Author: "Geetha, R." / Topic: medicine.medical_specialty - Searchworks@Jio Institute Digital Library Search Results

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71 results on '"Geetha, R."'

1. Comparison of different methods to manage supralevator rectal opening in anal fistulas: A retrospective cohort study

Author: Geetha R Menon, Pankaj Garg, and Baljit Kaur
Subjects: Anal fistula, medicine.medical_specialty, business.industry, Fistula, Rectum, General Engineering, Anal Canal, Retrospective cohort study, 030230 surgery, medicine.disease, Surgery, 03 medical and health sciences, 0302 clinical medicine, medicine.anatomical_structure, Treatment Outcome, Healing rate, medicine, Humans, Rectal Fistula, business, Retrospective Studies
Abstract: Introduction Supralevator fistula-in-ano are difficult to manage. If these fistulas have an additional supralevator internal-opening in rectum apart from the primary internal-opening at the dentate line, then the management becomes even more difficult. There is no literature/guidelines available on the management of supralevator rectal opening (SRO). Methods All consecutive supralevator fistula-in-ano patients having a SRO were retrospectively analyzed. The operative management of SRO in these fistulas was reviewed. All the fistulas were managed by the same procedure, transanal opening of intersphincteric space (TROPIS). The latter was a modification of LIFT (ligation of intersphincteric tract) procedure in which the intersphincteric tract was opened-up in the rectum rather than ligated (as is done in LIFT). The SRO was managed in three ways, group-1:SRO was laid-open into the rectum in continuity with the primary opening at dentate line, group-2:the mucosa around SRO was cauterized, group-3:nothing could be done to SRO. Results Out of 836 patients operated between 2015 and 2020, 138 patients (16.5%) had supralevator extension. Amongst these, 23/138 (16.6%) patients had a SRO. 2 patients were excluded (short follow-up) and 21 patients were included in the analysis. 12/13(92%) patients in group-1, 4/5 (80%) patients in group-2 and 2/3(67%) patients in group-3 got healed (p = 0.47, Chi-square test). The overall healing rate was 18/21(86%). Conclusions The supralevator rectal opening (SRO) heals well irrespective of the method utilized. Thus, proper management of the primary opening at the dentate line holds the key to fistula healing and SRO is perhaps not much responsible for persistence of the fistula. However, more studies are needed to corroborate these findings.
Published: 2022

2. Efficacy of high-intensity interval training on cardiac autonomic modulation in cardiovascular diseases and lifestyle disorders: a systematic review and meta-analysis

Author: S. Zaki, P. Bhati, Jamal Ali Moiz, and Geetha R Menon
Subjects: Autonomic function, medicine.medical_specialty, Physiology, business.industry, Veterinary (miscellaneous), Endocrinology, Diabetes and Metabolism, Biophysics, Disease, Biochemistry, Interval training, Physiology (medical), Internal medicine, Meta-analysis, Cardiology, medicine, Heart rate variability, Orthopedics and Sports Medicine, Autonomic modulation, business, High-intensity interval training
Abstract: The study aims to investigate the literature on the effect of high-intensity interval training (HIIT) on cardiac autonomic function in individuals with cardiovascular disease (CVD) and lifestyle disorders. We performed electronic database search from CENTRAL, WoS, Scopus, Pubmed, and PEDro up to 25th February 2021. Randomised control trials/quasi-experimental trials/cross-over trials that assessed the effects of HIIT with control/alternative treatment on cardiac autonomic control were included in this review. A total of 11 studies were included for qualitative analysis and among them, 8 were quantitatively analysed. A random-effect model of standardised mean difference (SMD) and mean difference of the respective outcome measures for cardiac autonomic control was determined. The findings of the qualitative analysis revealed the beneficial effects of HIIT on cardiac autonomic modulation. However, the majority of the studies had an unclear or high risk of bias for randomisation, concealment methods, and blinding of participants to the intervention that could have influenced the interpretation of the findings. The SMD revealed a significant effect of HIIT on standard deviation of N-N intervals (SDNN) (ms) [SMD: 0.40, 95% confidence interval (CI): -0.001 to 0.80, P=0.05], high frequency power (HF) (ms2) [0.46, 95% CI: 0.17 to 0.76, P=0.002], and ratio of low and high frequency power, (LF/HF) [-0.80, 95% CI: -1.27 to -0.33, P=0.0008]. In conclusion, HIIT may effectively modulate cardiac autonomic function by increasing parasympathetic dominance, sympathetic withdrawal, and sympathovagal balance in individuals with CVD and lifestyle disorders. The study has a PROSPERO registration number: CRD42021231225
Published: 2022

3. Guidelines on postoperative magnetic resonance imaging in patients operated for cryptoglandular anal fistula: Experience from 2404 scans

Author: Vipul D Yagnik, Baljit Kaur, Pankaj Garg, Geetha R Menon, and Sushil Dawka
Subjects: Anal fistula, medicine.medical_specialty, Active involvement, Fistula, Anal Canal, Postoperative mri, Internal opening, Magnetic resonance imaging, medicine, Humans, Rectal Fistula, In patient, Postoperative Period, Postoperative, Radionuclide Imaging, medicine.diagnostic_test, business.industry, Gold standard, Gastroenterology, General Medicine, medicine.disease, Hyperintensity, Radiology, business, Therapeutic and Diagnostic Guidelines
Abstract: Magnetic resonance imaging (MRI) is considered the gold standard for the evaluation of anal fistulas. There is sufficient literature available outlining the interpretation of fistula MRI before performing surgery. However, the interpretation of MRI becomes quite challenging in the postoperative period after the surgery of fistula has been undertaken. Incidentally, there are scarce data and no set guidelines regarding analysis of fistula MRI in the postoperative period. In this article, we discuss the challenges faced while interpreting the postoperative MRI, the timing of the postoperative MRI, the utility of MRI in the postoperative period for the management of anal fistulas, the importance of the active involvement and experience of the treating clinician in interpreting MRI scans, and the latest advancements in the field.
Published: 2021

4. Knowledge, Attitude and Perception of Planning Regarding Birth Preparedness and Complication Readiness at Tertiary Care Hospital Lucknow

Author: Geetha R
Subjects: medicine.medical_specialty, business.industry, Perception, media_common.quotation_subject, Family medicine, Birth preparedness, Medicine, Tertiary care hospital, business, Complication, media_common
Abstract: Background: Globally, eight hundred women die every day due to pregnancy or child birth related complications. Aim: A descriptive study to assess the level of birth preparedness and complication readiness among antenatal women at a tertiary care hospital. Method: A descriptive cross sectional study was undertaken by using purposive sampling technique to assess the knowledge, attitude and planning of perception among antenatal women. Total 82 samples of antenatal women in third trimester were selected through purposive sampling from Tertiary care Hospital, Lucknow. Non experimental quantitative approach in which structured interview questionnaire was used for assessing the socio demographic data. Knowledge by interview method, attitude by likert scale and perception of planning by contingency questionnaire. Descriptive and Inferential statistics were used for the analysis of the tabulated data. Results: Out of total study samples (n=82) 34(41%) of antenatal women were well prepared regarding BPCR whereas 47(57%) are average prepared and 1(1%) are less prepared regarding BPCR. Conclusion: Birth preparedness and complication readiness (BPCR) is a key component of globally accepted safe motherhood programs, which helps ensure women to reach professional care when labor begins and to reduce delays that occur when mothers in labor experience obstetric complications. Keywords: Assess, level, antenatal women, BPCR
Published: 2021

5. Heterogeneous contributions of change in population distribution of body mass index to change in obesity and underweight

