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Article: Do No Harm: The Hippocratic Oath.

Singhal, Sunny

2021 Volume 32, Issue 6, Page(s) 375

MeSH term(s)	Clinical Decision-Making/ethics ; Hippocratic Oath ; Humans ; Withholding Treatment/ethics
Language	English
Publishing date	2021-01-07
Publishing country	India
Document type	Journal Article
ZDB-ID	645116-0
ISSN	0970-258X
ISSN	0970-258X
DOI	10.4103/0970-258X.303624
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Article: Intractable hiccups: How can chest X-ray help?

Goyal, Laxmi Kant / Mathur, Nitish / Mathur, Ajay / Jain, Gunja / Singhal, Sunny

Journal of family medicine and primary care

2023 Volume 12, Issue 6, Page(s) 1229–1230

Abstract: We describe the case of a young male presenting with hiccups refractory to antacids. Due to high index of suspicion was evaluated with a chest X-ray which revealed pericardial effusion. The effusion was drained, and the hiccups resolved. It is a teaching ...

Abstract	We describe the case of a young male presenting with hiccups refractory to antacids. Due to high index of suspicion was evaluated with a chest X-ray which revealed pericardial effusion. The effusion was drained, and the hiccups resolved. It is a teaching moment, to consider simple imaging, i.e., chest X-ray in patients with refractory hiccups to rule out more serious underlying causes.
Language	English
Publishing date	2023-06-30
Publishing country	India
Document type	Case Reports
ZDB-ID	2735275-4
ISSN	2278-7135 ; 2249-4863
ISSN (online)	2278-7135
ISSN	2249-4863
DOI	10.4103/jfmpc.jfmpc_902_22
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Article: The changing perspective of clinical trial designs.

Ajmera, Yamini / Singhal, Sunny / Dwivedi, S N / Dey, A B

Perspectives in clinical research

2021 Volume 12, Issue 2, Page(s) 66–71

Abstract: Maintaining health and well-being of the population is a universal priority. Governments around the globe are therefore seeking greater efficiency and better outcomes from researches being held. Although large randomized trials or systematic review of ... ...

Abstract	Maintaining health and well-being of the population is a universal priority. Governments around the globe are therefore seeking greater efficiency and better outcomes from researches being held. Although large randomized trials or systematic review of several large trials provides the highest level of evidence, the intricate cost, time, and difficulties of conventional trials have led to questions about their sustainability commanding search for alternative approaches. Demands for improved competences in medical research have led to mounting interest in newer clinical trial designs. This article provides an insight into newer clinical trial designs, including cluster trials, adaptive designs, the master protocols along with their strengths, weaknesses, and which trials design should be opted for in different clinical scenarios.
Language	English
Publishing date	2021-01-08
Publishing country	India
Document type	Journal Article ; Review
ZDB-ID	2593231-7
ISSN	2229-5488 ; 2229-3485
ISSN (online)	2229-5488
ISSN	2229-3485
DOI	10.4103/picr.PICR_138_20
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Article ; Online: The prevalence of frailty and its relationship with sociodemographic factors, regional healthcare disparities, and healthcare utilization in the aging population across India.

Singhal, Sunny / Singh, Sumitabh / Dewangan, Gevesh Chand / Dey, Sharmistha / Banerjee, Joyita / Lee, Jinkook / Upadhyaya, Ashish Datt / Hu, Peifeng / Dey, Aparajit Ballav

Aging medicine (Milton (N.S.W))

2023 Volume 6, Issue 3, Page(s) 212–221

Abstract: Objective: To estimate frailty prevalence and its relationship with the socio-economic and regional factors and health care outcomes.: Methods: In this study, participants from the harmonized Diagnostic Assessment of Dementia for the Longitudinal ... ...

Abstract	Objective: To estimate frailty prevalence and its relationship with the socio-economic and regional factors and health care outcomes. Methods: In this study, participants from the harmonized Diagnostic Assessment of Dementia for the Longitudinal Aging Study in India (LASI-DAD) were included. The frailty index (FI) was calculated using a 32-variable deficit model, with a value of ≥ 25% considered as frail. Data on demographic (including caste and religion) and socioeconomic profiles and health care utilization were obtained. The state-wise health index maintained by the government based on various health-related parameters was used to group the participants' residential states into high-, intermediate-, and low-performing states. Multivariable and zero-inflated negative binomial regression was used to assess the relationship of frailty index with sociodemographic characteristics, health index, and health care expenditure or hospitalization. Results: Among the 3953 eligible participants, the prevalence of frailty was 42.34% (men = 34.99% and women = 49.35%). Compared to high-performing states, intermediate- and low-performing states had a higher proportion of frail individuals (49.7% Conclusion: There is a high prevalence of frailty among older Indian adults that is associated with sociodemographic factors and regional health care performance. Furthermore, frailty is associated with increased health care utilization and expenditure.
Language	English
Publishing date	2023-08-07
Publishing country	Australia
Document type	Journal Article
ISSN	2475-0360
ISSN (online)	2475-0360
DOI	10.1002/agm2.12263
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Article ; Online: Clinical features and outcomes of COVID-19 in older adults: a systematic review and meta-analysis.

