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Article: Optimization of Prescription Drug Monitoring Program to Overcome Opioid Epidemic in West Virginia.

Al-Astal, Ala-Eddin Yassin / Sodhi, Komal / Lakhani, Hari Vishal

2022 Volume 14, Issue 2, Page(s) e22434

Abstract: The development of the Prescription Drug Monitoring Program (PDMP) led to an innovation in the healthcare organization system (HCOs). The PDMP system has been utilized in different states at various organizational levels in an effort to achieve improved ... ...

Abstract	The development of the Prescription Drug Monitoring Program (PDMP) led to an innovation in the healthcare organization system (HCOs). The PDMP system has been utilized in different states at various organizational levels in an effort to achieve improved health outcomes, reduce the number of prescription drug overdoses, and lighten the economic burden that follows. However, during the implementation of PDMP, there were several barriers and limitations that were discovered. Those barriers impeded the process of utilization of PDMP, such as the complex user interface and lack of training for healthcare providers. The purpose of this paper was to examine the advances and limitations in the utilization and implementation of PDMP in the US healthcare industry and develop strategies for effective use of PDMP in West Virginia. The qualitative part of this paper was a literature review. The paper referred to several peer-reviewed studies and research articles from several reliable resources, which were reached by databases or Google Scholar. A total of 44 articles were reviewed for this study. The implementation of the PDMP was influenced by benefits and barriers. This article reviewed several studies in general that demonstrated positive outcomes from the implementation of PDMP, including a reduced number of prescription drug overdoses, coordinated care for patients, and improved health outcomes. However, the barriers and limitations were not neglected, which mainly include integration of PDMP into the electronic health record (EHR) system, lack of training for the providers, and lack of basic standards for the use of PDMP. Although the new health reforms encouraged the adaption of PDMP among providers, data reporting and data interpretation still remain major concerns for assessing the health outcomes of PDMP implementation.
Language	English
Publishing date	2022-02-21
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.22434
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Prevalence of Substance Abuse Among Trauma Patients in Rural West Virginia.

Mansoor, Kanaan / De Souza Goncalves, Bruno / Lakhani, Hari Vishal / Tashani, Mohammad / Jones, Sharon E / Sodhi, Komal / Thompson, Ellen / Dougherty, Thomas

Cureus

2023 Volume 15, Issue 3, Page(s) e36468

Abstract: Background: Substance abuse poses considerable clinical, economic, and social challenges. West Virginia is hailed as the epicenter of the substance abuse in the United States, the prevalence and pattern of different trauma mechanisms in a rural context ...

Abstract	Background: Substance abuse poses considerable clinical, economic, and social challenges. West Virginia is hailed as the epicenter of the substance abuse in the United States, the prevalence and pattern of different trauma mechanisms in a rural context or in patients with different forms of substance abuse remain unclear. Objective: We performed the following analysis to understand the prevalence of substance abuse in patients with different trauma mechanisms in the rural setting with high substance abuse in the West Virginia. Methods: We performed a cross-sectional retrospective analysis of adult trauma patients (motor vehicle, fall, assault, firearm suicide, brawl/rape and machinery) hospitalized in two tertiary care hospitals in West Virginia between 2006 and 2016. We identified all patients who had a urine drug screen (UDS) test and extracted the data related to the substance and trauma. Results: Among 8734 patients screened using UDS, 5940 (68.1%) patients were tested positive for the substance. Opiates, alcohol, benzodiazepines, and cannabis were the four most common substances identified in trauma victims. In all instances, the prescribed drug was less than 20%. Fatal outcome was observed in 366 patients in the sample, with 44% (n=162) testing positive for UDS, 12% (n=45) testing positive for only alcohol, and 15% (n=56) testing positive for both alcohol and UDS. Regarding the trauma mechanism, the motor vehicle accident (MVA) was the most prominent with a clear association of substance abuse with fatal outcome. Conclusion: The most prevalent trauma mechanism was a MVA, with a strong link between drug usage and mortality. Due to the high incidence of positive substance abuse screens, UDS tests may need to be more widely implemented in trauma in the West Virginia region. The findings of this study might help in establishing regional or national policies to reduce acute substance abuse.
Language	English
Publishing date	2023-03-21
Publishing country	United States
Document type	Journal Article
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.36468
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Article ; Online: Erratum: Role of adipocyte Na,K-ATPase oxidant amplification loop in cognitive decline and neurodegeneration.

