Publications by authors named "Ramasubramanian V"

Purpose: This study evaluated the dose fall off and valley dose percentage in pelvic cancer Lattice Radiotherapy (LRT) using various treatment techniques.

Methods: Forty five treatment plans were developed for 15 patients undergoing radiotherapy using a linear accelerator. Plans were categorized into three sets: RapidArc (RA), seven-field intensity-modulated radiation therapy (IMRT), and nine-field IMRT, both for high-dose (HD) vertices and the entire planning target volume (PTV).

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Article Synopsis
  • Genomic prediction (GP) in durum wheat has shown mixed results, with multivariate (MV) analysis emerging as a promising approach to enhance prediction accuracy (PA) for certain traits.
  • The study assessed PA of agronomic traits over two seasons and varying field conditions (high nitrogen/well-watered and low nitrogen/rainfed), applying univariate (UV) and multivariate models with different cross-validation schemes (MV-CV1 and MV-CV2).
  • Results indicated that MV-CV2 significantly improved PA, with some traits experiencing increases of up to 56.72%, especially when modeling related traits together, highlighting the potential of multivariate approaches in genomic prediction.
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There is limited real-world data from India examining the treatment characteristics, safety, and efficacy of ceftazidime-avibactam against Gram-negative organisms especially multidrug-resistant pathogens including carbapenem-resistant  and carbapenem-resistant . In this retrospective study, the real-world treatment patterns, effectiveness, and safety of ceftazidime-avibactam in treating Gram-negative infections were assessed. Data was extracted from electronic health records of adult patients admitted to the hospital with documented Gram-negative infection who had received treatment for at least 48 hours with ceftazidime-avibactam as a part of routine clinical management.

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Background Chronic kidney disease (CKD) is an emerging public health problem in India. Pulmonary hypertension (PH) is an overlooked cardiovascular complication of CKD. This study aimed to estimate the burden of PH among CKD patients undergoing hemodialysis in a selected tertiary care hospital.

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Background: Sepsis claims 1 in 5 lives annually as per global statistics. Sepsis incidence in recent studies represents at least 35 % of all ICU admissions and has a high mortality rate, especially in the presence of co-existing morbidities. The challenge has been to accurately diagnose the causative organism, considering factors such as possible polymicrobial infections, commensals and environmental contaminants.

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Introduction: Pneumococcal diseases pose a significant public health concern in India, with substantial morbidity and mortality, with the elderly and those with coexisting medical conditions being most at risk. Pneumococcus was also seen to be one of the main reasons for co-infection, pneumonia and complications in COVID. Current guidelines recommend vaccination for specific adult populations, but there is a lack of uniformity and guidance on risk stratification, prioritisation and optimal timing.

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Influenza is a significant public health and economic threat around the world. Epidemiological studies have demonstrated a close association between influenza pandemics and cardiovascular mortality. Moreover, it has been shown that there is a decrease in cardiovascular mortality in high-risk patients following vaccination with the influenza vaccine.

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Background: The availability of rapid diagnostic platforms for positive blood cultures has accelerated the speed at which the clinical microbiology laboratory can identify the causative organism and facilitate early appropriate antimicrobial therapy. There is a paucity of data regarding the clinical utility of the blood culture identification 2 (BCID2) panel test and its correlation with phenotypic drug susceptibility testing (DST) in flagged blood culture bottles from intensive care units (ICUs) in countries such as India, which have high rates of multidrug-resistant gram-negative bacteria (MDR-GNB).

Materials And Methods: We conducted a retrospective observational study in a tertiary care ICU on 200 patients above 18 years of age in whom a BCID2 test was ordered when blood cultures flagged positive.

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Objectives: To evaluate the impact of an online educational intervention on improving knowledge of antimicrobial resistance (AMR) and stewardship among final-year medical students in Chennai, India.

Methods: This was a prospective 'before-after' study conducted across 5 medical colleges in Chennai, India. Participants who were final-year (fourth year) undergraduate medical students were administered a pretest to evaluate baseline knowledge.

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Background: There is a scarcity of data regarding nosocomial infections in patients with COVID-19 treated with ECMO. This observational study from India aims to describe the epidemiology and microbiology of infections in patients with COVID-19 associated ECMO.

Methods: This is an ambi-directional observational study of COVID-19 ECMO patients admitted from April 2021 to June 2022 in a tertiary care hospital.

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The aim of this study is to create a single institution-based machine learning model for a dose prediction generation tool for post-operative carcinoma of the tongue cases prospectively. Intensity-modulated radiotherapy (IMRT) plans for 20 patients with carcinoma of the tongue were generated using the Eclipse treatment planning system. A machine learning model was generated using a Python 3.

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Objective: Intracavitary brachytherapy (ICBT) plays an important role in the management of carcinoma of the cervix. This study attempts to find the feasibility of intensity-modulated radiation therapy (IMRT) as a boost for patients who are not suitable for ICBT in order to improve their disease-free and overall survival.

