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15. Tuberculosis—Learning the Impact of Nutrition (TB LION): protocol for an interventional study to decrease TB risk in household contacts

Author

Cintron, Chelsie, Narasimhan, Prakash Babu, Locks, Lindsey, Babu, Senbagavalli, Sinha, Pranay, Rajkumari, Nonika, Kaipilyawar, Vaishnavi, Bhargava, Anurag, Maloomian, Kimberly, Chandrasekaran, Padma, Verma, Sheetal, Joseph, Noyal, Johnson, W. Evan, Wanke, Christine, Horsburgh, Jr., C. Robert, Ellner, Jerrold J., Sarkar, Sonali, Salgame, Padmini, Lakshminarayanan, Subitha, and Hochberg, Natasha S.

Published
2021
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16. Geographical information system-Aided noise pollution mapping of urban Puducherry, South India

Author

Devasia, James, Thulasingam, Mahalakshmy, Lakshminarayanan, Subitha, Naik, Bijaya, Shanmugavelu, Sabesan, Raju, Hari, and Premarajan, K.

Subjects
Geographic information systems, Noise pollution, Geographic information system, Environmental issues, Health, World Health Organization
Abstract

Byline: James. Devasia, Mahalakshmy. Thulasingam, Subitha. Lakshminarayanan, Bijaya. Naik, Sabesan. Shanmugavelu, Hari. Raju, K. Premarajan Context: Noise pollution and its influence on environmental and quality of human life are a [...]

Published
2022

18. Prevalence and the factors associated with microalbuminuria among patients with type 2 diabetes mellitus and/or hypertension in the urban areas of Puducherry district: a cross-sectional study.

Author

Sivanantham, Parthibane, Sahoo, Jaya Prakash, Lakshminarayanan, Subitha, Bobby, Zachariah, Loganathan, Vignesh, and Kar, Sitanshu Sekhar

Subjects
TYPE 2 diabetes, ALBUMINURIA, CITIES & towns, NON-communicable diseases, CROSS-sectional method
Abstract

Background Microalbuminuria is an early indicator for renal and cardiovascular diseases, especially among patients with diabetes mellitus (DM) and hypertension (HTN). We determined the prevalence and the factors associated with microalbuminuria among patients with type 2 DM and/or HTN in the urban areas of the Puducherry district in India. Methods We included 225 patients aged 40–69 years with DM and/or HTN from a non-communicable diseases (NCDs) survey conducted during 2019–2020 in the urban areas of Puducherry district. The prevalence of microalbuminuria and various biological risk factors of NCDs were assessed as per the WHO STEPS methodology. The prevalence of microalbuminuria was presented as proportions (95% CI), and the adjusted prevalence ratio (aPR) was estimated using weighted forward stepwise generalized linear modelling. P -value ≤0.05 was considered statistically significant. Results The mean (SD) age of the patients was 54 (11) years. Over one-third (38.2%) (95% CI: 31.6–44.4) of patients with DM and/or HTN had microalbuminuria. The prevalence was highest among those having both DM and HTN 48% (95% CI: 37–59), followed by those having only DM 40.6% (95% CI: 29–52.2) and only HTN 27.7% (95% CI: 18.1–38.6). The prevalence of microalbuminuria was twice (aPR = 2.1, 95% CI: 1.1–3.9) higher among women and 2.4 times (95% CI: 1.12–5.1) higher among those having both DM and HTN as compared to those with only HTN. Conclusion The prevalence of microalbuminuria among patients with DM and/or HTN is concerningly high. Population-based screening for microalbuminuria, especially among women and those having both DM and HTN, needs to be undertaken in the urban areas of Puducherry district. [ABSTRACT FROM AUTHOR]

Published
2024
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24. Perceptions about controlled human infection model (CHIM) studies among members of ethics committees of Indian medical institutions: A qualitative exploration