Sodhi, Komal / Pratt, Rebecca / Wang, Xiaoliang / Lakhani, Hari Vishal / Pillai, Sneha S / Zehra, Mishghan / Wang, Jiayan / Grover, Lawrence / Henderson, Brandon / Denvir, James / Liu, Jiang / Pierre, Sandrine / Nelson, Thomas / Shapiro, Joseph I

iScience

2023 Volume 26, Issue 12, Page(s) 108438

Abstract: This corrects the article DOI: 10.1016/j.isci.2021.103262.]. ...

Abstract	[This corrects the article DOI: 10.1016/j.isci.2021.103262.].
Language	English
Publishing date	2023-11-16
Publishing country	United States
Document type	Published Erratum
ISSN	2589-0042
ISSN (online)	2589-0042
DOI	10.1016/j.isci.2023.108438
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Article ; Online: Role of adipocyte Na,K-ATPase oxidant amplification loop in cognitive decline and neurodegeneration

Komal Sodhi / Rebecca Pratt / Xiaoliang Wang / Hari Vishal Lakhani / Sneha S. Pillai / Mishghan Zehra / Jiayan Wang / Lawrence Grover / Brandon Henderson / James Denvir / Jiang Liu / Sandrine Pierre / Thomas Nelson / Joseph I. Shapiro

iScience, Vol 26, Iss 12, Pp 108438- (2023)

2023

Keywords	Science ; Q
Language	English
Publishing date	2023-12-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Transitioning to Unfractionated Heparin in Treatment of Non-ST-Segment Elevation Myocardial Infarction Patients on Direct Oral Anti-Xa Inhibitors.

Mohamed Tashani / Raice A Stevens / Bruno de Souza Goncalves / Hari Vishal Lakhani / Sharon E Jones / Laura Given / Rebecca Sicking / Thomas Dougherty / Ellen Thompson / Komal Sodhi / Rameez T Sayyed / Mehiar El-Hamdani / Melissa D Lester / Mark A Studeny / Jason P Mader

Cellular and molecular biology (Noisy-le-Grand, France)

2023 Volume 69, Issue 3, Page(s) 191–197

Abstract: The heparin anti-Xa assay is affected by the use of direct oral anticoagulants (DOACs) and is utilized in the management of intravenous unfractionated heparin. Patients with non-ST-segment myocardial infarction (NSTEMI) receive intravenous unfractionated ...

Abstract	The heparin anti-Xa assay is affected by the use of direct oral anticoagulants (DOACs) and is utilized in the management of intravenous unfractionated heparin. Patients with non-ST-segment myocardial infarction (NSTEMI) receive intravenous unfractionated heparin with prior administration of DOACs poses challenges given these laboratory abnormalities. On this background, we evaluate if an elevated heparin anti-Xa assay may lead to the decision to delay heparin in the management of NSTEMI patients and the outcome of in-hospital mortality. This is a single-center chart review study with patients admitted between January 2019 and December 2020. Patients with a documented DOAC home medication and a diagnosis of NSTEMI were included. Data was collected for heparin anti-Xa levels at baseline, after 6 and 12 hours of hospitalization, in addition to the reason for the delay in the administration of heparin. Statistical analysis included the determination of r-squared correlation and one-way ANOVA using GraphPad Prism 8.0. A total of 44 patients were divided into three groups based on baseline Xa levels of patients. Elevated Xa level was noted more in patients who were taking apixaban. Heparin infusion was delayed among this sub-group of patients. Elevated baseline heparin anti-Xa levels were significantly improved after 12 hours. There was no correlation between elevated anti-Xa levels and activated partial thromboplastin time. No in-hospital mortality was observed among any of the subgroups. Collectively, this study demonstrates that the high sensitivity of heparin anti-Xa assay to DOACs affect assay accuracy and result in elevated heparin anti-Xa level with the use of DOACs resulting in delayed start of heparin therapy in treating NSTEMI patients.
MeSH term(s)	Humans ; Heparin/therapeutic use ; Non-ST Elevated Myocardial Infarction/drug therapy ; Non-ST Elevated Myocardial Infarction/chemically induced ; Factor Xa Inhibitors/therapeutic use ; Anticoagulants/therapeutic use ; Myocardial Infarction/drug therapy
Chemical Substances	Heparin (9005-49-6) ; Factor Xa Inhibitors ; Anticoagulants
Language	English
Publishing date	2023-03-31
Publishing country	France
Document type	Journal Article
ZDB-ID	1161779-2
ISSN	1165-158X ; 0145-5680
ISSN (online)	1165-158X
ISSN	0145-5680
DOI	10.14715/cmb/2023.69.3.28
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Article: Biomarker panel for early screening of trastuzumab -induced cardiotoxicity among breast cancer patients in west virginia.