Author: Maryam Sharafkhah, Emanuel Zitt, Majid Ezzati, Luxia Zhang, Young-Ho Khang, Ellina Rakhimova, Kairit Mikkel, Tiina Vlasoff, Eruke E. Egbagbe, Sidsel Graff-Iversen, Ilona Nenko, Magdalena Klimek, Mathilde Savy, Sanjib Kumar Sharma, Alfonso Siani, Luís Lopes, Vanina Bongard, Gregor Jurak, Jacqueline F. Price, Christina-Paulina Lambrinou, Maria Lc Iurilli, Rainford J. Wilks, Bontha V. Babu, Fereidoun Azizi, Harunobu Nakamura, Marialaura Bonaccio, Angela Döring, Zhenyu Zhang, Naser Ahmadi, Jolanta Słowikowska-Hilczer, Ana Paula Carlos Cândido, Clive Osmond, Thirunavukkarasu Sathish, Robert J. Adams, Themistoklis Tzotzas, Reina Engle-Stone, Atul Trivedi, Shoichiro Tsugane, Niels Møller, Jorge Bezerra, Dénes Molnár, Muhammad Fadhli Mohd Yusoff, Badreya Al-Lahou, J. Jaime Miranda, Bahram Mohajer, Sigmund A. Anderssen, Lital Keinan Boker, Eero Kajantie, Martin Gulliford, Maties Torrent, Sumit Bharadwaj, Toshiharu Ninomiya, Zbigniew Gaciong, Nayu Ikeda, Li Juan Wu, Adrian Richter, Licia Iacoviello, Marc J. Gunter, Wenbin Wei, Norsyamlina Che Abdul Rahim, Eman Aly, Ambady Ramachandran, Nils Lehmann, Soile E. Puhakka, Giovanni Veronesi, Hongsheng Bi, Eiji Oda, Jia Li Duan, Per Tynelius, José María Huerta, Janne Schurmann Tolstrup, Rodrigo M. Carrillo-Larco, Rosangela Fernandes Lucena Batista, Victoria E Soto-Rojas, Hanno Ulmer, Shukri F. Mohamed, Anthony Kafatos, Suyeon Park, Mohsen Ibrahim, Hamed Pouraram, Bin Zhou, May Soe Aung, Lars Bo Andersen, Erfan Ghasemi, René Charles Sylva, Himanshu K. Chaturvedi, Luc Dauchet, Ahmad Ali Zainuddin, Angela Chetrit, Dan Zhu, Valérie Deschamps, Ko Ko Zaw, Peter Vollenweider, Tomas Vega, Yves Martin-Prével, Mahfuzar Rahman, Dorja Vočanec, Roman Topor-Madry, Vinay Nangia, Herculina S. Kruger, Asher Fawwad, Emily Sonestedt, Elena Pahomova, Aleksander Giwercman, Elżbieta Dziankowska-Zaborszczyk, Cecilia Björkelund, Tatjana Hejgaard, Maria Puiu, Maria Benedetta Donati, Andrew Wong, Carlos P. Boissonnet, Santosh K. Bhargava, Patrick Kolsteren, Dermot O'Reilly, Bahareh Kheiri, Wolfgang Kratzer, Susanne R. de Rooij, H. Bas Bueno-de-Mesquita, Günther Fink, José R. Banegas, Michele Monroy-Valle, Drude Molbo, Mahmudur Rahman, Hynek Pikhart, Rafael N. Pichardo, Massimo Salvetti, Hui Cai, Sarah Filippi, Georg Posch, Hung-Kwan So, Yonghua Hu, Katsuyasu Kouda, Joana Carvalho, Gailute Bernotiene, Hannu Uusitalo, Thein Thein Htay, Felix Kaducu, Maigeng Zhou, Lars Ängquist, Thi Tuyet-Hanh Tran, Charles Lunogelo, Michel Joffres, Sabina Zambon, Ronald D. Gregor, Vayia Rarra, Seyed Mohammad Hashemi-Shahri, Loreto Santa Marina, Galina Obreja, Rudolf Kaaks, Aya Mostafa, Maria do Carmo Franco, Beata Gurzkowska, Chien-Jen Chen, Marie Moitry, Nizal Sarrafzadegan, Xiangjun Wang, Diego Giulliano Destro Christofaro, Imperia Brajkovich, Fangfang Chen, Francesco Panza, Ling Yang, Holly E. Syddall, Cecily Kelleher, Michael Tornaritis, Ningli Wang, Lutgarde Thijs, Marjolein Visser, Angelika Schaffrath Rosario, María José Tormo, Jostein Steene-Johannessen, Norbert Amougou, Emmanuella Magriplis, Mar Alvarez-Pedrerol, Jingli Gao, Stig E. Bojesen, Giuseppe Grosso, Seongjun Ha, Lauren Lissner, Mikhail Benet, Anastasia Markaki, Sanjay Rampal, Antônio Augusto Moura da Silva, Maria Lorenza Muiesan, Angelique Chan, Yvonne T. van der Schouw, Annamari Lundqvist, Philippe Amouyel, Kristyna Zejglicova, Charalambos Hadjigeorgiou, João Breda, Jørgen Meisfjord, Fatima Zahra Laamiri, Carl Lachat, Kai-Uwe Saum, Vilma Irazola, Leng Huat Foo, Óscar Lopes, Dickman Gareta, Flavio Nervi, Imre Janszky, Ruzena Kubinova, Terho Lehtimäki, Mario V. Capanzana, Moyses Szklo, Ramfis Nieto-Martínez, Viswanathan Mohan, Shuohua Chen, Arvind Pandey, Luigi Palmieri, Roya Kelishadi, Srinivasan Kannan, Jie Mi, Robert Beaglehole, Liliana Dacica, Jyrki K. Virtanen, Mohan Deepa, Peter Ueda, Isti Ilmiati Fujiati, Hermann Pohlabeln, Morten Sodemann, Jytte Halkjær, Zbigniew Kułaga, Sophie Visvikis-Siest, Farshad Farzadfar, Mohsen Azimi-Nezhad, Henry Völzke, Karolina Milkowska, Zahra Mohammadi, Belgin Ünal, Magda Gasull, George S. Stergiou, Marshall K. Tulloch-Reid, Seppo Koskinen, James E. Bennett, Marcela González-Gross, Virginija Dulskiene, Idris Guessous, Assembekov Batyrbek, Kamarul Imran Musa, Jeannette Lee, Josep Redon, Bihungum Bista, Luisa M Macieira, Johan Sundström, Andres Metspalu, Lariane M Ono, Flora A. Ukoli, Salar Rahimikazerooni, Andrea Gualtieri, Trevor S. Ferguson, Félicité Tchibindat, Eliza Cinteza, Ha Tp Do, Tajana Zeljkovic Vrkic, Tuyen D Le, Alison J. Hayes, Abdul Basit, Chandini Nekkantti, Teresa Norat, Eunice Ugel, Gulmira Aitmurzaeva, Mariachiara Di Cesare, Abdul Hamid Zargar, Vincenzo Solfrizzi, Garry L. Jennings, Aline Meirhaeghe, Kaare Christensen, Päivi Mäki, Xu Lin, Ali Esmaeili, Joanna Baran, Aneta Grajda, Renata Cifkova, Alexandre C. Pereira, Martin Bobak, Iuliia A Rusakova, Keiu Nelis, Damian K Francis, Guansheng Ma, Axel C. Carlsson, Alejandro Diaz, Alireza Ansari-Moghaddam, N Capkova, Zumin Shi, Maria Turley, Imelda A. Agdeppa, Helena I. S. Nogueira, Marcia Scazufca, Katharina Maruszczak, Natascia Rinaldo, Paulo A. Lotufo, Nuno Lunet, Thor Aspelund, Caroline H.D. Fall, Antonio Cabrera de León, Ahmad Faudzi Yusoff, Holger Theobald, Beatriz D'Agord Schaan, Pedro Marques-Vidal, William A. Neal, Mihai Gafencu, Tandi E. Matsha, Ana B. Crujeiras, Ahmad Reza Dorosty, Alain Morejon, Weili Yan, Dominique Hange, Bekbolat Zholdin, Frédéric Gottrand, Jorge Mota, Jana Námešná, Stevo Popovic, Louise Eriksen, Line Lund Kårhus, Cihangir Erem, Juergen Breckenkamp, Mathilde Kersting, Yi Song, Martin McKee, Aleksandra Gomula, Rafaela Rosário, Enzo Manzato, S. Goya Wannamethee, Sounnia Mediene Benchekor, Azim Nejatizadeh, Krishna Kumar Aryal, Juan P. González-Rivas, Vedrana Sember, Stephen T. McGarvey, Jukka T. Salonen, Patrick Pasquet, Patricia Varona-Pérez, Amelia C. Crampin, Ramin Heshmat, Violeta Iotova, Juvenal Soares Dias-da-Costa, Oye Gureje, Aletta E. Schutte, João Luiz Bastos, Anelise Reis Gaya, Konrad Jamrozik, Dalia Luksiene, Amina Barkat, Maria Paula Santos, José Camolas, Azli Baharudin, Diego Vanuzzo, Doris Stöckl, Rosalynn Siantar, Jouko Saramies, Albertino Damasceno, Davood Khalili, Simona Bo, Martina Müller-Nurasyid, Dominique Cottel, Markku Peltonen, Fikru Tullu, Ana Isabel Rito, Angélica Ochoa-Avilés, Annette J. Dobson, Christopher T. Cowell, Charumathi Sabanayagam, Rildo de Souza Wanderley Júnior, Oanh T. H. Trinh, Farahnaz Joukar, Mostafa K. Mohamed, Mostafa Qorbani, Jeongseon Kim, Helmut Schröder, Machi Suka, Natasja M. van Schoor, Jussi Kauhanen, Teresa Haugsgjerd, Goodarz Danaei, M. Fernanda Lima-Costa, Yong Tao, Elisabetta L. Romeo, Grazyna Jasienska, Victor Guillermo Sequera, Kazem Mohammad, Yanina Zócalo, Fernanda Cunha Soares, Jianfeng Wu, Mohammad Esmaeel Motlagh, María Elena Díaz-Sánchez, Monika Zuziak, Eldridge Ferrer, Anette Varbo, Leila Beltrami Moreira, Jeremy M. Jacobs, Kenneth James, Elena Sacchini, Pascal Bovet, Mahboubeh Parsaeian, Tania Lopez, Ya Xing Wang, Wojciech Drygas, Jody C Miller, Svetlana A. Shalnova, Maria Elisa Zapata, Chung T Nguyen, Nimmathota Arlappa, Edwige Landais, Thorkild I. A. Sørensen, Jeannette Klimont, Amirabbas Momenan, Erik J. Timmermans, Mari-Liis Tammesoo, Jost B. Jonas, Stefania Toselli, Maria Teresa Anselmo Olinto, Bahman Cheraghian, Kouamelan Doua, Esteban Carmuega, Marjeta Mišigoj-Duraković, Bo Werner, M. Arfan Ikram, Breige A. McNulty, Christa Meisinger, Clara Homs, Namuna Shrestha, Alina Kerimkulova, Youcef Laid, Claes Ohlsson, Alicia Matijasevich, Alison J Price, Ala'a Alkerwi, Kristine H. Allin, Lorenza Pilotto, Mohannad Al Nsour, Ingunn Holden Bergh, Marianna Noale, Heba Fouad, Vilnis Dzerve, Novie O. Younger-Coleman, Peter Willeit, Andrea R. V. R. Horimoto, Freda Pitakaka, Habiba Ben Romdhane, Savvas C. Savva, Rajeev Gupta, Jennifer Servais, Cristina Padez, Sarah P. Garnett, Maria del Cristo Rodriguez-Perez, Michala Lustigová, Tien Yin Wong, Rosa Haghshenas, Jonathan Giovannelli, Christina Howitt, Marleen E. Hendriks, Fadia AlBuhairan, Huashuai Chen, Gretchen A Stevens, Luís B. Sardinha, David Goltzman, Jenny M. Kindblom, Karina Mary de Paiva, Yousef Khader, Eric Monterrubio-Flores, Rajendra Pradeepa, Yi-Ting Lin, Martin Neovius, Juan Francisco Miquel, Ellis Owusu-Dabo, Anil Poudyal, Marzieh Katibeh, Tanja Stocks, Veronica Mocanu, Ulla Roggenbuck, Robespierre Ribeiro, Gabriele Eiben, Mary Simon, Christine Cameron, Hamid Hakimi, Kamel Ajlouni, Jakub Stokwiszewski, Iulia Jurca Simina, Pietro Amedeo Modesti, Frederick C. W. Wu, Peter Kristensen, Charles Mondo, Felix Gutzwiller, Mariana Sbaraini, Martijn Huisman, Betina H. Thuesen, Queenie Chan, Antonisamy Belavendra, Artur Mazur, Ulf Ekelund, Laura A. Rodríguez-Villamizar, Marcos André Moura-dos-Santos, Jean Ferrières, Farhad Zamani, Shina Avi, Yves Kameli, Luis Paulo Gomes Mascarenhas, Aluísio J D Barros, Thomas Meinertz Dantoft, Hossein Poustchi, Farid Najafi, Giovanni de Gaetano, Azaliia M Tuliakova, Vera Lanska, Tint Swe Latt, Matthias Bopp, Abbas Rezaianzadeh, Rod Jackson, Johan Van der Heyden, Reecha Sofat, Koen Van Herck, Allan G. Hill, Con Burns, Emanuela Pettenuzzo, Ming-Dong Wang, Stela McLachlan, Ulrike Gehring, Ranko Stevanovic, Nagalla Balakrishna, Lekhraj Rampal, Marjolijn C. E. Bragt, Saeid Eslami, Napoleón Pérez-Farinós, G. K. Mini, Viktoria Anna Kovacs, Rosemarie Martin, Nahla Hwalla, Wei Zheng, Hoang Van Minh, Edward D Janus, Laetitia Huiart, Farhad Pourfarzi, Sudha Ramachandra Rao, Fred Paccaud, Marcia Makdisse, Aye Aye Sein, Enrique Gutiérrez-González, Yang Yang, Anneke Blokstra, Henrike Galenkamp, Jaume Marrugat, Nazan Yardim, Wan Nazaimoon Wan Mohamud, Jesús Ibarluzea, Julio Zuñiga Cisneros, Laura Lauria, Argyro Karakosta, Dragana P Jovic, Jun Hata, Elio Riboli, Piotr Bandosz, Xun Tang, Parvina Mukhtorova, Jean Dallongeville, Jean-Bernard Ruidavets, Anne Tjønneland, Guillermo Frontera, Rahul Malhotra, Thomas Ferrao, Aleksandra Piwońska, Dusan Grafnetter, Mette Rasmussen, Daniel Weghuber, Sherali Rakhmatulloev, Martine Vrijheid, Johann Willeit, Motahareh Kheradmand, Małgorzata Mossakowska, Lechaba Tshepo, Dongfeng Gu, Hyeon Chang Kim, Vilmundur Gudnason, Maria Forsner, Peter Bjerregaard, Leon A. Simons, Rachael McLean, Japhet Killewo, Ramón Suárez-Medina, Y Nikitin, Eng Joo Tan, Jean Claude Mbanya, Aroor Bhagyalaxmi, Renata Kuciene, Kairat Davletov, Jose Eugenio Lozano, Afshin Ostovar, Niloofar Peykari, Guy De Backer, Soheir H Ahmed, Nicholas J. Wareham, Sai Yin Ho, Constanta Huidumac Petrescu, Maria Hassapidou, Iris Pigeot, Myriam Galfo, Susana Cararo Confortin, Blanca Sandra Ruiz-Betancourt, W. M. Monique Verschuren, Catterina Ferreccio, Fabio Galvano, Leila Houti, Daniel Bia, Annika Rosengren, Marcin Rutkowski, Biruta Velika, Joana Araújo, Fernando Rigo, Angela Spinelli, Scott B. McLean, Shirin Djalalinia, Marie Kunešová, Boban Mugoša, Sania Nishtar, Mangesh S. Pednekar, Shahla AlDhukair, Helle-Mai Loit, Antonis Zampelas, Altan Onat, Maciej Banach, Shohreh Naderimagham, Hajer Aounallah-Skhiri, Maja Bæksgaard Jørgensen, Yin Guo, Ewelina Czenczek-Lewandowska, Parasmani Dasgupta, Elvis Oa Wambiya, Inge Huybrechts, Raimund Erbel, Jari Jokelainen, Ana P. Ortiz, Stefan Kiechl, Emmanuel Cohen, Caleb Ochimana, Shynar Abdrakhmanova, Laura Censi, Iqbal Bata, Geetha R Menon, Snehalatha Chamukuttan, Pedro Plans-Rubio, Domenico Palli, Ana Azevedo, Slawomir Koziel, Benoît Salanave, Parinaz Mehdipour, Shu Ti Chiou, Lela Sturua, Lubica Ticha, Felipe Vogt Cureau, Jin Soo Moon, Ming-Hui Zhao, Urho M. Kujala, Nathalie Michels, Ertugrul Celikcan, Jaakko Tuomilehto, Judith Benedics, Tobias F. Rinke de Wit, Agnès Le Port, Reza Homayounfar, Andrea Rodriguez-Martinez, Tai Hing Lam, Yn-Tz Sung, Jürgen König, Kodavanti Mallikharjuna Rao, Hazzaa M. Al-Hazzaa, Karen Morgan, Bogdan Wojtyniak, Cynthia M. Pérez, Ilse Khouw, Manoli Garcia-de-la-Hera, Dong Wook Shin, Genc Burazeri, Ausra Petrauskiene, Charles Sossa Jérome, Kenisha Russell Jonsson, José Boggia, Daniela Galeone, Alice Bonilla-Vargas, Han Cg Kemper, Rahman Shiri, Stefaan Demarest, Else Karin Grøholt, San-Lin You, Adelheid Weber, Juha Auvinen, Aida Pilav, Sibel Gogen, Suzanne N Morin, Wan Mohamad Wan Bebakar, Viviane Cunha Cardoso, Kavumpurathu Raman Thankappan, Hana Zamrazilová, Frank Claessens, Karien Stronks, Helen Gonçalves, Tahir Aris, Luis Revilla, Sérgio Viana Peixoto, Zhamilya Battakova, Jing Liu, Eliza Markidou Ioannidou, Leticia Hernandez Cadena, Priscilla Duboz, Sandjaja, Tiina Laatikainen, Rafel Ramos, Sareh Eghtesad, Judith Simons, Orn Olafsson, E. Shyong Tai, Louise A. Baur, Nihal Thomas, Aung Soe Htet, Bente Sparboe-Nilsen, Paul Elliott, Soon-Woo Park, Angel R. Gonzalez, Ying-Wei Wang, Rob M. van Dam, Ryutaro Ohtsuka, Ludmila Sevcikova, Suhaila Abdul Ghaffar, Lynell V Maniego, Fariborz Mansour-Ghanaei, Maria Dorobantu, Giovanni Viegi, Xiaoguang Yang, Honor Bixby, Prakash C. Gupta, Ofra Kalter-Leibovici, Eugene Sobngwi, Ričardas Radišauskas, Jurate Medzioniene, Roy A Wong-McClure, Kim F. Michaelsen, Antonia Trichopoulou, Tania Tello, Francesco Branca, Johanna Gunnlaugsdottir, Els Clays, Wei-Yen Lim, Suzanne C. Ho, Toomas Veidebaum, Rebecca Goldsmith, Margot González-León, Matthias Nauck, Alibek Mereke, Marta Buoncristiano, Jakob Tarp, Rosalba Rojas-Martínez, Maya Tanrygulyyeva, Reza Malekzadeh, Abdonas Tamosiunas, Dimitrios Poulimeneas, Pedro Ordunez, Isabelle Herter-Aeberli, Khanh Le Nguyen Bao, Anne Juolevi, Vassilis Zafiropulos, Emanuela Gualdi-Russo, Jordi Sunyer, Manu Raj, Chaoqiang Jiang, Sofia Malyutina, Efthymios Kapantais, Maria Lazo-Porras, Maung Maung Than Htike, Michael Hobbs, Ranjit Mohan Anjana, Merike Liivak, Johan G. Eriksson, Margarita Samoutian, Andreia N. Pizarro, Mohammed Rasoul Tarawneh, Jean Woo, Kaspar Staub, Maria Teresa Menzano, Mojtaba Farjam, Adroaldo Cesar Araujo Gaya, Mohammad El-khateeb, Zulfiqar A Bhutta, Mukharram M. Bikbov, Hsien-Ho Lin, Oscar Noboa, Thomas Waldhör, Garry Brian, Simona Costanzo, Frank Tanser, Nor Azwany Yaacob, Michelle Cilia, Ivo Rakovac, Bill Stavreski, Ioannis Pagkalos, Ivan Pećin, Carlo M. Barbagallo, Abla M. Sibai, Yuna He, Matsuda Fumihiko, Bharathi Viswanathan, Ali Reza Safarpour, Wei Cheng Lo, Abdullatif Husseini, Jiang He, Liv Elin Torheim, Nipa Rojroongwasinkul, Aicha Soumare, Astrid Petersmann, Tomasz Grodzicki, Davide Noto, Panayiotis K. Yiallouros, Kelias P. Msyamboza, William R. Tebar, Yingfeng Zheng, Eha Nurk, Bhawesh Koirala, Ana Jelakovic, Suhad Bahijri, Freja B Kampmann, Qi Sheng You, Marika Ferrari, María-Elena González-Villalpando, Aline Wagner, Olfa Saidi, Anwar Batieha, Eduardo Capuano, Coimbatore Subramaniam Shanthirani, Dong Wook Kim, Albina A Fakhretdinova, Tom Wilsgaard, Maria Avdicova, Moesijanti Soekatri, Chiara Donfrancesco, Salim Mohanna, Paola Russo, Uruwan Yamborisut, Rafael dos Santos Henrique, Martin Nankap, Allan Linneberg, Khairil Si-Ramlee, Kirsten Mehlig, Christina Mavrogianni, Raluca Pop, Lèlita Santos, Graziella Bruno, Valentina Peterkova, Iná S. Santos, Georg Lappas, Alberto Palloni, Malay K. Mridha, Andrzej Pajak, Marta García-Solano, Stefaan De Henauw, Daniel Ferrante, Rute Santos, Anders Grøntved, Lucjan Szponar, Mihaela Vladulescu, Chien-An Sun, Jan A. Staessen, Paula Duarte de Oliveira, Norazizah Ibrahim Wong, Maria Nordendahl, Elaine M. Dennison, Jeonghee Lee, Diego Salmerón, Ida Maria Schmidt, Gao Pei, Noushin Mohammadifard, Igor Spiroski, Fernando Rodríguez-Artalejo, Xu Ma, Elin Pettersen Sørgjerd, Valéria Regecová, Cláudia S. Minderico, Johanna A. Otero, Jamila Abubakar Garba, Vesselka Duleva, Rui Ornelas, Ilpo Huhtaniemi, Cesar G. Victora, Lijuan Liu, Rody G. Sy, Mahmood Moosazadeh, Ali Ahmadi, Antonio Pedro Graça, Natalia Nowak-Szczepanska, Miao Li Chee, Michael Sjöström, Charles Agyemang, Shiqi Zhen, Xiu-Hua Guo, Pawel Kurjata, Jardena J. Puder, Mehrdad Azmin, Neil Murphy, Kaosar Afsana, Alireza Sadjadi, Johanna M. Geleijnse, Prashant Mathur, Elysée Claude Bika Lele, Raphael Mendes Ritti-Dias, Yannis Manios, Majid Shirani, Rosemary B. Duda, Liis Nelis, Jurate Klumbiene, Zhengming Chen, Wichai Aekplakorn, Alun Evans, Andrzej Wiecek, Lars Lind, Denise Eldemire-Shearer, Bernardo L. Horta, Macia Enguerran, Seyed Rasoul Zakavi, Daniel Fernández-Bergés, Kumiko Ohara, Ursula Kiechl-Kohlendorfer, Hermann Brenner, Przemyslaw Slusarczyk, Espen Bjertness, Jutta Stieber, Augusto Di Castelnuovo, Joel G. R. Roy, Aryeh D. Stein, Ruth Frikke-Schmidt, Vera Musil, Amaneh Shayanrad, Marcel Goldberg, Ramon O. Jimenez, Mohammad Reza Fattahi, Jolanda Hyska, Amir Houshang Mehrparvar, Elin Kolle, Mohamed Bamoshmoosh, Michelle Holdsworth, Felipe F. Casanueva, Børge G. Nordestgaard, Niels Wedderkopp, Eva Corpeleijn, Elias F. Gudmundsson, Antonio Mistretta, Daniel Lemogoum, Larissa Pruner Marques, Slavica Sović, Olli T. Raitakari, Marco Aurélio Peres, Alexandra Cucu, Gregorio Varela-Moreiras, Janine Clarke, Andrea Gazzinelli, Mieczysław Litwin, Sara Schramm, Xenophon Theodoridis, Harshpal Singh Sachdev, Mohammad Reza Mirjalili, Dimitrios Papandreou, Peter T. Katzmarzyk, Benjamin Acosta-Cazares, Ben Schöttker, Prabhdeep Kaur, Norlaila Mustafa, Shariq Rashid Masoodi, Sadaf G. Sepanlou, Adolfo Rubinstein, Francis Delpeuch, Julianne Williams, Abbas Dehghan, Leanne M. Riley, Heloisa Bettiol, Gabriele Nagel, Ellisiv B. Mathiesen, Ekaterina Stoyanova, Alisha N. Wade, Zhamyila Usupova, Arnaud Chiolero, Oonagh Markey, Jacqueline Ramke, Elena Bogova, Niveen M E Abu-Rmeileh, Nguyen D Nguyen, Tomasz Zdrojewski, Marjo-Riitta Järvelin, Jose Sanchez-Abanto, Rômulo Araújo Fernandes, Lourdes Ribas-Barba, Nalan Uysal, Mohamad Hasnan Ahmad, Krista Fischer, Maria Wany Louzada Strufaldi, Ramiro Guerrero, Farnam Mohebi, Tran Quoc Bao, Flávio Danni Fuchs, Salim Berkinbayev, Enisa Kujundzic, Sari Voutilainen, Farzad Hadaegh, Robert Lundqvist, Saeid Safiri, Iraj Mohebbi, George Luiz Lins Machado-Coelho, Annette Peters, Gonzalo Valdivia, Magdalena Korzycka, Rajiv T Erasmus, Masanori Iwasaki, Charmaine A. Duante, Sheikh Mohammed Shariful Islam, Quang Ngoc La, Ricky Eddie, Petra Rust, Daniela Rodrigues, Dirk De Bacquer, Karen Sparrenberger, Agneta Sjöberg, Thet Thet Mu, Katarzyna Dereń, Cora L. Craig, Jorge Motta, Janina Petkeviciene, Boyd Swinburn, Paibul Suriyawongpaisal, Visnja Djordjic, Ramón Alberto Rascón-Pacheco, Pradeep Joshi, Daan Kromhout, Marius B. Bjertness, Stefano Marventano, Juel Jarani, Alireza Khosravi, Eva Martos, David De Ridder, Lizzy M. Brewster, Nico Dragano, Liam Smeeth, Kenji Shibuya, Emma Ruiz Moreno, Hashem Jaddou, Grzegorz Sobek, Dimitrios Trichopoulos, Marvin Cervantes-Loaiza, Abu Am Hanif, Elaine M. Murtagh, Carlos A. Aguilar-Salinas, Graziella D'Arrigo, Kyungwon Oh, Heiner Boeing, Regina Heidinger-Felso, André Luiz Sena Guimarães, Balkish M. Naidu, Avula Laxmaiah, Ana M. B. Menezes, Marie Eliasen, Francesco Pistelli, Yuan He, Dusko Bjelica, José A. Casajús, Guang Ning, Lutgart Braeckman, Dirk Vanderschueren, Jochanan Stessman, Ivana Radic, Yi Zeng, Hans Concin, Damaskini Valvi, Sari Hantunen, Catherine Kyobutungi, Diego Augusto Santos Silva, Wenhua Zhao, Sok King Ong, Anne W. Taylor, Iraj Nabipour, Justyna Godos, Cyrus Cooper, Mattias Johansson, Samuel C. Dumith, Magdalena Muc, Sabine Schipf, Idowu O Senbanjo, Jim Mann, Rajaa Al-Raddadi, Yih Chung Tham, Kay-Tee Khaw, Joseph Cacciottolo, Ana Henriques, Sahar Saeedi Moghaddam, Reza Mohammadpourhodki, Bernhard O. Boehm, Songhomitra Panda-Jonas, Iveta Pudule, Elisabete Ramos, Lacramioara Aurelia Brinduse, Paul H. Lee, Terence W O'Neill, Javad Aghazadeh-Attari, Margus Punab, Bojan Jelaković, Camilla T. Damsgaard, Takafumi Ishida, Ekaterina Chikova-Iscener, Mirjam M. Heinen, Tazeen H. Jafar, Semánová Csilla, Constance Schultsz, Santiago F. Gomez, Raija Korpelainen, Edward W. Gregg, Laura Gutierrez, Pierre Traissac, Victor M. Herrera, Aristides M. Machado-Rodrigues, Fatemeh Malekzadeh, Shouling Wu, Jennifer L. Baker, Clicerio González-Villalpando, Eleonora d'Orsi, Irene G. M. van Valkengoed, Anna Fijałkowska, Wen-Harn Pan, Gregor Starc, Meghnath Dhimal, Murat Topbaş, George Moschonis, Robert Eggertsen, Abdullah Alkandari, Quang Ngoc Nguyen, Janette Walton, Elnaz Faramarzi, Saeed Dastgiri, Lien Braeckevelt, Nasheeta Peer, Radka Taxová Braunerová, Mohamed M. Ali, Steiner Krokstad, Harald Geiger, Morteza Shamshirgaran, Lela Shengelia, María Ángeles Dal Re Saavedra, Silvana Donoso, Khem Bahadur Karki, Timothy J. Key, Maria G. Grammatikopoulou, Susana Vale, Felix K. Assah, Juan A Rivera, Peter H. Whincup, Oana-Florentina Gheorghe-Fronea, Cassiano Ricardo Rech, Paul Ferdinand M. Reganit, Rachakulla Hari Kumar, Jaakko Mursu, Luis A. Moreno, Glen Gironella, Jelena Kos, Tilema Cama, Haakon E. Meyer, Jun Ma, Raphael E. Arku, Ziad Abdeen, Dianna J. Magliano, Jitendra Jonnagaddala, Konstantinos Gkiouras, Paola Nardone, Alberto Barceló, Tomi-Pekka Tuomainen, Francesco Gianfagna, Stefania Maggi, Mohammad Hossein Somi, Behrooz Hamzeh, Miquel Porta, Vesna Jureša, Alexander D. Deev, David Faeh, Antonio Bernabe-Ortiz, Sirkka Keinänen-Kiukaanniemi, Ian Hambleton, Stefan Savin, Andre Pascal Kengne, R. Krishna Kumar, Kurt Widhalm, Marco M Ferrario, Parisa Amiri, Anjani Kumar Jha, Thamara Hubler Figueiró, Jana Kratenova, Claudia M. Hormiga, Maria Tsigga, Zivka Dika, Indrapal I. Meshram, Ei Ei K. Nang, Ian Rouse, Rusidah Selamat, Paul Korrovits, Grethe S. Tell, Julie Taylor, Anabela Mota-Pinto, Paolo Vineis, Kotsedi D Monyeki, Khuong Quynh Long, Frank J Rühli, Shelly R. McFarlane, Sara Santos Sanz, Edyta Łuszczki, Maria G. Stathopoulou, Tara Coppinger, Karin De Ridder, Lucie Viet, Anna Bugge, Mehdi Yaseri, Safiah Md Yusof, Sandra C. Fuchs, Muhammad Islam, Irfan Nuhoglu, Rui Providência, Bernard Maire, Leandra Abarca-Gómez, Sinead Brophy, Maria Ruiz-Castell, Daniela Pierannunzio, Cristina Taddei, Gowri Mahasampath, Gustavo Velasquez-Melendez, Hanna Tolonen, Sudhir Kowlessur, Bagher Larijani, Laura Torres-Collado, Susi Kriemler, Ali Akbar Shayesteh, Cynthia Robitaille, Jorge Escobedo-de la Peña, Yufang Bi, Chinh Nguyen Huu, Line Tang Møllehave, Vincent Jr DeGennaro, Noor Ani Ahmad, Anar Dushpanova, Agustinus Soemantri, Susana Sans, Ionela Pascanu, Gwenaëlle Le Coroller, Inger Ariansen, Kodanda R Kanala, Gert B. M. Mensink, Abhijit Sen, Sergej M. Ostojic, Hanan F. Abdul Rahim, Hélène Delisle, Francisco J. Félix-Redondo, Yadlapalli S. Kusuma, Michael Knoflach, Moein Yoosefi, Tanja G. M. Vrijkotte, Wolfgang Ahrens, Osvaldo Santos, Bethlehem D. Solomon, Erik Lykke Mortensen, Nikhil D. Patel, Reynaldo Martorell, Ching-Yu Cheng, Stine Schramm, Hana Shimizu-Furusawa, Jacek Jóźwiak, Radwan Qasrawi, Herman Borghs, Zhanna Kalmatayeva, Heidi Klakk, Akram Pourshams, Naomi S. Levitt, Son Thai Pham, Simona Giampaoli, Dong Zhao, Indah Suci Widyahening, Merete Osler, Paula Margozzini, Silvia Bel-Serrat, Dora Romaguera, Monira Alarouj, Winsome R. Parnell, Marloes Cardol, Giota Touloumi, Janice Luisa Lukrafka, Adela Chirita-Emandi, Maryam Kavousi, Sanja Musić Milanović, Jean-Michel Gaspoz, Jalila El Ati, Sauli Herrala, Liang Xu, Pilar Guallar-Castillón, Bee Koon Poh, Luis Serra-Majem, Jonathan E. Shaw, Belong Cho, Daphne Mirkopoulou, Salvador Villalpando, Yuki Fujita, Tiffany K. Gill, Nish Chaturvedi, Erkin M. Mirrakhimov, Günay Can, Mark Woodward, Esther Lopez-Garcia, Mauro Virgílio Gomes de Barros, Ahmed A. Madar, Shoaib Afzal, Melanie J. Cowan, Gareth Stratton, Eduardo Salazar Martinez, Sameer Narake, Norie Sawada, Deepak Amarapurkar, Deepa Weerasekera, Diana A. 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Boddy, Jie Hao, David Alejandro González-Chica, Romana Roccaldo, Sara Magnacca, Peter Stehle, Victoria Farrugia Sant'Angelo, Gry Skodje, Maryam Keramati, Tabara Yasuharu, Ali Ghanbari, Gyulli M. Kazakbaeva, Takuro Furusawa, Felicia Cañete, Kari Kuulasmaa, Justina Vaitkeviciute, (NCD-RisC), NCD Risk Factor Collaboration, Imperial College London, Harvard T.H. Chan School of Public Health, Middlesex University [London], Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), Montpellier Interdisciplinary center on Sustainable Agri-food systems (Social and nutritional sciences) (UMR MoISA), Centre de Coopération Internationale en Recherche Agronomique pour le Développement (Cirad)-Institut de Recherche pour le Développement (IRD)-Centre International de Hautes Etudes Agronomiques Méditerranéennes - Institut Agronomique Méditerranéen de Montpellier (CIHEAM-IAMM), Centre International de Hautes Études Agronomiques Méditerranéennes (CIHEAM)-Centre International de Hautes Études Agronomiques Méditerranéennes (CIHEAM)-Institut national d’études supérieures agronomiques de Montpellier (Montpellier SupAgro), Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)-Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), Interactions Gène-Environnement en Physiopathologie Cardio-Vasculaire (IGE-PCV), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Wellcome TrustEuropean Commission, Clinical Developmental Psychology, APH - Mental Health, Sociology, The Social Context of Aging (SoCA), Nutrition and Health, Iurilli, Maria LC [0000-0003-0409-1635], Zhou, Bin [0000-0002-1741-8628], Ezzati, Majid [0000-0002-2109-8081], Apollo - University of Cambridge Repository, Epidemiology and Data Science, APH - Aging & Later Life, APH - Societal Participation & Health, Public and occupational health, APH - Health Behaviors & Chronic Diseases, VU University medical center, APH 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Tunis El Manar, University of Oulu, University of Zagreb, University of Ljubljana, Caja Costarricense de Seguro Social, Al-Quds University, National Center of Public Healthcare, Qatar University, Birzeit University, Usmanu Danfodiyo University Teaching Hospital, Instituto Mexicano del Seguro Social, Flinders University, Mahidol University, BRAC James P Grant School of Public Health, University of Copenhagen, Copenhagen University Hospital, Food and Nutrition Research Institute, Urmia University of Medical Sciences, Instituto Nacional de Ciencias Médicas y Nutrición, University of Amsterdam, Shahrekord University of Medical Sciences, Non-Communicable Diseases Research Center, University of Oslo, University of Bremen, Republican Center for Health Promotion, Endocrinology and Genetics, Princess Nourah bint Abdulrahman University, Kuwait Institute for Scientific Research, King Abdulaziz University, Dasman Diabetes Institute, Aldara Hospital and Medical Center, King Abdullah International 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Pure Earth, Institute of Epidemiology Disease Control and Research, University of Turku, Institut Universitari d’Investigacióen AtencióPrima` ria Jordi Gol, Universiti Putra Malaysia, University of Malaya, Sotiria Hospital, University of Valencia, University of the Philippines, Slovak Academy of Sciences, Nutrition Research Foundation, Minas Gerais State Secretariat for Health, CS S. Agustín Ibsalut, Amsterdam Institute for Global Health and Development, National Institute of Health Doutor Ricardo Jorge, Universidade Nove de Julho, Public Health Agency of Canada, Canarian Health Service, Universidad Industrial de Santander, Associazione Calabrese di Epatologia, University of Minho, Fiji National University, Spanish Nutrition Foundation, Public Health Agency of Sweden, Institute of Food Sciences of the National Research Council, Sitaram Bhartia Institute of Science and Research, Kindergarten of Avlonari, National Institute of Health, Catalan Department of Health, Biodonostia Health Research Institute, Instituto de Saúde Ambiental, South Karelia Social and Health Care District, McMaster University, University of Saõ Paulo Clinics Hospital, Hospital Italiano de Buenos Aires, Rigshospitalet, Academic Medical Center of University of Amsterdam, The George Institute for Global Health, Center for Oral Health Services and Research Mid-Norway, Lagos State University College of Medicine, University of Las Palmas de Gran Canaria, Comenius University, National Center for Disease Control and Public Health, Nippon Medical School, Sungkyunkwan University, Finnish Institute of Occupational Health, Public Health Promotion and Development Organization, St Vincent’s Hospital, Nes Municipality, Health Polytechnic Jakarta II Institute, Diponegoro University, University of Bari, Institut Régional de SantéPublique, University of Bordeaux, Oslo Metropolitan University, Ss. Cyril and Methodius University, University of Leuven, Lamprecht und Stamm Sozialforschung und Beratung AG, Bonn University, National Institute of Public Health - National Institute of Hygiene, Kalina Malina Kindergarten, The Jikei University School of Medicine, Fu Jen Catholic University, National Statistical Office, Scientific Research Institute of Maternal and Child Health, University of Lincoln, Central University of Kerala, Amsterdam Public Health Research Institute, Health Service of Murcia, Institut d’Investigacio Sanitaria Illes Balears, University of Bologna, Hellenic Health Foundation, Government Medical College, Sefako Makgatho Health Science University, Addis Ababa University, Universidad Centro-Occidental Lisandro Alvarado, Meharry Medical College, Dokuz Eylul University, University of Tampere Tays Eye Center, Sabiha Gokcen Ilkokulu, Polytechnic Institute of Porto, Icahn School of Medicine at