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3. Diagnostic Accuracy of Cerebrospinal Fluid Procalcitonin and Serum Procalcitonin in Adult Patients with Bacterial Meningitis: A Cross-sectional Study.

Author

KARAN, MONICA, PRIYADARSHINI, APARAJITA, AGGARWAL, KAVITA, TRIPATHY, KRISHNA PADARABINDA, and BEHERA, PRADIP KUMAR

Subjects
BACTERIAL meningitis, CEREBROSPINAL fluid, CALCITONIN, RECEIVER operating characteristic curves, CROSS-sectional method, SENSITIVITY & specificity (Statistics)
Abstract

Introduction: Bacterial Meningitis (BM) is a serious health problem worldwide with high mortality and permanent longterm neurological sequelae. Cerebrospinal Fluid (CSF) analysis is the cornerstone for diagnosing BM, but the lack of specificity creates a difficult clinical scenario for initiating proper treatment. Empiric antibiotic use in patients with suspected meningitis at primary care settings decreases the yield of CSF culture and alters CSF cytological and biochemical findings, making it further difficult to diagnose BM. To overcome this difficulty, there is a need for other biochemical markers with higher sensitivity and specificity. Aim: To determine the diagnostic sensitivity and specificity of Procalcitonin (PCT) in serum and CSF in patients with BM and compare its diagnostic accuracy in both sample types. Materials and Methods: A cross-sectional study was conducted in the Department of Internal Medicine at a tertiary care centre in eastern India from September 2018 to August 2020. A total of 82 adult patients with meningitis were recruited as per the protocol, and CSF analysis was done along with estimation of PCT in serum and CSF. Receiver Operating Characteristics (ROC) curve analysis of serum and CSF PCT was used to determine sensitivity and specificity with a 95% confidence interval. Results: Out of the 82 patients recruited, 30 (36.6%) had BM. CSF PCT with a cut-off value of >0.45 ng/mL had a sensitivity of 86.7% and specificity of 92.3%. The sensitivity of serum PCT with a cut-off value of >0.6 ng/mL was 83.3%, and specificity was 86.5%. There was no statistically significant difference in sensitivity and specificity between CSF and serum PCT in patients with BM (p-value=0.7988). Conclusion: Both serum and CSF PCT were found to have high sensitivity and specificity as markers for diagnosing BM without any statistically significant difference between them. [ABSTRACT FROM AUTHOR]

Published
2024
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8. MCQ on Neonatology

Author

Acharya, Viyatprajna, primary, Mohakud, NirmalKumar, additional, Behura, SushreeSmita, additional, Aggarwal, Kavita, additional, and Mandal, Meghaparna, additional

Published
2023
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9. Artificial intelligence in medical education

Author

Acharya, Viyatprajna, primary, Padhan, Prasanta, additional, Bahinipati, Jyotirmayee, additional, Mishra, Sanjukta, additional, Aggarwal, Kavita, additional, Jhajharia, Sumit, additional, Parida, Preetinanda, additional, Sahu, Debadyuti, additional, and Pradhan, Tapaswini, additional

Published
2023
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19. Performance evaluation of Xpert HBV viral load (VL) assay: Point-of-care molecular test to strengthen and decentralize management of chronic hepatitis B (CHB) infection

Author

Gupta Ekta, SK Sarin, Aggarwal Kavita, Sharma Manoj, Singh Gaurav, Khodare Arvind, and Nitiksha Rani

Subjects
Hepatitis, HBsAg, Real-time polymerase chain reaction, business.industry, Genotype, medicine, Hepatitis B, medicine.disease, business, Virology, Viral load, Genotyping, Point of care
Abstract

