Publications by authors named "Kiran T"

Background: People experiencing homelessness are at increased risk of contracting SARS-CoV-2 and of severe complications of COVID-19. Vaccination is promoted as a key strategy to protect against severe illness from SARS-CoV-2 infection, but rates of vaccination among people experiencing homelessness are lower than the general population. Studies suggest lower uptake is a result of vaccine hesitancy, but few theoretically engage with the structural drivers of vaccine hesitancy.

View Article and Find Full Text PDF

Organophosphorus poisoning poses a significant health threat, often resulting in high mortality and disability. The intermediate syndrome, characterized by muscle weakness in neck flexors and limbs, is prevalent. While uncommon, cases of vocal cord paralysis have been observed.

View Article and Find Full Text PDF

Purpose: Primary care access is a key health system metric, but little research has compared models to provide primary care access when one's regular physician is not available. We compared health system use after a visit with a patient's own family physician group (ie, within-group physician who was not the patient's primary physician) vs a visit with a walk-in clinic physician who was not part of the patient's family physician group.

Methods: We conducted a population-based, retrospective cohort study using administrative data from Ontario, Canada, including all individuals formally enrolled with a family physician, from April 1, 2019 to March 31, 2020.

View Article and Find Full Text PDF
Article Synopsis
  • - An audit tool named AmPAT was created to evaluate how well generalist doctors prescribe antimicrobials in outpatient settings, aiming to curb antimicrobial resistance (AMR).
  • - The tool's development involved four phases, including expert feedback and a pilot study, ultimately confirming high validity and reliability through various statistical measures.
  • - AmPAT includes 19 assessment items across three categories (patient, clinical, and treatment details) and demonstrates strong inter-rater agreement and internal consistency for rational prescribing practices.
View Article and Find Full Text PDF
Article Synopsis
  • Musculoskeletal disorders (MSDs) significantly impact global disability, accounting for 17% of years lived with dysfunction, highlighting the need for understanding risk factors for diagnosis and care.
  • The study assessed MSD prevalence in Indian adults over 45, finding that over half (53.5%) have MSDs, particularly affecting females and those over 60, with joint pain being most common.
  • Key risk factors associated with MSDs include certain occupations, pre-obesity, hypertension, and vigorous physical activity, while tailored interventions could improve musculoskeletal health by addressing modifiable factors like smoking and workplace risks.
View Article and Find Full Text PDF
Article Synopsis
  • The study aimed to compare family physicians working in walk-in clinics with those providing long-term care in Ontario, focusing on their characteristics and patient demographics.
  • The research linked a 2019 physician survey with health care data, revealing differences such as a higher percentage of male physicians and a diverse language background among walk-in clinic practitioners.
  • Results showed that walk-in clinic physicians typically served younger, less frequently seeking patients, many of whom were from diverse backgrounds and often attached to other family physicians.
View Article and Find Full Text PDF
Article Synopsis
  • - Male postpartum depression is common but under-researched, especially concerning effective treatments in low-income areas; this study investigated a specific intervention called Learning Through Play Plus Dads (LTP + Dads) for improving male mental health in Karachi, Pakistan.
  • - The study involved 357 fathers diagnosed with major depressive episodes, who were randomly assigned to either the LTP + Dads intervention or standard treatment; it measured various outcomes including depression, anxiety, and parenting stress over a 4 to 6 month period.
  • - Results showed that fathers who participated in the LTP + Dads intervention had significantly greater improvements in their depression symptoms compared to those receiving usual treatment.
View Article and Find Full Text PDF
Article Synopsis
  • - Pseudoxanthoma elasticum (PXE) is a rare connective tissue disease that impacts the formation of elastic fibers, which can complicate surgical procedures like revascularization in affected patients.
  • - A notable case involved a 43-year-old man with PXE and coronary artery disease who had successful off-pump coronary artery bypass graft (CABG) surgery using the left internal mammary artery (LIMA) to the left anterior descending (LAD) artery.
  • - This case represents the first occurrence of off-pump surgery for PXE in the UK and the second recorded in medical literature, suggesting a need for further research to establish standardized surgical practices for PXE patients.
View Article and Find Full Text PDF
Article Synopsis
  • Breastfeeding is critically important for infants, yet over half of Indian mothers experience delays in initiating it, often influenced by the type of delivery.
  • This study analyzed data from over 106,000 mothers to examine the link between institutional delivery and breastfeeding delays, considering various socioeconomic factors like age, education, and wealth.
  • Findings revealed that older mothers, those without formal education, and those from poorer or rural backgrounds faced the highest delays, while institutional delivery was associated with lower odds of initiation delays.
View Article and Find Full Text PDF
Article Synopsis
  • The study focuses on cardiovascular disease (CVD) risk management in India, emphasizing the importance of understanding risk factors, particularly hypertension, in a younger population in resource-limited settings.
  • Using data from the Longitudinal Ageing Study in India, researchers calculated 10-year CVD risk scores for adults aged 45 and older, taking into account factors like socio-demographics, exercise, and history of diabetes.
  • Results indicated that 68.8% of participants had a CVD risk score under 10%, with higher risks associated with being rural, poorer, and less educated, while urban dwellers and those who exercised regularly showed decreased risk.
View Article and Find Full Text PDF

Background: Variable benefits have been reported from the adjunctive use of simvastatin and the 5HT3 receptor antagonist, ondansetron, in patients with schizophrenia. We investigated their independent efficacy and possible synergy to improve negative symptoms of schizophrenia within a single trial.