Author

Sharma, Abhishek, primary, Apte, Aditi, additional, Rajappa, Medha, additional, Vaz, Manjulika, additional, Vaswani, Vina, additional, Goenka, Shifalika, additional, Malhotra, Samir, additional, Sangoram, Rashmi, additional, Lakshminarayanan, Subitha, additional, Jayaram, Suganya, additional, Mathaiyan, Jayanthi, additional, Farseena, Khadeejath, additional, Mukerjee, Prarthna, additional, Jaswal, Surinder, additional, Dongre, Amol, additional, Timms, Olinda, additional, Shafiq, Nusrat, additional, Aggarwal, Rakesh, additional, Kaur, Manmeet, additional, Juvekar, Sanjay, additional, Sekhar, Amrita, additional, and Kang, Gagandeep, additional

Published
2023
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26. Corrigendum: Malnutrition leads to increased inflammation and expression of tuberculosis risk signatures in recently exposed household contacts of pulmonary tuberculosis

Author

VanValkenburg, Arthur, primary, Kaipilyawar, Vaishnavi, additional, Sarkar, Sonali, additional, Lakshminarayanan, Subitha, additional, Cintron, Chelsie, additional, Babu, Senbagavalli Prakash, additional, Knudsen, Selby, additional, Joseph, Noyal Mariya, additional, Horsburgh, C. Robert, additional, Sinha, Pranay, additional, Ellner, Jerrold J., additional, Narasimhan, Prakash Babu, additional, Johnson, William Evan, additional, Hochberg, Natasha S., additional, and Salgame, Padmini, additional

Published
2022
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28. Malnutrition leads to increased inflammation and expression of tuberculosis risk signatures in recently exposed household contacts of pulmonary tuberculosis

Author

VanValkenburg, Arthur, primary, Kaipilyawar, Vaishnavi, additional, Sarkar, Sonali, additional, Lakshminarayanan, Subitha, additional, Cintron, Chelsie, additional, Prakash Babu, Senbagavalli, additional, Knudsen, Selby, additional, Joseph, Noyal Mariya, additional, Horsburgh, C. Robert, additional, Sinha, Pranay, additional, Ellner, Jerrold J., additional, Narasimhan, Prakash Babu, additional, Johnson, W. Evan, additional, Hochberg, Natasha S., additional, and Salgame, Padmini, additional

Published
2022
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30. Development of prognostic scoring system for predicting 1-year mortality among pulmonary tuberculosis patients in South India

Author

Krishnamoorthy, Yuvaraj, primary, Ezhumalai, Komala, additional, Murali, Sharan, additional, Rajaa, Sathish, additional, Majella, Marie Gilbert, additional, Sarkar, Sonali, additional, Lakshminarayanan, Subitha, additional, Joseph, Noyal Mariya, additional, Soundappan, Govindarajan, additional, Prakash Babu, Senbagavalli, additional, Horsburgh, Charles, additional, Hochberg, Natasha, additional, Johnson, W Evan, additional, Knudsen, Selby, additional, Pentakota, Sri Ram, additional, Salgame, Padmini, additional, Roy, Gautam, additional, and Ellner, Jerrold, additional

Published
2022
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31. Perceptions about controlled human infection model (CHIM) studies among members of ethics committees of Indian medical institutions: A qualitative exploration

Author

Sharma, Abhishek, primary, Apte, Aditi, additional, Rajappa, Medha, additional, Vaz, Manjulika, additional, Vaswani, Vina, additional, Goenka, Shifalika, additional, Malhotra, Samir, additional, Sangoram, Rashmi, additional, Lakshminarayanan, Subitha, additional, Jayaram, Suganya, additional, Mathaiyan, Jayanthi, additional, Farseena, Khadeejath, additional, Mukerjee, Prarthna, additional, Jaswal, Surinder, additional, Dongre, Amol, additional, Timms, Olinda, additional, Shafiq, Nusrat, additional, Aggarwal, Rakesh, additional, Kaur, Manmeet, additional, Juvekar, Sanjay, additional, Sekhar, Amrita, additional, and Kang, Gagandeep, additional

Published
2022
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33. Procalcitonin and C-Reactive Protein as an Early Predictor of Infection in Elective Gastrointestinal Cancer Surgery—a Prospective Observational Study

