It is common, asymptomatic, readily detectable, and easily treatable. Yet it burdens our economy substantially. Hypertension is the most common primary diagnosis in the US and accounts for over 38 million office visits per year [6]. Most patients will require two or more antihypertensive medications to achieve the goal of blood pressure less than 140/90 or 130/80 for patients with diabetes or kidney disease [7, 8]. Poor adherence to medication regimens is a common
Metabolic syndrome in South Asian immigrants: more than low HDL requiring aggressive management
Sunita Dodani, Rebecca Henkhaus, Jo Wick, James Vacek, Kamal Gupta, Lei Dong, Merlin G Butler
Lipids in Health and Disease , 2011, DOI: 10.1186/1476-511x-10-45
Abstract: Despite improvements in clinical outcomes and decrease in event rates by 50% over the past 30 years, coronary artery disease (CAD) continues to be a major cause of death in the US [1]. A disturbing trend toward high rates of CAD, insulin resistance or metabolic syndrome (MS) has been noted among South Asian immigrants (SAIs)- people from the Indian sub-continent (Bangladesh, Pakistan, India, Sri Lanka, Nepal and Bhutan) [2-6]. This is particularly alarming for several reasons; (i) South Asians represent one-fifth of the global population. In the US, 3.6 million, or 1.3% of the population, is made up of SAIs [7-10]. SAIs are the fastest growing Asian immigrant population in the US which has more than doubled since the 1980 s (growth rate of 108%), and of that growth, three-fourths is due to immigration [7] and (ii) prevalence of CAD in SAIs is twice as high as other immigrant populations [11] and three times higher than in the Framingham Heart Study (FHS), even after adjustment for all conventional risk factors [12-14].MS plays a causative role in the prevalence of type II diabetes (T2D) as well as premature atherosclerosis in SAIs, a pattern increasingly noted in parallel with migration and urbanization. Current guidelines for the criteria used to define MS including body mass index (BMI) and waist circumference (WC), were predominantly modeled after white Caucasians and are likely to underestimate MS and abdominal obesity in SAIs [13-16]. Evidence suggests that immigration from South Asia to the US, and the acculturation that occurs, exacerbates the consequences of MS and increases CAD risk. Moreover, low HDL is one of the components of MS and SAIs are known to have low HDL. However, assessment of HDL functionality and its correlation with MS is important and has not been studied in any population. In order to understand the type of MS and its association with dysfunctional HDL-Dys-HDL (if present), we conducted a National Institutes of Health (NIH) funded project
Pattern Formation in Tri-Trophic Ratio-Dependent Food Chain Model  [PDF]
Dawit Melese, Sunita Gakkhar
Applied Mathematics (AM) , 2011, DOI: 10.4236/am.2011.212213
Abstract: In this paper, a spatial tri-trophic food chain model with ratio-dependent Michaelis-Menten type functional response under homogeneous Neumann boundary conditions is studied. Conditions for Hopf and Turing bifurcation are derived. Sufficient conditions for the emergence of spatial patterns are obtained. The results of numerical simulations reveal the formation of labyrinth patterns and the coexistence of spotted and stripe-like patterns.
Pressure Sensor Based on Mechanically Induced LPFG in Novel MSM Fiber Structure  [PDF]
Sunita Ugale, Vivekanand Mishra
Optics and Photonics Journal (OPJ) , 2013, DOI: 10.4236/opj.2013.33036
Abstract:

We have proposed and demonstrated experimentally a novel and simple pressure sensor based on mechanically induced long period optical fiber gratings. We report here for the first time to our knowledge the characterization of mechanically induced long period fiber gratings in novel multimode-singlemode-multimode fiber structure. The MLPFG induced in single mode fiber and multimode fibers are studied separately and the results are compared with MLPFG induced in MSM fiber structure. MLPFG in MSM structure has much greater sensitivity. We have obtained maximum transmission loss peak of around 18 dB, and the sensitivity of pressure sensor is 8 dB/Kg.

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