Methods: Twenty patients with carcinoma of the cervix were included in this study.

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Introduction And Background: Rapid molecular diagnostics to predict carbapenem resistance well before the availability of routine drug sensitivity testing (DST) can serve as an antimicrobial stewardship tool in the context of high rates of Carbapenem-resistant (CRE).

Materials And Methods: A retrospective observational study of patients more than 18 years of age on whom Xpert Carba-R (FDA approved for rectal swab specimen) was done on gram-negative bacteria (GNB) flagged blood culture samples, in an Indian intensive care unit between January 2015 and November 2018. We analyzed the performance of Xpert Carba-R in comparison with routine DST.

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Article Synopsis
  • * An Expert Consensus Group discussed the local challenges of HZ epidemiology, the need for increased patient awareness, and the importance of HZ vaccination for better prevention and treatment.
  • * Although the highly effective recombinant zoster vaccine (RZV) is recommended for adults 50 and older in the U.S., it is not currently available in India, highlighting the necessity for a targeted immunization program due to the country's aging population and common risk factors.
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The impact of vaccinating the older population against vaccine-preventable diseases in terms of health, social and economic benefits has been increasingly recognised. However, there is a gap in the utilisation of vaccines worldwide. The population is ageing at an unprecedented pace in the Asia-Pacific (APAC) region, with the number of persons older than 65 years set to double by 2050 to around 1.

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Purpose: This study examined the optical impact of a DF contact lens during near viewing in a sample of habitual DF lens wearing children.

Methods: Seventeen myopic children aged 14 to 18 years who had completed 3 or 6 years of treatment with a DF contact lens (MiSight 1 Day; CooperVision, Inc., San Ramon, CA) were recruited and fit bilaterally with the DF and a single-vision (Proclear 1 Day; CooperVision, Inc.

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  • - This study aimed to assess the clinical profiles of adults with post-COVID multisystem inflammatory syndrome (MIS-A) in a southern India hospital from November 2020 to July 2021.
  • - Nine patients (5 men, average age 40) showed signs of MIS-A, all testing positive for SARS-CoV-2 antibodies while negative for active COVID-19, with common symptoms including fever and gastrointestinal distress.
  • - The majority received corticosteroid treatment, leading to recovery for six patients, while three patients unfortunately did not survive; elevated inflammatory markers were noted, but procalcitonin levels were not useful in distinguishing MIS-A from bacterial infections.
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Streptococcus pyogenes (SP) causes uncomplicated infections of throat & skin to severe life-threatening invasive diseases and poststreptococcal sequelae. Despite being common, it hasn't been studied much in recent times. Data of 93 adult patients >18 years, culture proven (SP) infections from 2016 to 2019 was studied in south India.

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These guidelines discuss the epidemiology, screening, diagnosis, posttransplant prophylaxis, monitoring, and management of endemic infections in solid organ transplant (SOT) candidates, recipients, and donors in South Asia. The guidelines also provide recommendations for SOT recipients traveling to this region. These guidelines are based on literature review and expert opinion by transplant physicians, surgeons, and infectious diseases specialists, mostly from South Asian countries (India, Pakistan, Bangladesh, Nepal, and Sri Lanka) as well as transplant experts from other countries.

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Soybean is grown primarily for the protein and oil extracted from its seed and its value is influenced by these components. The objective of this study was to map marker-trait associations (MTAs) for the concentration of seed protein, oil, and meal protein using the soybean nested association mapping (SoyNAM) population. The composition traits were evaluated on seed harvested from over 5000 inbred lines of the SoyNAM population grown in 10 field locations across 3 years.

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Objective: To establish a framework for implementing antimicrobial stewardship in Indian tertiary care hospitals, and identify challenges and enablers for implementation.

Methods: Over 2018-2021 the Indian Council of Medical Research followed a systematic approach to establish a framework for implementation of antimicrobial stewardship in Indian hospitals. We selected 20 Indian tertiary care hospitals to study the feasibility of implementing a stewardship programme.

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Background: Proposal of an integrated scoring approach assessing the quality of different treatment techniques in a radiotherapy planning comparison. This scoring method incorporates all dosimetric indices of planning target volumes (PTVs) as well as organs at risk (OARs) and provides a single quantitative measure to select an ideal plan.

Materials And Methods: The radiotherapy planning techniques compared were field-in-field (FinF), intensity modulated radiation therapy (IMRT), volumetric modulated arc therapy (VMAT), hybrid IMRT (H-IMRT), and hybrid VMAT (H-VMAT).

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Background: About 20%-30% of persons with major depression are said to have treatment-resistant depression (TRD) when they do not respond to antidepressants. These people continue to suffer in life and have poor quality of life. Although electroconvulsive therapy (ECT) is the most successful option in treating TRD, many people refuse ECT due to various reasons (stigma, the cost involved, and medical complications).

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