Publications by authors named "Gowri Sivaramakrishnan"

Head and neck cancer (HNC) represents a challenging oncological entity with significant morbidity and mortality rates. Despite advances in conventional therapies, including surgery, chemotherapy, and radiation therapy, the overall survival rates for advanced HNC remain suboptimal. In recent years, the emerging field of oncolytic virotherapy has gained attention as a promising therapeutic approach for various malignancies, including HNC.

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Background: Calciphylaxis is a serious, potentially fatal condition resulting in pathological calcification of soft tissues. While associated with chronic kidney disease, data regarding anticoagulant involvement remain limited.

Research Design And Methods: The United States Food and Drug Administration Adverse Event Reporting System (USFDA AERS) database was searched to identify calciphylaxis reports linked to anticoagulants from 2004 to 2024.

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Objectives: Large language models (LLMs) with advanced language generation capabilities have the potential to enhance patient interactions. This study evaluates the effectiveness of ChatGPT 4.0 and Gemini 1.

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Background: Acetaminophen, ibuprofen, and indomethacin are widely used as first-line drugs for patent ductus arteriosus (PDA) closure in preterm neonates. However, their relative safety profiles remain unclear.

Methods: Adverse event reports related to the first-line drugs used in PDA and neonates in general were retrieved from the US Food and Drug Authority (FDA) Adverse Event Reporting System.

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Background: Nicotine replacement therapies (NRTs) are the primary pharmacological option for smokers looking to quit. However, they can lead to oral health issues, including aphthous ulcers, gastric irritation resulting in tooth wear, mouth irritation, soreness, and dryness, which may decrease patient adherence. Dentists should be integrated into the tobacco cessation team to prevent, detect, and manage these oral side effects associated with NRT use.

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Background: Medication review and reconciliation is essential for optimizing drug therapy and minimizing medication errors. Large language models (LLMs) have been recently shown to possess a lot of potential applications in healthcare field due to their abilities of deductive, abductive, and logical reasoning. The present study assessed the abilities of LLMs in medication review and medication reconciliation processes.

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Background: Angiotensin receptor blockers (ARBs) are widely used for treating hypertension and heart failure. Angioedema has been reported as a controversial adverse effect of ARBs and the evidence on individual ARB risks is limited. This study aimed to assess signals of angioedema with different ARBs using the US FDA Adverse Event Reporting System (AERS) database.

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Background: Sodium glucose cotransporter-2 inhibitors (SGLT2is) have gained immense attention for a variety of indications. Limb amputations (LA) and fractures were reported in clinical trials. This network meta-analysis and meta-regression were carried out to quantify the risks of these events.

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Institutional review boards (IRBs) face delays in reviewing research proposals, underscoring the need for optimized standard operating procedures (SOPs). This study assesses the abilities of three artificial intelligence (AI) platforms to address IRB challenges and draft essential SOPs. An observational study was conducted using three AI platforms in 10 case studies reflecting IRB functions, focusing on creating SOPs.

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Objectives: Segmentation of anatomical structures on dento-maxillo-facial (DMF) computed tomography (CT) or cone beam computed tomography (CBCT) scans is increasingly needed in digital dentistry. The main aim of this research was to propose and evaluate a novel open source tool called DentalSegmentator for fully automatic segmentation of five anatomical structures on DMF CT and CBCT scans: maxilla/upper skull, mandible, upper teeth, lower teeth, and the mandibular canal.

Methods: A retrospective sample of 470 CT and CBCT scans was used as a training/validation set.

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Background: The US Food and Drug Administration (USFDA) communicates new drug safety concerns through drug safety communications (DSCs) and medication guides (MGs), which often challenge patients with average reading abilities due to their complexity. This study assesses whether large language models (LLMs) can enhance the readability of these materials.

Methods: We analyzed the latest DSCs and MGs, using ChatGPT 4.

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Introduction: Sodium glucose cotransporter-2 inhibitors (SGLT2is) are an emerging class of drugs with wide indications. Controversial evidence exists regarding the risk of urinary tract infection (UTI) and genital infections (GI) with SGLT2is paving way for undertaking this network meta-analysis and meta-regression study.

Methods: Data from randomized trials evaluating SGLT2is reporting the number of patients with UTI and GI were included.

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Background: Inhalational corticosteroids (ICS) were observed to increase the pneumonia risk in chronic obstructive pulmonary airway disorder (COPD). However, it is unknown whether any differences exist between the drugs within the ICS class.

