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Anilkumar T, Parameswaran S, Kurup A, Aswin Ganesh M, Abhishek V, Marthanda Pillai A. Idiopathic central sleep apnea with periodicity presenting as Cheyne-Stokes breathing – Case report. Ro J Neurol 2022. [DOI: 10.37897/rjn.2022.2.15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Cheyne-Stokes breathing (CSB) is described by a cyclic variation in breathing with periods of central apneas or hypopneas alternating with periods of hypopneas in a gradual waxing and waning manner. It is usually seen in patients with congestive cardiac failure or neurologic disorders. We describe this rare case of idiopathic central sleep apnea coming in a periodic fashion presenting as CSB pattern without specific causes. Overnight polysomnography test showed central sleep apnea; but cardiac evaluation and magnetic resonance imaging of the brain could not find any cause of this sleep-disordered breathing. Idiopathic central sleep apnea usually presents with poor quality of sleep, but many of them easily misdiagnosed and do not get any proper treatment.
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Fazaludeen Koya S, Lordson J, Khan S, Kumar B, Grace C, Nayar KR, Kumar V, Pillai AM, Sadasivan LS, Pillai AM, Abdullah AS. Tuberculosis and Diabetes in India: Stakeholder Perspectives on Health System Challenges and Opportunities for Integrated Care. J Epidemiol Glob Health 2022; 12:104-112. [PMID: 35006580 PMCID: PMC8907360 DOI: 10.1007/s44197-021-00025-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 12/03/2021] [Indexed: 12/02/2022] Open
Abstract
Background India has a dual burden of tuberculosis (TB) and diabetes mellitus (DM). Integrated care for TB/DM is still in the early phase in the country and can be considerably enhanced by understanding and addressing the challenges identified from stakeholders’ perspectives. This study explored the challenges and opportunities at individual, health system and policy level for integrated care of TB/DM comorbidities in India. Methods We used an outlier case study approach and conducted stakeholder interviews and focus group discussions with relevant program personnel including field staff and program managers of TB and DM control programs as well as officials of partners in Indian states, Kerala and Bihar. Results The integrated management requires strengthening the laboratory diagnosis and drug management components of the two individual programs for TB and DM. Focused training and sensitization of healthcare workers in public and private sector across all levels is essential. A district level management unit that coordinates the two vertical programs with a horizontal integration at the primary care level is the way forward. Substantial improvement in data infrastructure is essential to improve decision-making process. Conclusion Bi-directional screening and management of TB/DM comorbidities in India requires substantial investment in human resources, infrastructure, drug availability, and data infrastructure.
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Affiliation(s)
- Shaffi Fazaludeen Koya
- Global Institute of Public Health, Trivandrum, Kerala, India.,Boston University School of Public Health, Boston, MA, USA
| | - Jinbert Lordson
- Global Institute of Public Health, Trivandrum, Kerala, India.,Ananthapuri Hospitals and Research Institute, Trivandrum, Kerala, India
| | - Salman Khan
- Global Institute of Public Health, Trivandrum, Kerala, India
| | - Binod Kumar
- Independent Public Health Consultant, Patna, Bihar, India
| | - Chitra Grace
- Global Institute of Public Health, Trivandrum, Kerala, India
| | | | - Vinod Kumar
- Global Institute of Public Health, Trivandrum, Kerala, India
| | - Anand M Pillai
- Global Institute of Public Health, Trivandrum, Kerala, India.,Ananthapuri Hospitals and Research Institute, Trivandrum, Kerala, India
| | - Lal S Sadasivan
- Global Institute of Public Health, Trivandrum, Kerala, India
| | - A Marthanda Pillai
- Global Institute of Public Health, Trivandrum, Kerala, India.,Ananthapuri Hospitals and Research Institute, Trivandrum, Kerala, India
| | - Abu S Abdullah
- Global Health Research Center, Duke Kunshan University, Kunshan, Jiangsu, China.
