rakesh sharma - Academia.edu (original) (raw)
Papers by rakesh sharma
Fertility and Sterility, 2010
International Journal of Cardiology, 2000
There is now considerable evidence to suggest that neurohormonal and immune mechanisms may play a... more There is now considerable evidence to suggest that neurohormonal and immune mechanisms may play a central role in the pathogenesis of chronic heart failure (CHF), which is likely to have important implications for the management of this condition. It has been proposed that CHF is a state of immune activation with inflammatory cytokines contributing to both the central and the peripheral manifestations of this syndrome. The immune system is the body's natural defence mechanism against infection and other stresses, which has several different components that interact with each other in a complex manner. The main components which are thought to be relevant to the pathogenesis of CHF are: cytokines, adhesion molecules, autoantibodies, nitric oxide, and endothelin-1, and this review will concentrate on these factors. This article will also discuss the potential role of anti-cytokine therapies in the treatment of CHF.
Journal of the American College of Cardiology, 2003
We sought to describe the relationship between cholesterol and survival in patients with chronic ... more We sought to describe the relationship between cholesterol and survival in patients with chronic heart failure (CHF). BACKGROUND Increasing lipoprotein levels are a cardiovascular risk factor. In patients with CHF, the prognostic value of endogenous lipoproteins is not fully clarified. METHODS A group of 114 patients with CHF recruited to a metabolic study was followed for a minimum of 12 months (derivation study). The results were applied to a second group of 303 unselected patients with CHF (validation study). The relationship between endogenous lipoproteins and survival was explored. RESULTS In the derivation study, survival at 12 months was 78% (95% confidence interval [CI] 70% to 86%) and 56% (95% CI 51% to 62%) at 36 months. Increasing total serum cholesterol was a predictor of survival (hazard ratio 0.64, 95% CI 0.48 to 0.86), independent of the etiology of CHF, age, left ventricular ejection fraction, and exercise capacity. Receiver-operating characteristic curves demonstrated a best cutoff value of Յ5.2 mmol/l (200.8 mg/dl) as being the best predictor of mortality at 12 months (sensitivity 80.0%, specificity 62.9%). In the validation population, one-year survival was 88% (95% CI 84 to 91%) and three-year survival was 68% (95% CI 63 to 73%). The chance of survival increased 25% for each mmol/l increment in total cholesterol. Survival rates above and below the cutoff value for cholesterol in patients with ischemic heart disease (n ϭ 181) were 92% (95% CI 89 to 94) versus 75% (95% CI 64 to 85%) at one year and 72% (95% CI 67 to 76%) versus 50% (95% CI 43 to 56%) at three years. CONCLUSIONS In patients with CHF, lower serum total cholesterol is independently associated with a worse prognosis. (
Biomedicine & Pharmacotherapy, 2004
Of 54 patients with acute coronary artery disease (CAD) that were included in this study, 41 pati... more Of 54 patients with acute coronary artery disease (CAD) that were included in this study, 41 patients had acute myocardial infarction (AMI), five patients possible MI, four patients unstable angina and the remaining four angina pectoris. The control subjects (n-85) were randomly selected from the general population of the city of Moradabad of similar age range after exclusion for CAD (n=9), diabetes (n=6) and excess intake of trans fatty acids (n=20). The incidence of lipoprotein(a) excess (>30 mg/dl; 42.6 vs 24.7%; P<0.05) and mean concentration of lipoprotein(a) (Lp[a], 6.4 mg/dl, 95% confidence interval: 2.8-10.5; P<0.05) was significantly greater in the acute CAD group compared with control subjects. Mean total cholesterol and triglyeerides were significantly higher and mean nitrite level lower in the study group as compared with the control group.There was a significant greater incidence of cardiac events in the second quarter of the day compared with the fourth quarter. Lp(a), triglycerides, blood glucose, plasma insulin, malondialdehyde, diene conjugates, TBARS and TNFalpha and IL-6 levels, which were significantly greater during the acute phase, showed a significant decline and serum nitrite and coenzyme Q demonstrated an increase at 4 weeks of follow-up when the acute reactions evoked by MI had been controlled. Large breakfasts were a predisposing factor for cardiac events in the second quarter of the day and it was significantly associated with metabolic reactions. The findings indicate that acute reactions as a result or as circadian rhythms appear to be important in the pathogenesis of AMI-associated complications and that a large breakfast in association with nitrite deficiency may further trigger the circadian rhythms. However, more studies in a larger number of subjects would be necessary in order to confirm our findings.
Microelectronics Reliability, 1986
ABSTRACT This paper deals with the operational behaviour of a cold-standby redundant system incor... more ABSTRACT This paper deals with the operational behaviour of a cold-standby redundant system incorporating the concept of three states, with four types of failures, namely major unit failure, minor unit failure, partial failure due to critical human errors and complete failure due to critical human errors, under only one repair facility. Failure and repair times for the complex system follow exponential and general distributions, respectively. Repair is undertaken only when the system is either in degraded state or in failed state. Laplace transforms of the probabilities of being in various states as well as in up and down states are computed, along with the steady state behaviour of the system. A particular case of such a system has also been appended to highlight the important results.
