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Articles by V. Mohan
Total Records ( 9 ) for V. Mohan
  R. Pradeepa , M. Rema , J. Vignesh , M. Deepa , R. Deepa and V. Mohan
  AimsThis study was conducted to determine the prevalence of, and risk factors for, diabetic neuropathy (DN) in south Indian Type 2 diabetic subjects. MethodsSubjects were recruited from the Chennai Urban Rural Epidemiology Study, conducted on a representative cohort from Chennai city. A total of 1629 diabetic subjects were included, of whom 1291 were known to have diabetes (KD) subjects and 338 were randomly selected newly detected diabetic (NDD) subjects. Neuropathy was diagnosed if vibratory perception threshold at the great toe, measured by biothesiometry, exceeded mean + 2 sd of a healthy non-diabetic study population aged 20–45 years (cut point >= V). ResultsThe overall prevalence of DN was 26.1% (age-adjusted 13.1%) with no significant difference in gender. The prevalence of neuropathy was significantly higher in KD subjects compared with NDD subjects (27.8 vs. 19.5%, P = 0.002). The prevalence of diabetic retinopathy (24.1 vs. 15.3%, P < 0.0001) and hypertension (51.1 vs. 40.0%, P < 0.0001) were higher in those with neuropathy compared with those without. The odds ratio for neuropathy in subjects with duration of diabetes > 15 years compared with ≤ 5 years was 5.7 (95% confidence interval: 3.52–9.08, P < 0.0001). Regression analysis showed age (P < 0.0001), glycated haemoglobin (P = 0.001) and duration of diabetes (P = 0.045) to be significantly associated with neuropathy. ConclusionsThis cross-sectional population-based study shows that, among urban south Indian Type 2 diabetic subjects, the prevalence of DN is 26.1% and that DN is significantly associated with age, glycated haemoglobin and duration of diabetes.
  R. Pradeepa , B. Anitha , V. Mohan , A. Ganesan and M. Rema
 

Aims To determine risk factors for diabetic retinopathy (DR) in an urban South Indian Type 2 diabetic population.

Methods The Chennai Urban Rural Epidemiology Study is a large cross-sectional study conducted in Chennai, South India. A total of 1736 Type 2 diabetic subjects were recruited for this study, which included 1382 known diabetic subjects (90.4% response rate) and 354 randomly selected, newly detected diabetic subjects diagnosed by oral glucose tolerance test. All subjects underwent four-field stereo retinal colour photography, graded by the Early Treatment Diabetic Retinopathy Study protocol.

Results Of the 1736 Type 2 diabetic subjects photographed, photographs could be graded in 1715 subjects. Stepwise ordinal logistic regression analysis revealed that male gender (P=0.041), duration of diabetes (P<0.0001), glycated haemoglobin (HbA1c; P<0.0001), macroalbuminuria (P=0.0002) and insulin therapy (P=0.0001) were significantly associated with severity of DR. The risk for developing DR was 7.7 times (95% confidence interval 4.71–12.48, P<0.0001) for elevated postprandial plasma glucose levels compared with 4.2 times (95% confidence interval 2.78–6.34, P<0.0001) for elevated fasting plasma glucose when the fourth quartile values were compared with the first quartile glucose values.

Conclusions In South Indian Type 2 diabetic subjects, duration of diabetes, HbA1c, male gender, macroalbuminuria and insulin therapy were independent risk factors for severity of DR. Postprandial hyperglycaemia indicated a higher risk for DR compared with elevated fasting plasma glucose levels.

  E. J. Boyko , H. C. Gerstein , V. Mohan , S. Yusuf , P. Sheridan , S. Anand and J. E. Shaw
  Aims Risk of Type 2 diabetes varies by ethnicity, but whether ethnicity remains important among those who have impaired glucose tolerance or impaired fasting glucose is uncertain. Whether the effect of thiazolidinedione treatment on diabetes prevention in persons with non-diabetic dysglycaemia varies by ethnicity is also not known. We addressed these questions using data collected in the DREAM trial. Methods A 2-by-2 factorial double-blind randomized controlled trial to compare the effects of rosiglitazone and ramipril on the primary outcome of diabetes or death in persons meeting criteria for impaired glucose tolerance or impaired fasting glucose. The effect of these interventions by ethnicity was estimated using Cox regression analysis. Results Of 5269 adults, 2365 were randomly assigned to rosiglitzone and 2634 to placebo. South Asians showed a higher hazard for the primary outcome compared with Europeans (hazard ratio, 95% confidence interval 2.21, 1.41–3.47) adjusted for age, gender, BMI, waist–hip ratio and geographic region. A lesser increase in risk was seen in Black people (1.37, 1.04–1.81). A significant reduction in risk of the primary outcome with rosiglitazone treatment assignment was seen in all ethnic groups, but the treatment effect significantly differed by ethnicity (P = 0.0242), with South Asians experiencing a smaller, and Latinos a larger preventive effect. Conclusions Ethnicity is an important risk factor for Type 2 diabetes in dysglycaemic persons. All ethnic groups experienced a large significant reduction in diabetes risk because of rosiglitazone. The magnitude of this reduction differed by ethnicity. Given the post hoc nature of this analysis, further confirmation of these findings is needed.
  M. J. Davies , J. J. Gagliardino , L. J. Gray , K. Khunti , V. Mohan and R. Hughes
 