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Nair AT, Nayar KR, Koya SF, Abraham M, Lordson J, Grace C, Sreekumar S, Chembon P, Swarnam K, Pillai AM, Pandey AK. Social media, vaccine hesitancy and trust deficit in immunization programs: a qualitative enquiry in Malappuram District of Kerala, India. Health Res Policy Syst 2021; 19:56. [PMID: 34380514 PMCID: PMC8356375 DOI: 10.1186/s12961-021-00698-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 02/10/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND With increased penetration of the internet and social media, there are concerns regarding its negative role in influencing parents' decisions regarding vaccination for their children. It is perceived that a mix of religious reasons and propaganda by anti-vaccination groups on social media are lowering the vaccination coverage in Malappuram district of Kerala. We undertook a qualitative study to understand the factors responsible for generating and perpetuating vaccine hesitancy, the pathways of trust deficit in immunization programs and the interaction between various social media actors. METHODS In-depth interviews and focus group discussions were conducted among parents/caregivers, physicians, public sector health staff, alternative system medical practitioners, field healthcare workers and teachers in areas with highest and lowest vaccination coverage in the district, as well as with communication experts. RESULTS The trust deficit between parents/caregivers and healthcare providers is created by multiple factors, such as providers' lack of technical knowledge, existing patriarchal societal norms and critical views of vaccine by naturopaths and homeopaths. Anti-vaccine groups use social media to influence caregivers' perceptions and beliefs. Religion does not appear to play a major role in creating vaccine resistance in this setting. CONCLUSIONS A long-term, multipronged strategy should be adopted to address the trust deficit. In the short to medium term, the health sector can focus on appropriate and targeted vaccine-related communication strategies, including the use of infographics, soft skills training for healthcare workers, technical competency improvement through a mobile application-based repository of information and creation of a media cell to monitor vaccine-related conversations in social media and to intervene if needed.
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Affiliation(s)
- Anoop T. Nair
- Primary Health Center Chaliyar, Department of Health, Malappuram, Kerala India
| | | | - Shaffi Fazaludeen Koya
- Global Institute of Public Health, Trivandrum, Kerala India
- grid.189504.10000 0004 1936 7558Boston University School of Public Health, Boston, MA USA
- grid.415696.9Ministry of Health, Al Taif, Makkah, Saudi Arabia
| | - Minu Abraham
- Global Institute of Public Health, Trivandrum, Kerala India
| | | | - Chitra Grace
- Global Institute of Public Health, Trivandrum, Kerala India
| | | | - Priya Chembon
- Global Institute of Public Health, Trivandrum, Kerala India
| | - Kamala Swarnam
- grid.496580.6Ananthapuri Hospitals and Research Institute, Trivandrum, Kerala India
| | - A. Marthanda Pillai
- grid.496580.6Ananthapuri Hospitals and Research Institute, Trivandrum, Kerala India
| | - Anant Kumar Pandey
- Global Institute of Public Health, Trivandrum, Kerala India
- grid.444699.20000 0001 0669 2384Xavier Institute of Social Service (XISS), Ranchi, Jharkhand India
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Nair AT, Nayar KR, Koya SF, Abraham M, Lordson J, Grace C, Sreekumar S, Chembon P, Swarnam K, Pillai AM, Pandey AK. Social media, vaccine hesitancy and trust deficit in immunization programs: a qualitative enquiry in Malappuram District of Kerala, India. Health Res Policy Syst 2021. [DOI: https://doi.org/10.1186/s12961-021-00698-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Abstract
Background
With increased penetration of the internet and social media, there are concerns regarding its negative role in influencing parents’ decisions regarding vaccination for their children. It is perceived that a mix of religious reasons and propaganda by anti-vaccination groups on social media are lowering the vaccination coverage in Malappuram district of Kerala. We undertook a qualitative study to understand the factors responsible for generating and perpetuating vaccine hesitancy, the pathways of trust deficit in immunization programs and the interaction between various social media actors.
Methods
In-depth interviews and focus group discussions were conducted among parents/caregivers, physicians, public sector health staff, alternative system medical practitioners, field healthcare workers and teachers in areas with highest and lowest vaccination coverage in the district, as well as with communication experts.
Results
The trust deficit between parents/caregivers and healthcare providers is created by multiple factors, such as providers’ lack of technical knowledge, existing patriarchal societal norms and critical views of vaccine by naturopaths and homeopaths. Anti-vaccine groups use social media to influence caregivers' perceptions and beliefs. Religion does not appear to play a major role in creating vaccine resistance in this setting.
Conclusions
A long-term, multipronged strategy should be adopted to address the trust deficit. In the short to medium term, the health sector can focus on appropriate and targeted vaccine-related communication strategies, including the use of infographics, soft skills training for healthcare workers, technical competency improvement through a mobile application-based repository of information and creation of a media cell to monitor vaccine-related conversations in social media and to intervene if needed.