Pillai, Sneha S / Pereira, Duane G / Bonsu, Gloria / Chaudhry, Hibba / Puri, Nitin / Lakhani, Hari Vishal / Tirona, Maria Tria / Sodhi, Komal / Thompson, Ellen

Frontiers in pharmacology

2022 Volume 13, Page(s) 953178

Abstract: Cardiotoxicity is a well-known pathophysiological consequence in breast cancer patients receiving trastuzumab. Trastuzumab related cardiotoxicity typically results in an overall decline in cardiac function, primarily characterized by reduction in left ... ...

Abstract	Cardiotoxicity is a well-known pathophysiological consequence in breast cancer patients receiving trastuzumab. Trastuzumab related cardiotoxicity typically results in an overall decline in cardiac function, primarily characterized by reduction in left ventricular ejection fraction (LVEF) and development of symptoms associated with heart failure. Current strategies for the monitoring of cardiac function, during trastuzumab therapy, includes serial echocardiography, which is cost ineffective as well as offers limited specificity, while offering limited potential in monitoring early onset of cardiotoxicity. However, biomarkers have been shown to be aberrant prior to any detectable functional or clinical deficit in cardiac function. Hence, this study aims to develop a panel of novel biomarkers and circulating miRNAs for the early screening of trastuzumab induced cardiotoxicity. Patients with clinical diagnosis of invasive ductal carcinoma were enrolled in the study, with blood specimen collected and echocardiography performed prior to trastuzumab therapy initiation at baseline, 3- and 6-months post trastuzumab therapy. Following 6-months of trastuzumab therapy, about 18% of the subjects developed cardiotoxicity, as defined by reduction in LVEF. Our results showed significant upregulation of biomarkers and circulating miRNAs, specific to cardiac injury and remodeling, at 3- and 6-months post trastuzumab therapy. These biomarkers and circulating miRNAs significantly correlated with the cardiac injury specific markers, troponin I and T. The findings in the present study demonstrates the translational applicability of the proposed biomarker panel in early preclinical diagnosis of trastuzumab induced cardiotoxicity, further allowing management of cardiac function decline and improved health outcomes for breast cancer patients.
Language	English
Publishing date	2022-08-12
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2587355-6
ISSN	1663-9812
ISSN	1663-9812
DOI	10.3389/fphar.2022.953178
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Article ; Online: Adipocyte Na, K-ATPase Signaling Attenuates Experimental Uremic Cardiomyopathy.

Sodhi, Komal / Wang, Xiaoliang / Chaudhary, Muhammad A / Lakhani, Hari Vishal / Zehra, Mishghan / Nawab, Athar / Cottrill, Cameron L / Bai, Fang / Liu, Jiang / Sanabria, Juan R / Xie, Zijian / Shapiro, Joseph I

Cellular and molecular biology (Noisy-le-Grand, France)

2023 Volume 69, Issue 5, Page(s) 197–206

Abstract: Oxidative stress has been shown to cause an alteration of intracellular signaling in adipocytes that may lead to various comorbidities of obesity and cardiovascular complications. Evidence suggests that dysregulation of Na, K-ATPase signaling can ... ...

