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Article ; Online: Can conventional cardiovascular risk prediction models be improved by nuclear magnetic resonance (NMR) metabolomic signatures?

Sudevan, Remya

European journal of preventive cardiology

2022 Volume 30, Issue 3, Page(s) 241–242

MeSH term(s)	Humans ; Coronary Artery Disease ; Cardiovascular Diseases/diagnosis ; Risk Factors ; Magnetic Resonance Spectroscopy ; Heart Disease Risk Factors ; Healthy Lifestyle
Language	English
Publishing date	2022-12-21
Publishing country	England
Document type	Editorial ; Comment
ZDB-ID	2626011-6
ISSN	2047-4881 ; 2047-4873
ISSN (online)	2047-4881
ISSN	2047-4873
DOI	10.1093/eurjpc/zwac306
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Article ; Online: Aircraft noise and cardiovascular risk: are we witnessing an evolving risk factor of the future?

Sudevan, Remya

European journal of preventive cardiology

2022 Volume 30, Issue 15, Page(s) 1552–1553

MeSH term(s)	Humans ; Risk Factors ; Cardiovascular Diseases/diagnosis ; Cardiovascular Diseases/epidemiology ; Cardiovascular Diseases/etiology ; Environmental Exposure ; Heart Disease Risk Factors ; Fasting ; Aircraft ; Oxidative Stress
Language	English
Publishing date	2022-06-06
Publishing country	England
Document type	Editorial ; Comment
ZDB-ID	2626011-6
ISSN	2047-4881 ; 2047-4873
ISSN (online)	2047-4881
ISSN	2047-4873
DOI	10.1093/eurjpc/zwad129
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Article ; Online: Socioeconomic determinants of heart failure mortality: lessons from Denmark.

Sudevan, Remya

European journal of preventive cardiology

2021 Volume 28, Issue 1, Page(s) 76–77

MeSH term(s)	Denmark/epidemiology ; Heart Failure/diagnosis ; Heart Failure/epidemiology ; Heart Failure/therapy ; Humans ; Socioeconomic Factors
Language	English
Publishing date	2021-03-22
Publishing country	England
Document type	Editorial ; Comment
ZDB-ID	2626011-6
ISSN	2047-4881 ; 2047-4873
ISSN (online)	2047-4881
ISSN	2047-4873
DOI	10.1093/eurjpc/zwaa042
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Article ; Online: Is there a role for colchicine in secondary prevention of coronary artery disease?

Sudevan, Remya

European journal of preventive cardiology

2021 Volume 28, Issue 17, Page(s) 1914–1915

MeSH term(s)	Colchicine/adverse effects ; Coronary Artery Disease/complications ; Coronary Artery Disease/prevention & control ; Humans ; Secondary Prevention
Chemical Substances	Colchicine (SML2Y3J35T)
Language	English
Publishing date	2021-07-01
Publishing country	England
Document type	Editorial ; Comment
ZDB-ID	2626011-6
ISSN	2047-4881 ; 2047-4873
ISSN (online)	2047-4881
ISSN	2047-4873
DOI	10.1093/eurjpc/zwab064
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Article ; Online: One-year mortality after acute stroke: a prospective cohort study from a comprehensive stroke care centre, Kerala, India.

Nambiar, Vivek / Raj, Manu / Vasudevan, Damodaran / Bhaskaran, Renjitha / Sudevan, Remya

BMJ open

2022 Volume 12, Issue 11, Page(s) e061258

Abstract: Objectives: The primary objective was to report the 1-year all-cause mortality among patients with stroke. The secondary objectives were (1) to report the mortality stratified by type of stroke and sex and (2) to report predictors of 1-year mortality ... ...

Abstract	Objectives: The primary objective was to report the 1-year all-cause mortality among patients with stroke. The secondary objectives were (1) to report the mortality stratified by type of stroke and sex and (2) to report predictors of 1-year mortality among patients with stroke. Design: A prospective cohort study. Setting: Institutional-stroke care unit of a tertiary care hospital PARTICIPANTS: Patients who were treated in the study institution during 2016-2020 for acute stroke and were followed up for a period of 1 year after stroke in the same institution. Main outcome measures: The main outcome measures were the mortality proportion of any stroke and first ever stroke cohorts at select time points, including in-hospital stay, along with 2 weeks, 2 months, 6 months and 1 year after index stroke. The secondary outcomes were (1) mortality proportions stratified by sex and type of stroke and (2) predictors of 1-year mortality for any stroke and first ever stroke. Results: We recruited a total of 1336 patients. The mean age of participants was 61.6 years (13.5 years). The mortality figures for 2 weeks, 2 months, 6 months and 12 months after discharge were 79 (5.9%), 88 (6.7%), 101 (7.6%) and 114 (8.5%), respectively, in the full cohort. The in-hospital mortality was 45 (3.4%). The adjusted analysis revealed 3 predictors for 1-year mortality after first ever stroke-age, pre-treatment National Institutes of Health Stroke Scale (NIHSS) score and Modified Rankin Scale (mRS) score at baseline. The same for the full cohort had only two predictors-age and pre-treatment NIHSS score. Conclusion: Mortality of stroke at 1-year follow-up in the study population is low in comparison to several studies published earlier. The predictors of 1-year mortality after stroke included age, NIHSS score at baseline and mRS score at baseline.
MeSH term(s)	United States ; Humans ; Middle Aged ; Prospective Studies ; Comprehensive Health Care ; India/epidemiology ; Stroke/therapy ; Hospital Mortality
Language	English
Publishing date	2022-11-28
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-2022-061258
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Article: Utility of modified Mann assessment of swallowing ability (MMASA) in predicting aspiration risk and safe swallow in stroke patients.

