Publications by authors named "Amrita John"

Purpose: In the light of WHO's call for elimination of cervical cancer, primary human papillomavirus (HPV) screening through self-collection is a powerful tool that can improve screening coverage. Challenges encountered during implementation of the program are unique to each country. We conducted this systematic review to list the challenges in implementing primary HPV screening through self-sampling in Indian context.

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Context: Oral cancer is the third common cancer in India. Its mortality can be reduced through early detection and tobacco cessation ideally by dentists owing to their forte of work.

Aim: This study was conducted to discuss effectiveness of an advanced tele-mentoring programme in oral cancer screening and tobacco cessation for dentists across India.

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Importance: Visual screening for oral cancer has been found to be useful in a large randomized clinical trial in Kerala, India, showing substantial reduction in mortality. To address the shortage of medical personnel in resource-deficient regions, using the services of community health workers has been proposed as a strategy to fill the gap in human resources in health care.

Objective: To assess the feasibility of community health workers in screening and early detection of oral cancer using a mobile application capturing system.

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In an observational study, the sleeves and pockets of physicians' white coats often directly or indirectly contacted patients and environmental surfaces. DNA markers on the sleeves or pockets were frequently transferred to surfaces and patients. These findings suggest that contaminated white coats have the potential to contribute to pathogen transmission.

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Population based cancer screening was initiated in India in 2016 owing to an increased burden of cancers. A feasibility health system study was done by utilising community health workers (CHWs) to conduct the cancer screening. The current study is a qualitative study to elicit the barriers and facilitators in implementing population based cancer screening through CHWs.

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Background: The three most commonly occurring cancers in India are those of the breast, uterine cervix, and lip or oral cavity, together accounting for approximately 34% of all cancers. All the three cancers are amenable to prevention, early detection, and treatment through which the morbidity and mortality due to these cancers can be reduced. This pilot study was conducted to assess the operational feasibility of the national cancer screening guidelines.

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Background: Critical shortages of personal protective equipment, especially N95 respirators, during the coronavirus disease 2019 (COVID-19) pandemic continues to be a source of concern. Novel methods of N95 filtering face-piece respirator decontamination that can be scaled-up for in-hospital use can help address this concern and keep healthcare workers (HCWs) safe.

Methods: A multidisciplinary pragmatic study was conducted to evaluate the use of an ultrasonic room high-level disinfection system (HLDS) that generates aerosolized peracetic acid (PAA) and hydrogen peroxide for decontamination of large numbers of N95 respirators.

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Background: Shortages of personal protective equipment (PPE) including N95 respirators are an urgent concern in the setting of the global COVID-19 pandemic. Decontamination of PPE could be useful to maintain adequate supplies, but there is uncertainty regarding the efficacy of decontamination technologies.

Methods: A modification of the American Society for Testing and Materials standard quantitative carrier disk test method (ASTM E-2197-11) was used to examine the effectiveness of 3 methods, including ultraviolet-C (UV-C) light, a high-level disinfection cabinet that generates aerosolized peracetic acid and hydrogen peroxide, and dry heat at 70°C for 30 minutes.

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In a point-prevalence culture survey, 24 of 300 (8%) handles of electronic thermometers in 3 hospitals were contaminated with 1 or more potential pathogens. A DNA marker inoculated onto the handles of electronic thermometers in hospital and long-term care facility settings spread to surfaces in patient rooms, to other types of portable equipment, and to patients' hands. Our findings suggest that effective strategies are needed to reduce the risk for pathogen transmission by electronic thermometers.

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Touchscreens are a potential source of pathogen transmission. In our facility, patients and visitors rarely perform hand hygiene after using interactive touchscreen computer kiosks. An automated ultraviolet-C touchscreen disinfection device was effective in reducing bacteriophage MS2, bacteriophage ϕX174, methicillin-resistant Staphylococcus aureus, and Clostridium difficile spores inoculated onto a touchscreen.

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Herpes Zoster in the Older Adult.

Infect Dis Clin North Am

December 2017

Herpes zoster (HZ) is the result of reactivation of latent varicella zoster virus (VZV) and occurs most frequently in older adults. Classically, HZ presents as a unilateral, selflimited, dermatomal rash. Postherpetic neuralgia (PHN) is a common sequela, presenting as severe pain that persists after the rash has resolved.

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A DNA marker inoculated onto shared portable equipment in surgical and medical intensive care units disseminated widely to surfaces in patient rooms and provider work areas and to other types of portable equipment. These results demonstrate the potential for contaminated portable equipment to serve as a vector for dissemination of pathogens. Infect Control Hosp Epidemiol 2017;38:1247-1249.

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During patient care simulations, cauliflower mosaic virus DNA and bacteriophage MS2 performed similarly as surrogate markers of pathogen dissemination. These markers disseminated to the environment in a manner similar to spores but were more frequently detected on skin and clothing of personnel after personal protective equipment removal.

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A nonpathogenic DNA marker inoculated onto the television remote controls in rooms of 2 ambulatory long-term care facility (LTCF) residents disseminated to the hands of the LTCF residents, to high-touch surfaces in the room and on the ward, and to shared portable equipment. These findings suggest that contaminated high-touch surfaces in rooms of ambulatory LTCF residents are a potential source for widespread dissemination of pathogens.

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Background: Healthcare personnel often use incorrect technique for donning and doffing of personal protective equipment (PPE).

Objective: We tested the hypothesis that medical students receive insufficient training on correct methods for donning and doffing PPE.

Methods: We conducted a cross-sectional survey of medical students on clinical rotations at two teaching hospitals to determine the type of training they received in PPE technique.

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Effective use of personal protective equipment (PPE) is essential to protect personnel and patients in health care settings. However, in a survey of 222 health care personnel, PPE training was often suboptimal with no requirement for demonstration of proficiency. Fourteen percent of physicians reported no previous training in use of PPE.

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We report a case of a 46-year-old woman with hypertension and autosomal dominant polycystic kidney disease who presented with chest pain and was found to have spontaneous coronary artery dissection (SCAD) on diagnostic catheterization. We review the pathogenesis, management and prognosis of SCAD. We conclude that in patients with polycystic kidney disease who present with angina pectoris and positive cardiac biomarkers, coronary artery dissection should be considered.

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This work presents the clinical application of a robust and unique approach for RNA amplification, called a simple method for amplifying RNA targets (SMART), for the detection and identification of subtypes of H1N1 pandemic, H1N1 seasonal, and H3N2 seasonal influenza virus. While all the existing amplification techniques rely on the diffusion of two molecules to complex RNA structures, the SMART achieves fast and efficient amplification via single-molecule diffusion. The SMART utilizes amplifiable single-stranded DNA (ssDNA) probes, which serve as reporter molecules for capturing specific viral RNA (vRNA) sequences and are subsequently separated on a microfluidic chip under zero-flow conditions.

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