Abstract	Oxidative stress has been shown to cause an alteration of intracellular signaling in adipocytes that may lead to various comorbidities of obesity and cardiovascular complications. Evidence suggests that dysregulation of Na, K-ATPase signaling can contribute to systemic inflammation and redox signaling that leads to various metabolic disturbances. Hence the present study aims to explore the specific role of adipocyte Na, K-ATPase signaling in the amelioration of pathophysiological alterations of experimental uremic cardiomyopathy. Experimental uremic cardiomyopathy was induced by partial nephrectomy (PNx), and adipocyte-specific expression of NaKtide, a peptide that inhibits Na, K-ATPase signaling, was achieved using a lentivirus construct with NaKtide expression driven by an adiponectin promoter. Cardiomyopathy and anemia induced in partial nephrectomy mice were accompanied by an altered molecular phenotype of adipocytes, increased systemic inflammatory cytokines and oxidant stress within 4 weeks. These changes were significantly worsened by the addition of a Western diet (enriched in fat and fructose contents) but were prevented with specific expression of NaKtide in adipocytes. The skeletal muscle-specific expression of NaKtide did not ameliorate the disease phenotype. Adipocyte dysfunction and uremic cardiomyopathy developed in PNx mice, both were significantly ameliorated by the adipocyte-specific expression of NaKtide. These findings suggest that oxidative milieu in the adipocyte has a pivotal role in the development and progression of uremic cardiomyopathy in mice subjected to partial nephrectomy. If confirmed in humans, this may be a lead for future research to explore novel therapeutic targets in chronic renal failure.
MeSH term(s)	Humans ; Mice ; Animals ; Cardiomyopathies/etiology ; Cardiomyopathies/metabolism ; Sodium-Potassium-Exchanging ATPase/metabolism ; Signal Transduction ; Oxidative Stress ; Peptides/metabolism ; Adipocytes/metabolism
Chemical Substances	Sodium-Potassium-Exchanging ATPase (EC 7.2.2.13) ; Peptides
Language	English
Publishing date	2023-05-31
Publishing country	France
Document type	Journal Article
ZDB-ID	1161779-2
ISSN	1165-158X ; 0145-5680
ISSN (online)	1165-158X
ISSN	0145-5680
DOI	10.14715/cmb/2023.69.5.31
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ab Jg. 2022: Lesesaal (EG)

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Article ; Online: Retraction Note: The Adipocyte Na/K-ATPase Oxidant Amplification Loop is the Central Regulator of Western Diet-Induced Obesity and Associated Comorbidities.

Pratt, Rebecca D / Brickman, Cameron / Nawab, Athar / Cottrill, Cameron / Snoad, Brian / Lakhani, Hari Vishal / Jelcick, Austin / Henderson, Brandon / Bhardwaj, Niharika N / Sanabria, Juan R / Liu, Jiang / Xie, Zijian / Abraham, Nader G / Shapiro, Joseph I / Sodhi, Komal

Scientific reports

2022 Volume 12, Issue 1, Page(s) 9005

Language	English
Publishing date	2022-05-30
Publishing country	England
Document type	Journal Article ; Retraction of Publication
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-022-13459-9
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Article ; Online: Elucidating Potential Profibrotic Mechanisms of Emerging Biomarkers for Early Prognosis of Hepatic Fibrosis.

Zehra, Mishghan / Curry, James C / Pillai, Sneha S / Lakhani, Hari Vishal / Edwards, Cory E / Sodhi, Komal

International journal of molecular sciences

2020 Volume 21, Issue 13

Abstract: Hepatic fibrosis has been associated with a series of pathophysiological processes causing excessive accumulation of extracellular matrix proteins. Several cellular processes and molecular mechanisms have been implicated in the diseased liver that ... ...

Abstract	Hepatic fibrosis has been associated with a series of pathophysiological processes causing excessive accumulation of extracellular matrix proteins. Several cellular processes and molecular mechanisms have been implicated in the diseased liver that augments fibrogenesis, fibrogenic cytokines and associated liver complications. Liver biopsy remains an essential diagnostic tool for histological evaluation of hepatic fibrosis to establish a prognosis. In addition to being invasive, this methodology presents with several limitations including poor cost-effectiveness, prolonged hospitalizations, and risks of peritoneal bleeding, while the clinical use of this method does not reveal underlying pathogenic mechanisms. Several alternate noninvasive diagnostic strategies have been developed, to determine the extent of hepatic fibrosis, including the use of direct and indirect biomarkers. Immediate diagnosis of hepatic fibrosis by noninvasive means would be more palatable than a biopsy and could assist clinicians in taking early interventions timely, avoiding fatal complications, and improving prognosis. Therefore, we sought to review some common biomarkers of liver fibrosis along with some emerging candidates, including the oxidative stress-mediated biomarkers, epigenetic and genetic markers, exosomes, and miRNAs that needs further evaluation and would have better sensitivity and specificity. We also aim to elucidate the potential role of cardiotonic steroids (CTS) and evaluate the pro-inflammatory and profibrotic effects of CTS in exacerbating hepatic fibrosis. By understanding the underlying pathogenic processes, the efficacy of these biomarkers could allow for early diagnosis and treatment of hepatic fibrosis in chronic liver diseases, once validated.
MeSH term(s)	Biomarkers/metabolism ; Cardiac Glycosides/metabolism ; Early Diagnosis ; Epigenesis, Genetic ; Exosomes/metabolism ; Genetic Markers ; Humans ; Liver Cirrhosis/diagnosis ; Liver Cirrhosis/etiology ; Liver Cirrhosis/metabolism ; MicroRNAs/genetics ; Oxidative Stress ; Prognosis ; Signal Transduction ; Sodium-Potassium-Exchanging ATPase/metabolism ; Wound Healing/physiology
Chemical Substances	Biomarkers ; Cardiac Glycosides ; Genetic Markers ; MicroRNAs ; Sodium-Potassium-Exchanging ATPase (EC 7.2.2.13)
Language	English
Publishing date	2020-07-03
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2019364-6
ISSN	1422-0067 ; 1422-0067 ; 1661-6596
ISSN (online)	1422-0067
ISSN	1422-0067 ; 1661-6596
DOI	10.3390/ijms21134737
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Article ; Online: Systematic Review of Clinical Insights into Novel Coronavirus (CoVID-19) Pandemic: Persisting Challenges in U.S. Rural Population.