Methods: A 6-month, randomised, double-blind, placebo-controlled trial with a 4-arm, 2 × 2 factorial design, in three centres in Pakistan.

View Article and Find Full Text PDF

The COVID-19 pandemic significantly impacted primary care, but its effect on quality of care is not well understood. We used health administrative data to understand the changes in quality-of-care measures for primary care between October 2018 and April 2022. We examined the following domains: cancer screening, chronic disease (diabetes) management, high-risk prescribing, continuity of care and capacity of primary care services.

View Article and Find Full Text PDF

Microglia are immune cells that play important roles in the formation of the innate immune response within the central nervous system (CNS). The NOD-like receptor family pyrin domain-containing 3 (NLRP3) inflammasome is a multiple protein complex that is crucial for innate immunity, and excessive activation of the inflammasome for various reasons contributes to the pathogenesis of neurodegenerative diseases (NDs). β-adrenoceptor agonists have become the focus of attention in studies on NDs due to the high synthesis of β-adrenoceptors in the central nervous system (CNS).

View Article and Find Full Text PDF

: Heat shock proteins (HSPs) are stress proteins. The endogenous nitric oxide (NO) synthase inhibitor asymmetric dimethyl arginine (ADMA) is a mediator of endothelial dysfunction. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus causes endothelial dysfunction and coagulopathy through severe inflammation and oxidative stress.

View Article and Find Full Text PDF

Background: Eating disorders (EDs) are serious mental health conditions that affect a person physically and psychologically. In the past, EDs were only recognized as a cultural phenomenon/societal by-product of the West. However, research evidence marks its presence in non-western countries also, including South Asia.

View Article and Find Full Text PDF

Triggering receptors expressed on myeloid cells-1 (TREM-1) are transmembrane molecules expressed in cells of the immune system. Activation of TREM-1 leads to the release of pro-inflammatory mediators, which act as amplifiers of inflammation and thereby contribute to the pathogenesis of various diseases, whether inflammatory or not. This study explored the role of TREM-1 in the etiopathogenic context of fibromyalgia syndrome (FMS) and its association with disease activity.

View Article and Find Full Text PDF

Rationale: A common strategy to reduce COPD readmissions is to encourage patient follow-up with a physician within 1 to 2 weeks of discharge, yet evidence confirming its benefit is lacking. We used a new study design called target randomized trial emulation to determine the impact of follow-up visit timing on patient outcomes.

Methods: All Ontario residents aged 35 or older discharged from a COPD hospitalization were identified using health administrative data and randomly assigned to those who received and did not receive physician visit follow-up by within seven days.

View Article and Find Full Text PDF

Background: Limited interventions exist on reducing unwanted screen time (ST) among children from low- and middle-income countries (LMICs), so we developed and assessed the effectiveness of the program to lower unwanted media screen time (PLUMS) among children aged 2-5 years in Chandigarh, Union Territory, North India.

Methods: An open-label randomized control parallel group trial per CONSORT guidelines was conducted among randomly selected 340 families with children aged 2-5 (±3 months) years in Chandigarh, India. PLUMS was implemented at the family level with a focus on modifying the home media environment and targeted individual-level interventions using parent and child modules for 2 months.

View Article and Find Full Text PDF

Evidence has shown that parenting intervention programmes improve parental knowledge, attitudes, and practices, which helps in promoting child development. This study aims to examine the effectiveness of parenting intervention in improving child behaviours. This is a secondary analysis of data from a cluster-randomised controlled trial with depressed mothers aged 18-44 years with a child aged 0 to 36 months.

View Article and Find Full Text PDF

Background: The most important prognostic parameter is staging in colorectal cancers, and tumor budding (TB) is among the independent prognostic parameters that are increasing in significance. Cyclin D1 expression has been associated with poor prognosis as a marker of various tumors.

Aims And Objectives: In this study, the aim was to determine the activity of cyclin D1 in colon adenocarcinomas, tumors, and tumor buds and to compare the results with prognostic parameters.

View Article and Find Full Text PDF

Background: Through medicare, residents in Canada are entitled to medically necessary physician services without paying out of pocket, but still many people struggle to access primary care. We conducted a survey to explore people's experience with and priorities for primary care.

Methods: We conducted an online, bilingual survey of adults in Canada in fall 2022.

View Article and Find Full Text PDF
Article Synopsis
  • High-quality primary care leads to better health outcomes, yet the decline in primary care attachment and access has led many patients to rely on walk-in clinics for their health needs.
  • A study involving interviews with 19 walk-in physicians in Ontario revealed significant professional tension due to limited capacity for providing continuous and comprehensive care.
  • The findings highlighted a lack of resources and support for walk-in physicians, leading to confusion in patient care responsibilities and variations in the quality of care provided.
View Article and Find Full Text PDF

: Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory disease characterized by acute exacerbations. Systemic inflammation and oxidative stress play an important role in the pathogenesis of COPD. Exacerbations in COPD reduce the quality of life and are associated with rapid disease progression.

View Article and Find Full Text PDF

Background And Objectives: We compared experiences of patients who reported usually being seen by a resident with those usually seen by a staff physician.

Methods: We analyzed responses to a patient experience survey distributed at 13 family medicine teaching practices affiliated with the University of Toronto between May and June 2020. We analyzed responses to seven questions pertaining to timely access, continuity, and patient-centeredness.

View Article and Find Full Text PDF