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  1. Article ; Online: Mentoring Minorities: Five Foundational Lessons.

    Pakhale, Smita

    The American journal of medicine

    2021  Volume 134, Issue 10, Page(s) 1300–1303

    MeSH term(s) Cultural Diversity ; Ethnic Groups ; Female ; Humans ; Male ; Mentoring ; Minority Groups ; Students
    Language English
    Publishing date 2021-07-10
    Publishing country United States
    Document type Journal Article
    ZDB-ID 80015-6
    ISSN 1555-7162 ; 1873-2178 ; 0002-9343 ; 1548-2766
    ISSN (online) 1555-7162 ; 1873-2178
    ISSN 0002-9343 ; 1548-2766
    DOI 10.1016/j.amjmed.2021.07.001
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  2. Article ; Online: [No title information]

    Cowan, Juthaporn / Pakhale, Smita / Angel, Jonathan B

    CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne

    2023  Volume 195, Issue 6, Page(s) E249–E250

    Title translation Pneumonite du paillage chez un patient atteint de granulomatose chronique.
    MeSH term(s) Humans ; Patients ; Pneumonia
    Language French
    Publishing date 2023-02-03
    Publishing country Canada
    Document type Journal Article
    ZDB-ID 215506-0
    ISSN 1488-2329 ; 0008-4409 ; 0820-3946
    ISSN (online) 1488-2329
    ISSN 0008-4409 ; 0820-3946
    DOI 10.1503/cmaj.220713-f
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  3. Article: COVID-19 Pandemic: Did Strict Mobility Restrictions Save Lives and Healthcare Costs in Maharashtra, India?

    Ambade, Preshit Nemdas / Thavorn, Kednapa / Pakhale, Smita

    Healthcare (Basel, Switzerland)

    2023  Volume 11, Issue 14

    Abstract: Introduction: Maharashtra, India, remained a hotspot during the COVID-19 pandemic. After the initial complete lockdown, the state slowly relaxed restrictions. We aim to estimate the lockdown's impact on COVID-19 cases and associated healthcare costs.: ...

    Abstract Introduction: Maharashtra, India, remained a hotspot during the COVID-19 pandemic. After the initial complete lockdown, the state slowly relaxed restrictions. We aim to estimate the lockdown's impact on COVID-19 cases and associated healthcare costs.
    Methods: Using daily case data for 84 days (9 March-31 May 2020), we modeled the epidemic's trajectory and predicted new cases for different phases of lockdown. We fitted log-linear models to estimate the growth rate, basic (R
    Results: The estimated median R
    Conclusion: Maharashtra's early public health response delayed the pandemic and averted new cases and deaths during the first wave of the pandemic. However, we recommend that such restrictions be carefully used while considering the local socio-economic realities in countries like India.
    Language English
    Publishing date 2023-07-24
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2721009-1
    ISSN 2227-9032
    ISSN 2227-9032
    DOI 10.3390/healthcare11142112
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  4. Article ; Online: COPD Readmission: The Missing Link.

    Pakhale, Smita / Huynh, Nina / Tariq, Saania

    The American journal of medicine

    2022  Volume 135, Issue 10, Page(s) 1147–1149

    MeSH term(s) Humans ; Patient Readmission ; Pulmonary Disease, Chronic Obstructive/therapy ; Retrospective Studies ; Risk Factors
    Language English
    Publishing date 2022-07-09
    Publishing country United States
    Document type Editorial
    ZDB-ID 80015-6
    ISSN 1555-7162 ; 1873-2178 ; 0002-9343 ; 1548-2766
    ISSN (online) 1555-7162 ; 1873-2178
    ISSN 0002-9343 ; 1548-2766
    DOI 10.1016/j.amjmed.2022.06.001
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  5. Article ; Online: Mulch pneumonitis in a patient with chronic granulomatous disease.

    Cowan, Juthaporn / Pakhale, Smita / Angel, Jonathan B

    CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne

    2022  Volume 194, Issue 44, Page(s) E1510

    MeSH term(s) Humans ; Granulomatous Disease, Chronic/complications ; Granulomatous Disease, Chronic/diagnosis ; Pneumonia/drug therapy ; Lung
    Language English
    Publishing date 2022-11-15
    Publishing country Canada
    Document type Journal Article
    ZDB-ID 215506-0
    ISSN 1488-2329 ; 0008-4409 ; 0820-3946
    ISSN (online) 1488-2329
    ISSN 0008-4409 ; 0820-3946
    DOI 10.1503/cmaj.220713
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  6. Article: Why Female Smokers Have Poorer Long-Term Health Outcomes than Male Smokers: The Role of Cigarette Smoking During Pregnancy.

    Yang, Li / Zhou, Yunchun / Jiang, Mingyan / Wen, Wendy / Guo, Yanfang / Pakhale, Smita / Wen, Shi Wu

    Public health reviews

    2024  Volume 45, Page(s) 1605579

    Abstract: Objectives: ...