Mount Sinai, Universidad CEU San Pablo, University Miguel Hernandez, Vrije Universiteit Amsterdam, Sunflower Nursery School, North Karelia Center for Public Health, University of the Witwatersrand, Medical University of Vienna, Cork Institute of Technology, Institute for Medical Research, Xinjiang Medical University, Shanghai Educational Development Co. Ltd, Orebro University, University of London, Universitas Indonesia, Institute of Food and Nutrition Development of Ministry of Agriculture and Rural Affairs, Children’s Hospital of Fudan University, University of Cyprus, Niigata University, International Medical University, Iran University of Medical Sciences, Center for Diabetes and Endocrine Care, Peking University First Hospital, Jiangsu Provincial Center for Disease Control and Prevention, Sun Yat-sen University, West Kazakhstan Medical University, Inner Mongolia Medical University, University of Ghana, Maria Lc Iurilli , Bin Zhou , James E Bennett , Rodrigo M Carrillo-Larco , Marisa K Sophiea , Andrea Rodriguez-Martinez , Honor Bixby , Bethlehem D Solomon , Cristina Taddei , Goodarz Danaei , Mariachiara Di Cesare , Gretchen A Stevens , Leanne M Riley , Stefan Savin , Melanie J Cowan , Pascal Bovet , Albertino Damasceno , Adela Chirita-Emandi , Alison J Hayes , Nayu Ikeda , Rod T Jackson , Young-Ho Khang , Avula Laxmaiah , Jing Liu , J Jaime Miranda , Olfa Saidi , Sylvain Sebert , Maroje Sorić , Gregor Starc , Edward W Gregg , Leandra Abarca-Gómez , Ziad A Abdeen , Shynar Abdrakhmanova , Suhaila Abdul Ghaffar , Hanan F Abdul Rahim , Niveen M Abu-Rmeileh , Jamila Abubakar Garba , Benjamin Acosta-Cazares , Robert J Adams , Wichai Aekplakorn , Kaosar Afsana , Shoaib Afzal , Imelda A Agdeppa , Javad Aghazadeh-Attari , Carlos A Aguilar-Salinas , Charles Agyemang , Mohamad Hasnan Ahmad , Noor Ani Ahmad , Ali Ahmadi , Naser Ahmadi , Soheir H Ahmed , Wolfgang Ahrens , Gulmira Aitmurzaeva , Kamel Ajlouni , Hazzaa M Al-Hazzaa , Badreya Al-Lahou , Rajaa Al-Raddadi , Monira Alarouj , Fadia AlBuhairan , Shahla AlDhukair , Mohamed M Ali , Abdullah Alkandari , Ala'a Alkerwi , Kristine Allin , Mar Alvarez-Pedrerol , Eman Aly , Deepak N Amarapurkar , Parisa Amiri , Norbert Amougou , Philippe Amouyel , Lars Bo Andersen , Sigmund A Anderssen , Lars Ängquist , Ranjit Mohan Anjana , Alireza Ansari-Moghaddam , Hajer Aounallah-Skhiri , Joana Araújo , Inger Ariansen , Tahir Aris , Raphael E Arku , Nimmathota Arlappa , Krishna K Aryal , Thor Aspelund , Felix K Assah , Maria Cecília F Assunção , May Soe Aung , Juha Auvinen , Mária Avdicová , Shina Avi , Ana Azevedo , Mohsen Azimi-Nezhad , Fereidoun Azizi , Mehrdad Azmin , Bontha V Babu , Maja Bæksgaard Jørgensen , Azli Baharudin , Suhad Bahijri , Jennifer L Baker , Nagalla Balakrishna , Mohamed Bamoshmoosh , Maciej Banach , Piotr Bandosz , José R Banegas , Joanna Baran , Barbagallo CM, Alberto Barceló , Amina Barkat , Aluisio Jd Barros , Mauro Virgílio Gomes Barros , Abdul Basit , Joao Luiz D Bastos , Iqbal Bata , Anwar M Batieha , Rosangela L Batista , Zhamilya Battakova , Assembekov Batyrbek , Louise A Baur , Robert Beaglehole , Silvia Bel-Serrat , Antonisamy Belavendra , Habiba Ben Romdhane , Judith Benedics , Mikhail Benet , Ingunn Holden Bergh , Salim Berkinbayev , Antonio Bernabe-Ortiz , Gailute Bernotiene , Heloísa Bettiol , Jorge Bezerra , 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, Zhanna Kalmatayeva , Ofra Kalter-Leibovici , Yves Kameli , Freja B Kampmann , Kodanda R Kanala , Srinivasan Kannan , Efthymios Kapantais , Argyro Karakosta , Line L Kårhus , Khem B Karki , Marzieh Katibeh , Joanne Katz , Peter T Katzmarzyk , Jussi Kauhanen , Prabhdeep Kaur , Maryam Kavousi , Gyulli M Kazakbaeva , Ulrich Keil , Lital Keinan Boker , Sirkka Keinänen-Kiukaanniemi , Roya Kelishadi , Cecily Kelleher , Han Cg Kemper , Andre P Kengne , Maryam Keramati , Alina Kerimkulova , Mathilde Kersting , Timothy Key , Yousef Saleh Khader , Davood Khalili , Kay-Tee Khaw , Bahareh Kheiri , Motahareh Kheradmand , Alireza Khosravi , Ilse Msl Khouw , Ursula Kiechl-Kohlendorfer , Stefan Kiechl , Japhet Killewo , Dong Wook Kim , Hyeon Chang Kim , Jeongseon Kim , Jenny M Kindblom , Heidi Klakk , Magdalena Klimek , Jeannette Klimont , Jurate Klumbiene , Michael Knoflach , Bhawesh Koirala , Elin Kolle , Patrick Kolsteren , Jürgen König , Raija Korpelainen , Paul Korrovits , Magdalena Korzycka , 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Teresa A Olinto , Isabel O Oliveira , Mohd Azahadi Omar , Altan Onat , Sok King Ong , Lariane M Ono , Pedro Ordunez , Rui Ornelas , Ana P Ortiz , Pedro J Ortiz , Merete Osler , Clive Osmond , Sergej M Ostojic , Afshin Ostovar , Johanna A Otero , Kim Overvad , Ellis Owusu-Dabo , Fred Michel Paccaud , Cristina Padez , Ioannis Pagkalos , Elena Pahomova , Karina Mary de Paiva , Andrzej Pajak , Domenico Palli , Alberto Palloni , Luigi Palmieri , Wen-Harn Pan , Songhomitra Panda-Jonas , Arvind Pandey , Francesco Panza , Dimitrios Papandreou , Soon-Woo Park , Suyeon Park , Winsome R Parnell , Mahboubeh Parsaeian , Ionela M Pascanu , Patrick Pasquet , Nikhil D Patel , Ivan Pecin , Mangesh S Pednekar , Nasheeta Peer , Gao Pei , Sergio Viana Peixoto , Markku Peltonen , Alexandre C Pereira , Marco A Peres , Napoleón Pérez-Farinós , Cynthia M Pérez , Valentina Peterkova , Annette Peters , Astrid Petersmann , Janina Petkeviciene , Ausra Petrauskiene , Emanuela Pettenuzzo , Niloofar Peykari , Son 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, Cassiano Ricardo Rech , Josep Redon , Paul Ferdinand M Reganit , Valéria Regecová , Luis Revilla , Abbas Rezaianzadeh , Lourdes Ribas-Barba , Robespierre Ribeiro , Elio Riboli , Adrian Richter , Fernando Rigo , Natascia Rinaldo , Tobias F Rinke de Wit , Ana Rito , Raphael M Ritti-Dias , Juan A Rivera , Cynthia Robitaille , Romana Roccaldo , Daniela Rodrigues , Fernando Rodríguez-Artalejo , María Del Cristo Rodriguez-Perez , Laura A Rodríguez-Villamizar , Ulla Roggenbuck , Rosalba Rojas-Martinez , Nipa Rojroongwasinkul , Dora Romaguera , Elisabetta L Romeo , Rafaela V Rosario , Annika Rosengren , Ian Rouse , Joel Gr Roy , Adolfo Rubinstein , Frank J Rühli , Jean-Bernard Ruidavets , Blanca Sandra Ruiz-Betancourt , Maria Ruiz-Castell , Emma Ruiz Moreno , Iuliia A Rusakova , Kenisha Russell Jonsson , Paola Russo , Petra Rust , Marcin Rutkowski , Charumathi Sabanayagam , Elena Sacchini , Harshpal S Sachdev , Alireza Sadjadi , Ali Reza Safarpour , Saeid Safiri , Nader Saki , Benoit Salanave , Eduardo Salazar Martinez , Diego Salmerón , Veikko Salomaa , Jukka T Salonen , Massimo Salvetti , Margarita Samoutian , Jose Sánchez-Abanto , Sandjaja , Susana Sans , Loreto Santa Marina , Diana A Santos , Ina S Santos , Lèlita C Santos , Maria Paula Santos , Osvaldo Santos , Rute Santos , Sara Santos Sanz , Jouko L Saramies , Luis B Sardinha , Nizal Sarrafzadegan , Thirunavukkarasu Sathish , Kai-Uwe Saum , Savvas Savva , Mathilde Savy , Norie Sawada , Mariana Sbaraini , Marcia Scazufca , Beatriz D Schaan , Angelika Schaffrath Rosario , Herman Schargrodsky , Anja Schienkiewitz , Sabine Schipf , Carsten O Schmidt , Ida Maria Schmidt , Peter Schnohr , Ben Schöttker , Sara Schramm , Stine Schramm , Helmut Schröder , Constance Schultsz , Aletta E Schutte , Aye Aye Sein , Rusidah Selamat , Vedrana Sember , Abhijit Sen , Idowu O Senbanjo , Sadaf G Sepanlou , Victor Sequera , Luis Serra-Majem , Jennifer Servais , Ludmila Ševcíková , Svetlana A Shalnova , Teresa Shamah-Levy , Morteza Shamshirgaran , Coimbatore Subramaniam Shanthirani , Maryam Sharafkhah , Sanjib K Sharma , Jonathan E Shaw , Amaneh Shayanrad , Ali Akbar Shayesteh , Lela Shengelia , Zumin Shi , Kenji Shibuya , Hana Shimizu-Furusawa , Dong Wook Shin , Majid Shirani , Rahman Shiri , Namuna Shrestha , Khairil Si-Ramlee , Alfonso Siani , Rosalynn Siantar , Abla M Sibai , Antonio M Silva , Diego Augusto Santos Silva , Mary Simon , Judith Simons , Leon A Simons , Agneta Sjöberg , Michael Sjöström , Gry Skodje , Jolanta Slowikowska-Hilczer , Przemyslaw Slusarczyk , Liam Smeeth , Hung-Kwan So , Fernanda Cunha Soares , Grzegorz Sobek , Eugène Sobngwi , Morten Sodemann , Stefan Söderberg , Moesijanti Ye Soekatri , Agustinus Soemantri , Reecha Sofat , Vincenzo Solfrizzi , Mohammad Hossein Somi , Emily Sonestedt , Yi Song , Thorkild Ia Sørensen , Elin P Sørgjerd , Charles Sossa Jérome , Victoria E Soto-Rojas , Aïcha Soumaré , Slavica Sovic , Bente Sparboe-Nilsen , Karen Sparrenberger , Angela Spinelli , Igor Spiroski , Jan A Staessen , Hanspeter Stamm , Maria G Stathopoulou , Kaspar Staub , Bill Stavreski , Jostein Steene-Johannessen , Peter Stehle , Aryeh D Stein , George S Stergiou , Jochanan Stessman , Ranko Stevanovic , Jutta Stieber , Doris Stöckl , Tanja Stocks , Jakub Stokwiszewski , Ekaterina Stoyanova , Gareth Stratton , Karien Stronks , Maria Wany Strufaldi , Lela Sturua , Ramón Suárez-Medina , Machi Suka , Chien-An Sun , Johan Sundström , Yn-Tz Sung , Jordi Sunyer , Paibul Suriyawongpaisal , Boyd A Swinburn , Rody G Sy , Holly E Syddall , René Charles Sylva , Moyses Szklo , Lucjan Szponar , E Shyong Tai , Mari-Liis Tammesoo , Abdonas Tamosiunas , Eng Joo Tan , Xun Tang , Maya Tanrygulyyeva , Frank Tanser , Yong Tao , Mohammed Rasoul Tarawneh , Jakob Tarp , Carolina B Tarqui-Mamani , Radka Taxová Braunerová , Anne Taylor , Julie Taylor , Félicité Tchibindat , William R Tebar , Grethe S Tell , Tania Tello , Yih Chung Tham , K R Thankappan , Holger Theobald , Xenophon 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Islam, Muhammad, Islam, Sheikh Mohammed Shariful, Iwasaki, Masanori, Jacobs, Jeremy M, Jaddou, Hashem Y, Jafar, Tazeen, James, Kenneth, Jamil, Kazi M, Jamrozik, Konrad, Janszky, Imre, Janus, Edward, Jarani, Juel, Jarvelin, Marjo-Riitta, Jasienska, Grazyna, Jelakovic, Ana, Jelakovic, Bojan, Jennings, Garry, Jha, Anjani Kumar, Jiang, Chao Qiang, Jimenez, Ramon O, Jöckel, Karl-Heinz, Joffres, Michel, Johansson, Mattia, Jokelainen, Jari J, Jonas, Jost B, Jonnagaddala, Jitendra, Jørgensen, Torben, Joshi, Pradeep, Joukar, Farahnaz, Jovic, Dragana P, Jóźwiak, Jacek J, Juolevi, Anne, Jurak, Gregor, Simina, Iulia Jurca, Juresa, Vesna, Kaaks, Rudolf, Kaducu, Felix O, Kafatos, Anthony, Kajantie, Eero O, Kalmatayeva, Zhanna, Kalter-Leibovici, Ofra, Kameli, Yve, Kampmann, Freja B, Kanala, Kodanda R, Kannan, Srinivasan, Kapantais, Efthymio, Karakosta, Argyro, Kårhus, Line L, Karki, Khem B, Katibeh, Marzieh, Katz, Joanne, Katzmarzyk, Peter T, Kauhanen, Jussi, Kaur, Prabhdeep, Kavousi, Maryam, Kazakbaeva, Gyulli M, Keil, Ulrich, Boker, Lital Keinan, Keinänen-Kiukaanniemi, Sirkka, Kelishadi, Roya, Kelleher, Cecily, Kemper, Han CG, Kengne, Andre P, Keramati, Maryam, Kerimkulova, Alina, Kersting, Mathilde, Key, Timothy, Khader, Yousef Saleh, Khalili, Davood, Khaw, Kay-Tee, Kheiri, Bahareh, Kheradmand, Motahareh, Khosravi, Alireza, Khouw, Ilse MSL, Kiechl-Kohlendorfer, Ursula, Kiechl, Stefan, Killewo, Japhet, Kim, Dong Wook, Kim, Hyeon Chang, Kim, Jeongseon, Kindblom, Jenny M, Klakk, Heidi, Klimek, Magdalena, Klimont, Jeannette, Klumbiene, Jurate, Knoflach, Michael, Koirala, Bhawesh, Kolle, Elin, Kolsteren, Patrick, König, Jürgen, Korpelainen, Raija, Korrovits, Paul, Korzycka, Magdalena, Kos, Jelena, Koskinen, Seppo, Kouda, Katsuyasu, Kovacs, Viktoria A, Kowlessur, Sudhir, Koziel, Slawomir, Kratenova, Jana, Kratzer, Wolfgang, Kriemler, Susi, Kristensen, Peter Lund, Krokstad, Steiner, Kromhout, Daan, Kruger, Herculina S, Kubinova, Ruzena, Kuciene, Renata, Kujala, Urho M, Kujundzic, Enisa, Kulaga, Zbigniew, Kumar, R Krishna, Kunešová, Marie, Kurjata, Pawel, Kusuma, Yadlapalli S, Kuulasmaa, Kari, Kyobutungi, Catherine, La, Quang Ngoc, Laamiri, Fatima Zahra, Laatikainen, Tiina, Lachat, Carl, Laid, Youcef, Lam, Tai Hing, Lambrinou, Christina-Paulina, Landais, Edwige, Lanska, Vera, Lappas, Georg, Larijani, Bagher, Latt, Tint Swe, Lauria, Laura, Lazo-Porras, Maria, Le Coroller, Gwenaëlle, Le Nguyen Bao, Khanh, Le Port, Agnè, Le, Tuyen D, Lee, Jeannette, Lee, Jeonghee, Lee, Paul H, Lehmann, Nil, Lehtimäki, Terho, Lemogoum, Daniel, Levitt, Naomi S, Li, Yanping, Liivak, Merike, Lilly, Christa L, Lim, Wei-Yen, Lima-Costa, M Fernanda, Lin, Hsien-Ho, Lin, Xu, Lin, Yi-Ting, Lind, Lar, Linneberg, Allan, Lissner, Lauren, Litwin, Mieczyslaw, Liu, Lijuan, Lo, Wei-Cheng, Loit, Helle-Mai, Long, Khuong Quynh, Lopes, Lui, Lopes, Oscar, Lopez-Garcia, Esther, Lopez, Tania, Lotufo, Paulo A, Lozano, José Eugenio, Lukrafka, Janice L, Luksiene, Dalia, Lundqvist, Annamari, Lundqvist, Robert, Lunet, Nuno, Lunogelo, Charle, Lustigová, Michala, Łuszczki, Edyta, Ma, Guansheng, Ma, Jun, Ma, Xu, Machado-Coelho, George LL, Machado-Rodrigues, Aristides M, Macieira, Luisa M, Madar, Ahmed A, Maggi, Stefania, Magliano, Dianna J, Magnacca, Sara, Magriplis, Emmanuella, Mahasampath, Gowri, Maire, Bernard, Majer, Marjeta, Makdisse, Marcia, Mäki, Päivi, Malekzadeh, Fatemeh, Malekzadeh, Reza, Malhotra, Rahul, Rao, Kodavanti Mallikharjuna, Malyutina, Sofia K, Maniego, Lynell V, Manios, Yanni, Mann, Jim I, Mansour-Ghanaei, Fariborz, Manzato, Enzo, Margozzini, Paula, Markaki, Anastasia, Markey, Oonagh, Ioannidou, Eliza Markidou, Marques-Vidal, Pedro, Marques, Larissa Pruner, Marrugat, Jaume, Martin-Prevel, Yve, Martin, Rosemarie, Martorell, Reynaldo, Martos, Eva, Maruszczak, Katharina, Marventano, Stefano, Mascarenhas, Luis P, Masoodi, Shariq R, Mathiesen, Ellisiv B, Mathur, Prashant, Matijasevich, Alicia, Matsha, Tandi E, Mavrogianni, Christina, Mazur, Artur, Mbanya, Jean Claude N, McFarlane, Shelly R, McGarvey, Stephen T, McKee, Martin, McLachlan, Stela, McLean, Rachael M, McLean, Scott B, McNulty, Breige A, Benchekor, Sounnia Mediene, Medzioniene, Jurate, Mehdipour, Parinaz, Mehlig, Kirsten, Mehrparvar, Amir Houshang, Meirhaeghe, Aline, Meisfjord, Jørgen, Meisinger, Christa, Menezes, Ana Maria B, Menon, Geetha R, Mensink, Gert BM, Menzano, Maria Teresa, Mereke, Alibek, Meshram, Indrapal I, Metspalu, Andre, Meyer, Haakon E, Mi, Jie, Michaelsen, Kim F, Michels, Nathalie, Mikkel, Kairit, Milkowska, Karolina, Miller, Jody C, Minderico, Cláudia S, Mini, GK, Miquel, Juan Francisco, Mirjalili, Mohammad Reza, Mirkopoulou, Daphne, Mirrakhimov, Erkin, Mišigoj-Durakovic, Marjeta, Mistretta, Antonio, Mocanu, Veronica, Modesti, Pietro A, Moghaddam, Sahar Saeedi, Mohajer, Bahram, Mohamed, Mostafa K, Mohamed, Shukri F, Mohammad, Kazem, Mohammadi, Zahra, Mohammadifard, Noushin, Mohammadpourhodki, Reza, Mohan, Viswanathan, Mohanna, Salim, Yusoff, Muhammad Fadhli Mohd, Mohebbi, Iraj, Mohebi, Farnam, Moitry, Marie, Molbo, Drude, Møllehave, Line T, Møller, Niels C, Molnár, Déne, Momenan, Amirabba, Mondo, Charles K, Monroy-Valle, Michele, Monterrubio-Flores, Eric, Monyeki, Kotsedi Daniel K, Moon, Jin Soo, Moosazadeh, Mahmood, Moreira, Leila B, Morejon, Alain, Moreno, Luis A, Morgan, Karen, Morin, Suzanne N, Mortensen, Erik Lykke, Moschonis, George, Mossakowska, Malgorzata, Mostafa, Aya, Mota-Pinto, Anabela, Mota, Jorge, Motlagh, Mohammad Esmaeel, Motta, Jorge, Moura-dos-Santos, Marcos André, Mridha, Malay K, Msyamboza, Kelias P, Mu, Thet Thet, Muc, Magdalena, Mugoša, Boban, Muiesan, Maria L, Mukhtorova, Parvina, Müller-Nurasyid, Martina, Murphy, Neil, Mursu, Jaakko, Murtagh, Elaine M, Musa, Kamarul Imran, Milanovic, Sanja Music, Musil, Vera, Mustafa, Norlaila, Nabipour, Iraj, Naderimagham, Shohreh, Nagel, Gabriele, Naidu, Balkish M, Najafi, Farid, Nakamura, Harunobu, Námešná, Jana, Ei K Nang, Ei, Nangia, Vinay B, Nankap, Martin, Narake, Sameer, Nardone, Paola, Nauck, Matthia, Neal, William A, Nejatizadeh, Azim, Nekkantti, Chandini, Nelis, Keiu, Nelis, Lii, Nenko, Ilona, Neovius, Martin, Nervi, Flavio, Nguyen, Chung T, Nguyen, Nguyen D, Nguyen, Quang Ngoc, Nieto-Martínez, Ramfis E, Nikitin, Yury P, Ning, Guang, Ninomiya, Toshiharu, Nishtar, Sania, Noale, Marianna, Noboa, Oscar A, Nogueira, Helena, Norat, Teresa, Nordendahl, Maria, Nordestgaard, Børge G, Noto, Davide, Nowak-Szczepanska, Natalia, Al Nsour, Mohannad, Nuhoglu, Irfan, Nurk, Eha, O'Neill, Terence W, O'Reilly, Dermot, Obreja, Galina, Ochimana, Caleb, Ochoa-Avilés, Angélica M, Oda, Eiji, Oh, Kyungwon, Ohara, Kumiko, Ohlsson, Clae, Ohtsuka, Ryutaro, Olafsson, Örn, Olinto, Maria Teresa A, Oliveira, Isabel O, Omar, Mohd Azahadi, Onat, Altan, Ong, Sok King, Ono, Lariane M, Ordunez, Pedro, Ornelas, Rui, Ortiz, Ana P, Ortiz, Pedro J, Osler, Merete, Osmond, Clive, Ostojic, Sergej M, Ostovar, Afshin, Otero, Johanna A, Overvad, Kim, Owusu-Dabo, Elli, Paccaud, Fred Michel, Padez, Cristina, Pagkalos, Ioanni, Pahomova, Elena, de Paiva, Karina Mary, Pajak, Andrzej, Palli, Domenico, Palloni, Alberto, Palmieri, Luigi, Pan, Wen-Harn, Panda-Jonas, Songhomitra, Pandey, Arvind, Panza, Francesco, Papandreou, Dimitrio, Park, Soon-Woo, Park, Suyeon, Parnell, Winsome R, Parsaeian, Mahboubeh, Pascanu, Ionela M, Pasquet, Patrick, Patel, Nikhil D, Pecin, Ivan, Pednekar, Mangesh S, Peer, Nasheeta, Pei, Gao, Peixoto, Sergio Viana, Peltonen, Markku, Pereira, Alexandre C, Peres, Marco A, Pérez-Farinós, Napoleón, Pérez, Cynthia M, Peterkova, Valentina, Peters, Annette, Petersmann, Astrid, Petkeviciene, Janina, Petrauskiene, Ausra, Pettenuzzo, Emanuela, Peykari, Niloofar, Pham, Son Thai, Pichardo, Rafael N, Pierannunzio, Daniela, Pigeot, Iri, Pikhart, Hynek, Pilav, Aida, Pilotto, Lorenza, Pistelli, Francesco, Pitakaka, Freda, Piwonska, Aleksandra, Pizarro, Andreia N, Plans-Rubió, Pedro, Poh, Bee Koon, Pohlabeln, Hermann, Pop, Raluca M, Popovic, Stevo R, Porta, Miquel, Posch, Georg, Poudyal, Anil, Poulimeneas, Dimitrio, Pouraram, Hamed, Pourfarzi, Farhad, Pourshams, Akram, Poustchi, Hossein, Pradeepa, Rajendra, Price, Alison J, Price, Jacqueline F, Providencia, Rui, Puder, Jardena J, Pudule, Iveta, Puhakka, Soile E, Puiu, Maria, Punab, Margu, Qasrawi, Radwan F, Qorbani, Mostafa, Bao, Tran Quoc, Radic, Ivana, Radisauskas, Ricarda, Rahimikazerooni, Salar, Rahman, Mahfuzar, Rahman, Mahmudur, Raitakari, Olli, Raj, Manu, Rakhimova, Ellina, Rakhmatulloev, Sherali, Rakovac, Ivo, Rao, Sudha Ramachandra, Ramachandran, Ambady, Ramke, Jacqueline, Ramos, Elisabete, Ramos, Rafel, Rampal, Lekhraj, Rampal, Sanjay, Rarra, Vayia, Rascon-Pacheco, Ramon A, Rasmussen, Mette, Rech, Cassiano Ricardo, Redon, Josep, Reganit, Paul Ferdinand M, Regecová, Valéria, Revilla, Lui, Rezaianzadeh, Abba, Ribas-Barba, Lourde, Ribeiro, Robespierre, Riboli, Elio, Richter, Adrian, Rigo, Fernando, Rinaldo, Natascia, de Wit, Tobias F Rinke, Rito, Ana, Ritti-Dias, Raphael M, Rivera, Juan A, Robitaille, Cynthia, Roccaldo, Romana, Rodrigues, Daniela, Rodríguez-Artalejo, Fernando, del Cristo Rodriguez-Perez, María, Rodríguez-Villamizar, Laura A, Roggenbuck, Ulla, Rojas-Martinez, Rosalba, Rojroongwasinkul, Nipa, Romaguera, Dora, Romeo, Elisabetta L, Rosario, Rafaela V, Rosengren, Annika, Rouse, Ian, Roy, Joel GR, Rubinstein, Adolfo, Rühli, Frank J, Ruidavets, Jean-Bernard, Ruiz-Betancourt, Blanca Sandra, Ruiz-Castell, Maria, Moreno, Emma Ruiz, Rusakova, Iuliia A, Jonsson, Kenisha Russell, Russo, Paola, Rust, Petra, Rutkowski, Marcin, Sabanayagam, Charumathi, Sacchini, Elena, Sachdev, Harshpal S, Sadjadi, Alireza, Safarpour, Ali Reza, Safiri, Saeid, Saki, Nader, Salanave, Benoit, Martinez, Eduardo Salazar, Salmerón, Diego, Salomaa, Veikko, Salonen, Jukka T, Salvetti, Massimo, Samoutian, Margarita, Sánchez-Abanto, Jose, Sandjaja, null, Sans, Susana, Marina, Loreto Santa, Santos, Diana A, Santos, Ina S, Santos, Lèlita C, Santos, Maria Paula, Santos, Osvaldo, Santos, Rute, Sanz, Sara Santo, Saramies, Jouko L, Sardinha, Luis B, Sarrafzadegan, Nizal, Sathish, Thirunavukkarasu, Saum, Kai-Uwe, Savva, Savva, Savy, Mathilde, Sawada, Norie, Sbaraini, Mariana, Scazufca, Marcia, Schaan, Beatriz D, Rosario, Angelika Schaffrath, Schargrodsky, Herman, Schienkiewitz, Anja, Schipf, Sabine, Schmidt, Carsten O, Schmidt, Ida Maria, Schnohr, Peter, Schöttker, Ben, Schramm, Sara, Schramm, Stine, Schröder, Helmut, Schultsz, Constance, Schutte, Aletta E, Sein, Aye Aye, Selamat, Rusidah, Sember, Vedrana, Sen, Abhijit, Senbanjo, Idowu O, Sepanlou, Sadaf G, Sequera, Victor, Serra-Majem, Lui, Servais, Jennifer, Ševcíková, Ludmila, Shalnova, Svetlana A, Shamah-Levy, Teresa, Shamshirgaran, Morteza, Shanthirani, Coimbatore Subramaniam, Sharafkhah, Maryam, Sharma, Sanjib K, Shaw, Jonathan E, Shayanrad, Amaneh, Shayesteh, Ali Akbar, Shengelia, Lela, Shi, Zumin, Shibuya, Kenji, Shimizu-Furusawa, Hana, Shin, Dong Wook, Shirani, Majid, Shiri, Rahman, Shrestha, Namuna, Si-Ramlee, Khairil, Siani, Alfonso, Siantar, Rosalynn, Sibai, Abla M, Silva, Antonio M, Silva, Diego Augusto Santo, Simon, Mary, Simons, Judith, Simons, Leon A, Sjöberg, Agneta, Sjöström, Michael, Skodje, Gry, Slowikowska-Hilczer, Jolanta, Slusarczyk, Przemyslaw, Smeeth, Liam, So, Hung-Kwan, Soares, Fernanda Cunha, Sobek, Grzegorz, Sobngwi, Eugène, Sodemann, Morten, Söderberg, Stefan, Soekatri, Moesijanti YE, Soemantri, Agustinu, Sofat, Reecha, Solfrizzi, Vincenzo, Somi, Mohammad Hossein, Sonestedt, Emily, Song, Yi, Sørensen, Thorkild IA, Sørgjerd, Elin P, Jérome, Charles Sossa, Soto-Rojas, Victoria E, Soumaré, Aïcha, Sovic, Slavica, Sparboe-Nilsen, Bente, Sparrenberger, Karen, Spinelli, Angela, Spiroski, Igor, Staessen, Jan A, Stamm, Hanspeter, Stathopoulou, Maria G, Staub, Kaspar, Stavreski, Bill, Steene-Johannessen, Jostein, Stehle, Peter, Stein, Aryeh D, Stergiou, George S, Stessman, Jochanan, Stevanovic, Ranko, Stieber, Jutta, Stöckl, Dori, Stocks, Tanja, Stokwiszewski, Jakub, Stoyanova, Ekaterina, Stratton, Gareth, Stronks, Karien, Strufaldi, Maria Wany, Sturua, Lela, Suárez-Medina, Ramón, Suka, Machi, Sun, Chien-An, Sundström, Johan, Sung, Yn-Tz, Sunyer, Jordi, Suriyawongpaisal, Paibul, Swinburn, Boyd A, Sy, Rody G, Syddall, Holly E, Sylva, René Charle, Szklo, Moyse, Szponar, Lucjan, Tai, E Shyong, Tammesoo, Mari-Lii, Tamosiunas, Abdona, Tan, Eng Joo, Tang, Xun, Tanrygulyyeva, Maya, Tanser, Frank, Tao, Yong, Tarawneh, Mohammed Rasoul, Tarp, Jakob, Tarqui-Mamani, Carolina B, Braunerová, Radka Taxová, Taylor, Anne, Taylor, Julie, Tchibindat, Félicité, Tebar, William R, Tell, Grethe S, Tello, Tania, Tham, Yih Chung, Thankappan, KR, Theobald, Holger, Theodoridis, Xenophon, Thijs, Lutgarde, Thomas, Nihal, Thuesen, Betina H, Tichá, Lubica, Timmermans, Erik J, Tjonneland, Anne, Tolonen, Hanna K, Tolstrup, Janne S, Topbas, Murat, Topór-Madry, Roman, Torheim, Liv Elin, Tormo, María José, Tornaritis, Michael J, Torrent, Matie, Torres-Collado, Laura, Toselli, Stefania, Touloumi, Giota, Traissac, Pierre, Tran, Thi Tuyet-Hanh, Trichopoulos, Dimitrio, Trichopoulou, Antonia, Trinh, Oanh TH, Trivedi, Atul, Tshepo, Lechaba, Tsigga, Maria, Tsugane, Shoichiro, Tuliakova, Azaliia M, Tulloch-Reid, Marshall K, Tullu, Fikru, Tuomainen, Tomi-Pekka, Tuomilehto, Jaakko, Turley, Maria L, Twig, Gilad, Tynelius, Per, Tzotzas, Themistokli, Tzourio, Christophe, Ueda, Peter, Ugel, Eunice, Ukoli, Flora AM, Ulmer, Hanno, Unal, Belgin, Usupova, Zhamyila, Uusitalo, Hannu MT, Uysal, Nalan, Vaitkeviciute, Justina, Valdivia, Gonzalo, Vale, Susana, Valvi, Damaskini, van Dam, Rob M, Van der Heyden, Johan, van der Schouw, Yvonne T, Van Herck, Koen, Van Minh, Hoang, Van Schoor, Natasja M, van Valkengoed, Irene GM, Vanderschueren, Dirk, Vanuzzo, Diego, Varbo, Anette, Varela-Moreiras, Gregorio, Varona-Pérez, Patricia, Vasan, Senthil K, Vega, Toma, Veidebaum, Tooma, Velasquez-Melendez, Gustavo, Velika, Biruta, Veronesi, Giovanni, Verschuren, WM Monique, Victora, Cesar G, Viegi, Giovanni, Viet, Lucie, Villalpando, Salvador, Vineis, Paolo, Vioque, Jesu, Virtanen, Jyrki K, Visser, Marjolein, Visvikis-Siest, Sophie, Viswanathan, Bharathi, Vladulescu, Mihaela, Vlasoff, Tiina, Vocanec, Dorja, Vollenweider, Peter, Völzke, Henry, Voutilainen, Ari, Voutilainen, Sari, Vrijheid, Martine, Vrijkotte, Tanja GM, Wade, Alisha N, Wagner, Aline, Waldhör, Thoma, Walton, Janette, Wambiya, Elvis OA, Bebakar, Wan Mohamad Wan, Mohamud, Wan Nazaimoon Wan, de Souza Wanderley Júnior, Rildo, Wang, Ming-Dong, Wang, Ningli, Wang, Qian, Wang, Xiangjun, Wang, Ya Xing, Wang, Ying-Wei, Wannamethee, S Goya, Wareham, Nichola, Weber, Adelheid, Wedderkopp, Niel, Weerasekera, Deepa, Weghuber, Daniel, Wei, Wenbin, Weres, Aneta, Werner, Bo, Whincup, Peter H, Widhalm, Kurt, Widyahening, Indah S, Wiecek, Andrzej, Wilks, Rainford J, Willeit, Johann, Willeit, Peter, Williams, Julianne, Wilsgaard, Tom, Wojtyniak, Bogdan, Wong-McClure, Roy A, Wong, Andrew, Wong, Jyh Eiin, Wong, Tien Yin, Woo, Jean, Woodward, Mark, Wu, Frederick C, Wu, Jianfeng, Wu, Li Juan, Wu, Shouling, Xu, Haiquan, Xu, Liang, Yaacob, Nor Azwany, Yamborisut, Uruwan, Yan, Weili, Yang, Ling, Yang, Xiaoguang, Yang, Yang, Yardim, Nazan, Yaseri, Mehdi, Yasuharu, Tabara, Ye, Xingwang, Yiallouros, Panayiotis K, Yoosefi, Moein, Yoshihara, Akihiro, You, Qi Sheng, You, San-Lin, Younger-Coleman, Novie O, Md Yusof, Safiah, Yusoff, Ahmad Faudzi, Zaccagni, Luciana, Zafiropulos, Vassili, Zainuddin, Ahmad A, Zakavi, Seyed Rasoul, Zamani, Farhad, Zambon, Sabina, Zampelas, Antoni, Zamrazilová, Hana, Zapata, Maria Elisa, Zargar, Abdul Hamid, Ko Zaw, Ko, Zdrojewski, Tomasz, Zejglicova, Kristyna, Vrkic, Tajana Zeljkovic, Zeng, Yi, Zhang, Luxia, Zhang, Zhen-Yu, Zhao, Dong, Zhao, Ming-Hui, Zhao, Wenhua, Zhen, Shiqi, Zheng, Wei, Zheng, Yingfeng, Zholdin, Bekbolat, Zhou, Maigeng, Zhu, Dan, Zins, Marie, Zitt, Emanuel, Zocalo, Yanina, Cisneros, Julio Zuñiga, Zuziak, Monika, Ezzati, Majid, Filippi, Sarah, Cohortes épidémiologiques en population (CONSTANCES), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay-Université Paris Cité (UPCité), Université Paris Cité (UPCité), Centre International de Hautes Études Agronomiques Méditerranéennes (CIHEAM)-Centre International de Hautes Études Agronomiques Méditerranéennes (CIHEAM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Institut Agro - Montpellier SupAgro, and Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)-Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)
Subjects: Population -- Health aspects, Leanness, Baixo peso/Underweight, none, Double burden, alipainoisuus, tulotaso, global health, systematic analysis, Sedentary behaviors, RC1200, Prospective associations, 0302 clinical medicine, underweight, nälänhätä, Biology (General), skin and connective tissue diseases, Children, ComputingMilieux_MISCELLANEOUS, Body mass index, Human Nutrition & Health, education.field_of_study, Humane Voeding & Gezondheid, ylipaino, General Medicine, kansainvälinen vertailu, 3. Good health, World health, Medicine, A100 Pre-clinical Medicine, Population distribution, medicine.medical_specialty, QH301-705.5, Science, Socio-culturale, Nursing, Social sciences, General Biochemistry, Genetics and Molecular Biology, 03 medical and health sciences, Thinness, SDG 3 - Good Health and Well-being, BMI, epidemiology, obesity, None, Humans, Obesidade/Obesity, SDG 2 - Zero Hunger, education, VLAG, US adults, Omvårdnad, body mass index, malnutrition, obesity, underweight, nutritional and metabolic diseases, medicine.disease, terveellisyys, Obesity, Faculdade de Ciências Sociais, Body Mass Index, Prevalence, Risk Factors, General Biochemistry, WIAS, lihavuus, RA, Demography, N.A, double burden, Settore MED/09 - Medicina Interna, alueelliset erot, Nutrition and Disease, Animal Nutrition, [SDV]Life Sciences [q-bio], Medizin, 030204 cardiovascular system & hematology, 0601 Biochemistry and Cell Biology, Change distribution of body mass index, RA0421, Voeding en Ziekte, Epidemiology, Medicine and Health Sciences, Global health, Índice de massa corporal/Body Mass Index, 030212 general & internal medicine, Underweight, painoindeksi, 2. Zero hunger, General Neuroscience, aliravitsemus, elintarvikkeet, health, Public Health, Global Health, Social Medicine and Epidemiology, Diervoeding, 3142 Public health care science, environmental and occupational health, purl.org/pe-repo/ocde/ford#3.01.03 [https], Chinese adults, pooled analysis, medicine.symptom, Diet quality, B120 Physiology, Research Article, trends, purl.org/pe-repo/ocde/ford#1.06.03 [https], prevalence, Population, Mothers, Genetics and Molecular Biology, 3121 Internal medicine, medicine, Life Science, ddc:610, 3125 Otorhinolaryngology, ophthalmology, kehonkoostumus, Nutrition, Australian adults, General Immunology and Microbiology, purl.org/pe-repo/ocde/ford#3.01.04 [https], Ciências sociais, Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi, Malnutrition, Epidemiology and Global Health, sense organs, Estilos de Vida e Impacto na Saúde
Abstract: From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in different regions using data from 2896 population-based studies with 187 million participants. Changes in the prevalence of underweight and total obesity, and to a lesser extent severe obesity, are largely driven by shifts in the distribution of BMI, with smaller contributions from changes in the shape of the distribution. In East and Southeast Asia and sub-Saharan Africa, the underweight tail of the BMI distribution was left behind as the distribution shifted. There is a need for policies that address all forms of malnutrition by making healthy foods accessible and affordable, while restricting unhealthy foods through fiscal and regulatory restrictions., Wellcome Trust, Medical Research Council, peer-reviewed
Published: 2021