Aims

To identify real-world factors affecting adherence to insulin therapy in patients with Type 1 or Type 2 diabetes mellitus.

Methods

A literature search was conducted in PubMed and EMBASE in November 2011 to identify studies reporting factors associated with adherence/non-adherence to insulin therapy in adults with Type 1 or Type 2 diabetes.

Results

Seventeen studies were identified; six used self-reported measures and 11 used calculated measures of adherence. Most (13/17) were conducted exclusively in the USA. Four categories of factors associated with non-adherence were identified: predictive factors for non-adherence, patient-perceived barriers to adherence, type of delivery device and cost of medication. For predictive factors and patient-perceived barriers, only age, female sex and travelling were associated with non-adherence in more than one study. Fear of injections and embarrassment of injecting in public were also cited as reasons for non-adherence. Conversely, adherence was improved by initiating therapy with, or switching to, a pen device (in four studies), and by changing to an insurance scheme that lowered the financial burden on patients (in two studies).

Conclusions

Adherence to insulin therapy is generally poor. Few factors or patient-perceived barriers were consistently identified as predictive for non-adherence, although findings collectively suggest that a more flexible regimen may improve adherence. Switching to a pen device and reducing patient co-payments appear to improve adherence. Further real-world studies are warranted, especially in countries other than the USA, to identify factors associated with non-adherence and enable development of strategies to improve adherence to insulin therapy.

  Sachin Arora , Subhash L. Bodhankar , V. Mohan and Prasad A. Thakurdesai
  Diabetic nephropathy is the kidney complication of diabetes mellitus and leading to end stage renal disease. In the past, reconstructed antidiabetic combination from Trigonella foenum-graecum (fenugreek) seeds (IND01) containing 4-hydroxyisoleucine (40%), trigonelline (30%) and galactomannan (30%) showed excellent antihyperglycemic activity. The objective of the present study was to evaluate the renoprotective efficacy of IND01 in animal model of diabetes with and without ischemia reperfusion injury. The diabetes was induced by alloxan in dose of 160 mg kg-1, intraperitoneally (early nephropathy model, without ischemia reperfusion) or 70 mg kg-1, i.v. (model with ischemia reperfusion). In both models, effects of oral treatment of IND01 (50, 100 and 200 mg kg-1, daily once for 30 days) were observed on biochemical parameters (creatinine clearance) and urine (blood urea nitrogen). On day 30, rats were sacrificed and histology was performed on isolated kidneys. Alloxan administration with or without ischemia reperfusion showed symptoms of severe nephropathy (decreased creatinine clearance, increased BUN, presence of glomerular matrix formation, tubular necrosis, interstitial inflammation and fibrosis). The daily oral administration of IND01 (50-200 mg kg-1) showed potent and mild renoprotective effects on biochemical parameters against diabetic rats without ischemia (early nephropathy) and with ischemia model respectively. IND01 showed moderate protection from histological abnormalities in kidney of alloxan-induced rats without ischemia reperfusion injury (early nephropathy model). However, such protection was not offered by IND01 in alloxan induced rats with ischemia reperfusion injury. In conclusion, IND01 showed renoprotection in animal model of early nephropathy probably by effective glycemic control.
  V. Mohan and Y. Venkataramani
  Medical imaging plays a vital role in the field of diagnosis and surgical planning. Compression of medical images differs from standard image coding as it needs to preserve the clinically critical information with reduction in storage space required. Recent research has demonstrated the merit of encoding the Clinical ROI separately and encoding the insignificant part of the image using standard SPIHT technique. One unaddressed combination is the segmentation of CROI using soft computing approaches such as spatial FCM. This study proposes a technique for extracting the clinical ROI using spatial FCM and encoding the segmented portion using a suitable transform with directionality and multi resolution capability. The goal of the proposed technique is to preserve the clinical useful information with smooth contours to obtain a better compression ratio. In the proposed study, modified set partitioning in hierarchical tree (modified SPIHT) is used to code the wavelet based contourlet transformed coefficients of the Clinical Region of Interest (CROI) and remaining portion is encoded using DWT and SPIHT. The proposed study produces a better compression ratio for the MRI brain images with increased PSNR. Also it provides efficient representation of smooth edges in Digital Imaging and Communications in Medicine (DICOM) images.
  V Radha , J Ek , S Anuradha , T Hansen , O Pedersen and V. Mohan
 