Author

Ujjwal Das, Sathasivam Sureshkumar, Lakshminarayanan Subitha, Apurba Shankar Sastry, and Amaranathan Anandhi

Subjects
Calcitonin, medicine.medical_specialty, medicine.medical_treatment, Early detection, Procalcitonin, Postoperative Complications, Humans, Medicine, Gastrointestinal cancer, Early discharge, Early Detection of Cancer, Gastrointestinal Neoplasms, biology, business.industry, Incidence (epidemiology), C-reactive protein, Gastroenterology, medicine.disease, Surgery, Radiation therapy, C-Reactive Protein, ROC Curve, Oncology, biology.protein, Intraabdominal Infections, Observational study, business, Biomarkers
Abstract

Postoperative infections are a common entity following elective gastrointestinal surgery among which intra-abdominal infection is notorious and life threatening. Early detection could reduce postoperative morbidity and permit safe and early discharge. This study was aimed to establish the usefulness of procalcitonin (PCT) and C-reactive protein (CRP) on postoperative day 3 as reliable markers for early detection of intra-abdominal infection and other postoperative infections following elective gastrointestinal cancer surgery. A total of 125 patients following elective gastrointestinal cancer surgery were prospectively observed until discharge from January 2018 to December 2019. The incidence of intra-abdominal infections and other postoperative infections was recorded. Serum PCT and CRP were estimated on postoperative day 3 for all the patients. ROC analysis of PCT and CRP was performed to establish their predictability in detecting these infections. Risk factors for postoperative infections were also studied. The incidence of intra-abdominal infection (IAI) was 24%. The difference in PCT between the infected and non-infected patients was statistically significant (p = 0.001) but not in CRP (p = 0.223). On ROC analysis of CRP and PCT in detecting IAI, the areas under the curve were 0.494 and 0.615 respectively. Raised serum PCT values on postoperative day 3 indicate the presence of infections and should prompt the surgeon to consider other investigations to confirm the presence of IAI and other postoperative infections and plan early intervention thus expediting the postoperative recovery. CTRI/2018/12/016695

Published
2021

34. Development of prognostic scoring system for predicting 1-year mortality among pulmonary tuberculosis patients in South India.

Author

Krishnamoorthy, Yuvaraj, Ezhumalai, Komala, Murali, Sharan, Rajaa, Sathish, Majella, Marie Gilbert, Sarkar, Sonali, Lakshminarayanan, Subitha, Joseph, Noyal Mariya, Soundappan, Govindarajan, Babu, Senbagavalli Prakash, Horsburgh, Charles, Hochberg, Natasha, Johnson, W Evan, Knudsen, Selby, Pentakota, Sri Ram, Salgame, Padmini, Roy, Gautam, and Ellner, Jerrold

Subjects
TUBERCULOSIS treatment, EXPERIMENTAL design, CONFIDENCE intervals, LEUCOPENIA, RESEARCH methodology, INTERVIEWING, NEUTROPHILS, LYMPHOCYTES, ANEMIA, RESEARCH funding, DESCRIPTIVE statistics, PREDICTIVE validity, POLICY sciences, SOCIODEMOGRAPHIC factors, LONGITUDINAL method, PROBABILITY theory
Abstract

Background Development of a prediction model using baseline characteristics of tuberculosis (TB) patients at the time of diagnosis will aid us in early identification of the high-risk groups and devise pertinent strategies accordingly. Hence, we did this study to develop a prognostic-scoring model for predicting the death among newly diagnosed drug sensitive pulmonary TB patients in South India. Methods We undertook a longitudinal analysis of cohort data under the Regional Prospective Observational Research for Tuberculosis India consortium. Multivariable cox regression using the stepwise backward elimination procedure was used to select variables for the model building and the nomogram-scoring system was developed with the final selected model. Results In total, 54 (4.6%) out of the 1181 patients had died during the 1-year follow-up period. The TB mortality rate was 0.20 per 1000 person-days. Eight variables (age, gender, functional limitation, anemia, leukopenia, thrombocytopenia, diabetes, neutrophil–lymphocyte ratio) were selected and a nomogram was built using these variables. The discriminatory power was 0.81 (95% confidence interval: 0.75–0.86) and this model was well-calibrated. Decision curve analysis showed that the model is beneficial at a threshold probability ~15–65%. Conclusions This scoring system could help the clinicians and policy makers to devise targeted interventions and in turn reduce the TB mortality in India. [ABSTRACT FROM AUTHOR]

