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Article: Factors Affecting Best-Tolerated Dose of Pirfenidone in Patients with Fibrosing Interstitial Lung Disease.

Mandovra, Neha P / Vaidya, Preyas J / Shah, Ria S / Nighojkar, Aishwarya S / Chavhan, Vinod B / Lohiya, Ayush / Leuppi, Joerg D / Leuppi-Taegtmeyer, Anne / Chhajed, Prashant N

Journal of clinical medicine

2023 Volume 12, Issue 20

Abstract: The aim of the study was to examine the best-tolerated dose of pirfenidone, the adverse effects profile, and potential factors other than drug dose influencing the tolerability of pirfenidone in patients with fibrosing interstitial lung diseases (ILDs). ... ...

Abstract	The aim of the study was to examine the best-tolerated dose of pirfenidone, the adverse effects profile, and potential factors other than drug dose influencing the tolerability of pirfenidone in patients with fibrosing interstitial lung diseases (ILDs). We performed an observational retrospective study of 113 patients with IPF and other fibrosing ILDs treated with pirfenidone. Baseline liver function tests (LFTs) and dose escalation of pirfenidone were recorded for all patients. The best-tolerated dose was continued if the patient did not tolerate full dose (2400 mg) despite repeated dose escalation attempts. Potential risk factors such as age, height, weight, body mass index (BMI), body surface area (BSA), gender, smoking, and presence of comorbidities were analyzed between 3 groups of best-tolerated pirfenidone doses: 2400 mg/day vs. <2400 mg/day, 2400 mg/day vs. 1800 mg/day, and 2400 mg/day vs. 1200 mg/day. A total of 24 patients tolerated 2400 mg/day, and 89 patients tolerated <2400 mg/day (43 tolerated 1800 mg/day, 45 tolerated 1200 mg/day and 1 tolerated 600 mg/day). Patients who tolerated 2400 mg/day were taller and had a larger BSA as compared to those tolerating <2400 mg/day. Overall, males tolerated the drug better. Presence of comorbidities or smoking did not affect the tolerance of pirfenidone, except for the presence of cerebrovascular diseases. Various adverse effects did not have any significantly different frequencies between the compared groups. Moreover, 71.7% of patients experienced at least one side effect. 1200 mg/day was the best-tolerated dose in the majority of the patients. Male patients with a larger BSA and greater height showed better tolerability of pirfenidone overall.
Language	English
Publishing date	2023-10-13
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm12206513
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Travel restrictions and infectious disease outbreaks.

Vaidya, Ria / Herten-Crabb, Asha / Spencer, Julia / Moon, Suerie / Lillywhite, Louis

Journal of travel medicine

2020 Volume 27, Issue 3

Abstract: Background: A key purpose of the International Health Regulations (IHR) is to prevent unwarranted interruptions to trade and travel during large and/or transnational infectious disease outbreaks. Nevertheless, such outbreaks continue to disrupt the ... ...

