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26 results on '"Chandran, Arul"'

3. The Impact of Diabetes Mellitus in Patients with Chronic Obstructive Pulmonary Disease (COPD) Hospitalization

Author

Gunasekaran, Kulothungan, primary, Murthi, Swetha, additional, Elango, Kalaimani, additional, Rahi, Mandeep Singh, additional, Thilagar, Bright, additional, Ramalingam, Sathishkumar, additional, Voruganti, Dinesh, additional, Paramasivam, Vijaya Kumar, additional, Kolandaivel, Krishna Prasad, additional, Arora, Ashish, additional, and Chandran, Arul, additional

Published
2021
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17. Triple versus dual inhaler therapy in moderate‐to‐severe COPD: A systematic review and meta‐analysis of randomized controlled trials

Author

Zayed, Yazan, primary, Barbarawi, Mahmoud, additional, Kheiri, Babikir, additional, Haykal, Tarek, additional, Chahine, Adam, additional, Rashdan, Laith, additional, Hamid, Kewan, additional, Sundus, Saira, additional, Banifadel, Momen, additional, Aburahma, Ahmed, additional, Bachuwa, Ghassan, additional, and Chandran, Arul, additional

Published
2019
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18. Mycobacterium chimaeralung infection and empyema in a patient without cardiopulmonary bypass

Author

Ahmad, Muhammad, Yousaf, Amman, Khan, Hafiz Muhammad Waqas, Munir, Ahmad, and Chandran, Arul

Abstract

AbstractMycobacterium chimaerais a nontuberculous mycobacterium that belongs to the Mycobacterium avium complex. Invasive infections are very rare and have been associated with contaminated heater-cooler water systems used during cardiopulmonary bypass. There is usually a long latency period and patients have nonspecific symptoms that can result in a delayed diagnosis or misdiagnosis. We report a case of M. chimaerainfection in a man who presented with worsening shortness of breath and was found to have pleural effusion. The patient did not have any history of cardiopulmonary bypass surgery, which raises concerns about community spread of this rare infection and needs further investigation in the general population. Furthermore, he had a history of sarcoidosis and was on immunosuppressive medications, which might suggest that immunosuppressed patients can acquire this infection without the described risk factors.

Published
2022
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20. Long-acting Muscarinic Antagonist Versus Inhaled Corticosteroid when Added to Long-acting β-agonist for COPD: A Meta-analysis

Author

Oba, Yuji, Chandran, Arul V., and Devasahayam, Joe V.

Subjects
hormones, hormone substitutes, and hormone antagonists
Abstract

The purpose of this study was to systematically review the efficacy and safety of long-acting β-agonist/long-acting muscarinic antagonist (LABA/LAMA) and LABA/inhaled corticosteroid (ICS) combinations in patients with advanced chronic obstructive pulmonary disease (COPD). Randomized clinical trials of at least 12 weeks of duration comparing LABA/LAMA and LABA/ICS combinations were included. We chose forced expiratory volume in 1 second (FEV1), St. George's Respiratory Questionnaire (SGRQ) score, Transitional Dyspnea Index (TDI), COPD Assessment Test (CAT) score, COPD exacerbations, mortality, and other safety parameters as outcome assessment criteria. We included six randomized controlled trials with a total of 4,319 patients. Most patients did not have a history of exacerbation. LABA/LAMA was associated with greater improvement in FEV1 than LABA/ICS (mean difference (MD) 0.09L, 95%confidence interval (CI) 0.07 to 0.11L; high certainty). Two treatments appeared clinically equivalent in improving SGRQ (MD −0.12, 95%CI −1.16 to 0.92; high certainty), TDI (MD 0.15, 95%CI −0.05 to 0.35; high certainty), and CAT scores (MD 0.28 95%CI −0.29 to 0.85; moderate certainty). LABA/LAMA was associated with an absolute reduction of approximately 8% in the incidence of pneumonia compared with LABA/ICS (risk ratio 0.41, 95%CI 0.18 to 0.94; moderate certainty). There was no significant difference in safety and exacerbation outcomes. However, equivalence of two treatments could not be concluded due to imprecision especially for mortality, cardiac serious adverse events, and severe exacerbations. Our findings support the use of dual long-acting bronchodilators for patients with advanced COPD but without frequent exacerbations given the excess risk of pneumonia with LABA/ICS.

Published
2016
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21. Dupilumab safety and efficacy in uncontrolled asthma: a systematic review and meta-analysis of randomized clinical trials.