Published
2023
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35. Impact of nutrition status and body mass index on mortality in hospitalized general medical patients: A prospective observational study

Author

Vineet Agrawal, Lakshminarayanan Subitha, Rajappa Medha, and Surendran Deepanjali

Subjects
Male, Adult, Nutrition and Dietetics, Malnutrition, Medicine (miscellaneous), Nutritional Status, Middle Aged, Protein-Energy Malnutrition, Body Mass Index, Hospitalization, Nutrition Assessment, Weight Loss, Humans, Female
Abstract

Malnutrition and low body mass index (BMI) are risk factors for mortality in hospitalized patients. Data substantiating this are unavailable for hospitalized general medical patients in our setting. We studied the prevalence of malnutrition among patients admitted to general medical wards in a tertiary care hospital and its role as a risk factor for 1-month mortality. We also investigated the association of BMI with mortality.In this prospective observational study, nutrition assessment using Subjective Global Assessment (SGA) and anthropometric measurements was performed in 395 hospitalized general medical patients. Charlson Comorbidity Index (CCI) and Modified Early Warning System (MEWS) score were calculated. Clinical course and vital status at 1 month after discharge was noted. Factors associated with mortality were identified using logistic regression.The mean age of the study population was 46.2 + 16.1 years; 247 (62.5%) were males. Of 395 patients, 129 (32.7%) belonged to SGA A, 155 (39.2%) to SGA B, and 111 (28.1%) to SGA C. Mean (±SD) BMI was 23.38 (±5.33); 141 (35.6%) were obese. Mortality was observed in 61 (15.4%) patients. Patients in the lowest BMI quartile had the lowest mortality. The adjusted regression analysis showed that higher age and MEWS scores were independently associated with mortality. Severe malnourishment (SGA C) was another important predictor. Further, the odds of death increased consistently across the consecutive BMI quartiles.Higher age, higher MEWS scores, severe malnourishment, and higher BMI scores were independent risk factors for 1-month mortality in hospitalized general medical patients.

Published
2022

37. Depressive Symptoms and Health-Related Quality of Life in Patients with Cardiovascular Diseases Attending a Tertiary Care Hospital, Puducherry—A Cross-Sectional Study

Author

Essakky Saravanan, Arokiasamy Senthilkumar, Santhosh Satheesh, Vikas Menon, Lakshminarayanan Subitha, and Dinesh Kumar Giriyappa

Subjects
medicine.medical_specialty, Cross-sectional study, Population, hrqol, Neurosciences. Biological psychiatry. Neuropsychiatry, 030204 cardiovascular system & hematology, Coronary artery disease, 03 medical and health sciences, 0302 clinical medicine, Quality of life, cardiovascular disease, medicine, Risk factor, education, Depression (differential diagnoses), education.field_of_study, patient health questionnaire 9, business.industry, General Neuroscience, medicine.disease, eq-5d-3l, Public hospital, depression, Physical therapy, Anxiety, Original Article, Neurology (clinical), medicine.symptom, business, 030217 neurology & neurosurgery, coronary artery disease, RC321-571
Abstract