Abstract	Background: A key purpose of the International Health Regulations (IHR) is to prevent unwarranted interruptions to trade and travel during large and/or transnational infectious disease outbreaks. Nevertheless, such outbreaks continue to disrupt the travel industry. This aspect of the IHR has received little attention in the academic literature despite its considerable impact on affected States and commercial activity. This article outlines the challenges and gaps in knowledge regarding the relationship between outbreaks and the travel sector and discusses the opportunities for further research and policy work to overcome these challenges. Methodology: We conducted a literature review on the relationship between outbreaks and travel restrictions, with a particular focus on the 2014-16 Ebola epidemic in West Africa. This review was complemented by an expert roundtable at Chatham House and further supported by case studies and qualitative interviews. Results: Numerous travel stakeholders are affected by, and affect, large-scale infectious disease outbreaks. These stakeholders react in different ways: peer pressure plays an important role for both governments and the travel sector, and the reactions of the media and public influence and are influenced by these stakeholders. While various data sources on travel are available, and World Health Organization is mandated to work with States, there is no recognized coordinating body to disseminate timely, consistent, reliable and authoritative information and best practices to all stakeholders. Conclusion: This article highlights the interdependent relationship between various travel stakeholders. The reasons for interruption of travel during the 2014-16 Ebola outbreak were complex, with decisions by States only partly contributing to the cessation. Decisions by non-state actors, particularly the travel industry itself, contributed significantly and were based on a variety of factors. Further research, analysis and policy development are required to mitigate the health and economic consequences of infectious disease outbreaks. Any further research will also need to take account of COVID-19 travel-related issues.
MeSH term(s)	Africa, Western ; Aircraft ; Betacoronavirus ; COVID-19 ; Communicable Disease Control/methods ; Communication ; Coronavirus Infections ; Decision Making ; Disease Outbreaks/prevention & control ; Hemorrhagic Fever, Ebola/epidemiology ; Hemorrhagic Fever, Ebola/history ; History, 21st Century ; Humans ; Industry ; Mass Media ; Pandemics ; Pneumonia, Viral ; SARS-CoV-2 ; Travel
Keywords	covid19
Language	English
Publishing date	2020-04-16
Publishing country	England
Document type	Historical Article ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1212504-0
ISSN	1708-8305 ; 1195-1982
ISSN (online)	1708-8305
ISSN	1195-1982
DOI	10.1093/jtm/taaa050
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Article ; Online: Study protocol for a pilot prospective, observational study investigating the condition suggestion and urgency advice accuracy of a symptom assessment app in sub-Saharan Africa

Elizabeth Millen / Nahya Salim / Hila Azadzoy / Mustafa Miraji Bane / Lisa O'Donnell / Marcel Schmude / Philipp Bode / Ewelina Tuerk / Ria Vaidya / Stephen Henry Gilbert

BMJ Open, Vol 12, Iss

the AFYA-‘Health’ Study

2022 Volume 4

Keywords	Medicine ; R
Language	English
Publishing date	2022-04-01T00:00:00Z
Publisher	BMJ Publishing Group
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: Investigating the Potential for Clinical Decision Support in Sub-Saharan Africa With AFYA (Artificial Intelligence-Based Assessment of Health Symptoms in Tanzania): Protocol for a Prospective, Observational Pilot Study.

Schmude, Marcel / Salim, Nahya / Azadzoy, Hila / Bane, Mustafa / Millen, Elizabeth / O'Donnell, Lisa / Bode, Philipp / Türk, Ewelina / Vaidya, Ria / Gilbert, Stephen

JMIR research protocols

2022 Volume 11, Issue 6, Page(s) e34298

Abstract: Background: Low- and middle-income countries face difficulties in providing adequate health care. One of the reasons is a shortage of qualified health workers. Diagnostic decision support systems are designed to aid clinicians in their work and have the ...

Abstract	Background: Low- and middle-income countries face difficulties in providing adequate health care. One of the reasons is a shortage of qualified health workers. Diagnostic decision support systems are designed to aid clinicians in their work and have the potential to mitigate pressure on health care systems. Objective: The Artificial Intelligence-Based Assessment of Health Symptoms in Tanzania (AFYA) study will evaluate the potential of an English-language artificial intelligence-based prototype diagnostic decision support system for mid-level health care practitioners in a low- or middle-income setting. Methods: This is an observational, prospective clinical study conducted in a busy Tanzanian district hospital. In addition to usual care visits, study participants will consult a mid-level health care practitioner, who will use a prototype diagnostic decision support system, and a study physician. The accuracy and comprehensiveness of the differential diagnosis provided by the diagnostic decision support system will be evaluated against a gold-standard differential diagnosis provided by an expert panel. Results: Patient recruitment started in October 2021. Participants were recruited directly in the waiting room of the outpatient clinic at the hospital. Data collection will conclude in May 2022. Data analysis is planned to be finished by the end of June 2022. The results will be published in a peer-reviewed journal. Conclusions: Most diagnostic decision support systems have been developed and evaluated in high-income countries, but there is great potential for these systems to improve the delivery of health care in low- and middle-income countries. The findings of this real-patient study will provide insights based on the performance and usability of a prototype diagnostic decision support system in low- or middle-income countries. Trial registration: ClinicalTrials.gov NCT04958577; http://clinicaltrials.gov/ct2/show/NCT04958577. International registered report identifier (irrid): DERR1-10.2196/34298.
Language	English
Publishing date	2022-06-07
Publishing country	Canada
Document type	Journal Article
ZDB-ID	2719222-2
ISSN	1929-0748
ISSN	1929-0748
DOI	10.2196/34298
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Article ; Online: Study protocol for a pilot prospective, observational study investigating the condition suggestion and urgency advice accuracy of a symptom assessment app in sub-Saharan Africa: the AFYA-'Health' Study.