    Abstract Objectives:
    Language English
    Publishing date 2024-02-29
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 217531-9
    ISSN 2107-6952 ; 0301-0422
    ISSN (online) 2107-6952
    ISSN 0301-0422
    DOI 10.3389/phrs.2024.1605579
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  7. Article ; Online: Explaining Caste-Based Disparities in Enrollment for National Health Insurance Program in India: a Decomposition Analysis.

    Ambade, Preshit Nemdas / Pakhale, Smita / Rahman, Tauhidur

    Journal of racial and ethnic health disparities

    2022  Volume 10, Issue 4, Page(s) 1918–1932

    Abstract: Background: Caste plays a significant role in individual healthcare access and health outcomes in India. Discrimination against low-caste communities contributes to their poverty and poor health outcomes. The Rashtriya Swasthya Bima Yojana (RSBY), a ... ...

    Abstract Background: Caste plays a significant role in individual healthcare access and health outcomes in India. Discrimination against low-caste communities contributes to their poverty and poor health outcomes. The Rashtriya Swasthya Bima Yojana (RSBY), a national health insurance program, was created to improve healthcare access for the poor. This study accounts for caste-based disparities in RSBY enrollment in India by decomposing the contributions of relevant factors.
    Methods: Using the data from the 2015-2016 round of the National Family Health Survey, we compare RSBY enrollment rates of low-caste and high-caste households. We use a non-linear extension of Oaxaca-Blinder decomposition and estimate two models by pooling coefficients across the comparison groups and all caste groups. Enrollment differentials are decomposed into individual- and household-level characteristics, media access, and state-level fixed effects, allowing 2000 replications and random ordering of variables.
    Results: The analysis of 480,766 households show that scheduled tribe households have the highest enrollment (18.85%), followed by 14.13% for scheduled caste, 10.67% for other backward caste, and 9.33% for high caste. Household factors, family head's characteristics, media access, and state-level fixed effects account for a 32% to 52% gap in enrollment. More specifically, the enrollment gaps are attributable to differences in wealth status, educational attainment, residence, family size, dependency ratio, media access, and occupational activities of the households.
    Conclusions: Weaker socio-economic status of low-caste households explains their high RSBY enrollments.
    MeSH term(s) Humans ; Social Class ; Insurance, Health ; Health Services Accessibility ; India ; National Health Programs ; Socioeconomic Factors
    Language English
    Publishing date 2022-08-22
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2760524-3
    ISSN 2196-8837 ; 2197-3792
    ISSN (online) 2196-8837
    ISSN 2197-3792
    DOI 10.1007/s40615-022-01374-8
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Drug-drug interactions with CFTR modulator therapy in cystic fibrosis: Focus on Trikafta®/Kaftrio®.

    Purkayastha, Debanjali / Agtarap, Kyla / Wong, Kristy / Pereira, Onella / Co, Jannie / Pakhale, Smita / Kanji, Salmaan

    Journal of cystic fibrosis : official journal of the European Cystic Fibrosis Society

    2023  Volume 22, Issue 3, Page(s) 478–483

    Abstract: The combination of CFTR modulators ivacaftor, tezacaftor and elexacaftor (Trikafta®, Kaftrio®) significantly improve outcomes, including survival in a broad range of cystic fibrosis patients. These drugs have complicated metabolic profiles that make the ... ...

    Abstract The combination of CFTR modulators ivacaftor, tezacaftor and elexacaftor (Trikafta®, Kaftrio®) significantly improve outcomes, including survival in a broad range of cystic fibrosis patients. These drugs have complicated metabolic profiles that make the potential for drug interactions an important consideration for prescribers, care providers and patients. Prolonged survival also increases risk of age-related disease and their associated pharmacotherapy, further increasing the risk of drug interactions and the need for increased vigilance amongst care providers. We systematically searched the literature for studies identifying and evaluating pharmacokinetic and pharmacodynamic drug interactions involving the components of Trikafta®/Kaftrio®. We also searched electronic databases of drugs for possible drug interactions based on metabolic profiles. We identified 86 potential drug interactions of which 13 were supported by 14 studies. There is a significant need for research to describe the likelihood, magnitude and clinical impact of the drug interactions proposed here.
    MeSH term(s) Humans ; Cystic Fibrosis/drug therapy ; Cystic Fibrosis/metabolism ; Cystic Fibrosis Transmembrane Conductance Regulator/genetics ; Cystic Fibrosis Transmembrane Conductance Regulator/metabolism ; Mutation ; Aminophenols/therapeutic use ; Benzodioxoles/therapeutic use ; Drug Combinations ; Drug Interactions
    Chemical Substances elexacaftor, ivacaftor, tezacaftor drug combination ; Cystic Fibrosis Transmembrane Conductance Regulator (126880-72-6) ; Aminophenols ; Benzodioxoles ; Drug Combinations ; CFTR protein, human
    Language English
    Publishing date 2023-01-16
    Publishing country Netherlands
    Document type Systematic Review ; Journal Article ; Review
    ZDB-ID 2084724-5
    ISSN 1873-5010 ; 1569-1993
    ISSN (online) 1873-5010
    ISSN 1569-1993
    DOI 10.1016/j.jcf.2023.01.005
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  9. Article ; Online: Environmentally sustainable opportunities for health systems: metered-dose inhaler prescribing, dispensing, usage, and waste at The Ottawa Hospital.