Singhal, Sunny / Kumar, Pramod / Singh, Sumitabh / Saha, Srishti / Dey, Aparajit Ballav

BMC geriatrics

2021 Volume 21, Issue 1, Page(s) 321

Abstract: Background: Few studies have focused on exploring the clinical characteristics and outcomes of COVID-19 in older patients. We conducted this systematic review and meta-analysis to have a better understanding of the clinical characteristics of older ... ...

Abstract	Background: Few studies have focused on exploring the clinical characteristics and outcomes of COVID-19 in older patients. We conducted this systematic review and meta-analysis to have a better understanding of the clinical characteristics of older COVID-19 patients. Methods: A systematic search of PubMed and Scopus was performed from December 2019 to May 3rd, 2020. Observational studies including older adults (age ≥ 60 years) with COVID-19 infection and reporting clinical characteristics or outcome were included. Primary outcome was assessing weighted pooled prevalence (WPP) of severity and outcomes. Secondary outcomes were clinical features including comorbidities and need of respiratory support. Result: Forty-six studies with 13,624 older patients were included. Severe infection was seen in 51% (95% CI- 36-65%, I Conclusion: Approximately half of older patients with COVID-19 have severe infection, one in five are critically ill and one in ten die. More high-quality evidence is needed to study outcomes in this vulnerable patient population and factors affecting these outcomes.
MeSH term(s)	Aged ; COVID-19 ; Cough ; Fever ; Humans ; Respiration, Artificial ; SARS-CoV-2
Language	English
Publishing date	2021-05-19
Publishing country	England
Document type	Journal Article ; Meta-Analysis ; Systematic Review
ZDB-ID	2059865-8
ISSN	1471-2318 ; 1471-2318
ISSN (online)	1471-2318
ISSN	1471-2318
DOI	10.1186/s12877-021-02261-3
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Article: Drooping shoulders: A rare manifestation of an uncommon disease.

Bansal, Rishav / Singh, Sumitabh / Singhal, Sunny / Dewangan, Gevesh / Das, Chandan Jyoti / Dey, Aparajit Ballav

The National medical journal of India

2021 Volume 33, Issue 5, Page(s) 276–277

Abstract: Primary systemic amyloidosis is an uncommon disease which presents with involvement of the kidney, heart, peripheral nervous system and liver. The involvement of skeletal muscles called amyloid myopathy is uncommon. We report a 74-year-old male who ... ...

Abstract	Primary systemic amyloidosis is an uncommon disease which presents with involvement of the kidney, heart, peripheral nervous system and liver. The involvement of skeletal muscles called amyloid myopathy is uncommon. We report a 74-year-old male who presented with progressively drooping shoulders followed by other muscular involvement without other organ involvement as a manifestation of amyloidosis. The patient was managed with melphalan, prednisolone and thalidomide with clinical improvement.
MeSH term(s)	Aged ; Amyloidosis ; Humans ; Kidney ; Male ; Melphalan ; Muscular Diseases ; Shoulder
Chemical Substances	Melphalan (Q41OR9510P)
Language	English
Publishing date	2021-07-02
Publishing country	India
Document type	Case Reports
ZDB-ID	645116-0
ISSN	0970-258X
ISSN	0970-258X
DOI	10.4103/0970-258X.317479
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Article ; Online: Low one-repetition-maximum knee extension is significantly associated with poor grip strength, female sex, and various aging-related syndromes.

Singhal, Sunny / Bansal, Rishav / Dewangan, Gevesh Chand / Upadhyay, Ashish Datt / Dwivedi, Sada Nand / Chatterjee, Prashun / Chakrawarty, Avinash / Dey, Aparajit Ballav

Aging medicine (Milton (N.S.W))

2020 Volume 3, Issue 2, Page(s) 125–131

Abstract: Objective: Muscle strength in older adults is usually measured according to grip strength, which demonstrates upper muscle strength only. In this study, we used one-repetition-maximum (1-RM) knee extension as a measure of lower limb strength and ... ...