Millen, Elizabeth / Salim, Nahya / Azadzoy, Hila / Bane, Mustafa Miraji / O'Donnell, Lisa / Schmude, Marcel / Bode, Philipp / Tuerk, Ewelina / Vaidya, Ria / Gilbert, Stephen Henry

BMJ open

2022 Volume 12, Issue 4, Page(s) e055915

Abstract: Introduction: Due to a global shortage of healthcare workers, there is a lack of basic healthcare for 4 billion people worldwide, particularly affecting low-income and middle-income countries. The utilisation of AI-based healthcare tools such as symptom ...

Abstract	Introduction: Due to a global shortage of healthcare workers, there is a lack of basic healthcare for 4 billion people worldwide, particularly affecting low-income and middle-income countries. The utilisation of AI-based healthcare tools such as symptom assessment applications (SAAs) has the potential to reduce the burden on healthcare systems. The purpose of the AFYA Study (AI-based Assessment oF health sYmptoms in TAnzania) is to evaluate the accuracy of the condition suggestions and urgency advice provided by a user on a Swahili language Ada SAA. Methods and analysis: This study is designed as an observational prospective clinical study. The setting is a waiting room of a Tanzanian district hospital. It will include patients entering the outpatient clinic with various conditions and age groups, including children and adolescents. Patients will be asked to use the SAA before proceeding to usual care. After usual care, they will have a consultation with a study-provided physician. Patients and healthcare practitioners will be blinded to the SAA's results. An expert panel will compare the Ada SAA's condition suggestions and urgency advice to usual care and study provided differential diagnoses and triage. The primary outcome measures are the accuracy and comprehensiveness of the Ada SAA evaluated against the gold standard differential diagnoses. Ethics and dissemination: Ethical approval was received by the ethics committee (EC) of Muhimbili University of Health and Allied Sciences with an approval number MUHAS-REC-09-2019-044 and the National Institute for Medical Research, NIMR/HQ/R.8c/Vol. I/922. All amendments to the protocol are reported and adapted on the basis of the requirements of the EC. The results from this study will be submitted to peer-reviewed journals, local and international stakeholders, and will be communicated in editorials/articles by Ada Health. Trial registration number: NCT04958577.
MeSH term(s)	Adolescent ; Child ; Humans ; Mobile Applications ; Observational Studies as Topic ; Pilot Projects ; Prospective Studies ; Symptom Assessment ; Tanzania
Language	English
Publishing date	2022-04-11
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2599832-8
ISSN	2044-6055 ; 2044-6055
ISSN (online)	2044-6055
ISSN	2044-6055
DOI	10.1136/bmjopen-2021-055915
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Article: Travel restrictions and infectious disease outbreaks

Vaidya, Ria / Herten-Crabb, Asha / Spencer, Julia / Moon, Suerie / Lillywhite, Louis

J. travel med

Abstract: BACKGROUND: A key purpose of the International Health Regulations (IHR) is to prevent unwarranted interruptions to trade and travel during large and/or transnational infectious disease outbreaks. Nevertheless, such outbreaks continue to disrupt the ... ...

