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Article ; Online: Reply to: Probiotics for the Prevention of COVID-19 Sequelae.

Kurian, Shilia Jacob / Miraj, Sonal Sekhar

2022 Volume 53, Issue 6, Page(s) 644

MeSH term(s)	COVID-19/prevention & control ; Disease Progression ; Humans ; Probiotics/therapeutic use ; SARS-CoV-2
Language	English
Publishing date	2022-08-15
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	1156844-6
ISSN	1873-5487 ; 0188-4409 ; 0188-0128
ISSN (online)	1873-5487
ISSN	0188-4409 ; 0188-0128
DOI	10.1016/j.arcmed.2022.08.005
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Article ; Online: Nutritional status in patients with tuberculosis and diabetes mellitus: A comparative observational study.

Girishbhai Patel, Divya / Baral, Tejaswini / Jacob Kurian, Shilia / Malakapogu, Pravachana / Saravu, Kavitha / Sekhar Miraj, Sonal

Journal of clinical tuberculosis and other mycobacterial diseases

2024 Volume 35, Page(s) 100428

Abstract: Background: India has been estimated to have 14 % of malnourished population and a high TB incidence burden with a 26.9 lakh cases. Malnutrition and diabetes mellitus are major risk factors for tuberculosis infection. Malnutrition in patients with both ... ...

Abstract	Background: India has been estimated to have 14 % of malnourished population and a high TB incidence burden with a 26.9 lakh cases. Malnutrition and diabetes mellitus are major risk factors for tuberculosis infection. Malnutrition in patients with both tuberculosis and diabetes (TB-DM) population worsens the disease severity, treatment outcomes and increases morbidity and mortality risk. Objective: To assess the nutritional status in patients with TB-DM compared with patients with TB and DM alone. Method: Records from January 2016 to November 2020 for patients admitted to Kasturba Hospital, Manipal were assessed. Data pertaining to glycemic parameters, nutritional parameters, and other relevant laboratory parameters were extracted for assessment. The study population were divided into three groups i.e. patients with TB-DM, TB and DM. The statistical association was carried out with one-way ANOVA method, considering p < 0.05 as statistically significant. Results: A total of 291 patients were included, with 97 patients in each group; among those, male and female were 86.27 % and 13.73 % respectively. Cardiovascular co-morbidity was predominant in the DM (68.04 %) and TB-DM (26.8 %) group. The mean value of HbA1c (10.47 %) was found to be highest for the TB-DM group. Low levels of albumin were reported by 71.91 % of patients of the TB group, whereas 73.68 % patients in TB-DM group had vitamin D deficiency. Moreover, higher prevalence of low MCV and MCH in the TB-DM group suggest an increased risk of iron-deficiency anemia. Conclusion: The findings of our study reflect the need for implementation of nutritional support in patients with TB-DM.
Language	English
Publishing date	2024-03-12
Publishing country	England
Document type	Journal Article
ISSN	2405-5794
ISSN (online)	2405-5794
DOI	10.1016/j.jctube.2024.100428
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Article ; Online: Cholecalciferol Exhibits no Antibacterial Effect on Staphylococcus aureus and Escherichia coli: an in-vitro Study.

Kurian, Shilia Jacob / Biswas, Avirup / Kulavalli, Shrivathsa / Aranjani, Jesil Mathew / Pattanaik, Amrita / Munisamy, Murali / Saravu, Kavitha / Rodrigues, Gabriel Sunil / Miraj, Sonal Sekhar

Recent advances in anti-infective drug discovery

2024

Abstract: Background: The pleiotropic effect of cholecalciferol (vitamin D3) has gained significant momentum and has been explored widely.: Objectives: The study aimed to investigate the antimicrobial effect of cholecalciferol against S. aureus and E. coli.: ...

Abstract	Background: The pleiotropic effect of cholecalciferol (vitamin D3) has gained significant momentum and has been explored widely. Objectives: The study aimed to investigate the antimicrobial effect of cholecalciferol against S. aureus and E. coli. Methods: An in-vitro study was performed for the antimicrobial effect of cholecalciferol against S. aureus and E. coli. The minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) were determined following the broth microdilution method. Results: The MIC value of cholecalciferol against both S. aureus and E. coli was 0.312 mg/ml, and the MBC for both organisms was 1.25 mg/ml. However, we also observed a significant antimicrobial effect in the dimethyl sulfoxide (DMSO) control at 12.5% (v/v). Therefore, the observed antimicrobial effect may be attributed to DMSO, indicating cholecalciferol does not directly inhibit S. aureus and E. coli. Conclusion: This study indicates that cholecalciferol does not directly inhibit S. aureus and E. coli. Hence, we suggest exploring the antibacterial properties of other vitamin D analogs, such as calcitriol or its synergetic effect with other antimicrobial agents.
Language	English
Publishing date	2024-01-24
Publishing country	United Arab Emirates
Document type	Journal Article
ISSN	2772-4352
ISSN (online)	2772-4352
DOI	10.2174/0127724344277290231211051800
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Article ; Online: Cefepime-induced Neurotoxicity: A Retrospective Cohort Study in a South-Indian Tertiary Healthcare Facility.