6. Role of MRI to confirm healing in complex high cryptoglandular anal fistulas: long‐term follow‐up of 151 cases

Author: Baljit Kaur, Geetha R Menon, Pankaj Garg, Vipul D Yagnik, and Sushil Dawka
Subjects: Adult, Male, Anal fistula, medicine.medical_specialty, Tuberculosis, Long term follow up, Fistula, Anal Canal, Postoperative mri, 03 medical and health sciences, 0302 clinical medicine, Recurrence, medicine, Humans, Rectal Fistula, business.industry, Gastroenterology, Mean age, Middle Aged, medicine.disease, Magnetic Resonance Imaging, Surgery, Treatment Outcome, 030220 oncology & carcinogenesis, Radiological weapon, 030211 gastroenterology & hepatology, business, Follow-Up Studies
Abstract: AIM Complex fistula-in-ano can recur even after complete clinical healing has occurred. 'Radiological healing' of fistula on MRI correlates well with long-term healing rates but no study has yet objectively quantified this. The aim of this study was to assess the accuracy of anal fistula healing as documented on MRI and to correlate it with long-term healing as evidenced on long-term follow-up. METHODS Patients with clinically healed anal fistulas who also had radiological healing checked by postoperative MRI were included in the study. RESULTS Three hundred and twenty-five patients operated for high complex fistula-in-ano were followed up for 14-68 months (median 38 months). Postoperative MRI was done to assess radiological healing of the fistula in 151 patients, and they were included in the study. The mean age was 39.4 ± 10.5 years (116 men). Five patients were lost to follow-up. The fistulas did not heal radiologically (on MRI) in 20 patients and recurred in all these patients. The fistulas healed radiologically (on MRI) in 126 patients. On long-term follow-up, 124/126 patients remained healed while 2/126 had a recurrence. In the first patient, the fistula recurred 40 months after complete radiological healing. In the second patient, the fistula recurred 10 months after complete radiological healing but pus from the fistula tested positive for tuberculosis (by real-time polymerase chain reaction) and he was excluded from the analysis. Thus, there was only one (1/125) recurrence on long-term follow-up. CONCLUSIONS Radiological healing on MRI correlates well with long-term healing in complex fistula-in-ano.
Published: 2021

7. Diagnosis of anorectal tuberculosis by polymerase chain reaction, GeneXpert and histopathology in 1336 samples in 776 anal fistula patients

Author: Geetha R Menon, Ankita Goyal, Pankaj Garg, Vipul D Yagnik, and Sushil Dawka
Subjects: Anal fistula, medicine.medical_specialty, GeneXpert MTB/RIF, Tuberculosis, business.industry, Fistula-in-ano, medicine.disease, Tuberculosis, Histopathology, Polymerase chain-reaction, GeneXpert, law.invention, Surgery, 03 medical and health sciences, 0302 clinical medicine, law, 030220 oncology & carcinogenesis, Retrospective Cohort Study, Medicine, 030211 gastroenterology & hepatology, Histopathology, business, Polymerase chain reaction
Abstract: BACKGROUND The association of tuberculosis (TB) with anal fistulas can make its treatment quite difficult. The main challenge is timely detection of TB in anal fistulas and its proper management. There is little data available on diagnosis and management of TB in anal fistulas. AIM To detect TB in fistula-in-ano patients were analyzed in different methods utilized. METHODS A retrospective analysis of different methods, polymerase chain-reaction (PCR), GeneXpert and histopathology (HPE), utilized to detect tuberculosis in fistula-in-ano patients, treated between 2014-2020, was performed. The sampling was done for tissue (fistula tract lining) and pus (when available). The detection rate of various tests to detect TB and prevalence rate of TB in simple vs complex fistulae were studied. RESULTS In 1336 samples (776 patients) tested, TB was detected in 133 samples (122 patients). TB was detected in 52/703 (7.4%) samples tested by PCR-tissue, in 77/331 (23.2%) samples tested by PCR-pus, 3/197 (1.5%) samples tested with HPE-tissue and 1/105 (0.9%) samples tested by GeneXpert. To detect TB, PCR-tissue was significantly better than HPE-tissue (52/703 vs 3/197 respectively) (P = 0.0012, significant, Fisher’s exact test) and PCR-pus was significantly better than PCR-tissue (77/331 vs 52/703 respectively) (P < 0.00001, significant, Fisher’s exact test). TB fistulas were more complex than non-tuberculous fistulas [78/113 (69%) vs 278/727 (44.3%) respectively] (P < 0.00001, significant, Fisher’s exact test) but the overall healing rate was similar in tuberculous and non-tuberculous fistula groups [90/102 (88.2%) vs 518/556 (93.2%) respectively] (P = 0.10, not significant, Fisher’s exact test). CONCLUSION This is the largest study of anorectal TB to be published. The detection of TB by polymerase chain-reaction was significantly higher than by histopathology and GeneXpert. Amongst polymerase chain-reaction, pus had a higher detection rate than tissue. TB fistulas were more complex than non-tuberculous fistulas but aggressive diagnosis and meticulous treatment led to comparable overall success rates in both groups.
Published: 2021

8. Disease-Specific Out-of-Pocket Payments, Catastrophic Health Expenditure and Impoverishment Effects in India: An Analysis of National Health Survey Data

Author: Jeetendra Yadav, Denny John, and Geetha R Menon
Subjects: Economics and Econometrics, medicine.medical_specialty, India, Developing country, Health administration, Head count ratio, 03 medical and health sciences, 0302 clinical medicine, Environmental health, Health care, medicine, Humans, Outpatient clinic, 030212 general & internal medicine, Catastrophic Illness, Family Characteristics, Health economics, Poverty, business.industry, 030503 health policy & services, Health Policy, Public health, General Medicine, Health Surveys, Business, Health Expenditures, 0305 other medical science
Abstract: In India, more than two-thirds of the total health expenditure is incurred through out-of-pocket expenditure (OOPE) by households. Morbidity events thus impose excessive financial risk on households. The Sustainable Development Goals Target 3.8 specifies financial risk protection for achieving universal health coverage (UHC) in developing countries. This study aimed to estimate the impact of OOPE on catastrophic health expenditure (CHE) and impoverishment effects by types of morbidity in India. Data came from the 75th round of the National Sample Survey (NSS) on the theme ‘Social consumption in India: Health’, which was conducted during the period from July 2017 to June 2018. For the present study, 56,722 households for hospitalisation, 29,580 households for outpatient department (OPD) care and 6285 households for both (OPD care and hospitalisation) were analysed. Indices, namely health care burden, CHE, poverty head count ratio and poverty gap ratio using standard definitions were analysed. Households with members who underwent treatment for cancers, cardiovascular diseases, psychiatric conditions, injuries, musculoskeletal and genitourinary conditions spent a relatively high amount of their income on health care. Overall, 41.4% of the households spent > 10% of the total household consumption expenditure (HCE) and 24.6% of households spent > 20% of HCE for hospitalisation. A total of 20.4% and 10.0% of households faced CHE for hospitalisation based on the average per capita and average two capita consumption expenditure, respectively. Health care burden, CHE and impoverishment was higher in households who sought treatment in private health facilities than in public health facilities. Our study suggests that there is an urgent need for political players and policymakers to design health system financing policies and strict implementation that will provide financial risk protection to households in India.
Published: 2021

9. Transanal opening of the intersphincteric space: a novel sphincter‐sparing procedure to treat 325 high complex anal fistulas with long‐term follow‐up

Author: Pankaj Garg, Baljit Kaur, and Geetha R Menon
Subjects: Adult, Male, Anal fistula, medicine.medical_specialty, Long term follow up, Fistula, Anal Canal, Fistulotomy, 03 medical and health sciences, 0302 clinical medicine, Recurrence, Healing rate, medicine, Humans, Rectal Fistula, Abscess, business.industry, Gastroenterology, Middle Aged, Anal canal, medicine.disease, Surgery, Treatment Outcome, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Sphincter, 030211 gastroenterology & hepatology, business, Organ Sparing Treatments, Follow-Up Studies
Abstract: Aim Sepsis in the intersphincteric plane behaves like an abscess in a closed space and is present in most complex fistulas. Ignoring this sepsis is a cause of recurrence. Complex fistulas can be successfully managed by transanal opening of the intersphincteric space (TROPIS) into the anal canal. The long-term efficacy of the TROPIS procedure was analysed in an exclusive cohort of high complex anal fistulas. Methods All consecutive patients operated for a high complex fistula-in-ano were included prospectively. Preoperative MRI scans were obtained for all the patients. The intersphincteric space and internal opening was laid open into the anal canal while preserving the external sphincter. The external tracts were thoroughly curetted and cleaned. Fistula healing rate and objective incontinence scores (preoperatively and during long-term follow-up) were analysed. Results A total of 325 patients (age 39.9 ± 10.9 years, 292 men) were operated with TROPIS and had a follow-up of 7-67 months (median 36 months). In the cohort, 67.4% (219) had recurrent fistulas, 82.8% (269) had multiple tracts, 36.3% (118) had horseshoe tracts, 37.5% (122) had associated abscesses and 24% (78) were supralevator fistulas. Nineteen patients were excluded. Fistulas healed completely in 78.4% (240/306) of patients and did not heal in 21.6% (66/306) of patients. 36/66 of these patients were operated again and the fistulas healed in 28 patients. Thus, the overall healing rate was 87.6% (268/306). The mean preoperative and postoperative incontinence scores were 0.085 ± 0.35 and 0.119 ± 0.48 respectively (P = 0.38). The healing rate of fistulas with associated acute abscesses was similar to the fistulas without abscesses (87% vs. 88%, P = 0.85). Conclusion Transanal opening of the intersphincteric space is a safe and highly effective sphincter-sparing procedure to manage high complex fistulas-in-ano.
Published: 2021

10. A Simple Protocol to Effectively Manage Anal Fistulas with No Obvious Internal Opening

Author: Vipul D Yagnik, Konica Singla, Pankaj Garg, Geetha R Menon, and Baljit Kaur
Subjects: Anal fistula, medicine.medical_specialty, Cure rate, recurrence, Fistula, education, Physical examination, Fistulotomy, fistula-in-ano, 03 medical and health sciences, 0302 clinical medicine, medicine, health care economics and organizations, Original Research, Clinical and Experimental Gastroenterology, medicine.diagnostic_test, business.industry, Urethral sphincter, Gastroenterology, medicine.disease, internal opening, Surgery, horseshoe, anal fistula, 030220 oncology & carcinogenesis, 030211 gastroenterology & hepatology, business, MRI
Abstract: Pankaj Garg,1,2 Baljit Kaur,3 Konica Singla,2 Geetha R Menon,4 Vipul D Yagnik5 1Department of Colorectal Surgery, Indus International Hospital, Mohali, India; 2Department of Colorectal Surgery, Garg Fistula Research Institute (GFRI), Haryana, India; 3Department of Radiology, SSRD Imaging Centre, Chandigarh, India; 4Department of Biostatistics, Indian Council of Medical Research, New Delhi, India; 5Department of Surgical Gastroenterology, Nishtha Surgical Hospital and Research Centre, Patan, Gujarat, IndiaCorrespondence: Pankaj GargGarg Fistula Research Institute (GFRI), H.no- 1042, Sector-15, Panchkula, Haryana, 134113, IndiaFax +91 9501522000Email drgargpankaj@yahoo.comPurpose: In some anal fistulas, the internal/primary opening cannot be located even after examination and assessment on MRI or transrectal ultrasound. The efficacy of a simple new protocol to manage such therapeutically challenging fistulas was tested.Patients and Methods: All anal fistula patients operated consecutively over 7 years were included in the study. A simple two-step protocol was followed for fistulas in which the internal opening was not locatable after clinical examination and MRI assessment. First, the MRI was reassessed. The site where the fistula was closest to the internal sphincter was noted. It was assumed that the internal-opening was located at that position and the fistula was treated accordingly. Second, in horseshoe anal fistulas with no apparent internal opening, it was assumed that the internal opening was located in the midline. Low fistulas were treated by fistulotomy and high fistulas by a sphincter-sparing procedure. Incontinence was evaluated by objective incontinence scores (Vaizey scores).Results: A total of 757 patients were operated (median follow-up-33 months). Of these, 57 patients were excluded due to short or inadequate follow-up. In 154/700 (22%) patients, the internal opening could not be located while in 546/700 (78%), the internal opening was found. Both the groups were similar in all parameters. In the “internal-opening found” group, the fistula healed completely in 486/546 (89%) and in the ‘internal-opening not found group’, the fistula healed in 140/156 (90.9%) (p=1.01). The objective continence scores did not change significantly after surgery in both the groups.Conclusion: This new protocol seems effective as a high cure rate could be achieved in ‘internal-opening not found’ fistulas which was comparable to fistula healing in the ‘internal-opening found’ group.Keywords: anal fistula, internal opening, horseshoe, MRI, recurrence, fistula-in-ano
Published: 2021

11. Intracranial hypertension in patients with aneurysmal subarachnoid hemorrhage: a systematic review and meta-analysis

Author: Ravish Keni, Rafael Martinez-Perez, Luis Rafael Moscote-Salazar, Sagar Galwankar, William A Florez, Geetha R Menon, Andrei Fernandes Joaquim, Amit Agrawal, Harsh Deora, and Ezequiel Garcia-Ballestas
Subjects: medicine.medical_specialty, Subarachnoid hemorrhage, business.industry, Mortality rate, General Medicine, medicine.disease, 030218 nuclear medicine & medical imaging, Newcastle–Ottawa scale, 03 medical and health sciences, 0302 clinical medicine, Meta-analysis, Internal medicine, Etiology, medicine, Clinical endpoint, Surgery, Neurology (clinical), Neurosurgery, business, 030217 neurology & neurosurgery, Intracranial pressure
Abstract: Aneurysmal subarachnoid hemorrhage (aSAH) is a devastating and life-threatening condition with high mortality and morbidity. Even though there is an association with intracranial pressure (ICP) raise and aSAH, there is a lack of recommendations regarding the indications for ICP monitoring in patients with aSAH. Defining what patients are at a higher risk to develop intracranial hypertension and its role in the functional outcome and mortality in patients with aSAH will be the purpose of the following systematic review and meta-analysis. The primary endpoint is to determine the prevalence and impact on mortality of ICP in patients with aSAH. Secondary endpoints aim to describe the variables related to the development of ICP and the relationship between traumatic and aneurysmal etiology of intracranial hypertension. PubMed, Embase, Central Cochrane Registry of Controlled Trials, and research meeting abstracts were searched up to August 2019 for studies that performed ICP monitoring, assessed the prevalence of intracranial hypertension and the mortality, in adults. Newcastle Ottawa scale (NOS) was used to assess study quality. The statistical analysis was performed using the Mantel-Haenszel methodology for the prevalence and mortality of intracranial hypertension for reasons with a randomized effect analysis model. Heterogeneity was assessed by I2. A total of 110 bibliographic citations were identified, 20 were considered potentially eligible, and after a review of the full text, 12 studies were considered eligible and 5 met the inclusion criteria for this review. One study obtained 7 points in the NOS, another obtained 6 points, and the rest obtained 5 points. Five studies were chosen for the final analysis, involving 793 patients. The rate of intracranial hypertension secondary to aSAH was 70.69% (95% CI 56.79–82.84%) showing high heterogeneity (I2 = 92.48%, p =
Published: 2020

