Publications by authors named "Balakrishnan K"

An elderly patient with renal cell carcinoma underwent a robotic nephrectomy. After an uneventful intraoperative period, soon after extubation she developed generalized seizures and was diagnosed with posterior reversible encephalopathy syndrome (PRES) on neuroimaging. Management included antiepileptic and antihypertensive therapies, necessitating intensive care and neurorehabilitation.

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End-stage heart failure due to left ventricular noncompaction (LVNC) poses unique challenges for ventricular assist device implantation, like inflow cannula obstruction due to trabeculations. We report a case of an 11-year-old boy with LVNC who underwent successful HeartWare implantation as a bridge to transplant for high pulmonary vascular resistance and had successful heart transplantation after 4 years of HeartWare support.

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Purpose: Despite significant improvements in the design and performance of continuous flow left ventricular assist devices (CFLVADs), one of the most important reasons hampering further penetration of this technology is the occurrence of adverse events, especially strokes. One of the well-known risk factors for strokes is hypertension which is particularly common in patients undergoing a CFLVAD implant. While the device is implanted in the heart, strokes happen due to pathology in the brain and we hypothesised that modelling the blood flow in the circle of Willis might shed light on the causation of strokes in this situation.

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Aspiration pneumonia is a serious problem in the elderly due to weakened swallowing reflexes or underlying gastroesophageal reflux disease (GERD). This can lead to acute respiratory distress syndrome (ARDS), which can become life-threatening, sometimes requiring extra corporeal membrane oxygenation (ECMO) support. Lung transplantation is a possible therapeutic option for patients with no signs of lung recovery despite prolonged ECMO support.

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Repeated measurements of household air pollution may provide better estimates of average exposure but can add to costs and participant burden. In a randomized trial of gas versus biomass cookstoves in four countries, we took supplemental personal 24-h measurements on a 10% subsample for mothers and infants, interspersed between protocol samples. Mothers had up to five postrandomization protocol measurements over 16 months, while infants had three measurements over one year.

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Exposure to household air pollution has been linked to adverse health outcomes among women aged 40-79. Little is known about how shifting from biomass cooking to a cleaner fuel like liquefied petroleum gas (LPG) could impact exposures for this population. We report 24-h exposures to particulate matter (PM), black carbon (BC), and carbon monoxide (CO) among women aged 40 to <80 years participating in the Household Air Pollution Intervention Network trial.

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Background: Air pollution may impair child growth and cognitive development, with potential markers including birth length and head circumference.

Methods: The Household Air Pollution Intervention Network (HAPIN) trial was an open label multi-country-randomized controlled trial, with 3200 pregnant women aged 18-34 years (9-19 weeks of gestation) randomly assigned in a 1:1 ratio to receive liquefied petroleum gas (LPG) stove intervention compared to women continuing to cook with solid fuels for 18 months. Particulate matter ≤ 2.

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Background: Lead exposure is a widely acknowledged risk to public health for children and adults. However, despite efforts to phase out major sources over the last several decades, estimates of the prevalence of blood lead exposures and associated risks remain poorly characterized in many low- and middle-income countries.

Objectives:  This study aimed to determine blood lead levels (BLLs) and assess potential sources of lead exposure among urban communities in Chennai, Tamil Nadu.

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Objectives: Technological advances in identifying gene expression profiles are being applied to study an array of cancers. The goal of this study was to identify differentially expressed genes in pancreatic ductal adenocarcinoma (PDAC) and examine their potential role in tumorigenesis and metastasis.

Methods: The transcriptomic profiles of PDAC and non-tumorous tissue samples were derived from the gene expression omnibus (GEO), which is a public repository.

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Article Synopsis
  • The study evaluates how social vulnerability and health factors influence outcomes in pediatric medullary thyroid cancer using a review of the SEER database from 1975 to 2016.
  • In this analysis of 174 patients, five-year overall survival was 97.7% and disease-specific survival was 98.3%, but certain demographics impacted outcomes.
  • Specifically, Asian or Pacific Islander race is linked to worse survival rates, while localized disease without metastasis is protective; further research is needed to explore these disparities.
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Neck injuries from parachute opening shock (POS) are a concern in skydiving and military operations. This study employs finite element modeling to simulate POS scenarios and assess cervical spine injury risks. Validated against various conditions, including whiplash, the model replicates head/neck kinematics and soft tissue responses.

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Introduction: The dengue epidemic poses a significant public health challenge in Malaysia, and the concurrent presence of dengue and SARS-CoV-2 infections has further strained its healthcare system. Sabah, the second largest state in Malaysia, located in the northern part of Borneo Island, has been particularly hard-hit by both dengue and SARS-CoV-2 outbreaks. This study aims to analyze the status of dengue infections in Sabah over the past decade and understand the impact of the COVID-19 pandemic on dengue virus transmission.