Panjikaran, Nittu Devassy / Iyer, Rajalakshmi / Sudevan, Remya / Bhaskaran, Renjitha

Journal of family medicine and primary care

2022 Volume 11, Issue 9, Page(s) 5123–5128

Abstract: Introduction: Aspiration pneumonia is one of the commonest causes of post-stroke mortality. We may be able to reduce this morbidity and mortality by assessing the risk of aspiration in stroke patients. Assessment of this risk can be done using a ... ...

Abstract	Introduction: Aspiration pneumonia is one of the commonest causes of post-stroke mortality. We may be able to reduce this morbidity and mortality by assessing the risk of aspiration in stroke patients. Assessment of this risk can be done using a physician-administered screening protocol to assess dysphagia. A score of ≥95 is a good cut off to detect patients who can take oral feeds safely. Objectives: The primary objective was to predict aspiration risk using the Modified Mann Assessment Swallowing Ability (mMASA) scale. The secondary objective was to predict the safety of oral feeds using the same scale. Materials and methods: An analytical cross-sectional study was conducted at a tertiary care rehabilitation centre in South India. A total of 100 stroke patients who underwent stroke rehabilitation in the study institution were divided into patients who were able to eat orally or not based on the mMASA scale. Demographic and stroke characteristics were recorded. The mMASA score was calculated and those with a score of ≥95 were given oral feeds. Those who scored <95 were given swallow therapy and re-evaluated in 2 weeks. Also, the mMASA score below which the patient was likely to develop aspiration pneumonia was detected using the receiver operating characteristic curve (ROC). Results: Out of the 100 patients, 37 patients had a score of ≥95 and were started on oral feeds and had no complications; the rest were started on 2 weeks of swallow therapy. On re-evaluation after swallow therapy, 12 more were started on oral feeds. The remaining 51 patients did not reach the cut-off score of ≥95 and were continued on nasogastric tube feeding. A total of 11 patients developed features of aspiration pneumonia; all of them belonged to the group of 51 patients who consistently had a mMASA score <95. The ROC curve determined that a score of <89 was a good cut off to predict patients who are at high risk of aspiration. Conclusion: The scale can be used to predict the likelihood of aspiration and readiness to start oral feeds in sub-acute stroke patients.
Language	English
Publishing date	2022-10-14
Publishing country	India
Document type	Journal Article
ZDB-ID	2735275-4
ISSN	2278-7135 ; 2249-4863
ISSN (online)	2278-7135
ISSN	2249-4863
DOI	10.4103/jfmpc.jfmpc_1628_21
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Article ; Online: Outcomes of Coronary Artery Disease Patients with Severe Left Ventricular Dysfunction Undergoing Surgical Management.

Ponnuru, Srawanthi / Radhakrishnan, Bineesh K / Sudevan, Remya / Karunakaran, Jayakumar

The heart surgery forum

2022 Volume 25, Issue 2, Page(s) E204–E212

Abstract: Background: Surgical revascularization by coronary artery bypass grafting (CABG) is the gold standard treatment for coronary artery disease. But, in patients with severe left ventricular dysfunction (ischemic cardiomyopathy), the result of CABG is ... ...