12. Orbital and Visual Apparatus Injuries in Patients with Head Injuries

Author: Mitasha Singh, Andreas Rubiano, Dhaval Shukla, Ugan Singh Meena, Ranabir Pal, Amit Chakrabarty, Luis Rafael Moscote-Salazar, Amit Agrawal, Amey Savardekar, Sagar Galwankar, Virendra Deo Sinha, Ashok Munivenkatappa, Geetha R Menon, and Prashant Bhandarkar
Subjects: medicine.medical_specialty, Neurology, Head (linguistics), business.industry, medicine, MEDLINE, Visual Acuity, Craniocerebral Trauma, Humans, In patient, Neurology (clinical), business, Surgery
Published: 2021

13. Association Between Ambient Air Pollutants and Meteorological Factors With SARS-CoV-2 Transmission and Mortality in India: an Exploratory Study

Author: Sivaraman Balaji, Kiran Rade, Jayaprakasam Madhumathi, Simran Kohli, Geetha R Menon, Harpreet Singh, Jasmine Kaur, Samiran Panda, Sumit Aggarwal, Sandip Mandal, Nupur Mahajan, and Tanvi Singh
Subjects: Meteorological, medicine.medical_specialty, Meteorological Concepts, Health, Toxicology and Mutagenesis, India, law.invention, law, Environmental health, Case fatality rate, Health care, Pandemic, Environmental monitoring, medicine, Humans, Cities, Mortality, Rank correlation, SARS-CoV-2 transmission, Air Pollutants, business.industry, Research, Incidence (epidemiology), Public health, Public Health, Environmental and Occupational Health, COVID-19, Industrial medicine. Industrial hygiene, RC963-969, Geography, Transmission (mechanics), Parameters, Particulate Matter, Public aspects of medicine, RA1-1270, business, Environmental Monitoring
Abstract: Background The Coronavirus disease 2019 (COVID-19) pandemic poses a serious public health concern worldwide. Certain regions of the globe were severely affected in terms of prevalence and mortality than other. Although the cause for this pattern is not clearly understood, lessons learned from previous epidemics and emerging evidences suggest the major role of ecological factors like ambient air pollutants (AAP) and meteorological parameters in increased COVID-19 incidence. The present study aimed to understand the impact of these factors on SARS-CoV-2 transmission and their associated mortality in major cities of India. Methods This study used secondary AAP, meteorological and COVID-19 data from official websites for the period January-November 2020, which were divided into Pre-lockdown (January-March 2020), Phase I (April to June 2020) and Phase II (July to November 2020) in India. After comprehensive screening, five major cities that includes 48 CPCB monitoring stations collecting daily data of ambient temperature, particulate matter PM2.5 and 10 were analysed. Spearman and Kendall’s rank correlation test was performed to understand the association between SARS-CoV-2 transmission and AAP and, meteorological variables. Similarly, case fatality rate (CFR) was determined to compute the correlation between AAP and COVID-19 related morality. Results The level of air pollutants in major cities were significantly reduced during Phase I compared to Pre-lock down and increased upon Phase II in all the cities. During the Phase II in Delhi, the strong significant positive correlation was observed between the AAP and SARS-CoV-2 transmission. However, in Bengaluru, Hyderabad, Kolkata and Mumbai AAP levels were moderate and no correlation was noticed. The relation between AT and SARS-CoV-2 transmission was inconclusive as both positive and negative correlation observed. In addition, Delhi and Kolkata showed a positive association between long-term exposure to the AAP and COVID-19 CFR. Conclusion Our findings support the hypothesis that the particulate matter upon exceeding the satisfactory level serves as an important cofactor in increasing the risk of SARS-CoV-2 transmission and related mortality. These findings would help public health experts to understand the SARS-CoV-2 transmission against ecological variables in India and provides supporting evidence to healthcare policymakers and government agencies for formulating strategies to combat the COVID-19.
Published: 2021

14. Perianal Tuberculosis: Lessons Learned in 57 Patients From 743 Samples of Histopathology and Polymerase Chain Reaction and a Systematic Review of Literature

Author: Mahak Garg, Rashmi Khadapkar, Pankaj Garg, Geetha R Menon, and B R Das
Subjects: Male, medicine.medical_specialty, Tuberculosis, Fistula, Antitubercular Agents, Prevalence, Aftercare, India, Polymerase Chain Reaction, Gastroenterology, law.invention, 03 medical and health sciences, 0302 clinical medicine, Recurrence, law, Internal medicine, Outcome Assessment, Health Care, medicine, Humans, Rectal Fistula, Prospective cohort study, Polymerase chain reaction, Bacteriological Techniques, business.industry, Incidence, Incidence (epidemiology), Outcome measures, Reproducibility of Results, Mycobacterium tuberculosis, General Medicine, Middle Aged, medicine.disease, Magnetic Resonance Imaging, Tuberculosis, Gastrointestinal, Surgical Procedures, Operative, 030220 oncology & carcinogenesis, Streptomycin, Female, 030211 gastroenterology & hepatology, Histopathology, Fissure in Ano, business
Abstract: BACKGROUND Few data are published on perianal tuberculosis. OBJECTIVE This study aimed to determine the best method to diagnose tuberculosis in patients with fistula-in-ano and to conduct a systematic review to determine the incidence and characteristics of tuberculosis fistula-in-ano. DATA SOURCES The prospective study data and existing literature were derived from PubMed, Google scholar, and Scopus STUDY SELECTION:: Prospective analysis of patients with tuberculous fistula-in-ano treated between 2014 and 2018 was conducted, and a systematic review of studies describing ≥3 patients with tuberculosis fistula-in-ano was completed. INTERVENTION Testing of tuberculosis was performed by histopathology or polymerase chain reaction of tissue or pus from the fistula tract. MAIN OUTCOME MEASURES The primary outcomes measured were the detection rate of various tests to detect tuberculosis in fistula-in-ano and the prevalence rate of tuberculosis in simple versus complex fistulas. RESULTS In 637 samples (410 patients) tested, tuberculosis was detected in 49 samples (43 patients). Additional samples (n = 106) sent in patients with a high index of suspicion tested positive in 14 more patients. Thus, overall, 63 samples tested positive in 57 patients (total: 743 samples in 410 patients were tested). Tuberculosis was detected in 2 of 181 patients (1.1%) in tissue (histopathology), in 28 of 341 patients (8.2%) in tissue (polymerase chain reaction), and in 19 of 115 patients (16.5%) in pus (polymerase chain reaction) samples. To detect tuberculosis, tissue (polymerase chain reaction) was significantly better than tissue (histopathology) (28/341 vs 2/181, p < 0.00001) and pus (polymerase chain reaction) was significantly better than tissue (polymerase chain reaction) (19/115 vs 28/341, p < 0.0009). Tuberculosis was significantly more common in complex fistulas than in simple fistulas (20.3% vs 7.2%, p = 0.0002). The systematic review (n = 199) highlighted that tubercular fistulas are more common in recurrent and complex fistulas and in tuberculosis endemic regions. LIMITATIONS The true sensitivity and specificity of each testing modality could not be determined because not all patients with tuberculosis fistula-in-ano were tested by every diagnostic modality studied. CONCLUSIONS The tuberculosis detection rate of polymerase chain reaction was significantly higher than histopathology. Among polymerase chain reaction, pus had higher detection rate than tissue. Tuberculosis was associated with more complex and recurrent fistulas.
Published: 2019

15. Chest sonography versus chest radiograph in children admitted to paediatric intensive care - A prospective study

Author: Neeraj Gupta, Geetha R Menon, Anil Sachdev, Kamal K Saxena, Anuj Khatri, and Dhiren Gupta
Subjects: medicine.medical_specialty, Critical Care, Point-of-care testing, Point-of-Care Systems, Intensive Care Units, Pediatric, 03 medical and health sciences, 0302 clinical medicine, Double-Blind Method, Medicine, Humans, 030212 general & internal medicine, Prospective Studies, Prospective cohort study, Child, Lung, Ultrasonography, Chest imaging, medicine.diagnostic_test, business.industry, Paediatric intensive care, Ultrasound, Public Health, Environmental and Occupational Health, Pneumothorax, respiratory system, respiratory tract diseases, Pleural Effusion, Radiography, Infectious Diseases, 030228 respiratory system, Radiology, business, Chest radiograph
Abstract: There is a paucity of studies on the correlation between chest radiograph and ultrasound (US) in children. Our objective was to study the correlation between bedside chest radiograph and ultrasound findings in 413 children with 1002 episodes of chest radiograph and US enrolled for a prospective, double-blinded observational study in a multidisciplinary paediatric intensive care unit. Weighted κ statistic for agreement was different for right and left lungs and varied from 50% for left pleural effusion to 98% for right pneumothorax. Pulmonary oedema, pneumothorax and pleural effusion were diagnosed by ultrasound alone in a significantly higher number of patients as compared to chest radiograph (P = 0.001). Chest ultrasound is therefore deemed more sensitive than chest radiograph in detection of pleural effusion, pulmonary oedema and pneumothorax.
Published: 2021

16. A Systematic Review and Meta-analysis of Prevalence of Epilepsy, Dementia, Headache, and Parkinson Disease in India

Author: Vikas Dhiman, R S Dhaliwal, Rajnarayan R Tiwari, Supreet Kaur, Mendu Vardhan Rao Vishnu, Denny John, Amar Mishra, and Geetha R Menon
Subjects: Pediatrics, medicine.medical_specialty, Parkinson's disease, Population, Prevalence, India, Disease, Epilepsy, Health services, medicine, Dementia, Humans, education, education.field_of_study, business.industry, Headache, Parkinson Disease, medicine.disease, Cross-Sectional Studies, Neurology, Meta-analysis, Neurology (clinical), business
Abstract: Background: There are wide variations reported in the prevalence rates of common neurological disorders in India leading to huge treatment gap. There is no comprehensive systematic review reporting prevalence of common neurological conditions affecting Indians which is essential for developing and aligning health services to meet patient care. Objectives: The aim of this study was to perform a systematic review and meta-analysis of prevalence of epilepsy, dementia, headache, and Parkinson's disease (PD) in India from 1980 to 2019. Methods and Materials: We performed a bibliographic systematic search in PubMed and Google Scholar along with manual search for peer-reviewed cross-sectional studies and community-based surveys reporting prevalence of epilepsy, dementia, headache, and PD in India from January 1980 to July 2019. Meta-analysis was performed adopting a random-effects model using “Metafor” package in R. Results: The systematic review and meta-analysis included 50 studies [epilepsy (n = 22), dementia (n = 19), headache (n = 6), and PD (n = 3)] including a total of 179,1541 participants of which 5,890 were diagnosed with epilepsy, 1,843 with dementia, 914 with headache, and 121 were diagnosed with PD. The pooled prevalence of epilepsy was 4.7 per 1,000 population (95% CI: 3.8–5.6) with high heterogeneity (P Conclusions: The findings could be used for appropriate policy measures and targeted treatments for addressing these conditions.
Published: 2021

17. Burden of injuries and its associated hospitalization expenditure in India

Author: Amit Agarwal, Geetha R Menon, Jeetendra Yadav, and Denny John
Subjects: Burden of disease, 050210 logistics & transportation, medicine.medical_specialty, Family Characteristics, business.industry, Public health, 05 social sciences, Public Health, Environmental and Occupational Health, Poison control, India, Affect (psychology), Hospitalization, Cost of Illness, Environmental health, 0502 economics and business, Medicine, Humans, 0501 psychology and cognitive sciences, Health Expenditures, business, Safety Research, 050107 human factors
Abstract: Injuries are a major public health concern, affect the most productive age group i.e. (15-60 years) and increases disability adjusted life years (DALYs) and results in a huge financial burden on the household. Disease burden is represented by DALYs and economic burden represents the out of pocket (OOP) and catastrophic health expenditure (CHE). We examined the burden of injury and its impact on household financial burden among the working population (15-60 years) in India. We used data on National and State Level DALYs for Injuries for 2017 from the published National Disease Burden Estimate (NBE, 2019) Study. The cost of treatment was extracted from 75th round of the National Sample Survey Organization (NSSO, 2017-18). DALYs is the sum of YLLs and YLDs. OOPEs were estimated as a per episode of hospitalization expenses after reimbursement and CHE was defined as out of pocket expenditure exceeding 10% of household consumption expenditure. Accidental injuries particularly road traffic injuries have higher DALY rates among 15-60 years in India (1288 DALYs per 100,000). However, the mean OOPE was found to be higher due to intentional self-harm. Persons suffering from injury in states like Punjab, Haryana, UP, Gujarat, Karnataka and Andhra Pradesh approached private facilities more compared to public facilities. Whereas, people from states like Jammu and Kashmir, Orissa, West Bengal, North East availed public facilities more than private. OOPE was found to be five times more in private facilities than in public. The households who sought treatment in private facilities were faced 3 times more to Catastrophic expenditure than those who took the treatment in public hospital of any injury. The present study indicated high DALYs, OOPE and % CHE for injury in India. Higher proportion of households were pushed to catastrophic expenditure due to high OOPE of injury treatment. Disease and economic burden due to road traffic injury and fall was found to be high as compared to other injuries. Our study strengthens the need for executing effective financial protection approach in India like PM-JAY, to minimize the financial burden incurred due to injuries in India.
Published: 2021

18. Burden of Non-Communicable Diseases and Its Associated Economic Costs in India

Author: Geetha R Menon, Denny John, and Jeetendra Yadav
Subjects: History, medicine.medical_specialty, Polymers and Plastics, business.industry, Low resource, Public health, Declaration, Survey sampling, Industrial and Manufacturing Engineering, Years of potential life lost, Economic cost, Environmental health, Health care, Medicine, Business and International Management, business, Disease burden
Abstract: Background: Non communicable diseases (NCD) are a rising problem worldwide and is a cause of public health concern in India too. These diseases result in high health care demand and are expensive especially in low resource settings. We studied the NCD burden estimates for India and its major states and the associated cost. Methods: The disease burden was estimated using DALYs (Disability Adjusted life years), the Years of Life lost (YLL) and Years lived in disability (YLD). National Sample Survey was used to calculate OOPE and CHE. Results: NCDs account for 16939 DALYs per 100,000 in India. About 50-70% of patients took treatment in private facilities. There is huge variation in the utilization of health facilities, disease burden and cost of treatment across the states. Karnataka had highest DALY rate of 25790 DALYs per 100,000 but Chandigarh showed highest mean OOPE of INR 63952 and Arunachal Pradesh showed the highest CHE of 47.7 percent. Conclusions: The economic burden of NCDs is notably high both in terms of OOPE and CHE and indicate variation across states in both diseases burden and economic burden. The findings highlight the need for improvement of NCD management programmes in socioeconomically lower states of India. Funding Information: No funds received for this research. Declaration of Interests: None declared.
Published: 2021

19. Lessons learned from an audit of 1250 anal fistula patients operated at a single center: A retrospective review

Author: Sushil Dawka, Ankita Goyal, Pankaj Garg, Geetha R Menon, Baljit Kaur, and Vipul D Yagnik
Subjects: Anal fistula, medicine.medical_specialty, Retrospective review, Incontinence, business.industry, education, Fistulotomy, Audit, medicine.disease, Single Center, humanities, Surgery, body regions, 03 medical and health sciences, 0302 clinical medicine, Recurrence, 030220 oncology & carcinogenesis, medicine, Retrospective Cohort Study, 030211 gastroenterology & hepatology, business
Abstract: BACKGROUND A complex anal fistula is a challenging disease to manage. AIM To review the experience and insights gained in treating a large cohort of patients at an exclusive fistula center. METHODS Anal fistulas operated on by a single surgeon over 14 years were analyzed. Preoperative magnetic resonance imaging was done in all patients. Four procedures were performed: fistulotomy; two novel sphincter-saving procedures, proximal superficial cauterization of the internal opening and regular emptying and curettage of fistula tracts (PERFACT) and transanal opening of intersphincteric space (TROPIS), and anal fistula plug. PERFACT was initiated before TROPIS. As per the institutional GFRI algorithm, fistulotomy was done in simple fistulas, and TROPIS was done in complex fistulas. Fistulas with associated abscesses were treated by definitive surgery. Incontinence was evaluated objectively by Vaizey incontinence scores. RESULTS A total of 1351 anal fistula operations were performed in 1250 patients. The overall fistula healing rate was 19.4% in anal fistula plug (n = 56), 50.3% in PERFACT (n = 175), 86% in TROPIS (n = 408), and 98.6% in fistulotomy (n = 611) patients. Continence did not change significantly after surgery in any group. As per the new algorithm, 1019 patients were operated with either the fistulotomy or TROPIS procedure. The overall success rate was 93.5% in those patients. In a subgroup analysis, the overall healing rate in supralevator, horseshoe, and fistulas with an associated abscess was 82%, 85.8%, and 90.6%, respectively. The 90.6% healing rate in fistulas with an associated abscess was comparable to that of fistulas with no abscess (94.5%, P = 0.057, not significant). CONCLUSION Fistulotomy had a high 98.6% healing rate in simple fistulas without deterioration of continence if the patient selection was done judiciously. The sphincter-sparing procedure, TROPIS, was safe, with a satisfactory 86% healing rate for complex fistulas. This is the largest anal fistula series to date.
Published: 2020

20. Natural History of a Patient with Sacral Chordoma: Case Report and Literature Review

Author: Daniel G. Gridley, Brooke Kennamer, Salvatore C. Lettieri, Geetha R. Nair, Laurence D. Rhines, Karole M. Davis, and Iman Feiz-Erfan
Subjects: musculoskeletal diseases, Male, medicine.medical_specialty, Sacrum, Constipation, Urinary system, Conservative Treatment, Treatment Refusal, 03 medical and health sciences, 0302 clinical medicine, Quality of life, medicine, Chordoma, Fecal incontinence, Humans, Pain Management, Rectal Pain, Aged, Spinal Neoplasms, business.industry, medicine.disease, Magnetic Resonance Imaging, Surgery, Natural history, 030220 oncology & carcinogenesis, Disease Progression, Neurology (clinical), medicine.symptom, business, Tomography, X-Ray Computed, 030217 neurology & neurosurgery, Sacral Chordoma
Abstract: Background Chordomas are rare, slow-growing, locally aggressive, malignant tumors of the spine. Chordomas are conventionally treated with surgical resection with or without radiation. There is an absence of literature documenting the natural history of a primary sacral chordoma. Case Description A 65-year-old man presented with rectal pain, constipation, urinary and fecal incontinence, S1 radiculopathy, and a palpable rectal mass. A needle biopsy confirmed the pathologic diagnosis of sacral chordoma. The patient declined to have surgery because of the surgical risks involved. He was managed conservatively with supportive care only. The patient was routinely followed in clinic and had a subjective and objective excellent quality of life with adequate pain management. Meanwhile, his neurologic status did not deteriorate. During follow-up, some posterolateral aspects of the chordoma regressed. However, the bulk of the lesion continued to slowly progress. The patient survived for 7.5 years. He eventually succumbed to urosepsis and new-onset peritoneal metastasis. Conclusions To our knowledge, the patient is the only documented case in the literature of an untreated biopsy-proven sacral chordoma. The patient's tumor was intended for resection, and therefore comparable with data from treated chordomas. The patient's survival is similar to the median survival in treated chordomas. The patient's survival was despite negative prognosticators, such as advanced age of the patient and high sacral location above S2.
Published: 2020

21. Height and body-mass index trajectories of school-aged children and adolescents from 1985 to 2019 in 200 countries and territories: a pooled analysis of 2181 population-based studies with 65 million participants