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Hot springs are known to harbor potentially unique microorganisms due to the extreme temperatures in which they thrive and their biotechnologically important enzymes that are active at high temperature, which are beneficial for various industries. Sabah, Malaysia, houses several hot springs, yet knowledge of their microbiological diversity remains limited. Here, the raw sequence data of bacterial communities in a hot spring through metagenomic analysis are revealed.

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In modern scientific literature, the dominant role of statistical rigor is undeniable. However, the methodology and the language behind this science is often forbidding and not surgeon friendly and hence often forces the average reader to skim through the details and jump to the conclusions section and if the P value is reported to be statistically significant, we regard the conclusions as valid.However, if we make friends with statistical techniques and try to understand it,the results can be gratifying.

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Purpose: The purpose of the study was to describe the development and feasibility of implementing the DM-BOOST program in support of an established diabetes self-management education and support (DSMES) program.

Methods: A patient panel of 4 adults with type 2 diabetes (T2DM) codesigned DM-BOOST. DM-BOOST is a patient-focused program that includes peer-written text messages about diabetes self-management behaviors and digital health training to improve patient portal use and initiate goal setting prior to a scheduled DSMES appointment.

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Objectives: The 2017 Lancet Commission reports 'Serious Health-related Suffering' (SHS) as an abyss in healthcare services. It lists 20 common health conditions and 15 symptoms as commonly associated with SHS. In 2015, 80% of SHS prevalence, an estimated 61 million, was noted as from low-middle-income countries.

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Article Synopsis
  • Researchers are trying to find better ways to predict how long people will live after getting a liver transplant, because current models don't do a good job.
  • They tested new methods using data from patients who waited for liver transplants and found that a specific model helped them predict survival more accurately.
  • Better predictions can help doctors and patients make smarter choices about organ transplants, which might lead to better health outcomes for patients.
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The objective of this study was to identify differentially expressed genes and their potential influence on the carcinogenesis of serous-type ovarian cancer tumors. Serous cancer is an epithelial ovarian cancer subtype and is the most common type of ovarian cancer. Transcriptomic profiles of serous cancer and non-cancerous datasets were obtained from the Gene Expression Omnibus (GEO-NCBI).

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Article Synopsis
  • Household air pollution is a major environmental risk, especially in low- and middle-income countries, contributing to approximately 1.6 million premature deaths, prompting the HAPIN study to evaluate the impact of liquefied petroleum gas (LPG) stoves on health outcomes.
  • The study involved 800 pregnant women from Guatemala, India, Peru, and Rwanda, randomly assigning them to receive LPG stoves or continue using traditional biomass fuels, and monitored health indicators for 18 months.
  • The HAPIN Data Management Core effectively used the REDCap platform to collect and manage over 50 million data points, ensuring quality control and real-time data access, despite facing some logistical challenges.
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Objectives: To investigate potential demographic bias in artificial intelligence (AI)-based simulations of otolaryngology, residency selection committee (RSC) members tasked with selecting one applicant among candidates with varied racial, gender, and sexual orientations.

Methods: This study employed random sampling of simulated RSC member decisions using a novel Application Programming Interface (API) to virtually connect to OpenAI's Generative Pre-Trained Transformers (GPT-4 and GPT-4o). Simulated RSC members with diverse demographics were tasked with ranking to match 1 applicant among 10 with varied racial, gender, and sexual orientations.

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Exploring the Role of Cap Grafts in tracheocutaneous fistula Closure. A tracheocutaneous fistula (TCF) is an abnormal connection that forms between the trachea (windpipe) and the skin of the neck. If spontaneous closure does not occur, fibrosis of the surrounding tissue may result in a persistent TCF and in some cases, iatrogenic laryngotracheal stenosis at the level of tracheostoma, the so-called A-frame deformity.

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Objectives: Ineffective esophageal motility (IEM) on high-resolution manometry (HRM) is not consistently associated with specific clinical syndromes or outcomes. We evaluated the prevalence, clinical features, management, and outcomes of pediatric IEM patients across the United States.

Methods: Clinical and manometric characteristics of children undergoing esophageal HRM during 2021-2022 were collected from 12 pediatric motility centers.

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Article Synopsis
  • Many households rely on inefficient biomass burning for cooking, causing $1.6 trillion in health and environmental damages each year.
  • Cleaner alternatives like gas and electricity are often unaffordable or unreliable for these households.
  • The text suggests that completely opposing fossil fuel subsidies ignores the potential benefits of subsidizing gas for cooking to improve health and reduce emissions.
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