Publications by authors named "Pisharody S"

Purpose: Transatlantic guidelines endorse quality metrics for timely reperfusion in patients with ST-elevation myocardial infarction (STEMI). Compliance in low- and middle-income countries (LMICs) is largely unknown.

Study Design: We prospectively evaluated 2928 STEMI patients in Kerala, India, across 16 PCI-capable hospitals who received reperfusion with either primary percutaneous coronary intervention (PPCI) or fibrinolysis.

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Background: Heart failure (HF) management is often challenging due to poor adherence to GDMT and self-care. Continuous monitoring of patients by a dedicated care manager may enhance adherence to self-care and treatment and prevent hospitalisations. For the adoption and acceptance of a collaborative care model (CCM) for HF management in Indian settings, understanding the perspectives of all stakeholders regarding its various components and feasibility is needed.

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Heart failure (HF) is a debilitating condition associated with enormous public health burden. Management of HF is complex as it requires care-coordination with different cadres of health care providers. We propose to develop a team based collaborative care model (CCM), facilitated by trained nurses, for management of HF with the support of mHealth and evaluate its acceptability and effectiveness in Indian setting.

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Background: Sex-based differences have been found in outcomes following ST-segment myocardial infarction (STEMI). Studies assessing sex-based differences in STEMI among Indian patients have reported conflicting results.

Methods: A prospective multicenter registry of consecutive patients with STEMI who presented to percutaneous coronary intervention (PCI)-capable hospitals in the Indian state of Kerala between June 2013 and March 2017 was used to assess 1-year outcomes.

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Article Synopsis
  • Q fever and spotted fever group rickettsioses (SFGR) are prevalent in northern Tanzania, causing significant severe febrile illnesses and necessitating incidence estimates to understand their impact.
  • A study evaluated cases from 2007 to 2008 and 2012 to 2014 at referral hospitals using serology tests to determine the incidence of these diseases.
  • Findings revealed that the annual incidence estimates were notably high for both Q fever (80 and 56 cases per 100,000) and SFGR (147 and 75 cases per 100,000) across the two periods, highlighting the need for improved control measures in the region.
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Community-onset bloodstream infections (CO-BSI) are major causes of severe febrile illness and death worldwide. In light of new data and the growing problem of antimicrobial resistance (AMR) among pathogens causing BSI, we undertook a systematic review of hospital-based studies of CO-BSI among patients hospitalized with fever. Without restriction to language or country, we searched PubMed, Web of Science, and Scopus for prospective hospital-based studies of culture-confirmed CO-BSI among febrile inpatients.

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Objectives: Hospital-based studies of community-onset bloodstream infections (CO-BSI) are less resource-intensive to carry out than population-based incidence studies. We examined several metrics capturing the potential role of Salmonella Typhi as a cause of CO-BSI for making inferences about incidence.

Methods: We systematically reviewed three databases for hospital-based studies of CO-BSI.

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Background: ST-elevation myocardial infarction (STEMI) continues to be a major cause of cardiovascular mortality in Kerala, India. Timely primary percutaneous coronary intervention (PCI) is the recommended reperfusion strategy for STEMI. There is limited data on the safety, effectiveness, equity and efficiency of regional primary PCI services in India.

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Purpose: Training in Interventional Radiology currently uses the apprenticeship model, where clinical and technical skills of invasive procedures are learnt during practice in patients. This apprenticeship training method is increasingly limited by regulatory restrictions on working hours, concerns over patient risk through trainees' inexperience and the variable exposure to case mix and emergencies during training. To address this, we have developed a computer-based simulation of visceral needle puncture procedures.

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Palpation is a widely used diagnostic method in medical practice. The sensitivity of palpation is highly dependent upon the skill of clinicians, which is often difficult to master. There is a need of simulators in palpation training.

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Introduction: Bone mineral density (BMD) is currently the preferred surrogate for bone strength in clinical practice. Finite element analysis (FEA) is a computer simulation technique that can predict the deformation of a structure when a load is applied, providing a measure of stiffness (N mm(-1)). Finite element analysis of X-ray images (3D-FEXI) is a FEA technique whose analysis is derived from a single 2D radiographic image.

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Unlabelled: Generalized Procrustes analysis and thin plate splines were employed to create an average 3D shape template of the proximal femur that was warped to the size and shape of a single 2D radiographic image of a subject. Mean absolute depth errors are comparable with previous approaches utilising multiple 2D input projections.

Introduction: Several approaches have been adopted to derive volumetric density (g cm(-3)) from a conventional 2D representation of areal bone mineral density (BMD, g cm(-2)).

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Areal bone mineral density (aBMD) is the most common surrogate measurement for assessing the bone strength of the proximal femur associated with osteoporosis. Additional factors, however, contribute to the overall strength of the proximal femur, primarily the anatomical geometry. Finite element analysis (FEA) is an effective and widely used computer-based simulation technique for modelling mechanical loading of various engineering structures, providing predictions of displacement and induced stress distribution due to the applied load.

