Publications by authors named "Ragavan M"

Adolescent relationship abuse (ARA) has significant sequelae and is more prevalent among sexual and gender-diverse youth (SGDY). Increased parental involvement and communication has been linked to decreased prevalence of ARA and associated health risks. Parents of SGDY may have unique needs and experiences regarding communicating with their children about ARA, yet little research has examined this area.

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The Child Opportunity Index (COI) is a validated measurement that uses a composite index of 29 indicators of social determinants of health linked to the US Census. Patients post-Fontan palliation for single ventricle physiology often have reduced exercise capacity compared to the general population. Our hypothesis is that COI levels are directly associated with exercise capacity and inversely with late outcomes.

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Article Synopsis
  • The study aimed to compare the surgical outcomes of vesicovaginal fistula (VVF) repair using the Hugo RAS Medtronic robot and the da Vinci Xi robot.
  • Both robotic systems were evaluated in a non-randomized manner, focusing on patient demographics, operative details, complications, and postoperative outcomes.
  • Results showed similar mean operative times and blood loss for both robots, with minimal complications, indicating that both systems are effective and safe for VVF repair.
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  • The study examines the link between the Child Opportunity Index (COI) and the management and outcomes of pediatric supraventricular tachycardia (SVT), focusing on ablation use over a 5.5-year period.
  • Researchers analyzed data from 306 SVT patients, finding that those with a low COI had significantly higher rates of hospital admissions compared to those with a high COI, but there was no difference in ablation utilization or outcomes across COI categories.
  • The results suggest that while social determinants, indicated by COI, may influence hospital resource use, they have a limited effect on treatment effectiveness for SVT patients.
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  • Pelvic organ prolapse (POP) is prevalent among women over 50, with sacrocolpopexy being a common surgical treatment, though it can lead to complications like bowel dysfunction and urinary incontinence.
  • This study compares the outcomes of robotic sacrocolpopexy and ileopectopexy, analyzing data from 35 patients who underwent these procedures between 2021 and 2023.
  • Results indicated that ileopectopexy had no complications compared to sacrocolpopexy, which had some bowel issues, suggesting that ileopectopexy could be a safer alternative, although further research is necessary to confirm these results.
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Introduction: This study evaluates the safety and feasibility of the Medtronic Hugo robot-assisted surgery (RAS) system in gynecological and urogynecological procedures. Through a retrospective analysis of prospectively collected data from the first 100 surgeries performed at Apollo Hospitals Chennai, we aim to provide insights into the system's effectiveness, including outcomes, complications, and overall surgical efficiency in major gynecological and urogynecological operations.

Methods: A single experienced robotic surgeon conducted the surgeries, including hysterectomies (n=66).

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To explore pediatricians' perspectives on supporting intimate partner violence (IPV) survivors, including (a) clinical practices and resource use, (b) ideal resources, and (c) barriers to the use of existing resources, we conducted dyadic and individual virtual interviews with pediatricians recruited through Twitter and the American Academy of Pediatrics Council, section, and chapter listservs. The interviews were approximately 60 minutes in length, audio recorded, and transcribed verbatim. We used a thematic analysis approach and hybrid deductive-inductive coding.

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Purpose: Teen economic abuse (TEA) is an understudied form of adolescent relationship abuse with limited measures available to assess prevalence. The purpose of this article is to assess the underlying dimensions of survey items (developed with youth) to refine measurement of and validate the structures comprising TEA and examine differences in prevalence of TEA perpetration (Prp) and victimization (Vct) by demographic characteristics.

Methods: This cross-sectional, online survey was conducted between July and September 2021.

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Article Synopsis
  • - Adolescent relationship abuse (ARA) is common among Latine youth, yet research on cultural and structural factors affecting their experiences is scarce, particularly regarding the role of parental influence.
  • - This study explored the connections between acculturation, discrimination, and differences in these factors between adolescents and their parents, using matched surveys from 182 adolescent-parent pairs in Pittsburgh and Kansas City.
  • - Findings revealed that higher conflict in adolescent acculturation led to lower ARA victimization, while increased discrimination was linked to higher rates of both victimization and perpetration; greater differences in acculturation and discrimination between adolescents and parents also correlated with higher ARA incidents.
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Introduction: The aim of this study was to determine the associations between type 2 diabetes or prediabetes and loneliness and related social experiences in young adults, a population at increasingly high risk of type 2 diabetes.