Abstract	Objective: Muscle strength in older adults is usually measured according to grip strength, which demonstrates upper muscle strength only. In this study, we used one-repetition-maximum (1-RM) knee extension as a measure of lower limb strength and assessed its relationship with grip strength and various geriatric syndromes. Methods: One hundred outpatients over the age of 65 years were recruited from a geriatric medicine center in India. The 1-RM knee extension was measured along with grip strength. Various geriatric conditions were measured, such as: nutrition (using the Mini Nutritional Assessment), cognition (Hindi Mental State Questionnaire), depression (5-item Geriatric Depression Scale), frailty (Fried and Rockwood models), and osteoporosis (dual-energy X-ray absorptiometry scan). Sarcopenia was diagnosed using the Asian Working Group for Sarcopenia criteria. Results: The mean age of participants was 72.5 years with 69% of them male. Median values of 1-RM knee extension and grip strength were 2.29 (0.5-10.0) and 17.5 (0-78), respectively. The 1-RM knee extension had moderate correlation with grip strength ( Conclusion: The 1-RM knee extension has only moderate correlation with grip strength. A lower 1-RM knee extension value is significantly associated with female sex and various geriatric conditions, such as malnutrition, dementia, depression, frailty, and sarcopenia.
Language	English
Publishing date	2020-04-28
Publishing country	Australia
Document type	Journal Article
ISSN	2475-0360
ISSN (online)	2475-0360
DOI	10.1002/agm2.12109
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Article: Serum creatinine and cystatin C-based index can be a screening biomarker for sarcopenia in older population.

Singhal, Sunny / Singh, Sumitabh / Upadhyay, Ashish Datt / Dwivedi, Sada Nand / Das, Chandan Jyoti / Mohta, Srikant / Chatterjee, Prasun / Dey, Aparajit Ballav / Chakrawarty, Avinash

European geriatric medicine

2019 Volume 10, Issue 4, Page(s) 625–630

Abstract: Purpose: Considering the clinical impact of sarcopenia, it would be interesting to get a rapid and sensible screening tool. We conducted a cross-sectional study with the motive to use an index based on serum creatinine and cystatin C to screen ... ...

Abstract	Purpose: Considering the clinical impact of sarcopenia, it would be interesting to get a rapid and sensible screening tool. We conducted a cross-sectional study with the motive to use an index based on serum creatinine and cystatin C to screen sarcopenia in older people in outpatient settings. Methods: 100 participants above the age of 65 years were recruited from the outpatient department of Geriatric medicine of a tertiary care hospital in India. Muscle mass, muscle strength and physical performance were measured by DXA scan, hand-held dynamometer and 4 m gait speed, respectively. Sarcopenia was identified using Asian working group of sarcopenia (AWGS) criteria. Serum creatinine and cystatin C were measured for all participants. Serum creatinine/cystatin C ratio and biochemical total body muscle mass index (TBMM) were calculated and its association was checked with sarcopenia. Results: The prevalence of sarcopenia was 53%. Mean serum creatinine/cystatin C ratio was 74.79 ± 24.91. It was not significantly associated with sarcopenia. Mean biochemical TBMM index of participants was 36.40 ± 7.88 (males-38.77 ± 7.72, females-31.22 ± 5.13). The lower value of biochemical TBMM index was significantly associated with an increased risk of sarcopenia (p < 0.01). Cut-off value of 40.9 in males (sensitivity-79.41%; specificity-61.76%) and 32.2 in females (sensitivity-78.95%; specificity-66.67%) was proposed for identification of sarcopenia. Conclusion: Out of the two indices, only low biochemical total body muscle mass index is significantly associated with sarcopenia and a value of less than 40.9 in males and 32.2 in females can be used to screen sarcopenia in older people.
Language	English
Publishing date	2019-05-17
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2556794-9
ISSN	1878-7657 ; 1878-7649
ISSN (online)	1878-7657
ISSN	1878-7649
DOI	10.1007/s41999-019-00197-x
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Article ; Online: South Asian Working Action Group on SARCOpenia (SWAG-SARCO) - A consensus document.

Dhar, Minakshi / Kapoor, Nitin / Suastika, Ketut / Khamseh, Mohammad E / Selim, Shahjada / Kumar, Vijay / Raza, Syed Abbas / Azmat, Umal / Pathania, Monika / Rai Mahadeb, Yovan Parikshat / Singhal, Sunny / Naseri, Mohammad Wali / Aryana, Igp Suka / Thapa, Subarna Dhoj / Jacob, Jubbin / Somasundaram, Noel / Latheef, Ali / Dhakal, Guru Prasad / Kalra, Sanjay

Osteoporosis and sarcopenia

2022 Volume 8, Issue 2, Page(s) 35–57

Abstract: The South Asian population is rapidly ageing and sarcopenia is likely to become a huge burden in this region if proper action is not taken in time. Several sarcopenia guidelines are available, from the western world and from East Asia. However, these ... ...

