Catalogue Search | MBRL
Are you sure you want to remove the book from the shelf?
{{itemTitle}}
95
result(s) for
"Dutta, Puja"
Sort by:
Correlation between clinical and pathological features of cutaneous calciphylaxis
Calciphylaxis is a rare and life-threatening disease that classically manifests with painful skin lesions. It occurs mainly in patients with end-stage renal disease (ESRD) treated with dialysis, has poor outcomes, and has no FDA-approved treatment. Our cohort study aims to examine the clinical and pathological features of calciphylaxis and investigates the correlation between cutaneous clinical manifestations and histopathological findings. Data from 70 calciphylaxis patients who were evaluated at the Massachusetts General Hospital between January 2014 and April 2018 were collected from the institutional electronic database. The median age was 58 years (interquartile range [IQR]: 49-69 years), 60% were women, and 73% were of white race. Most (74%) patients reported severe pain at the time of calciphylaxis diagnosis with a median pain intensity score of 8/10 (IQR: 6-10) on a 0-10 pain scale. The median time from symptom onset to clinical diagnosis was 9 weeks (IQR: 6-16 weeks). The majority (87%) of patients presented with open necrotic wounds (advanced stage lesion) at the time of diagnosis. Common cutaneous clinical features included ulceration (79%), induration (57%), and erythema (41%), while common pathological features included cutaneous microvascular calcification (86%) and necrosis (73%). The presence of fibrin thrombi in skin biopsies was associated with pain severity (p = 0.04). The stage of a skin lesion positively correlated with the presence of necrosis on histological analyses (p = 0.02). These findings have implications for improving understanding of calciphylaxis origins and for developing novel treatments.
Journal Article
The State of Economic Inclusion Report 2021
Transforming the economic lives of people in extreme poverty and vulnerability is a persistent challenge and drives economic inclusion programs worldwide. This milestone report presents data and evidence from 219 economic inclusion programs in 75 countries reaching over 92 million people, assesses the evidence, and reveals new information on costs.
eBook
Right-to-work?
In 2006, India embarked on an ambitious attempt to fight poverty by attempting to introduce a wage floor in a setting in which many unskilled workers earn less than the minimum wage. The 2005 national rural employment guarantee act (NREGA) creates a justiciable \"right to work\" by promising 100 days of wage employment in every financial year to all rural households whose adult members volunteer to do unskilled manual work. In attempting to fight poverty in poor places with weak administrative capabilities, the idea of \"rights\" has often been invoked. This book aims to contribute to the understanding of the efficacy of poor states in fighting poverty using an ambitious rights-based program - the largest antipoverty public employment program in India, and possibly anywhere in the world. The program authors study is India's Mahatma Gandhi National Rural Employment Guarantee Scheme (MGNREGS), which was launched to implement the NREGA. This book presents survey-based estimates for India as a whole as well as results for Bihar. Results for India are based on the 2009-10 national sample survey. Two surveys were carried out in 2009 and 2010 and spanned 150 villages spread across all 38 districts in Bihar. These data are supplemented by qualitative research in six districts to better understand supply-side challenges. A distinctive feature of the methodology is that the authors identify the key counterfactual outcomes of interest - that is, what Bihar Rural Employment Guarantee Scheme (BREGS) participants will have done in the absence of the program - by directly asking individual BREGS participants. The advantage of this approach is that it produces an individual-specific estimate of impact - exploiting the information available for each participant - rather than delivering only a mean impact. The authors find compelling evidence that the scheme is reaching relatively poor families. It is important that reform efforts for MGNREGS work on both of these aspects - a stronger, more capable, local administration, plus more effective participation by civil society.
eBook
Trade Protection and Industry Wages in India
This paper examines the link between trade protection and industry wage premia in India using a unique dataset combining employment survey data with industry-level data for various years between 1983 and 2000. The author finds that India's trade reforms were not distributionally neutral. The impact of protection on industry wage premia was positive and statistically significant, though modest in magnitude: workers employed in industries with high tariffs received higher wages than apparently identical workers in low-tariff industries. Because industries with high initial levels of protection were also those with the largest tariff reductions during this period and had the highest share of unskilled workers, the positive tariff-wage effect implies that the trade reforms were likely to have increased wage inequality as the relative wages of the (predominantly unskilled) workers in these manufacturing industries fell.
Journal Article
Implications of Transfusion in Adults with Congenital Heart Disease Undergoing Cardiac Surgery
The number of adults with congenital heart disease (CHD) requiring cardiovascular (CV) surgery is increasing rapidly in today’s era. We hypothesized that exposure to perioperative blood products is associated with worse outcomes in adults. All adults (≥ 18 years old) undergoing CV surgery with Cardio-Pulmonary Bypass (CPB) between 2015 and 2020 were reviewed retrospectively. Associations between transfusion and outcomes were studied by univariable logistic regression and Wilcoxon rank sum tests. Cox/ logistic regression was used to assess (a) postoperative ventilation time and length of stay, and (b) major complications, respectively. Of 323 patients, 170 (53%) received blood products perioperatively. The median age was 27 (interquartile range [IQR]: 22–36) years, there were 181 (46%) males, and 16 (5%) patients had single ventricle anatomy. Patients receiving products experienced more complications (OR: 6.6, 95% CI: [2.9, 14.7],
p
< 0.001) specifically, cardiac arrest (OR: 8.8, 95% CI: [1.1, 71.9],
p
= 0.04). Transfusion was associated with greater frequency of thrombosis ((OR: 7.8, 95% CI: [1.8, 34.7],
p
= 0.01)), longer ventilation time (HR: 3.0, 95% CI: [2.4, 3.9],
p
< 0.001), and longer hospital length of stay (HR: 2.7, 95% CI: [2.1, 3.4],
p
< 0.001). Longer CPB time (OR: 1.0, 95% CI: [1.0, 1.1],
p
< 0.001) and prior cardiac surgery (OR: 1.6, 95% CI: [1.3, 2.1],
p
< 0.001) were independent predictors of perioperative blood product transfusion. Adults who received perioperative blood products experienced more complications and worse in-hospital outcomes. Future research on optimizing blood product transfusion based on risk prediction is needed to optimize outcomes in adults with CHD.