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Naser, Ahmed, Soheir H, Ahrens, Wolfgang, Aitmurzaeva, Gulmira, Ajlouni, Kamel, Al-Hazzaa, Hazzaa M, Al-Othman, Amani Rashed, Al-Raddadi, Rajaa, Alarouj, Monira, AlBuhairan, Fadia, AlDhukair, Shahla, Ali, Mohamed M, Alkandari, Abdullah, Alkerwi, Ala'a, Allin, Kristine, Alvarez-Pedrerol, Mar, Aly, Eman, Amarapurkar, Deepak N, Amiri, Parisa, Amougou, Norbert, Amouyel, Philippe, Andersen, Lars Bo, Anderssen, Sigmund A, Angquist, Lars, Anjana, Ranjit Mohan, Ansari-Moghaddam, Alireza, Aounallah-Skhiri, Hajer, Araujo, Joana, Ariansen, Inger, Aris, Tahir, Arku, Raphael E, Arlappa, Nimmathota, Aryal, Krishna K, Aspelund, Thor, Assah, Felix K, Assuncao, Maria Cecilia F, Aung, May Soe, Auvinen, Juha, Avdicova, Maria, Azevedo, Ana, Azimi-Nezhad, Mohsen, Azizi, Fereidoun, Azmin, Mehrdad, Babu, Bontha V, Jorgensen, Maja Baeksgaard, Baharudin, Azli, Bahijri, Suhad, Baker, Jennifer L, Balakrishna, Nagalla, Bamoshmoosh, Mohamed, Banach, Maciej, Bandosz, Piotr, Banegas, Jose R, Baran, Joanna, 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Zampelas, Antonis, Zamrazilova, Hana, Zapata, Maria Elisa, Zargar, Abdul Hamid, Zaw, Ko Ko, Zdrojewski, Tomasz, Vrkic, Tajana Zeljkovic, Zeng, Yi, Zhang, Luxia, Zhang, Zhen-Yu, Zhao, Dong, Zhao, Ming-Hui, Zhao, Wenhua, Zhen, Shiqi, Zheng, Wei, Zheng, Yingfeng, Zholdin, Bekbolat, Zhou, Maigeng, Zhu, Dan, Zocalo, Yanina, Cisneros, Julio Zuniga, Zuziak, Monika, Faculdade de Ciências da Nutrição e Alimentação, Instituto de Saúde Pública da Universidade do Porto, Interactions Gène-Environnement en Physiopathologie Cardio-Vasculaire (IGE-PCV), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Environnement, Santé, Sociétés (ESS), Centre National de la Recherche Scientifique (CNRS), European Project: 774548, Reproductive Origins of Adult Health and Disease (ROAHD), Rodriguez-Martinez A, Zhou B, Sophiea MK, Bentham J, Paciorek CJ, Iurilli ML, Carrillo-Larco RM, Bennett JE, Di Cesare M, Taddei C, Bixby H, Stevens GA, Riley LM, Cowan MJ, Savin S, 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Juresa V., Kaaks R., Kaducu F.O., Kafatos A., Kajantie E.O., Kalmatayeva Z., Kalter-Leibovici O., Kameli Y., Kanala K.R., Kannan S., Kapantais E., Karki K.B., Katibeh M., Katz J., Katzmarzyk P.T., Kauhanen J., Kaur P., Kavousi M., Kazakbaeva G.M., Keil U., Keinan Boker L., Keinanen-Kiukaanniemi S., Kelishadi R., Kelleher C., Kemper H.C., Keramati M., Kerimkulova A., Kersting M., Key T., Khader Y.S., Khalili D., Khaw K.-T., Kheiri B., Kheradmand M., Khosravi A., Khouw I.M., Kiechl-Kohlendorfer U., Kiechl S., Killewo J., Kim D.W., Kim H.C., Kim J., Kindblom J.M., Klakk H., Klimek M., Klimont J., Klumbiene J., Knoflach M., Koirala B., Kolle E., Kolsteren P., Konig J., Korpelainen R., Korrovits P., Korzycka M., Kos J., Koskinen S., Kouda K., Kovacs V.A., Kowlessur S., Koziel S., Kratzer W., Kriemler S., Kristensen P.L., Krokstad S., Kromhout D., Krtalic B., Kruger H.S., Kubinova R., Kuciene R., Kujala U.M., Kujundzic E., Kulaga Z., Kumar R.K., Kunesova M., Kurjata P., Kusuma Y.S., Kuulasmaa K., Kyobutungi C., La Q.N., Laamiri F.Z., Laatikainen T., Lachat C., Laid Y., Lam T.H., Lambrinou C.-P., Landais E., Lanska V., Lappas G., Larijani B., Latt T.S., Lauria L., Lazo-Porras M., Le Nguyen Bao K., Le Port A., Le T.D., Lee J., Lee P.H., Lehmann N., Lehtimaki T., Lemogoum D., Levitt N.S., Li Y., Liivak M., Lilly C.L., Lim W.-Y., Lima-Costa M.F., Lin H.-H., Lin X., Lin Y.-T., Lind L., Linneberg A., Lissner L., Litwin M., Liu J., Liu L., Lo W.-C., Loit H.-M., Long K.Q., Lopes L., Lopes O., Lopez-Garcia E., Lopez T., Lotufo P.A., Lozano J.E., Lukrafka J.L., Luksiene D., Lundqvist A., Lundqvist R., Lunet N., Lunogelo C., Lustigova M., Luszczki E., Ma G., Ma J., Ma X., Machado-Coelho G.L., Machado-Rodrigues A.M., Machi S., Macieira L.M., Madar A.A., Maggi S., Magliano D.J., Magnacca S., Magriplis E., Mahasampath G., Maire B., Majer M., Makdisse M., Maki P., Malekzadeh F., Malhotra R., Mallikharjuna Rao K., Malyutina S.K., Maniego L.V., Manios Y., Mann J.I., Mansour-Ghanaei F., Manzato E., Margozzini P., Markaki A., Markey O., Markidou Ioannidou E., Marques-Vidal P., Marques L.P., Marrugat J., Martin-Prevel Y., Martin R., Martorell R., Martos E., Marventano S., Mascarenhas L.P., Masoodi S.R., Mathiesen E.B., Mathur P., Matijasevich A., Matsha T.E., Mavrogianni C., Mazur A., Mbanya J.C.N., McFarlane S.R., McGarvey S.T., McKee M., McLachlan S., McLean R.M., McLean S.B., McNulty B.A., Mediene-Benchekor S., Medzioniene J., Mehdipour P., Mehlig K., Mehrparvar A.H., Meirhaeghe A., Meisfjord J., Meisinger C., Menezes A.M.B., Menon G.R., Mensink G.B., Menzano M.T., Mereke A., Meshram I.I., Metspalu A., Mi J., Michaelsen K.F., Michels N., Mikkel K., Milkowska K., Miller J.C., Minderico C.S., Mini G.K., Miquel J.F., Mirjalili M.R., Mirkopoulou D., Mirrakhimov E., Misigoj-Durakovic M., Mistretta A., Mocanu V., Modesti P.A., Moghaddam S.S., Mohajer B., Mohamed M.K., Mohamed S.F., Mohammad K., Mohammadi Z., Mohammadifard N., Mohammadpourhodki R., Mohan V., Mohanna S., Mohd Yusoff M.F., Mohebbi I., Mohebi F., Moitry M., Molbo D., Mollehave L.T., Moller N.C., Molnar D., Momenan A., Mondo C.K., Monroy-Valle M., Monterrubio-Flores E., Monyeki K.D.K., Moosazadeh M., Moreira L.B., Morejon A., Moreno L.A., Morgan K., Morin S.N., Mortensen E.L., Moschonis G., Mossakowska M., Mostafa A., Mota-Pinto A., Mota J., Motlagh M.E., Motta J., Moura-dos-Santos M.A., Mridha M.K., Msyamboza K.P., Mu T.T., Muc M., Mugosa B., Muiesan M.L., Mukhtorova P., Muller-Nurasyid M., Murphy N., Mursu J., Murtagh E.M., Musa K.I., Music Milanovic S., Musil V., Mustafa N., Nabipour I., Naderimagham S., Nagel G., Naidu B.M., Najafi F., Nakamura H., Namesna J., Nang E.E.K., Nangia V.B., Nankap M., Narake S., Nardone P., Nauck M., Neal W.A., Nejatizadeh A., Nelis K., Nelis L., Nenko I., Neovius M., Nervi F., Nguyen C.T., Nguyen D., Nguyen Q.N., Nieto-Martinez R.E., Nikitin Y.P., Ning G., Ninomiya T., Nishtar S., Noale M., Noboa O.A., Nogueira H., Norat T., Nordendahl M., Nordestgaard B.G., Noto D., Nowak-Szczepanska N., Nsour M.A., Nuhoglu I., Nurk E., O'Neill T.W., O'Reilly D., Obreja G., Ochimana C., Ochoa-Aviles A.M., Oda E., Oh K., Ohara K., Ohlsson C., Ohtsuka R., Olafsson O., Olinto M.T.A., Oliveira I.O., Omar M.A., Onat A., Ong S.K., Ono L.M., Ordunez P., Ornelas R., Ortiz A.P., Ortiz P.J., Osler M., Osmond C., Ostojic S.M., Ostovar A., Otero J.A., Overvad K., Owusu-Dabo E., Paccaud F.M., Padez C., Pagkalos I., Pahomova E., Paiva K.M.D., Pajak A., Palli D., Palloni A., Palmieri L., Pan W.-H., Panda-Jonas S., Pandey A., Panza F., Papandreou D., Park S.-W., Park S., Parnell W.R., Parsaeian M., Pascanu I.M., Pasquet P., Patel N.D., Pednekar M.S., Peer N., Peixoto S.V., Peltonen M., Pereira A.C., Peres M.A., Perez-Farinos N., Perez C.M., Peterkova V., Peters A., Petersmann A., Petkeviciene J., Petrauskiene A., Pettenuzzo E., Peykari N., Pham S.T., Pichardo R.N., Pierannunzio D., Pigeot I., Pikhart H., Pilav A., Pilotto L., Pistelli F., Pitakaka F., Piwonska A., Pizarro A.N., Plans-Rubio P., Poh B.K., Pohlabeln H., Pop R.M., Porta M., Posch G., Poudyal A., Poulimeneas D., Pouraram H., Pourfarzi F., Pourshams A., Poustchi H., Pradeepa R., Price A.J., Price J.F., Providencia R., Puder J.J., Pudule I., Puhakka S.E., Puiu M., Punab M., Qasrawi R.F., Qorbani M., Quoc Bao T., Radic I., Radisauskas R., Rahimikazerooni S., Rahman M., Raitakari O., Raj M., Rakhimova E., Rakhmatulloev S., Rakovac I., Ramachandra Rao S., Ramachandran A., Ramke J., Ramos E., Ramos R., Rampal L., Rampal S., Rarra V., Rascon-Pacheco R.A., Rasmussen M., Rech C.R., Redon J., Reganit P.F.M., Regecova V., Revilla L., Rezaianzadeh A., Ribas-Barba L., Ribeiro R., Riboli E., Richter A., Rigo F., Rinaldo N., Rinke de Wit T.F., Rito A., Ritti-Dias R.M., Rivera J.A., Robitaille C., Roccaldo R., Rodrigues D., Rodriguez-Artalejo F., Rodriguez-Perez M.D.C., Rodriguez-Villamizar L.A., Roggenbuck U., Rojas-Martinez R., Rojroongwasinkul N., Romaguera D., Romeo E.L., Rosario R.V., Rosengren A., Rouse I., Roy J.G., Rubinstein A., Ruhli F.J., Ruidavets J.-B., Ruiz-Betancourt B.S., Ruiz Moreno E., Rusakova I.A., Russell Jonsson K., Russo P., Rust P., Rutkowski M., Sabanayagam C., Sacchini E., Sachdev H.S., Sadjadi A., Safarpour A.R., Safi S., Safiri S., Saidi O., Saki N., Salanave B., Salazar Martinez E., Salmeron D., Salomaa V., Salonen J.T., Salvetti M., Samoutian M., Sanchez-Abanto J., Sandjaja, Sans S., Santa Marina L., Santos D.A., Santos I.S., Santos L.C., Santos M.P., Santos O., Santos R., Santos Sanz S., Saramies J.L., Sardinha L.B., Sarrafzadegan N., Sathish T., Saum K.-U., Savva S., Savy M., Sawada N., Sbaraini M., Scazufca M., Schaan B.D., Schaffrath Rosario A., Schargrodsky H., Schienkiewitz A., Schindler K., Schipf S., Schmidt C.O., Schmidt I.M., Schnohr P., Schottker B., Schramm S., Schroder H., Schultsz C., Schutte A.E., Sebert S., Sein A.A., Selamat R., Sember V., Sen A., Senbanjo I.O., Sepanlou S.G., Sequera V., Serra-Majem L., Servais J., Sevcikova L., Shalnova S.A., Shamah-Levy T., Shamshirgaran M., Shanthirani C.S., Sharafkhah M., Sharma S.K., Shaw J.E., Shayanrad A., Shayesteh A.A., Shengelia L., Shi Z., Shibuya K., Shimizu-Furusawa H., Shin D.W., Shin Y., Shirani M., Shiri R., Shrestha N., Si-Ramlee K., Siani A., Siantar R., Sibai A.M., Silva A.M., Silva D.A.S., Simon M., Simons J., Simons L.A., Sjoberg A., Sjostrom M., Skodje G., Slowikowska-Hilczer J., Slusarczyk P., Smeeth L., So H.-K., Soares F.C., Sobek G., Sobngwi E., Sodemann M., Soderberg S., Soekatri M.Y., Soemantri A., Sofat R., Solfrizzi V., Somi M.H., Sonestedt E., Song Y., Sorgjerd E.P., Sossa Jerome C., Soto-Rojas V.E., Soumare A., Sovic S., Sparboe-Nilsen B., Sparrenberger K., Spinelli A., Spiroski I., Staessen J.A., Stamm H., Stathopoulou M.G., Staub K., Stavreski B., Steene-Johannessen J., Stehle P., Stein A.D., Stergiou G.S., Stessman J., Stevanovic R., Stieber J., Stockl D., Stocks T., Stokwiszewski J., Stoyanova E., Stratton G., Stronks K., Strufaldi M.W., Sturua L., Suarez-Medina R., Suka M., Sun C.-A., Sundstrom J., Sung Y.-T., Sunyer J., Suriyawongpaisal P., Swinburn B.A., Sy R.G., Syddall H.E., Sylva R.C., Szklo M., Szponar L., Tai E.S., Tammesoo M.-L., Tamosiunas A., Tan E.J., Tang X., Tanser F., Tao Y., Tarawneh M.R., Tarp J., Tarqui-Mamani C.B., Taxova Braunerova R., Taylor A., Taylor J., Tchibindat F., Tebar W.R., Tell G.S., Tello T., Thankappan K.R., Theobald H., Theodoridis X., Thijs L., Thomas N., Thuesen B.H., Ticha L., Timmermans E.J., Tjonneland A., Tolonen H.K., Tolstrup J.S., Topbas M., Topor-Madry R., Torheim L.E., Tormo M.J., Tornaritis M.J., Torrent M., Torres-Collado L., Toselli S., Traissac P., Tran T.T.-H., Trichopoulos D., Trichopoulou A., Trinh O.T., Trivedi A., Tshepo L., Tsigga M., Tsugane S., Tuliakova A.M., Tulloch-Reid M.K., Tullu F., Tuomainen T.-P., Tuomilehto J., Turley M.L., Tynelius P., Tzotzas T., Tzourio C., Ueda P., Ugel E., Ukoli F.A., Ulmer H., Unal B., Usupova Z., Uusitalo H.M., Uysal N., Vaitkeviciute J., Valdivia G., Vale S., Valvi D., van Dam R.M., Van der Heyden J., van der Schouw Y.T., Van Herck K., Van Minh H., van Valkengoed I.G., Vanderschueren D., Vanuzzo D., Varbo A., Varela-Moreiras G., Varona-Perez P., Vasan S.K., Vega T., Veidebaum T., Velasquez-Melendez G., Velika B., Veronesi G., Verschuren W.M., Victora C.G., Viegi G., Viet L., Villalpando S., Vineis P., Vioque J., Virtanen J.K., Visser M., Visvikis-Siest S., Viswanathan B., Vladulescu M., Vlasoff T., Vocanec D., Volzke H., Voutilainen A., Voutilainen S., Vrijheid M., Vrijkotte T.G., Wade A.N., Wagner A., Waldhor T., Walton J., Wambiya E.O., Wan Bebakar W.M., Wan Mohamud W.N., Wanderley Junior R.D.S., Wang M.-D., Wang N., Wang Q., Wang X., Wang Y.X., Wang Y.-W., Wannamethee S.G., Wareham N., Weber A., Wedderkopp N., Weerasekera D., Weghuber D., Wei W., Weres A., Werner B., Whincup P.H., Widhalm K., Widyahening I.S., Wiecek A., Wilks R.J., Willeit J., Willeit P., Williams J., Wilsgaard T., Wojtyniak B., Wong-McClure R.A., Wong A., Wong J.E., Wong T.Y., Woo J., Woodward M., Wu F.C., Wu J., Wu L.J., Wu S., Xu H., Xu L., Yaacob N.A., Yamborisut U., Yan W., Yang L., Yang X., Yang Y., Yardim N., Yaseri M., Yasuharu T., Ye X., Yiallouros P.K., Yoosefi M., Yoshihara A., You Q.S., You S.-L., Younger-Coleman N.O., Yusof S.M., Yusoff A.F., Zaccagni L., Zafiropulos V., Zakavi S.R., Zamani F., Zambon S., Zampelas A., Zamrazilova H., Zapata M.E., Zargar A.H., Zaw K.K., Zdrojewski T., Zeljkovic Vrkic T., Zeng Y., Zhang L., Zhang Z.-Y., Zhao D., Zhao M.-H., Zhao W., Zhen S., Zheng W., Zheng Y., Zholdin B., Zhou M., Zhu D., Zocalo Y., Zuniga Cisneros J., Zuziak M., and Ezzati M.
Subjects: Male, body-mass index, ADULTHOOD, Adolescents, pituuskasvu, Pediatrics, Body Mass Index, 0302 clinical medicine, Child Development, nuoret, Public health surveillance, Medicine, Health Status Indicators, 10. No inequality, Child, 11 Medical and Health Sciences, Body mass index, ComputingMilieux_MISCELLANEOUS, education.field_of_study, VDP::Medisinske Fag: 700::Helsefag: 800::Samfunnsmedisin, sosialmedisin: 801, General Medicine, Body mass indexes, kansainvälinen vertailu, 3. Good health, Geography, Health, 030220 oncology & carcinogenesis, Child, Preschool, Medical and Health sciences, purl.org/becyt/ford/3 [https], medicine.medical_specialty, School-aged adolescents, Socio-culturale, lapset (ikäryhmät), Nursing, territories, ravinto, purl.org/becyt/ford/3.3 [https], 03 medical and health sciences, School Children, SDG 3 - Good Health and Well-being, SYSTEMATIC ANALYSIS, Humans, school-aged children and adolescents, Montenegro, education, Science & Technology, Omvårdnad, Health sciences, Medical and Health sciences, Ciências médicas e da saúde, Bayes Theorem, Anthropometry, Adolescent Development, medicine.disease, TRENDS, Height and Body-mass Index, Faculdade de Ciências Sociais, UNDERNUTRITION, Height index trajectories, Height, body mass index, children , epidemiology, risk factors, growth, Stature, Demography, Settore MED/09 - Medicina Interna, Internationality, [SDV]Life Sciences [q-bio], 030204 cardiovascular system & hematology, Body-mass index trajectories, Epidemiology, Medicine and Health Sciences, risk factors, countries, EPIDEMIOLOGY, height, children, adolescents, BMI, 030212 general & internal medicine, painoindeksi, Child development, 2. Zero hunger, Medicine(all), School age child, obestity children cardiovascular, Population Health, 1. No poverty, Pediatrik, Public Health, Global Health, Social Medicine and Epidemiology, 3142 Public health care science, environmental and occupational health, Pooled analysis, NUTRITION, Female, medicine.symptom, pooled analysis, Life Sciences & Biomedicine, terveys, height, BMI, nutrition, health, children, adolescents, Adolescent, growth, Population, body-mass, Population based, Body-mass index, Young Adult, Medicine, General & Internal, Meta-Analysis as Topic, General & Internal Medicine, parasitic diseases, Weight gain, School-aged childrens, Age trajectories, business.industry, Height, Weight, Body Height, Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi, Malnutrition, ONSET, Ciências da Saúde, Ciências médicas e da saúde, School-aged children, VDP::Medical disciplines: 700::Health sciences: 800::Community medicine, Social medicine: 801, business, terveysriskit, Estilos de Vida e Impacto na Saúde
Abstract: BACKGROUND: Comparable global data on health and nutrition of school-aged children and adolescents are scarce. We aimed to estimate age trajectories and time trends in mean height and mean body-mass index (BMI), which measures weight gain beyond what is expected from height gain, for school-aged children and adolescents., METHODS: For this pooled analysis, we used a database of cardiometabolic risk factors collated by the Non-Communicable Disease Risk Factor Collaboration. We applied a Bayesian hierarchical model to estimate trends from 1985 to 2019 in mean height and mean BMI in 1-year age groups for ages 5–19 years. The model allowed for non-linear changes over time in mean height and mean BMI and for non-linear changes with age of children and adolescents, including periods of rapid growth during adolescence., FINDINGS: We pooled data from 2181 population-based studies, with measurements of height and weight in 65 million participants in 200 countries and territories. In 2019, we estimated a difference of 20 cm or higher in mean height of 19-year-old adolescents between countries with the tallest populations (the Netherlands, Montenegro, Estonia, and Bosnia and Herzegovina for boys; and the Netherlands, Montenegro, Denmark, and Iceland for girls) and those with the shortest populations (Timor-Leste, Laos, Solomon Islands, and Papua New Guinea for boys; and Guatemala, Bangladesh, Nepal, and Timor-Leste for girls). In the same year, the difference between the highest mean BMI (in Pacific island countries, Kuwait, Bahrain, The Bahamas, Chile, the USA, and New Zealand for both boys and girls and in South Africa for girls) and lowest mean BMI (in India, Bangladesh, Timor-Leste, Ethiopia, and Chad for boys and girls; and in Japan and Romania for girls) was approximately 9–10 kg/m2. In some countries, children aged 5 years started with healthier height or BMI than the global median and, in some cases, as healthy as the best performing countries, but they became progressively less healthy compared with their comparators as they grew older by not growing as tall (eg, boys in Austria and Barbados, and girls in Belgium and Puerto Rico) or gaining too much weight for their height (eg, girls and boys in Kuwait, Bahrain, Fiji, Jamaica, and Mexico; and girls in South Africa and New Zealand). In other countries, growing children overtook the height of their comparators (eg, Latvia, Czech Republic, Morocco, and Iran) or curbed their weight gain (eg, Italy, France, and Croatia) in late childhood and adolescence. When changes in both height and BMI were considered, girls in South Korea, Vietnam, Saudi Arabia, Turkey, and some central Asian countries (eg, Armenia and Azerbaijan), and boys in central and western Europe (eg, Portugal, Denmark, Poland, and Montenegro) had the healthiest changes in anthropometric status over the past 3·5 decades because, compared with children and adolescents in other countries, they had a much larger gain in height than they did in BMI. The unhealthiest changes—gaining too little height, too much weight for their height compared with children in other countries, or both—occurred in many countries in sub-Saharan Africa, New Zealand, and the USA for boys and girls; in Malaysia and some Pacific island nations for boys; and in Mexico for girls., INTERPRETATION: The height and BMI trajectories over age and time of school-aged children and adolescents are highly variable across countries, which indicates heterogeneous nutritional quality and lifelong health advantages and risks., Wellcome Trust, AstraZeneca Young Health Programme, EU., peer-reviewed
Published: 2020

22. Trends in snakebite deaths in India from 2000 to 2019 in a nationally representative mortality study

Author: Kapila Piyasena, Mehak Bhatia, Geetha R Menon, Patrick Brown, Wilson Suraweera, Rehana Begum, Prabha Sati, Sze Hang Fu, David A. Warrell, Prabhat Jha, Rashmi Rodrigues, and Romulus Whitaker
Subjects: Male, Snake Bites, snakebite, 0302 clinical medicine, Epidemiology, Case fatality rate, Global health, 030212 general & internal medicine, Biology (General), Child, Aged, 80 and over, General Neuroscience, 1. No poverty, General Medicine, Middle Aged, 3. Good health, Child, Preschool, Medicine, Female, Seasons, Research Article, Human, Wet season, Adult, medicine.medical_specialty, Adolescent, QH301-705.5, mortality risk incidence, Science, 030231 tropical medicine, India, General Biochemistry, Genetics and Molecular Biology, World health, 03 medical and health sciences, Young Adult, million death study, medicine, Humans, Envenomation, antivenom envenomation snake, case fatality, Aged, Low altitude, General Immunology and Microbiology, business.industry, Infant, Newborn, Infant, Epidemiology and Global Health, Rural area, business, Demography
Abstract: The World Health Organization call to halve global snakebite deaths by 2030 will require substantial progress in India. We analyzed 2833 snakebite deaths from 611,483 verbal autopsies in the nationally representative Indian Million Death Study from 2001 to 2014, and conducted a systematic literature review from 2000 to 2019 covering 87,590 snakebites. We estimate that India had 1.2 million snakebite deaths (average 58,000/year) from 2000 to 2019. Nearly half occurred at ages 30–69 years and over a quarter in children < 15 years. Most occurred at home in the rural areas. About 70% occurred in eight higher burden states and half during the rainy season and at low altitude. The risk of an Indian dying from snakebite before age 70 is about 1 in 250, but notably higher in some areas. More crudely, we estimate 1.11–1.77 million bites in 2015, of which 70% showed symptoms of envenomation. Prevention and treatment strategies might substantially reduce snakebite mortality in India.
Published: 2019

23. Does resistance training modulate cardiac autonomic control? A systematic review and meta-analysis

Author: M. Ejaz Hussain, Jamal Ali Moiz, Pooja Bhati, and Geetha R Menon
Subjects: medicine.medical_specialty, Neurology, Endocrine and Autonomic Systems, business.industry, Strength training, 030204 cardiovascular system & hematology, Baroreflex, Confidence interval, law.invention, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, Internal medicine, Meta-analysis, Heart rate, Cardiology, Medicine, Heart rate variability, Neurology (clinical), business, 030217 neurology & neurosurgery
Abstract: To systematically evaluate the literature on the effects of resistance training (RT) on cardiac autonomic control in healthy and diseased individuals. Electronic databases Pubmed, PEDro, and Scopus were systematically searched from their inception up to June 2018. Randomized controlled trials, quasi-experimental trials, and cross-over controlled trials investigating the effect of RT (of at least 4 weeks duration) on cardiac autonomic control assessed either by linear or non-linear measures of heart rate variability (HRV), baroreflex sensitivity, or post-exercise heart rate recovery were included. Of the studies retrieved, 28 were included in the systematic review. Meta-analysis was performed on 21 studies of the total 28 studies. Quality and characteristic assessment revealed fair quality evidence. The majority of literature on healthy humans suggested no change in cardiac autonomic control following RT. Standardized mean differences (SMD) showed a significant effect of RT on root mean square of successive differences between adjacent inter-beat (R-R) intervals (RMSSD) [SMD 0.96, 95% confidence interval (CI) 0.20–1.73; p = 0.01], ratio of low- to high-frequency power of HRV (LF/HF ratio; SMD −0.72, 95% CI −1.03 to −0.42; p
Published: 2018

24. The impact of measles immunization campaigns in India using a nationally representative sample of 27,000 child deaths

Author: Shaza A. Fadel, Benjamin Kc Wong, Geetha R Menon, Prabhat Jha, Shally Awasthi, Ajay Khera, and Rajesh Kumar
Subjects: Male, 0301 basic medicine, 0302 clinical medicine, Epidemiology, Global health, 030212 general & internal medicine, Biology (General), child, General Neuroscience, Mortality rate, Vaccination, General Medicine, Multilevel regression, 3. Good health, Child, Preschool, Medicine, Female, Insight, Research Article, Human, medicine.medical_specialty, QH301-705.5, Science, Measles Vaccine, India, immunization, Mass Vaccination, Measles, General Biochemistry, Genetics and Molecular Biology, 03 medical and health sciences, medicine, Humans, measles, interrupted time series, General Immunology and Microbiology, business.industry, Infant, Interrupted time series, Interrupted Time Series Analysis, medicine.disease, Survival Analysis, mortality, Epidemiology and Global Health, 030104 developmental biology, Immunization, business, Measles immunization, Demography
Abstract: India comprises much of the persisting global childhood measles mortality. India implemented a mass second-dose measles immunization campaign in 2010. We used interrupted time series and multilevel regression to quantify the campaign’s impact on measles mortality using the nationally representative Million Death Study (including 27,000 child deaths in 1.3 million households surveyed from 2005 to 2013). 1–59 month measles mortality rates fell more in the campaign states following launch (27%) versus non-campaign states (11%). Declines were steeper in girls than boys and were specific to measles deaths. Measles mortality risk was lower for children living in a campaign district (OR 0.6, 99% CI 0.4–0.8) or born in 2009 or later (OR 0.8, 99% CI 0.7–0.9). The campaign averted up to 41,000–56,000 deaths during 2010–13, or 39–57% of the expected deaths nationally. Elimination of measles deaths in India is feasible., eLife digest The introduction of the measles vaccine in the 1960s led to large reductions in measles deaths in many countries. Yet, measles remains a major killer of children younger than age five worldwide, particularly among children living in Africa and Asia, where fewer children are immunized. India has been particularly hard hit, with annual child measles deaths exceeding 60,000 in 2005. In the 1990s, India’s national vaccination program made one dose of the measles vaccine part of routine vaccinations through much of the country to help reduce the numbers of measles deaths. However, it was one of the last countries to add a second dose of measles vaccine as recommended by the World Health Organization, which has been shown to prevent infection and death in 90-95% of vaccinated children. In 2008, the Indian government announced it would introduce a second dose of measles vaccine to its routine vaccine schedule for children from 2010 onwards. Prior to the introduction of a second-dose measles vaccine, campaigns were launched to increase immunization rates in regions where few children were being vaccinated. But how many young children’s lives were saved by these campaigns was unknown. Now, Wong et al. show that India’s measles immunization campaigns saved the lives of 41,000 to 56,000 children between 2010 and 2013. This averted between 39-57% of the expected measles deaths nationally during that time period. Wong et al. used data from the Million Death Study, which used household surveys to capture information on the cause of 27,000 child deaths in India between 2005 and 2013, to assess the affects of the state vaccination campaigns on measles deaths. Changes in measles deaths were compared to changes in unrelated child deaths to make sure any differences were related to the vaccination campaigns and not other improvements in children’s health care. Indian states with measles immunization campaigns saw larger decreases in measles deaths among children younger than five than states without such a campaign (27% vs 11%). Similar decreases were not seen in child deaths from other causes. Girls, who are disproportionately affected by measles in India, benefited from larger reductions in deaths than boys in states with immunization campaigns. The success of two-dose measles vaccination campaigns at reducing young children’s deaths in India may help to boost vaccination rates and help combat parents’ hesitance to immunize their children.
Published: 2019