Background Globally, coronary artery disease (CAD) was the leading cause of health losses. The emergence of revascularization has brought a major change in the management of CAD. Depression and cardiovascular diseases (CVD) are the two highly prevalent noncommunicable diseases (NCD), which lead to poor quality of life and high socio-economic loss for the patient. The rate of depressive episodes was higher in CAD population in comparison to population with other heart problems. Objectives The primary objective of the current study is to determine the proportion of those with depressive symptoms through Patient Health Questionnaire-9 (PHQ-9) among CAD patients in a tertiary care public hospital. Methods It was a cross-sectional analytical design, which assess the percentage of patients with depressive symptoms among CAD patients, using a pretested, semistructured questionnaire. The PHQ-9 and EuroQoL five-dimensional three-level (EQ-5D-3L) questionnaire, a quality-of-life instrument (five items), were used, which was validated in the Tamil version. Statistical Analysis Categorical variables was expressed as proportion. We used Chi-square as a statistical test to calculate the p value and risk estimation with 95% CI. Results Out of 541 patients, 159 (30%) patients had mild-to-moderate depressive symptoms, of which 144 (89%) participants were greater than 50 years. In EQ-5D-3L, around one-third of the participants reported pain or discomfort and anxiety or depression. Conclusion The study concludes that the assessment of health-related quality of life (HRQoL) is becoming increasingly important in the management of CAD patients. Studies have shown that depression predicts subsequent quality of life, while others have shown that HRQoL is a risk factor for ongoing depression. Treatment of depression may improve subsequent physical HRQoL; hence, it is vital to address both during their follow-up to improve outcomes among patients with CAD.

Published
2021

41. High prevalence of abdominal obesities and metabolically unhealthy individuals in a highly urbanized district of India: findings of a cross-sectional survey in Puducherry.

Author

Sivanantham, Parthibane, Sahoo, Jaya Prakash, Lakshminarayanan, Subitha, Bobby, Zachariah, and Kar, Sitanshu Sekhar

Subjects
ABDOMINAL adipose tissue, BODY mass index, CITY dwellers, INDIANS (Asians), WAIST circumference
Abstract

Background Abdominal obesities are better markers for predicting cardiovascular abnormalities than risk stratification based only on body mass index (BMI). We aimed to estimate the prevalence of abdominal adiposities using predictive equations for Asian Indian adults and to determine the prevalence of metabolically healthy subjects among those overweight/obese and with normal BMI. Methods A community-based survey was conducted among those aged 18–69 years in the district of Puducherry between February 2019 and February 2020. We surveyed 2,560 individuals selected through multi-stage cluster random sampling from urban and rural areas (50 wards and 50 villages, respectively) of the district. Anthropometric measurements, such as height, weight, waist circumference, and blood pressure were recorded from each participant. Fasting blood sample was collected from each alternate participant to estimate metabolic risk factors. Results Over four-fifths (85.6%; 95% CI: 84.2–86.9) and two-thirds (69.7%; 95% CI: 67.9–71.6) of the population in the district had high levels of intra-abdominal adipose tissue (IAAT) and total abdominal fat (TAF), respectively. Both the risk factors were significantly higher among women and urban population. About 43% (95% CI: 41–44.9) of the population had high abdominal subcutaneous adipose tissue (SCAT) with a significantly higher prevalence among the urban population. Among those overweight/obese (n  = 773), almost all 99.4% (95% CI: 98.7–99.9) were metabolically unhealthy. Among subjects with normal BMI (n  = 314), only about 2.9% (95% CI: 1.3–4.8) were metabolically healthy. Conclusion We highlight the substantially high prevalence of IAAT, TAF, and SCAT in the district of Puducherry. Almost all the study population was metabolically unhealthy irrespective of their BMI levels. [ABSTRACT FROM AUTHOR]

Published
2023
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49. Nutritional Supplementation Would Be Cost-Effective for Reducing Tuberculosis Incidence and Mortality in India: The Ration Optimization to Impede Tuberculosis (ROTI-TB) Model

Author

Sinha, Pranay, primary, Lakshminarayanan, Subitha L, additional, Cintron, Chelsie, additional, Narasimhan, Prakash Babu, additional, Locks, Lindsey M, additional, Kulatilaka, Nalin, additional, Maloomian, Kimberly, additional, Prakash Babu, Senbagavalli, additional, Carwile, Madeline E, additional, Liu, Anne F, additional, Horsburgh, C Robert, additional, Acuna-Villaorduna, Carlos, additional, Linas, Benjamin P, additional, and Hochberg, Natasha S, additional

Published
2021
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