Abstract	BACKGROUND: A key purpose of the International Health Regulations (IHR) is to prevent unwarranted interruptions to trade and travel during large and/or transnational infectious disease outbreaks. Nevertheless, such outbreaks continue to disrupt the travel industry. This aspect of the IHR has received little attention in the academic literature despite its considerable impact on affected States and commercial activity. This article outlines the challenges and gaps in knowledge regarding the relationship between outbreaks and the travel sector and discusses the opportunities for further research and policy work to overcome these challenges. METHODOLOGY: We conducted a literature review on the relationship between outbreaks and travel restrictions, with a particular focus on the 2014-16 Ebola epidemic in West Africa. This review was complemented by an expert roundtable at Chatham House and further supported by case studies and qualitative interviews. RESULTS: Numerous travel stakeholders are affected by, and affect, large-scale infectious disease outbreaks. These stakeholders react in different ways: peer pressure plays an important role for both governments and the travel sector, and the reactions of the media and public influence and are influenced by these stakeholders. While various data sources on travel are available, and World Health Organization is mandated to work with States, there is no recognized coordinating body to disseminate timely, consistent, reliable and authoritative information and best practices to all stakeholders. CONCLUSION: This article highlights the interdependent relationship between various travel stakeholders. The reasons for interruption of travel during the 2014-16 Ebola outbreak were complex, with decisions by States only partly contributing to the cessation. Decisions by non-state actors, particularly the travel industry itself, contributed significantly and were based on a variety of factors. Further research, analysis and policy development are required to mitigate the health and economic consequences of infectious disease outbreaks. Any further research will also need to take account of COVID-19 travel-related issues.
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #688204
Database	COVID19

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Article ; Online: Travel restrictions and infectious disease outbreaks

Vaidya, Ria / Herten-Crabb, Asha / Spencer, Julia / Moon, Suerie / Lillywhite, Louis

2020

Abstract	BACKGROUND: A key purpose of the International Health Regulations (IHR) is to prevent unwarranted interruptions to trade and travel during large and/or transnational infectious disease outbreaks. Nevertheless, such outbreaks continue to disrupt the travel industry. This aspect of the IHR has received little attention in the academic literature despite its considerable impact on affected States and commercial activity. This article outlines the challenges and gaps in knowledge regarding the relationship between outbreaks and the travel sector and discusses the opportunities for further research and policy work to overcome these challenges. METHODOLOGY: We conducted a literature review on the relationship between outbreaks and travel restrictions, with a particular focus on the 2014-16 Ebola epidemic in West Africa. This review was complemented by an expert roundtable at Chatham House and further supported by case studies and qualitative interviews. RESULTS: Numerous travel stakeholders are affected by, and affect, large-scale infectious disease outbreaks. These stakeholders react in different ways: peer pressure plays an important role for both governments and the travel sector, and the reactions of the media and public influence and are influenced by these stakeholders. While various data sources on travel are available, and World Health Organization is mandated to work with States, there is no recognized coordinating body to disseminate timely, consistent, reliable and authoritative information and best practices to all stakeholders. CONCLUSION: This article highlights the interdependent relationship between various travel stakeholders. The reasons for interruption of travel during the 2014-16 Ebola outbreak were complex, with decisions by States only partly contributing to the cessation. Decisions by non-state actors, particularly the travel industry itself, contributed significantly and were based on a variety of factors. Further research, analysis and policy development are required to mitigate the health and economic consequences of infectious disease outbreaks. Any further research will also need to take account of COVID-19 travel-related issues.
Keywords	RA0421 Public health. Hygiene. Preventive Medicine ; HV Social pathology. Social and public welfare. Criminology ; HE Transportation and Communications ; covid19
Subject code	380
Language	English
Publishing date	2020-04-16
Publishing country	uk
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Travel restrictions and infectious disease outbreaks

Vaidya, Ria / Herten-Crabb, Asha / Spencer, Julia / Moon, Suerie / Lillywhite, Louis

Journal of Travel Medicine

2020 Volume 27, Issue 3

Abstract: Abstract Background A key purpose of the International Health Regulations (IHR) is to prevent unwarranted interruptions to trade and travel during large and/or transnational infectious disease outbreaks. Nevertheless, such outbreaks continue to disrupt ... ...