Alijani, Erfan / Miraj, Sonal Sekhar / Kurian, Shilia Jacob / Rao, Mahadev / Saravu, Kavitha

Current drug safety

2022 Volume 18, Issue 1, Page(s) 69–78

Abstract: Background: Cefepime is a fourth-generation cephalosporin with a broad spectrum coverage and anti-pseudomonal activity. The safety profile of cefepime was relatively favourable until neurotoxicity was first reported in 1999. Despite cefepime-induced ... ...

Abstract	Background: Cefepime is a fourth-generation cephalosporin with a broad spectrum coverage and anti-pseudomonal activity. The safety profile of cefepime was relatively favourable until neurotoxicity was first reported in 1999. Despite cefepime-induced neurotoxicity (CIN), it continues to be a principal part of parenteral treatment for various infections. Objective: The study aimed to determine the incidence and risk factors for CIN compared to other antibiotics. Methods: A retrospective cohort study was conducted involving 738 patients over eight months in Kasturba Medical College and Hospital, Manipal, India. Patients with cefepime were selected as study cohort (SC; n= 496), and other antibiotics were included in the reference cohort (RC; n=242). Results: The results showed that 53 (10.7%) patients developed neurotoxicity in the SC, whereas 12 (5%) patients in the RC. A significant association was found between neurotoxicity and cefepime use (X Conclusion: The study found a higher incidence of CIN compared to other antibiotics-induced neurotoxicity and a harmful association between cefepime use and CIN development. Besides, renal failure is a risk factor for CIN. Therefore, the study warrants the use of cefepime, where no other alternatives are available.
MeSH term(s)	Humans ; Cefepime/adverse effects ; Cephalosporins/adverse effects ; Retrospective Studies ; Tertiary Healthcare ; Anti-Bacterial Agents/adverse effects ; Neurotoxicity Syndromes/diagnosis ; Neurotoxicity Syndromes/epidemiology ; Neurotoxicity Syndromes/etiology ; Renal Insufficiency/drug therapy
Chemical Substances	Cefepime (807PW4VQE3) ; Cephalosporins ; Anti-Bacterial Agents
Language	English
Publishing date	2022-03-10
Publishing country	United Arab Emirates
Document type	Journal Article
ZDB-ID	2250840-5
ISSN	2212-3911 ; 1574-8863
ISSN (online)	2212-3911
ISSN	1574-8863
DOI	10.2174/1574886317666220309090408
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Article ; Online: Association of serum ferritin with severity and clinical outcome in COVID-19 patients

Shilia Jacob Kurian / Sara Poikayil Mathews / Abin Paul / Subeesh K. Viswam / Shivashankara Kaniyoor Nagri / Sonal Sekhar Miraj / Shubhada Karanth

Clinical Epidemiology and Global Health, Vol 21, Iss , Pp 101295- (2023)

An observational study in a tertiary healthcare facility

2023

Abstract: Background: Ferritin, an intracellular protein, has a pivotal role in immune dysregulation. Hyperferritinemia has been associated with higher disease severity and adverse clinical outcomes in COVID-19, including mortality. We aimed to study the ... ...

Abstract	Background: Ferritin, an intracellular protein, has a pivotal role in immune dysregulation. Hyperferritinemia has been associated with higher disease severity and adverse clinical outcomes in COVID-19, including mortality. We aimed to study the association of serum ferritin levels with disease severity and clinical outcomes and its severity prediction potential in COVID-19 patients. Methods: This retrospective study included 870 adult patients with symptomatic COVID-19 infection hospitalized between July 1, 2020 to December 21, 2020. All the patients had a positive polymerase chain reaction test result of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Results: The median age was 55 (IQR:40, 65) years with a male predominance [66.32% (n = 577)], among 870 COVID-19. Of these, 413 (47.47%) had mild COVID-19, and 457 (52.53%) had moderate plus severe COVID-19 disease. Median ferritin levels were significantly high in moderate to severe COVID-19 infection compared to mild [545.8 (326.0, 1046.0) vs 97.3 (52.65–155.5) (p = 0.001)], and in patients who developed a complication compared to without complications [380 (177.05, 863.15) vs 290 (110.9, 635) (p = 0.002). A slight elevation in median ferritin levels was observed in patients who had an ICU stay than non-ICU [326 (129.8, 655) vs 309 (119.1, 684) (p = 0.872)]. The cut-off for ferritin was identified at >287.4 ng/ml for mild versus moderate plus severe COVID-19 infections. Conclusion: Moderate to severe COVID-19 patients have elevated ferritin levels. Patients with more than 287.4 ng/ml ferritin value would have greater chances of developing moderate to severe COVID-19 infections.
Keywords	COVID-19 ; Ferritin ; Risk factor ; SARS-CoV-2 ; Severity ; Public aspects of medicine ; RA1-1270
Subject code	610
Language	English
Publishing date	2023-05-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
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Article: Association of serum ferritin with severity and clinical outcome in COVID-19 patients: An observational study in a tertiary healthcare facility.