Lakhani, Hari Vishal / Pillai, Sneha S / Zehra, Mishghan / Sharma, Ishita / Sodhi, Komal

International journal of environmental research and public health

2020 Volume 17, Issue 12

Abstract: 1) Introduction. A recent viral outbreak of novel coronavirus (CoVID-19) was declared as a pandemic by the World Health Organization (WHO) due to its global public health concern. There has been an aggressive growth in the number of emerging cases ... ...

Abstract	(1) Introduction. A recent viral outbreak of novel coronavirus (CoVID-19) was declared as a pandemic by the World Health Organization (WHO) due to its global public health concern. There has been an aggressive growth in the number of emerging cases suggesting rapid spread of the virus. Since the first reported case of CoVID-19, there has been vast progress in understanding the dynamics of CoVID-19. However, there is an increasing evidence of epidemiological disparity in disease burden between urban and rural areas, with rural areas having minimal pandemic preparedness and their own healthcare challenges. Therefore, this review aims to provide insight on the pathogenesis and the transmission dynamics of CoVID-19 along with pharmacological and non-pharmacological intervention strategies to mitigate the clinical manifestation of this virus. This review also aims to assess existing challenges of the CoVID-19 pandemic in rural areas based on past pandemic experiences and the effect on rural population. (2) Methods. A literature review was conducted using databases such as PubMed, Science Direct, Academic Search Premier, ProQuest, and Google Scholar, along with information from governmental organizations such as Centers for Disease Control and Prevention (CDC) and World Health Organization (WHO). (3) Results. The causative virus, with its likely zoonotic origin, has demonstrated high pathogenicity in humans through increasing human-to-human transmission leading to extensive mitigation strategies, including patient quarantine and mass "social distancing" measures. Although the clinical manifestation of symptoms is mild in majority of the virus-inflicted population, critical patients may present with pneumonia and acute respiratory distress syndrome, exacerbated by pre-existing comorbidities, eventually leading to death. While effective coronavirus disease (CoVID-19)-specific vaccines and drugs are under clinical trials, several pharmacological and non-pharmacological interventions have been adapted to manage symptoms and curtail the effect of the virus to prevent increasing morbidity and mortality. Several persisting challenges have been noted for mitigating CoVID-19 in rural areas, including the poor healthcare infrastructure, health literacy, pandemic preparedness along with the fact that majority of rural population are frail subjects with pre-existing comorbidities. (4) Discussion. The increasing rate of incidence of CoVID-19 presents its own challenges, burdening healthcare institutions and the global economy, and impacting the physical and mental health of people worldwide. Given the clinical insights into CoVID-19 and the challenges presented in this review for the U.S. rural population, mitigation strategies should be designed accordingly to minimize the morbidity and mortality of this contagion.
MeSH term(s)	Betacoronavirus ; COVID-19 ; Comorbidity ; Coronavirus Infections/epidemiology ; Coronavirus Infections/pathology ; Coronavirus Infections/transmission ; Humans ; Incidence ; Pandemics ; Pneumonia, Viral/epidemiology ; Pneumonia, Viral/pathology ; Pneumonia, Viral/transmission ; Public Health ; Quarantine ; Rural Population ; SARS-CoV-2 ; United States/epidemiology
Keywords	covid19
Language	English
Publishing date	2020-06-15
Publishing country	Switzerland
Document type	Journal Article ; Systematic Review
ISSN	1660-4601
ISSN (online)	1660-4601
DOI	10.3390/ijerph17124279
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