Abstract	Abstract Background A key purpose of the International Health Regulations (IHR) is to prevent unwarranted interruptions to trade and travel during large and/or transnational infectious disease outbreaks. Nevertheless, such outbreaks continue to disrupt the travel industry. This aspect of the IHR has received little attention in the academic literature despite its considerable impact on affected States and commercial activity. This article outlines the challenges and gaps in knowledge regarding the relationship between outbreaks and the travel sector and discusses the opportunities for further research and policy work to overcome these challenges. Methodology We conducted a literature review on the relationship between outbreaks and travel restrictions, with a particular focus on the 2014–16 Ebola epidemic in West Africa. This review was complemented by an expert roundtable at Chatham House and further supported by case studies and qualitative interviews. Results Numerous travel stakeholders are affected by, and affect, large-scale infectious disease outbreaks. These stakeholders react in different ways: peer pressure plays an important role for both governments and the travel sector, and the reactions of the media and public influence and are influenced by these stakeholders. While various data sources on travel are available, and World Health Organization is mandated to work with States, there is no recognized coordinating body to disseminate timely, consistent, reliable and authoritative information and best practices to all stakeholders. Conclusion This article highlights the interdependent relationship between various travel stakeholders. The reasons for interruption of travel during the 2014–16 Ebola outbreak were complex, with decisions by States only partly contributing to the cessation. Decisions by non-state actors, particularly the travel industry itself, contributed significantly and were based on a variety of factors. Further research, analysis and policy development are required to mitigate the health and economic consequences of infectious disease outbreaks. Any further research will also need to take account of COVID-19 travel-related issues.
Keywords	General Medicine ; covid19
Language	English
Publisher	Oxford University Press (OUP)
Publishing country	uk
Document type	Article ; Online
ZDB-ID	1212504-0
ISSN	1708-8305 ; 1195-1982
ISSN (online)	1708-8305
ISSN	1195-1982
DOI	10.1093/jtm/taaa050
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Zs.A 4120: Show issues

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Article: Sub-biochemical hypothyroidism: an exaggerated thyroid stimulating hormone response to thyrotrophin releasing hormone.

Sheth, J J / Thakore, P B / Trivedi, B B / Shah, N N / Vaidya, R A

The Journal of the Association of Physicians of India

1999 Volume 47, Issue 3, Page(s) 275–279

Abstract: ... T4, FT4) were done by immunoradiometric assay (IRMA), and radioimmunoassay (RIA) respectively ...