Abstract	The South Asian population is rapidly ageing and sarcopenia is likely to become a huge burden in this region if proper action is not taken in time. Several sarcopenia guidelines are available, from the western world and from East Asia. However, these guidelines are not fully relevant for the South Asian healthcare ecosystem. South Asia is ethnically, culturally, and phenotypically unique. Additionally, the region is seeing an increase in non-communicable lifestyle disease and obesity. Both these conditions can lead to sarcopenia. However, secondary sarcopenia and sarcopenic obesity are either not dealt with in detail or are missing in other guidelines. Hence, we present a consensus on the screening, diagnosis and management of sarcopenia, which addresses the gaps in the current guidelines. This South Asian consensus gives equal importance to muscle function, muscle strength, and muscle mass; provides cost-effective clinical and easy to implement solutions; highlights secondary sarcopenia and sarcopenic obesity; lists commonly used biomarkers; reminds us that osteo-arthro-muscular triad should be seen as a single entity to address sarcopenia; stresses on prevention over treatment; and prioritizes non-pharmacological over pharmacological management. As literature is scarce from this region, the authors call for more South Asian research guided interventions.
Language	English
Publishing date	2022-05-25
Publishing country	Netherlands
Document type	Journal Article ; Review
ISSN	2405-5263
ISSN (online)	2405-5263
DOI	10.1016/j.afos.2022.04.001
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Article ; Online: Prevalence of dementia in India: National and state estimates from a nationwide study.

Lee, Jinkook / Meijer, Erik / Langa, Kenneth M / Ganguli, Mary / Varghese, Mathew / Banerjee, Joyita / Khobragade, Pranali / Angrisani, Marco / Kurup, Ravi / Chakrabarti, Sankha Shubhra / Gambhir, Indrajeet Singh / Koul, Parvaiz A / Goswami, Debabrata / Talukdar, Arunanshu / Mohanty, Rashmi Ranjan / Yadati, Raju Sathyanarayana / Padmaja, Mekala / Sankhe, Lalit / Rajguru, Chhaya /

Gupta, Monica / Kumar, Govind / Dhar, Minakshi / Chatterjee, Prasun / Singhal, Sunny / Bansal, Rishav / Bajpai, Swati / Desai, Gaurav / Rao, Abhijith R / Sivakumar, Palanimuthu T / Muliyala, Krishna Prasad / Bhatankar, Swaroop / Chattopadhyay, Aparajita / Govil, Dipti / Pedgaonkar, Sarang / Sekher, T V / Bloom, David E / Crimmins, Eileen M / Dey, Aparajit Ballav

Alzheimer's & dementia : the journal of the Alzheimer's Association

2023 Volume 19, Issue 7, Page(s) 2898–2912

Abstract: Introduction: Prior estimates of dementia prevalence in India were based on samples from selected communities, inadequately representing the national and state populations.: Methods: From the Longitudinal Aging Study in India (LASI) we recruited a ... ...

Abstract	Introduction: Prior estimates of dementia prevalence in India were based on samples from selected communities, inadequately representing the national and state populations. Methods: From the Longitudinal Aging Study in India (LASI) we recruited a sample of adults ages 60+ and administered a rich battery of neuropsychological tests and an informant interview in 2018 through 2020. We obtained a clinical consensus rating of dementia status for a subsample (N = 2528), fitted a logistic model for dementia status on this subsample, and then imputed dementia status for all other LASI respondents aged 60+ (N = 28,949). Results: The estimated dementia prevalence for adults ages 60+ in India is 7.4%, with significant age and education gradients, sex and urban/rural differences, and cross-state variation. Discussion: An estimated 8.8 million Indians older than 60 years have dementia. The burden of dementia cases is unevenly distributed across states and subpopulations and may therefore require different levels of local planning and support. Highlights: The estimated dementia prevalence for adults ages 60+ in India is 7.4%. About 8.8 million Indians older than 60 years live with dementia. Dementia is more prevalent among females than males and in rural than urban areas. Significant cross-state variation exists in dementia prevalence.
MeSH term(s)	Male ; Female ; Humans ; Dementia/epidemiology ; Prevalence ; Aging ; Neuropsychological Tests ; India/epidemiology
Language	English
Publishing date	2023-01-13
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	2211627-8
ISSN	1552-5279 ; 1552-5260
ISSN (online)	1552-5279
ISSN	1552-5260
DOI	10.1002/alz.12928
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