Aim: This study aimed to evaluate the risk of pneumonia associated with different ICS and identify factors that predict pneumonia in patients with moderate-to-severe COPD using a network meta-analysis.

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Article Synopsis
  • *A comprehensive network meta-analysis evaluated 73 studies and nearly 86,000 participants, showing SGLT2is are linked to a significantly higher risk of DKA compared to placebo.
  • *Key findings highlighted that risk increases with certain SGLT2is and factors like dosage, type of diabetes, and diabetes duration, with moderate certainty in the evidence presented.
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Background: Institutional review boards (IRBs) have been criticised for delays in approvals for research proposals due to inadequate or inexperienced IRB staff. Artificial intelligence (AI), particularly large language models (LLMs), has significant potential to assist IRB members in a prompt and efficient reviewing process.

Methods: Four LLMs were evaluated on whether they could identify potential ethical issues in seven validated case studies.

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Background: The association of asthma with oral conditions such as dental caries, dental erosion, periodontal diseases and oral mucosal changes has been the subject of debate among dental practitioners. Existing evidence indicates that an inhaler is the most common and effective way of delivering the asthma medications directly into the lungs. Few studies in the past attributed this association to the changes in salivary flow caused due to these medications.

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Article Synopsis
  • The study investigates parents' understanding of dental avulsion injuries, emphasizing how immediate care can affect the tooth’s prognosis and overall dental health.
  • A survey conducted among 360 parents revealed that many mistakenly believe they have adequate knowledge about managing avulsed teeth, often opting for harmful methods to store and clean the tooth.
  • The findings highlight a significant knowledge gap among parents, indicating a critical need for educational initiatives to ensure they receive accurate information on proper avulsion management.
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Objectives: Healthcare-related information sharing via social media is on the rise following the coronavirus disease 2019 (COVID-19) pandemic. Dental practices primarily use social media to search, share, and communicate health-related information. Considering the increasing trend of using social media, the primary aim of the present study was to identify the use of social media by dentists and laypeople to post and view dentistry-related content in Bahrain.

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Objectives: Intrapleural thrombolytics have been trialed for facilitating pleural fluid drainage in patients with complicated parapneumonic effusion. The present study is a network metaanalysis of randomized clinical trials (RCTs) that have evaluated these thrombolytics.

Methods: Electronic databases (Medline, Cochrane CENTRAL, and Google Scholar) were searched for appropriate RCTs evaluating the therapeutic effect of thrombolytics in patients with complicated parapneumonic effusion.

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Background: Aerosols and spatter are generated in a dental clinic during aerosol-generating procedures (AGPs) that use high-speed hand pieces. Dental healthcare providers can be at increased risk of transmission of diseases such as tuberculosis, measles and severe acute respiratory syndrome (SARS) through droplets on mucosae, inhalation of aerosols or through fomites on mucosae, which harbour micro-organisms. There are ways to mitigate and contain spatter and aerosols that may, in turn, reduce any risk of disease transmission.

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Background: Nicotine replacement therapy is the first choice pharmacotherapy for smoking cessation. Oral side effects caused due to NRT lead to discontinuation of treatment. The objective of this meta-analysis was to look for the certainty of evidence on the number of patients that reported oral side effects due to the use of NRT.

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Background: 20-80% of adults presenting to a dental clinic experience anxiety. Negative past dental experiences and environmental factors such as the waiting area of a dental clinic or sound of a drill are commonly considered triggering factors for anxiety. Anxiety management strategies are considered a part of routine dental procedure, due to increased prevalence and compromised patient care.

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COVID-19 poses a challenge beyond the virus itself, in that lockdown has been associated increased use of the internet and social media. Disinformation about prevention and treatment strategies for COVID-19 can have lethal consequences. The United States Food and Drug Administration (USFDA) is currently monitoring the compliance of manufacturing firms as well as medicinal product advertisers to the Federal Food, Drug, and Cosmetic Act, 21 USC § 321(h) regulations.

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Background: Adult obesity has been associated with various systemic diseases and is an increasing problem in Bahrain. Recent evidence indicates a correlation between adult obesity and periodontitis. Hence the aim of this study was to assess the prevalence of periodontitis in overweight/obese adults in Bahrain and to determine the factors associated with periodontitis in these obese adults.

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