Abstract	Background: The availability of sensitive and specific assays for evaluation of the thyroid axis has allowed definition of thyroid disorders at subclinical stage. This has almost obviated the use of thyrothrophin releasing hormone (TRH) study. We describe here a group of patients with minimal signs of hypothyroidism having normal thyroid function tests (T3, T4, thyroid stimulating hormone (TSH)) and have shown exaggerated TSH response to TRH. Material and methods: Total 82 subjects were studied. Of these, 11 were age and sex matched controls, and 71 were patients. In all subjects TSH and other thyroid assays (T3, T4, FT4) were done by immunoradiometric assay (IRMA), and radioimmunoassay (RIA) respectively. Thyroid antibody was carried out by haemagglutination method. Results were compared to age and sex related normal ranges. To further investigate the status of thyroid axis, TRH study was carried out using standard protocol. Results: Based on TRH study patients were grouped in three categories. Group 1 included 29 patients whose TSH response to TRH was normal. Group 2 included 20 patients with normal baseline TSH and exaggerated TSH response to TRH and Group 3 included 18 patients with baseline TSH in the range of 5 to 10 mu IU/ml and exaggerated TSH response to TRH. There was a significant difference to total T3 between group 1 and 3 (p < 0.05) but mean values were within normal limits. While no significant difference was observed in total T4 between controls and patient's group. Serum TSH values were high in group 3 as compared to controls and Group 1 and 2 (p < 0.0001). For Free T4 no statistical significance was observed between Group 1, 2 and 3. Thyroid antibodies were positive in 22.7% of patients in Group 2 and 33.33% in Group 3. Conclusion: We conclude from the present study that even with sensitive TSH assays TRH study still has a role to mark the early stage of hypothyroidism. Those with a normal or upper normal TSH with exaggerated response to TRH are termed as sub-biochemical hypothyroidism and can be considered for thyroid replacement therapy.
MeSH term(s)	Adolescent ; Adult ; Aged ; Child ; Female ; Humans ; Hyperthyroidism/blood ; Hyperthyroidism/diagnosis ; Male ; Middle Aged ; Probability ; Radioimmunoassay ; Reference Values ; Sensitivity and Specificity ; Severity of Illness Index ; Thyroid Function Tests ; Thyrotropin/blood ; Thyrotropin/drug effects ; Thyrotropin-Releasing Hormone
Chemical Substances	Thyrotropin-Releasing Hormone (5Y5F15120W) ; Thyrotropin (9002-71-5)
Language	English
Publishing date	1999-03
Publishing country	India
Document type	Clinical Trial ; Controlled Clinical Trial ; Journal Article
ZDB-ID	800766-4
ISSN	0004-5772
ISSN	0004-5772
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Article: Quantitation of serum lactate dehydrogenase-5 with monoclonal antibodies.

Vaidya, H C / Dietzler, D N / Ladenson, J H

Clinica chimica acta; international journal of clinical chemistry

1986 Volume 161, Issue 3, Page(s) 315–325

Abstract: ... were fused with SP2/0-Ag14. Two hybridomas were produced which recognized the antigen. Competitive RIA ...

Abstract	Spleen cells from BALB/cJ mice which had been immunized with human lactate dehydrogenase-1 (LDH-1) were fused with SP2/0-Ag14. Two hybridomas were produced which recognized the antigen. Competitive RIA revealed that one antibody ('Smit-LDH') recognized the H subunit of LDH while the other ('Hem-LDH') recognized both H and M subunits of LDH. With the use of these antibodies we developed an assay for LDH-5 activity in which serum is incubated for 30 min at room temperature with the two antibodies ('Smit-LDH' and 'Hem-LDH' in the ratio 64:1.3, micrograms/ml) immobilized on latex beads to extract LDH-1 through LDH-4. After centrifugation, the LDH activity of the supernatant is measured and represents LDH-5 activity. Latex beads coated with bovine serum albumin were used as control. The LDH-5 activity as determined by our assay correlated well (r = 0.98) with the values obtained by an electrophoresis method. There was no interference due to LDH-1 through LDH-3 up to 3,000 U/l and LDH-4 up to 350 U/l. Serum samples with total LDH activity above 1,000 U/l were appropriately diluted in order to avoid interference by LDH-4. Use of these monoclonal antibodies allows precise, rapid and direct measurement of LDH-5 activity in serum.
MeSH term(s)	Animals ; Antibodies, Monoclonal ; Female ; Humans ; Isoenzymes ; L-Lactate Dehydrogenase/blood ; L-Lactate Dehydrogenase/immunology ; Mice ; Mice, Inbred BALB C ; Temperature
Chemical Substances	Antibodies, Monoclonal ; Isoenzymes ; L-Lactate Dehydrogenase (EC 1.1.1.27)
Language	English
Publishing date	1986-12-30
Publishing country	Netherlands
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, P.H.S.
ZDB-ID	80228-1
ISSN	1873-3492 ; 0009-8981
ISSN (online)	1873-3492
ISSN	0009-8981
DOI	10.1016/0009-8981(86)90016-1
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