25. Mortality from Particulate Matter 2·5 in India: National Prospective Proportional Mortality Study

Author: George D'Souza, Guowen Huang, Prabhat Jha, Joy K Chakma, Patrick Brown, Howard Hu, Rajesh Kumar, Rehana Begum, Peter S Rodriguez, Rajesh Dikshit, Randeep Guleria, Yurie Izawa Maher, K. R. Balakrishnan, Sze Hang Fu, R S Dhaliwal, and Geetha R Menon
Subjects: medicine.medical_specialty, business.industry, Odds ratio, Stroke mortality, Particulates, medicine.disease, World health, Environmental health, Proportional mortality, Epidemiology, medicine, business, Stroke, Functional illiteracy
Abstract: Background: Direct studies on the extent to which long-term exposure to ambient particulate matter (PM) of 2·5 µm diameter causes adult mortality in India are lacking, despite over 99% of Indians being exposed to levels that the World Health Organisation (WHO) considers unsafe. Methods: We conducted a prospective proportional mortality study within the Million Death Study (MDS) to provide the first-ever direct national estimates of chronic respiratory disease, heart attack and stroke mortality from exposure to particulate matter (PM2·5) in India from 2001-13. We calculated odds ratios (ORs) for three-year annual median PM2·5 exposures measured 1-3 years earlier (and the closest three-year range or 4-6 years earlier) in about 14 000 small villages or urban blocks, adjusted for individual age, year of death, smoking status, rural/urban residency, and area-level female illiteracy. ORs adjusted for spatial clustering. Findings: PM2.5 exposure levels increased from 2000 to 2014, particularly in North India. Among 77 976 cases and 38 283 injury controls at ages 15-69 years, the excess mortality risks per 10 unit µg/m3 increase in PM2·5 exposure were 2% and 3% for chronic respiratory disease and heart attack, respectively, but 22% for stroke in the northeast states. Risks were similar for each sex, above 70 years and in various sensitivity analyses, including in areas reporting lower solid fuel use. Adjustment for spatial clustering reduced the risks for chronic respiratory and heart attack, but not for stroke. Interpretation: If these modest risks are causal, then PM2·5 exposure accounted for 225 000 deaths from respiratory and vascular disease at ages 15-69 years in 2015 in India, but with considerable uncertainty (range 16 000 to 571 000 deaths). The modest excess risks suggest suitable caution in interpreting the direct MDS evidence, and even more caution in extrapolating the WHO's current model-based risks to India. Funding Statement: Supported by the Indian Council of Medical Research, Canadian Institutes of Health Research Foundation grant (FDN 154277), the University of Toronto, the National Institutes of Health grants (1R01TW007939). Declaration of Interests: The authors declare no competing interests. Ethics Approval Statement: Not required.
Published: 2019

26. Extreme horseshoe and circumanal anal fistulas-challenges in diagnosis and management

Author: Vipul D Yagnik, Pankaj Garg, Geetha R Menon, and Baljit Kaur
Subjects: Anal fistula, medicine.medical_specialty, Scoring system, Fistula, Magnetic resonance imaging, medicine, Abscess, Extreme, Horseshoe (symbol), Incontinence, Horseshoe, medicine.diagnostic_test, business.industry, Incidence (epidemiology), General Medicine, Anal canal, medicine.disease, Circumferential, Surgery, medicine.anatomical_structure, Medicine, Original Article, business
Abstract: Objectives Extreme horseshoe anal fistulas are rare, and there are little data on the diagnosis and management of these fistulas. Materials and methods Patients with horseshoe anal fistula, in which the fistula tract encircled more than 75% of the anal circumference were included in the study. All patients were assessed by a preoperative magnetic resonance imaging (MRI). The patients were managed by a sphincter-sparing procedure. The continence was evaluated by an objective continence scoring system (Vaizey's scores). Results 1059 anal fistula patients were operated on over 7-years with a median follow-up of 36 months (range: 5-79 months). There were 47/1059 (4.4%) patients with extreme horseshoe anal fistulas. In 4/47 patients, the fistulas were complete circumanal (encircling anal canal completely). The mean age was 39.5 ± 10.9 years, M/F-41/6. The fistula was supralevator in 12/47 (25.5%), had an associated abscess in 28/47 (59.6%), and was recurrent in 33/47 (70.2%) patients. The tracts were intersphincteric in 27/47, transsphincteric in 2/47, and both (intersphincteric and transsphincteric) in 18/47 patients. All patients (n = 47) were managed by a sphincter-sparing procedure. Four patients were lost to follow-up. The fistula healed completely in 34/43 (79%) patients. There was no significant difference between preoperative and postoperative Vaizey's continence scores 0.031 ± 0.17 and 0.033 ± 0.18 respectively (P=0.90, Mann-Whitney U-test). Conclusion Extreme horseshoe fistulas are rare, with an incidence of about 4% (in a referral practice). The missed diagnosis of circumferential tracts could lead to a recurrence. MRI was pivotal to confirm the diagnosis. Proper identification and management of internal opening and adequate drainage of all tracts were crucial for successfully treating extreme horseshoe fistulas.
Published: 2021

27. Phosphaturic mesenchymal tumor of the brain without tumor-induced osteomalacia in an 8-year-old girl: case report

Author: Daniel Gridley, Iman Feiz-Erfan, Mark B. Ellis, Geetha R Nair, and Suresh Lal
Subjects: Fibroblast growth factor 23, Pathology, medicine.medical_specialty, Hypophosphatemia, Dura mater, Skull Neoplasms, Connective tissue, Diagnosis, Differential, 03 medical and health sciences, 0302 clinical medicine, Parenchyma, Biomarkers, Tumor, Humans, Mesenchymoma, Medicine, Cerebellar Neoplasms, Child, Hypophosphatemia, Familial, Osteomalacia, Reverse Transcriptase Polymerase Chain Reaction, business.industry, General Medicine, medicine.disease, Magnetic Resonance Imaging, Phosphaturic mesenchymal tumor, Fibroblast Growth Factors, Gene Expression Regulation, Neoplastic, Fibroblast Growth Factor-23, Skull, Treatment Outcome, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Ataxia, Female, Tomography, X-Ray Computed, business, Complication, 030217 neurology & neurosurgery
Abstract: Phosphaturic mesenchymal tumor (mixed connective tissue variant) (PMT-MCT) are tumors that may cause tumor-induced osteomalacia and rarely appear intracranially. The authors describe the case of an 8-year-old girl who was found to have PMT-MCT with involvement of the cerebellar hemisphere and a small tumor pedicle breaching the dura mater and involving the skull. This was removed surgically in gross-total fashion without further complication. Histologically the tumor was confirmed to be a PMT-MCT. There was no evidence of tumor-induced osteomalacia. At the 42-month follow-up, the patient is doing well, has no abnormalities, and is free of recurrence. PMT-MCTs are rare tumors that may involve the brain parenchyma. A gross-total resection may be effective to cure these lesions.
Published: 2016

28. Pattern of reporting and practices for the management of traumatic brain injury: An overview of published literature from India

Author: Ranabir Pal, Amey Savardekar, Amit Chakrabarty, Luis Rafael Moscote-Salazar, Andres M. Rubiano, Dhaval Shukla, Amit Agrawal, Prashant Bhandarkar, Virendra Deo Sinha, Mitasha Singh, Ashok Munivenkatappa, Geetha R Menon, Sagar Galwankar, Ugan Singh Meena, and Rubiano, Andrés M. [0000-0001-8931-3254]
Subjects: medicine.medical_specialty, Traumatic brain injury, Population, India, World health, 03 medical and health sciences, 0302 clinical medicine, Injury Severity Score, Brain Injuries, Traumatic, Global health, medicine, Humans, In patient, 030212 general & internal medicine, education, Lesiones traumáticas del encéfalo, Outcome, education.field_of_study, business.industry, Incidence (epidemiology), Incidence, Publications, Age Factors, medicine.disease, Management, Neurology, Family medicine, Mechanism of injury, Conducta en la búsqueda de información, Body region, Neurology (clinical), Estudios de seguimiento, business, 030217 neurology & neurosurgery
Abstract: Background: Published literature regarding the demographics and mechanism of injury for traumatic brain injury (TBI) in India has not been analyzed in an organized sample. Objectives: The objective of this systematic review was to organize the published literature from India related to TBI and analyze it in a very specific sample to identify the specific patterns of injury and associated mortality. Materials and Methods: A search strategy with specific inclusion criteria was performed in PubMed, Cochrane, Web of Science, and the World Health Organisation (WHO) Global Health Library. The process included an additional search within the indexed literature and the website-based population survey reports. Results: Our review identified 72 studies from 300 potentially relevant articles based on the broad criteria that defined the demographics of the patients suffering from TBI and the details of trauma sustained, including the mechanism of injury as well as its diagnosis, management, and outcome. Changes in demographic patterns, the patterns of the body regions involved, the associated injuries, the clinical presentation, the follow-up status of patients suffering from TBI, who may or may not have shown clinical improvement, the overall outcome, as well as the mortality and disability status reported in the literature were analyzed. A high incidence of TBI in the productive population is of serious concern. Extremes of ages are more vulnerable to severe injury and a poor outcome. Conclusion: Quantitative analysis of injuries and outcomes of TBI victims shows a bigger health impact in the economically active population and in patients in the extremes of age groups.
Published: 2018

29. Laying open (deroofing) and curettage of sinus as treatment of pilonidal disease: a systematic review and meta-analysis

Author: Pankaj Garg, Geetha R Menon, and Vikas Gupta
Subjects: medicine.medical_specialty, Pilonidal disease, business.industry, medicine.medical_treatment, MEDLINE, Healing time, General Medicine, 030230 surgery, Curettage, Surgery, 03 medical and health sciences, 0302 clinical medicine, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Meta-analysis, medicine, Operating time, business, Minimally invasive procedures, Sinus (anatomy)
Abstract: Background Laying open (deroofing, not excision) and curettage of the sinus is a minimally invasive procedure to treat pilonidal disease. A consensus on its efficacy and outcomes has not been reached. We reviewed and meta-analysed the efficacy of this procedure. Methods PubMed, Medline, Scopus, Ovid, Cochrane central register of controlled trials (CENTRAL) and Google scholar databases were searched. All studies describing laying open (not excision) of sinus with curettage of the tract to treat pilonidal disease (simple and complicated) were included. The primary outcome parameter was recurrence and the secondary outcome parameters were complication rate, operating time, return to work and healing time. Results A total of 1194 studies were screened. Out of these, 13 studies were finally included for the analysis. The analysis (n = 1445) demonstrated a net proportion meta-analysis (random effect) pooled rate of 4.47% (95% CI = 0.029-0.063) for recurrence, 1.44% (95% CI = 0.005-0.028) for complications, 34.59 min (95% CI = 13.58-55.61) for operating time, 21-72 days for healing time and 8.4 days (95% CI = 5.23-11.72) for return to work. The procedure was possible under local anaesthesia in seven out of 13 studies. Conclusions The meta-analysis demonstrates that laying open (deroofing) and curettage has distinct advantages. These are high success rate, possible in all types of pilonidal disease (simple and complex), low complication rate, short operating time and early return to normal routine and work. This procedure can be conveniently under local anaesthesia as an outpatient procedure.
Published: 2015

30. COMPARATIVE STUDY OF IRON SUPPLEMENTS IN SOUTH INDIAN ANTENATAL WOMEN WITH IRON DEFICIENCY ANEMIA

Author: Geetha R, Rageshwari S, Parvathavarthini S, Sowmia K R, Priestly Vivekkumar S, Simhadri Nagesh V S D N A, and Umamageswari A
Subjects: medicine.medical_specialty, Pregnancy, Obstetrics, business.industry, Iron deficiency, medicine.disease, Ferrous Fumarate, Surgery, Carbonyl iron, Tolerability, Iron-deficiency anemia, medicine, Hemoglobin, Adverse effect, business, medicine.drug
Abstract: BACKGROUND: Iron deficiency anemia is the most common nutritional disorder in the world. It is a major public health problem particularly among pregnant women with adverse effects on the mother and the new born. Iron supplementation is universally recommended to correct or prevent iron deficiency. AIMS & OBJECTIVE: The present study was conducted to compare the efficacy and tolerability of three oral iron preparations in anemic pregnant women of more than 14 weeks of gestation. MATERIALS AND METHODS: Randomized Control trial, done at Tagore Medical College and Hospital, Chennai. 60 antenatal women were selected; they were divided into three groups, 20 in each group. They were treated with Carbonyl iron, ferrous sulphate and ferrous fumarate. Hemoglobin estimation was done at 0 day, 30 th and 60 th day. Adverse effects were monitored. RESULTS: Data analysis showed an increase in haemoglobin levels in all three groups after the 30th day (p
Published: 2014

31. Modulation of cardiac autonomic control by resistance training in human participants

Author: Pooja Bhati, Geetha R Menon, Jamal Ali Moiz, and M. Ejaz Hussain
Subjects: medicine.medical_specialty, Neurology, Endocrine and Autonomic Systems, business.industry, Resistance training, MEDLINE, medicine.disease, Autonomic control, Autonomic nervous system, Physical medicine and rehabilitation, Diabetes mellitus, Medicine, Neurology (clinical), business
Published: 2018

32. Cost-effectiveness of glaucoma screening in cataract camps versus opportunistic and passive screening in urban India: A study protocol

Author: Denny John, Shalinder Sabherwal, Geetha R Menon, Atanu Majumdar, Saptarshi Mukherjee, and Suneeta Dubey
Subjects: detection rate, medicine.medical_specialty, genetic structures, Cost effectiveness, Population, costs, Glaucoma, Context (language use), General Biochemistry, Genetics and Molecular Biology, Study Protocol, 03 medical and health sciences, 0302 clinical medicine, Medicine, 030212 general & internal medicine, General Pharmacology, Toxicology and Pharmaceutics, Prospective cohort study, education, cost-effectiveness, Cost database, education.field_of_study, General Immunology and Microbiology, business.industry, screening, Articles, General Medicine, medicine.disease, eye diseases, glaucoma, Family medicine, Economic evaluation, Cohort, 030221 ophthalmology & optometry, sense organs, business
Abstract: India has an estimated 12 million people affected with glaucoma; however, no organised screening programme exists. Cases are usually detected opportunistically. This study documents the protocol for detecting glaucoma in suspects in cataract camps conducted by Shroff Charity Eye Hospital in North India. We report a cost-effectiveness alongside prospective study design of patients attending cataract camps where glaucoma screening will be integrated. The eligible population for glaucoma screening is non-cataract patients. Patients will undergo glaucoma screening by a trained optometrist using a pre-determined glaucoma screening algorithm. Specific diagnostic cut-off points will be used to identify glaucoma suspects. Suspected patients will be referred to the main hospital for confirmatory diagnosis and treatment. This group will be compared to a cohort of patients arriving from cataract camps conducted by the institute in similar areas and undergoing examination in the hospital. The third arm of the study includes patients arriving directly to the hospital for the first time. Cost data will be captured from both the screening components of cataract-only and glaucoma screening-integrated camps for screening invitation and screening costs. For all three arms, examination and treatment costs will be captured using bottom-up costing methods at the hospital. Detection rates will be calculated by dividing the number of new cases identified during the study by total number of cases examined. Median, average and range of costs across the three arms will be calculated for cost comparisons. Finally, cost-effectiveness analysis will be conducted comparing cost per case detected across the three arms from a quasi-societal perspective with a time horizon of 1 year. Ethics approval for the study has been obtained from the institutional ethics committee of the hospital. The study protocol will be useful for researchers and practitioners for conducting similar economic evaluation studies in their context.
Published: 2019

33. Long-term continence disturbance after lateral internal sphincterotomy for chronic anal fissure: a systematic review and meta-analysis

Author: Mahak Garg, Pankaj Garg, and Geetha R Menon
Subjects: medicine.medical_specialty, Time Factors, medicine.medical_treatment, Fistula, Anal Canal, law.invention, Patient satisfaction, Randomized controlled trial, law, medicine, Humans, Defecation, Abscess, Digestive System Surgical Procedures, business.industry, Incidence (epidemiology), Gastroenterology, medicine.disease, Surgery, Treatment Outcome, Patient Satisfaction, Meta-analysis, Chronic Disease, Fissure in Ano, Lateral internal sphincterotomy, business, Fecal Incontinence, Follow-Up Studies
Abstract: Aim A systematic review was carried out to analyse continence at 2 years or more after lateral internal sphincterotomy (LIS) for chronic anal fissure (CAF). Method PubMed, MEDLINE, Scopus, Embase, Ovid, SCI, Cochrane Central Register of Controlled Trials (CENTRAL) and Google Scholar were used to search the literature from 1969–2012 for studies reporting a follow-up of more than 2 years after LIS for CAF. The primary outcome parameter analysed was continence. The secondary outcome parameters included success rate, recurrence, incidence of postoperative abscess and fistula formation and patient satisfaction. Results Of 324 studies screened, 22 (n = 4512) were included. The mean follow-up period ranged from 24–124 months. The overall continence disturbance rate was 14% (95% CI 0.09–0.2). Weighted analysis showed flatus incontinence in 9% (95% CI 0.04–0.16), soilage/seepage in 6% (95% CI 0.03–0.1), accidental defaecation in 0.91% (95% CI 0.003–0.02), incontinence to liquid stool in 0.67% (95% CI 0.001–0.02) and incontinence to solid stool in 0.83% (95% CI 0.003–0.02) of patients. Conclusion The long-term risk of continence disturbance after lateral internal sphincterotomy is significant. Randomized controlled trials with a long follow-up are needed to substantiate these findings and to redefine its role in the treatment of chronic anal fissure.
Published: 2013

34. Mesh fixation compared to nonfixation in total extraperitoneal inguinal hernia repair: a randomized controlled trial in a rural center in India

Author: Mohamed Ismail, Geetha R Menon, Srijith Nair, Jai Deep Thakur, Nikhilesh Nain, Pankaj Garg, and Muhammed Shereef
Subjects: Male, Rural Population, medicine.medical_specialty, Visual analogue scale, India, Hernia, Inguinal, Statistics, Nonparametric, law.invention, Postoperative Complications, Randomized controlled trial, Recurrence, law, medicine, Humans, Hernia, Herniorrhaphy, Pain Measurement, Pain, Postoperative, Chi-Square Distribution, Urinary retention, business.industry, Length of Stay, Middle Aged, Surgical Mesh, medicine.disease, Surgery, Inguinal hernia, Treatment Outcome, Surgical mesh, Seroma, Female, medicine.symptom, business, Abdominal surgery
Abstract: Several studies have shown that nonfixation of mesh in total extraperitoneal (TEP) inguinal hernia repair is safe and has no disadvantage compared to mesh fixation in terms of recurrence rate, pain scores, and other morbidity parameters. The aim of this study was to compare the effect of nonfixation of mesh with fixation in laparoscopic TEP inguinal hernia repair in a rural hospital in India. One hundred four patients were randomized to mesh nonfixation group or a fixation group during TEP. The postoperative pain scores on a visual analog scale (VAS) at 24 h, 1 week, 1 month, and 1 year, urinary retention, seroma formation, length of hospital stay, days taken to resume normal activities, and recurrence after 2 years were analyzed. The trial was registered at www.clinicaltrials.gov (ID: NCT01117337). One hundred four patients (194 hernias) were randomized to mesh nonfixation or fixation. The pain scores at 24 h were comparable (Fix, 1.31 ± 0.4; Nonfix, 1.42 ± 0.5, P = 0.23). The length of hospital stay (Fix, 1.12 ± 0.3 days; Nonfix, 1.15 ± 0.4 days, P = 0.7) and days taken to resume normal activities (Fix, 7.77 ± 1.3 days; Nonfix, 7.96 ± 1.15 days, P = 0.44) were also similar for both groups. The mean pain scores at 1 week (Fix, 1.25 ± 0.5; Nonfix, 1.34 ± 0.6, P = 0.42), 1 month (Fix, 1.06 ± 0.2; Nonfix, 1.17 ± 0.4, P = 0.12), 1 year (Fix, 1.04 ± 0.2; Nonfix, 1.13 ± 0.4, P = 0.11), and 2 years (Fix, 1.03 ± 0.2; Nonfix, 1.0, P = 0.17) were comparable for both groups. There was no recurrence in either group at a minimum follow-up of 2 years. There was no significant difference between fixation and nonfixation of mesh in TEP inguinal hernia repair with respect to postoperative pain, length of hospital stay, resumption of normal activities, seroma formation, and recurrence rate. Nonfixation of mesh is safe and recommended in TEP inguinal hernia repair when done by an experienced surgeon, even in a rural setting. The study highlights the potential for universal application of the procedure.
Published: 2011

35. ‘Zoonoses? Not sure what that is…’ An assessment of knowledge of zoonoses among medical students in India

Author: Abhay Gaidhane, Lalit Sankhe, Sampath Krishnan, Sudha Ramani, Manish Kakkar, and Geetha R Menon
Subjects: Knowledge assessment, medicine.medical_specialty, Veterinary medicine, Medical curriculum, Students, Medical, Education, Medical, business.industry, Public Health, Environmental and Occupational Health, Alternative medicine, India, General Medicine, Disease, Knowledge score, Cross-Sectional Studies, Infectious Diseases, Zoonoses, Family medicine, Animals, Humans, Medicine, Parasitology, Clinical Competence, Curriculum, business
Abstract: Summary This study focuses on estimating knowledge of zoonoses among medical students and recent graduates, with an aim of understanding critical gaps in medical education with respect to zoonoses. A semi-structured tool for knowledge assessment, having nine principal domains of knowledge and five domains of practice, was developed and validated. Using this tool, cross-sectional data was collected from 364 medical students and recent graduates and knowledge scores were calculated based on pre-defined guidelines. Out of the 364 respondents, only 10 defined zoonoses accurately (2.8%). Only 33.7% of the respondents in the public college (62 out of 184) and 3.3% in the private college (6 out of 180) could correctly name three common parasitic zoonoses in India. Only 5.5% of respondents (20 out of 361) were able to identify rabies as a disease transmitted by animals other than dogs. Knowledge on all emerging and new infectious diseases was poor. The average knowledge score was 64% in the public medical college and 41.4% in the private medical college. These poor scores imply that, on average, a student knows only 40–60% of what is needed to diagnose, treat and report zoonotic diseases effectively. Considering the changing landscape of infectious diseases, the current medical curriculum needs to be revised to improve understanding of existing zoonoses and also include emerging diseases.
Published: 2011

36. Clinical pulmonary infection score to diagnose ventilator-associated pneumonia in children

Author: Krishan Chugh, Dhiren Gupta, Geetha R Menon, Anil Sachdev, M. Sethi, and Chand Wattal
Subjects: Male, medicine.medical_specialty, medicine.medical_treatment, India, Severity of Illness Index, Bronchoscopy, Pediatric surgery, Severity of illness, medicine, Humans, Prospective Studies, Child, Intensive care medicine, Prospective cohort study, Mechanical ventilation, medicine.diagnostic_test, business.industry, Ventilator-associated pneumonia, Infant, Pneumonia, Ventilator-Associated, bacterial infections and mycoses, medicine.disease, respiratory tract diseases, Clinical trial, Pneumonia, Child, Preschool, Pediatrics, Perinatology and Child Health, Female, business
Abstract: There is a need to validate and suggest easy clinical method for diagnosis of ventilator-associated pneumonia (VAP) in developing countries.To validate the use of simplified Clinical Pulmonary Infection Score (CPIS) for the diagnosis of VAP.Prospective study.Pediatric intensive care unit of a tertiary care teaching hospital.30 children receiving mechanical ventilation for more than 48 hours and with simplified CPIS=6.All patients underwent flexible bronchoscopy to obtain bronchoalveolar lavage which was analyzed quantitatively. Colony count = 10(4) cfu/mL was considered reference standard for definite VAP.Of the five variables used for simplified CPIS, only patients temperature (P=0.013) and PaO2/FiO2 ratio were significant (P0.001) to differentiate the presence of definite VAP. Patients with definite VAP (BAL colony count = 10(4) cfu/mL) had CPIS of 8.4 while in no definite VAP group it was 6.4 (P=0.007). CPIS of 8 was found to have sensitivity of 80%, specificity 80%, PPV 86.9%, NPV 70.5% and accuracy 80%. The area under Receiver operating characteristic curve of CPIS against reference standard was 0.81± 0.069 (P=0.001).Simplified CPIS is useful in patients on mechanical ventilation to diagnose ventilator-associated pneumonia.
Published: 2011

37. Intraoperative Touch Imprint and Frozen Section Analysis of Sentinel Lymph Nodes After Neoadjuvant Chemotherapy for Breast Cancer