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Parameswaran S, Anil Kumar T, Marthanda Pillai A. P-SP003. Idiopathic central sleep apnea with periodicity presenting as cheyne-stokes breathing. Clin Neurophysiol 2021. [DOI: 10.1016/j.clinph.2021.02.220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Abstract
Four-year old boy was admitted with acute onset of fever with seizures and altered sensorium. His mother had history of contact with influenza A H1N1 virus (H1N1) infection. Blood counts, electrolytes, blood sugar and ammonia were normal. Liver enzymes were mildly elevated. CSF study showed elevated protein, normal sugar and no pleocytosis. Cerebrospinal fluid (CSF) viral panel was negative. Magnetic resonance imaging brain was suggestive of acute necrotizing encephalopathy. His throat swab and sputum polymerase chain reaction was positive for H1N1. He was managed with ventilation, intravenous steroids and other supportive measures. At discharge his sensorium improved but had neurological sequelae. We are presenting this case as this is a very rare complication of H1N1 infection with high rate of mortality. Early supportive measures and steroids/intravenous immunoglobulin may save the patient.
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Affiliation(s)
- Mili Thomas
- Department of Pediatrics and Neonatology, Ananthapuri Hospitals and Research Institute, Thiruvananthapuram, Kerala 695024
| | - Kamala Swarnam
- Department of Pediatrics and Neonatology, Ananthapuri Hospitals and Research Institute, Thiruvananthapuram, Kerala 695024
| | - Gopika Sekhar Remadevi
- Department of Pediatrics and Neonatology, Ananthapuri Hospitals and Research Institute, Thiruvananthapuram, Kerala 695024
| | - A Marthanda Pillai
- Department of Neurosurgery, Ananthapuri Hospitals and Research Institute, Thiruvananthapuram, Kerala 695024
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Anand T, Shaffi M, Pillai A M, Lathika Rajendrakumar A, Sreemathy L, Rajasekharan Nayar K, Lordson J, Abraham M, Rajeev P, Marthanda Pillai A, Kumar A, Grace A C, Jacob J. Prevalence of hypertension and prehypertension among a coastal population in south India: baseline findings from a population-based health registry project in Kerala. Public Health 2018. [DOI: https://doi.org/10.1016/j.puhe.2017.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Anand TN, Shaffi M, Pillai A M, Lathika Rajendrakumar A, Sreemathy LS, Rajasekharan Nayar K, Lordson J, Abraham M, Rajeev P, Marthanda Pillai A, Kumar A, Grace A C, Jacob J. Prevalence of hypertension and prehypertension among a coastal population in south India: baseline findings from a population-based health registry project in Kerala. Public Health 2018; 155:107-109. [PMID: 29346068 DOI: 10.1016/j.puhe.2017.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Revised: 11/21/2017] [Accepted: 11/23/2017] [Indexed: 02/05/2023]
Affiliation(s)
- T N Anand
- Global Institute of Public Health, Thiruvananthapuram, Kerala, India.
| | - M Shaffi
- Global Institute of Public Health, Thiruvananthapuram, Kerala, India; Directorate of Public Health, Ministry of Health, Al Taif, Saudi Arabia.
| | - M Pillai A
- Global Institute of Public Health, Thiruvananthapuram, Kerala, India; Ananthapuri Hospitals and Research Institute, Thiruvananthapuram, Kerala, India.
| | | | - L S Sreemathy
- Global Institute of Public Health, Thiruvananthapuram, Kerala, India; PATH, Washington DC, USA.
| | | | - J Lordson
- Global Institute of Public Health, Thiruvananthapuram, Kerala, India; Ananthapuri Hospitals and Research Institute, Thiruvananthapuram, Kerala, India.
| | - M Abraham
- Global Institute of Public Health, Thiruvananthapuram, Kerala, India.
| | - P Rajeev
- Ananthapuri College of Nursing, Thiruvananthapuram, Kerala, India.
| | | | - A Kumar
- Global Institute of Public Health, Thiruvananthapuram, Kerala, India; Gillings School of Global Public Health, North Carolina, USA.
| | - C Grace A
- Global Institute of Public Health, Thiruvananthapuram, Kerala, India.
| | - J Jacob
- Ananthapuri Hospitals and Research Institute, Thiruvananthapuram, Kerala, India.