Abstract	Background: Surgical revascularization by coronary artery bypass grafting (CABG) is the gold standard treatment for coronary artery disease. But, in patients with severe left ventricular dysfunction (ischemic cardiomyopathy), the result of CABG is different from those with normal left ventricular function. The coronary artery disease pattern in the Indian subconti-nent is different from the western world, due to the diffuse nature of coronary involvement, the smaller size of native vessels, increased prevalence of diabetes mellitus and other risk factors, and more prevalence of severe left ventricular dysfunction. Most of the studies regarding the surgical outcomes in ischemic cardiomyopathy come from western countries. This study attempts to assess the outcomes of surgical management of ischemic cardiomyopathy in the Indian subcontinent. Methods: A single-center retrospective cohort study was conducted at Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram. The data of CAD pa-tients, who underwent surgical coronary revascularization for severe LV dysfunction from January 2010 to December 2014, were collected from the hospital records and through tele-phonic interviews in a structured study proforma. A total of 146 patients satisfied the criteria and were followed up for a period of 5 years. Results: The mean age of the study population was 55.6 (8.8) years. Male preponderance was observed (94.52%; N = 138). CABG alone was done in 62.3% (N = 91) of the study partici-pants. CABG with linear plication was done in 23.3% (N = 34), CABG with MV repair in 7.5% (N = 11), and CABG with DORS in 6.8% (N = 10). The majority of patients (N = 54, 37%) received 4 grafts. Thirty-day mortality observed in the study population was 11 (7.5%). The causes documented were cardiac causes in 9 (82%), cerebrovascular events in one (9%), and septicemia in one (9%). The mean of 5-year survival of the study population was 94.2 (3.5) months with 95% CI 87.32, 101.13. There was a substantial improvement in the degree of mitral regurgitation. Ejection fraction (EF) also showed improvement. The mean preoperative EF was 29.51 (4.84%) and that of post-op was 39.92 (9.0%). Conclusion: Despite the challenges of diffusely diseased coronary arteries, severe LV dysfunction, addressing associated significant MR and ventricular aneurysms, the outcome of surgical management of CAD with severe LV dysfunction, in the Indian population can be done with acceptable results. Randomized control studies in this subset can provide more solid evidence in this regard.
MeSH term(s)	Cardiomyopathies/surgery ; Coronary Artery Bypass ; Coronary Artery Disease/complications ; Coronary Artery Disease/diagnosis ; Coronary Artery Disease/surgery ; Humans ; Male ; Middle Aged ; Myocardial Ischemia ; Retrospective Studies ; Ventricular Dysfunction, Left/diagnosis ; Ventricular Dysfunction, Left/surgery
Language	English
Publishing date	2022-03-21
Publishing country	United States
Document type	Journal Article
ZDB-ID	2069188-9
ISSN	1522-6662 ; 1098-3511
ISSN (online)	1522-6662
ISSN	1098-3511
DOI	10.1532/hsf.4353
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Article: Low Dose Prophylaxis in Hemophilia Care.

Sidharthan, Neeraj / Sudevan, Remya

Indian journal of hematology & blood transfusion : an official journal of Indian Society of Hematology and Blood Transfusion

2019 Volume 36, Issue 1, Page(s) 16–25

Abstract: Hemophilia is an inherited bleeding disorder which causes impaired blood clotting. The severity of disease depends on the type of Hemophilia, level of clotting factor concentrate (CFC), phenotypic heterogeneity and the development of inhibitors. The ... ...

Abstract	Hemophilia is an inherited bleeding disorder which causes impaired blood clotting. The severity of disease depends on the type of Hemophilia, level of clotting factor concentrate (CFC), phenotypic heterogeneity and the development of inhibitors. The currently accepted standard of care of this disease is prophylaxis therapy (PT) with CFC. Prophylaxis therapy for Hemophilia is given in developed countries for the last few decades. On the contrary, episodic therapy (ET) is still the mode of treatment in middle and low income countries. ET is documented to have several potential risks such as increased bleeding rate, disability due to haemarthrosis, poor quality of life and increased chances of mortality. Several studies conducted in developed countries have confirmed the clinical efficacy of PT in Hemophilia treatment. Currently, there exist several challenges for implementation of this effective treatment in resource poor nations. Low dose prophylaxis (LDP) has been developed as a solution to minimize these challenges and to provide better care for subjects with Hemophilia from low resource countries. The impact of LDP was evaluated by several recent studies and the reported clinical outcomes seem to suggest an optimistic future for this line of therapy. Several themes related to Hemophilia care like inhibitor development, tolerance, pharmacokinetics of CFCs and cost-benefit analysis of different prophylaxis regimens are currently understood poorly. These distinct elements are highly relevant to assess the actual benefits of LDP regimen in a global scale.
Language	English
Publishing date	2019-06-15
Publishing country	India
Document type	Journal Article ; Review
ZDB-ID	2422370-0
ISSN	0974-0449 ; 0971-4502
ISSN (online)	0974-0449
ISSN	0971-4502
DOI	10.1007/s12288-019-01147-0
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Article: Fluorodeoxyglucose-positron emission tomography (FDG-PET) of carotid arteries and non-alcoholic fatty liver disease (NAFLD): An analytical cross-sectional study from a teaching hospital, Kerala, South India.