Context: Mutations in the HNF 1A gene are the most common cause of maturity-onset diabetes of the young (MODY) in most populations. India currently has the largest number of people with diabetes in the world, and onset of type 2 diabetes occurs at a younger age with possible overlap with MODY. There are very few data on MODY mutations from India.

Objective: The objective was to screen coding and promoter regions of HNF1A gene for mutations in unrelated South Indian subjects in whom a clinical diagnosis of MODY was made.

Design: This was an observational cross-sectional study.

Setting: The study was conducted at a diabetes specialties centre in Chennai in southern India.

Patients: Ninety-six unrelated south Indian subjects in whom clinical diagnosis of MODY was made were included in the study. The control population comprised of 57 unrelated nondiabetic subjects selected from the Chennai Urban Rural Epidemiology Study, a study conducted on a representative population (aged ≥20 yr) of Chennai.

Results: We identified nine novel variants comprising seven mutations (one novel mutation –538G>C at promoter region and six novel coding region mutations) and two polymorphisms in the HNF1A gene. Functional studies revealed reduced transcriptional activity of the HNF1A promoter for two promoter variants. We also observed cosegregation with diabetes of the Arg263His coding region mutation in eight members of one MODY family, whereas it was absent in nondiabetic subjects of this family.

Conclusion: This study suggests that mutations in the HNF1A gene comprise about 9% of clinically diagnosed MODY subjects in southern India and a novel Arg263His mutation cosegregates with MODY in one family.

  S. Vijayalakshmi and V. Mohan
  Problem statement: To find frequently occurring Sequential patterns from web log file on the basis of minimum support provided. We introduced an efficient strategy for discovering Web usage mining is the application of sequential pattern mining techniques to discover usage patterns from Web data, in order to understand and better serve the needs of Web-based applications. Approach: The approaches adopt a divide-and conquer pattern-growth principle. Our proposed method combined tree projection and prefix growth features from pattern-growth category with position coded feature from early-pruning category, all of these features are key characteristics of their respective categories, so we consider our proposed method as a pattern growth, early-pruning hybrid algorithm. Results: Our proposed Hybrid algorithm eliminated the need to store numerous intermediate WAP trees during mining. Since only the original tree was stored, it drastically cuts off huge memory access costs, which may include disk I/O cost in a virtual memory environment, especially when mining very long sequences with millions of records. Conclusion: An attempt had been made to our approach for improving efficiency. Our proposed method totally eliminates reconstructions of intermediate WAP-trees during mining and considerably reduces execution time.
  V. Mohan and Ayswarya Radhakrishnan
  Microorganisms like Rhizobia, Azotobacters, Azospirillum, Phosphate Solubilizing Bacteria, Mycorrhizal fungi play an important role in plant nutrition through the uptake of critical elements even from nutrient poor and hostile soils. In recent years, use of these beneficial microbes as bio-inoculants for the production of quality planting stock in forest nurseries is well known. Selection of potential isolates of microbial inoculants is essential for application as bio-fertilizer to produce quality seedlings in nurseries. In the present study, twenty three different isolates of Phosphate Solubilizing Bacteria (PSB) were isolated from teak growing areas of Andhra Pradesh, Kerala and Tamil Nadu in India. These isolates were mass cultured and inoculated to teak tissue culture raised plantlets in nursery condition to test their efficacy on the growth and biomass production of teak. It was observed that out of 23 isolates screened, the isolates KED-4 (Bacillus subtilis) and TCO-6 (Pseuodomonas fluorescens) were the most potential isolates for enhancing growth and biomass production of teak plantlets. An attempt was also made to determine the synergistic effect between these 2 isolates. The present study demonstrated that application of both the isolates together not only enhanced the growth but also increased the biomass and the quality of the plantlets.
 
 
 
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