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Articles by G Agarwal
Total Records ( 3 ) for G Agarwal
  M Howard , G Agarwal and L. Hilts

Background. Satisfaction with access to primary care is one component of overall patient satisfaction. The objectives of this paper were to describe patient satisfaction with access in interprofessional family practices and to examine predictors of being less than satisfied with access.

Methods. A survey was mailed to 770 randomly selected patients in two academic interprofessional family practices in Hamilton, Canada. Most items were positively worded statements on a five-point scale from strongly agree to strongly disagree. Outcomes were the proportion of respondents agreeing with statements regarding access. For items where ≥25% of respondents did not agree, we examined socio-demographic predictors of disagreement using multiple variable logistic regression.

Results. The response rate was 49.9% (384/770). One-quarter or more of respondents did not agree that they received an explanation if the appointment was delayed at the office, obtain urgent appointments, obtain prescription refills without a visit or that wait times at the office were reasonable. Predictors of not agreeing included younger age, being married or single, more educated, employed and of non-white ethnicity. Less than 10 minutes was the most satisfactory wait time for the appointment to begin; however, the most common wait time reported was 11–20 minutes. One-quarter of respondents had visited the weekend/holiday clinic in the past 12 months; however, use was not associated with perceived ability to obtain an appointment in 1–2 days.

Conclusions. While satisfaction was generally high, some aspects of access could be improved by changes in practice organization or patient education regarding expectations.

  D Ward , N Murch , G Agarwal and D. Bell

Background: It is well recognized that alcohol is a growing problem in the UK with significant morbidity and mortality and associated resource implications for the National Health Service (NHS). The inpatient management of alcohol withdrawal is felt to be variable between hospitals. The aim of this study was to assess the variation in pharmacological management and acute inpatient alcohol services across NHS hospitals in the UK.

Method: A web-based survey was distributed to Society for Acute Medicine (SAM) members and others with an interest in Acute Medicine between January and March 2008.

Results: The results suggest poor utilization of guidelines, variable drug regimens and differences in acute alcohol-related support services.

Conclusion: In response to these findings, we suggest that a simplified national approach is required for what is now recognized to be an epidemic problem.

  N. M Dagia , G Agarwal , D. V Kamath , A Chetrapal Kunwar , R. D Gupte , M. G Jadhav , S. S Dadarkar , J Trivedi , A. A Kulkarni Almeida , F Kharas , L. C Fonseca , S Kumar and M. R. Bhonde

A promising therapeutic approach to diminish pathological inflammation is to inhibit the increased production and/or biological activity of proinflammatory cytokines (e.g., TNF-, IL-6). The production of proinflammatory cytokines is controlled at the gene level by the activity of transcription factors, such as NF-B. Phosphatidylinositol 3-kinase (PI3K), a lipid kinase, is known to induce the activation of NF-B. Given this, we hypothesized that inhibitors of PI3K activation would demonstrate anti-inflammatory potential. Accordingly, we studied the effects of a preferential p110/ PI3K inhibitor (compound 8C; PIK-75) in inflammation-based assays. Mechanism-based assays utilizing human cells revealed that PIK-75-mediated inhibition of PI3K activation is associated with dramatic suppression of downstream signaling events, including AKT phosphorylation, IKK activation, and NF-B transcription. Cell-based assays revealed that PIK-75 potently and dose dependently inhibits in vitro and in vivo production of TNF- and IL-6, diminishes the induced expression of human endothelial cell adhesion molecules (E-selectin, ICAM-1, and VCAM-1), and blocks human monocyte-endothelial cell adhesion. Most importantly, PIK-75, when administered orally in a therapeutic regimen, significantly suppresses the macroscopic and histological abnormalities associated with dextran sulfate sodium-induced murine colitis. The efficacy of PIK-75 in attenuating experimental inflammation is mediated, at least in part, due to the downregulation of pertinent inflammatory mediators in the colon. Collectively, these results provide first evidence that PIK-75 possesses anti-inflammatory potential. Given that PIK-75 is known to exhibit anti-cancer activity, the findings from this study thus reinforce the cross-therapeutic functionality of potential drugs.

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