    Caron, Carolanne / Sajwani, Shellyza / Bateman, Katherine / Degenhardt, Owen / Gaudreau-Simard, Mathilde / Pakhale, Smita / Kanji, Salmaan

    The Lancet. Planetary health

    2024  Volume 8 Suppl 1, Page(s) S5

    Abstract: Background: The carbon footprint of Canada's health sector is among the worst in the world, responsible for 4·6% of Canada's total greenhouse gas emissions. A quarter of emissions from Canada's health sector are linked to pharmaceuticals, including ... ...

    Abstract Background: The carbon footprint of Canada's health sector is among the worst in the world, responsible for 4·6% of Canada's total greenhouse gas emissions. A quarter of emissions from Canada's health sector are linked to pharmaceuticals, including metered dose inhalers (MDIs). MDIs use propellants, such as hydrofluorocarbons, which act as greenhouse gas emissions and contribute to the health-care sector's overall carbon footprint. The objective of this study was to describe MDI prescribing, dispensing, usage, and waste patterns at The Ottawa Hospital (Ottawa, ON, Canada). Secondary objectives included estimating the monetary and carbon cost of current practice and the potential benefits and costs of switching to the more environmentally friendly dry powder inhalers.
    Methods: In this retrospective point-prevalence cohort study, we identified 100 consecutive patients from medical and surgical services at both campuses of The Ottawa Hospital from health records discharged from medical and surgical services and who were prescribed at least one MDI during their admission. Medical records were reviewed and data related to demographics, MDI prescribing, dispensing, usage, and wastage were collected using a pre-piloted electronic case report form. Financial cost was calculated using local costing estimates and carbon cost was calculated using published estimates.
    Findings: Between Jan 1, 2023, and June 1, 2023, we collected data for 100 eligible patients, of whom 60 (60%) were female and 90 (90%) were admitted to hospital medicine wards (10% from surgical wards). The median length of stay was 7 (range 1-47) days. The most common inpatient diagnoses were respiratory tract infections in 43 (43%) of 100 patients and chronic obstructive pulmonary disease exacerbations in 28 (28%) of 100 patients. The median number of MDIs prescribed during a patients stay was two (range one to 15) and the median number dispensed was one (range one to seven). For formulary options of MDIs, of the 200 (range 30-1400) actuations dispensed per patient, 8% were used, representing 92% wastage. During the audit, 315 MDIs were dispensed in total, of which 97 were not used at all.
    Interpretation: MDIs are significant contributors to the carbon footprint attributed to pharmaceutical use in hospitals. This study suggests that 90% of MDI doses are wasted, showing that there is substantial room for improvement.
    Funding: None.
    MeSH term(s) Humans ; Female ; Male ; Greenhouse Gases ; Cohort Studies ; Retrospective Studies ; Nebulizers and Vaporizers ; Metered Dose Inhalers ; Hospitals ; Carbon
    Chemical Substances Greenhouse Gases ; Carbon (7440-44-0)
    Language English
    Publishing date 2024-04-15
    Publishing country Netherlands
    Document type Journal Article
    ISSN 2542-5196
    ISSN (online) 2542-5196
    DOI 10.1016/S2542-5196(24)00070-6
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  10. Article ; Online: Fever of Unknown Origin Secondary to Pulmonary Histoplasmosis in Scleroderma-Related Interstitial Lung Disease.

    Stanton, Amanda / Mulpuru, Sunita / Pease, Christopher / Deslandes, Vincent / Souza, Carolina / Pakhale, Smita

    The American journal of medicine

    2022  Volume 136, Issue 4, Page(s) 365–367

    MeSH term(s) Humans ; Histoplasmosis/complications ; Histoplasmosis/diagnosis ; Fever of Unknown Origin ; Lung Diseases, Interstitial/diagnosis ; Lung Diseases, Interstitial/etiology ; Lung Diseases, Fungal ; Scleroderma, Systemic/complications
    Language English
    Publishing date 2022-12-08
    Publishing country United States
    Document type Journal Article
    ZDB-ID 80015-6
    ISSN 1555-7162 ; 1873-2178 ; 0002-9343 ; 1548-2766
    ISSN (online) 1555-7162 ; 1873-2178
    ISSN 0002-9343 ; 1548-2766
    DOI 10.1016/j.amjmed.2022.11.018
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