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Recent years have seen a significant increase in the use of Interventional Radiology (IR) as an alternative to open surgery. A large number of IR procedures commences with needle puncture of a vessel to insert guidewires and catheters: these clinical skills are acquired by all radiologists during training on patients, associated with some discomfort and occasionally, complications. While some visual skills can be acquired using models such as the ones used in surgery, these have limitations for IR which relies heavily on a sense of touch.

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Coherent short-pulse laser excitation has been used to control the approximate energy and relative proximity of two valence electrons within the same alkaline-earth atom, thereby providing insight into the dynamical evolution of a three-body Coulomb system. Our time-domain experiments enable direct experimental study of the electron dynamics at the classical limit of a two-electron atom. As an example, we look at the mechanism of autoionization for one two-electron configuration class and find that the doubly excited atom decays through a single violent electron-electron collision rather than a gradual exchange of energy between the electrons.

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Picosecond laser pulses have been used to sequentially photoionize both valence electrons from neutral Ba atoms, producing two radially localized continuum wave packets. The Coulomb interaction between the two outgoing electrons can result in the recapture of one of the electrons by the parent ion. The energy distribution of Rydberg ions formed via this "post-collision" interaction is measured as a function of the delay between the ionizing laser pulses.

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The wheat straw, an inedible biomass that can be continuously produced in a space vehicle has been used to produce activated carbon for effective control of NOx emissions from the incineration of wastes. The optimal carbonization temperature of wheat straw was found to be around 600 degrees C when a burnoff of 67% was observed. The BET surface area of the activated carbon produced from the wheat straw reached as high as 300 m2/g.

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The use of the activated carbon produced from rice hulls to control NOx emissions for future deep space missions has been demonstrated. The optimal carbonization temperature range was found to be between 600 and 750 degrees C. A burnoff of 61.

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Considerable evidence exists to support the hypothesis that human-generated wastes can be utilized as resources in crop production. In the waste mix from a Closed Ecological Life Support System (CELSS), the elemental resources are found mainly in the solid fraction. In order to make these resources available for crop growth, it is necessary to convert the solid wastes to either an aqueous or a gaseous phase.

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The signal transduction and activator of transcription (Stat) gene family has been highly conserved throughout evolution. Gene duplication and divergence has produced 7 mammalian Stat genes, each of which mediates a distinct process. While some Stat proteins are activated by multiple cytokines, Stat2 is highly specific for responses to type I interferon.

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Life support technologies are being developed for long-duration space missions at NASA Ames Research Center as part of the Controlled Ecological Life Support System (CELSS) Program. The primary goal of the CELSS Program is to develop small-scale ecological systems, a CELSS, that mimic ecological systems on Earth. This small-scale replica CELSS can provide all of the necessary life support functions and recycle nearly 100% of the waste products.

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The tyrosine kinase JAK1 and the transcription factors STAT1 and STAT3 are phosphorylated in response to epidermal growth factor (EGF) and other growth factors. We have used EGF receptor-transfected cell lines defective in individual JAKs to assess the roles of these kinases in STAT activation and signal transduction in response to EGF. Although JAK1 is phosphorylated in response to EGF, it is not required for STAT activation or for induction of the c-fos gene.

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N-Methylnitrosourea (NMU)-induced codon 12 Ki-ras mutations were analyzed in premalignant thymic lymphomas from C57BL/6J mice by using a selective polymerase chain reaction amplification strategy. The frequency of codon 12 Ki-ras mutations was 67% (16 of 24) in NMU-treated animals with premalignant stage I disease. Previously, animals with different stages of disease had been analyzed for cytogenetic changes and for mutations in the p53 tumor suppressor gene.

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The distinct pattern of transcriptional responses of cells to different extracellular signals requires a signal transduction pathway that provides rapid, accurate, and faithful transmission of information from the cell surface to the nucleus. One mechanism exploited by many cytokines, exemplified by interferons (IFN) but also used by many interleukins and growth factors, uses a family of cytoplasmic transcription factors that are activated by tyrosine phosphorylation. Once phosphorylated by receptor-associated tyrosine kinases, these proteins assemble into multimeric transcription factors, translocate to the nucleus, and bind specific DNA sequence elements in the promoters of target genes.

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We analysed 31 non-glioblastoma astrocytomas for alterations in p53 protein expression and for mutations in the p53 gene. Immunohistochemistry detected p53 protein accumulation in 71% (five of seven) of juvenile pilocytic astrocytomas (WHO grade I), 63% (five of eight) of astrocytomas (WHO grade II), and 63% (10 of 16) of anaplastic astrocytomas (WHO grade III). The single strand conformation polymorphism (SSCP) assay of exons 2-11 of the p53 gene and direct DNA sequencing identified p53 mutations in 14% (one of seven) of grade I, 25% (two of eight) of grade II, and 19% (three of 16) of grade III astrocytomas.

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