IntroductionEstimation of hepatitis B (HBV) viral load (VL) is critical in hepatitis-B cascade-of-care and currently there is no point of care (POC) molecular assay available for that. This study evaluated the performance of a new near point of care molecular assay Xpert HBV-VL assay against FDA approved Real time PCR assays.Materials & methodsIn this retrospective study 119 archived plasma samples from HBV infected patients, and 53 hepatitis B surface antigen (HBsAg) patients were simultaneously tested for HBV DNA quantification on 2 real time PCR conventional assays and Xpert assay. The routine method for reporting to patient was Abbott Real Time PCR.ResultsThe range of HBV DNA load in samples was 1 to 8.76 log10IU/ml with a median load of 4.46 (IQR: 1-8.76) log10IU/ml as detected by routine assay (Abbott Real-Time HBV VL assay). Genotyping could be done in 95 (79.8%) samples and genotype D (83; 87.37%) was found commonest. The Xpert assay demonstrated good correlation with Abbott (R2= 0.944) and Roche (R2= 0.963). On comparison the mean difference (95% Confidence Interval) in average viral load was −0.018 log10 IU/ml and −0.043 log10 IU/ml when Xpert was compared with the Abbott and Roche assay, respectively. The overall sensitivity, specificity, negative predictive value and positive predictive value of the Xpert assay was found 97.5%, 100%, 94.65 & 100% respectively.ConclusionXpert HBV-VL assay which has a potential for near point of care molecular testing has shown excellent performance and found to be a reliable method for HBV DNA quantification.

Published
2020
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20. Cost- Effectiveness of Avatrombopag for the Treatment of Thrombocytopenia in Patients with Chronic Liver Disease

Author

Mladsi, Deirdre, Barnett, Christine, Aggarwal, Kavita, Vredenburg, Michael, Dieterich, Douglas, and Kim, Ray

Subjects
ClinicoEconomics and Outcomes Research, thrombocytopenia, liver diseases platelet transfusion, cost-effectiveness, health care economics and organizations, Original Research
Abstract

Deirdre Mladsi,1 Christine Barnett,1 Kavita Aggarwal,2 Michael Vredenburg,2 Douglas Dieterich,3 Ray Kim4 1RTI Health Solutions Research, Triangle Park, NC, USA; 2Dova Pharmaceuticals, Durham, NC, USA; 3Icahn School of Medicine, New York, NY, USA; 4School of Medicine, Stanford University, Stanford, CA, USACorrespondence: Deirdre MladsiRTI Health Solutions Research, Triangle Park, NC 27709-2194 Tel +1 919 541 7094Fax +1 919 541 7222Email dmladsi@rti.orgBackground and Aim: Thrombocytopenia is common in people with chronic liver disease, who frequently undergo invasive procedures. To minimize the risk of bleeding, prophylactic platelet transfusions have traditionally been used but carry many risks. The aim of this study was to evaluate the cost-effectiveness of avatrombopag compared with platelet transfusion and lusutrombopag as a treatment for thrombocytopenia in adult patients with chronic liver disease scheduled to undergo a medical procedure.Methods: A decision-tree model was developed from a US payer perspective to capture acute events observed in phase 3 global randomized controlled clinical trials and, to support exploratory analyses, potential longer-term complications resulting from a major bleed or thromboembolic event. Treatment costs were taken from publicly available data sources. The interventions were evaluated in the overall trial populations and in subpopulations with higher and lower baseline platelet counts. Results were presented as incremental cost per platelet transfusion avoided. One-way and probabilistic sensitivity analyses were conducted.Results: In the overall population, avatrombopag reduced the need for platelet transfusions and produced cost-savings compared with platelet transfusion (80% fewer prophylactic platelet transfusions, $4250 lower costs) and lusutrombopag (42% fewer prophylactic platelet transfusions, $5819 lower costs). Similar results were seen in both the higher and lower platelet count subpopulations. The one-way and probabilistic sensitivity analyses found that the use of avatrombopag is cost-saving with the incremental cost-effectiveness ratio in quadrant IV (decreased costs, prophylactic platelet transfusions avoided).Conclusion: The use of avatrombopag is expected to be cost-saving while reducing the need for prophylactic platelet transfusions compared with platelet transfusion and lusutrombopag.Keywords: liver diseases platelet transfusion, thrombocytopenia, cost-effectiveness

Published
2020

21. Confidence of UK Ophthalmology Registrars in Managing Posterior Capsular Rupture: Results from a National Trainee Survey.