Methods: This was a cross-sectional analysis using data from adults aged 18-35 years enrolled in the All of Us Research Program. Exposures included loneliness, social support, discrimination, neighborhood social cohesion, and stress, measured by standardized surveys.

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  • Climate change is making health problems worse for kids, especially those with asthma, because of things like heat, pollution, and mold.
  • A study found that most caregivers (78%) are really worried about how climate change affects their children's health and believe it's causing more asthma issues.
  • Caregivers think it's important to talk about these health risks with their child's doctor, but there are some challenges in having those conversations.
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Introduction: Patients with advanced ALK-positive NSCLC typically have poor response to immunotherapy; the benefit of consolidation durvalumab in patients with unresectable stage III ALK-positive NSCLC remains unclear. Herein, we compare the efficacy and safety of consolidation ALK tyrosine kinase inhibitor (TKI) versus durvalumab or observation after concurrent chemoradiation.

Methods: We conducted a retrospective study using a multicenter study of 17 institutions globally.

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Metabolic dysfunction-associated steatotic liver disease (MASLD) prevalence is increasing annually and affects over a third of US adults. MASLD can progress to metabolic dysfunction-associated steatohepatitis (MASH), characterized by severe hepatocyte injury, inflammation, and eventual advanced fibrosis or cirrhosis. MASH is predicted to become the primary cause of liver transplant by 2030.

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Purpose: Circulating tumor DNA (ctDNA) testing has become a promising tool to guide first-line (1L) targeted treatment for advanced non-small cell lung cancer (aNSCLC). This study aims to estimate the clinical validity (CV) and clinical utility (CU) of ctDNA-based next-generation sequencing (NGS) for oncogenic driver mutations to inform 1L treatment decisions in aNSCLC through a systematic literature review and meta-analysis.

Methods: A systematic literature search was conducted in PubMed/MEDLINE and Embase to identify randomized control trials or observational studies reporting CV/CU on ctDNA testing in patients with aNSCLC.

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Purpose: Sexual and gender diverse youth (SGDY) are at greater risk for adolescent relationship abuse (ARA) than cisgender heterosexual youth, but there are not enough evidence-based interventions for reducing ARA among SGDY. We piloted online human-centered design (HCD) methodology to engage SGDY in generating ARA intervention ideas. This study evaluated the acceptability, appropriateness, and feasibility of the online methods and identified SGDY-derived intervention ideas for reducing ARA.

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Economic abuse is one form of intimate partner violence (IPV) intended to control a survivor's ability to make, save, or spend money to gain power over them. Perinatal people may be more vulnerable to economic abuse due to changes in employment and finances. This study's aims were to explore how economic abuse manifests among pregnant and parenting survivors and how best to support pregnant and parenting survivors of economic abuse.

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The coronavirus disease 2019 pandemic was a public health emergency that impacted adolescents across the United States and disproportionately affected youth experiencing marginalization due to less access to resources and supports. This study reviews the increases in intimate partner and youth violence during the pandemic, mechanisms contributing to these increases, and the overarching health impacts on adolescents. Pediatric health professionals have a vital role to play in implementing healing-centered practices and prevention efforts that mitigate impacts of trauma and violence and that support youth and families in pathways to healing and recovery.

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Paraurethral leiomyoma is an exceptionally rare benign smooth muscle tumor adjacent to the female urethra, presenting diagnostic challenges due to nonspecific symptoms like urinary obstruction and dysuria. This case report details the clinical presentation, diagnostic workup, and surgical management of a 45-year-old woman with a paraurethral leiomyoma. Diagnosis involved clinical examination, imaging, and biopsy.

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Background: Recent pediatric guidelines recommend clinicians offer anti-obesity medication (AOM) as an adjunct to intensive lifestyle intervention.

Objective: To investigate pediatricians' perspectives about prescribing AOM, including barriers and facilitators.

Methods: An investigator-developed survey was emailed to primary care pediatric physicians (n = 187) and advanced practice providers (n = 190) within an academic-affiliated network.

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