Kurian, Shilia Jacob / Mathews, Sara Poikayil / Paul, Abin / Viswam, Subeesh K / Kaniyoor Nagri, Shivashankara / Miraj, Sonal Sekhar / Karanth, Shubhada

Clinical epidemiology and global health

2023 Volume 21, Page(s) 101295

Abstract	Background: Ferritin, an intracellular protein, has a pivotal role in immune dysregulation. Hyperferritinemia has been associated with higher disease severity and adverse clinical outcomes in COVID-19, including mortality. We aimed to study the association of serum ferritin levels with disease severity and clinical outcomes and its severity prediction potential in COVID-19 patients. Methods: This retrospective study included 870 adult patients with symptomatic COVID-19 infection hospitalized between July 1, 2020 to December 21, 2020. All the patients had a positive polymerase chain reaction test result of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Results: The median age was 55 (IQR:40, 65) years with a male predominance [66.32% (n = 577)], among 870 COVID-19. Of these, 413 (47.47%) had mild COVID-19, and 457 (52.53%) had moderate plus severe COVID-19 disease. Median ferritin levels were significantly high in moderate to severe COVID-19 infection compared to mild [545.8 (326.0, 1046.0) vs 97.3 (52.65-155.5) (p = 0.001)], and in patients who developed a complication compared to without complications [380 (177.05, 863.15) vs 290 (110.9, 635) (p = 0.002). A slight elevation in median ferritin levels was observed in patients who had an ICU stay than non-ICU [326 (129.8, 655) vs 309 (119.1, 684) (p = 0.872)]. The cut-off for ferritin was identified at >287.4 ng/ml for mild versus moderate plus severe COVID-19 infections. Conclusion: Moderate to severe COVID-19 patients have elevated ferritin levels. Patients with more than 287.4 ng/ml ferritin value would have greater chances of developing moderate to severe COVID-19 infections.
Language	English
Publishing date	2023-03-30
Publishing country	India
Document type	Journal Article
ISSN	2452-0918
ISSN	2452-0918
DOI	10.1016/j.cegh.2023.101295
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Article ; Online: Impact of tuberculosis disease on human gut microbiota: a systematic review.

Baral, Tejaswini / Kurian, Shilia Jacob / Thomas, Levin / Udyavara Kudru, Chandrashekar / Mukhopadhyay, Chiranjay / Saravu, Kavitha / Manu, Mohan K / Singh, Jitendra / Munisamy, Murali / Kumar, Amit / Khandelwal, Bidita / Rao, Mahadev / Sekhar Miraj, Sonal

Expert review of anti-infective therapy

2023 Volume 21, Issue 2, Page(s) 175–188

Abstract: Introduction: This systematic review evaluates the gut microbiota (GM) status in tuberculosis (TB) patients compared to healthy volunteers due to the disease or its treatment.: Areas covered: We conducted a systematic review of all articles published ...