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Pillai AM. [India]Food Safety-A Global Public Health Concern. Japan Med Assoc J 2015; 58:161-164. [PMID: 27081602 PMCID: PMC4829763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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Koshy L, Easwer HV, Premkumar S, Alapatt JP, Pillai AM, Nair S, Bhattacharya RN, Banerjee M. Risk factors for aneurysmal subarachnoid hemorrhage in an Indian population. Cerebrovasc Dis 2010; 29:268-74. [PMID: 20090318 DOI: 10.1159/000275501] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2009] [Accepted: 10/18/2009] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Aneurysmal subarachnoid hemorrhage (aSAH) has a mortality rate as high as 50%. The prevalence of intracranial aneurysms from various parts of India varies from 0.75 to 10.3%, with higher numbers of cases being diagnosed due to the increasing age of the population and improvements in imaging techniques. However, little is known about the attributable risk factors of aSAH in the Indian population. METHODS Using a case-control study we estimated the risk of factors such as hypertension, cigarette smoking, alcohol consumption, diabetes mellitus and family history of aSAH in a South Indian population. The population-attributable risk (PAR) of smoking, hypertension and alcohol use was estimated for the South Indian as well as for the general Indian population. RESULTS Our results showed that cigarette smoking (OR, 3.59; p < 0.001) and a history of hypertension (OR, 2.98; p < 0.001) were significant risk factors associated with aSAH. When patients were classified by gender, it was observed that being a smoker and having hypertension increased the risk for aSAH by nearly fourfold in men. Among women, hypertension and older age were significant risk factors. The PAR estimates indicated that smoking (OR, 3.59; 95% CI, 2.13-6.06) and hypertension (OR, 2.98; 95% CI, 1.73-5.12) are significant risk factors. CONCLUSIONS Hypertension and smoking may be causal risk factors which might also modify the effect of genetic factors that could increase susceptibility to aSAH in the Indian population. Since these risk factors are amenable to effective modification, our findings will be useful for a gender-specific management of aSAH.
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Affiliation(s)
- Linda Koshy
- Human Molecular Genetics Laboratory, Rajiv Gandhi Centre for Biotechnology, Thiruvananthapuram, India
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Pillai AM, Vasudevan S. Hydatid cyst of the orbit producing proptosis--a case report. J Indian Med Assoc 1996; 94:116-118. [PMID: 8810213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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Pillai AM. Impact of gatt agreement on drug prices. J Indian Med Assoc 1995; 93:113, 120. [PMID: 8522810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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Pillai AM, Allapat J. Lumbar intradural disc prolapse. J Indian Med Assoc 1994; 92:238. [PMID: 7963607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
- A M Pillai
- Department of Neurosurgery, Medical College Hospital, Trivandrum
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Alappat JP, Pillai AM, Prasanna D, Sambasivan M. Giant cell reparative granuloma of the craniofacial complex: case report and review of the literature. Br J Neurosurg 1992; 6:71-4. [PMID: 1562304 DOI: 10.3109/02688699209002905] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Giant cell reparative granuloma (GCRG) is an infrequent non-tumoural lesion affecting particularly the maxillary and mandibular bones and only rarely the cranial bones. The pathogenesis is still controversial and the differential diagnosis, especially from giant cell tumours of bone, is difficult. A case of GCRG of the sphenoid masquerading as an intracranial tumour is reported here. The relevant literature is reviewed.
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Chandran S, Pillai AM. Chondroid syringoma-scalp. A case report. Indian J Cancer 1990; 27:97-100. [PMID: 2172155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
A case of chondroid syringoma of scalp is reported. The case is of particular interest because of repeated recurrence with bone and dural infiltration.
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Affiliation(s)
- S Chandran
- Department of Neuro Surgery Medical College, Kerala, India
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Pillai AM, Sambasivan M. Uniocular proptosis in children. Indian J Ophthalmol 1989; 37:166-70. [PMID: 2638302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
A retrospective study on 80 children with uniocular proptosis has been done. Of these 57 had orbital lesions, 19 had periorbital lesions and 4 had intracranial lesions. The clinical, radiological and pathological aspects as well as the management of these conditions are discussed.
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Pillai AM. Experience with spontaneous intracerebral haematomas. J Indian Med Assoc 1988; 86:233-6. [PMID: 3235841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Pillai AM, Sambasivan M. Congenital cystic eye--a case report with CT scan. Indian J Ophthalmol 1987; 35:88-91. [PMID: 3450626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
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