Rane, Sameer / Thachathodiyl, Rajesh / Palaniswamy, Shanmuga S / Menon, Jaideep C / Sudevan, Remya

Journal of family medicine and primary care

2022 Volume 11, Issue 7, Page(s) 3766–3770

Abstract: Introduction: Evidence related to carotid artery F-fluorodeoxyglucose-positron emission tomography (FDG -PET) and non-alcoholic fatty liver disease (NAFLD) is limited from a low-resource setting. The present study aims to examine the association between ...

Abstract	Introduction: Evidence related to carotid artery F-fluorodeoxyglucose-positron emission tomography (FDG -PET) and non-alcoholic fatty liver disease (NAFLD) is limited from a low-resource setting. The present study aims to examine the association between FDG-PET uptakes by the carotid arteries in patients having different grades of NAFLD. Materials and methods: An analytical cross-sectional study was done in a tertiary care center in South India for 1 year. Sonographically confirmed NAFLD patients of the age group 18 years and above were consecutively enrolled for the study after getting informed consent. Anthropometric measurements, ultrasonography for identifying the grades of fatty liver and FDG-PET were performed in the study participants. The data for the study were collected by the research personnel and entered in Microsoft Excel. The data were analyzed in the IBM SPSS version 20.0 software. Results: A total of 24 patients were in the final analysis. The mean age of patients in this study was 56.79 (11.26) years. Among the 24 patients, 95.83% ( Conclusion: The findings of this study showed increased uptake of FDG-PET in carotids in subjects with moderate fatty liver when compared with those with mild fatty liver.
Language	English
Publishing date	2022-07-22
Publishing country	India
Document type	Journal Article
ZDB-ID	2735275-4
ISSN	2278-7135 ; 2249-4863
ISSN (online)	2278-7135
ISSN	2249-4863
DOI	10.4103/jfmpc.jfmpc_2291_21
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Article ; Online: Tricuspid Regurgitation in Ostium Secundum Atrial Septal Defects: Repair or Not?

Prasanna Kumar, Chirag Sumithra / Radhakrishnan, Bineesh K / Sudevan, Remya / Karunakaran, Jayakumar

The heart surgery forum

2020 Volume 23, Issue 2, Page(s) E239–E244

Abstract: Background: Longstanding ostium secundum atrial septal defects lead to functional tricuspid regurgitation. Significant functional tricuspid regurgitation associated with left heart valve disease is addressed at the time of primary left heart valve ... ...

Abstract	Background: Longstanding ostium secundum atrial septal defects lead to functional tricuspid regurgitation. Significant functional tricuspid regurgitation associated with left heart valve disease is addressed at the time of primary left heart valve surgery. In contrast, there is no global recommendation for tricuspid regurgitation associated with atrial septal defects. This study assesses changes in tricuspid regurgitation after isolated atrial septal defect closure. Methods: Retrospectively, records were examined of 100 patients who underwent isolated ostium secundum atrial septal defect closure without tricuspid valve repair. Echocardiograms were done preoperatively and 3 days, 3 months, and 1 year after surgery. Data on tricuspid regurgitation status, right ventricle dimensions, and pulmonary artery hypertension status were collected and analyzed. Results: After surgical closure, echocardiography showed a regression of tricuspid regurgitation to mild or less in 76% of patients at 3 days, 89% at 3 months, and 93% at 1 year. Severe pulmonary artery hypertension (32% patients preoperatively) showed statistically significant regression: 14% at 3 days, 10% at 3 months, and 2% at 1 year. Preoperatively, the mean right ventricular internal diameter was 37.9 mm, which decreased to 34 ± 5.5 mm (mean ± standard deviation) at 3 days, 32.3 ± 5.3 mm at 3 months, and 31.3 ± 5.4 mm at 1 year. It was also noted that regression favored patients who were <25 years old. Conclusion: Tricuspid valve repair may not be required in patients with ostium secundum atrial septal defect with functional tricuspid regurgitation.
MeSH term(s)	Adolescent ; Adult ; Aged ; Cardiac Surgical Procedures/methods ; Decision Making ; Echocardiography ; Female ; Follow-Up Studies ; Heart Septal Defects, Atrial/complications ; Heart Septal Defects, Atrial/diagnosis ; Heart Septal Defects, Atrial/surgery ; Heart Ventricles/physiopathology ; Humans ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Tricuspid Valve Insufficiency/diagnosis ; Tricuspid Valve Insufficiency/etiology ; Tricuspid Valve Insufficiency/physiopathology ; Young Adult
Language	English
Publishing date	2020-04-23
Publishing country	United States
Document type	Journal Article
ZDB-ID	2069188-9
ISSN	1522-6662 ; 1098-3511
ISSN (online)	1522-6662
ISSN	1098-3511
DOI	10.1532/hsf.2859
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