Abstract	Introduction: This systematic review evaluates the gut microbiota (GM) status in tuberculosis (TB) patients compared to healthy volunteers due to the disease or its treatment. Areas covered: We conducted a systematic review of all articles published in PubMed, Web of Science, and Embase that assessed the impact of TB disease and anti-tubercular therapy (ATT) on GM from inception till January 2022 (Protocol registration number in PROSPERO: CRD42021261884). Regarding the microbial diversity indices and taxonomy, we found a significant difference in GM status between the TB and healthy control (HC) groups. We found an overabundance of Phylum Expert opinion: The modulation of GM in TB patients in clinical practice may serve as a promising target to reverse the dysbiosis caused. Moreover, this can optimistically change the TB treatment outcome. We expect that appropriate probiotic supplementation with antimycobacterial treatment during tuberculosis disease will help stabilize the GM throughout the treatment phase and protect the GM from dysbiosis.
MeSH term(s)	Humans ; Gastrointestinal Microbiome ; Dysbiosis/microbiology ; Tuberculosis/microbiology ; Mycobacterium tuberculosis ; Treatment Outcome
Language	English
Publishing date	2023-01-03
Publishing country	England
Document type	Systematic Review ; Research Support, Non-U.S. Gov't
ZDB-ID	2181279-2
ISSN	1744-8336 ; 1478-7210
ISSN (online)	1744-8336
ISSN	1478-7210
DOI	10.1080/14787210.2023.2162879
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Article ; Online: Vitamin D receptor gene polymorphism and vitamin D supplementation on clinical/ treatment outcome in tuberculosis: current and future perspectives.

Sekhar Miraj, Sonal / Vyas, Navya / Kurian, Shilia Jacob / Baral, Tejaswini / Thomas, Levin / Reddy, B Shrikar / Munisamy, Murali / Banerjee, Mithu / Rao, Mahadev

Expert review of anti-infective therapy

2022 Volume 20, Issue 9, Page(s) 1179–1186

Abstract: Introduction: Tuberculosis (TB) is a transnational public health concern, which requires more precise treatment strategies than the existing approaches. Vitamin D modulates the inflammatory and immune response to the disease. Robust evidence shows that ... ...

Abstract	Introduction: Tuberculosis (TB) is a transnational public health concern, which requires more precise treatment strategies than the existing approaches. Vitamin D modulates the inflammatory and immune response to the disease. Robust evidence shows that vitamin D deficiency and its receptor gene polymorphism influence the susceptibility to TB and the outcome of the anti-tubercular treatment (ATT). However, in the different populations, these findings were inconsistent and even contradictory. Areas covered: The current review focuses on the association between vitamin D receptor (VDR) gene polymorphism with the risk of development of TB disease and response to the ATT. Additionally, it reviews various systematic reviews and meta-analyses on the impact of vitamin D supplements on both clinical and treatment outcomes in TB patients. Expert opinion: Although the majority of the findings rule out the benefits of the supplementation, sufficient evidence is available to warrant larger epidemiological research that should be aimed to generate possible interaction among the VDR polymorphism, vitamin D status, and the outcome in TB. We conclude that establishing such an association in different ethnic populations will help design nutrigenomics- or pharmacogenomics-based vitamin D supplementation to develop a personalized medicine approach to flatten the curve of TB disease.
MeSH term(s)	Dietary Supplements ; Genetic Predisposition to Disease ; Humans ; Polymorphism, Genetic ; Receptors, Calcitriol/genetics ; Treatment Outcome ; Tuberculosis/drug therapy ; Tuberculosis/genetics ; Vitamin D/therapeutic use ; Vitamin D Deficiency/drug therapy ; Vitamin D Deficiency/genetics
Chemical Substances	Receptors, Calcitriol ; VDR protein, human ; Vitamin D (1406-16-2)
Language	English
Publishing date	2022-05-31
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2181279-2
ISSN	1744-8336 ; 1478-7210
ISSN (online)	1744-8336
ISSN	1478-7210
DOI	10.1080/14787210.2022.2081546
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Article ; Online: Phytotherapy in Diabetic Foot Ulcers: A Promising Strategy for Effective Wound Healing

Miraj, Sonal Sekhar / Kurian, Shilia Jacob / Rodrigues, Gabriel Sunil / Saravu, Kavitha / Rao, Mahadev / Raychaudhuri, Siba Prasad / Downs, Bernard W. / Bagchi, Debasis

Journal of the American Nutrition Association. 2023 Apr. 3, v. 42, no. 3, p. 295-310

2023 , Page(s) 295–310

Abstract: Despite the advancement in wound care, the effective therapy of chronic diabetic ulcers continues to be a challenge. Wound healing is a highly controlled process, which involves a sequence of complex overlapping steps. This healing pathway comprises of ... ...