Author

Swampillai, Andrew J., Nowak, Victoria A., Maubon, Laura, Neffendorf, James E., Sahota, Dilraj, Williams, Olayinka, Lakhani, Bansri, Soare, Cristina, Sychev, Ivan, Ridyard, Edward, Patel, Praveen J., Park, Jonathan C., Ophthalmology Trainee Clinical Research Network, Abbas, Sajjad, Abdalla, Yasmine, Abdel-Hay, Ahmed, Aggarwal, Kavita, Agorogiannis, Eleftherios, Ah-See, Kim L. Wong, and Ahmed, Mahmoud

Published
2022
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22. Respiratory viral infections by Non-influenza viruses are associated with more adverse clinical outcome in patients with underlying liver disease: a single centre laboratory based study.

Author

Gupta, Ekta, primary, Padhi, Abhishek, additional, Aggarwal, Kavita, additional, Ramachandran, Krithiga, additional, Agarwal, Reshu, additional, Pasupulleti, Samba Siva, additional, Bhattacharya, Debajyoti, additional, Maiwall, Rakhi, additional, and Sarin, Shiv, additional

Published
2020
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31. SME FINANCE

Author

GUPTA, MONICA, primary, SHEKHAR, SHASHI, primary, and AGGARWAL, KAVITA, primary

Published
2019
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36. Serum Homocysteine Levels in Patients with Retinal Vein Occlusion in a Spanish Population

Author

Aggarwal Kavita, Davey Keith, Wait Tanitha, Patel Jai-Hin, Thethy Jo, and Patel Chetan K

Subjects
medicine.medical_specialty, Retinal Vein, genetic structures, Tropicamide, business.industry, medicine.medical_treatment, 030204 cardiovascular system & hematology, eye diseases, 03 medical and health sciences, 0302 clinical medicine, Tamsulosin, Ophthalmology, Occlusion, medicine, Pupillary response, Mydriasis, 030212 general & internal medicine, medicine.symptom, Complication, business, Capsulorhexis, medicine.drug
Abstract

The mean age of patients was 7 years older compared to the gold standard. Throughout surgery, mydriasis was smaller by 0.5-0.7 mm and was unaffected by tamsulosin use or iris colour. Age and pre-operative mydriasis with G tropicamide 1% significantly explained most of the variation in pupil diameter prior to capsulorhexis (p < 0.05). All patients requiring mechanical pupil dilation had pupils that dilated to less than 5 mm pre-operatively. The visual results and complication profiles matched that of the reference standard.

Published
2017

39. Prevalence and correlates of antenatal depression among women registered at antenatal clinic in North India.

Author

Dahiya, Neha, Aggarwal, Kavita, and Kumar, Rajesh

Abstract

Objective: Women pass through many stages throughout her lifetime. Among these phases, pregnancy is crucial phase. If women are not able to cope with this stress, it may lead to adverse outcomes of pregnancy. Early detection of possible depression in pregnant women may lead to decrease in incidence of depression and adverse outcomes of pregnancy. Materials and Methods: The present study was done in an urban primary health center of east Delhi where antenatal and postnatal services are provided. Two hundred pregnant women who attended antenatal clinic for their antenatal checkup were included in the study. Edinburgh postnatal depression scale was used to diagnose possible depression. The presence of a statistically significant difference between possibility of depression in terms of various socioeconomic, obstetric, gender issues, life events, previous psychiatric history and family relationships was ascertained using Chi-square/Fisher's exact test. Logistic regression was carried out to determine important confounding variables. Results: The mean age of participants was 25.32 ± 3.86 years. Of total 200 women, 42 (21%) women were found to be suffering from possible depression. The possibility of depression was found to be significantly higher in literate participants (P = 0.001) and in women who were married after 18 years of age (P = 0.016). Participants who wanted the present pregnancy and whose spouses were alcoholic were found to be associated significantly (P = 0.00). On applying logistic regression, age and abortion history was found to be significant. Conclusion: This study demonstrates that the prevalence of antenatal depression is high in developing countries, and universal screening of depression during antenatal and postnatal period is feasible along with other antenatal and postnatal services provided to them. [ABSTRACT FROM AUTHOR]

Published
2020
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