Author

Zayed, Yazan, Kheiri, Babikir, Banifadel, Momen, Hicks, Michael, Aburahma, Ahmed, Hamid, Kewan, Bachuwa, Ghassan, and Chandran, Arul

Subjects
CLINICAL trials, META-analysis, ASTHMA, ADVERSE health care events, DATABASE searching
Abstract

Objective: We aimed to perform a meta-analysis evaluating the efficacy and safety of dupilumab in patients with uncontrolled asthma. Data source: A search of electronic databases was performed using PubMed, Cochrane library and Embase. Study selection: The literature search was conducted independently by two reviewers. Only randomized controlled trials (RCTs) that compared between placebo and dupilumab in patients with uncontrolled asthma were included in this analysis. Pooled risk ratios (RRs) and mean differences (MDs) with their corresponding 95% confidence intervals (CIs) were calculated for dichotomous and continuous data, respectively. Results: A total of four RCTs representing 2,992 patients were included. Pooled analysis showed significant reductions of the annualized rate of severe asthma exacerbation in the dupilumab group compared with placebo (RR 0.44; 95% CI 0.35–0.055; P < 0.01; I2 = 42%). In addition, the absolute forced expiratory volume at 1 s (FEV1) changes were significantly increased for the dupilumab group (MD 0.14; 95% CI: 0.12–0.17; P < 0.01; I2 = 0%). Finally, there were no significant differences between both groups in the development of any adverse event, serious adverse events, adverse events leading to death, discontinuation of medication due to adverse event or the occurrence of upper respiratory tract, influenza or bronchitis infections. However, dupilumab was associated with an increased risk of injection site reactions compared with placebo (RR 1.91; 95% CI 1.41, 2.59; P < 0.01; I2 = 24%). Conclusion: Among patients with uncontrolled asthma, the addition of dupilumab was associated with a reduced risk of severe asthma exacerbations and improvement in FEV1 without an increased risk of adverse events apart from injection site reactions with dupilumab. [ABSTRACT FROM AUTHOR]

Published
2019
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22. C1q Nephropathy: The Unique Underrecognized Pathological Entity

Author

Devasahayam, Joe, Erode-Singaravelu, Gowrishankar, Bhat, Zeenat, Oliver, Tony, Chandran, Arul, Zeng, Xu, Dakshinesh, Paramesh, and Pillai, Unni

Subjects
Article Subject, urologic and male genital diseases
Abstract

C1q nephropathy is a rare glomerular disease with characteristic mesangial C1q deposition noted on immunofluorescence microscopy. It is histologically defined and poorly understood. Light microscopic features are heterogeneous and comprise minimal change disease (MCD), focal segmental glomerulosclerosis (FSGS), and proliferative glomerulonephritis. Clinical presentation is also diverse, and ranges from asymptomatic hematuria or proteinuria to frank nephritic or nephrotic syndrome in both children and adults. Hypertension and renal insufficiency at the time of diagnosis are common findings. Optimal treatment is not clear and is usually guided by the underlying light microscopic lesion. Corticosteroids are the mainstay of treatment, with immunosuppressive agents reserved for steroid resistant cases. The presence of nephrotic syndrome and FSGS appear to predict adverse outcomes as opposed to favorable outcomes in those with MCD. Further research is needed to establish C1q nephropathy as a universally recognized distinct clinical entity. In this paper, we discuss the current understanding of pathogenesis, histopathology, clinical features, therapeutic options, and outcomes of C1q nephropathy.

Published
2015
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26. Mycobacterium chimaera lung infection and empyema in a patient without cardiopulmonary bypass.

Author

Ahmad M, Yousaf A, Khan HMW, Munir A, and Chandran A

Abstract

Mycobacterium chimaera is a nontuberculous mycobacterium that belongs to the Mycobacterium avium complex. Invasive infections are very rare and have been associated with contaminated heater-cooler water systems used during cardiopulmonary bypass. There is usually a long latency period and patients have nonspecific symptoms that can result in a delayed diagnosis or misdiagnosis. We report a case of M. chimaera infection in a man who presented with worsening shortness of breath and was found to have pleural effusion. The patient did not have any history of cardiopulmonary bypass surgery, which raises concerns about community spread of this rare infection and needs further investigation in the general population. Furthermore, he had a history of sarcoidosis and was on immunosuppressive medications, which might suggest that immunosuppressed patients can acquire this infection without the described risk factors., (Copyright © 2022 Baylor University Medical Center.)

Published
2022
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