Abstract	Despite the advancement in wound care, the effective therapy of chronic diabetic ulcers continues to be a challenge. Wound healing is a highly controlled process, which involves a sequence of complex overlapping steps. This healing pathway comprises of hemostasis, inflammation, proliferative, and remodeling phases. Recent evidence suggests that phytomedicines can prevent or repair different kinds of destructive cellular damage, including chronic wounds. Several phytochemicals such as polyphenols, alkaloids, flavonoids, terpenoids, and glycosides have pleiotropic effects, including stimulation of fibroblast proliferation, the main step in wound healing. Besides, the mechanism involves induction of collagen synthesis, migration, and reepithelization and their antimicrobial, antioxidant, anti-inflammatory, and immunomodulatory actions. Similarly, the use of phytochemicals alone or as an adjuvant with standard therapy has demonstrated promising results in managing complications in the diabetic foot. For instance, the extract of Carica papaya has been shown antioxidant, antimicrobial, and anti-inflammatory, and immunomodulatory effects, which, together with proteolytic enzymatic activity, contributes to its wound healing property. It is generally believed that phytotherapy has no or minimal toxicity than synthetic therapeutic agents, favoring its use in diabetic foot ulcer management. The current review highlights the selected phytochemicals and their sources; and potential application in diabetic foot ulcer management. Key teaching points and nutritional relevanceCurrently, phytochemicals have been shown wide potential in disease. management including alleviating clinical manifestations, preventing degenerative disease, and curing illness. Increased evidence of phytochemical as anti-infective and anti-inflammatory suggests its role in the management of diabetic foot ulcer(DFU). Potential benefit along with minimal adverse effect favors its application as adjuvant therapy. Further research is needed to standardize its dose and formulation to enhance its clinical application in DFU management.
Keywords	Carica papaya ; adjuvants ; adverse effects ; antioxidants ; collagen ; diabetic foot ; enzyme activity ; fibroblasts ; flavonoids ; glycosides ; hemostasis ; inflammation ; nutrition ; phytotherapy ; polyphenols ; proteolysis ; terpenoids ; toxicity ; diabetic wound ; phytochemicals ; phytomedicine ; wound healing
Language	English
Dates of publication	2023-0403
Size	p. 295-310
Publishing place	Taylor & Francis
Document type	Article ; Online
ISSN	2769-707X
DOI	10.1080/07315724.2022.2034069
Database	NAL-Catalogue (AGRICOLA)

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Article ; Online: Phytotherapy in Diabetic Foot Ulcers: A Promising Strategy for Effective Wound Healing.

Miraj, Sonal Sekhar / Kurian, Shilia Jacob / Rodrigues, Gabriel Sunil / Saravu, Kavitha / Rao, Mahadev / Raychaudhuri, Siba Prasad / Downs, Bernard W / Bagchi, Debasis

Journal of the American Nutrition Association

2022 Volume 42, Issue 3, Page(s) 295–310

Abstract	Despite the advancement in wound care, the effective therapy of chronic diabetic ulcers continues to be a challenge. Wound healing is a highly controlled process, which involves a sequence of complex overlapping steps. This healing pathway comprises of hemostasis, inflammation, proliferative, and remodeling phases. Recent evidence suggests that phytomedicines can prevent or repair different kinds of destructive cellular damage, including chronic wounds. Several phytochemicals such as polyphenols, alkaloids, flavonoids, terpenoids, and glycosides have pleiotropic effects, including stimulation of fibroblast proliferation, the main step in wound healing. Besides, the mechanism involves induction of collagen synthesis, migration, and reepithelization and their antimicrobial, antioxidant, anti-inflammatory, and immunomodulatory actions. Similarly, the use of phytochemicals alone or as an adjuvant with standard therapy has demonstrated promising results in managing complications in the diabetic foot. For instance, the extract of Carica papaya has been shown antioxidant, antimicrobial, and anti-inflammatory, and immunomodulatory effects, which, together with proteolytic enzymatic activity, contributes to its wound healing property. It is generally believed that phytotherapy has no or minimal toxicity than synthetic therapeutic agents, favoring its use in diabetic foot ulcer management. The current review highlights the selected phytochemicals and their sources; and potential application in diabetic foot ulcer management.Key teaching points and nutritional relevanceCurrently, phytochemicals have been shown wide potential in disease. management including alleviating clinical manifestations, preventing degenerative disease, and curing illness.Increased evidence of phytochemical as anti-infective and anti-inflammatory suggests its role in the management of diabetic foot ulcer(DFU).Potential benefit along with minimal adverse effect favors its application as adjuvant therapy.Further research is needed to standardize its dose and formulation to enhance its clinical application in DFU management.
MeSH term(s)	Humans ; Diabetic Foot/drug therapy ; Wound Healing ; Antioxidants/pharmacology ; Phytotherapy ; Anti-Infective Agents/pharmacology ; Diabetes Mellitus/drug therapy
Chemical Substances	Antioxidants ; Anti-Infective Agents
Language	English
Publishing date	2022-04-25
Publishing country	United States
Document type	Review ; Journal Article ; Research Support, Non-U.S. Gov't
ISSN	2769-707X
ISSN (online)	2769-707X
DOI	10.1080/07315724.2022.2034069
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