Fertility and Sterility, 2010
International Journal of Cardiology, 2000
There is now considerable evidence to suggest that neurohormonal and immune mechanisms may play a... more There is now considerable evidence to suggest that neurohormonal and immune mechanisms may play a central role in the pathogenesis of chronic heart failure (CHF), which is likely to have important implications for the management of this condition. It has been proposed that CHF is a state of immune activation with inflammatory cytokines contributing to both the central and the peripheral manifestations of this syndrome. The immune system is the body's natural defence mechanism against infection and other stresses, which has several different components that interact with each other in a complex manner. The main components which are thought to be relevant to the pathogenesis of CHF are: cytokines, adhesion molecules, autoantibodies, nitric oxide, and endothelin-1, and this review will concentrate on these factors. This article will also discuss the potential role of anti-cytokine therapies in the treatment of CHF.
Journal of the American College of Cardiology, 2003
We sought to describe the relationship between cholesterol and survival in patients with chronic ... more We sought to describe the relationship between cholesterol and survival in patients with chronic heart failure (CHF). BACKGROUND Increasing lipoprotein levels are a cardiovascular risk factor. In patients with CHF, the prognostic value of endogenous lipoproteins is not fully clarified. METHODS A group of 114 patients with CHF recruited to a metabolic study was followed for a minimum of 12 months (derivation study). The results were applied to a second group of 303 unselected patients with CHF (validation study). The relationship between endogenous lipoproteins and survival was explored. RESULTS In the derivation study, survival at 12 months was 78% (95% confidence interval [CI] 70% to 86%) and 56% (95% CI 51% to 62%) at 36 months. Increasing total serum cholesterol was a predictor of survival (hazard ratio 0.64, 95% CI 0.48 to 0.86), independent of the etiology of CHF, age, left ventricular ejection fraction, and exercise capacity. Receiver-operating characteristic curves demonstrated a best cutoff value of Յ5.2 mmol/l (200.8 mg/dl) as being the best predictor of mortality at 12 months (sensitivity 80.0%, specificity 62.9%). In the validation population, one-year survival was 88% (95% CI 84 to 91%) and three-year survival was 68% (95% CI 63 to 73%). The chance of survival increased 25% for each mmol/l increment in total cholesterol. Survival rates above and below the cutoff value for cholesterol in patients with ischemic heart disease (n ϭ 181) were 92% (95% CI 89 to 94) versus 75% (95% CI 64 to 85%) at one year and 72% (95% CI 67 to 76%) versus 50% (95% CI 43 to 56%) at three years. CONCLUSIONS In patients with CHF, lower serum total cholesterol is independently associated with a worse prognosis. (
Biomedicine & Pharmacotherapy, 2004
Of 54 patients with acute coronary artery disease (CAD) that were included in this study, 41 pati... more Of 54 patients with acute coronary artery disease (CAD) that were included in this study, 41 patients had acute myocardial infarction (AMI), five patients possible MI, four patients unstable angina and the remaining four angina pectoris. The control subjects (n-85) were randomly selected from the general population of the city of Moradabad of similar age range after exclusion for CAD (n=9), diabetes (n=6) and excess intake of trans fatty acids (n=20). The incidence of lipoprotein(a) excess (>30 mg/dl; 42.6 vs 24.7%; P<0.05) and mean concentration of lipoprotein(a) (Lp[a], 6.4 mg/dl, 95% confidence interval: 2.8-10.5; P<0.05) was significantly greater in the acute CAD group compared with control subjects. Mean total cholesterol and triglyeerides were significantly higher and mean nitrite level lower in the study group as compared with the control group.There was a significant greater incidence of cardiac events in the second quarter of the day compared with the fourth quarter. Lp(a), triglycerides, blood glucose, plasma insulin, malondialdehyde, diene conjugates, TBARS and TNFalpha and IL-6 levels, which were significantly greater during the acute phase, showed a significant decline and serum nitrite and coenzyme Q demonstrated an increase at 4 weeks of follow-up when the acute reactions evoked by MI had been controlled. Large breakfasts were a predisposing factor for cardiac events in the second quarter of the day and it was significantly associated with metabolic reactions. The findings indicate that acute reactions as a result or as circadian rhythms appear to be important in the pathogenesis of AMI-associated complications and that a large breakfast in association with nitrite deficiency may further trigger the circadian rhythms. However, more studies in a larger number of subjects would be necessary in order to confirm our findings.
Microelectronics Reliability, 1986
ABSTRACT This paper deals with the operational behaviour of a cold-standby redundant system incor... more ABSTRACT This paper deals with the operational behaviour of a cold-standby redundant system incorporating the concept of three states, with four types of failures, namely major unit failure, minor unit failure, partial failure due to critical human errors and complete failure due to critical human errors, under only one repair facility. Failure and repair times for the complex system follow exponential and general distributions, respectively. Repair is undertaken only when the system is either in degraded state or in failed state. Laplace transforms of the probabilities of being in various states as well as in up and down states are computed, along with the steady state behaviour of the system. A particular case of such a system has also been appended to highlight the important results.