Journal Article
Regulation of Staphylococcus aureus-induced CXCR1 expression via inhibition of receptor mobilization and receptor shedding during dual receptor (TNFR1 and IL-1R) neutralization
Our earlier studies proposed a radically new idea suggesting interdependency between TNF-α/TNFR1 and IL-1β/IL-1R pathways in modulation of Staphylococcus aureus-induced CXCL8/CXCR1 axis. However, the effects of inhibition of cytokine receptor mobilization at intracellular level and surface TNFR1 and IL-1R shedding on S. aureus-induced CXCR1 expression have not been studied so far in peritoneal macrophages. This study aimed to investigate the role of inhibition of receptor mobilization from the intracellular pool (using brefeldin A) and surface receptor shedding (using TAPI-1) on CXCR1 expression during dual receptor (TNFR1 plus IL-1R) neutralization in peritoneal macrophages isolated from wild-type Swiss Albino mice. Release of superoxide anion, nitric oxide, and hydrogen peroxide was measured and cytokine production was done by ELISA. Expression of surface receptors (TNFR1, IL-1R, and CXCR1) and inflammatory mediators was studied by Western blot. It was observed that S. aureus-infected macrophages showed elevated ROS production, secretion of TNF-α, IL-1β, and CXCL8, along with increased expression of surface receptors (TNFR1, IL-1R, and CXCR1), and inflammatory markers (iNOS and COX-2) compared with control or treated groups (p < 0.05). However, prior treatment of macrophages with BFA or TAPI-1 in the presence of anti-TNFR1 antibody and IRAP during S. aureus infection showed significant reduction of all these parameters (p < 0.05). We can conclude that targeting of TNFR1 and IL-1R (with major focus on surface expression study) either through blockage of intracellular receptor trafficking pathway or via surface receptor shedding diminishes TNFR1/IL-1R interaction and consequently downregulates CXCR1 expression along with inflammatory signalling pathways during bacterial infections.
Journal Article
Clinical implications of acute shunt thrombosis in paediatric patients with systemic-to-pulmonary shunt re-interventions
Systemic-to-pulmonary shunts are used as a source of pulmonary blood flow in palliated Congenital Heart Disease in neonates and young infants. Shunt thrombosis, often requiring shunt interventions during index hospitalisation, is associated with poor outcomes. We hypothesised that extensive use of perioperative pro-coagulant products may be associated with shunt thrombosis.
Children (≤18 years) undergoing systemic-to-pulmonary shunts with in-hospital shunt reinterventions between 2016 and 2020 were reviewed retrospectively. Perioperative associations to shunt thrombosis were examined by univariate logistic regression and Wilcoxon rank sum tests as appropriate. Cox and log transformed linear regression were used to analyse postoperative ventilation duration, length of stay, and cost.
Of 71 patients requiring in-hospital shunt intervention after systemic-to-pulmonary shunts, 10 (14%) had acute shunt thrombosis, and among them five (50%) died. The median age was four (interquartile range: 0-15) months. There were 40 (56%) males, 41 (58%) had single ventricle anatomy, and 29 (40%) were on preoperative anticoagulants. Patients with acute shunt thrombosis received greater volume of platelets (p = 0.04), cryoprecipitate (p = 0.02), and plasma (p = 0.04) postoperatively in the ICU; experienced more complications (p = 0.01) including re-exploration for bleeding (p = 0.008) and death (p = 0.02), had longer hospital length of stays (p = 0.004), greater frequency of other arterial/venous thrombosis (p = 0.02), and greater hospital costs (p = 0.002).
Patients who develop acute shunt thrombosis receive more blood products perioperatively and experience worse hospital outcomes and higher hospital costs. Future research on prevention/early detection of shunt thrombosis is needed to improve outcomes in infants after systemic-to-pulmonary shunt surgery.
Journal Article
Trade Protection and Inter-Industry Wages in India
This paper examines the link between trade protection and industry wage premia in India using a unique dataset combining employment survey data with industry-level data for various years between 1983 and 2000. The author finds that India's trade reforms were not distributionally neutral. The impact of protection on inter-industry wage premia was positive and statistically significant, though modest in magnitude: workers employed in industries with high tariffs received higher wages than apparently identical workers in low-tariff industries. Because industries with high initial levels of protection were also those with the largest tariff reductions during this period and had the highest share of unskilled workers, the positive tariff-wage effect implies that the trade reforms likely increased wage inequality as the relative wages of the predominantly unskilled workers in these manufacturing industries fell.
Journal Article