Author: Chiu Hsieh Hsu, Ian K. Komenaka, Dan Hobohm, Lakshmi Jayaram, Harikrishna Dave, Geetha R Nair, Marcia E. Bouton, and Rozbeh Torabi
Subjects: medicine.medical_specialty, medicine.medical_treatment, Sentinel lymph node, Breast Neoplasms, Breast cancer, medicine, Frozen Sections, Humans, In patient, Retrospective Studies, Frozen section procedure, Chemotherapy, Intraoperative Care, Sentinel Lymph Node Biopsy, business.industry, Reproducibility of Results, Cancer, Middle Aged, Sentinel node, medicine.disease, Neoadjuvant Therapy, Surgery, Female, Breast disease, Radiology, business
Abstract: Objective: To evaluate the accuracy of touch imprint and frozen section analysis of sentinel nodes after neoadjuvant chemotherapy. Summary Background Data: Intraoperative evaluation of the sentinel node can determine the need for axillary dissection at the time of initial operation and therefore spare the patient a second operation. Little data, however, exists on the accuracy of intraoperative evaluation of sentinel nodes after neoadjuvant chemotherapy. Methods: A retrospective chart review was performed of all sentinel node procedures for breast cancer from 2004 to 2008 at a single institution. The sentinel node procedure was done before (no-NACT) chemotherapy in 107 patients and 37 had the procedure after neoadjuvant (NACT) chemotherapy. Intraoperative analysis of sentinel nodes was performed using touch imprint and frozen section techniques. Results: In the no-NACT group, intraoperative assessment by touch imprint analysis had 61% sensitivity, 100% specificity, and 87% accuracy. Frozen section analysis was similar with 74% sensitivity, 100% specificity, and 90% accuracy. In the NACT group, touch imprint analysis had 79% sensitivity, 100% specificity, and 90% accuracy. Frozen section analysis was again similar with 74% sensitivity, 100% specificity, and 83% accuracy. When the no-NACT group and the NACT group were compared, both frozen section and touch imprint analysis had similar sensitivity, specificity, and accuracy. Conclusions: Intraoperative evaluation of sentinel nodes with touch imprint and frozen section analysis in patients treated with neoadjuvant chemotherapy showed acceptable sensitivity, specificity, and accuracy. Nearly all of the misses in intraoperative evaluation were in patients with micrometastases.
Published: 2010

38. ASSESSMENT OF KNOWLEDGE AND PRACTICE TOWARD DISPOSAL OF EXPIRED DRUGS AMONG MEDICAL PROFESSIONALS IN CHENNAI - A CROSS-SECTIONAL PROSPECTIVE STUDY

Author: Umamageswari Arunachalam, Priestly Vivekkumar S, Geetha R, and Guru Scindia Mv
Subjects: Pharmacology, medicine.medical_specialty, business.industry, education, Pharmacist, Microsoft excel, Pharmaceutical Science, 030206 dentistry, Drug diversion, medicine.disease, Dispose pattern, Substance abuse, 03 medical and health sciences, 0302 clinical medicine, Harm, Family medicine, medicine, Pharmacology (medical), 030212 general & internal medicine, Accidental poisoning, business, Prospective cohort study
Abstract: Objective: Proper disposal of expired drugs can avoid drug abuse, drug diversion, environmental contamination, and accidental poisoning by children and animals. Our study was aimed to assess the knowledge and practice toward disposal of expired drugs among medical professionals.Methods: After obtaining verbal consent, a self-administered pretested questionnaire was given to tutors, junior resident, senior resident, assistant professors, associate professors, and professors of Tagore Medical and Dental College and Hospital. The questionnaire has two parts; part one includes demographic details of the study participants, and part two comprises questions, regarding their awareness, knowledge, and practice toward disposal of expired drugs. Data were described as a percentage and analyzed using Sigma Graphpad prism version-5 and Microsoft Excel 2007.Results: A total of 156 medical professionals participated in the study. Among them, 85 were males and 71 were females, whereas 123 (78.8%) were medical and 33 (21.2%) were dental faculties. It was observed that 74.3% of respondents check the expiry date of the drug always and 62.2% said the drug loses its therapeutic effect after the expiry date. Analyzing the method to dispose the expired drugs, 77.6% throw in their household dustbins, 2.6% flush in toilets, 19.2% return to the pharmacist, and 4.5% bury. One-fourth of the medical professionals not aware about environmental hazards due to improper disposal and also believe they do not cause any harm. 64% of preferred pharmacist would be the appropriate person to inform about proper disposal of drugs.Conclusion: This study shows lacunae in the knowledge and practice about proper disposal of expired drugs and recommends discussion regarding improper disposal and its consequences in various health programs.
Published: 2017

39. Laparoscopic total extraperitoneal repair of recurrent inguinal hernias

Author: Mohamed Ismail, Mahesh Rajagopal, Pankaj Garg, and Geetha R Menon
Subjects: medicine.medical_specialty, medicine.diagnostic_test, Urinary retention, business.industry, medicine.medical_treatment, Retrospective cohort study, medicine.disease, Hernia repair, Surgery, Inguinal hernia, Surgical mesh, Seroma, medicine, medicine.symptom, Laparoscopy, business, Abdominal surgery
Abstract: This study aimed to compare the outcome and morbidity parameters of laparoscopic total extraperitoneal (TEP) repair for recurrent and primary inguinal hernias. A retrospective analysis was conducted over a 3-year period. The recurrence rate; pain scores at 24 h, 1 week, and 4 weeks; hospital stay; days to resumption of normal activities; seroma formation; and urinary retention rates were noted. Of 937 patients, 52 underwent recurrent and 885 underwent primary hernia repair. The follow-up period was 12 to 40 months (median, 25 months). The mean operating time was longer in the recurrent group (32.7 ± 6.3 min) than in the primary group (30.1 ± 6.1 min; p = 0.015). The mean pain scores at 24 h were similar in the two groups (2.28 ± 0.5 for the recurrent group vs. 2.20 ± 0.4 for the primary group; nonsignificant difference). However the pain scores at 1 week were significantly higher in the recurrent group (1.35 ± 0.5) than in the primary group (1.20 ± 0.4; p = 0.017). The hospital stay (1.19 ± 0.4 vs. 1.07 ± 0.3 days; p = 0.002) and the time to resumption of normal activities (8.62 ± 2.6 vs. 7.67 ± 1.4 days; p < 0.0001) were significantly longer in the recurrent group than in the primary group. The urinary retention (9.6% vs. 5.4%; nonsignificant difference) and seroma formation (3.8% vs. 3.5%; p = 0.5) were similar in the recurrent and the primary groups, respectively. There were two recurrences and two conversions to open procedure in the primary group and none in the recurrent group. Laparoscopic TEP repair of recurrent inguinal hernia is safe and effective, with recurrence and conversion rates similar to those for primary hernia repair. However, the operative time, pain at 1 week and 1 month postoperatively, hospital stay, and time to resumption of normal activities with recurrent repair were significantly greater than with laparoscopic primary hernia repair.
Published: 2009

40. The efficacy of anal fistula plug in fistula-in-ano: a systematic review

Author: A. Bhatia, Geetha R Menon, Pankaj Garg, Jeremy Song, and H. Kalia
Subjects: Anal fistula, medicine.medical_specialty, business.industry, Fistula, Gastroenterology, MEDLINE, Cochrane Library, medicine.disease, law.invention, Surgery, Sepsis, Randomized controlled trial, law, medicine, Prospective cohort study, Abscess, business
Abstract: Aims To assess the efficacy of anal fistula plug (AFP) procedure for the treatment of fistula-in-ano especially the complex fistulas. Method The database of PUBMED, MEDLINE, SCOPUS, EMBASE and COCHRANE LIBRARY for the period 1995–2009 was searched. A systematic analysis was carried to evaluate the success rate of AFP procedure in fistula-in-ano. Results A total of 25 studies were extracted and 12 (n = 317) were finally included in the systematic review. The follow-up period ranged from 3.5 to 12 months. The AFP procedure had a success rate (patient cure rate) ranging from 24% to 92%. In complex fistula-in-ano in prospective studies (8/12 studies), the success rate was 35–87%. The success rate in patients with Crohn’s disease was 29–86%. The success rate in the patients with single tracts was 44–93% and in patients with multiple tracts, success ranged from 20% to 71%. The abscess formation/sepsis rate was 4–29% (11/108) and the plug extrusion rate was 4–41% (42/232–19%). Conclusion Anal fistula plug procedure has a success rate ranging from 24% to 92% in different studies. In prospective studies of complex fistula-in-ano, there was a moderate success rate of 35–87%. As AFP is associated with low morbidity and sepsis, it appears to be a safe procedure. Further randomized controlled trials studying objective parameters of fistula healing are needed to substantiate these findings.
Published: 2009

41. Comparison of Interrupted Versus Continuous Closure in Abdominal Wound Repair: A Meta-analysis of 23 Trials

Author: Sandeep Kumar, Chandra Sekhar Agrawal, Sunil Chumber, Anurag Srivastava, Geetha R Menon, and Himanshu Gupta
Subjects: Relative risk reduction, medicine.medical_specialty, Incisional hernia, medicine.medical_treatment, lcsh:Surgery, suture techniques, Dehiscence, Surgical Wound Dehiscence, operative surgical procedures, Laparotomy, medicine, Odds Ratio, Humans, Hernia, Randomized Controlled Trials as Topic, surgical wound dehiscence, business.industry, lcsh:RD1-811, medicine.disease, Surgery, meta-analysis, medicine.anatomical_structure, Anesthesia, Number needed to treat, Abdomen, business, abdomen
Abstract: Objective There is a lack of consensus among surgeons over interrupted versus continuous methods of abdominal wound closure. The objective of this study was to perform a meta-analysis to estimate the pooled odds ratio (OR) for dehiscence and incisional hernia in the interrupted technique of laparotomy wound closure as compared to the continuous technique. Methods All randomized, controlled trials comparing continuous and interrupted methods of laparotomy wound closure, with burst abdomen and/or incisional hernia as the outcomes, were included in the meta-analysis. MEDLINE, Clinical Evidence and the Cochrane Library were searched. Burst abdomen and incisional hernia were the two primary outcomes. Results Twenty-three studies were identified, with a total of 10,900 patients. The interrupted method of closure was associated with significantly less dehiscence as compared with the continuous method (OR, 0.576; p =0.014; relative risk reduction, 39.8%; number needed to treat, 143). The interrupted technique was also found to be better in the nonabsorbable suture , vertical incision and mass closure subgroups. However, no difference in the hernia risk was found between the two methods. Conclusion Interrupted laparotomy wound closure reduces the odds of dehiscence by half compared with continuous wound closure.
Published: 2008

42. Deubiquitinating enzyme CYLD negatively regulates RANK signaling and osteoclastogenesis in mice

Author: Minying Zhang, Wei Jin, Ato Wright, Emmanuel M. Paul, Geetha R. Babu, William Reiley, Jun You, Mikyoung Chang, Andrew J. Lee, and Shao Cong Sun
Subjects: Male, medicine.medical_specialty, Osteoclasts, Stimulation, Biology, Bone and Bones, Deubiquitinating Enzyme CYLD, Negative regulator, Mice, Expression pattern, Ubiquitin, Downregulation and upregulation, Osteoclast, Internal medicine, medicine, Animals, Bone Resorption, Mice, Knockout, TNF Receptor-Associated Factor 6, Receptor Activator of Nuclear Factor-kappa B, RANK Ligand, Cell Differentiation, General Medicine, Cell biology, Cysteine Endopeptidases, medicine.anatomical_structure, Endocrinology, biology.protein, Osteoporosis, Tumor necrosis factor alpha, Transcription Factor TFIIH, Signal Transduction, Transcription Factors, Research Article
Abstract: Osteoclastogenesis is a tightly regulated biological process, and deregulation can lead to severe bone disorders such as osteoporosis. The regulation of osteoclastic signaling is incompletely understood, but ubiquitination of TNF receptor–associated factor 6 (TRAF6) has recently been shown to be important in mediating this process. We therefore investigated the role of the recently identified deubiquitinating enzyme CYLD in osteoclastogenesis and found that mice with a genetic deficiency of CYLD had aberrant osteoclast differentiation and developed severe osteoporosis. Cultured osteoclast precursors derived from CYLD-deficient mice were hyperresponsive to RANKL-induced differentiation and produced more and larger osteoclasts than did controls upon stimulation. We assessed the expression pattern of CYLD and found that it was drastically upregulated during RANKL-induced differentiation of preosteoclasts. Furthermore, CYLD negatively regulated RANK signaling by inhibiting TRAF6 ubiquitination and activation of downstream signaling events. Interestingly, we found that CYLD interacted physically with the signaling adaptor p62 and thereby was recruited to TRAF6. These findings establish CYLD as a crucial negative regulator of osteoclastogenesis and suggest its involvement in the p62/TRAF6 signaling axis.
Published: 2008

43. Overweight Latino Children and Adolescents Have Marked Endothelial Dysfunction and Subclinical Vascular Inflammation in Association With Excess Body Fat and Insulin Resistance

Author: Geetha R. Soodini, Edward S. Horton, Osama Hamdy, A. Enrique Caballero, Sriurai Porramatikul, Kelb Bousquet-Santos, Antonio Claudio Lucas da Nóbrega, Ludivina Robles-Osorio, and Valeria Montagnani
Subjects: Male, Vasculitis, medicine.medical_specialty, Adolescent, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, Blood Pressure, Type 2 diabetes, Overweight, Leukocyte Count, Absorptiometry, Photon, Insulin resistance, Internal medicine, Diabetes mellitus, Plasminogen Activator Inhibitor 1, Internal Medicine, medicine, Humans, Obesity, Endothelial dysfunction, Child, Triglycerides, Advanced and Specialized Nursing, Adiponectin, Tumor Necrosis Factor-alpha, business.industry, Insulin, Hispanic or Latino, Glucose Tolerance Test, Intercellular Adhesion Molecule-1, medicine.disease, Intercellular adhesion molecule, C-Reactive Protein, Endocrinology, Adipose Tissue, Tissue Plasminogen Activator, Female, Endothelium, Vascular, Insulin Resistance, medicine.symptom, business
Abstract: OBJECTIVE—We measured plasma markers of endothelial dysfunction, vascular inflammation, and pro-coagulation in obese Hispanic/Latino children and adolescents with normal glucose tolerance and determined their relationship to body composition and indexes of glucose and lipid metabolism. RESEARCH DESIGN AND METHODS—A total of 38 lean or obese Hispanic children and adolescents (10–18 years of age) were selected. The overweight group (n = 21) had a BMI >85th percentile for their age and sex, and the lean group (n = 17) had a BMI between the 25th and 50th percentiles. Studies included an oral glucose tolerance test, measurements of plasma glucose and lipids, several markers of endothelial function and inflammation, and determination of body composition by dual X-ray absorptiometry. RESULTS—The obese group had higher systolic blood pressure and plasma triglycerides and was more insulin resistant than the lean group. The obese group also had higher plasma soluble intercellular adhesion molecule (259.5 ± 60.0 vs. 223.2 ± 47.5 ng/ml, P = 0.047), tumor necrosis factor-α (2.57 ± 1.1 vs. 1.74 ± 0.6 pg/ml, P = 0.008), high-sensitivity C-reactive protein (2.0 vs. 0.13 mg/l, P < 0.0001), plasminogen-activated inhibitor-1 (47.0 ± 35.7 vs. 12.0 ± 5.2 ng/ml, P < 0.0001), tissue plasminogen activator (6.1 ± 1.9 vs. 4.1 ± 0.8 ng/ml, P = 0.001), and white blood cell count (6.9 vs. 5.3 × 103, P = 0.031) and lower levels of adiponectin (8.7 ± 3.3 vs. 12.6 ± 5.2 μg/ml, P = 0.022). No significant differences were observed for soluble vascular cell adhesion molecule or interleukin-6. CONCLUSIONS—Overweight Hispanic children and adolescents with normal glucose tolerance exhibit increased plasma markers of endothelial dysfunction and subclinical inflammation in association with obesity and insulin resistance. These abnormalities may predispose them to the development of type 2 diabetes and cardiovascular disease.
Published: 2008

44. Obesity and endothelial function

Author: Osama Hamdy and Geetha R. Soodini
Subjects: medicine.medical_specialty, business.industry, Endocrinology, Diabetes and Metabolism, medicine.disease, Obesity, Vascular endothelial growth factor B, Coronary artery disease, Endocrinology, Vascular endothelial growth factor C, Fat accumulation, Internal medicine, Diabetes mellitus, Internal Medicine, medicine, business, Visceral fat, Function (biology)
Abstract: Purpose of reviewThe growing prevalence of diabetes and coronary artery disease (CAD) parallels the increased prevalence of obesity. This review explains the pathogenic role of excessive fat accumulation, especially the visceral fat in altering endothelial function. It clarifies the link between adi
Published: 2004

45. Adiponectin and Leptin in Relation to Insulin Sensitivity

Author: Geetha R. Soodini and Osama Hamdy
Subjects: medicine.medical_specialty, Adiponectin, business.industry, Endocrinology, Diabetes and Metabolism, Leptin, Adipose tissue, Adipokine, White adipose tissue, medicine.disease, Endocrinology, Insulin resistance, Internal medicine, Internal Medicine, medicine, Resistin, business, hormones, hormone substitutes, and hormone antagonists, Dyslipidemia
Abstract: An increased amount of adipose tissue or its disproportionate distribution between central and peripheral body regions is related to the development of insulin resistance, type 2 diabetes mellitus, dyslipidemia, atherosclerosis, and coronary artery disease. Until recently, adipose tissue was regarded as a storage depot for lipids. It is now viewed as a hormonally active organ that plays a crucial metabolic role. The most important products of adipose tissue collectively referred to as adipocytokines, include adiponectin, leptin, tumor necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6), resistin, plasminogen-activating inhibitor-I (PAI-1), and angiotensinogen. These low and medium molecular weight proteins play an important role in the adipose tissue physiology and are believed to be a link between obesity, insulin resistance and endothelial dysfunction. This review describes the metabolic role of two of these proteins, adiponectin and leptin, in relation to insulin sensitivity.
Published: 2004

46. Randomized Controlled Trial in Advance Stage Breast Cancer Patients for the Effectiveness on Stress Marker and Pain through Sudarshan Kriya and Pranayam

Author: Komal Kashyap, Santosh Patnaik, Surajpal, Neeta Kumar, Manju Mehta, Vishwajeet Singh, Sushma Bhatnagar, Geetha R Menon, and Thirumurthy Velpandian
Subjects: Evidence hierarchy, law.invention, Randomized controlled trial, law, Pain perception, Stage (cooking), Journal analysis, Cancer, Evidence-based palliative care, lcsh:R5-920, Depression, Health Policy, Radioresistance, Cardiovascular disease, Chronic disease model, Non-compliance, Stress marker, Induction chemotherapy, Data collection, Risk factor surveillance, Evidence analysis, Original Article, lcsh:Medicine (General), Hemodialysis patients, medicine.medical_specialty, Psychiatric morbidity, India, Pain, Stress, Psychosocial stress, Hybrid regimen, Breast cancer, Internal medicine, Chronic renal failure, medicine, World Health Organization STEPwise approach, Radiotherapy, Emergency department, business.industry, Yoga, Significant difference, Public Health, Environmental and Occupational Health, Functional status, Pranayam, medicine.disease, Socio-demographic factors, Treatment, Levels of evidence, Sudarshan kriya, Cervical cancer, Physical therapy, business, Disease reporting, Serum cortisol
Abstract: Objective: The objective of this study is to examine the effect of a cognitive, behavioral stress management module of Sudarshan Kriya (SK) and P on levels of serum cortisol and pain among the women suffering from advanced stage breast cancer. Materials and Methods: Participants (n = 147) were screened and randomized to receive standard care (n = 69) versus standard along with SK and Pranayam (P) intervention (n = 78) imparted in one 18 hrs workshop spread during 3 days. Participants were expected to practice it at home 20 min daily as adjuvant to standard pharmacological treatment for pain. Results: There was a significant difference in blood cortisol levels after 3 months of practice of SK and P. Mean blood levels in the intervention arm were 341.2 ng/ml against 549.2 ng/ml in the control arm (P ≤ 0.002). Pain perception in comparison to control arm reduced by 3 points in SK and P arm on 0-10 verbal scale of pain. Conclusion: SK and P is an effective intervention in reducing stress and pain among advance stage patients of breast cancer.
Published: 2013

47. Implications of depression in rheumatoid arthritis: do subtypes really matter?

Author: Geetha R. Komatireddy, Karen L. Smarr, Janda L. Buchholz, Karen D. Multon, Jerry C. Parker, John F. Kosciulek, and John E. Hewett
Subjects: medicine.medical_specialty, Dysthymic Disorder, Psychometrics, business.industry, Immunology, Arthritis, medicine.disease, humanities, Rheumatology, Rheumatoid arthritis, Epidemiology, Minor depressive disorder, medicine, Immunology and Allergy, Antidepressant, Major depressive disorder, Pharmacology (medical), business, Psychiatry
Abstract: Objective To examine depressive disorders and health status in patients with rheumatoid arthritis (RA), controlling for potential confounds. Method Subjects (n = 426) completed measures of depressive symptoms (Center for Epidemiological Studies Depression Scale [CES-D]) and health status (Arthritis Impact Measurement Scales 2 [AIMS2]), via cross-sectional survey. Subjects (n = 299) with few depressive symptoms (CES-D ≤10) were not evaluated further. Subjects with CES-D ≥11 were interviewed using the Primary Care Evaluation of Mental Disorders to diagnose major depressive disorder (MDD; n = 46), dysthymic disorder (DD; n = 21), or minor depressive disorder (MND; n = 18). Results Regression analyses examined differences between the depressive disorders on AIMS2 subscales. Health status scores were similar between the depressive disorder subcategories; significant differences were found between MDD and MND on AIMS2 Physical scores and MDD and DD on AIMS2 Symptom scores. Conclusion Regarding health status, presence of depression itself seems to overshadow differences between depression subtypes; antidepressant treatments/referrals for persons with concomitant RA and any depressive disorder subtype appear warranted.
Published: 2000

48. A confirmatory factor analysis of the center for epidemiologic studies depression scale in rheumatoid arthritis patients: Additional evidence for a four-factor model

Author: Soo Hyun Rhee, Gail E. Wright, Karen L. Smarr, Gregory F. Petroski, Jerry C. Parker, Janda L. Buchholz, Geetha R. Komatireddy, and Karen D. Multon
Subjects: medicine.medical_specialty, education.field_of_study, Psychometrics, business.industry, Immunology, Population, Center for Epidemiologic Studies Depression Scale, medicine.disease, Factor structure, humanities, Confirmatory factor analysis, Rheumatology, Telephone interview, Internal medicine, Rheumatoid arthritis, Immunology and Allergy, Medicine, Pharmacology (medical), business, Psychiatry, education, Depression (differential diagnoses)
Abstract: Objective To examine the factor structure of the Center for Epidemiologic Studies Depression Scale (CES-D) in a sample of patients with rheumatoid arthritis (RA), testing all of the alternative models suggested by the previous evidence Methods The CES-D was administered to a group of RA patients (n = 685) during a structured telephone interview. The telephone interview was repeated 6 months later (n = 537) and 12 months later (n = 453). Confirmatory factor analyses were conducted to test alternative models. Results The correlated 4-factor model and the second-order 4-factor model were the best fitting models. Conclusion The factor structure of the CES-D previously found in the general population was replicated in an RA sample. The results are consistent with previous evidence of criterion contamination in the CES-D when used in an RA sample and provide support for the view that a single summary score may not be the most informative index of the CES-D.
Published: 1999

49. Ruptured Intrahepatic Aneurysm as the Initial Manifestation of Polyarteritis Nodosa

Author: Geoffrey D. Beale, Geetha R. Komatireddy, Timothy S. Loy, and Diego T. Yangco
Subjects: medicine.medical_specialty, Abdominal pain, Polyarteritis nodosa, business.industry, medicine.disease, Thrombosis, Aneurysm, Rheumatology, Acute abdomen, Pathognomonic, medicine.artery, medicine, Radiology, Superior mesenteric artery, Differential diagnosis, medicine.symptom, business
Abstract: polyarteritis nodosa (PAN) is characterized by panarteritis involving all layers of the vessel wall of medium and small arteries and adjacent veins leading to thrombosis and aneurysmal dilatation. We present the case of a 21-year-old Caucasian man with an acute abdomen with a massive gastrointestinal (GI) hemorrhage caused by a large intrahepatic aneurysmal rupture needing surgery. This was the initial manifestation of underlying PAN, which had not been diagnosed before the event. This patient's postoperative course was complicated by continued hemorrhage prompting further diagnostic abdominal arteriography, which revealed multiple art-eurysms along the superior mesenteric artery. The aneurysmal wall biopsy revealed lymphocytic infiltrates, scattered giant cells, and minimal necrosis. A diagnosis of PAN was entertained based on arteriographic findings, although no pathognomonic demonstration of multiple visceral aneu-rysms is a characteristic finding of PAN, The patient survived the catastrophic event, and treatment with corticosteroids was initiated, which led to an uncomplicated hospital stay. Furthermore, outpatient follow ups showed continued clinical improvement with corticosteroid therapy and a repeat angiogram performed elsewhere demonstrated resolution of most of the aneurysms. Our case represents an unusual initial clinical manifestation of PAN and is one of the few cases reported with a torrential (GI) hemorrhage resulting from a rupture of an intrahepatic aneurysm, which is associated with increased mortality. The clinical significance of abdominal pain is not always apparent. It may occur in the absence of any gross intra-abdominal lesions, or, as in our patient, may herald an acute abdominal catastrophe. The clinician should consider PAN in the differential diagnosis of a massive GI hemorrhage. It is also important to note that early diagnosis followed by aggressive treatment can be lifesaving.
Published: 1998

50. High prevalence of hyperhomocysteinemia among Indian patients of vascular disease

Author: Mamta Kankra, Geetha R Menon, Seema Bhargava, Rajiv Parakh, Anjali Manocha, L. M. Srivastava, and Chandra Shekhar Aggarwal
Subjects: Adult, medicine.medical_specialty, Hyperhomocysteinemia, High prevalence, Adolescent, business.industry, Vascular disease, Biochemistry (medical), Clinical Biochemistry, India, Comorbidity, General Medicine, Middle Aged, medicine.disease, Biochemistry, Text mining, Internal medicine, Prevalence, medicine, Humans, Vascular Diseases, business, Aged
Published: 2006

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